Objective: The review aims to evaluate associations of occasional and moderate drinking with cardiovascular diseases (CVD), specifically to compare results for occasional and moderate drinking, as moderate drinking is widely investigated while occasional drinking is relatively understudied and can potentially inform whether alcohol is causally related to CVD. Methods: A systematic review was conducted by searching for observational and interventional studies from three databases (ScienceDirect, Ebscohost, and PubMed) for alcohol consumption and its association with cardiovascular health. Online internet sources were also used for more supplementary research in this literature review. Patient-oriented outcomes, primarily on heart diseases, including cardiovascular heart disease, myocardial infarction, and coronary heart disease, were extracted from all study groups. Results: Fifteen studies were included, most of which were conducted in the United States of America (9 studies). Generally, moderate alcohol consumption is associated with a reduction in CVD risks, including extensive coronary calcification, sudden cardiac death, congestive heart failure, acute coronary syndrome, ischemic heart disease. Studies also suggests that alcohol may be associated with better endothelial function and lower systolic blood pressure Current occasional alcohol use is found to be associated lower IHD mortality in men, but is not related to IHD mortality in women. Conclusion: We found consistent evidence of protective association of moderate alcohol consumption against cardio-mortality and CVD, while occasional alcohol consumption has relatively less protection against CHD deaths. Such associations were only found in studies with living controls. Only a small number of studies have studied occasional drinking, in relation to cardiovascular health. Further studies that specifically examine occasional drinking, are needed. If the biological effects of occasional drinking towards CVD are limited, then occasional drinking may indicate the magnitude of residual and unobserved confounding in the association with cardiovascular health. This will in turn inform alcohol-related policies such as alcohol duties and minimum alcohol pricing. / published_or_final_version / Public Health / Master / Master of Public Health

Background Smoking is a well-established causal risk factor of premature death. The prevalence of smoking has been estimated to be more than 50% in Chinese men. However, previous reviews of the association between smoking and mortality from all-causes and lung cancer were mainly relied on developed countries. The current systematic review of cohort studies aims at summarizing the existing studies on the association of smoking with all-cause and lung cancer mortality in China. Methods Articles published from 1980 to 2014were searched systematically in databases including PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and Google scholar. Main results of all studies were extracted and summarized. Results A total of 14 cohort studies examining the association of smoking with all-cause and lung cancer mortality in Chinese populations were identified. Compared with never smoking, current smoking was associated with higher risks of all-cause and lung cancer mortality in all studies. The relative risks (RR) for current smokers were from 1.20 to 2.29 for all-cause mortality and from 2.44 to 9.40 for lung cancer mortality. Former smokers also showed higher RRs for all-cause mortality (RR=1.20-1.48) and for lung cancer mortality (RR=2.06-6.50) compared with never smokers. Furthermore, dose-response associations of increasing smoking categories with all-cause mortality and lung cancer mortality were observed in most of the studies. Conclusions The risk estimates for all-cause and lung cancer mortality from smoking in China were lower than those from the western countries suggesting that the tobacco epidemic is at an early stage in China. Further large cohort studies giving updated risk estimates are warranted for advocating stringent tobacco control policies in China. / published_or_final_version / Public Health / Master / Master of Public Health

abstract / Public Health / Master / Master of Philosophy

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Polychlorinated biphenyls (PCBs) are a class of bioactive chemical once used in industrial applications, but which now contaminate the world environment. PCBs are lipophilic with few natural degadatory mechanisms, and thus they accumulate in human and animal tissues, and are passed to subsequent generations via transfer between mother and offspring. Research has shown that PCBs can interfere with brain and sexual organ development, and adult sexual behaviors and reproduction. However, previous studies produced contradictory results based on the dose and method of administration, species, and the age at exposure. The research detailed in this thesis elucidates the effects of prenatal exposure to low levels of a commercial mixture of PCBs, Aroclor (A) 1221, on female reproductive function. The studies undertaken in this dissertation focus on three areas relevant to understanding long-term effects of PCBs on reproductive physiology in female rats: (1) developmental effects in two generations, (2) sexual behaviors in the first generation, and (3) gene expression in the first generation. In the first research section of this dissertation, the sexual and somatic development of PCB-exposed animals is investigated in first (F1) and second (F2) generation females. Dose-dependent effects are observed in both generations, and a greater number of endpoints are significantly affected in the F2, including circulating hormone levels and uterine and ovarian weight. The second research section of the dissertation explores whether sexual behaviors in the first generation of exposed animals are altered by A1221, using a paced mating paradigm designed to elucidate female-typical behaviors. Several salient behaviors are affected by PCB exposure, including likelihood to mate, mating trial pacing, and stress-related vocalizations. The third research chapter discusses the results of a genomewide microarray assay performed on the preoptic area of the brain. The preoptic area is a neuroendocrine control center implicated in regulation of reproductive physiology and behavior. Taken together, these results suggest that A1221 has long lasting and trans-generational effects on the development and behavior of exposed females, accompanied by altered gene expression in a neuroendocrine region of the brain. These findings have implications for female reproductive health and reproductive success in wildlife and humans.

published_or_final_version / Zoology / Master / Master of Philosophy

No description available.

This thesis explores the relevance of international law in the multilateral protection and promotion of public health in a world sharply divided by poverty and underdevelopment. In this endeavour, the thesis predominantly uses the concept of "mutual vulnerability" to discuss the globalisation of diseases and health hazards in the emergent global neighbourhood. Because pathogens do not respect geo-political boundaries, this thesis argues that the world has become one single germ pool where there is no health sanctuary. The concept of mutual vulnerability postulates that the irrelevance or obsolescence of national boundaries to microbial threats has created the capability to immerse all of humanity in a single microbial sea. It follows, therefore, that neither protectionism nor isolationism offers any effective defences against advancing microbial forces. As a result, the thesis argues that contemporary multilateral health initiatives should be driven primarily by enlightened self-interest as opposed to parochial protectionist policy. This study is primarily situated within the discipline of international law. Nonetheless, it draws on the social sciences in its analysis of traditional medicine in Africa. It also makes overtures to medical historians in its discussion of the attitudes of societies to diseases and to the evolution of public health diplomacy, to international relations in its analysis of international regime theories, and to a number of other disciplines interested in the phenomenon of globalisation. This interdisciplinary framework for analysis offers a holistic approach to public health policy-making and scholarship to counter the segmented approaches of the present era. Thus, this thesis is concerned with four related projects. First, it explores the relevance of legal interventions in the promotion and protection of public health. If health is a public good, legal interventions are indispensable intermediate strategies to deliver the final dividends of good health to the vulnerable and the poor in all societies. Second, it explores multicultural approaches to health promotion and protection and argues for a humane health order based on multicultural inclusiveness and multi-stakeholder participation in health-policy making. Using African traditional malaria therapies as a case study, the thesis urges an animation of transnational civil society networks to evolve a humane health order, one that fulfils the desired vision of harmony and fairness. Third, it makes an argument for increased collaboration among lawyers, epidemiologists and scholars of other disciplines related to public health. Using the tenets of health promotion and primary health care, the thesis urges an inter-disciplinary dialogue to facilitate the needed "epidemiological transition" across societies, especially in the developing world. Fourth, the thesis makes modest proposals towards the reduction of unequal disease burdens within and among nation-states. The thesis articulates these proposals genetically under the rubric of communitarian globalism, a paradigm that strives to meet the lofty ideals of the "law of humanity". In sum, it projects a humane world where all of humanity is inexorably tied in a global compact, where the health of one person rises and falls with the health of every other person, and where every country sees the health problems of other countries as its own. Arduous as these tasks may be, they are achievable only if damaged trust of past decades is rebuilt. Because the Westphalian sovereign states lack the full capacity to exhaustively pursue all the dynamics of communitarian globalism, multilateral governance structures must necessarily extend to both state and non-state actors. In this quest, the thesis concludes, international law - with its bold claims to universal protection of human rights and the enhancement of human dignity - is indispensable as a mechanism for reconstructing the public health trust in the relations of nations and of peoples.