(Thesis: M.S.M.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Experimental studies link oscillatory flow accompanied by flow reversal to impaired endothelial cell function. The relation of retrograde flow with vascular function and arterial stiffness remains incompletely defined. We measured brachial diastolic flow patterns along with vasodilator function and central and peripheral arterial stiffness in 5708 participants (age 47±13 years, 53% women) of the Framingham Heart Study Offspring and Third Generation cohorts. Brachial artery diastolic flow reversal was present in 35% of participants. In multivariable regression models, the presence of flow reversal was associated with lower flow-mediated dilation and reactive hyperemia (both P<0.0001). The relation of diastolic flow velocity with vasodilator function was nonlinear with a decline in vascular function associated with increasing magnitude of flow reversal. Flow reversal was associated with greater central aortic stiffness, measured by carotid-femoral pulse wave velocity, and conversely with lower muscular artery stiffness, measured by carotid-radial pulse wave velocity (both P<0.0001). In a large, community-based cohort, brachial artery flow reversal is prevalent and relates to impaired vasodilator function and higher aortic stiffness. Our findings support the possibility that retrograde flow may be relevant to vascular dysfunction. / 2031-01-01

Thesis (M.A.)--York University, 2008. Graduate Programme in Kinesiology and Health Science. / Typescript. Includes bibliographical references. Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR45926

Thesis (M.S.)--University of Michigan, 1979.

Thesis (M.S.)--University of Michigan, 1979.

Thesis (D. Min.)--Boston University, 1999. / Abstract. Includes bibliographical references (leaves 74-85).

Thesis (D. Min.)--Boston University, 1999. / Abstract. Includes bibliographical references (leaves 74-85).

Thesis (D. Min.)--Boston University, 1999. / Abstract. Includes bibliographical references (leaves 74-85).

The research reported in this dissertation examines the dissemination of heart health promotion within the Ontario public health system. It contributes to a relatively new research agenda to understand how to enhance implementation of the new public health; to apply knowledge of effective community- and population-based prevention. Three studies are reported, which extend research conducted in Ontario from 1994 to 1998 as part of the Canadian Heart Health Initiative Ontario Project (CHHIOP). Study one combined diffusion and social ecological theories to examine the dissemination process at the level of the public health system and over a ten year period. Studies two and three examined the implementation stage in more depth, with a view to understand variability across Ontario communities. Study two was a quantitative path analysis to identify determinants of 1997 levels of implementation, and study three was a comparative case study to understand change in implementation from 1994 to 1996. Main data sources were quantitative and qualitative data from CHHIOP. Findings reinforce the need for a systems view of dissemination; that dissemination is a long-term, iterative process; and that organizational capacity building is a vital part of the dissemination process, especially when new practices represent a significant departure from traditional concepts and ways of doing business. The research demonstrates that the interplay of internal organizational factors (e.g. champions, leadership, organizational structure) and external system factors (e.g. research, political priorities, experiences of other jurisdictions, partnerships) helps to explain movement within and across dissemination stages. Findings suggest promising areas for dissemination research, including replicating similar research in other public health systems. Findings also suggest promising strategies to accelerate the dissemination of effective health promotion, including specific strategies to further enhance heart health promotion in Ontario. / Thesis / Doctor of Philosophy (PhD)

With over 18% of the Canadian population born outside of Canada, the health of immigrants is an important concern. Heart health is of particular importance because heart disease is the leading cause of death among men and women in Canada. Using data from the National Population Health Survey (NPHS), the purpose of this thesis is to first establish whether immigrants to Canada have lower rates of coronary heart disease (CHD), and high blood pressure (HBP) than native-born Canadians, and second to determine the lifestyle and psychosocial factors that predict heart health and compare them between immigrants and native-born Canadians. Regression and survival analyses of the NPHS data indicate that lifestyle and psychosocial risk factors such as smoking status, body mass index, alcohol consumption and depression affect immigrants and native-born Canadians similarly. Immigration variables such as length of time in the host country and country of origin are significant risk factors for HBP, however, not in the incidence of CHD. Immigrants were more likely to have HBP than native-born Canadians. However, immigrants have a significantly lower incidence of CHD than native-born Canadians. Native-born Canadians are at a higher risk of heart disease at a younger age than immigrants. These results suggest that there must be other factors relating to immigration affecting the heart health of immigrants. Due to the complexity and high incidence of heart disease in Canada, it may never be possible to ascertain all of the risk factors for heart disease. However, this study has identified several key risk factors and has excluded other variables as possible risk factors. The risk factors identified in this study can form the basis for the development of heart health programs to target all Canadians-both native-and foreign-born. / Thesis / Master of Arts (MA)

Cardiovascular disease (CVD) represents a large portion of the burden of illness for industrial nations, and biomedical research has implicated lifestyle choices and socioeconomic conditions as primary determinants of CVD. There has been a resultant shift from curative to preventive and population health promoting strategies to reduce this burden of illness. The present research is part of a larger research program, the Canadian Heart Health Initiative-Ontario Project (CHHIOP), a two-stage (quantitative and qualitative) longitudinal study designed to investigate and strengthen community-based heart health activities in both the formal and informal public health systems. This study builds upon CHHIOP's qualitative findings to examine how community relationships and community development approaches play out in local contexts to shape the reality of (heart) health promotion practice. Although community development is a central concept in heart health policy there has been no analysis of its understanding, support or use among community health stakeholders. In order to address these questions thirty key informant interviews were conducted with community heart health stakeholders from eight of the 42 health unit areas across Ontario. The findings reveal that three patterns of community heart health practice appeared across the communities, illustrating a continuum of collaboration. These patterns are typfied by different community atmospheres for collaboration, the divergent nature of agency inter-relations, and distinct composites in the use of community (development) approaches. Central themes across communities illustrated the importance of local community contexts, the lack of a common understanding of community development, and the emergence of a shift in health agencies' ways of doing business. Local perspectives and the dynamics of intra-community relations were allowed to emerge and highlight the need for place-sensitive implementation of health promotion strategies at the community level. / Thesis / Master of Arts (MA)