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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Diagnosing autism spectrum disorders in children : medical and social perspectives

Russell, Ginny January 2010 (has links)
In this submission, five articles are presented examining one theme: diagnosis of autism spectrum disorders (ASD) in children. Three articles provides perspectives on various social and medical factors that influence the diagnosis of ASD, and the others examine social and behavioural outcomes for children diagnosed with ASD. One article provides an in depth examination of the dilemmas of diagnosis from a parental perspective. The research utilized both qualitative and quantitative methods. A secondary analysis of a longitudinal birth cohort study revealed that there were a number of children who had autistic traits equally severe as those with clinical diagnosis. Further analysis exposed a possible gender bias in diagnosis. Outcomes for children with ASD diagnoses were worse than for those without diagnoses but with comparable behaviours as preschoolers. ASD diagnosis apparently had no positive effect on the developmental trajectory of prosocial behaviour. The implications of these results are discussed. Analysis of qualitative data collected in semi-structured interviews with parents of both diagnosed and undiagnosed children exposed dilemmas faced by parents as they contemplated an ASD diagnosis and highlighted parental action to de-stigmatise the condition after diagnosis had been applied. The body of work as a whole falls at the junction of clinical and educational psychology, developmental psychology, social psychology, social psychiatry, sociology and epidemiology. It draws attention to a number of social processes that contribute to ASD diagnosis. Overall, it is argued, the work supports the conceptualisation of ASD as both a biologically and socially determined condition.
2

Analysis of routinely collected repeated patient outcomes

Holm Hansen, Christian January 2014 (has links)
Clinical practice should be based on the best available evidence. Ideally such evidence is obtained through rigorously conducted, purpose-designed clinical studies such as randomised controlled trials and prospective cohort studies. However gathering information in this way requires a massive effort, can be prohibitively expensive, is time consuming, and may not always be ethical or practicable. When answers are needed urgently and purpose-designed prospective studies are not feasible, retrospective healthcare data may offer the best evidence there is. But can we rely on analysis with such data to give us meaningful answers? The current thesis studies this question through analysis with repeated psychological symptom screening data that were routinely collected from over 20,000 outpatients who attended selected oncology clinics in Scotland. Linked to patients’ oncology records these data offer a unique opportunity to study the progress of distress symptoms on an unprecedented scale in this population. However, the limitations to such routinely collected observational healthcare data are many. We approach the analysis within a missing data context and develop a Bayesian model in WinBUGS to estimate the posterior predictive distribution for the incomplete longitudinal response and covariate data under both Missing At Random and Missing Not At Random mechanisms and use this model to generate multiply imputed datasets for further frequentist analysis. Additional to the routinely collected screening data we also present a purpose-designed, prospective cohort study of distress symptoms in the same cancer outpatient population. This study collected distress outcome scores from enrolled patients at regular intervals and with very little missing data. Consequently it contained many of the features that were lacking in the routinely collected screening data and provided a useful contrast, offering an insight into how the screening data might have been were it not for the limitations. We evaluate the extent to which it was possible to reproduce the clinical study results with the analysis of the observational screening data. Lastly, using the modelling strategy previously developed we analyse the abundant screening data to estimate the prevalence of depression in a cancer outpatient population and the associations with demographic and clinical characteristics, thereby addressing important clinical research questions that have not been adequately studied elsewhere. The thesis concludes that analysis with observational healthcare data can potentially be advanced considerably with the use of flexible and innovative modelling techniques now made practicable with modern computing power.
3

Longitudinal Analysis of the effect of meteorological factors, allergens, and air pollution on respiratory condition in children

Song, Yunna 09 1900 (has links)
<p> In this report we explore how the effect of meteorological factors, allergens, and air pollution on respiratory conditions in children using longitudinal data. Our analysis makes use of a dataset from the DAVIS study in southern Ontario. The response variables are children's lower respiratory tract (URT) and upper respiratory tract (URT) scores. The explanatory variables are readings of various meteorological, allergen, and air pollution factors. First we make use of generalized estimating equations to find the main factors that are associated with certain respiratory conditions in children as measured by LRT and URT scores. Then we determine whether there are any interactions between the significant factors associated with LRT /URT scores. Comparisons between case and control groups are made to determine whether children with asthma are more sensitive to any of the changes in meteorological, allergen, and air pollution factors. The analysis results show that the significant factor that is associated with LRT scores for children with asthma is the two-day lag daily average changes in air pressure. On average an increase in air pressure will result in an increase in children's LRT scores. The interaction terms that remained in the final model show some degree of significance but without strong evidence to support it. Children in the case groups are more sensitive to meteorological factors, allergens, and air pollution than the children in control groups. </p> / Thesis / Master of Science (MSc)
4

Loneliness as a risk factor for mortality and morbidity

Patterson, Andrew C 11 1900 (has links)
Studies over the past couple of decades have depicted loneliness as a significant concern to physical health, although its meaning for overall health outcomes is still unclear. The precise impact of loneliness on life expectancy and on specific disease processes remains unknown. With regression modeling techniques, this thesis uses data from the Alameda County Health and Ways of Living Study to characterize the impact of loneliness on self-rated health, mortality, and fatalities from specific diseases. A key hypothesis is that loneliness as a health problem hinges on its persistence over time. This hypothesis is also tested by examining the reliability of the loneliness measure across the full 34 years of the survey. A second test is to examine its interplay with marital status as a mutable social circumstance. Results show that loneliness is a risk factor for poor self-rated health, non-ischemic cardiovascular diseases, cerebrovascular diseases, infections, and overall mortality. Results also show that loneliness need not be a stable problem across the life span in order to pose health risks. The reliability of the loneliness measure fades across time and levels of loneliness also vary with changes in marital status. Loneliness did not clearly mediate the impact of marital status on self-rated health, mortality, or specific causes of death.
5

Loneliness as a risk factor for mortality and morbidity

Patterson, Andrew C 11 1900 (has links)
Studies over the past couple of decades have depicted loneliness as a significant concern to physical health, although its meaning for overall health outcomes is still unclear. The precise impact of loneliness on life expectancy and on specific disease processes remains unknown. With regression modeling techniques, this thesis uses data from the Alameda County Health and Ways of Living Study to characterize the impact of loneliness on self-rated health, mortality, and fatalities from specific diseases. A key hypothesis is that loneliness as a health problem hinges on its persistence over time. This hypothesis is also tested by examining the reliability of the loneliness measure across the full 34 years of the survey. A second test is to examine its interplay with marital status as a mutable social circumstance. Results show that loneliness is a risk factor for poor self-rated health, non-ischemic cardiovascular diseases, cerebrovascular diseases, infections, and overall mortality. Results also show that loneliness need not be a stable problem across the life span in order to pose health risks. The reliability of the loneliness measure fades across time and levels of loneliness also vary with changes in marital status. Loneliness did not clearly mediate the impact of marital status on self-rated health, mortality, or specific causes of death.
6

Assessment of Intra- and Inter-individual Variability of Outcome Measures in Ankylosing Spondylitis and the Efficacy and Adverse Effects of Anti-TNF Therapy

Maxwell, Lara J 05 July 2011 (has links)
Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease that has a highly variable disease course. Three biologic agents, adalimumab, etanercept, and infliximab, have been developed for the treatment of AS. We conducted three studies: 1) an exploratory analysis of a year-long longitudinal dataset to gain insight into the variability of disease activity, physical function, and well-being and to explore the relationship between these outcome measures; 2) a systematic review of the available evidence for the efficacy of biologic treatment; 3) a systematic review of potential adverse effects of this treatment. We found that repeated measures of disease activity, function and well-being fluctuate considerably between patients, with complex patterns occurring over time within patients. There was mostly high quality evidence that these biologics are efficacious against placebo. We did not find evidence of an increase in serious adverse events or serious infections from short-term randomized controlled trials.
7

Assessment of Intra- and Inter-individual Variability of Outcome Measures in Ankylosing Spondylitis and the Efficacy and Adverse Effects of Anti-TNF Therapy

Maxwell, Lara J 05 July 2011 (has links)
Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease that has a highly variable disease course. Three biologic agents, adalimumab, etanercept, and infliximab, have been developed for the treatment of AS. We conducted three studies: 1) an exploratory analysis of a year-long longitudinal dataset to gain insight into the variability of disease activity, physical function, and well-being and to explore the relationship between these outcome measures; 2) a systematic review of the available evidence for the efficacy of biologic treatment; 3) a systematic review of potential adverse effects of this treatment. We found that repeated measures of disease activity, function and well-being fluctuate considerably between patients, with complex patterns occurring over time within patients. There was mostly high quality evidence that these biologics are efficacious against placebo. We did not find evidence of an increase in serious adverse events or serious infections from short-term randomized controlled trials.
8

Participation in out-of-school activities and the socio-economic gap in children's academic outcomes

Kadar Satat, Gitit January 2015 (has links)
Social stratification research has consistently found persistent inequalities in the academic outcomes of children from different socio-economic status (SES) groups. Research in the sociology of education has shown that students from higher SES groups outperform peers from lower SES groups on various academic indicators as well as make greater academic progress when assessed at two or more separate points in time. Recent evidence from the US has also shown that participation in leisure out-of-school activities (OSA) is among the factors which may contribute to maintaining or even widening these inequalities. Similar evidence is lacking in the UK. The present research focuses on this issue by analysing the role of participation in leisure OSA in the process of reproduction of social inequalities in academic outcomes among British school-aged children. The study draws on social and cultural capital theories to address the following questions: a) Are there differences in participation in OSA among school-aged children in dissimilar SES groups?; b) Taking into account children’s SES, is participation in OSA associated with their academic outcomes?; c) Does the association between participation in OSA and children’s academic outcomes vary across different SES groups? Using data from the third and fourth sweeps of the Millennium Cohort Study (MCS), when cohort members were aged 5 and 7 years old, the research explores participation in three categories of leisure activities; a) social-group activities, b) commercial-public activities, and c) home-centred activities. Children’s academic outcomes are assessed using verbal and non-verbal standardised tests, as well as by teachers’ assessment. The study applied regression models to examine the relationships between children’s SES, participation in OSA and academic outcomes. The statistical analyses were carried out in a multilevel framework which enabled the MCS hierarchical data structure and area variations to be accounted for. The findings suggest that participation in some, but not all leisure OSA is one of the factors which contributes to socio-economic inequalities in educational outcomes among British school-aged children. This is because participation in OSA is associated with better academic performance among all students, however those in high SES groups are more likely to be exposed to such activities. After controlling for SES, gender, family characteristics, school type, absenteeism and geographical variation, there is a small to moderate positive relationship between participation in a number of different leisure OSA and 7-year-olds' academic performance. Interestingly, variations among children from different SES groups were found in the extent to which attendance at certain OSA (e.g. after-school clubs) is associated with academic development between age 5 and 7: children from lower SES who attend such activities tend to progress more academically than children from intermediate and higher SES.
9

Vliv plavecké části triatlonu na celkový výkon v triatlonu v závodech mistrovství světa v letech 2000 - 2010 / Effect of swimming on the overall triathlon performance in triathlon races World Championships in years 2000 - 2010

Koktová, Veronika January 2011 (has links)
Title: The influence of swimming part of triathlon the total performance in competitions of world championships 2000-2010. Objectives: The aim is to investigate the influence of the swimming part of the total performance in triathlon in the lost 10 years. Methods: The relation between two variables (times from swimming and the total time of competitions from competitions of world championships 2000-2010 were described with the help of linear regression. Individual years were then compared in a point graph. Results: Our hypothese were confirmmed. It means that the result from the swimming part explains the result from the competition in less than 30%, which means the R2 is smaller than 0,3. We also found, that the influnence of the swimming part on the final result in triathlon has not changed in the last years. The relationship times in the swimming part and total (final) times was closest in 2005 (R2= 0,21). In other years, this dependence is lower, R2 was smaller than 0,07. Keywords: linear regression, longitudinal analysis, performance
10

Assessment of Intra- and Inter-individual Variability of Outcome Measures in Ankylosing Spondylitis and the Efficacy and Adverse Effects of Anti-TNF Therapy

Maxwell, Lara J January 2011 (has links)
Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease that has a highly variable disease course. Three biologic agents, adalimumab, etanercept, and infliximab, have been developed for the treatment of AS. We conducted three studies: 1) an exploratory analysis of a year-long longitudinal dataset to gain insight into the variability of disease activity, physical function, and well-being and to explore the relationship between these outcome measures; 2) a systematic review of the available evidence for the efficacy of biologic treatment; 3) a systematic review of potential adverse effects of this treatment. We found that repeated measures of disease activity, function and well-being fluctuate considerably between patients, with complex patterns occurring over time within patients. There was mostly high quality evidence that these biologics are efficacious against placebo. We did not find evidence of an increase in serious adverse events or serious infections from short-term randomized controlled trials.

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