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No description available.

Thesis (Ph. D.)--Rutgers University, 2010. / "Graduate Program in Public Health." Includes bibliographical references.

The Maclagan Manuscripts (1892–1903) are derived from transcriptions of an extensive range of oral traditional narratives collected from a large number of named loci throughout the Highlands and Islands of Scotland, but principally from Argyllshire and the Inner Hebrides. They are named after Dr R. C. Maclagan (1839– 1919), an Edinburgh doctor, who began the collection at the instigation of the British Folklore Society and continued to supervise the collectors’ work till its completion. From the multifarious number of subjects included in the manuscripts, the chosen topic of the thesis was selected for detailed research and examination because of the recorded accounts of diseases, illnesses and treatments experienced by patients and their families within the framework of traditional healing beliefs and practices derived from a distinctive Celtic ethnographic culture. The main objectives within the selected methodology of the thesis were, firstly, to present a comprehensive description of the nature of holistic beliefs and practices associated with healing named diseases; secondly, to interpret the named diseases and the likelihood of success or failure of treatment in relation to the presumed underlying causation. Finally, it was considered important to set the experiential suffering of illness and diseases against the contextual background of daily life cycle of beliefs and communal daily living as found in the manuscripts. I am confident that the first two stated objectives of the thesis have been achieved within the limits of the oral narratives; the attempt to meet the requirements of the final phase of research, while complete within the defined set limits, has clearly shown that the manuscripts, in their entirety, represent an extensive original resource of oral traditions from the Highlands and Islands which have as yet not been researched in detail (Mac-an- Tuairnear 2007). Completion of this thesis was facilitated by the formation of a Microsoft Access database inclusive of all the manuscript key subjects- samples of which can be found in the Appendix.

Thesis (Ph.D.). / Written for the Dept. of Educational and Counselling Psychology. Title from title page of PDF (viewed 2008/02/12). Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 103-115).

Medical cartography can provide valuable insights into the epidemiology and ecology of infectious diseases, providing a quantitative representation of the distribution of these pathogens. Such methods therefore provide a key step in informing public health policy decisions ranging from prioritising sites for further investigation to identifying targets for interventions. By increasing the resolution at which risk is defined, policymakers are provided with an increasingly informed approach for considering next steps as well as evaluating past progress. In spite of their benefits however, global maps of infectious disease are lacking in both quality and comprehensiveness. This thesis sets out to investigate the next steps for medical cartography and details the use of species distribution models in evaluating global distributions of a variety of zoonotic diseases of public health importance. Chapter 2 defines a methodology by which global targets for infectious disease mapping can be quantitatively assessed by comparing the global burden of each disease with the demand from national policymakers, non-governmental organisations and academic communities for global assessments of disease distribution. Chapter 3 introduces the use of boosted regression trees for mapping the distribution of a group of vector-borne diseases identified as being a high priority target, the leishmaniases. Chapter 4 adapts these approaches to consider Ebola virus disease. This technique shows that the West African outbreak was ecologically consistent with past infections and suggests a much wider area of risk than previously considered. Chapter 5 investigates Marburg virus disease and considers the variety of different factors relating to all aspects of the transmission cycle that must be considered in these analyses. Chapters 6 and 7 complete the mapping of the suite of viral haemorrhagic fevers by assessing the distribution of Crimean-Congo haemorrhagic fever and Lassa fever. Finally, Chapter 8 considers the risk that these viral haemorrhagic fevers present to the wider African continent, quantifying potential risk of spillover infections, local outbreaks and more widespread infection. This thesis addresses important information gaps in global knowledge of a number of pathogens of public health importance. In doing so, this work provides a template for considering the global distribution of a number of other zoonotic diseases.

The prevalence of overweight and obesity have risen to epidemic proportions. Overweight and obesity are prominent risk factors for the development of chronic disease including diabetes, cardiovascular disease and cancer. Especially pronounced in women of reproductive age and children, the obesity epidemic represents a major threat to global health. Maternal obesity is a key predictor of childhood obesity and diseases of metabolic origin in adulthood. Previous work has demonstrated that the exposure to early life adversity, in the context of maternal obesity, is associated with an increased risk of metabolic disease and obesity in the offspring later in life. Although the mechanisms outlining the relationship between maternal and offspring obesity remain unclear, the intestinal microbiota has come forth as a promising area of research. To understand the factors involved in the maternal intestinal microbial shifts with healthy pregnancy, the preliminary study focused on investigating whether female sex-steroid hormones mediate maternal intestinal microbial shifts in non-pregnant, regularly cycling female mice. We have identified that intestinal microbial shifts are not associated with sex-steroid hormone fluctuations. The second study examined whether maternal intestinal microbial shifts that occur during obese pregnancy were associated with altered inflammatory signaling and function of the maternal intestine and placenta at a critical period of development; embryonic (E) day 14.5. Females fed a high fat diet (HFD) were significantly heavier at mating and throughout gestation compared to CON. At E14.5, High fat (HF) dams displayed increased adiposity, hyperglycemia, hyperinsulinemia, hyperleptinemia and were insulin resistant. Pregnancy and maternal obesity resulted in shifts in the maternal intestinal microbiota, where the most significant increase in microbial relative abundance was exhibited by the mucin degrading genus, Akkermansia. At E14.5, maternal intestinal microbial shifts were associated with higher maternal intestinal NFκB activity in all sections of the maternal intestine, most notably in the maternal colon. Maternal obesity was associated with increased Muc5ac mRNA levels and a modest increase in CD3+ T cells in the maternal colon at E14.5. However, maternal intestinal permeability was unchanged between groups. In the placenta, mRNA levels of key signaling components in the pro-inflammatory toll-like receptor 4 (TLR4) pathway; TRAF6, NFκB and potent pro-inflammatory cytokine TNF-α were increased and in HF females. Maternal obesity was associated with an increase in CD3+ T cells in the junctional zone (JZ), but not in the labyrinth zone (LZ) of the placenta at E14.5. These findings were associated with increased mRNA levels of critical nutrient transporters; glucose transporter 1 (GLUT1) and sodium-coupled neutral amino acid transporter 2 (SNAT2) and a modest increase in glucose transporter 3 (GLUT3) in HF placentae compared to CON. These data identify the mechanistic signaling pathways and cell types involved in modulating the intrauterine environment, thus contributing to the current literature devoted to the investigation of the developmental origins of obesity. / Thesis / Master of Science (MSc)

Background: Pregnancy induces transient bone mass loss. Dairy foods might promote bone health, yet few interventions have been conducted to optimize maternal bone health in the perinatal period. Objectives: To conduct a Nutrition+Exercise randomized controlled trial (RCT) in pregnant women to assess the impact on maternal bone health by measures of calciotropic and bone biomarkers at the end of pregnancy and in the post-partum period. Study design: In the Be Healthy in Pregnancy (BHIP) RCT, 203/241 women consented at randomization (12-17 weeks (wk) gestation) to the bone health sub-study and received either usual care or a Nutrition+Exercise intervention that provided an individualized high protein diet (50% as dairy products) and a walking program throughout pregnancy. Maternal characteristics and fasting blood samples were obtained at 12-17 wk and 36-38 wk gestation, and at six months post-partum. Vitamin D status from the BHIP participants was compared to the FAMILY birth cohort participants (assessed at 24-36 wk gestation) to assess changes over a ten-year span. The response of the calciotropic and bone biomarkers to the RCT intervention was assessed at the end of pregnancy and in the post-partum period. Results: Adequate vitamin D status in pregnancy was observed in 322 participants from the FAMILY and 191 from the BHIP study, impacted by season and supplement intake. For participants in the BHIP study, serum 1,25-dihydroxyvitamin D concentrations increased throughout pregnancy and were not associated with serum 25(OH)D. Participants from the intervention group had lower serum bone resorption marker CTX compared to control group, which was reflected in cord serum. No differences were observed with other bone biomarkers at the end of pregnancy or in the post-partum period. Conclusion: Higher protein and calcium intake compared to the control group during pregnancy minimized bone resorption, thus protecting maternal bone health in the perinatal period. / Thesis / Doctor of Philosophy (Medical Science) / Background: Adaptations in maternal bone metabolism during pregnancy and the post-partum period provide the offspring with the nutrients needed to mineralize their bones. Maternal diet and hormonal changes influence these metabolic changes. Method: In 203 women recruited to the Bone-Be Healthy in Pregnancy Study randomized controlled trial, we compared changes in bone metabolism during pregnancy and at six months post-partum between women randomized to an individualized and monitored Nutrition + Exercise intervention or usual care (control) throughout pregnancy. Results: The intervention group consumed more protein and calcium, but had similar and adequate vitamin D status. At the end of pregnancy, women in the intervention group had less bone loss compared to the control group, but all measures were similar at 6 months post-partum. Clinical significance: The nutrition and exercise intervention reduced maternal bone loss during pregnancy, and could be a feasible intervention to support bone health of pregnant women.

Yes / Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the ‘framework approach’ described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.