Dissertations / Theses on the topic 'Citing Medicine'

Many recent epidemiological studies have linked health effects with short-term exposure to air pollution levels commonly found in North America. The association of ozone and fine particulate matter with mortality and hospital admissions in 12 Canadian cities was explored in a time-series study. City-specific estimates were obtained by Poisson regression models adjusting for the confounding effects of seasonality and temperature. Estimates were then pooled across cities using the inverse variance method. Results suggest significant associations across all outcomes except cardiovascular hospital admissions. Generally, stronger associations were found among the elderly. Effect estimates were robust to adjustment for seasonality confounding but were sensitive to lag structures. Considering the large population exposed to air pollution, reductions in ozone and particulate matter would lead to considerable health benefits.

Over the past decade there has been mounting evidence of the significant role played by the myriad attributes of our city's built environments in shaping our health and well-being. This thesis hypothesizes that the constituent components of the built environment, especially the configuration and design of land uses and street networks governs the distribution of resources and services, configures the neighbourhood activity space, and thereby influences individual physical activity behaviours, social interactions, weight outcomes as well as mental health and well being. Enhanced accessibility to health-promoting community resources improves local opportunities for physical activity, thereby enhancing mobility, social interactions and independence as well as reducing isolation. The first section of this thesis conceptualizes the urban health niche as a novel holistic and spatially-explicit paradigm in public health and proposes a health niche model of healthy city. Based on the proposed paradigm and gathered research evidence, multilevel data sets pertaining to health, socio-economic, built and natural environment have been produced and integrated together to constitute the high resolution database, spatial Design Network Analysis for Urban Health (sDNA-UH). sDNA-UH has been developed for the assembly constituency of Caerphilly, South Wales enabling operationalization of the spatial elements of the proposed urban health niche. State-of-the-art spatial and network analysis techniques have been employed upon the UK Ordnance Survey Mastermap data layers to quantify the various facets of urban built environment in the form of built environment morphological metrics (morphometrics) with the potential to influence individual's health. Based on the developed sDNA-UH, a series of three empirical studies comprising multilevel cross-sectional and longitudinal models have been presented which examine the association between specific attributes of a built environment and health outcomes. Firstly, a two-part multi-level regression model was employed to examine the impact of built environment configuration upon psychological distress. Land use mix, density of amenities, local street-network general accessibility (‘betweenness’) and slope variability were identified as significant predictors. Secondly, the first long-term longitudinal evidence relating the built environment to change in obesity in older people identified land use mix, density of amenities street network accessibility and slope variability as significant predictors. The third study examined the health effects of differential accessibility of an individual's dwelling with respect to multiple service and facility catchments at multiple spatial scales. Dwelling level density, dwelling type, density of community services, street network movement potential expressed in terms of betweenness index as well as neighbourhood-level deprivation were identified as the significant parameters. The study reported significant differences in point estimates and level of significance when comparing the two spatial scales of 0.5 and 1.0 mile street network catchments. The empirical evidence thus generated lends support to the thesis’ principal hypothesis that the built environment influences individual health behaviour and eventually health. The research concludes that optimized design and planning of urban built environments act as effective public health intervention in our goal of health-sustaining communities and a healthy city.

Die Studie wird in fünf Teile unterteilt: Das erste Kapitel beschäftigt sich mit Patentanmeldungen und geförderten Patenten im USPTO, WIPO, und EPO. In diesem Kapitel wird die Korrelation zwischen dem BIP und der länderspezifischen Patentanzahl analysiert. Das zweite Kapitel gibt einen Überblick über die Literatur über Patente in MEDLINE. In diesem Kapitel wird eine szientometrische Analyse durchgeführt, damit die Entwicklung der Patentliteratur in MEDLINE über den Zeitraum von 1965 bis 2005 quantitativ gemessen werden kann. Das dritte Kapitel befasst sich mit der Literatur über Patente im SCI. In diesem Kapitel werden alle Dokumente, die vom SCI über den Zeitraum 1965 bis 2005 als “Patents“ indexiert wurden, unter die Lupe genommen. Das vierte Kapitel analysiert die Patenten, die im SCI zitiert werden. Das fünfte Kapitel analysiert die Anzahl der Literaturhinweise (Referenzen) pro Veröffentlichung im SCI über den Zeitraum 1970-2005. In diesem Hinblick wurde eine Gesamtzahl von 10,000 Dokumenten pro Jahr ausgesucht sowie der Bedeutungswert von Nennungen pro Zeitschrift berechnet. Die Analyse der Daten ergab: Die USA sind das führende Land bezüglich der Erstellung und der Zulassung von Patenten, gleichermaßen gefolgt von Japan und Deutschland. Die Halbwertszeit der Zitierung von Patenten beträgt seit 1994 konstant 8,1 Jahre. Das ist eine 41% längere Zitierungsrate gegenüber den allgemeinen wissenschaftlichen Dokumenten im SCI. Es gibt eine lineare Korrelation zwischen der Zahl von Literaturhinweisen (Referenzen) in einem Journal, wie sie im SCI erfasst sind, und der Wahrscheinlichkeit zitiert zu werden. Die Anzahl der Literaturhinweise (Referenzen) pro Veröffentlichung zwischen 1970 und 2005 im SCI ist ständig angestiegen. Die Selbstzitation von Zeitschriften bei einer steigenden Zahl von Verweisen beeinflusst die Steigerung des Impact Factor im SCI. Die Leitartikelpolitik der Sprachen wurde in der MEDLINE und im SCI geändert.<br>This study is divided into five sections. The first section consists of patent applications and granted patents issued by USPTO, WIPO), and EPO. In this section the relationship between the GDP and country’s patent quantity is analysed. The second section analysis the patent literature in MEDLINE. In this section a scientometric analysis is performed to assess the quantitative trend of patent literature in MEDLINE throughout 1965-2005. The third section analysis the patent literature in the SCI. In this section all documents indexed as a topic of “patents” in the SCI throughout 1965-2005 are analysed. The fourth section analysis the citations to the patent documents indexed in the SCI, and illustrate the average number of cited references per paper for patent citing documents. The fifth section analysis the references per paper in the SCI through 1970-2005. The Analyses of data showed: The USA is the leading country filing and granting patents followed by Japan and Germany respectively. The half-life of citations to the patent-documents is 41% higher than the half-life of citations to the general scientific documents in the SCI. The number of references per paper from 1970 to 2005 has steadily increased. The rough constant percentage of self-citation of journals and the growing increase of references per paper led to the absolute growing number of self-citations and to the increase of the Impact Factor of the citing journals in the SCI. The editorial policy of languages is being changed in MEDLINE and in the SCI. The consideration of policy makers in these databases have been focused on the literature of science in English. There was a tendency in the last decades towards collaboration in scientific publishing with American authors that can be observed in the SCI with authors from different countries.

Thesis (Ph.D.)--University of Western Sydney, 2007.<br>A thesis submitted to the University of Western Sydney, College of Health and Science, School of Biomedical and Health Sciences, in fulfilment of the requirements for the degree of Doctor of Philosophy. Includes bibliography.

Background: Despite the important, and well-established, link between poverty and poor health, previous research has shown that there is an ‘excess’ level of mortality in Scotland compared to England and Wales: that is, higher mortality seemingly not explained by differences in levels of socio-economic deprivation. This excess has been shown to be ubiquitous in Scotland, but greatest in and around Glasgow and the West Central Scotland conurbation. To investigate this further, the aims of this research were: first, to compare levels of mortality and deprivation – and, specifically, the extent to which differences in the latter explain differences in the former – between Glasgow and its two most comparable English cities, Liverpool and Manchester; and second, to investigate, by means of collection and analyses of new population survey data, some of the many hypotheses that have been proposed to explain Scotland’s, and Glasgow’s, ‘excess’ levels of poor health. Methods: Geographic Information System (GIS) software was used to create small geographical units for Glasgow comparable in size to those available for the English cities (average population size: 1,600). Rates of ‘income deprivation’ were calculated for these small areas across all three cities. All-cause and cause-specific standardised mortality ratios were calculated for Glasgow relative to Liverpool and Manchester, standardising for age, sex and income deprivation decile. In addition, a range of historical socio-economic and mortality data was analysed. Three of the previously suggested explanations for excess Scottish mortality were investigated: lower levels of social capital; a lower ‘Sense of Coherence’(SoC); and a different ‘psychological outlook’ (specifically, lower levels of optimism). To do so, a representative survey of the adult population of Glasgow, Liverpool and Manchester was undertaken. Previously validated question sets and scales were used to measure the three hypotheses: levels of social capital were assessed by means of an expanded version of the Office for National Statistics (ONS) core ‘Social Capital Harmonised Question Set’ (covering views about the local area, civic participation, social networks and support, social participation, and reciprocity and trust); SoC was measured by Antonovsky’s 13-item scale (SOC-13); and levels of optimism were assessed using the Life Orientation Test (Revised) (LOT-R). The data were analysed by means of multivariate regression analyses, thus ensuring that any observed differences between the cities were independent of differences in the characteristics of the survey samples (age, gender, social class, ethnicity etc.). Results: The deprivation profiles of Glasgow, Liverpool and Manchester were shown to be very similar: approximately a quarter of the total population of each city was classed as income deprived in 2005, with the distributions of deprivation across the cities’ small areas also extremely alike. Despite this, after statistical adjustment for any remaining differences in deprivation, premature deaths (<65 years) in the period 2003-07 were 30% higher in Glasgow compared to Liverpool and Manchester, with deaths at all ages almost 15% higher. This excess was seen across virtually the whole population: all adult age groups, males and females, and among those living in deprived and non-deprived neighbourhoods. However, a difference was observed between the excess for deaths at all ages and that for premature deaths. For the former, the 15% higher mortality was distributed fairly evenly across deprivation deciles, and the greatest contribution (in terms of causes of death) was from cancers and diseases of the circulatory system; in the latter case, the excess was much higher in comparisons of those living in the more, rather than less, deprived areas (particularly men), and was driven in particular by higher rates of death from alcohol, drugs and suicide. Importantly, the excess appears to be increasing over time. The analyses of the survey data showed SoC to be higher, not lower, among the Glasgow sample compared to those in both English cities. Levels of optimism (measured by the LOT-R scale) were very similar in Glasgow and Liverpool, and higher than that measured among the Manchester sample. Although not all aspects of social capital presented the Glasgow sample in a more negative light, Glasgow respondents were, however, characterised by lower levels of social participation, trust and reciprocity. A number of these differences were greatest in comparisons of those of higher, rather than lower, socio-economic status. Conclusions: As currently measured, socio-economic deprivation does not appear to explain the differences in mortality between the cities: there is a high level of ‘excess’ mortality in Glasgow compared to the English cities. While many theories have been proposed to explain this, on the basis of the analyses included within this thesis, it seems highly unlikely that two of these – lower Sense of Coherence and a different psychological outlook (optimism) – play a part. However, it is possible that differences in aspects of social capital may play a role in explaining some of the excess, particularly that observed in comparisons of less deprived populations. The concluding chapter of the thesis argues that excess mortality in Scotland and, in particular, its largest city, is a deeply complex phenomenon: the causes, therefore, are likely to be equally complex and multifactorial. It is postulated that, given the fundamental link between deprivation and mortality, the essence and reality of deprivation experienced by sections of Glasgow’s population may not have been fully captured by the measures employed within research to date. More speculatively, the role of history may be important in seeking to identify the potentially different, unmeasured, facets of deprivation experienced by people in Glasgow compared to those in Liverpool and Manchester. It is also possible that protective factors (relating to, for example, ethnicity and social capital) may be at work in the two comparator English cities. However, given that excess mortality has been shown for all parts of Scotland compared to England & Wales, and not just Glasgow, this is not in any way a complete explanation.

Multiple factors account for inequality in health outcomes and in access to healthcare in the UK, including ethnicity and length of residence in the country. This thesis explores the subjective experiences of a group of recent low-income international migrants who live in Brighton and Hove and have used local health services to seek care for a range of illnesses and conditions. The project was formulated in collaboration with Brighton and Hove City Council and the then NHS Brighton and Hove (now Brighton and Hove Clinical Commissioning Group), using local professional knowledge and experience to recruit participants and collect narratives from a ‘hard to reach' social group. The theoretical background of this thesis draws on ‘lived' experience in the context of illness. Analysis of qualitative interviews, using narrative typologies derived from the work of Frank (1991), revealed both the commonalities across and the specificities of illness experiences, and highlighted a multi-factorial web of bio-psychosocial and economic factors at play. The interviews overwhelmingly fitted with a chronic, ‘chaos' typology, in which diagnoses were commonly contested. The particularities of recent migrant status impacted upon participants' illness experiences and healthcare use. Migrants made comparisons with health systems in their countries of origin and managed healthcare through social networks. The findings from the data analysis around patient experience showed that the overall experience was negative, characterised by disappointment, with communication and access problems as recurrent themes. These outcomes may be explained by both direct and indirect discrimination. Direct discrimination and stigma were perceived by many participants in the attitudes and practices of staff, which some participants linked to their own ethnicity, immigration status and faith. From this study it is possible to hypothesise that healthcare practices and policy may give rise to some of the perceptions of discrimination.

Orientador: Maria Stella Martins Bresciani<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências Humanas<br>Made available in DSpace on 2018-08-22T18:09:44Z (GMT). No. of bitstreams: 1 Correia_LucianaCristina_M.pdf: 2587452 bytes, checksum: d3f6b2d40f5947d83d018d008702c96b (MD5) Previous issue date: 2013<br>Resumo: O presente texto de dissertação analisa as relações entre medicina e espaço urbano presentes na cadeira de Higiene da Faculdade de Medicina de São Paulo, no período entre 1918 e 1928. A intenção é acompanhar e analisar o olhar dos médicos pertencentes ao departamento de Higiene para as cidades paulistas. Para tanto, primeiramente, recuperamos aspectos do campo médico paulista no início do século XX, por meio de pesquisa bibliográfica. Analisamos também as mudanças na legislação estadual que deu origem à Faculdade de Medicina, bem como a trajetória da Fundação Rockefeller, pois levamos em consideração o fato de que a cadeira de Higiene possuía um laboratório anexo, o Instituto de Higiene. Tanto a cadeira como o Instituto de Higiene são frutos de um acordo entre a Faculdade de Medicina e a Fundação Rockfeller. Assim, buscamos enfatizar em nossa leitura que a cooperação entre essas duas instituições coaduna-se com a atuação internacional da Fundação Rockefeller. Para analisar especificamente a estrutura da disciplina de Higiene, utilizamos os relatórios dos professores responsáveis pela disciplina no Instituto, enviados à Fundação Rockefeller e também a inspeção sanitária realizada pelo médico Mário da Costa Galvão em Mogi das Cruzes para demonstrar que o olhar dos médicos voltava-se especialmente para os equipamentos sanitários das cidades<br>Abstract: This text dissertation analyzes the relationship between medicine and urban space in the present chair of Hygiene, Medical School, São Paulo, between 1918 and 1928. The intention is to observe and analyze the look of doctors belonging to the department of Hygiene for the cities of São Paulo. To do so, first, we recover aspects of the medical field São Paulo in the early twentieth century, through literature. We also analyzed changes in state law that gave rise to the Faculty of Medicine as well as the trajectory of the Rockefeller Foundation since we take into consideration the fact that the chair had a laboratory attached, the Institute of Hygiene. Both the chair and the Institute of Hygiene are the result of an agreement between the School of Medicine and the Rockefeller Foundation. So we try to emphasize in our reading that the cooperation between these two institutions is consistent with international operations of the Rockefeller Foundation. To specifically analyze the structure of the discipline of Hygiene, we use the reports of teachers responsible for discipline in the Institute sent to the Rockefeller Foundation and also the sanitary inspection performed by the doctor Mario Costa Galvão in Mogi das Cruzes to demonstrate that physicians look-back especially for sanitation of cities<br>Mestrado<br>Politica, Memoria e Cidade<br>Mestra em História

Poor urban Australians face a substantial health disadvantage: on average, they can expect to die earlier and suffer more physical disease, mental illness and injuries than wealthier Australians. This thesis examines the potential of one approach to reducing the problem of health disadvantage, namely, systematically intervening in disadvantaged locations. Such an approach is gaining support, especially in the United Kingdom and Australia; there is therefore a need to determine its possibilities and limitations. The thesis is written from the theoretical perspectives of critical social science and political economy of health. The research synthesises empirical data and critical analysis, combining findings from the health inequalities literature and analyses of contemporary political and economic contexts. It also includes two original studies: a quantitative analysis of the patterning of socio-economic disadvantage in Sydney suburbs, and a qualitative case study of a disadvantaged location: Mt Druitt, NSW. The health inequalities research shows that reducing health disadvantage is largely a question of reducing socio-economic disadvantage. A model of social exclusion is used to show how socio-economic disadvantage develops in capitalist societies. Following from this analysis, it is argued that a locational approach can have little impact on the macro political and economic antecedents of socio-economic and health disadvantage. Given these macro constraints, the thesis examines the possible ameliorative impact of a locational approach to health disadvantage here too, there are many limitations. A locational approach would have a limited population reach as most health disadvantaged people do not live in identifiably disadvantaged locations. Location itself creates only a modest independent burden on health, thus improving the amenity of disadvantaged locations will contribute little to reducing health disadvantage. In Australia, the creation of the most visibly disadvantaged urban locations is almost entirely a consequence of policies to concentrate public housing. Although it can be expected that locational interventions will be focused in these locations, there are substantial policy barriers to addressing the major socioeconomic determinants of health , low income, unemployment and sole parent poverty, in public housing estates, Location based policies to alleviate aspects of health and socio-economic disadvantage are assessed. In general locational policies and interventions have had a disappointing track record in buffering populations against issues such as poverty, unemployment and childhood disadvantage. Four specific policies are examined. There is a case to provide improved health services in disadvantaged locations. Measures to improve social capital or change the social mix of locations will have a very small, if any, impact on health. Early intervention in disadvantaged locations is rational in that the precursors of health and socioeconomic disadvantage occur in early life; however, population reach is limited and only the most expensive and intensive of these programs have produced good results. The case study of Mt Druitt shows that agencies are willing to implement a wide range of interventions to alleviate location based socio-economic and health disadvantage. Some of these interventions can be expected to have good results for some individuals. However, there is a lack of a systematic approach to problems in this location, and substantial barriers exist to creating widespread positive change. Overall, despite growing interest in a locational approach to addressing health disadvantage, and evidence of considerable energy at grass root level, a locational approach can be expected to contribute little to improving the health of socio-economically disadvantaged urban Australians.

This study is entitled, “determination of the presence of antibiotics and bacterial pathogens with their susceptibility in fresh milk from the San Nicolas community and the cities of Penipe, Guano, and Chambo in the Chimborazo province”. It was funded by the Benson Institute of Brigham Young University and Nestle. The objectives were: 1) to determine the presence of antibiotics in fresh milk from the San Nicolas community and the cities of Penipe, Guano, and Chambo, 2) to determine the presence of bacterial pathogens in milk from the places previously mentioned, and 3) to detect the susceptibility of the isolated bacteria to the most commonly used antibiotics on the market. With regard to the presence of antibiotics, they were only found once in Chambo (beta-lactams) and once in San Nicolas (tetracycline). Three types of pathogenic bacteria were found: Escherichia coli, Streptococcus agalactiae, and Staphylococcus aureus. Only one bacterium was found that has not been studied: Pseudomonas aureoqinosa. This bacterium was found in milk from San Nicolas. With regard to the susceptibility of the bacteria to antibiotics, it was found that Escherichia coli was sensitive to the following antibiotics: nitrofurans, erimethoprina, trimethoprim and sulfonamides, and tetracyclines and spectomicina. Escherichia coli also showed medium sensitivity to chloramphenicol as well as resistance to ampicillin and sulfonamides. Streptococcus agalactiae was sensitive to lincomycin, neomycin, enrofloxacin, and clindamycin. It also showed medium sensitivity to erythromycin and low tetracycline and penicillin as well as resistance to gentamicin. Lastly, Staphylococcus aureus was sensitive to neomycin and enrofloxacin. In addition, it showed medium sensitivity to lincomycin, gentamicin, clindamycin, and tetracycline as well as resistance to low erythromycin and penicillin. This study was done over a four month period with at least 12 samples being collected from each area. A total of 60 samples were analyzed. Based on the results obtained, our recommendation is that hygienic measures are taken in obtaining and transporting milk to eliminate the growth of bacterial pathogens. Also, we recommend the use of the effective antibiotics listed above in order to completely eradicate these microorganisms.

碩士<br>中國文化大學<br>觀光事業學系觀光休閒事業管理碩士在職專班<br>105<br>Taiwan Medical beauty industry rapid development, the annual output of up to 80 billion yuan in 2011, the result of rapid development, attracting many physicians, therapists, beauticians join this emerging industry, consumer acceptance of higher medical cosmetic willing to invest more money to treatment, resulting in increased demand for medical cosmetic clinic in the medical beauty business hours and holidays to the people affected by the impact of consumer habits In normal days off to go to work, manpower is quite tight, in addition to the more medical disputes have also been reported in people understand the beauty of medicine, medical cosmetic practitioners Working under great pressure, and leisure time is another phase of the oppressed. Casual bring people in physical, intellectual, emotional, social, and environmental well-being status to five faces, not only significantly associated with physical and mental health, but also allows people to promote health and improve performance efficiency performance, to understand the medical cosmetic practitioners casual obstacles, so do the study.

Poor urban Australians face a substantial health disadvantage: on average, they can expect to die earlier and suffer more physical disease, mental illness and injuries than wealthier Australians. This thesis examines the potential of one approach to reducing the problem of health disadvantage, namely, systematically intervening in disadvantaged locations. Such an approach is gaining support, especially in the United Kingdom and Australia; there is therefore a need to determine its possibilities and limitations. The thesis is written from the theoretical perspectives of critical social science and political economy of health. The research synthesises empirical data and critical analysis, combining findings from the health inequalities literature and analyses of contemporary political and economic contexts. It also includes two original studies: a quantitative analysis of the patterning of socio-economic disadvantage in Sydney suburbs, and a qualitative case study of a disadvantaged location: Mt Druitt, NSW. The health inequalities research shows that reducing health disadvantage is largely a question of reducing socio-economic disadvantage. A model of social exclusion is used to show how socio-economic disadvantage develops in capitalist societies. Following from this analysis, it is argued that a locational approach can have little impact on the macro political and economic antecedents of socio-economic and health disadvantage. Given these macro constraints, the thesis examines the possible ameliorative impact of a locational approach to health disadvantage here too, there are many limitations. A locational approach would have a limited population reach as most health disadvantaged people do not live in identifiably disadvantaged locations. Location itself creates only a modest independent burden on health, thus improving the amenity of disadvantaged locations will contribute little to reducing health disadvantage. In Australia, the creation of the most visibly disadvantaged urban locations is almost entirely a consequence of policies to concentrate public housing. Although it can be expected that locational interventions will be focused in these locations, there are substantial policy barriers to addressing the major socioeconomic determinants of health , low income, unemployment and sole parent poverty, in public housing estates, Location based policies to alleviate aspects of health and socio-economic disadvantage are assessed. In general locational policies and interventions have had a disappointing track record in buffering populations against issues such as poverty, unemployment and childhood disadvantage. Four specific policies are examined. There is a case to provide improved health services in disadvantaged locations. Measures to improve social capital or change the social mix of locations will have a very small, if any, impact on health. Early intervention in disadvantaged locations is rational in that the precursors of health and socioeconomic disadvantage occur in early life; however, population reach is limited and only the most expensive and intensive of these programs have produced good results. The case study of Mt Druitt shows that agencies are willing to implement a wide range of interventions to alleviate location based socio-economic and health disadvantage. Some of these interventions can be expected to have good results for some individuals. However, there is a lack of a systematic approach to problems in this location, and substantial barriers exist to creating widespread positive change. Overall, despite growing interest in a locational approach to addressing health disadvantage, and evidence of considerable energy at grass root level, a locational approach can be expected to contribute little to improving the health of socio-economically disadvantaged urban Australians.<br>Doctor of Philosophy (PhD)

Natural products and derivatives thereof have contributed significantly to drug discovery and development and have also been used in traditional medicine for the treatment of various disease states. Sometimes, the use of such traditional medicines may be based upon many hundreds, if not thousands, of years of human experience. An advantage of drugs derived from natural products compared to synthetic drugs is their availability and the likelihood of reduced side effects. Drugs and drug leads derived from natural products may also be less time consuming and expensive to develop and may be more accessible to developing countries. An exciting advance in this area is the application of computational chemistry to potentially bioactive molecules that can be identified in such natural products. Thus, the structural and physicochemical properties of such molecules can be reconciled with current theories on the molecular aspects of a given disease and/or be used to improve upon such theories or to develop new ones. Computed properties may also be benchmarked to experimental data for isolated molecules of interest that can lead to improved molecular design. In this context, two different strategies have been devised and implemented for the identification and development of potentially bioactive compounds from medicinal plant materials whereby reliable molecular structures and experimental data, that have been previously reported in the peer reviewed scientific literature, have been reconciled with carefully designed computational chemistry calculations and/or further experimentation - with a view to (I) developing improved antioxidants as potential anti-inflammatory drugs and (II) to identify small molecule potential metal chelators that may pass through the blood brain barrier and potentially ameliorate neurodegenerative diseases such as Alzheimer’s or Parkinson’s disease. Thus two bioactive products derived from medicinal plants, namely Ribes nigrum (Blackcurrant leaves) and Bacopa Monnieri (Brahmi tea), that are traditionally employed to treat rheumatic disease and neurodegenerative symptoms, respectively, have been chosen for investigation under these strategies. These plant materials have been extensively investigated in the scientific literature in terms of the identification of the structures of their potentially bioactive molecules and also with respect to experimental and biological investigations. For the former material, the purported anti-inflammatory effects of the component poly phenolic molecules, in terms of their reported experimental radical scavenging propensities, have been reconciled with their computed antioxidant capacities. These have also been related to a range of computed qualitative and quantitative structural and physicochemical properties. This is with a view to optimizing their antioxidant potential and possibly designing anti- inflammatory drug candidates. For the latter material, a screening of the reported molecular structures of potentially bioactive components has identified two smaller molecular fragments, namely the isomers jujubogenin and pseudojujubogenin, that may also be present in the plant extract and that are deemed capable of passing through the blood brain barrier and complexing transition elements within the brain, specifically copper and/or zinc, that are associated with stabilizing the amyloid plaque of Alzheimer’s disease, or iron, that may over-load the substantial nigra in Parkinson’s disease. In this thesis, the metal complexes of these two molecules have been modelled utilizing semi-empirical quantum chemistry and density functional calculations and the characteristics of the copper, zinc and iron complexes have been described. These studies clearly show that the diaquo, square planar copper complex of jujubogenin is the preferred structure, revealing that jujubogenin is an excellent bidentate ligand for this particular transition metal. The corresponding zinc complex was also shown to be feasible, but less likely to form; whereas the iron complex was shown not to be accommodated at all. To complement these studies, the Brahmi tea material was extracted with a range of solvents, and fractions were systematically subjected to ESI- MS. Scrutiny of the resultant spectra revealed the presence of the protonated jujubogenin moiety in one of the ethyl acetate fractions. Subsequent spiking of this fraction with copper, zinc and iron revealed the presence in the spectra of the diaquo copper complex of jujubogenin, exactly as predicted from the computer modelling. Notably, no zinc or iron complexes could be detected and competition experiments only revealed the presence of the copper complex - also consistent with the computer modelling. Subsequent MS/MS experiments on the copper complex yielded the free ligand. In summary, for possible anti-inflammatory agents, these investigations show that the computed homolytic bond dissociation energies of the component poly phenolics, by themselves, are not sufficient to explain enhanced antioxidant activity and suggest that other properties such as molecular conformation, steric effects and, in particular, the magnitude and direction of the dipole moment also have important roles to play. In relation to possible drug leads for the treatment of neurological conditions, the discovery of the extraordinary copper specificity of the jujubogenin molecule, both computationally and experimentally, makes this molecule a candidate for a BBB penetrating chelating agent that could be active towards the amelioration of Alzheimer’s disease and possibly other conditions. This is an exciting discovery and warrants the isolation of jujubogenin and its derivatives in for further testing. Thus, the design and implementation of the key strategies devised and described within this thesis and their respective application to two selected traditional medicines relating to specific disease states, is demonstrably useful in the rational design of drug candidates and suggest new avenues for future research.

Purpose: To develop a conception of osteopathic practice that assists in defining the profession. Practices by those who comprise a profession are representative of the profession. As such, practices of professional osteopaths were analysed: what they were and how they were conducted, to develop a conception of practice. The key research questions were: What role does clinical reasoning play in defining osteopathic practice? What are the acts that constitute osteopathic clinical practice? How might Pragmatism provide a philosophy that informs the principles and practice of osteopathy? Can Pragmatism provide a bridge to the issues within osteopathy? Method: Pragmatism provided the epistemology with meaning occurring from socially situated acts. Fifteen Australian registered osteopathic practitioners volunteered to have their practice videoed and then respond to a semi-structured interview. The interview addressed questions about the acts that occurred in the consult, with the video recording as a prompt. The transcripts were interpreted, coded and the emergent themes from all transcripts were then pooled and coded to develop knowledge themes. Conclusions: Osteopathic practice is a professional social behaviour that interprets a patient’s concerns with a series of gestures and acts to construct a shared meaning as a basis for ongoing acts that are aligned with establishing meaning relating to the sensitising impulse. Key to these gestures and acts is a structured organised approach that consists of social praxis that supports the conducting of phronesis in the betterment of society. The professional social behaviour contains within it all that is the osteopathic profession and is focused on an individualized experience that occurs within the consult, as the key vehicle of the acts of the profession.

A saúde é definida como "um estado de completo bem-estar físico, mental e social e não somente ausência de afeções e enfermidades" sendo um valor ssociado à comunidade e não ao indivíduo per si. É um direito da pessoa humana, que deve ser assegurado independentemente da raça, da religião, ideologia política ou condição sócio-económica. A saúde é, desta forma, um valor coletivo, um bem de todos, devendo cada um gozá-la individualmente, sem prejuízo de outrém e, solidariamente, com todos (Sanchez e Ciconelli, 2012). A necessidade de uma maior compreensão ao nível da saúde e também pelas melhorias dos processos referentes ao mesmo permitiram a inclusão de políticas e ações de vários setores sociais que alteraram a saúde nas populações. Dessa forma, através de um ponto de vista de coprodução e responsabilidade social pela saúde, começou a surgir a ideia do movimento das cidades saudáveis (Loureiro et al., 2013). Os municípios associados à Rede Portuguesa das Cidades Saudáveis (RPCS) comprometem-se, através de um planeamento racional, implementar práticas para a promoção da saúde, fundamentada em políticas abrangentes ao espaço físico, cultural e no processo educativo das comunidades, incentivando a sua participação bem como a sua ação (Loureiro et al., 2013). A RPCS inclui uma variedade ampla de projetos referente à saúde da população atuado em áreas diversas tais como envelhecimento, ativo e saudável, desenvolvimento ambiental e sustentabilidade, equidade, multiculturalidade e imigração, saúde mental e bem-estar social, diminuir as doenças, promover a saúde e cidadania (RPCS, 2007). Ainda assim, os membros da RPCS não são numerosos devido ao escasso conhecimento deste tipo de movimento por parte dos municípios do território naional, pela obrigatoriedade de implementação dos projetos nas cidades e freguesias ou também devido ao investimento monetário nestes projetos dado que possuem um tempo de execção prolongado e os resultados são obtidos ao longo do tempo (RPCS, 2013).<br>Health is defined as "a state of complete physical, mental and social well-being and not only the absence of affections and infirmities" being a value associated with the community and not with the individual per se. It is a right of the human person, which must be ensured regardless of race, religion, political ideology or socio-economic condition. Health is thus a collective value, a good of all, and each should enjoy it individually, without prejudice to others and jointly with all (Sanchez and Ciconelli, 2012).The need for greater understanding in health and also the improvements in the processes related to health have allowed the inclusion of policies and actions of various social sectors that have altered health in populations. Thus, from a point of view of coproduction and social responsibility for health, the idea of the movement of healthy cities began to appear (Loureiro et al., 2013). The municipalities associated with the Portuguese Network of Healthy Cities (RPCS) undertake, through rational planning, to implement practices for health promotion, based on comprehensive policies on the physical, cultural and educational space of the communities, encouraging their participation as well as its action (Loureiro et al., 2013). The RPCS includes a wide variety of projects addressing the health of people engaged in diverse areas such as aging, active and healthy, environmental development and sustainability, equity, multiculturalism and immigration, mental health and social welfare, disease reduction, health and citizenship (RPCS, 2007). Nevertheless, the members of the RPCS are not numerous due to the scarce knowledge of this type of movement by the municipalities of the national territory, the obligation to implement the projects in the cities and parishes or also due to the monetary investment in these projects, since they have a time of and results are obtained over time (RPCS, 2013).

Evidence-based practice (EBP) is a core skill of all health professionals and a professional registration requirement for paramedics in Australia, NZ, and the UK. Paramedic Academics (PAs) have a key role in teaching EBP to paramedic undergraduates. However, only limited literature exists to assess the preparedness of PAs to do so. The current research is conducted under the paradigm of constructivism using the mixed methods of a phenomenological guided multiple repeated individual case studies using sequential semi-structured interviews incorporating vignettes and a positivist-based survey. The Evidence-Based Practice Profile-Paramedic (EBP2 -P) survey assesses the domains of relevance, terminology, practice, confidence, and sympathy to EBP. Demographic data was also collected. Data analysis was Cronbach’s alpha coefficient, descriptive statistics, Welch’s unequal variances t-test and Factorial AVOVA. A total of 106 PAs from Australia (61), NZ (20) and the UK (25) responded to the survey. Most respondents had a paramedic background (89%) and >10 years clinical experience (68%). Only 11% held a PhD while 12% held a Master’s by Research and 30% a Master’s by coursework. Under half of respondents had any EBP education (48%) or published an academic paper or presented at a conference (43%). Mean academic experience was four years with 22% reporting less than one year. EBP2 -P scores for the PAs were statistically significantly superior (p < .05) to other allied health professional academics in the domains of practice and sympathy and not significantly different in relevance, terminology, and confidence. The themes of variable EBP training levels, academic, and clinical use, inexperienced PAs, lack of higher degrees, resistance to students practicing EBP from clinical supervisors were detected in the qualitative phase. Student paramedics’ attitudes to EBP were influenced strongly by early clinical placements and they disliked being taught by non-paramedic staff that did not understand the paramedic environment and used irrelevant examples. The pattern of the EBP2 -P scores demonstrated that the PA cohort is at least as capable as the Allied Health Academics regarding the EBP characteristics evaluated. Differences between Australian PAs and their UK and NZ counterparts may be due to variation in years professional registration programs began. Some academics, in-service educators, and clinical managers require EBP education. Further support is needed for PAs to publish, present, and remain in academia. Paramedic EBP education should be themed through each unit of an undergraduate course with an explicit teaching of the five steps early, integrated into practical clinical situations and featuring prominently in a capstone project. Key recommendations for practice include retaining and developing paramedic academics with appropriate mentors; facilitating research and training opportunities; and monitor wages to align with ambulance industry. Furthermore, recommendations for higher education delivery focus on ensuring EBP is integrated into all units in the paramedic undergraduate curricula and implementing a EBP education program for clinical supervisors. Recommendations for further research involve conducting a EBP2 -P study of paramedic students transiting into the workforce, development, and evaluation of assessing EBP competency using OSCEs in undergraduate paramedicine and developing a paramedic signature pedagogy consensus statement based on a systematic review and Delphi survey. This work has provided insights regarding the key role paramedic academics have in teaching EBP to paramedic undergraduates. Findings from the current study reinforce that progression has been made in developing the professional culture to support the integration of EBP as a critical component of paramedicine education and practice.

A urbanização é uma das grandes mudanças demográficas mais relevantes do mundo, no entanto é considerada um dos maiores fatores de risco para a saúde humana. Apesar das cidades fornecerem um melhor estilo de vida à população, devido a apresentarem melhor acesso a cuidados de saúde, melhores condições de vida, tendo em consideração fatores culturais, sociais e económicos. No entanto, a vida nas cidades apresenta também inúmeras consequências negativas. O número de pessoas que migram das áreas rurais para as urbanas é cada vez maior, assim sendo prevê-se que no ano de 2050 a população mundial excederá 9 biliões de habitantes e 67% desses, viverão em áreas urbanas. As migrações entre cidades, países e até mesmo continentes, aumenta enormemente o risco de transmissão de doenças infeciosas. Esta revisão teve como objetivo compreender o estilo de vida urbano, fazendo um estudo aprofundado das consequências positivas e negativas deste estilo de vida. Mostra também de que forma as doenças infeciosas podem afetar o ser humano neste tipo de comunidade e qual a importância da resistência antimicrobiana.<br>Urbanization is one of the most important major demographic changes in the world, however it is also considered one of the greatest risk factors for human health. Although cities provide a better lifestyle for the population, due to having better access to health care, better living conditions, taking into account cultural, social and economic factors life in cities also has numerous negative consequences. People migrating from rural to urban areas is increasing, so it is predicted that in the year 2050 the world population will exceed 9 billion inhabitants and 67% of these will live in urban areas. Migration between cities, countries and even continents, greatly increases the risk of transmitting infectious diseases. This review aimed to understand the urban lifestyle, making an in-depth study of the positive and negative consequences of this lifestyle. It also shows how infectious diseases can affect humans in this type of community and the importance of antimicrobial resistance.