Comparison of non-HDL cholesterol and waist circumference vs. triglyceride levels and waist circumference in predicting coronary heart disease risk

BACKGROUND: Dyslipidemia is recognized as a major cause of coronary heart disease (CHD). Emerged evidence suggests that the combination of triglycerides (TG) and waist circumference can be used to predict the risk of CHD. However, considering the known limitations of TG, non-high-density lipoprotein (non-HDL = Total cholesterol - HDL cholesterol) cholesterol and waist circumference model may be a better predictor of CHD. PURPOSE: The Framingham Offspring Study data were used to determine if combined non-HDL cholesterol and waist circumference is equivalent to or better than TG and waist circumference (hypertriglyceridemic waist phenotype) in predicting risk of CHD. METHODS: A total of3,196 individuals from Framingham Offspring Study, aged ~ 40 years old, who fasted overnight for ~ 9 hours, and had no missing information on nonHDL cholesterol, TG levels, and waist circumference measurements, were included in the analysis. Receiver Operator Characteristic Curve (ROC) Area Under the Curve (AUC) was used to compare the predictive ability of non-HDL cholesterol and waist circumference and TG and waist circumference. Cox proportional-hazards models were used to examine the association between the joint distributions of non-HDL cholesterol, waist circumference, and non-fatal CHD; TG, waist circumference, and non-fatal CHD; and the joint distribution of non-HDL cholesterol and TG by waist circumference strata, after adjusting for age, gender, smoking, alcohol consumption, diabetes, and hypertension status. RESULTS: The ROC AUC associated with non-HDL cholesterol and waist circumference and TG and waist circumference are 0.6428 (CI: 0.6183, 0.6673) and 0.6299 (CI: 0.6049, 0.6548) respectively. The difference in the ROC AVC is 1.29%. The p-value testing if the difference in the ROC AVCs between the two models is zero is 0.10. There was a strong positive association between non-HDL cholesterol and the risk for non-fatal CHD within each TO levels than that for TO levels within each level of nonHDL cholesterol, especially in individuals with high waist circumference status. CONCLUSION: The results suggest that the model including non-HDL cholesterol and waist circumference may be superior at predicting CHD compared to the model including TO and waist circumference.

THE PREVALENCE AND PREDICTION OF PULMONARY FIBROSIS IN AN

This thesis describes an ancillary project to the Early Diagnosis of Mesothelioma and Lung Cancer in Prior Asbestos Workers study and was conducted to determine the effects of asbestos exposure, pulmonary function and cigarette smoking in the prediction of pulmonary fibrosis. 613 workers who were occupationally exposed to asbestos for an average of 25.9 (SD=14.69) years were sampled from Sarnia, Ontario. A structured questionnaire was administered during a face-to-face interview along with a low-dose computed tomography (LDCT) of the thorax. Of them, 65 workers (10.7%, 95%CI 8.12—12.24) had LDCT-detected pulmonary fibrosis. The model predicting fibrosis included the variables age, smoking (dichotomized), post FVC % splines and post- FEV1% splines. This model had a receiver operator characteristic area under the curve of 0.738. The calibration of the model was evaluated with R statistical program and the bootstrap optimism-corrected calibration slope was 0.692. Thus, our model demonstrated moderate predictive performance.

The relationship between body mass index and breast cancer recurrence/progression and breast cancer-specific death

The aim of this study was to describe the nonlinear association between body mass index (BMI) and breast cancer outcomes and to determine whether BMI improves prediction of outcomes. A cohort of906 breast cancer patients diagnosed at Henry Ford Health System, Detroit (1985-1990) were studied. The median follow-up was 10 years. Multivariate logistic regression was used to model breast cancer recurrence/progression and breast cancer-specific death. Restricted cubic splines were used to model nonlinear effects. Receiver operator characteristic areas under the curves (ROC AUC) were used to evaluate prediction. BMI was nonlinearly associated with recurrence/progression and death (p= 0.0230 and 0.0101). Probability of outcomes increased with increase or decrease ofBMI away from 25. BMI splines were suggestive of improved prediction of death. The ROC AUCs for nested models with and without BMI were 0.8424 and 0.8331 (p= 0.08). I f causally associated, modifying patients BMI towards 25 may improve outcomes.

A study of self-directed learning at an Ontario college of applied arts and technology

Ontario Colleges of Applied Arts and Technology (CAATs) are currently in the process of restructuring to ensure quality, accountability, and accessibility of college education. References to learner involvement and self-directed learning are prevalent. "Alternative delivery" and "paradigm shift" are current buzzwords within the Ontario CAAT system as an environment is created supportive of change. Instability of funding has also dictated a need for change. Therefore, a focus has become quality of learning with less demand on public resources. This qualitative case study was conducted at an Ontario CAAT to gather descriptive, perceptual data from post-secondary community college educators who were identified as supportive of self-directed learning and from post-secondary, traditional-aged college students who were perceived by their educators to be selfdirected learners. This college was selected because of initiatives to modify its academic paradigm to encourage what was reputed in the Ontario CAAT system to be self-directed learning. The purpose of this study was to investigate how postsecondary, traditional-aged college students and their educators perceive self-directed learning as part of the teaching-learning experience within a community college setting. Educator participants of the study were selected based on the results of a teaching and learning survey intended to identify educators supportive of self-directed learning. A total of 317 surveys were distributed to every full-time educator at the sample college; 192 completed surveys were returned for a return rate of 61 %. Of these, 8% indicated instructional beliefs and values supportive of self-directed learning. A purposive sample of six educators was selected using a maximulp variation sampling strategy. A network selection sampling strategy was used to select a purposive sample of seven post-secondary students who were identified by the sample educators as selfdirected learners. The results of the study show that students and educators have similar perspectives and operating definitions of self-directed learning and all participants believe they either practice or facilitate self-directed learning. However, their perspectives and practices are not consistent with the literature which emphasizes learner autonomy or control in course structure and content. A central characteristic of the participants represented in this study is the service-oriented professions with which each is associated. Experientiallearning opportunities were highly valued for the options provided in increasing learner independence and competencies in reflective practice. Although there were discrepancies between espoused theory and theory in practice in terms of course structure, the process of self-directed learning was being practiced and supported outside the classroom structure in clinical settings, labs and related experiences.

Niagara alternative food projects : networks, discourses and nature /

This thesis undertakes an exploration of the nature of alternative food projects in Niagara. A review of various theoretical approaches to the study of food and agriculture, suggests that actor-network theory offers the most useful lens through which to understand these projects. In particular, actor-network theory facilitates non-dualistic theorisations of power and scale and a commitment to the inclusion of non-humans in the 'social' sciences. The research is based on 19 in-depth interviews with actors involved in various urban and rural projects including community supported agriculture, community gardens, chefs using local seasonal food, a winery that grows organically, the good food box, a value-added small business, and organic producers. The analysis consists of four themes. The first analytical section pays special attention to the prominence of agri-tourism in Niagara, and examines the ways in which the projects in the sample interact with agri-tourist networks. In the second section the discussion focuses on the discourses and practices of resistance among Niagara alternative food actors. The participants' interviews suggest there are more discourses of resistance toward agri-tourist than toward dominant food networks. The third section questions commodity chain theorisations of alternative food projects. In particular, this section shows how the inclusion of non-human actors in an analysis confounds conceptualisations of 'short' and 'local' chains. The final analytical section assesses relations of power in Niagara alternative food projects. Three important conclusions arise from this research. First, Niagara alternative food projects cannot be conceptualised as operating at the 'local' scale. Broadening the scope of analysis to include non-human actors, it becomes apparent that these projects actually draw on a variety of extra-local actors. They are at once local and global. Second, the projects in this sample are simultaneously part of alternative, dominant and agri-tourist networks. While Niagara alternative food projects do perform many of the roles characteristic of alternative food systems, they are also involved in practices of development, business, and class distinction. Thus, alternative food networks should not be understood as separate from and in direct opposition to dominant food networks. Despite the second conclusion, this research determines that Niagara alternative food projects have made significant strides in the reworking of power. The projects represented in this thesis do engage in resistant practices and are associated with increased levels ofjustice.

Forecasting the Yield Curve of Government Bonds: A Comparative Study

For the past 20 years, researchers have applied the Kalman filter to the modeling and forecasting the term structure of interest rates. Despite its impressive performance in in-sample fitting yield curves, little research has focused on the out-of-sample forecast of yield curves using the Kalman filter. The goal of this thesis is to develop a unified dynamic model based on Diebold and Li (2006) and Nelson and Siegel’s (1987) three-factor model, and estimate this dynamic model using the Kalman filter. We compare both in-sample and out-of-sample performance of our dynamic methods with various other models in the literature. We find that our dynamic model dominates existing models in medium- and long-horizon yield curve predictions. However, the dynamic model should be used with caution when forecasting short maturity yields

Registered Nurses' Perceptions about Facilitators and Barriers to Maternal Skin to Skin Contact in the Operating Room

Abstract It is recommended that all new mothers experience skin-to-skin contact (SSC) with their newborns immediately after birth. However, SSC is not commonly practiced after cesarean deliveries. To understand facilitators and barriers regarding SSC in the operating room (OR), a descriptive online and paper survey was conducted with 68 Registered Nurses from four hospitals in Ontario. The theory of planned behavior framed the study. Nurses had positive attitudes, and believed most health care team members supported SSC in the OR, but were uncertain about their control over the behavior. Nurses who had practiced the behavior in the past had more positive attitudinal and normative beliefs, and perceived some barriers as less difficult. Attitude and past behavior were the only significant multivariate predictors of intention to practice SSC in the future. Results suggest that shifting attitude and supporting more experience with the practice may increase nurses’ implementation of SSC in the OR.

Indenture between The Honourable Peter Russell, His Majesty’s Receiver General and William Dickson

Indenture between The Honourable Peter Russell, His Majesty’s Receiver General and William Dickson 10 acres bounded by a Port, and a Military Reserve. This document is slightly torn and taped. This does not affect the text – instrument no. 6507, Aug. 22, 1798.