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Cheung, Sok-yee, and 張淑儀. "Determinants of outpatient satisfaction in a specialist clinic in HongKong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B3197160X.
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Landguth, David C. "Public health specializations and education needs to support homeland security." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 2006. http://library.nps.navy.mil/uhtbin/hyperion/06Mar%5FLandguth.pdf.
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Thesis (M.A. in Security Studies (Homeland Security and Defense))--Naval Postgraduate School, March 2006.Thesis Advisor(s): Anke Richter. "March 2006." Includes bibliographical references (p.175-178). Also available online.
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Wong, Sau-Yee, and 黃秀怡. "Determinants of patient satisfaction towards medication information inSOPD patients: DISMIS study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31972330.
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Yi, Yuxiang, and 易宇翔. "Factors affecting adherence to new specialist outpatient appointments among elderly patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B2662798X.
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Mountcastle, Keitha K. "Barriers to research utilization among clinical nurse specialists /." For electronic version search Digital dissertations database. Restricted to UC campuses. Access is free to UC campus dissertations, 2003. http://uclibs.org/PID/11984.
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Thesis (Ed. D.)--University of California, Davis, 2003.Degree granted in Educational Leadership. Joint doctoral program with California State University, Fresno. Includes bibliographical references. Also available via the World Wide Web. (Restricted to UC campuses).
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Бідучак, Анжела Степанівна. "Training of specialists in sports medicine us and Ukraine." Thesis, Сучасні підходи до вищої медичної освіти в Україні (з дистанційним під’єднанням ВМ(Ф)НЗ України за допомогою відеоконференц-зв’язку) : матеріали XIV Всеукр. наук.-практ. конф. з міжнар. участю, присвяченої 60-річчю ТДМУ (Тернопіль, 18–19 трав. 2017 р.) : у 2 т. / Терноп. держ. мед. ун-т імені І. Я. Горбачевського. – Тернопіль : ТДМУ, 2017. – Т. 1. – 211 с, 2017. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/12389.
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Susanto, Steffenie. "Pediatric venipuncture| Child Life specialists' perspectives." Thesis, Mills College, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1538411.
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During procedures like venipuncture, Child Life Specialists are able to incorporate non-pharmacological measures when most medical staff focused on pharmacological measures. There is little research about what types of interventions Child Life Specialists believe are effective at minimizing children's pain and increasing coping skills during venipuncture. The purpose of the current study was to examine Child Life Specialists' perspectives on the different techniques available in the hospital setting. An online survey of 75 Certified Child Life Specialists asked about the types of techniques that Child Life Specialists use during venipuncture. Further, questions asked how Child Life Specialists felt about the efficacy of pharmacological and non-pharmacological techniques with a variety of different ages. Results revealed that Child Life Specialists felt that combining two techniques helps to minimize pain during venipuncture for pediatric patients more than the use of a single technique. These results applied to preschoolers, school-aged children and adolescents.
Keywords: child life specialist, venipuncture, pain, distress
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Williams, J. Gary. "Supervised autonomy : medical specialties and structured conflict in an Australian General Hospital /." Title page, contents and abstract only, 1991. http://web4.library.adelaide.edu.au/theses/09PH/09phw7242.pdf.
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Zweigenthal, Virginia E. M. "The contribution of public health medicine specialists to South Africa's health system." Doctoral thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/22843.
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Background: While South Africa's Constitution, health legislation and policies value public health (PH) approaches, Public Health Medicine (PHM) specialists are largely invisible in the health services. Despite this, many undertake specialist training. The reasons for this mismatch, for doctors' motivations for this training, and the career paths of PHM specialists are not known – nor is it known if their practice is aligned with the intentions of trainers, policy makers and employers. Postulates for their invisibility are that they are not required, are unknown, are interchangeable, not 'service-ready' or unavailable. Aims: This thesis investigates the match between 'desired', 'actual' and 'intended' use of doctors with PH expertise in contemporary South Africa. It explores the motivations of doctors undertaking PH studies, the actual careers of PHM specialists and the intended roles of this cadre of staff. Methods: Firstly, through an electronic survey, motivations for studying and career paths of doctors completing Master of Public Health (MPH) at the University of Cape Town – the foundational PH training for selected specialist training – were examined. Secondly, through focus groups and in-depth interviews, motivations for specialist training, anticipated career paths and perspectives of the future of PHM and of specialists-intraining (registrars), were probed. An on-line survey of PHM specialists' career paths, their reflections on the speciality's value and future was undertaken. Finally, through in-depth interviews, a qualitative study explored the perspectives of key stakeholders in South Africa's health service about PHM's value in the context of current health system reform. Findings: A number of factors underlie PHM's absence in the services. In post-apartheid South Africa, PH functions have been overshadowed by an inordinate focus on 'personal' curative services. Under current legislation, PHM is largely not a requirement for service positions, resulting in many participants (20%) not registering as specialists. PH practice is context-specific and its core functions are practised by others, resulting in overlapping boundaries between PHM and other trained professionals. Together with poor advocacy for the speciality, these resulted in PHM largely being eclipsed in health system design. In 2010, PHM comprised less than 200 specialists, mainly mature doctors who are increasingly female. There was a close match between 'desired', 'actual' and 'intended' roles of PHM specialists. Unlike doctors who undertook MPH studies to obtain research and technical skills, together with population approaches for career progression, PHM registrars and specialists trained to impact on health systems, underpinned by a commitment to social justice. Specialists' broad theoretical and experiential training produced versatile professionals able to work in complex service settings, with competencies spanning strategic and technical functions, which fast-tracked them for leadership. In 2010, a third of PHM specialists worked for the state health sector and a third for universities, mostly as managers or academics; the rest in NGOs, research institutions or independently. Besides those in 'joint appointment' health service and academic posts, less than a handful worked in designated service specialist posts. Specialists were highly satisfied with their careers. The majority had worked in the state sector at one time, but many had left to pursue academic and other careers. Although salaried specialists' remuneration had improved following the Occupational Specific Dispensation (OSD), this had not affected those in management and would not attract prospective specialists to management positions unless the work environment favouring autonomy and innovation improved. Despite an uneven presence, study participants agreed that the PHM's contribution centred on a 'public health intelligence' function – finding and interpreting information; supporting services through management and leadership; providing policy making and planning capacity and research at various levels. Some argued for PHM to be a requirement for senior line management posts in the future. Conclusions and recommendations: South Africa's current health reform is an opportunity for PHM to refine its professional identity, competencies and location. Being cognisant of its multi-disciplinary nature, it must locate itself in a common identity of a profession and workforce, in "a fabric of many professions dedicated to a common endeavour".10 A 'public health identity' needs to be constructed, reflecting the diverse PH professional functions.11 The desired size, shape and roles of the PH workforce, including PHM specialists, needs to be addressed through fora of PH stakeholders – the governmental health sector, civil society employers, universities, existing and prospective specialists - focussing on positions for specialists and PH professionals, the creation of posts, the design of training curricula, and registrar placements. Research that evaluates and explores the development of the PH workforce in South Africa, comparing it with other country settings, will inform the development and competency of the profession, and the health sector that aims to "improve quality of life for all".
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Hargrove, Tannis Mardece. "A phenomenological study of reiki practitioners and their perceptions of reiki as it relates to their personal health." CONNECT TO THIS TITLE ONLINE, 2008. http://etd.lib.umt.edu/theses/available/etd-05282008-162819/.
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Deason, Lynne Jenny. "The contamination level of campylobacter jejuni in retail chicken quarters." FIU Digital Commons, 1998. http://digitalcommons.fiu.edu/etd/2758.
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The purpose of this study was to determine the contamination level of Campylobacterjejuni in chicken quarters. Ninety-seven thigh and breast samples were purchased from thee supermarkets (Publix, Winn- Dixie, and Sedano's) in Miami-Dade County, Florida over an eight-week period. The bacteria were removed from the chicken skin by shaking the sample in a sterile bag containing nutrient broth. This extract was enriched in thioglycollate broth and subcultured onto selective media, which were incubated for 48 hours under microaerophilic conditions. Suspected colonies that were positive for the four biochemical tests performed were considered C. jejuni.
The overall rate of contamination was 62%. Publix had the highest rate of contamination, 72%. Winn-Dixie had a contamination rate of 66%. Sedano's had the lowest rate of contamination, 48%.
These findings show that the current methods used in preparing chicken for retail sale is not sufficient to eliminate pathogens, including Campylobacter jejuni.
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Gamper, Frederick. "Dysregulated toll-like receptor mechanisms : the cause of atherosclerosis?" Thesis, University of Sussex, 2011. http://sro.sussex.ac.uk/id/eprint/6904/.
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It is estimated that in the European Union 2 million deaths each year (42% of total) are as a result of cardiovascular disease, of which atherosclerosis is a major underlying factor. In 2006 this was estimated to cost the European Union an astonishing €192 billion. Once considered a lipid storage disorder it is becoming apparent that atherosclerosis is in fact due to an inflammatory dysfunction, with a number of endogenous and exogenous activators coming to light. The process of atheroma formation is poorly understood. This study seeks to discover the underlying mechanisms of plaque development with the view to develop novel therapeutics for this disease. Our results demonstrate a modulatory role of endogenous low density lipoprotein (LDL), “bad cholesterol”, on bacterial infections. Using primary human umbilical vein endothelial cells (HUVECs) I have shown that “non-self” oxidised LDL can reduce cell surface expression of pattern recognition receptors (PRRs) of the innate immune system, causing modulation of the cellular response directed towards atherosclerosis-associated bacterial pathogen-associated molecular patterns (PAMPs). Triple label fluorescent confocal microscopy of HUVECs revealed altered trafficking and targeting of PRRs of the innate immune system when endogenous LDL were combined with a bacterial infection in comparison to infection alone, indicating a source of the inflammatory dysfunction observed in this disease. This study illustrates that oxidatively modified LDL has a profound effect on bacterial infection, dramatically altering cellular response which may begin to explain the root cause of atherosclerosis. Through experimentation with human embryonic kidney (HEK) transfectants and HUVEC PRR silencing this study uncovered lipid raft dependant Toll-like receptors (TLRs) as fundamental culprits of this multi-factorial disease, with emphasis on TLR2 and TLR4. Future therapy designed for atherosclerosis will unquestionably involve the manipulation of TLR signalling.
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Rausch, Kimberly B. "An exploration into complementary and alternative medicine at home and abroad." Virtual Press, 2006. http://liblink.bsu.edu/uhtbin/catkey/1349767.
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The White House Commission on Complementary and Alternative Medicine Policy (WHCCAMP) suggests that CAM may be useful in contributing to the achievement of the nation's health objectives listed in Healthy People 2010 (Chapter 8: CAM and wellness in health promotion, 2002). The purpose of this study was to compare CAM practitioners and practices in Australia, where CAM has been embraced, to those in the United States. Overall there were many similarities and few differences between the two country's results. The themes that resulted from analyzing the transcripts of 5 in-depth interviews with practitioners included; collaboration and integration, community descriptions, general characteristics of practice, general characteristics of practitioner, growth and life purpose, holism, need for health culture change, personalized attention/tailored intervention, and technology use. The implications that resulted may inform users of CAM, students of medicine, and American citizens who desire safe alternative ways to improve their health.Fisher Institute for Wellness and Gerontology
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Ahluwalia, Vishwadeep. "Optimization of Functional MRI methods for olfactory interventional studies at 3T." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1953.
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Functional MRI technique is vital in investigating the effect of an intervention on cortical activation in normal and patient population. In many such investigations, block stimulation paradigms are still the preferred method of inducing brain activation during functional imaging sessions because of the high BOLD response, ease in implementation and subject compliance especially in patient population. However, effect of an intervention can be validly interpreted only after reproducibility of a detectable BOLD response evoked by the stimulation paradigm is first verified in the absence of the intervention. Detecting a large BOLD response that is also reproducible is a difficult task particularly in olfactory Functional MRI studies due to the factors such as (a) susceptibility-induced signal loss in olfactory related brain areas and (b) desensitization to odors due to prolonged odor stimulation, which is typical when block paradigms are used. Therefore, when block paradigms are used in olfactory interventional Functional MRI studies, the effect of the intervention may not be easily interpretable due to the factors mentioned above. The first task of this thesis was to select a block stimulation paradigm that would produce a large and reproducible BOLD response. It was hypothesized that a BOLD response of this nature could be produced if within-block and across-session desensitization could be minimized and further, that desensitization could be minimized by reducing the amount of odor by pulsing the odor stimulus within a block instead of providing a continuous odor throughout the block duration. Once the best paradigm was selected, the second task of the thesis was to select the best model for use in general linear model (GLM) analysis of the functional data, so that robust activation is detected in olfactory related brain areas. Finally, the third task was to apply the paradigm and model that were selected as the best among the ones tested in this thesis, to an olfactory interventional Functional MRI study investigating the effect of food (bananas) eaten to satiety on the brain activation to the odor related to that food. The methods used in this thesis to ensure valid interpretation of an interventional effect, can serve as a template for the experimental design of future interventional Functional MRI studies.
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Smith, Fiona Jane Elizabeth. "The ongoing care of patients with cancer : what is the appropriate balance of cancer care between specialists and primary care?" Thesis, University of Glasgow, 2015. http://theses.gla.ac.uk/5970/.
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Background: Mortality rates have fallen resulting in people living longer with cancer. However, cancer survivors can face significant treatment related physical and psychosocial issues including comorbidities. Treatment related side effects can persist in the long-term or may occur many years later. There is now a focus on the best way to provide appropriate care to people who have survived cancer and its treatment. Aim: The aim of this study is to explore the appropriate balance of cancer care for patients following diagnosis and treatment between specialist and primary care. Methods: Semi-structured interviews with a purposive sample of 40 oncologists, CNSs and GPs across Scotland. Data are analysed in a systematic fashion using constant comparison. Findings: Many patients face significant health care issues after a diagnosis of cancer. Professionals often play a pivotal role during follow-up by identifying and managing patients’ physical and psychosocial needs and by sign posting to address the challenges that arise. Psychosocial needs, long-term and late effects are sometimes not addressed. Oncologists are leaders of the cancer care process. CNSs often play a central role in survivorship both in specialist and primary care. GPs’ roles are seen to span the full spectrum of survivorship care, although this is largely opportunistic in nature. Communication between specialist and primary care is a key issue. Professionals perceived that there is insufficient contact across the interface in terms of understanding others’ viewpoints about the nature of their work. Efforts are needed to improve the timeliness and detail of letters to primary care. Successful primary care follow-up may require development of nurses’ roles in general practice and the community. It is perceived that GPs could attend specialist care for survivorship education or become cancer specialists in general practice. Cancer Care Reviews are considered useful tools in terms of allowing GPs to engage with their patients. Improvements to technology and further research are considered central to optimal cancer care. Conclusion: Considerable barriers exist with the current system of follow-up. After the treatment phase, GP survivorship care is largely opportunistic and driven by patients’ needs. Based on the findings from this study, strategies of care could potentially be planned to facilitate the role of primary care. However, research supporting these practices is needed.
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Hamdy, Ronald C., and E. Michael Lewiecki. "Osteoporosis (Oxford American Rheumatology Library), 1st Edition." Digital Commons @ East Tennessee State University, 2013. http://amzn.com/0199927707.
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The book distills the available information on osteoporosis into an easily comprehensible format that serves as a practical guide for busy clinicians.
Contents:Definition & epidemiology -- Basic bone pathophysiology -- Bone densitometry -- Diagnosis -- Identifying patients at risk of fractures -- Non-pharmacologic management of osteopenia and osteoporosis -- Pharmacologic management of osteoporosis, part 1 -- Pharmacologic management of osteoporosis, part 2 -- Monitoring patients on treatment -- Vertebral augmentation procedures -- Corticosteroid-induced bone loss -- Primary hyperparathyroidism -- Premenopausal women -- Men -- Atypical femoral shaft fractures -- Osteonecrosis of the jaw -- Osteoporosis in children and adolescents.https://dc.etsu.edu/etsu_books/1077/thumbnail.jpg
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Harrison, Anne Johnston. "Epileptogenesis Causes Long-Term Plasticity Changes in Calbindin D-28k in the Rat Pilocarpine Model of Acquired Epilepsy." VCU Scholars Compass, 2005. http://scholarscompass.vcu.edu/etd/855.
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Epilepsy is one of the most common neurological disorders, affecting more than 2% of children and 1% of adults in the U.S. Emerging research has demonstrated that calcium, as a major second messenger system, underlies many of these injury-induced plasticity changes associated with the development of epilepsy. Recent evidence has suggested that long term elevations in neuronal resting calcium levels play a role in initiating and maintaining epileptogenesis (the development of epilepsy). Collaborations between our lab and others have produced microarray data that suggests that a major calcium-binding protein, calbindin D-28k, mRNA levels are decreased in epileptic rats even up to one year following pilocarpine treatment. The goal of this research effort was to determine if epileptogenesis alters basal calcium levels by producing a long-term change in the expression of the major calcium binding protein in neurons, calbindin D-28k. Immunohistochemistry (MC) and western blot experiments have been conducted to test the hypothesis that epileptogenesis produces a long lasting decrease in the expression of calbindin in the hippocampus in the rat pilocarpine model of acquired epilepsy. IHC experiments indicated that changes in calbindin expression occur gradually over a 2-4 week interval after the initial injury. Significant decreases in calbindin immunoreactivity are seen in the hippocampus of epileptic animals, at one month, four months, and six months post-pilocarpine treatment. However, these changes were not seen as early as 4 days post-status epilepticus. Western blots quantitated differences between epileptic animals and naive controls. Long lasting decreases in calbindin may play an important role in the altered calcium homeostatic mechanisms observed in epileptic neurons. These findings will help to elucidate one of many changes that occurs in epilepsy.
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Wright, Suzanne. "Predictors of Situation Awareness in Graduate Student Registered Nurse Anesthetists." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/2014.
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ABSTRACT PREDICTORS OF SITUATION AWARENESS IN GRADUATE STUDENT REGISTERED NURSE ANESTHETISTS Suzanne M. Wright, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2009 Major Director: J. James Cotter, Ph.D. Situation awareness (SA) is defined as one’s perception of the elements of the environment, the comprehension of their meaning, and the projection of their status in the near future. Stated more simply, SA is knowing what is going on around you. The concept of SA is well known in the field of aviation which is characterized by complexity and dynamism. The discipline of anesthesia shares these same characteristics, yet the study of SA in this setting is in its infancy. Human error has been implicated in nearly 80% of all preventable medical errors. It is well documented that lack of SA frequently contributes to human error. Although the discipline of anesthesia has led the medical field in patient safety through rigorous study of human error and adverse events in the operating room, crises in anesthesia still exist. Nurse anesthetists should possess the ability to acquire and maintain SA at all times during clinical situations in the operating room, yet there are no studies examining SA in this population. Guided by Endsley’s theory of situation awareness, the purpose of this study was to provide nurse anesthesia educators with a best evidence predictor model of SA in GSRNAs for curricular implementation. The study objectives are to determine: a) the extent to which memory, cognition, and automaticity are related to situation awareness, b) the extent to which any relationship amongst memory, cognition, and automaticity mediates their relationship with situation awareness, and c) the extent to which Endsley’s theory of situation awareness is supported in the GSRNA population. After IRB approval, 71 GSRNAs were randomly selected from each of three universities chosen for this study. A non-experimental, correlational design was used to measure the relationship between memory, cognition, and automaticity and SA. Situation awareness was measured by the WOMBAT-CS, a computer-based assessment tool for evaluating SA in complex-system operators such as pilots, air traffic controllers, and anesthetists. A stepwise multiple regression was performed between the GSRNA attributes and SA scores. Beta-weights were used to identify the magnitude each relationship. Findings from this study revealed that cognition best predicts SA in the population of Graduate Student Registered Nurse Anesthetists, with the addition of memory and automaticity contributing no additional predictive value to the model. The results of this study have the potential to make a positive impact on the education and training of GSRNAs. Additionally, this study may provide foundational support for further research directed at assessing the effectiveness of high-fidelity simulated operating room environments in promoting SA in GSRNAs.
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Szkil, Andrea Michelle. ""Here everything is possible" : forensic specialists' work with human remains in post-war Bosnia and Herzegovina." Thesis, University of Sussex, 2013. http://sro.sussex.ac.uk/id/eprint/45169/.
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This thesis explores the work carried out by forensic specialists employed by the International Commission on Missing Persons (ICMP). Headquartered in Sarajevo, Bosnia and Herzegovina (BiH), ICMP assists the work of local governments around the world in addressing the issue of missing persons following armed conflict, atrocities, and natural disasters. This thesis focuses on ICMP's efforts to aid the Bosnian government in locating, exhuming, and identifying the remains of the individuals who went missing during the country's recent war (1992-1995). Utilising data obtained via interviews with and observations of ICMP staff members, it primarily represents a study of the management of professional identity in emotionally charged situations, examining the experiences of the forensic specialists who work in the organisation's three mortuary facilities throughout BiH. It explores forensic specialists' work with human remains, their interactions with victims' family members, and their attendance at events in which victims are commemorated and/or buried. Discussion of forensic specialists' experiences with the deceased brings into consideration their varying responses to the remains, emphasising the prevalence and perceived importance of emotional detachment. Situations in which emotional detachment from the remains may prove challenging are considered, as are the varying techniques forensic specialists utilise in managing emotional responses to their work. Examination of forensic specialists' interactions with the living suggests their general dislike of these encounters, although the positive aspects of these interactions are also examined. Exploration of forensic specialists' opinions of attending burials and/or commemorations brings into further consideration the balance between emotional attachment and detachment. While respondents noted the importance of maintaining an emotional connection to their work, they nevertheless emphasised the importance of avoiding such responses while in the mortuary. Commemorations and/or burials become ‘safe spaces' for forensic specialists to express and experience emotional responses to their work that are not overtly professional.
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de, las Pozas Georgia. "The relationship between acculturation and the effects of caregiving of the elderly among Cuban-Americans." FIU Digital Commons, 1999. http://digitalcommons.fiu.edu/etd/3017.
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The purpose of this study was to establish the perceived caregiving effects among thirty Cuban-born individuals caring for elderly relatives and the relationship of these effects with acculturation.
Most common difficulties were lack of private time, or social life, and decreased emotional and physical health. Satisfactions were mostly derived from fostering the elders' welfare. A strong positive relationship was found between caregivers' difficulties and stability of the caregiving dyad (r= - 0.642, p< .001). Caregivers involved in more unstable caregiver-care receiver dyads had more stress associated with caregiving difficulties. The acculturation factors of language, electronic media, and social relations, and the stability of the caregiving dyad accounted for 54 percent of the variation in caregivers' difficulties (p< .001) but only 21 percent of the variation of caregivers' satisfaction (p<.221).
These findings provided preliminary data of caregiving characteristics among Cuban-Americans and the importance of including acculturation in studies involving minorities.
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Owusu-Boakyewaah, Olivia. "THE CULTURAL CONTEXT OF ALZHEIMER’S DISEASE: THE IMPACT OF PERCEPTION AND KNOWLEDGE ON WILLINGNESS TO SEEK MEDCIAL [i.e., medical] HELP AMONG GHANAIAN IMMIGRANTS IN THE UNITED STATES." VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/2465.
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This correlational study explored the knowledge, perceived seriousness, and willingness to seek medical help for Alzheimer’s Disease (AD) among Ghanaian Immigrants currently residing in the Unites States. Study participants were 163 Ghanaian Immigrants between the ages of 45 and 90, attending Ghanaian community churches in Virginia and Maryland. Significant results include a positive correlation between knowledge and perceived seriousness of the disease, perceived seriousness of the disease was negatively correlated with caregiving experience. These results as well as several seemingly counterintuitive findings are discussed in terms of the Health Disparities and Psychometric challenges. Specifically, these results points to the necessity for future research and implication for action in the following areas: 1) Further qualitative exploration to develop a deep, rich understandings of the phenomenon of AD among Ghanaian Immigrants, 2) Improved cultural sensitivity in psychometric assessment with immigrant populations of AD knowledge, perceptions, and willingness to seek assistance, 3) Person Centeredness and Cultural Humility in Educational Interventions to empower individuals and parallel existing cultural beliefs rather than displacing them.
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Fay, Vanessa. "Maternal-fetal medicine specialists' experiences of conducting feticide as part of termination of pregnancy : an interpretative phenomenological analysis." Thesis, University of Sheffield, 2013. http://etheses.whiterose.ac.uk/4692/.
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Todd, Catherine Angela. "A clinically valid simulator with tactile sensing to train specialists to perform cochlear implantation." Access electronically, 2006. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20070208.171637/index.html.
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Pugh, Dale M. "A phenomenological study of clinical decision making by flight nurse specialists in emergency situations." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1999. https://ro.ecu.edu.au/theses/1249.
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Clinical decision making is an integral, multifaceted phenomenon fundamental to nursing practice. The domain of flight nursing practice is unique in terms of knowledge, structure, clinical presentations and environment. The uniqueness and diversity of patient scenarios and the advanced practice level of the flight nurse role blend to provide a potential rollercoaster flight mission. At the time this research was conducted nursing standards to guide clinical decision making were being developed. Medically orientated clinical guidelines were in place, but they were designed to highlight a specific, well defined clinical scenario or skill. It has been argued that guidelines for nursing practice do not always parallel the complex clinical situations in which advanced practitioners may find themselves (Malone, 1992b). Flight Nurse Specialists (FNSs) with greater than two years flight nursing experience employed by the Royal Flying Doctor Service (RFDS) - Western Operations were interviewed regarding their experiences of clinical decision making in emergency situations. Using a phenomenological methodology, indepth interviews were audiotaped and transcribed. The interviews were analysed using the method described by Colaizzi (1978). Data was described and interpreted, common themes were extrapolated and analysed. A Gestalt of Knowing was identified by the interconnection and interrelationships of the extrapolated themes. The three themes are: Ways of Knowing the Patient, Context of Knowing and Reflective Practice. Ways of Knowing the Patient is constructed with the sub-themes intuitive knowing, experiential knowing and objective knowing. The second theme, Context of Knowing, is made up of the sub-themes aviation environment, non or minimised involvement in triage, knowing co11eagues, solo practitioner, experiential level and practice guidelines. Self-critique and change in practice formed the theme Reflective Practice. Findings provide a significant contribution to the knowledge of clinical decision making in nursing and to the practice of flight nursing in the Western Australian context. Several recommendations arose from the findings in relation to further research, policy making, standards development and practice developments. Further research is needed into the themes and sub-themes. FNSs need to be allowed to undertake the role of triage for those flights that they will undertake as the solo health professional. The development of standards for flight nursing would benefit from the consideration of the findings of this study and other qualitative studies of clinical decision making. Reflective practice should be considered as a mechanism for not only evaluating practice but as a mechanism for identifying stressful events.
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Chanti-Ketterl, Marianne. "Lipoproteins and Health Outcomes: Cognitive and Physical Function in Older Adults." Scholar Commons, 2015. http://scholarcommons.usf.edu/etd/5920.
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Cardiovascular health is a major determinant of quality of life and mortality, especially in older adulthood. With the world’s oldest population increasing at expedited rates, challenges from cardiovascular conditions and its implications are spawning. Although it is well known that dyslipidemia may lead to cardiac events, less is known about the effects on cognitive and physical function in older adults. Epidemiological studies show that optimizing current preventive strategies even at older ages may reduce the incidence of cardiovascular comorbidity (e.g. hypertension, stroke) and increase quality of life. Determining the association between lipoproteins and cognitive and functional performance in older adults may help develop interdisciplinary interventions designed to maintain independence longer and improve the overall quality of life.
The current dissertation contains two studies examining serum lipoproteins, specifically total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) in older adults in relation to cognitive and functional outcomes. The first study examined the association between lipoproteins and cognitive performance in a cognitively normal older adult population. Results showed an association between low levels of TG and higher composite cognitive scores (CCS), but this association disappeared when apolipoprotein ε4 allele (APOE ε4 allele) was adjusted for in the model. High levels of HDL-C were also associated with the CCS and this association remained significant even after adjusting for APOE ε4 allele. Furthermore, these associations were only significant among women. High HDL-C remained linked with visuospatial function and attention and working memory even after adjusting for APOE ε4 allele. Further moderation analysis indicated that the association between TGs, HDL-C and cognitive performance was moderated by the APOE ε4 allele. Stratification by carriers and non-carriers of the ε 4 allele indicated that the previous association was only significant for non-carriers.
The second study of this dissertation is a longitudinal analysis, which explored the association between TC, LDL-C, TG and HDL-C and physical function. Random effects analysis was used to assess whether lipoprotein levels affect subsequent change in physical function. All models were adjusted for baseline age, sex, education, and perceived current economic situation, cardiovascular risk factors and comorbidity inclusive of cognitive disability. Results showed that lower levels of TC and HDL-C had cross-sectional associations with more ADL disability but not longitudinally, and higher levels of TG were related to better grip function. Moderation analysis of the previous significant association indicated that only cognitive disability moderated the cross-sectional association between TC and for ADLs. Further stratification showed that the association was only pertinent for participants with cognitive disability. Independent of cardiovascular risk factors and an extensive list of comorbidities, older adults living in the community with higher levels of TC, TG and HDL-C were associated with better physical function outcomes. Lipid patterns in older adults may be indicative of physical function and may serve clinicians as a tool to compress morbidity in older adults and help them maintain independence and a high quality of life for as long as possible.
In conclusion, lipid levels in older adults play an important role in maintaining cognitive and physical function into older ages, thus maintaining a good quality of life. Higher HDL-C seemed to be the lipid associated with maintaining cognitive function, while TC dominated the association with physical function.
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Falenski, Katherine Winslow. "Functional Redistribution of Hippocampal Cannabinoid Cb1 Receptors in the Rat Pilocarpine Model of Acquired Epilepsy." VCU Scholars Compass, 2006. http://scholarscompass.vcu.edu/etd/1280.
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Cannabinoids, such as the marijuana derivative Δ9-THC, are known to have CBl receptor-mediated anticonvulsant effects in several animal models of seizures and epilepsy, including the rat pilocarpine model of acquired epilepsy. However, the distribution of CBl receptor expression and function in brains of epileptic rats has not been characterized. Therefore, this dissertation was initiated to evaluate the effect of epileptogenesis on the distribution and function of the endogenous CBI receptor system in the rat pilocarpine model, a well-established model of acquired temporal lobe epilepsy. Using immunohistochemistry, we demonstrated that chronically epileptic rats exhibit a unique, long-term, and specific redistribution of hippocampal CBl receptors when compared to controls, with concurrent layer-specific increases and decreases in CBl receptor expression within the hippocampus. In addition, studies in this dissertation demonstrated using [3H] WIN55,212-2 autoradiography and agonist-stimulated [35S]GTPγS autoradiography that this CBl receptor-specific reorganization results in corresponding functional changes manifested by alterations in CBl receptor binding and G-protein activation. These regionally selective changes were dependent on NMDA receptor activation during the initial insult of pilocarpine-induced status epilepticus (SE), and were independent of seizure suppression produced with phenobarbital administration in epileptic rats. Furthermore, time-course studies utilizing these techniques demonstrate that within a week following SE, a widespread loss of CBl receptor expression and function occurs throughout the hippocampus. The subsequent redistribution of CBl receptors that occurs temporally correlates with the emergence of spontaneous recurrent seizures, and is still observed up to 1 year following SE. Overall, the reorganization of cannabinoid receptors in epilepsy implicates the endocannabinoid system in modulating neuroexcitability in the epileptic state. This CBl receptor redistribution represents an essentially permanent neuronal plasticity change associated with epileptogenesis, and could account for the anticonvulsant effect of cannabinoids observed in this model.
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Sardina, Angela. "Pain and Physical Function in a Socioeconomically Diverse Sample of Black and White Adults." Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6948.
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Musculoskeletal pain alters physiological function and these changes may be evidenced as early as middle age. Previous research has concluded that middle-aged adults are a high-risk group for chronic pain and report functional limitations similar to older adults. However, few studies have explored the unique individual factors (e.g., sociodemographic, health, and psychosocial characteristics) that may drive the pain experience; and more research is needed that examines the relationships between musculoskeletal pain and physical function, using objective performance measures, in a sample of racially and socioeconomically diverse adults.
Data from the Healthy Aging in Neighborhoods of Diversity across the Life Span Study (HANDLS) were analyzed across two cross-sectional studies. The first study examined the association between subjective (self-reported) and objective measures of pain (passive range of motion) of the hands, neck and low back. Additionally, this study explored the unique predictors that may be associated with inconsistency between subjective and objective measurements of pain. Results indicated weak but significant correlations between subjective and objective hand- pain measurements. However, there were no significant correlations identified between subjective and objective neck-pain measurements, or subjective and objective low back pain measurements.
Three binary logistic regression models were conducted to explore the relationship between sociodemographic (Model 1), health (Model 2), and psychosocial characteristics (Model 3) of consistent and inconsistent pain measurements for each pain site. There were no significant relationships between sociodemographic, health, or psychosocial characteristics and consistent and inconsistent hand pain measurements. However, individuals who reported a history of depressive symptoms were nearly 1.8 times more likely to report inconsistent neck pain. Follow-up analyses to explore two-way interactions across unique predictors identified that individuals with a history of depressive symptoms, who were below poverty status, were nearly 3 times more likely to report inconsistent neck pain. Additionally, females, individuals with a greater number of comorbidities, and those with a history of depressive symptoms tended to demonstrate inconsistent low back pain. Follow-up analyses identified that those who identified a history of depressive symptoms, and reported the quality of their neighborhood as “poor” to “fair”, were 3.3 times more likely to demonstrate inconsistent low back pain measurements.
The second study examined the relationship between pain, pain interference and a global measure of physical function. Additionally, the study investigated whether relationships between pain, pain interference, and global physical function were moderated by sociodemographic characteristics (e.g., age, sex, race, and measures of socioeconomic status). In multivariable regression analyses, musculoskeletal pain was significantly associated with physical function, particularly among middle-aged and older individuals. Additionally, pain interference was significantly associated with physical function, particularly among older adults.
This dissertation strives to further our understanding of the unique factors that contribute to individualized pain experiences among under-represented populations, and to identify functional deficits that may be evidenced earlier in the life course. Furthermore, this dissertation is intended to motivate further research that explores appropriately timed non-pharmacological interventions that are tailored to the needs of diverse groups, in efforts to reduce musculoskeletal pain, pain interference, and sustain functional independence in later life.
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Belyea, Michelle Anne. "The Effects of Needle Play on Pre-School Children's Anxiety Concerning Injections." VCU Scholars Compass, 1985. http://hdl.handle.net/10156/1328.
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Chen, Tuo Yu. "The Effects of the A Matter of Balance Program on Falls, Physical Risks of Falls, and Psychological Consequences of Falling among Older Adults." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4808.
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The effectiveness of the A Matter of Balance (MOB) program, a multifactorial falls prevention intervention, is uncertain. Although targeting multiple risk factors of falling at the same time seems reasonable and desirable, in that falls are often caused by several risk factors, results from previous studies investigating the effects of multifactorial falls prevention interventions are inconsistent. In addition, research shows that single factor interventions (e.g., exercise) can produce the same effects. The cost-effectiveness of multifactorial falls prevention interventions has varied across studies (e.g., Jenkyn, Hoch, & Speechley, 2012; Tinetti, Baker, et al., 1994). Despite the fact that the American Geriatrics Society and British Geriatrics Society (2001) have incorporated multifactorial falls prevention interventions into geriatric practice guidelines, more studies are needed to better understand the effects of the MOB program on falls and risk factors for falling among older adults.
The MOB program aims to reduce fear of falling by increasing self-efficacy and perceived control (Tennstedt et al., 1998). This program provides exercises to enhance older adults' physical capacities, lessons to teach seniors fall-related risk factors, and methods to enhance self-efficacy. Previous studies mainly focused on the effects of the MOB program on fear of falling and falls efficacy. However, falls, fear of falling, and physical frailty (e.g., poor balance) are all correlated. Little is known about the effects of the MOB program on falls and related physical risk factors. Meanwhile, fear of falling and falls efficacy are two constructs often used to delineate psychological consequences of falling, but there has been confusion about these two constructs. As a result, researchers have been using measures developed for falls efficacy to assess fear of falling in error. Previous study also shows that both fear of falling and falls efficacy need to be examined after intervention with separate appropriate measures(e.g., Valentine, Simpson, Worsfold, & Fisher, 2011). Nevertheless, in the research of the MOB program, studies often examined either fear of falling or falls efficacy, but not both (e.g., Tennstedt et al., 1998; Zijlstra et al., 2009). Therefore, whether the MOB program could improve both fear of falling and falls efficacy is uncertain.
This dissertation includes three studies to examine the effects of the MOB program. The first study explores whether the program could effectively prevent falls and improve physical risk factors (i.e., mobility, walking speed, and postural control) among older adults. The second study examines the psychometric properties of a modified fear of falling measure and the effects of the program on fear of falling and falls-efficacy. The third study investigates whether the effects of the MOB program on falls, mobility, walking speed, and postural control can be maintained across five months. Three studies using a comparison group design were conducted to examine each objective. Data were collected at baseline (Time 1), the conclusion of the program (Time 2), and at a 3-month follow-up (Time 3).
Overall, the studies in this dissertation show that older adults can improve their mobility, walking speed, postural control, fear of falling, and falls efficacy by participating in the MOB program but the program did not affect the total number of falls. The results also showed that older adults who received the MOB program reached their highest performance on mobility and walking speed immediately at the end of the program. However, their performance on postural control continued to improve and was the best at the 3-month follow-up.
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Corbett, Gina M. "The Corbett Pain Scale : a multidimensional pain scale for adult intensive care patients /." VCU Scholars Compass, 2006. http://hdl.handle.net/10156/1432.
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Fihosy, Sonia M. "Exploring culture and illness." Thesis, Canterbury Christ Church University, 2015. http://create.canterbury.ac.uk/13856/.
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A grounded theory exploration of cultural and spiritual influences on adjustment in adolescents with liver disease. The evidence-base for adjustment in adolescents with liver disease is minimal, but treatment non-adherence in adolescent liver transplant recipients is known to range between 17-53%, increasing medical complication risks. Evidence has also shown that spirituality impacts on illness perceptions and behaviours of adolescents with other diseases. In this study, ten semi-structured interviews were conducted with 16-24 years olds, recruited from a regional liver clinic in the UK. Half were liver transplant recipients. The study found that navigating cultural expectations was challenging, particularly around education, employment and socialising (e.g. participation with peers and avoiding alcohol). Several participants reported an illness-related spiritual or socio-cultural crisis, sometimes resulting in non-adherence. This seemed to be followed by a turning point, eventually leading to a state of acceptance, personal development and possibly, spiritual growth. Trusted individuals were often instrumental in helping participants to overcome difficulties. However, for some, adjustment was transitory. As such, this appeared to be a cyclical process, entangled with universal adolescent developmental tasks. The study concluded that more exploration is required on treatment adherence and overall functioning in adolescents with liver disease, taking into account socio-cultural and spiritual influences.
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Vedam, Subrahmanya. "Management of Respiratory Motion in Radiation Oncology." VCU Scholars Compass, 2002. http://scholarscompass.vcu.edu/etd_retro/162.
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Respiratory motion poses significant problems in the radiotherapy of tumors located at sites (lung, liver, pancreas, breast) that are affected by such motion. Effects of respiratory motion on the different stages of the radiotherapy process (imaging, treatment planning and treatment delivery), has formed the focus of significant research over the last decade. Results from such research have revealed that respiratory motion affects the instantaneous position of almost all structures in the thorax and abdomen to different degrees based on their corresponding anatomic location and muscular attachments. As an example, diaphragm motion was found to be of the order of 1.5 cm, predominantly in the superior-inferior (SI) direction during normal breathing. This indicates a similar magnitude of motion for tumors located in the lower lobes of the lung and in the abdomen.The conventional method of accounting for such motion is to add a margin (based on an estimate of the expected range of organ motion) around the clinical target volume (CTV) that is delineated from the image data. This margin also includes errors due beam-bony anatomy alignment during radiation delivery and errors in patient position between simulation and subsequent treatment delivery sessions. Such a margin estimate may or may not encompass the "current" extent of motion exhibited by the tumor, resulting in either a higher dose to the surrounding normal tissue or a potential cold spot in the tumor volume. Several clinical studies have reported the existence of a direct relationship between the reduction in mean dose to the lung and the incidence of radiation induced pneumonitis. Therefore, subjecting additional normal lung tissue to high dose radiation by adding large margins based on organ motion estimates may result in an increased risk of radiation induced lung injury.Monitoring and accounting for respiratory motion can however potentate a reduction in the amount of normal tissue that receives high dose radiation, thereby decreasing the probability of normal tissue complication and also increasing the possibility for dose escalation to the actual tumor volume. The management (monitoring and accounting) of respiratory motion during radiation oncology forms the primary theme of this dissertation.Specific aims of this thesis dissertation include (a) identifying the deleterious effects of respiratory motion on conventional radiation therapy techniques (b) examining the different solutions that have been proposed to counter the deleterious effects of respiratory motion during radiotherapy (c) summarizing the relevant work conducted at our institution as part of this thesis in addressing the issue of respiratory motion and (d) visualizing the future direction of research in the management of respiratory motion in radiation oncology.Among the various techniques available to manage respiratory motion in radiation oncology such as respiratory gated and breath hold based radiotherapy, our research initially focused on respiratory gated radiotherapy, employing a commercially available external marker based real time position monitoring system. Multiple session recordings of simultaneous diaphragm motion and external marker motion revealed a consistent linear relationship between the two signals indicating that the external marker motion (along the anterior-posterior (AP) direction) could be used as a "surrogate" for motion of internal anatomy (along the SI direction). The predictability of diaphragm motion based on such external marker motion both within and between treatment sessions was also determined to be of the order of 0.1 cm.Analysis of the parameters that affected the accuracy and efficacy of respiratory gated radiotherapy revealed a direct relationship between the amount of residual motion and the width of the "gate" window. It also followed therefore that a trade-off existed between the width of the "gate" and the accuracy of gated treatments and also the overall "Beam ON" time. Further, gating during exhale was found to be more reproducible than gating during inhale. Although, it was evident that a reduction in the width of the "gate" implied a reduction in the margins added around the clinical target volume (CTV), such a reduction was limited by setup error.A study of the potential gains that could be derived from respiratory gating (based on motion phantom experimental set up) indicated a potential CTV-PTV margin reduction of 0.2-1.1 cm while employing gating alone in combination with an electronic portal imaging device, thus decreasing the amount of healthy tissue receiving radiation. In addition, gating also improved the quality of images obtained during simulation by reducing the amount of motion artifacts that are typically seen during conventional spiral CT imaging.Imparting some form of training was hypothesized to better enable patients to breathe in a reproducible fashion, which was further thought to increase the accuracy and efficacy of gated radiotherapy, especially when the "gate" was set close to the inhale portion of the breathing cycle. An analysis of breathing patterns recorded from five patients over several sessions under conditions of normal quiet breathing, breathing with audio instructions and breathing with visual feedback indicated that training improved the reproducibility of amplitude or frequency of patient breathing cycles.An initial exploration into respiration synchronized radiotherapy was thought to facilitate realization of reduced margins without having to hold the radiation beam delivery during a breathing cycle (as is the case with gating). A feasibility study based on superimposition of respiratory motion of a tumor (simulated by a sinusoidal motion oscillator) onto the initial beam aperture as formed by the multileaf collimator (MLC) revealed that tumor dose measurements obtained with such a set up were equivalent to those delivered to a static tumor by a static beam.Finally, a feasibility study for a method to acquire respiration synchronized images of a motion phantom and a patient (in order to perform respiration synchronized treatment planning and delivery) yielded success in the form of a 4D CT data set with reduced motion artifacts.In summary, respiratory gated radiotherapy and respiration synchronized are both viable approaches to account for respiratory motion during radiotherapy. While respiratory gated radiotherapy has been successfully implemented in some centers, several technical advances are required to enable similar success in the implementation of respiration synchronized radiotherapy. However, the potential clinical gains that can be obtained from either of the above approaches and their relative contributions to margin reduction will determine their future applicability as routine treatment procedures.
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Craig, Aaron C. "A National Investigation of Pre-Activity Health Screening Procedures in Fitness Facilities: Perspectives from American College of Sports Medicine Certified Health Fitness Specialists." Scholar Commons, 2014. http://scholarcommons.usf.edu/etd/5461.
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It is well established in the literature that the morbidity and mortality rates due to chronic diseases such as cardiovascular disease, cancer, hypertension, and diabetes in the U.S are alarmingly high. Likewise, there is ample data which demonstrates that participating in physical activity can help prevent and control many types of chronic diseases. Though the benefits outweigh the risks of participation in physical activity, the risks must be acknowledged.
Published standards and guidelines in the health fitness field have been established to address operational practices of fitness facilities, increase safety of participants and mitigate these risks. The present study was a national investigation conducted to determine adherence to published standards and guidelines for self- and professionally-guided pre-activity health screening procedures (PHSP) across various settings (i.e., Hospital/Clinical, Community, Commercial, Corporate, University, Government). Additionally, this study obtained perspectives from study participants regarding familiarity with, importance of adherence to and legal liability associated with published standards and guidelines. As the American College of Sports Medicine (ACSM) is considered the gold standard in health and fitness, only ACSM's published standards and guidelines, specifically those related to pre-activity health screening, were included in the present study.
A survey instrument was developed and validated to obtain the data for this study. The link for the web-based survey was sent from the ACSM's Certification Department to all ACSM Health Fitness Specialists (HFS) who lived in the US (n=9,433); a total of 1,246 (13.2%) responded to the survey. The survey instrument consisted of 54 questions including 14 participant related (i.e., Q1, Q3, Q34-Q45), 32 facility related (i.e., Q2, Q4-Q33, Q46), seven demographic related (Q47-Q53), and one open-ended question (Q54). Exclusion criteria removed any HFS who was not currently working part- or full-time in a fitness facility, which left 677 usable responses for data analysis. Special measures were taken to remove duplicate responses for any given facility which resulted in a lower number of usable responses (n=656) for those 32 questions.
As hypothesized, the Hospital/Clinical setting had significantly (p<.006) higher percentages of fitness facilities (93%) which require new participants to complete a pre-activity screening device than all other settings (i.e., University (56%), Community (54%), Commercial(40%), and Government (67%)). Additionally, the Hospital/Clinical setting was also found to be significantly higher than Corporate relative to this same variable. Regarding the second research hypothesis, the Corporate setting was found to have significantly (p<.006) higher percentages (78%) of fitness facilities which require new participants to complete a pre-activity screening device than the Community setting.
Twenty-six percent of respondents indicated they their facility conducted self-guided, 43% professionally guided, and 31% offered both self- and professionally-guided PHSP. High percentages of fitness facilities (73%) required new participants to complete a pre-activity screening device with 47% and 87% of these facilities requiring medical clearance for at-risk new participants for self- and professionally-guided screening procedures, respectively. At-risk was defined in the study as someone with known disease (e.g., cardiac, pulmonary or metabolic) or with signs/symptoms and/or risk factors associated with cardiac, pulmonary, or metabolic disease. Also, participants with other medical conditions (e.g., pregnancy, orthopedic injury) may be considered at- risk. The majority (86%) of facilities offered personal training and nearly all of these (99.6%) required clients of personal trainers to complete a pre-activity screening device. Additionally, 84% of these facilities required medical clearance for at-risk clients. Data regarding other aspects of PHSP for facilities were also obtained such as frequency of completion for participants, privacy, confidentiality, and security of information obtained, participant refusal to complete, and waivers for guests.
Regarding their familiarity, 69% of respondents indicated that they were very familiar with the ACSM's Guidelines for Exercise Testing and Prescription (ACSM's GETP); however only 52% indicated they used the ACSM's GETP for development and implementation of their facility's PHSP. Of these facilities, the results regarding the inclusion of the GETP criteria on their screening device were: (a) 96%, 91%, 87% for known CV, pulmonary and metabolic disease, respectively, (b) 44-95% for each of the nine signs/symptoms with dizziness/syncope the highest (95%) and intermittent claudication the lowest (44%), and (c) 64%- 99% for each of the nine CV risk factors with smoking the highest (99%) and high-density lipoprotein the lowest (64%).
Although 52% of respondents reported more than adequate academic preparation, 70% reported being very confident in conducting professionally-guided pre-activity health screening procedures and that adherence to published standards and guidelines was very important. However, only 28% of respondents reported more than adequate academic preparation regarding legal implications involving PHSP. Other data from the HFSs regarding PHSP were also obtained such as their perspectives of the importance to management to adhere to and familiarity with published standards and guidelines as well as their knowledge of legal issues related to PHSP. In the open-ended question, respondents provided comments and challenges (n=509) that they encountered while conducting PHSP. These data were analyzed, coded and then categorized into three major themes: 1) medical clearance related issues, 2) administrative/procedural related issues, 3) member related issues.
Compared to previous research, adherence to published standards and guidelines, as evidenced by the percentage of facilities which require new participants and clients of personal trainers to complete a pre-activity screening device, seems to be generally increasing. Additionally, relative to the requirement of medical clearance for personal training clients also seems to demonstrate an upward trend. However, the requirement of medical clearance for at-risk new participants remains about the same as previous studies (ranging from 49%-82% of the facilities) and the current study (47% for self-guided and 87% for professionally-guided). For facilities that were not conducting PHSP (27%), the major reasons why were reinforced by the comments to the open-ended question and were similar to those found in a previous study that investigated the same.
The findings from this study indicated that there are areas that may need to be addressed within the profession to help increase adherence to published standards and guidelines especially in Community, Commercial, University, and Government settings. For example, these facilities might need a more simplified approach and additional guidance from the ACSM for more effectively and efficiently conducting PHSP. Additionally, academic programs could contribute by more comprehensively integrating PHSP into courses and practical learning opportunities for students. Given the importance of conducting PHSP, future research in PHSP focused on issues specific to individual settings may help establish the framework and provide direction for stakeholders to address this relevant issue in the field.
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Olejownik, Jennifer M. "Complementary and alternative medical providers and the experience of integration a case study /." Columbus, Ohio : Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1187096162.
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Bi, Hongwei. "A doctor-patient communication tool (DPCT) Ryodoroku application on the web." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2044.
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Han, Shaojie. "Evidence for Absence of Latchbridge Formation in Phasic Saphenous Artery." VCU Scholars Compass, 2005. http://scholarscompass.vcu.edu/etd/948.
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Tonic arterial smooth muscle can produce strong contractions indefinitely by formation of slowly cycling crossbridges (latchbridges) that maintain force at a high energy economy. To fully understand the uniqueness of mechanisms regulating tonic arterial contraction, comparisons have been made to phasic visceral smooth muscles that do not sustain high forces. This study explored mechanisms of force maintenance in a phasic artery by comparing KCl-induced contractions in the tonic, femoral artery (FA) and its primary branch, the phasic saphenous artery (SA). KCl rapidly (5 N/m2) and [ca2+]i (250 nM) in FA and SA. By 10 min, [ca2+]i declined to 175 nM in both tissues but stress was sustained in FA (1.3 x 105N/m2) and reduced by 40% in SA (0.8 x l05 N/m2). Reduced tonic stress correlated with reduced myosin light chain (MLC) phosphorylation in SA (28% vs. 42% in FA). SA expressed more MLC phosphatase than FA, and permeabilized (β-escin) SA relaxed more rapidly than FA in the presence of MLC kinase blockade, suggesting that MLC phosphatase activity in SA was greater than that in FA. The reduction in MLC phosphorylation in SA was insufficient to account for reduced tonic force (latchbridge model), and SA expressed more "fast" myosin isoforms than did FA. Cytochalasin-D reduced force-maintenance more in FA than SA. These data support the hypothesis that strong force-maintenance is absent in SA because expressed motor proteins do not support latchbridge formation, and because actin polymerization is not stimulated.
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Pohnert, Tami. "The Effects of Pet Ownership on Physical Well-Being in Older Adults." VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/2238.
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A large percentage of Americans own pets which may impact their health. This study examines pet ownership’s effect on well being in older adults looking at race/ethnicity. A sample of 6,565 older adults (>60) was selected from the Third National Health and Nutrition Survey. Pet owners comprised 28.3% of the sample. The theories of symbolic interaction and social integration were used to examine pet ownership’s effect on physical components of well-being. The descriptive results showed statistically significant differences in age, education, income, and marital status between pet owners and non-pet owners. Pet owners were younger, more educate, higher income and married. Similar results were found for Caucasians, African Americans and Mexican Americans. Logistic regression for the entire sample revealed pet owners were more likely to have a positive self perception of health, normal blood pressure, improved function, less chronic conditions, improved function and more falls. Multiple regression revealed pet owners had more hospital stays, but fewer physician visits and nursing home stays than non-pet owners. When examined by race/ethnicity differences were found between pet owners and non-pet owners that differed from the general sample results. This research revealed that pets overall positively impact their owners’ health but it appears to differ based on race/ethnicity. Further research is needed on pet ownership’s effect on older adults specifically in regards to race.
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Hansen, Kevin E. "Analyzing the effect of complaints, investigation of allegations, and deficiency citations on the quality of care in United States nursing homes (2007 – 2012)." Scholar Commons, 2015. http://scholarcommons.usf.edu/etd/5697.
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The quality of care in nursing homes has been evaluated from many varying perspectives, but few studies have analyzed quality in light of complaints made to state survey agencies by residents, their family members, or other individuals interacting with the nursing home. This study analyzed complaints, investigation of complaint allegations, and complaint-related deficiency citations to determine their effect, if any, on the quality of care in nationwide nursing homes. Using the Online Survey Certification and Reporting (OSCAR) survey dataset for facility characteristics and the complaint investigation dataset for outcomes of complaint investigation, analyses conducted included descriptives, correlations, conceptual mapping for complaint-related deficiencies, chi-square tests of independence, t-tests, and generalized estimating equations. At baseline, approximately 66% of nursing homes were for-profit and roughly 53% belonged to a chain membership, while the average percent of residents receiving Medicaid for care reimbursement was 60%. Results indicated that nursing homes differed significantly by profit status and chain membership on whether a complaint was received and whether a deficiency citation was issued following a complaint investigation. Additionally, certain facility and resident-aggregated characteristics, as indicated by odds ratios, were associated with an increase in the likelihood of receiving a complaint or a complaint-related citation. With respect to facility characteristics, for-profit nursing homes and those nursing homes belonging to a chain membership were found to have more complaints and more complaint-related deficiency citations than nonprofit nursing homes and non-chain facilities. Resident-aggregated characteristics, such as a nursing home having more residents restrained, more residents with a catheter, or more residents with a diagnosis of depression, indicated a greater likelihood of receiving a complaint or complaint-related deficiency citation in longitudinal analyses. While additional research could aid in interpreting the effect of complaints on quality of care in nursing homes, study results indicate several facility and resident-aggregated factors that may aid in better understanding of quality of care and improve the training of surveyors and nursing home staff to improve quality of care for residents.
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Ligon, Mary B. "Improving Life Satisfaction of Elders through Oral History: The Narrator's Perspective." VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd/939.
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Oral history is a method of preserving historical information through in-depth interviews. Because the process requires narrators to use remote recall while sharing their life experiences, it can also be considered a reminiscence-related activity. Before this study, the positive effects on narrators of providing an oral history were noted in the research literature but had not been evaluated through quantitative methods. Based on theoretical constructs of Erikson and Butler, it was hypothesized that participation in oral history interviews would improve the life satisfaction of narrators. Life satisfaction was operationalized and measured using the Life Satisfaction Index Version A (LSIA). The purposes of this study were to evaluate the influence of an oral history intervention on the life satisfaction of community-dwelling elders and to identify participant characteristics associated with change in life satisfaction scores.Sixty community-dwelling, older adults who were free of cognitive impairment and mental illness were recruited from agencies serving the social and recreational needs of elders in Richmond, VA. Participants were randomly assigned to an intervention group or a control group. LSIA scores were collected pretest, posttest, and again at retest, ten weeks after the intervention. Mean LSIA scores from the control and treatment groups were compared for differences at posttest and retest using an analysis of covariance (ANCOVA). Regression analysis was used to identify participant characteristics associated with improved life satisfaction at posttest and retest. Oral history interviews were conducted by Virginia Commonwealth University students enrolled in a gerontology course. Participants discussed lifetime events with students on three occasions for approximately one hour per session using a researcher-developed interview guide. No statistically significant differences in LSIA scores were found between groups at posttest (p=0.74) or retest (p=0.051) although retest scores may indicate a trend toward improvement. Lower LSIA scores at pretest were associated with positive change in LSIA scores at retest (p=5.001). These results suggest that oral history may not improve life satisfaction immediately but there may be a trend toward improvement given time and that elders least satisfied with their lives at the onset are most likely to show positive change by retest.
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Wills, Emily H. "An Epidemiological Look at Injuries among High School Athletes Participating in a Variety of Sports for Both Sexes." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/honors/325.
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Physical activity is part of a healthy lifestyle, but participating in athletic activities like team sports can lead to injury. This study was designed to find the differences in types of high school sports injuries and how frequently these injuries occur among different sports and between males and females. A survey was given to members of the football, boys’ basketball, girls’ basketball, baseball, softball, and volleyball teams of a central Appalachian high school. The highest rate of injury was found in girls’ basketball at 86.7%, followed by football at 85.2%, boys’ basketball at 70.6%, softball and volleyball each at 69.2%, and baseball at 33.3%. Significant differences were also found between the most prevalent types of injuries in each sport. Differences in types of injuries were reported by male and female athletes who participated in comparable sports such as boys’ and girls’ basketball and softball and baseball. More research into why these differences exist could result in more individualized prevention strategies for high school athletes.
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Elías, Maya N. "The Relationship Between Sleep Quality and Motor Function in Hospitalized Older Adult Survivors of Critical Illness." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7616.
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The primary, descriptive aim of this dissertation was to describe the nighttime sleep quality of previously mechanically ventilated older adult patients within 24-48 hours of transfer out of the intensive care unit (ICU) to a medical-surgical floor. The secondary, exploratory aim was to examine the relationships between post-ICU sleep efficiency (SE) and wake after sleep onset (WASO) with grip strength in previously mechanically ventilated older adult patients within 24-48 hours of transfer out of the ICU.
The study included 30 adults ages 65 and older (11 women, 19 men; age 71.37 ± 5.35, range 65-86 years), who were functionally independent at home prior to hospitalization, mechanically ventilated during their ICU stay, and were within 24-48 hours of transfer out of ICU to a medical-surgical floor at Tampa General Hospital, a level 1 trauma center. Subjects wore an actigraph monitor on the dominant wrist (Actiwatch Spectrum) to monitor sleep over two consecutive nights. Parameters of post-ICU sleep quality included total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), sleep latency (SL), and number of awakenings (NA). The outcome measure of motor function was dominant hand grip strength, assessed by the National Institutes of Health Toolbox Motor Battery Grip Strength Test. Sleep data collected between nighttime hours (9:00 PM to 9:00 AM) on both nights were analyzed. For the descriptive aim, means for each sleep parameter and clinical characteristics were reported. For the exploratory aims, multiple regression analyses examined the individual associations between mean sleep parameters (SE and WASO) and grip strength.
Study subjects had a mean SE of 63.24 ± 3.88% and spent 135.39 ± 9.94 minutes awake after sleep onset. The mean TST among subjects was 7.55 ± 2.52 hours, ranging from 2.02 to 10.84 hours of sleep, out of the 12 hours of total time in bed. A total of 6 (20%) subjects slept less than 5 hours each night, and a total of 6 (20%) subjects slept greater than 10 hours each night. The mean SL among study subjects was 42.57 minutes, and ranged from 0.0 to 237.75 minutes. Overall, subjects’ average NA was 78.28 ± 26.39, ranging from 35 to 136 awakenings.
In multiple regression analysis, SE was significantly and negatively associated with grip strength, after adjusting for potential confounding factors. The model predictors explained 80.8% of the variance in grip strength, [R2 = .808, F(10, 15) = 6.324, p = .001]. Higher SE independently predicted worse grip strength (β = -0.326, p = .036). Further, among the tertiles of subjects with moderate or high TST (sleep duration ≥ 6 hours, n = 23), there remained a significant, negative association between SE and grip strength. The predictors explained 73.7% of the variance in grip strength, [R2 = .737, F(5, 15) = 8.416, p = .001]. Higher SE independently predicted worse grip strength among the subset of subjects with moderate or high sleep duration (β = -0.296, p = .046). Among the two quartiles of subjects with moderate-high or high WASO (≥ 120 minutes spent awake after sleep onset, n = 16), there was a significant, negative association between WASO and grip strength, after adjusting for covariates. The model indicated that the predictors explained 91.4% of the variance in grip strength [R2 = .914, F(6, 8) = 14.134, p = .001]. Greater WASO independently predicted worse grip strength (β = -0.276, p = .04). Finally, the effects of sex and preexisting obstructive sleep apnea (OSA) on grip strength were individually examined. Higher SE independently predicted worse grip strength among male subjects (β = -0.353, p = .039), as did preexisting OSA (β = -0.493, p = .033).
In summary, objectively measured sleep quality was disturbed among previously mechanically ventilated, hospitalized older adults, even after transfer out of ICU to a medical-surgical floor. Longer TST and greater SE predicted worse grip strength among these frail patients who were previously independent, community dwelling older adults. Among the subjects with more severely fragmented sleep, WASO also independently predicted weaker grip strength. As poor grip strength is an indicator of ICU-acquired weakness, optimal sleep duration and less sleep disturbances may be crucial in prevention of worse functional outcomes and new institutionalization. Additional research is needed to discern the temporality of associations between sleep quality and motor function among older adult survivors of critical illness.
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Granic, Antoneta. "The Role of Lipoproteins/cholesterol in Genomic Instability and Chromosome Mis-segregation in Alzheimer's and Cardiovascular Disease." Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3126.
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Several lines of evidence link Alzheimer's disease (AD) to atherosclerosis (CVD), including that elevated low density lipoprotein (LDL)-cholesterol is a common risk factor. Development of genomic instability could also link the two diseases. Previous fluorescence in situ hybridization (FISH) analyses revealed a clonal expansion of aneuploid smooth muscle cells underlying atherosclerotic plaques. Likewise, cellular and mouse models of AD revealed tau-dependent mitotic defects and subsequent aneuploidy partly resulting from amyloid-beta (A&beta) interference with microtubule (MT) stability, and specific MT motors function. Moreover, AD patients develop aneuploid/hyperploid cells in brain and peripheral tissues, implicating similar mechanism that may lead to apoptosis and neurodegeneration.
This dissertation tested the hypothesis that elevated lipoproteins and cholesterol may contribute to genomic instability in AD and CVD and showed that: (1) treatment with oxidized LDL (OX-LDL), LDL and water soluble cholesterol, but not high density lipoprotein (HDL), induced chromosome mis-segregation, including trisomy and tetrasomy 12, 21, and 7 in human epithelial cells (hTERT-HME1), primary aortic smooth muscle cells, fibroblasts, mouse splenocytes and neural precursors; (2) LDL-induced aneuploidy may depend on a functional LDL receptor (LDLR), but not amyloid precursor protein (APP) gene; (3) fibroblasts and brain cells of patient with the mutation in the Niemann-Pick C1 gene (NPC1) characterized by impaired intracellular cholesterol trafficking and changed intracellular cholesterol distribution harbored trisomy 21 cells; (4) young wild-type mice fed high and low cholesterol diets developed aneuploidy in spleen but not in brain cells within 12 weeks; (5) like with the studies on A&beta-induced aneuploidy, calcium chelation reduced OX-LDL and LDL-mediated chromosomal instability; and (6) altering plasma membrane fluidity with ethanol attenuated OX-LDL and LDL-induced aneuploidy.
These results suggest a novel biological mechanism by which disrupted cholesterol homeostasis may promote both atherosclerosis and AD by inducing chromosome mis-segregation and development of aneuploid cells. Understanding the cause and consequence of chromosomal instability as a common pathological trait in AD and CVD may be beneficial to designing therapies relevant for both diseases.
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Green, Heather Joyce. "Characterization of the Zona Incerta." VCU Scholars Compass, 2005. http://hdl.handle.net/10156/1829.
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Pearson, Julie Ann. "Perceived Deprivation in Active Duty Military Nurse Anesthetists." Also available to VCU users online:, 2006. http://hdl.handle.net/10156/1784.
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McLain, Nina E. "Anesthesia Clinical Performance Outcomes: Does Teaching Methodology Make A Difference?" Availabe to VCU users online at:, 2007. http://hdl.handle.net/10156/1778.
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Mignot, Leo. "Sociogenèse d’une spécialité médicale : le cas de radiologie interventionnelle." Thesis, Bordeaux, 2017. http://www.theses.fr/2017BORD0902.
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Initiée dans les années 1960, la radiologie interventionnelle comprend les actes médicaux invasifs ayant pour but le traitement ou le diagnostic d’une pathologie réalisés sous guidage ou sous contrôle d’un moyen d’imagerie. L’enjeu de la thèse est de développer l’analyse sociohistorique de l’émergence d’une spécialité médicale – la radiologie interventionnelle – et d’en étudier les stratégies de légitimation. Trois axes d’investigation interdépendants sont plus particulièrement privilégiés. Le premier d’entre eux vise à comprendre comment est née cette pratique médicale en établissant l’archéologie des innovations dont elle résulte. Dans le deuxième, il s’agit d’analyser les stratégies de valorisation et les modes de faire-valoir de la radiologie interventionnelle. Les velléités d’autonomisation des radiologues interventionnels les ont ainsi conduits à mobiliser différents registres de légitimité (légitimité scientifique, légitimité professionnelle dans le champ médical, légitimité régulatoire). Le troisième axe permet quant à lui la prise en compte de la question de la démarcation sociale et des frontières. Étant porteuse d’une transgression de la dichotomie établie entre sphères diagnostique et thérapeutique, la radiologie interventionnelle a de fait entraîné une reconfiguration des relations entre spécialités. L’investigation s’appuie sur une méthodologie plurielle combinant entretiens semidirectifs, observations in situ (bloc opératoire, scanner, réunions de concertation pluridisciplinaire, consultations) et exploitation de données scientométriques. Une mise en perspective internationale avec la situation canadienne permet d’étudier l’impact des contextes nationaux sur la diffusion et la reconnaissance de la radiologie interventionnelleIntroduced in the 1960s, interventional radiology includes invasive medical procedures for the treatment or diagnosis of a pathology performed under the guidance or control of an imaging device. The aim of the thesis is to develop the sociohistorical analysis of the emergence of a medical specialty – interventional radiology – and to study its legitimization strategies. Three interdependent lines of inquiry are privileged in particular. The first aims to understand how this medical practice was born by establishing the archaeology of the innovations that gave rise to it. In the second, it is a question of analyzing the strategies of valorization and the ways of valuing interventional radiology. The interventional radiologists’ desire for independence has led them to mobilize different registers of legitimacy (scientific legitimacy, professional legitimacy in the medical field, regulatory legitimacy). The third line of inquiry allows for the issue of social demarcation and boundaries to be taken into account. As it is a means of transgressing the established dichotomy between the diagnostic and therapeutic spheres, interventional radiology has in fact led to a reconfiguration of the relations between specialties. The investigation is based on a methodology combining semi-directive interviews, in situ observations (operating theater, multidisciplinary consultation meetings, consultations) and the use of scientometric data. An international perspective on the Canadian situation makes it possible to study the impact of national contexts on the dissemination and recognition of interventional radiology
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Samuriwo, Kuwandandishe Priscilla. "An exploration of methods used by Shona speaking traditional health practitioners in the prevention of mental illness." Thesis, University of Limpopo, 2018. http://hdl.handle.net/10386/2054.
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Thesis (M. A. (Clinical Psychology)) --University of Limpopo, 2018Studies by the World Health Organisation have shown that mental illness is an international health concern across the globe, with one in four people (25%) suffering from mental disorders in both developed and developing countries. In many African countries traditional health practitioners are the health care providers of choice for individuals, families and communities. The aim of this study was to explore methods used by Shona speaking traditional health practitioners in the prevention of mental illness in Bulawayo, Zimbabwe. A qualitative research design was used in the present study. Ten Shona speaking traditional health practitioners (male=9; female=1) were selected through purposive sampling and requested to participate in the study. Data was collected using semi-structured interviews and analysed through thematic content analysis. It was found that traditional healers tend to commonly understand and conceptualise mental illness in terms of the causes instead attaching nosological labels to these conditions. The findings of the study also show that most of the traditional health practitioners interviewed had similar methods of preventing mental illness both in families and individuals. Culture was found to be central in shaping how the traditional health practitioners understand and prevent mental illness. Ancestors were found to be pivotal in specifically determining the methods to prevent mental illness for each client. The study is concluded by recommending closer collaboration between the dominant Western health care system and traditional healing in order to improve mental health care provision in Zimbabwe.
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Perona, Carrion Judith. "Entre França i Espanya. El sorgiment d’un nou espai de comunicació científica per mitjà de la revista La Medicina Catalana. Portantveu de l’Occitània mèdica (Barcelona, 1933-1938)." Doctoral thesis, Universitat Autònoma de Barcelona, 2016. http://hdl.handle.net/10803/381082.
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Els orígens de la premsa científica periòdica es remunten a les pràctiques de transmissió del coneixement emanades de la denominada República de les Lletres, en particular a les publicacions aparegudes dins les acadèmies reials o les societats erudites de l’Antic Règim. Pel que fa a la seva tipologia, les revistes mèdiques presentaven als inicis del segle XX una gran varietat, tant de format i periodicitat com de temàtica, de dependència institucional i d’especialització. Seu d’una potent indústria editorial, Barcelona esdevingué aleshores un dels centres més importants d’edició de publicacions mèdiques –llibres i revistes– en l’àmbit lingüístic del castellà. La Medicina Catalana. Portantveu de l’Occitània mèdica (LMC) és una revista representativa del catalanisme mèdic, i constitueix un fet particular dins el panorama científic de dos països europeus –França i Espanya– amb una llarga tradició centralista: l’aspiració de metges catalans i occitans, del Midi francès, a crear un espai propi –l’Occitània mèdica del subtítol de la revista– de comunicació científica, més enllà dels imperatius marcats pels Estats francès i espanyol.
El primer número LMC va aparèixer l’octubre de 1933, coincidint amb l’autonomia universitària i la reforma del pla d’estudis de medicina de la Universitat de Barcelona, i l’entrada en vigor de l’oficialitat del català, que esperonà les publicacions i l’ús públic de la llengua autòctona. El seu director, el metge Leandre Cervera i Astor, al costat de l’editor Josep Miracle i Montserrat i amb Ismael Girard des de Tolosa de Llenguadoc, va aconseguir que la publicació es mantingués fins l’any 1939, quan les tropes franquistes van ocupar Barcelona i es van prohibir definitivament les publicacions en llengua catalana. Fent servir el català com a vehicle de comunicació, LMC donava cabuda en les seves pàgines a articles originals i també a resums, convenientment traduïts i comentats, d’articles prèviament publicats en revistes internacionals i en diferents llengües. Igualment, incloïa seccions, com ara “Occitània mèdica” i “Noticiari d’activitats”, que referien les activitats mèdiques realitzades, i també les programades, així com les novetats esdevingudes, en els territoris catalano-occitans, això és, el triangle geogràfic Alacant-Bordeus-Marsella, que comptava aleshores amb uns 10 milions d’habitants. LMC suposa l’existència, a Catalunya i a la seva àrea d’influència lingüística comprès el sud de França, d’un públic lector integrat per professionals de la medicina, i probablement d’altres sectors sanitaris, que actualitzava regularment els seus coneixements en català d’acord amb unes àrees temàtiques que es corresponien amb les especialitats mèdiques en ús. Va ser una publicació periòdica concebuda i dissenyada des de la tensió entre forces divergents, que tendien cap a la diversificació de les ciències mèdiques, i alhora forces convergents, que impedien la fragmentació en distintes professions sanitàries. Des del primer número, la subsistència de la revista depenia no tant dels potencials subscriptors com d’uns ingressos estables procedents de la publicitat, en especial de la indústria farmacèutica.
La memòria d’aquesta tesi doctoral s’emmarca en una línia d’investigació, iniciada ara fa ja més d’un dècada, sobre la medicina a la Catalunya de la primera meitat del segle XX, una etapa on es va consolidar, sobretot a la ciutat de Barcelona i la seva àrea metropolitana, a més de l’anomenada medicina de laboratori i d'una àmplia oferta d’especialitats mèdiques, un potent sector editorial en l’àmbit de la medicina.The origins of the scientific press back to regular practices knowledge transfer arising from the so-called “Republic of Letters”, between 1550 and 1750, in particular publications appeared in the royal academies or erudite societies of the Old Regime. Regarding its type, medical journals appeared in the early twentieth century and presented a variety of format and frequency of publication, themes, institutional departments and specializations. Barcelona, home of a powerful publishing industry, became one of the most important places for publications of medical journals, books and magazines in the field medicine and in spanish language. La Medicina Catalana. Portantveu de l’Occitània mèdica (LMC) is a representative journal of the ‘catalanisme mèdic’, and is a particular fact within the scientific scene of two European Countries, France and Spain, with a long centralized tradition: the aspiration of catalan and occitans doctors, from the french Midi, to create their own space - l'Occitània Medica, subtitle of the journal - of scientific communication beyond the imperatives set by the French and Spanish states. The first issue of LMC appeared in October 1933, coinciding with autonomy of university, the reform of the studies of medicine at University of Barcelona and the beginning of the official status of Catalan language, which promotes publications and public use of the native language. Its director, Dr. Leandre Cervera Astor, along with the editor and Josep Miracle Montserrat and Ismael Girard from Tolosa de Llenguadoc, achieved the publication stayed until 1939, when military troops of Franco occupied Barcelona and banned publications in catalan language. Using the catalan as a vehicle for communication, LMC gave place in its pages to original articles and abstracts, properly translated and commented, articles previously published in international journals and in different languages. Furthermore, LMC included sections such as "Occitània medica" and "Noticiari d’activitats ", which concerned medical activities carried out, and also planned, as well as news and medical informations occurred in the territories of Catalonia and Occitan, which is the geographical triangle Alacant-Bordeaus-Marsella, which had then about 10 million habitants. LMC implies the existence, in Catalonia and its area of language influence including the south of France, a readership audience composed of medical professionals, and probably of other health sectors, who regularly update their knowledge in catalan according to some areas of interest that corresponded with medical specialties in use. It was a periodical conceived and designed by the tension between divergent forces that tended towards diversification of medical sciences, and converging forces that prevented fragmentation of knowledge in different health professions. Since the first issue of the magazine livelihood depended not so much by potential subscribers as a source of economic entries, but from advertising especially in the pharmaceutical industry. This thesis is part of a research, which began more than a decade ago, about the medicine in Catalonia in the first half of the twentieth century, a period in which, especially in the city of Barcelona and its metropolitan area, the so-called laboratory medicine and a wide range of medical specialties were consolidated together with a powerful publishing sector in the field of medicine.
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Owens, Myra G. "Factorial Validity of the Team Skills Scale as used for Geriatric Interdisciplinary Team Training (GITT)." VCU Scholars Compass, 2006. http://hdl.handle.net/10156/1568.
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Shah, Tanvi Jayendra. "Obesity as a Risk Factor for Preeclampsia: Role of Inflammation and the Innate Immune System." VCU Scholars Compass, 2007. http://hdl.handle.net/10156/1934.
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