Dissertations / Theses on the topic 'Testis Self-examination, Medical. Testis'

Thesis (M.S.)--West Virginia University, 2009.<br>Title from document title page. Document formatted into pages; contains iii, 76 p. : ill. Includes abstract. Includes bibliographical references (p. 40-43).

This investigation examined the self-efficacy beliefs of medical professionals towards medically-related tasks. Although several instruments existed that measured different aspects of career self-efficacy, none of them was relevant nor appropriate to people who have already chosen their occupational field of choice. The typical scales utilized in assessing career self efficacy are generalized across occupations and not relevant to someone who was already employed in a profession. The purpose of the present study was to develop a new scale, Medical Tasks Self-Efficacy (MTSE), to measure the self-efficacy beliefs of a specific employed population toward their occupational tasks. The analysis of the MTSE was conducted using respondents (N=307) of medical professionals, specifically physicians and nurses. The reliability and validity of the scale was analyzed through four phases of scale development.Phase one consisted of item development which included the generation of an item pool from special occupational books and interviews with medical professionals (N=8). Additional experts (N=3) in scale construction were also consulted during this phase. Thirty-two items were developed originally and then, through consultation, reduced to 27 items. Phase two involved a pilot study with respondents from various medical settings in the midwest (N=34). The pilot study helped to provide preliminary reliability information and to modify the necessary demographic information. One more item was dropped from the scale during this phase and thus the revised MT SE consisted of 26 items.Phase three consisted of a major investigation (N=209) to test the initial factor structure of the MTSE and to examine the internal consistency. Using a principal components extraction, the MTSE yielded a two factor solution which seemed to best fit the data both in terms of statistical configuration and theoretical soundness. Factor One constituted tasks involving “medical content competencies" and held an alpha coefficient of .93. Factor Two constituted tasks involving "interpersonal process competencies" and held an alpha coefficient of .87.The fourth and final phase (N=64) was conducted to test the convergent and discriminant validity of the scale and to examine the test-retest reliability. Convergent and discriminant validity were tested using the Task Specific Occupational Self-Efficacy Scale (TSOSS) and the Beck Depression Inventory (BDI). The MTSE was hypothesized to demonstrate convergent validity with the TSOSS. Both factors of the MTSE were significantly correlated with the overall TSOSS, and additionally correlated with the four factors of the TSOSS, with one exception. Only Factor Two ("interpersonal process competencies") of the MTSE did not correlate significantly with factor four of the TSOSS. The BDI was used to test discriminant validity. The BDI did not correlate significantly with either of the factors of the MT SE. Thus, the MTSE demonstrated both convergent and discriminant validity with the instruments utilized in this study. The two-week test-retest correlation was .80, additionally demonstrating a stable reliability estimate in the MT SE. Limitations and implications for future research of the MT SE were provided.<br>Department of Counseling Psychology and Guidance Services

Neuropsychologists are increasingly asked to determine whether a patient may be malingering symptoms of a mild closed head injury. This issue is particularly salient within the context of civil litigation and the potential of significant financial awards. Patients' performances on neuropsychological tests have historically been assumed to accurately reflect their abilities and deficits. Optimal motivation and performance cannot be automatically assumed within the context of litigation. Moreover, comorbid anxiety and depression are frequently present in head injury patients and adversely affect the patient's performance.The frequent comorbidity of psychiatric and medical symptoms complicates interpretation of a patient's neuropsychological evaluation whether or not the patient is involved in litigation. This comorbidity may result in an inaccurate diagnosis, thus delaying treatment potentially causing greater harm to the patient.The present study was conducted to expand previous research that discriminated between simulated malingered and neurological patient responses to a neuropsychological self-report inventory. Additionally, the study investigated the, utility of the Neuropsychological Symptom Inventory in discriminating between simulated medical, psychiatric and malingered patient responses. Results indicated that the NSI was able to discriminate malingered responses from medical and psychiatric patient responses. However, applying a lie scale derived from previous research with the NSI did not allow discrimination between the malingered group and the psychiatric patients. Use of a factor solution derived from earlier research may offer not only greater prediction in detection of malingerers, but also evaluation of symptom profiles of medical and psychiatric patients. The NSI may provide an efficient screen for exaggerated symptoms as well as an indication of the level of general neuropsychological functioning of the patient when included in a neuropsychological evaluation.<br>Department of Educational Psychology

Introduction: Chronic diseases can be prevented and improved by regular physical activity and reduced sedentary time. An adequate leg strength and leg function in treatment and prevention of these disease is something to strive for. To the Lifestyle Reception at Karlskoga Hospital are patients with mild to moderate mental illness referred where a new method Self-measurement tests of leg strength is used, containing 30 seconds chair-stand test, squat, heel rise and maximal step-up test, aiming to simple training and indicating an objective measure of leg strength. Objective: To describe the group of patients referred to the Lifestyle Reception and investigate change of leg strength/leg function using Self-measurement tests, self-rated health and self-rated physical function following 12 weeks of intervention. Methods: A clinical intervention study of 29 patients referred to the Lifestyle Reception at Karlskoga Hospital between Nov 2017 and March 2018. They participated in an intervention consisting of group training twice a week for 12 weeks. A sign-in and a sign-out interview was carried out where data (tests and a questionnaire) of the study was collected. Result: 29 patients (24 women / 5 men) participated. The mean age was 39 years and the mean BMI was 31 (corresponding to obesity). All patients were on sick leave to some extent. The theoretical individual maximal step-up height (% -tMSH) improved from 65% to 75% (p &lt;0.001). The patients could on average do 5.5 more 30s-chair-stand-test (p &lt;0.001) and the proportion who managed to do squats without support increased from 57% to 90%. Significant improvements were seen for the self-rated health (p &lt;0.001) and also for the HAD scale (anxiety p = 0.012; depression p = 0.04). However, the improvement of the self-rated physical function was not significant. Conclusion: Significant improvements in all four self-tests of leg strength / leg function could be measured after the intervention as well as a significant improvement of self-rated health. Self-measurement test of leg strength is considered to be a simple and useful test method in clinical practice.

Each year hundreds of thousands of women in Europe need to catheterize themselves instead of urinating the usual way, because of diseases or injuries. However, self-catheterization is hard for a lot of women due to the location of the urethra, and they need some type of aid to help them. The design company MMID in the Netherlands developed a concept with a mirror and a light, which is attached to a toilet seat. Though, it was noticed that it was too hard to handle for the users, hence the authors were asked to improve the user friendliness with the product. Since the intuition aspect was the largest problem they decided to focus on intuition. MMID’s original prototypes were tested by patients and continence nurses to get relevant information that only real users can give, and by mixed women without troubles, to get an insight in the intuition aspect. The nurses and the patients tested the prototypes and were observed, whereupon they took part in a semi-structured interview and a questionnaire, respectively. During the intuition tests the women’s interactions with the prototypes were filmed, and they answered a short questionnaire. The films were then analyzed. The tests showed that the product was very hard to understand and that it gave a feeling of being unstable. This gave the project the focus to make the product easy to open up, without having to assemble it before each use. All important aspects were gathered and several ideation sessions were performed. The results were put together into three concepts and 3D printed prototypes. These models were tested by women interacting with them to see their intuitive actions, which were also filmed. The women also participated in semi-structured interviews. Based on these results a concept choice was made where the simplest solution with one pivoting point was chosen. The concept was further developed and functional prototypes and non-functional prototypes were made. The non-functional models were tested for only intuition among random women, the same way as before. The functional models were tested by patients and nurses at four hospitals in the Netherlands, also these tests were similar to the ones in the first round. The overall results were positive and the product had been significantly improved; a lot thanks to the fact that it did not need to be assembled before it could be used. The biggest negative aspect was that a signifier for opening the product was missing.<br>Varje år behöver hundratusentals kvinnor i Europa katetrisera sig själva istället för att urinera som vanligt, på grund av sjukdomar eller skador. Självkatetrisering är dock krångligt för många kvinnor på grund av placeringen av urinrörets öppning. Designföretaget MMID i Nederländerna tog fram ett koncept med en spegel och en lampa som fästs på toalettsitsen för att hjälpa dessa kvinnor. Det upptäcktes dock att detta koncept var svårförstått och således ombads författarna att förbättra användarvänligheten hos produkten. Då intuitionsaspekten hos produkten var det största problemet bestämde de sig för att fokusera på intuitionen. MMIDs ursprungliga prototyper testades av patienter och urologisköterskor för att få relevant information som bara riktiga användare kan ge, samt av blandade kvinnor utan åkommor för att få inblick i intuitionsaspekten. Sköterskorna och patienterna testade prototyperna och observerades, varpå de deltog i semistrukturerade intervjuer respektive fyllde i ett frågeformulär. Under intuitionstesterna filmades kvinnornas interaktion med prototyperna, varpå de svarade på ett kort frågeformulär. Filmerna analyserades sedan. Testerna visade bland annat att produkten var väldigt svårförstådd samt gav en känsla av att vara ostadig. Detta gav projektet fokuset att skapa en produkt som kan öppnas upp på ett enkelt sätt utan att behöva monteras ihop innan varje användning. Alla viktiga aspekter sammanställdes och flertalet idégenereringar genomfördes. Resultaten från dessa sattes ihop till tre koncept, vilka överfördes till 3D-printade modeller. Modellerna testades genom att kvinnor fick interagera med dem varpå deras intuitiva handlingar observerades. Detta spelades in på video och kvinnorna ombads även att svara på frågor i en kort semistrukturerad intervju. Baserat på dessa resultat gjordes ett konceptval där den enklaste lösningen, med en rotationspunkt, valdes. Efter detta utvecklades konceptet vidare och funktionella samt icke-funktionella prototyper tillverkades. Dessa prototyper testades i en tredje testomgång, där de icke-funktionella prototyperna testades för enbart intuition av godtyckliga kvinnor, på samma sätt som tidigare. De funktionella prototyperna testades av patienter och sköterskor på fyra sjukhus i Nederländerna, likt första testomgången. De övergripande resultaten var positiva och produkten var signifikant förbättrad, mycket tack vare att den inte behövde sättas ihop innan den kunde användas. Den största negativa aspekten var att det saknades en indikator som underlättade öppnandet av produkten.

<p>Objective: The aim of this study was to evaluate a new underfill-function in a POCT-instrument from HemoCue AB (Ängelholm, Sweden). The instrument is in use today among diabetes patients for self-monitoring blood glucose (SMBG). The new function is supposed to guarantee that measuring only will be performed on a sufficient sample volume to assure that the correct glucose value is received.</p><p>Methods and results: Blood samples (whole blood) from 12 patients were analysed with the instrument. Measuring were performed using different volumes in the cuvette. Full cuvette, 3µL, 2µL, 1µL and a measuring on an empty cuvette. The instrument performed measurements on all volumes added to the cuvette except for the empty cuvette. The less sample volume that was used the lower glucose values were reported by the instrument.</p><p>Conclusions: The new under fill-function did not work satisfactory. If such function would be more reliable it would be beneficial for the patient controlling hers/his bloodglucose provided that the testing procedure is being correctly done. This is very important because the results are often used to treat the patient.</p>

Since 2002, the Canadian state has mandatorily tested applicants for permanent residence for HIV (Human immune deficiency virus). The policy and practices associated with this screening have never been critically scrutinized. Authoritative claims about what happens in the conduct of the immigration medical examination are at odds with the experience of immigrant applicants living with HIV. This is the analytic entry point into this inquiry that is organized within the theoretical and methodological frame offered by institutional ethnography and political activist ethnography. Analysis is connected to broader research literatures and the historical record. The goal of this study is to produce detailed, contextualized understandings of the social and ruling relations that organize the lives of immigrants to Canada living with HIV. These are generated from the material conditions of their lives. An assumption about how organization happens is the social and reflexive production of knowledge in people’s day-to-day lives through which connections between local and extra-local settings are empirically investigable. I investigate the organization of the Canadian immigration process. How is this institutional complex ordered and governed? How is immigration mandatory HIV testing organized, and with what consequences to HIV-positive applicants to Canada? This is a text-mediated organization where all the sites are connected by people’s work and the texts they circulate. The positive result of an immigration HIV test catalyzes the state’s collection of medical data about an applicant. These are entered into state decision-making about the person’s in/admissibility to Canada. I focus on a key component of the immigration process, which is medical examination and HIV testing with this, along with the HIV test counselling practices that happen (or not) there. The reported absence of the latter form of care causes problems and contradictions for people. This investigation adopts the standpoint of these persons to investigate their problems associated with HIV testing. The main empirically supported argument I make is that the Canadian state’s ideological work related to the HIV policy and mandatory screening ushers in a set of institutional practices that are highly problematic for immigrants with HIV. This argument relies on data collected in interviews, focus groups, observations, and analysis of texts organized under Canada’s Immigration and Refugee Protection Act (S.C., 2001, c. 27) and textually mediated, discursively organized concepts that shape people’s practice. Canadian immigration medical policy makers should make use of these findings, as should civil society activists acting on behalf of immigrants to Canada living with HIV. I make nine specific recommendations for future action on HIV and immigration in Canada.

Arranjos supramoleculares combinando o lípide catiônico brometo de dioctadecildimetilamônio (DOD) com polímeros, como carboximetilcelulose (CMC) e cloreto de poli(dialildimetilamônio) (PDDA), foram preparados na forma de nanopartículas (NPs), na ausência ou presença de antimicrobiano tradicional, como a claritromicina (CLA). NPs preparadas por atração eletrostática entre os fragmentos de bicamada (BF) de DOD, CMC e PDDA foram avaliadas, in vitro, quanto à atividade contra isolados clínicos de micro-organismos multirresistentes (MR) a antimicrobianos, como Pseudomonas aeruginosa MR, Klebsiella pneumoniae produtora da enzima carbapenemase do tipo KPC, Staphylococcus aureus resistente à meticilina/oxacilina (MRSA) e Candida albicans resistente ao fluconazol, através do método de plaqueamento e contagem de viáveis. As NPs de DOD BF/CMC/PDDA apresentam alta atividade de amplo espectro contra micro-organismos MR, em que o PDDA é o componente responsável pela excelente atividade biocida das NPs. O mecanismo de ação antimicrobiana indica a dissociação dessas NPs na presença dos micro-organismos, com a remoção de biopolímeros da parede celular microbiana pelo PDDA, conforme visualizado por microscopia eletrônica de varredura, ocorrendo lise da membrana microbiana e liberação de compostos fosforilados para o meio extracelular. Também foram desenvolvidas neste trabalho NPs carreadoras de CLA à base de DOD e polímeros. Solução etanólica contendo CLA/DOD foi injetada em solução aquosa de CMC, formando arranjos coloidalmente estáveis e aniônicos, que posteriormente foram adicionados de solução de PDDA, para a obtenção de arranjos estáveis e catiônicos. CLA/DOD/CMC e CLA/DOD/CMC/PDDA NPs incorporaram CLA em quantidade suficiente para inibir o crescimento de M. abscessus no interior de macrófagos bem como evitar a formação de biofilmes, sendo que altas doses de CLA foram tóxicas aos macrófagos, enquanto doses menores apresentaram baixa toxicidade e boa atividade antimicrobiana. NPs catiônicas carreando CLA foram tóxicas aos macrófagos nas concentrações de PDDA testadas. A natureza particulada das CLA NPs possivelmente aumenta a retenção intracelular de CLA em comparação com CLA livre, podendo prolongar atividade da CLA contra patógenos intracelulares. Desta maneira, arranjos supramoleculares combinando lípide e polímeros, com ou sem antimicrobianos tradicionais poderão encontrar diversas aplicações nas áreas farmacêutica, médica, alimentícia e biotecnológica.<br>Supramolecular assemblies combining cationic lipid dioctadecyldimethylammonium bromide (DOD) and polymers, such as sodium carboxymethylcellulose (CMC) and poly(diallyldimethylammonium chloride) (PDDA), were prepared as nanoparticles (NPs), in the absence or presence of traditional antibiotic, such as clarithromycin (CLA). NPs prepared by electrostatic attraction between DOD bilayer fragments (BF), CMC and PDDA were evaluated against clinical strains of multidrug resistant (MDR) microorganisms, such as Pseudomonas aeruginosa MDR, Klebsiella pneumoniae producer of KPC carbapenemase enzyme, methicillin-resistant Staphylococcus aureus (MRSA) and Candida albicans fluconazole resistant, by plating and colony forming unities counting. DOD BF/CMC/PDDA NPs display high and broad-spectrum activity against MDR microrganisms, and PDDA is the excellent biocidal component in the NPs. The mechanism of antimicrobial action shows that NPs disassembly in the presence of microrganisms, with biopolymers withdrawn from the cell wall, as observed by scanning electron microscopy, consecutively lysing bacterial membrane as determined from the leakage of inner phosphorylated compounds. In this work there have also been developed NPs, based on lipid and polymers, as carriers for CLA. Ethanolic solution co-solubilizing CLA/DOD was injected in CMC aqueous solution, yielding colloidaly stable and anionic NPs, that were further added of PDDA solution, yielding stable and cationic NPs. CLA/DOD/CMC NPs and CLA/DOD/CMC/PDDA NPs incorporated CLA at doses high enough to inhibit M. abscessus growth inside macrophages or in biofilms. Larger CLA doses were toxic to macrophages while lower CLA doses reduced toxicity to macrophages despite their high antimicrobial activity. Cationic CLA NPs exhibited substantial toxicity against macrophages at the PDDA concentrations tested. The particulate nature of these CLA NPs possibly increases intracellular CLA retention in comparison to free CLA, probably extending CLA activity against intracellular pathogens. In conclusion, supramolecular assemblies combining cationic lipid and polymers, with or without traditional antibiotics, may find multiple possibilities of applications at pharmaceutical, medical, food and biotecnological fields.

The purpose of the study was to describe the determinants and practice of HIV self-testing among health care workers (HCWs) in Nyeri provincial hospital, Kenya. A descriptive cross-sectional study was conducted to determine the rate of HIV self-testing, explore the factors influencing the practice and describe access to HIV psychosocial support, care and treatment. The study was guided by the concepts of the protection motivation theory. Data was collected from 348 HCWs and analysed by means of logistic regression. Results showed that 65.8% of the HCWs had practiced HIV self-testing among themselves. Age, self efficacy and response efficacy were found to be significant predictors of HIV self-testing. Willingness to access HIV psychosocial support (71.3%) and care and treatment (73.9%) was high. Self-testing is highly practiced by HCWs.<br>Public Health<br>M.A. (Public Health)

The purpose of the study was to describe the determinants and practice of HIV self-testing among health care workers (HCWs) in Nyeri provincial hospital, Kenya. A descriptive cross-sectional study was conducted to determine the rate of HIV self-testing, explore the factors influencing the practice and describe access to HIV psychosocial support, care and treatment. The study was guided by the concepts of the protection motivation theory. Data was collected from 348 HCWs and analysed by means of logistic regression. Results showed that 65.8% of the HCWs had practiced HIV self-testing among themselves. Age, self efficacy and response efficacy were found to be significant predictors of HIV self-testing. Willingness to access HIV psychosocial support (71.3%) and care and treatment (73.9%) was high. Self-testing is highly practiced by HCWs.<br>HIV self-testing among health care workers at Nyeri Provincial Hospital in Kenya<br>HIV self-testing among health care workers<br>Public Health<br>M.A. (Public Health)