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Longitudinal Quantitative Analysis Of Gait And Balance In Friedreich's Ataxia, Jeannie B. Stephenson Dec 2014

Longitudinal Quantitative Analysis Of Gait And Balance In Friedreich's Ataxia, Jeannie B. Stephenson

USF Tampa Graduate Theses and Dissertations

Friedreich's Ataxia (FA) is an autosomal-recessive, neurodegenerative disease characterized by progressive lower extremity muscle weakness and sensory loss, balance deficits, limb and gait ataxia, and dysarthria. FA is considered a sensory ataxia because the dorsal root ganglia and spinal cord dorsal columns are involved early in the disease, whereas the cerebellum is affected later. Balance deficits and gait ataxia are often evaluated clinically and in research using clinical rating scales. Recently, quantitative tools such as the Biodex Balance System SD and the GAITRite Walkway System have become available to objectively assess balance and gait, respectively. However, there are limited studies …


Structural Processes And Local Meaning: Explanatory Models, Political Economy, And Chagas Disease In Tropical Bolivia, Colin James Forsyth Nov 2014

Structural Processes And Local Meaning: Explanatory Models, Political Economy, And Chagas Disease In Tropical Bolivia, Colin James Forsyth

USF Tampa Graduate Theses and Dissertations

This project describes and analyzes explanatory models of Chagas disease among people in a highly endemic area of eastern Bolivia, and examines the role that cultural and structural factors play in shaping explanatory models of this disease. Dressler (2001) characterizes medical anthropology as divided between two poles; the constructivist, which focuses on the "meaning and significance that events have for people," and the structuralist, which emphasizes the relationships between the components of a given society. This project endeavors to synthesize structuralist and constructivist perspectives by understanding the interaction between structural processes and explanatory models of Chagas disease.

The research took …


Not On My Street: Exploration Of Culture, Meaning And Perceptions Of Hiv Risk Among Middle Class African American Women, Corliss D. Heath Nov 2014

Not On My Street: Exploration Of Culture, Meaning And Perceptions Of Hiv Risk Among Middle Class African American Women, Corliss D. Heath

USF Tampa Graduate Theses and Dissertations

Black women remain at a higher risk for HIV infection than women of any other ethnic group. Of all new infections reported among U.S. women in 2010, 64% occurred in African Americans compared to 18% Whites and 15% Hispanic/Latina women (CDC 2013a; CDC 2014b). While the literature on HIV risk among African American women is extensive, it mostly focuses on low income, low education subgroups of women or those involved in high risk behaviors such as drug use. Very little has been done to understand the risk for HIV among college educated, middle class women who do not fit into …


Examination Of Possible Protective Effect Of Rhesus D Positive Blood Factor On Toxoplasma-Related Depressive Symptoms In Pregnancy, Lisa Lynn Parnell Nov 2014

Examination Of Possible Protective Effect Of Rhesus D Positive Blood Factor On Toxoplasma-Related Depressive Symptoms In Pregnancy, Lisa Lynn Parnell

USF Tampa Graduate Theses and Dissertations

Toxoplasma gondii infects approximately one third of the population worldwide. There is strong evidence that a relationship between T. gondii titer and depressive symptoms exists. There is also evidence suggesting a protective effect of RhD positive blood factor on toxoplasma-induced behavioral and personality changes. This protective effect may influence the relationship between T. gondii and prenatal depressive symptoms. The purpose of this secondary data analysis was to examine the possible protective effect of RhD positive blood factor on prenatal depressive symptoms in 56 pregnant women with T. gondii infection. The cross-sectional design was utilized to answer the question “Does positive …


Knowledge And Acceptance Of Hpv And The Hpv Vaccine In Young Men And Their Intention To Be Vaccinated, Brenda Renee Jasper Nov 2014

Knowledge And Acceptance Of Hpv And The Hpv Vaccine In Young Men And Their Intention To Be Vaccinated, Brenda Renee Jasper

USF Tampa Graduate Theses and Dissertations

Sexually active young men are at high risk of contracting HPV and developing genital warts and penile/anal cancers. They contribute significantly to the incidence of HPV in women. The HPV vaccine, Gardasil, was approved in 2009 for use in preventing HPV 6 and 11 in young males ages 9 to 26. Knowledge and awareness of the virus and the vaccine is limited among young men. Promoting education and prevention measures regarding HPV and reducing personal risks to HPV is significant in narrowing the gap between acquisition of the HPV virus and cancer sequelae. A correlational design utilizing cross-sectional survey methodology …


The Physiological Effects Of Precooling Beverage Temperatures On Heat Strain In Collegiate Women Soccer Players, Taylor Welch Nov 2014

The Physiological Effects Of Precooling Beverage Temperatures On Heat Strain In Collegiate Women Soccer Players, Taylor Welch

USF Tampa Graduate Theses and Dissertations

Precooling is a method used to decrease initial pre-exercise core temperature in order to facilitate a greater margin for heat production before a maximum core temperature is reached. The purpose of this study was to examine the differences in physiological and perceptual effects of precooling using beverages of three different temperatures: room temperature beverage (24.88 ± 1.13°C), cold beverage (6.15 ± 3.16°C) and ice slushy (-1.61 ± 0.45°C) in a hot environment (27.88 ± 0.72°C and 35.36 ± 0.83°C for wet globe bulb temperature and dry bulb temperature respectively). For all trials the environmental temperature was set to 35°C with …


Risk Factors For Recurrent Major Depressive Disorder In A Nationally Representative Sample, Graig Charles Defeo Nov 2014

Risk Factors For Recurrent Major Depressive Disorder In A Nationally Representative Sample, Graig Charles Defeo

USF Tampa Graduate Theses and Dissertations

The public use version of the National Comorbidity Survey - Replication (NCS-R) dataset was used (N = 995) to investigate risk factors for recurrent major depressive disorder (MDD) that are evident before recovery from the first major depressive episode (MDE) by comparing persons diagnosed with MDD who experienced a single MDE to persons with recurrent MDD.

Multiple logistic regression analyses assessed the independent risk of recurrent MDD for each of the following risk factors: an early age of onset (old), absence of a life stress trigger, chronic first episode, childhood parental loss, parental maltreatment, parental depression, comorbid anxiety disorder, and …


Work Productivity Loss From Depression: Evidence From An Employer Survey, Kathryn Rost, Hongdao Meng, Stanley Xu Nov 2014

Work Productivity Loss From Depression: Evidence From An Employer Survey, Kathryn Rost, Hongdao Meng, Stanley Xu

Mental Health Law & Policy Faculty Publications

Background: National working groups identify the need for return on investment research conducted from the purchaser perspective; however, the field has not developed standardized methods for measuring the basic components of return on investment, including costing out the value of work productivity loss due to illness. Recent literature is divided on whether the most commonly used method underestimates or overestimates this loss. The goal of this manuscript is to characterize between and within variation in the cost of work productivity loss from illness estimated by the most commonly used method and its two refinements.

Methods: One senior health benefit specialist …


An Exploration Of The Health Experiences Of Youth Who Were Trafficked For Sex, Christine Ann Meister Oct 2014

An Exploration Of The Health Experiences Of Youth Who Were Trafficked For Sex, Christine Ann Meister

USF Tampa Graduate Theses and Dissertations

This pilot study used photovoice methodology to explore the current health needs of youth who were trafficked for sex and are now living in an alternative family care setting. The goals of this study were to add to the current literature regarding the health needs of victims of domestic minor sex trafficking and to add a qualitative aspect to the evaluation of the Citrus Helping Adolescents Negatively Impacted by Commercial Exploitation (CHANCE) program. Disposable cameras were distributed to a group of adolescent girls enrolled in the program who were then tasked with taking pictures of things that made them feel …


Perspectives Of Hiv + Women On The Mother To Child Transmission Of Hiv In Addis Ababa, Ethiopia, Kimberly Anne Fleek Oct 2014

Perspectives Of Hiv + Women On The Mother To Child Transmission Of Hiv In Addis Ababa, Ethiopia, Kimberly Anne Fleek

USF Tampa Graduate Theses and Dissertations

Purpose and rationale: In 2012, an estimated 9,500 infants in Ethiopia were born with HIV. Mortality for these infants is high, and preventing infection offers the best hope for reducing the childhood death rates. Effective measures exist which can reduce the likelihood of a child acquiring HIV from its mother to less than 2%, and the necessary anti-retroviral medications are free and accessible to Ethiopian women. However, Prevention of Mother to Child Transmission of HIV (PMTCT) efforts in the country have not kept pace with the global reduction in infant infections over the last decade, and the Ethiopian MTCT rate …


Documenting Mass Rape: Medical Evidence Collection Techniques As Humanitarian Technology, Jaimie Morse Oct 2014

Documenting Mass Rape: Medical Evidence Collection Techniques As Humanitarian Technology, Jaimie Morse

Genocide Studies and Prevention: An International Journal


Aim: Emerging global networks of human rights activists, doctors, and nurses have advocated for increased collection of medical evidence in conflict-affected countries to corroborate allegations of sexual violence and facilitate prosecution in international and domestic courts. Such initiatives are part of broader shifts in human rights advocacy to document human rights violations using rigorous, standardized methodologies. In this paper, I consider three principal forms of medical evidence to document sexual violence and their use in these settings: the patient medical record, the medical certificate, and the sexual assault medical forensic exam (commonly known as the “rape kit”).

Methods: Combining archival …


Intervention Impact On Depression Product Appraisal And Purchasing Behavior By Employers: A Randomized Trial, Kathryn M. Rost, Donna Marshall, Stanley Xu Sep 2014

Intervention Impact On Depression Product Appraisal And Purchasing Behavior By Employers: A Randomized Trial, Kathryn M. Rost, Donna Marshall, Stanley Xu

Mental Health Law & Policy Faculty Publications

Background: Employers can purchase high quality depression products that provide the type, intensity and duration of depression care management shown to improve work outcomes sufficiently for many employers to achieve a return on investment. The purpose of this randomized controlled trial was to test an intervention to encourage employers to purchase a high quality depression product for their workforce.

Methods: Twenty nine organizations recruited senior health benefit professional members representing public or private employers who had not yet purchased a depression product for all 100+ workers in their company. The research team used randomization blocked by company size to …


Accuracy Of /T/ Productions In Children With Cochlear Implants As Compared To Normal-Hearing, Articulation Age-Matched Peers, Terry Gier Jul 2014

Accuracy Of /T/ Productions In Children With Cochlear Implants As Compared To Normal-Hearing, Articulation Age-Matched Peers, Terry Gier

USF Tampa Graduate Theses and Dissertations

Children who receive cochlear implants (CIs) demonstrate considerable variability in speech sound production. Investigations focused on speech sound development in children with CIs have shown initial accelerated growth, followed by a plateau where consonant order of acquisition generally mirrors that of NH children, but is slower (Blamey, Barry, & Pascale, 2001; Serry & Blamey, 1999; Spencer & Guo, 2013). A notable exception to this pattern, /t/, has been shown to be acquired later-than normal in several investigations (Blamey et al., 2001; Chin, 2003; Ertmer, True Kloiber, Jongmin, Connell Kirleis, & Bradford, 2012). The primary purpose of this investigation was to …


Effects Of Workplace Incivility On Nurses' Emotions, Well-Being, And Behaviors: A Longitudinal Study, Zhiqing Zhou Jul 2014

Effects Of Workplace Incivility On Nurses' Emotions, Well-Being, And Behaviors: A Longitudinal Study, Zhiqing Zhou

USF Tampa Graduate Theses and Dissertations

This dissertation used an experience sampling design to examine effects of experienced workplace incivility from three categories of organizational insiders (coworkers, supervisors, and physicians) and from organizational outsiders (patients and their visitors) on targets' emotions, burnout, physical symptoms, and their own uncivil behaviors toward each of the four groups of people. Data were collected from 75 nurses with each nurse responding to online surveys twice per week for 5 consecutive weeks. Results from hierarchical linear modeling showed that within individuals, negative emotions were positively associated with experienced workplace incivility (overall and source-specific), burnout was positively associated with overall workplace incivility …


Evaluating The Effectiveness Of Tagteach For Teaching Yoga Postures To Novice Yoga Practitioners, Jessica Sade Andrews Jul 2014

Evaluating The Effectiveness Of Tagteach For Teaching Yoga Postures To Novice Yoga Practitioners, Jessica Sade Andrews

USF Tampa Graduate Theses and Dissertations

Abstract

Over the past few years there has been an increasing number of people practicing yoga. There also have been reports of injuries as a result of practicing yoga. Many injuries have been attributed to poor teaching which can result in improper alignment. This study utilized a teaching technology, TAGteach to aide in skill acquisition of novice yoga practitioners. The current study focused on teaching three beginner asanas (poses) to novice practitioners. The intervention included the asanas being broken down by task analysis and the steps tagged one by one. The intervention was assessed by a multiple baseline across behaviors …


Can Anyone With Low Income Be Food Secure?: Mitigating Food Insecurity Among Low Income Households With Children In The Tampa Bay Area, Edgar Allan Amador Jul 2014

Can Anyone With Low Income Be Food Secure?: Mitigating Food Insecurity Among Low Income Households With Children In The Tampa Bay Area, Edgar Allan Amador

USF Tampa Graduate Theses and Dissertations

In the US over the last few years, approximately 14.5% of households experience food insecurity at some point throughout the year. While studies on food insecurity in the US have determined that household income and specifically income available to spend on food is of critical importance to food security, it is still unclear why some households with low income are able to maintain food security while others experience food insecurity in a pattern characterized as not constant but recurrent. This dissertation compares households with children at different levels of food security and insecurity using the USDA Core Food Security Module …


Her-Storicizing Baldness: Situating Women's Experiences With Baldness From Skin And Hair Disorders, Kasie Holmes Jul 2014

Her-Storicizing Baldness: Situating Women's Experiences With Baldness From Skin And Hair Disorders, Kasie Holmes

USF Tampa Graduate Theses and Dissertations

A general goal to my study was to promote an inclusive approach to baldness by sharing and centering women's experiences with baldness from skin and hair conditions, such as autoimmune alopecia areata conditions and monilethrix. Specifically, a main goal of my study was to her-storicize the lived experiences of women who are bald from skin and hair conditions by examining medical and cultural discourses surrounding these conditions, femininity, and female baldness. Additionally, my study considers strategies of accommodation and resistance that bald women perform in a given context, space, or time. For instance, I consider the ways participants manage their …


Medical Pluralism In A Neoliberal State: Health And Deservingness In Southern Belize, Douglas Carl Reeser Jul 2014

Medical Pluralism In A Neoliberal State: Health And Deservingness In Southern Belize, Douglas Carl Reeser

USF Tampa Graduate Theses and Dissertations

This ethnography explores the varied contours of a national health care system and how it is used in conjunction with traditional forms of health care in Toledo District, Belize, focused on the largest town of Punta Gorda (P.G.), In a medically plural environment, a variety of health care options are used based on a wide range of social, economic, and structural factors that shape people's choices and decisions. The convenience of and experience with low-cost home- and self-care options make these the most common first choice during an illness event in P.G., however a deeper exploration of health behavior reveals …


Ketamine Psychedelic Psychotherapy: Focus On Its Pharmacology, Phenomenology, And Clinical Applications, Eli Kolp, Harris L. Friedman, Evgeny Krupitsky, Karl Jansen, Mark Sylvester, M. Scott Young, Anna Kolp Jul 2014

Ketamine Psychedelic Psychotherapy: Focus On Its Pharmacology, Phenomenology, And Clinical Applications, Eli Kolp, Harris L. Friedman, Evgeny Krupitsky, Karl Jansen, Mark Sylvester, M. Scott Young, Anna Kolp

Mental Health Law & Policy Faculty Publications

Meant to be an authoritative guide for psychiatrists and others interested in understanding and applying ketamine psychedelic psychotherapy (KPP), this paper focuses on its pharmacology, phenomenology, and clinical applications. Ketamine is a dissociative anesthetic widely used by physicians and veterinarians in the United States. In addition to its anesthetic and dissociative properties, ketamine also has a multitude of other psychological and pharmacological properties, which include analgesic, sedative, neuroprotective, anxiolytic, antidepressant, stimulant, euphoriant, and hallucinogenic effects. The literature on the clinical application of KPP is comprehensively reviewed, practical advice for using KPP is given, and the pharmacology and phenomenology of ketamine-induced …


Cancer And Infection, Kathleen Hope Plummer Jun 2014

Cancer And Infection, Kathleen Hope Plummer

USF Tampa Graduate Theses and Dissertations

E. coli is the most frequently isolated Gram negative pathogen from bacteremia in cancer patients and is repeatedly recovered from many other extraintestinal illnesses. These infections are commonly endogenous in nature and interfere with the treatment of cancer resulting in increased healthcare costs, morbidity, and mortality rates. Cancer and the treatments related to cancer cause alterations in the microbiome of the gut and other organs. Despite this point, there is a serious lack of knowledge about the genetic types of E. coli infecting cancer patients. This gap results in vague prevention strategies and limited treatment options for cancer patients. Multi …


Applying Modeled Hemi-Ellipsoids To The Study Of Pressure Distribution In Normal And Paraplegic Seated Subjects, Alicia Billington Jun 2014

Applying Modeled Hemi-Ellipsoids To The Study Of Pressure Distribution In Normal And Paraplegic Seated Subjects, Alicia Billington

USF Tampa Graduate Theses and Dissertations

The three goals of this research were to investigate how normal subjects move while seated, how paraplegic patients move while seated, and whether seated movements can be modeled using a hemi-ellipsoid shape. Pressure readings were recorded at 11 Hz using a 36 by 36 sensor pressure map by XSENSOR. Subjects were instructed to move or perform pressure relief as they normally would while seated. Analysis was performed using Microsoft Excel with Solver and Matrix.xla add-ins and automated with VBA code. Major movements and time intervals between movements were calculated by locating the area of maximum pressure on each hemi-buttock for …


Water And Health In The Nandamojo Watershed Of Costa Rica: Community Perceptions Towards Water, Sanitation, And The Environment, James Mcknight Jun 2014

Water And Health In The Nandamojo Watershed Of Costa Rica: Community Perceptions Towards Water, Sanitation, And The Environment, James Mcknight

USF Tampa Graduate Theses and Dissertations

Understanding the relationships between human health, water, sanitation, and environmental health is a requirement to understanding the challenges that face researchers when it comes to addressing global health relating to water and sanitation. Access to improved water and sanitation is not only a precondition to health, but to all aspects of daily living. Target 7.C of the Millennium Development Goals (MDGs) addresses worldwide disparities in access to improved water and sanitation by calling for the reduction in "half of the proportion of people without sustainable access to safe drinking water and sanitation by 2015". Over 90% of the population of …


The Reproductive Lives Of Chuukese Women: Transnationalism In Guam And Chuuk, Sarah Ann Smith Jun 2014

The Reproductive Lives Of Chuukese Women: Transnationalism In Guam And Chuuk, Sarah Ann Smith

USF Tampa Graduate Theses and Dissertations

Chuuk, one state of the Federated States of Micronesia (FSM), experiences significant transnational migration to the United States (U.S.), particularly to the Territory of Guam. This migration is facilitated by the Compact of Free Association (COFA), an agreement with several Micronesian countries previously under U.S. administration that allows for free movement of their citizens into the U.S. Although part of Micronesia, Guam's colonized residents resist an identity connected to rest of Micronesia. With very poor health outcomes, the Chuukese represent a political and social body of bodies that bring sickness, babies and increased costs to the Guam government without adequate …


Trend Analysis And Modeling Of Health And Environmental Data: Joinpoint And Functional Approach, Ram C. Kafle Jun 2014

Trend Analysis And Modeling Of Health And Environmental Data: Joinpoint And Functional Approach, Ram C. Kafle

USF Tampa Graduate Theses and Dissertations

The present study is divided into two parts: the first is on developing the statistical analysis and modeling of mortality (or incidence) trends using Bayesian joinpoint regression and the second is on fitting differential equations from time series data to derive the rate of change of carbon dioxide in the atmosphere.

Joinpoint regression model identifies significant changes in the trends of the incidence, mortality, and survival of a specific disease in a given population. Bayesian approach of joinpoint regression is widely used in modeling statistical data to identify the points in the trend where the significant changes occur. The purpose …


Illness Perceptions Of Polycystic Ovary Syndrome, Elizabeth Baker Jun 2014

Illness Perceptions Of Polycystic Ovary Syndrome, Elizabeth Baker

USF Tampa Graduate Theses and Dissertations

Polycystic ovary syndrome (PCOS) is a chronic illness that affects approximately five million premenopausal women in the United States and is associated with significant cosmetic, reproductive, metabolic, and psychological consequences. Despite its prevalence, few studies have explored the lived experiences and illness perceptions of women living with PCOS. Identifying illness perceptions of women living with (WLW) PCOS is important, because mounting research suggests that a person's perceptions of their chronic illness and its management determine that person's coping behaviors (e.g., adherence, self-management) and, consequently, illness outcomes.

In this dissertation, the Common Sense Model (CSM) is used as a framework to …


Statistical Analysis, Modeling, And Algorithms For Pharmaceutical And Cancer Systems, Bong-Jin Choi May 2014

Statistical Analysis, Modeling, And Algorithms For Pharmaceutical And Cancer Systems, Bong-Jin Choi

USF Tampa Graduate Theses and Dissertations

The aim of the present study is to develop a statistical algorithm and model associ- ated with breast and lung cancer patients. In this study, we developed several statistical softwares, R packages, and models using our new statistical approach.

In the present study, we used the five parameters logistic model for determining the optimal doses of a pharmaceutical drugs, including dynamic initial points, an automatic process for outlier detection and an algorithm that develops a graphic user interface(GUI) program. The developed statistical procedure assists medical scientists by reducing their time in determining the optimal dose of new drugs, and can …


Implications Of Human Umbilical Cord Blood Cells: An Immunotherapeutic Strategy For Alzheimer's Disease, Donna Darlington May 2014

Implications Of Human Umbilical Cord Blood Cells: An Immunotherapeutic Strategy For Alzheimer's Disease, Donna Darlington

USF Tampa Graduate Theses and Dissertations

ABSTRACT

Alzheimer's disease (AD) is the most common progressive age related dementia and the fourth major cause of mortality in the elderly in the United States. AD is pathologically characterized by deposition of amyloid beta (Aβ) plaques in the brain parenchyma and neurofibrillary tangles (NFTs) within the neuronal soma. While pharmacological targets have been discovered, current strategies for the symptomatic or disease-modifying treatment of AD do not significantly slow or halt the underlying pathological progression of the disease. Consequently, more effective treatment is needed. One possibility for amelioration is using human umbilical cord blood cell (HUCBC) therapy. HUCBCs comprise a …


Savor The Memory: A Reminiscence Exercise To Increase Positive Emotions And Reduce Depression Risk In Anxious Individuals, Bethany Morris May 2014

Savor The Memory: A Reminiscence Exercise To Increase Positive Emotions And Reduce Depression Risk In Anxious Individuals, Bethany Morris

USF Tampa Graduate Theses and Dissertations

A growing literature suggests that experiencing positive emotions provides psychological benefits (e.g., Coifman et al. 2007), and interventions increasing positive emotions may reduce depression risk (Geschwind et al., 2011). The present study tested whether reminiscence, a method of positive emotion savoring (Quoidbach et al., 2010), can mitigate depression risk by increasing positive emotions in an unselected sample and a subsample of at-risk anxious individuals. Female participants (n=336) were randomized to a reminiscence or control condition and asked to complete daily mental imagery exercises focusing on a positive memory (reminiscence) or a neutral laboratory memory (control) for one week. As expected, …


Assessing The Impacts Of Unrestricted Pesticide Use In Small-Scale Agriculture On Water Quality And Associated Human Health And Ecological Implications In An Indigenous Village In Rural Panam[Aacute], Sarah Louise Watson May 2014

Assessing The Impacts Of Unrestricted Pesticide Use In Small-Scale Agriculture On Water Quality And Associated Human Health And Ecological Implications In An Indigenous Village In Rural Panam[Aacute], Sarah Louise Watson

USF Tampa Graduate Theses and Dissertations

In 2014, the global pesticide industry's projected worth is $52 billion and by 2020, the developing world will make up one-third of the world's chemical production and consumption. Pesticides can have unintended negative consequences for human health and the environment, especially in the developing world where regulations are loose or nonexistent. One country with unrestricted use of pesticides is Panam[aacute], especially in Santa Rosa de Cucunatí. In this indigenous village, small-scale farmers and ranchers spray paraquat, glyphosate, picloram, and 2,4-D at higher elevations than the spring water source of a gravity-fed water system, the river, and the village. The objective …


"They're Our Bosses": Representations Of Clients, Guardians, And Providers In Caregivers' Narratives, Dina Vdovichenko May 2014

"They're Our Bosses": Representations Of Clients, Guardians, And Providers In Caregivers' Narratives, Dina Vdovichenko

USF Tampa Graduate Theses and Dissertations

The purpose of this study is to examine how various characters are portrayed within the self-narratives of women who are employed to care for adults with disabilities. This research looks at how these women's personal narratives construct characters-their clients (the individuals they provide services for), clients' guardians, and how these women portray themselves as caregivers. Interviews were conducted with eight women who provide paid care services to physically and/or cognitively impaired adults who receive services through the Florida Developmental Disabilities Home and Community Based Services Waiver Program. This program endorses specific expectations about the nature and purpose of caregiving. According …