Medicine and Health Sciences Commons^™

Examining Demographic And Environmental Factors In Predicting The Perceived Impact Of Cancer On Childhood And Adolescent Cancer Survivors, Nazan Cetin

Dissertations and Theses

Cancer survivors' perceptions on how cancer has impacted their lives has been identified as a "critical predictor" of psychosocial well-being and quality of life outcomes. Given the dramatic increase in survival rates and the long-term health and psychosocial challenges, as well as survivorship care barriers, this study focuses special attention on childhood and adolescent cancer survivors and is guided by Tedeschi and Calhoun's theory of posttraumatic growth and Hammond's theory of distinctiveness. This study aims to examine the influence of demographic (i.e., age at diagnosis, biological sex, race/ethnicity, type of cancer) and environmental factors (i.e., geographical location and insurance type), …

Treatment Disparities In Emergency Medical Services: The Influence Of Race/Ethnicity, Obesity, And English Proficiency, Jamie Kennel

Dissertations and Theses

Different treatment in healthcare settings provided to different social groups of people may lead to disparities in health, quality of life, and life span. Despite the critical role among healthcare services that Emergency Medical Services (EMS) provides disproportionately for marginalized communities, it remains unclear if and to what extent treatment disparities take place in the pre-hospital setting. Guided by the theoretical frameworks of social worth, aversive racism, and stigma, this study utilizes medical chart data from three different public and private datasets to investigate treatment disparities by Emergency Medical Service providers for racial minority, obese, and limited English proficiency patients. …

Enhancing Value-Based Healthcare With Reconstructability Analysis: Predicting Risk For Hip And Knee Replacements, Cecily Corrine Froemke

Dissertations and Theses

Legislative reforms aimed at slowing growth of US healthcare costs are focused on achieving greater value, defined specifically as health outcomes achieved per dollar spent. To increase value while payments are diminishing and tied to individual outcomes, healthcare must improve at predicting risks and outcomes.

One way to improve predictions is through better modeling methods. Current models are predominantly based on logistic regression (LR). This project applied Reconstructability Analysis (RA) to data on hip and knee replacement surgery, and considered whether RA could create useful models of outcomes, and whether these models could produce predictions complimentary to or even stronger …

Foundational Knowledge And Other Predictors Of Commitment To Trauma-Informed Care, Stephanie Anne Sundborg

Dissertations and Theses

Trauma-informed care (TIC) is an approach to service delivery based on the understanding of the prevalence of psychological trauma among service users, knowledge about the impact trauma has on engagement to services, and recognition that service settings can be re-traumatizing. For more than a decade, momentum has been building on this topic. Practitioners are pursuing the knowledge and skills needed to implement trauma-informed service delivery, while organizations are building infrastructure and processes aimed at supporting this approach. Disciplines across many human service sectors are eager to incorporate TIC into policy and practice. Despite this enthusiasm, implementation efforts are slow. Acquiring …

Novel Compound, 84f2, Inhibits Calmodulin Deficient Ryr2, Robert Carl Klipp

Dissertations and Theses

The cardiac ryanodine receptor (RyR2) plays a key role in excitation-contraction coupling (ECC). Mutations in RyR2 are known to be linked to the arrhythmogenic disorder, catecholaminergic polymorphic ventricular tachycardia (CPVT), a deadly disease which is characterized by a leak of calcium from sarcoplasmic reticulum and a decrease in calmodulin (CaM) binding. A novel drug, 84F2, shown to inhibit arrhythmias in RyR2-R176Q heterozygous CPVT mouse hearts (2.5 µg/kg), decrease spark frequency in cells derived from CPVT mice (IC₅₀ = 35 nM), and inhibit RyR2 single channel activity at low nanomolar concentrations (IC₅₀ = 8 nM). When CaM is added …

Characterization Of Methylene Diphenyl Diisocyanate Protein Conjugates, Morgen Mhike

Dissertations and Theses

Diisocyanates (dNCO) such as methylene diphenyl diisocyanate (MDI) are used primarily as cross-linking agents in the production of polyurethane products such as paints, elastomers, coatings and adhesives, and are the most frequently reported cause of chemically induced immunologic sensitization and occupational asthma (OA). Immune mediated hypersensitivity reactions to dNCOs include allergic rhinitis, asthma, hypersensitivity pneumonitis and allergic contact dermatitis.

There is currently no simple diagnosis for the identification of dNCO asthma due to the variability of symptoms and uncertainty regarding the underlying mechanisms. Immunological sensitization due to dNCO exposure is traditionally thought to require initial conjugation of the dNCO to …

Catecholamine Interactions With The Cardiac Ryanodine Receptor, Robert Carl Klipp

Dissertations and Theses

The cardiac ryanodine receptor (RyR2) is a Ca²⁺ ion channel found in the sarcoplasmic reticulum (SR), an intracellular membranous Ca²⁺ storage system. It is well known that a destabilization of RyR2 can lead to a Ca²⁺ flux out of the SR, which results in an overload of intracellular Ca²⁺; this can also lead to arrhythmias and heart failure. The catecholamines play a large role in the regulation of RyR2; stimulation of the Beta-adrenergic receptor on the cell membrane can lead to a hyperphosphorylation of RyR2, making it more leaky to Ca²⁺. We have …

Metaphor Use In Interpersonal Communication Of Body Perception In The Context Of Breast Cancer, Jennifer Mary Fillion

Dissertations and Theses

Female breast cancer patients are often confused, frustrated, and devastated by changes occurring in their bodies and the treatment process. Many women express frustration and concern with the inability to know what the next phases of their life will bring. Previous research also states that many women struggle to communicate with others about treatment as well as side effects. This research examined how woman are use metaphors to describe their experience with breast cancer, specifically throughout the treatment period related to body image struggles. I qualitatively conducted interviews with women who were either currently in treatment or just finishing. My …

The Institutional Context That Supports Team-Based Care For Older Adults, Anna Foucek Tresidder

Dissertations and Theses

The aging population in the U.S. is dramatically increasing; it is predicted that not only will individuals live longer but also that they will live with multiple chronic diseases that could require high levels of medical and social resources. While the aging population increases, the number of health care providers choosing to specialize in caring for the elderly is decreasing just as dramatically. Teams are believed to be a possible response to more efficiently use the providers available, take advantage of alternative provider types, and integrate a range of health and social services to meet patient needs more effectively. Interdisciplinary …

Stress Reactions Of Division-I Track Athletes, Laura Elizabeth Skarda

Dissertations and Theses

Problem: Track and field athletes, along with cross-country athletes have multiple and back to back seasons, creating overuse injuries. Stress fractures or stress reactions to the bone are the overuse injuries focused on in this study and literature review. There is a lack of information in the literature regarding stress reactions. Purpose: The goal of the study is to understand more information about stress reactions to bone and possibly increase the knowledge of health care professionals. Methods: Three case studies were examined through pre-existing medical chart notes and athletic trainer's notes regarding the stress reactions. A literature review was also …

Short-Term Plasticity At The Schaffer Collateral: A New Model With Implications For Hippocampal Processing, Andrew Hamilton Toland

Dissertations and Theses

A new mathematical model of short-term synaptic plasticity (STP) at the Schaffer collateral is introduced. Like other models of STP, the new model relates short-term synaptic plasticity to an interaction between facilitative and depressive dynamic influences. Unlike previous models, the new model successfully simulates facilitative and depressive dynamics within the framework of the synaptic vesicle cycle. The novelty of the model lies in the description of a competitive interaction between calcium-sensitive proteins for binding sites on the vesicle release machinery. By attributing specific molecular causes to observable presynaptic effects, the new model of STP can predict the effects of specific …

Humor-Related Social Exchanges And Mental Health In Assisted Living Residents, Ann Elizabeth Mcqueen

Dissertations and Theses

Social contact is known to be vital for older adults' mental and physical health, but few studies of social interactions have taken place in long-term care settings. The current study investigated whether the psychological well-being of assisted living residents was influenced by factors associated with residents' social interactions involving humor. Specific aims of the present study were to develop and test a measure related to humor-related social exchanges, to examine how humor-related social exchanges affect residents' mental health, and to explore whether humor-related social exchanges mediated the effects of resident and facility characteristics on indices of mental health. One hundred …

Patient-Guided Investigation Of The Restoration Of Health Following Traumatic Brain Injury, Nancy Ann Carney

Dissertations and Theses

The development of emergency department medical interventions and the implementation of fast-transport trauma systems has decreased the rate of death resulting from traumatic brain injury (TBI). Without corresponding methods for long-term treatment and recovery, the prevalence of people disabled by TBI has increased, creating a growing public health problem. Investigations generated by physicians, rehabilitation programs, and social scientists, which attempt to associate standard measures of injury severity with outcome, leave unexplained variance in long-term functional status for persons with TBI.

The purpose of this investigation was to use persons with brain injury and their family members, to guide an analysis …

The Health Belief Model As A Predictor Of Gynecological Exams: Does Sexual Orientation Matter?, Lynn Elizabeth Kunkel

Dissertations and Theses

Screening and early detection are essential for the management and control of most diseases. It is important for women to practice routine health care that includes both clinical and self examinations. Today, many women go without health care due to barriers which prevent them from obtaining adequate care. The present study was designed to investigate, using the Health Belief Model, whether there is a difference between heterosexual and lesbian women in obtaining gynecological exams. Responses from 238 participants, 70 heterosexuals and 168 lesbians, indicated that the Health Belief Model was a significant predictor of whether women complied with recommended guidelines …

Audiological In-Service Regarding Hearing Impairment And Its Impact On Communication In The Geriatric Population, Marie Barlow Lassell

Dissertations and Theses

At least two studies have been found conducted in the area of audiological in-services and their impact on the people to whom they were presented. In 1981, Dancer and Keiser studied the effects of empathy training on geriatric-care nurses and in 1985, Dampier, Dancer, and Keiser studied changing attitudes of college students toward older persons with hearing loss. Both of the studies investigated the effect of in-service training on empathy, rather than using the traditional academicallyoriented in-service program approach. Both studies found statistical results indicating a significant positive change in the subjects' feelings toward hearing impaired geriatrics. Additionally, Dancer et …

From 'The Help Of Grave And Modest Women' To 'The Care Of Men Of Sense': The Transition From Female Midwifery To Male Obstetrics In Early Modern England, Karen L. Smith Adams

Dissertations and Theses

Until the sixteenth century, childbirth in England was the exclusive domain of women and was orchestrated by the female midwife. By the end of the seventeenth century, university-educated and church-approved male physicians were systematically beginning to usurp the midwife's role in the lying-in room and to gradually assume authority and power over the process of childbirth. Ultimately doctor-dominated childbirth threatened, and in some places accomplished, the displacement of the midwife. No one factor was responsible for the shift in delivery room personnel nor was the transition from female midwives to male obstetricians a "natural" one. This thesis looks at three …

Body Weight Changes Throughout The Menstrual Cycle And Their Effect Upon The Components Of Body Composition, Lovina M. Query

Dissertations and Theses

Research has shown that women experience fluctuations in body weight (BW) due to water retention and/or other processes at various times in the menstrual cycle. The purpose of this study is to measure women repeatedly throughout the course of one menstrual cycle and

(1) to confirm whether significant fluctuations in weight occur at various times and

(2) to determine whether there are significant differences in the components of body composition by hydrostatic weighing which are related to any changes in BW.

It was concluded that while significant fluctuations in BW occur at certain times in the menstrual cycle, the changes …

Serial Cardiovascular Adaptations During Pregnancy, Mark Vincent Hart

Dissertations and Theses

Maternal cardiovascular adaptations appear to be essential in order to supply extra circulation to both the developing fetus and maternal system during a successful pregnancy. Since inadequate cardiovascular adjustments may produce abortions or maternal morbidity, the characterization of maternal cardiovascular changes during pregnancy and the elaboration of the underlying mechanism for these changes are essential to the understanding of how the heart enlarges during pregnancy and what significance this enlargement might have. To provide needed information regarding this time course and extent of maternal cardiac enlargement and the hormonal and hemodynamic changes which may be responsible for these changes, the …

Some Observations Of The Swedish Psychiatric System, Gunnar Robert Almgren

Dissertations and Theses

The purpose of this report is to introduce the reader to the system of psychiatric services in Sweden. The format of this report is a brief summary of the economic, political and value context of the Swedish welfare state, a review of the essential services available to the Swedish citizen under present Swedish social welfare policy, and then an overview of Sweden's psychiatric system. The overview of the system itself includes a discussion of general characteristics as well as an examination of the system as it operates in one particular region.

A Descriptive Study Of Social Service Needs And Demographic Characteristics Of Selected Emergency Room Patients, Anne K. Parker

Dissertations and Theses

The purpose of this study is to gain information about the social service needs and demographic characteristics of patients admitted to Providence Hospital's emergency room during the hours a social worker is not available. The emergency room staff requested the information in order to utilize it in planning emergency room services.

Children With Porencephaly: A Study Of Services, Dana Kaufman, Elisabeth Mason

Dissertations and Theses

This study was conducted to serve as a follow-up of services received and/or needed by families with children who have been identified by Crippled Children's Division of the University of Oregon Health Sciences Center as having porencephaly, usually a severe form of brain damage. Porencephaly refers to cystic cavities or lesions in the brain caused by a prenatal insult to the brain resulting in varying degrees of motor and mental deficits. These children have been seen in general as part of the Cerebral Palsy Clinic. There may be a lack of awareness on part of the parents and the staff …

Women In Menopause: A Study Of Gynecologist's Perceptions, Zadell Cogan, Sharon Kennedy

Dissertations and Theses

The purpose of this study was to explore the needs of women experiencing menopause. Since women at this time experience physical, social and emotional changes, they may have a special need for services. Doctors were selected as the population for study because they treat so many women at this age and because they are powerful transmitters of our culture. This exploratory study was designed to provide descriptive information about the doctors' perceptions.

Results are reported from interviews with seventeen gynecologists from the Portland metropolitan area in Oregon. Attempts were made to interview all female gynecologists in the area. Male gynecologists …

Foster Family Care For The Aged, Donald V. Sekora

Dissertations and Theses

The following was a research practicum instituted as an actual project for the State of Montana Welfare Department between June, 1970, and May, 1971. The project had a two-fold purpose in being conceived: one purpose was to fulfill a graduate school academic requirement; and the second purpose was to fulfill a responsibility to the people of Montana who would eventually gain some benefits from this project. The series of written documents that follow are the description of that project's conception and actualization in six Montana counties. The first part is the project idea and theory; the next two parts consist …