Medicine and Health Sciences Commons^™

The Effect Of Pre-Emergence Gastric Aspiration On Postoperative Nausea And Vomiting Following Abdominal Surgery, Marc Alan Friedberg

Theses and Dissertations

An investigation was undertaken to determine the effect of pre-emergence gastric aspiration on the incidence of postoperative nausea and vomiting in abdominal surgery patients. Thirty female ASA I and ASA II patients were randomly assigned to either a control group (n = 16) or a treatment group (n = 14). Those patients in the treatment group received pre-emergence gastric aspiration with a suction catheter; those patients in the control group did not. The incidence of postoperative nausea and vomiting was determined at various time intervals. Data were analyzed using Student's t test and the Chi-square statistic. Results indicated that there …

Corticosteroid Effects And Senescence In Cultured Endothelium, Stephen A. Gudas

Theses and Dissertations

Cultures of human umbilical vein endothelial cells were treated with heparin-corticosteroid combinations to determine effects on cellular growth. Standard proliferation assays, colony formation assays, and cytoflourometric analysis were the methods employed. Dexamethasone (DEX) and hydrocortisone (HC) were inhibitory to growth of HUVEC when EtOH was used as a solvent and fully supplemented medium (20% serum) was employed. When DMSO was the solvent, growth enhancement sometimes occurred when (DEX) was the test steroid; growth inhibition occurred with this steroid when a reduced (1%) serum component was used. Since significant inhibition of cell colony formation in response to DEX administration was observed, …

Glucocorticoid-Responsive Hepatic Cytochromes P-450 In The Rat: Multiplicity And Differential Regulation, Keith Alan Hostetler

Theses and Dissertations

The multiplicity of glucocorticoid-responsive hepatic cytochromes P-450 in the rat was investigated by developing a series of monoclonal antibody probes directed against purified steroid-inducible isozymes from the rat (P-450p) and man (HLp). Two antibodies, termed 1G8 and 13-7-10, showed unique specificity for purified cytochromes P-450 upon immunoblot analyses. These antibodies were further characterized in terms of their reactivity toward proteins in liver microsomes from untreated and xenobiotic-treated rats. Three P-450p-related proteins were identified using 1G8 and 13-7-10 to monitor the expression of P-450p family subtypes. In untreated rats, members of this family exhibited sex-specific expression. Treatment with various chemicals resulted …

Modeling The Determinants Of Hospital Mortality, Abdolmohsin S. Al-Haider

Theses and Dissertations

This study examined hospital characteristics that affected the differential in hospital mortality, while controlling for the effect of community attributes. Analytical models for the determinants of hospital mortality were formulated and validated through an empirical examination of 243 hospitals that had higher or lower mortality rates than expected for Medicare beneficiaries. The dependent variable for this study was death rates for 1984 Medicare patients in united states hospitals released in 1986 by the Health Care Financing Administration.

Structural equation models that portray the causal relation between organizational constructs and hospital mortality rate were formulated. This causal model was empirically validated. …

New Antimuscarinic Agents For Improved Treatment Of Poisoning By Cholinesterase Inhibitors, Robert Lee Hudkins

Theses and Dissertations

Poisoning by organophosphate cholinesterase inhibitors results in a rapid rise in acetylcholine (ACh) in the synapse and many pronounced pharmacological effects in numerous tissues in the body. The treatment for organophosphorus poisoning involves administration of a cholinesterase—reactivating oxime to restore the activity of the cholinesterase and an antimuscarinic agent to block the response to the excess ACh. Presently atropine is the standard antimuscarinic agent used clinically as an antidote. This research was directed toward finding an antimuscarinic agent better than atropine as an antidote.

Since caramiphen and aprophen have been reported to be effective antidotes we synthesized numerous structural variations …

The Financial Performance Of System Acquired Hospitals, Janet Lynch

Theses and Dissertations

This study investigated the financial performance of not-for-profit hospitals in 10 Southern states acquired by either the for-profit or not-for-profit multihospital systems between the years 1978 through 1982. The impact of system affiliation on acquired hospitals was investigated by looking at average financial performance from the two years before acquisition to 1984/1985. Differences between the performance of hospitals acquired by for-profit and not-for-profit multihospital systems were examined as well. with regard to the latter, major findings revealed both for-profit and not-for-profit multihospital systems increased debt in acquired hospitals and made improvements to plant and equipment. For-profit multihospital systems additionally increased …

The Relationship Between Position And Incidence Of Spinal Headache Following Spinal Anesthesia In The Young Adult Female, Royce A. Fishell

Theses and Dissertations

This investigation determined the difference in the incidence of spinal headache in 33 patients placed in 30 degrees (°) head-up position versus 33 patients who remained flat for four hours following the administration of spinal anesthesia. An experimental design was used. The two randomly assigned groups presented for elective postpartum tubal ligation under spinal anesthesia. Group A was placed flat and group B had the head of their beds elevated 30° postoperatively. Strict procedural protocol was adhered to prior to and during the administration of the spinal anesthetic. To determine if the patients had any symptoms consistent with spinal headache, …

Agentive Theory As Therapy: An Outcome Study, Daniel K. Judd

Theses and Dissertations

The present study evaluated the efficacy of a four-week seminar which emphasized the principles of Agentive Theory. This theory, which is compatible with theories of a phenomenological/ existential perspective, was first developed by C. T. Warner, an American philosopher. Agentive Theorists/Therapists emphasize that our negative emotions, ie., depression, anger, etc. , are assertions or judgments we make and not merely feelings we are responsible for controlling or expressing. Forty-eight outpatients who sought help with personal/emotional problems from a department of behavioral medicine were assigned to either a treatment or waiting-list control Group. Following a four-week treatment phase, the treatment group …

Affect, Cognition And Attention In The Chronic Alcohol Abuser: A Hemispheric Laterality Perspective, Edward P. Kehrwald

Theses and Dissertations

The present study investigated the performance of chronic alcohol abusers and controls on attention, memory, cognition, and emotion from a hemispheric laterality perspective. The purpose of this study was to explore the relationship between these variables and their role in processing of experiences. Measures which are believed to be predominantly a function of the right hemisphere were explored in some depth.

The subjects in the experimental group were chronic alcohol abusers recently admitted to an inpatient addiction facility. The subjects in the control group were volunteers from the community who d1d not have any significant alcohol problem. Only right-handed males …

The Effect Of Utilization Controls On Hmo Enrollees' Health, Satisfaction With Care, And Disenrollment, Barbara Stewart Brown

Theses and Dissertations

The purpose of this prospective study is to examine the effects of differences in utilization controls on HMO enrollees' health, satisfaction with quality of care and access, and disenrollment. Previous studies of alternative care systems have shown that they are able to decrease costs (Luft, 1981; Anderson, Herald, Butler, Kohrman, & Morrison, 1985), but have not examined the organizational structure within the organization that oversees utilization. No prior studies have examined the effects of different types and degrees of utilization controls on the health, satisfaction, and access of enrollees.

For this investigation, Williamson's (1975) theory of organizations, transaction costs economics, …

Alternative Pharmacokinetic Models In End Stage Renal Disease During Continuous Ambulatory Peritoneal Dialysis, Eugenio Cefali

Theses and Dissertations

An important principle of pharmacokinetic modeling is to use the least complicated model possible that adequately describes the process studied. Pharmacokinetic studies in peritoneal dialysis often attempt to describe the time course of drug concentration in the dialysate. Peritoneal dialysis patients are subjected to the inconvenience and risk of infection associated with sampling peritoneal fluid. Alternative pharmacokinetic models were used to study drug distribution during continuous ambulatory peritoneal dialysis (CAPD). Efficient pharmacokinetic models of distribution in the peritoneal cavity were described for three drugs and the classes they represent.

Procainamide pnarmacokinetics were determined in six CAPD patients. The time course …

Nosocomial Respiratory Tract Infections Associated With The Use Of Ventilatory Support Systems: Epidemiological And Bacteriological Study Of The Effect Of Changing Breathing Circuits At 24 Or 48 Hours, Virginia Archer Lamb

Theses and Dissertations

Nosocomial (hospital-acquired) pneumonia (HAP) continues to be an important cause of morbidity and mortality in the hospital. HAP is the third most common nosocomial infection after urinary tract and surgical wound infections. In addition, HAP is the nosocomial infection with the highest mortality rate. These infections are often difficult to treat, because most are caused by Gram-negative bacilli (GNB) that may be highly resistant to antimicrobial agents. HAPs frequently occur in intensive care patients with underlying lung and/or systemic diseases. Many patients are intubated and are on assisted ventilation. Several sources of infection associated with ventilators or respirators have been …

Comparison Of Virulent And Avirulent Legionella Pneumophila And Evaluation Of Fish As A Potential Environmental Reservoir/Experimental Model, Sandra Reading Sommer

Theses and Dissertations

Legionella pneumophila was first recognized as a cause of human pneumonia in 1976 . Since then, much has been learned about the microbiology, pathophysiology and epidemiology of this organism. The features which permit one strain but not another to invade human lung tissue and produce disease remain incompletely understood. This study e valuated several attributes of a virulent and an avirulent strain of L. pneumophila in an attempt to identify characteristics which would distinguish the two. Evaluation of a new medium, buffered egg yolk agar, showed that virulence was maintained after 26 passages, which was the same as the buffered …

An Assessment Of Pain Responses During Stages Of Pregnancy, Ann H. Dunbar

Theses and Dissertations

As physical therapists are becoming more involved with the pregnant population both in traditional patient care as well as in childbirth education, a better understanding of the influence of pregnancy on the pain system is needed. The purpose of this study was to determine if an endogenous analgesia system is present in pregnant humans as has been shown to be present in animals (Ginzler, 1980). Women's affective and intensity responses were measured during late pregnancy, labor and post-partum. Using a repeated measures design, fifteen women responded to thermal stimuli (43-52 degrees C) by marking a visual analogue scale. No significant …

The Effect Of A Cardiovascular Risk Factor Education Program On Health Behaviors Of Selected School Age Children, Terry M. Tuck, Sharon K. Williams

Theses and Dissertations

This study, using a quasi-experimental design, was conducted to explore the effect of a cardiovascular risk factor education program on the health behaviors of a group of fifth grade children. The following hypothesis was tested:

There will be a statistically significant improvement in self-reported health behaviors of school age children who receive a cardiovascular risk factor education program as compared to the self-reported health behaviors of those school age children who do not receive a cardiovascular risk factor education program.

One hundred and nineteen subjects, 63 in the experimental group and 56 in the control group, were tested using the …

An Evaluation Of The Effectiveness Of A Substance Abuse Awareness And Prevention Program Developed For Use With University-Level Varsity Student-Athletes, Robert Joseph Marcello

Theses and Dissertations

Substance abuse problems affect all segments of society including collegiate athletics. Drug testing programs are viewed as one method of combating this problem, however, more emphasis should be placed upon developing effective prevention programs. Towards this end, the first purpose of this study was to draw from available literature to design a prevention program which would cater to the specific needs of student- athletes. The position is taken that since multiple factors such as genetic predisposition, the pharmacological properties of various substances, psychological variables, and environmental/socio-cultural influences are implicated in the etiology of substance abuse difficulties, multi-focused/broad-spectrum intervention programs would …

The Role Of Familial Conflict In The Adaptation To Menarche: Sequential Analysis Of Family Interaction, Grayson N. Holmbeck

Theses and Dissertations

Past research has suggested that temporary perturbations characterize parent-adolescent relations after the onset of pubertal change. The purpose of this study was to further delineate the characteristics of these disruptions in families with seventh-grade girls. Current operational definitions of family conflict in an observational context are inadequate and a potentially more useful definition was offered: conflict is believed to exist when there is the simultaneous occurrence of opposing interpersonal forces.

Two studies were conducted. A validation study was done to determine the psychosocial correlates of the following conflict variables: frequencies and reciprocal dyadic sequences of interruptions and disagreements. The affective …

Extent Of Participation In The Strategic Planning Process By Executive Nurses In Virginia's Acute Care Hospital, Mary R. Pippin

Theses and Dissertations

The purpose of this study was to determine the extent to which executive nurses participate in strategic planning for their institutions,and the extent to which these executive nurses utilize the strategic planning process for their nursing departments. The effect of ownership, size, and educational level of the executive nurse on the extent of participation in institutional strategic planning and the utilization of the strategic planning process for their nursing departments was also examined.

The population of the study included all executive nurses employed in short-term, nonmiltary, Virginia hospitals, which were members of the Virginia Hospital Association. Questionnaires were mailed to …

Health Locus Of Control Belief And Health Behavior In Patients With Job Related Injuries, Elnora H. Allen

Theses and Dissertations

This study examines the relationship between an individual's health locus of control belief and four variables: previous job injury experience, the duration of work absence due to previous job injury, appointment keeping behavior, and the wage replacement ratio. Seventy-two subjects with job related injuries referred to an industrial physical therapist were administered the Multidimensional Health Locus of Control Scale (MHLC). There was an uneven distribution of subjects according to MHLC belief patterns with more subjects demonstrating a "pure internal" health locus of control belief. No significance (Q > .05) was found between our four variables associated with a job injury and …

Nurse Practitioners' Perceptions And Behavioral Intent Toward Private Practice And Professional Autonomy, Steven David Mitnick

Theses and Dissertations

The purpose of this study was to determine: 1) the perceptions of nurse practitioners toward private practice and professional autonomy, and 2) nurse practitioners' behavioral intent towards private practice and professional autonomy. Data were collected with a questionnaire designed by the researcher to measure demographic data, nurse practitioners' perceptions and behavioral intent toward private practice and professional autonomy, and knowledge of legal issues pertaining' to private practice. Of 153 possible respondents, 100 (64%) nurse practitioners in the State of Maryland participated in the study.

Data were presented descriptively by number and percentage. The typical nurse practitioner was 31 to 40 …

Control Of Hospital Strategy In Small Multihospital Systems, Lora Hanson Warner

Theses and Dissertations

Hospitals are joining multihospital systems (MHSs) with growing frequency. About 80% of MHSs are small, composed of 2-7 hospitals. An important management issue in MHSs is the extent to which member hospitals retain control over their own strategic directions.

Using a contingency framework, this study uses both system and hospital—level determinants to explain the extent to which hospital members of MHSs control their own strategies. Survey and secondary data from 272 member hospitals of 62 small multi hospital systems (size 2-7 hospitals) are analyzed. System dispersion, size, ownership, strategic type, and age along with hospital occupancy, size, relationship to the …

Development Of The Analytical Methodology For Pyrimethamine And Its Application To Studies Of Partitioning And Binding In The Subcompartments Of Blood, Anita C. Rudy

Theses and Dissertations

An original HPLC assay was developed for pyrimethamine (PYR) in plasma, RBCs, and buffer for the purpose of studying its plasma protein binding and RBC partitioning.

Equilibrium dialysis (ED) was used to study protein binding. Isotonic phosphate buffer used in ED did not prevent small volume shifts. The pH of the plasma affected the protein binding of PYR although it was not significant for the comparison of binding at pH 7.4 vs. 8.0. PYR at 1000 ng/ml averaged 93.1% bound to plasma proteins. Binding to pure human albumin was 86.5% at lower levels of albumin and PYR (350 ng/ml). There …

Synthesis Of Polyhydroxybenzene Derivatives For Evaluation As Antitumor Agents, Douglas L. Brown

Theses and Dissertations

In order to prepare more effective inhibitors of ribonucleotide reductase a series of 4-substituted and 4,5-disubstituted catechols were synthesized and tested. The derivatives synthesized were also examined for their antitumor activity against L1210 leukemia in mice. A free radical scavenging assay was performed to establish what electronic parameters may govern in vitro and/or in vivo activity. The molecular features of the most potent compounds were compared to the features of the natural substrate of reduction, CDP, UDP, GDP and ADP.

The results obtained from the free radical assay did not show any correlation to the results observed either in vitro …

Phonetic Ambiguity Perception In Reading Disabled And Non-Disabled Children And Adolescents, Elizabeth A. Carter

Theses and Dissertations

There are speculations that disabled readers may fail to correctly decode written words because they are insensitive to language's phonetic form. This insensitivity is presumed by some to be due to a speech perceptual deficit. The purpose of the current study was to assess differences between disabled and non-disabled adolescents and elementary school students in their perceptual accuracy in decoding phonetically ambiguous speech. The effects of two processing factors derived from previous research, priming and word form (e.g., Spencer & Carter, 1982), were also examined to assess how perceptual processes may differ between groups. Clinical evidence of some verbal problems …

Health Perception, Anginal Symptoms And Life Satisfaction After Coronary Artery Bypass And Percutaneous Transluminal Coronary Angioplasty, Diana Creger Porter

Theses and Dissertations

The purpose of this descriptive correlational study was to gather data about the perceived health, anginal symptoms and life satisfaction in CABG and PTCA patients. The study explored the interrelationships among the variables and the differences between the two groups. The problem statement was:

1. How do patients perceive their own past, present and future health, level of anginal symptoms and life satisfaction after CABG and PTCA?

2. What are the interrelationships among perceived health, anginal symptoms and life satisfaction in CABG and PTCA patients.

The conceptual framework for this study was based on the social theory of symbolic interactionism …

Age And Experience Differences In Posture And Movement Of Children While English Horseback Riding At A Walk, Mary Katherine Belissary

Theses and Dissertations

The purposes of this study were to: (1) describe posture and movement of non-disabled children while English horseback riding at a walk, (2) propose a developmental sequence for each of three components of body posture and movement: the upper extremity the lower extremity, and the head and trunk, and (3) describe age differences in posture and movement while riding.

The study was designed as a cross-sectional descriptive study. Thirty children without disabilities: ten five-year-olds who had never received formal riding lessons; ten seven- and eight-year-olds who had received six months or less of formal riding lessons; and ten nine and …

The Incidence Of Auscultatory Gaps In Hospitalized Adults, Elizabeth Tayloe Courts

Theses and Dissertations

The study was undertaken to determine the incidence of auscultatory gaps in hospitalized adults and to determine whether a relationship existed between the presence of a gap and the patient's age, sex, race, or medical diagnosis. Blood pressures were taken bilaterally on 120 randomly selected hospitalized adults using the technique recommended by the American Heart Association. None of the subjects in the sample had an auscultatory gap present.

Illness Behaviour Questionnaire As A Predictor Of Problematic And Aproblematic Patients With A Painful Upper Extremity, Suzanne S. Seay

Theses and Dissertations

The purpose of this study was to measure the illness behavior of acute and chronic upper extremity pain patients using the Illness Behaviour Questionnaire (IBQ), to determine' the rehabilitation outcome by pre-set criteria, and to determine the effectiveness of the seven scales of the IBQ in predicting the problem pain patient. Each subject completed a self-administered test packet which included the IBQ. Each was identified by the investigator as a problematic or as a problematic patient using information in the medical chart. Patients entering the study with acute pain (n=12) had less pain upon discharge and returned more quickly to …

The Effects Of Religious Affiliation And Attendance On Illicit Sexual Behavior And Substance Abuse, Thomas W. Zane

Theses and Dissertations

A sample of 7724 college students in Washington and Utah was selected to study the relationships of religious activity and religious affiliation to illicit sexual behaviors, use of marijuana, and getting drunk. For all religious affiliations (except for the Jews), there were significant correlations between church activity and the measured illicit behaviors. LDS rates of behavior were significantly lower at <.001 for the five illicit behaviors. Two factor analyses were calculated to determine which sexual behaviors would load on a single factor and which substances would load on another factor. Extramarital coitus, heavy petting, and passionate kissing formed the first "sexual" factor. The use of beer, liquor, and marijuana combined with the behavior getting drunk to form the "substance-abuse" factor. A canonical analysis reported a moderate relationship with a canonical coefficient of .534 between the two factors. A discriminant analysis based on each subjects' religious affiliation and activity level yielded a 70-80 percent correct classification percentage.

The Effects Of Needle Play On Pre-School Children's Anxiety Concerning Injections, Michelle Anne Belyea

Theses and Dissertations

The purpose of this study was to determine the effects of needle play in reducing pre-school children's anxiety concerning injections. The Pre-school Observational Scale of Anxiety was used to measure the degree of anxiety experienced by the children. The hypothesis stated that there would be a significant decrease in anxiety of pre-school children who participated in needle play as compared with the anxiety scores of pre-school children who did not participate in needle play.The sample consisted of 20 pre-school children who were receiving routine health care and injections for immunizations or PPDs (purified protein derivative) at a county health department …