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Articles 2731 - 2760 of 5384
Full-Text Articles in Medicine and Health Sciences
A Comparative Effectiveness Study Of Continuous Positive Airway Pressure (Cpap) Related Skin Breakdown When Using Different Nasal Interfaces In The Extremely Low Birth Weight (Elbw) Neonate, Katherine Newnam
Theses and Dissertations
Nasal continuous positive airway pressure (CPAP) is reportedly superior to mechanical ventilation in the neonatal population by reducing bronchopulmonary dysplasia (BPD). The neonate is vulnerable to injury secondary to immature physiological systems and skin structures and the current CPAP devices place constant pressure on nares, nasal septum and forehead, increasing injury risk. Through the framework of comparative effectiveness research an examination of nasal interfaces currently used during neonatal CPAP was conducted in an effort to provide scientifically supported recommendations and improve clinical outcomes. The primary aim of this study was to determine differences in the frequency, severity and specific types …
Chromosome-Specific Telomere Length In Women With Breast Cancer: Their Relationship To Chemotherapy And Acquired Psychoneurological Symptoms, Areej Alhareeri
Chromosome-Specific Telomere Length In Women With Breast Cancer: Their Relationship To Chemotherapy And Acquired Psychoneurological Symptoms, Areej Alhareeri
Theses and Dissertations
Breast cancer (BC) is one of the most common diagnosed malignancies in females. Although 90% of early diagnosed women are expected to survive for at least 5 years, their quality of life is adversely affected by a cluster of symptoms which we collectively named “psychoneurological symptoms’’ (PN). Given that acquired telomere attrition has been speculated to be a causal factor in chronic diseases and the lack in the literature of mechanisms giving rise to PN symptoms, this study was performed to assess telomere length using a chromosome-specific telomere assay before receiving chemotherapy and at the first chemotherapy. We showed significant …
Effects Of Short-Term Minocycline Treatments On Inflammatory Cell Response In The Acute Stage Following Tbi, Henna Ayub
Effects Of Short-Term Minocycline Treatments On Inflammatory Cell Response In The Acute Stage Following Tbi, Henna Ayub
Theses and Dissertations
Following traumatic brain injury (TBI), neuroinflammation contributes to the secondary injury. Microglia are the resident immune cells of the central nervous system (CNS), and when activated can exert either protective or detrimental effects on surrounding tissue. They are often segregated into subpopulations based on their type of activation, either pro- inflammatory (M1, classically activated), or anti-inflammatory (M2, alternatively activated). Minocycline, an anti-inflammatory drug, is known to be neuroprotective and to have effect on microglia. However, the effect of minocycline on subpopulations of inflammatory cells in the acute stage following injury is unclear. It is also unclear whether minocycline has a …
Understanding Molecular Interactions: Application Of Hint-Based Tools In The Structural Modeling Of Novel Anticancer And Antiviral Targets, And In Protein-Protein Docking, Hardik Parikh
Theses and Dissertations
Computationally driven drug design/discovery efforts generally rely on accurate assessment of the forces that guide the molecular recognition process. HINT (Hydropathic INTeraction) is a natural force field, derived from experimentally determined partition coefficients that quantifies all non-bonded interactions in the biological environment, including hydrogen bonding, electrostatic and hydrophobic interactions, and the energy of desolvation. The overall goal of this work is to apply the HINT-based atomic level description of molecular systems to biologically important proteins, to better understand their biochemistry – a key step in exploiting them for therapeutic purposes. This dissertation discusses the results of three diverse projects: i) …
Automatic Block-Matching Registration To Improve Lung Tumor Localization During Image-Guided Radiotherapy, Scott Robertson
Automatic Block-Matching Registration To Improve Lung Tumor Localization During Image-Guided Radiotherapy, Scott Robertson
Theses and Dissertations
To improve relatively poor outcomes for locally-advanced lung cancer patients, many current efforts are dedicated to minimizing uncertainties in radiotherapy. This enables the isotoxic delivery of escalated tumor doses, leading to better local tumor control. The current dissertation specifically addresses inter-fractional uncertainties resulting from patient setup variability. An automatic block-matching registration (BMR) algorithm is implemented and evaluated for the purpose of directly localizing advanced-stage lung tumors during image-guided radiation therapy. In this algorithm, small image sub-volumes, termed “blocks”, are automatically identified on the tumor surface in an initial planning computed tomography (CT) image. Each block is independently and automatically registered …
Attire And Appearance Of Orthodontists: A Survey Of Parent Preferences, Gillian Kelly
Attire And Appearance Of Orthodontists: A Survey Of Parent Preferences, Gillian Kelly
Theses and Dissertations
The objective of this study was to evaluate parents’ preferences of the appearance and attire of orthodontists. Six subjects were asked to pose for photographs wearing various combinations of attire (casual, scrubs, white coat, formal), hairstyle and nametag. Survey participants were presented with choice sets and asked to select the most and least preferred provider photographs. A total of 77 parents of orthodontic patients participated in the computer-based survey. The results indicated that there were significant differences due to provider sex (P = 0.0013), provider age (P < .0001), dress (P < .0001), nametag (P = 0.0065) and hair (P < .0001). The most preferred providers were the younger female and the older male. Formal attire or scrubs was the most preferred style of dress. There was also a preference for the use of a nametag and for the provider to have his/her hair in a controlled style.
Acute Pharmacological Treatment Given To Older Adults With Acute Myocardial Infarction: A Nationwide Emergency Department Study, 1992-2010, Maryam S. Alowayesh
Acute Pharmacological Treatment Given To Older Adults With Acute Myocardial Infarction: A Nationwide Emergency Department Study, 1992-2010, Maryam S. Alowayesh
Theses and Dissertations
OBJECTIVES: To determine the pattern and predictors of use of antiplatelet agents and beta-blockers given in the emergency department (ED) to older adults with acute myocardial infarction (AMI) and its effects on in-hospital mortality and length of hospital stay (LOS) and to determine the effect of computerized ED guideline reminders on their utilization. METHODS: A cross-sectional study using the National Hospital Ambulatory Medical Care Survey (NHAMCS) ED data for years 1992 to 2010 was conducted. Patients were included if they had an admission diagnosis of AMI (ICD-9-CM code 410.xx) and were ≥55 years. Survey logistic regression was used to examine …
The Influence Of Active Reminders On Oral Hygiene Compliance In Orthodontic Patients, Matthew Eppright
The Influence Of Active Reminders On Oral Hygiene Compliance In Orthodontic Patients, Matthew Eppright
Theses and Dissertations
Text message reminders have proven effective for positive behavioral changes in medicine, but their influence on oral hygiene compliance has never been tested. This study aimed to determine if text message reminders about oral hygiene have an influence on the level of compliance. In this prospective randomized controlled clinical trial, 42 orthodontic patients were assigned to a text message or control group. Parents of patients assigned to the text message group received a reminder text message one weekday each week. Oral hygiene compliance was measured using bleeding index, modified gingival index, plaque index, and visual examination of white spot lesion …
The Role Of Alginate In The Inhibition Of Macrophage Phagocytosis Of Mucoid Pseudomonas Aeruginosa, Warren Rowe Iii
The Role Of Alginate In The Inhibition Of Macrophage Phagocytosis Of Mucoid Pseudomonas Aeruginosa, Warren Rowe Iii
Theses and Dissertations
During colonization of the cystic fibrosis airway Pseudomonas aeruginosa converts from non-mucoid to a mucoid phenotype, characterized by the production of the exopolysaccharide alginate. Alginate production has been shown to enhance survival by promoting biofilm formation, evading complement killing, and resisting phagocytosis. The mechanism by which alginate protects P. aeruginosa from phagocytosis is unclear. To investigate the role of alginate in the inhibition of phagocytosis, a human monocytic cell line (THP-1) and a murine alveolar macrophage cell line (MH-S) were used to determine the effects of alginate on macrophage binding, signaling, and phagocytosis. Phagocytosis assays using the mucoid cystic fibrosis …
Ethanol Regulation Of Glucocorticoid Responsive Genes, Blair Costin
Ethanol Regulation Of Glucocorticoid Responsive Genes, Blair Costin
Theses and Dissertations
Glucocorticoid hormones modulate acute and chronic behavioral and molecular responses to drugs of abuse including psychostimulants and opioids. Acute ethanol activates the hypothalamic pituitary adrenal (HPA) axis causing the release of adrenal glucocorticoid hormones, but following chronic ethanol the HPA axis is dysregulated in both humans and rodents. Thus, there is growing evidence that glucocorticoids might also modulate behavioral and molecular responses to ethanol. Previous microarray studies in the Miles’ laboratory have shown that the well-known glucocorticoid responsive gene, Serum and Glucocorticoid-regulated Kinase 1, Sgk1, is prominently up regulated by acute ethanol (2 g/kg) in the prefrontal cortex (PFC) of …
Systematic Analysis Of Abc Transporters In Streptococcus Sanguinis, Sawsan Atia
Systematic Analysis Of Abc Transporters In Streptococcus Sanguinis, Sawsan Atia
Theses and Dissertations
The bacterium Streptococcus sanguinis is a primary member of the human oral microflora and also has been recognized as a key player in the bacterial colonization of the mouth. It is considered the most common viridians streptococcal species implicated in infective endocarditis. In all kingdoms of life, ATP binding cassette (ABC) transporters are essential to many cellular functions. Sequencing of the SK36 genome provided the opportunity to study ABC transporter mutants and their relationship with acidity of the oral environment. Despite numerous studies that have focused on carbohydrate uptake systems in closely related streptococcal species such as S. mutans, S. …
Development Of Antagonists Targeting Chemokine Receptor Ccr5 And The Chemokine Receptor Ccr5 – Mu Opioid Receptor Heterodimer, Christopher Kent Arnatt
Development Of Antagonists Targeting Chemokine Receptor Ccr5 And The Chemokine Receptor Ccr5 – Mu Opioid Receptor Heterodimer, Christopher Kent Arnatt
Theses and Dissertations
The chemokine receptor CCR5 (CCR5) plays an integral role within the inflammatory network of cells. Importantly, CCR5 is a mediator in several disease states and can be targeted using small molecule antagonists. Within this work, CCR5’s role in prostate cancer and HIV/AIDS has been exploited in order to develop potential therapeutics and probes. First, a series of novel compounds was designed by using pharmacophore-based drug design based upon known CCR5 antagonists and molecular modeling studies of the CCR5 receptor’s three-dimensional conformation. Once synthesized, these compounds were tested for their CCR5 antagonism and their anti-proliferative effects in several prostate cancer cell …
A Study Of Coverage Optimized Planning Incorporating Models Of Geometric Uncertainties For Prostate Cancer, Huijun Xu
Theses and Dissertations
A fundamental challenge in the treatment planning process of multi-fractional external-beam radiation therapy (EBRT) is the tradeoff between tumor control and normal tissue sparing in the presence of geometric uncertainties (GUs). To accommodate GUs, the conventional way is to use an empirical planning treatment volume (PTV) margin on the treatment target. However, it is difficult to determine a near-optimal PTV margin to ensure specified target coverage with as much normal tissue protection as achievable. Coverage optimized planning (COP) avoids this problem by optimizing dose in possible virtual treatment courses with GU models directly incorporated. A near-optimal dosimetric margin generated by …
Optimization Of Radiation Therapy In Time-Dependent Anatomy, W. Tyler Watkins
Optimization Of Radiation Therapy In Time-Dependent Anatomy, W. Tyler Watkins
Theses and Dissertations
The objective of this dissertation is to develop treatment planning techniques that have the potential to improve radiation therapy of time-dependent (4D) anatomy. Specifically, this study examines dose estimation, dose evaluation, and decision making in the context of optimizing lung cancer radiation therapy. Two methods of dose estimation are compared in patients with locally advanced and early stage lung cancer: dose computed on a single image (3D-dose) and deformably registered, accumulated dose (or 4D-dose). The results indicate that differences between 3D- and 4D- dose are not significant in organs at risk (OARs), however, 4D-dose to a moving lung cancer target …
Hospital Electronic Health Record Adoption And Its Influence On Postoperative Sepsis, Naleef Fareed
Hospital Electronic Health Record Adoption And Its Influence On Postoperative Sepsis, Naleef Fareed
Theses and Dissertations
Electronic Health Record (EHR) systems could make healthcare delivery safer by providing benefits such as timely access to accurate and complete patient information, advances in diagnosis and coordination of care, and enhancements for monitoring patient vitals. This study explored the nature of EHR adoption in U.S. hospitals and their patient safety performance in relation to one hospital acquired condition: postoperative sepsis – a condition that complicates hospitalizations, increases lengths of stay, and leads to higher mortality rates. Administrative data from several sources were utilized in order to obtain comprehensive information about the patient, organizational, and market characteristics of hospitals, their …
Correlates And Predictors Of Risky Sexual Partnering, Jennifer Nield
Correlates And Predictors Of Risky Sexual Partnering, Jennifer Nield
Theses and Dissertations
Introduction: Sexually Transmitted Diseases, including HIV/AIDS, continue to be a major burden in the United States. Sexual partnering behaviors contribute to the spread of STDs. Sexual concurrency has been shown to exponentially increase STD prevalence in populations. Serial monogamy with short periods between sexual partners also introduces risk. Methods: We identified sexually active men and women from the 2006-2010 National Survey of Family Growth (NSFG) and used sub sets for each particular study. Sexual partnering was defined as being concurrent, serially monogamous or monogamous in the previous year. Polytomous logistic regression models were developed to evaluate the associations between age …
Sensory Modulation Disorder: Impact On Coping And Occupational Performance, Audrey E. Kane
Sensory Modulation Disorder: Impact On Coping And Occupational Performance, Audrey E. Kane
Theses and Dissertations
Occupational therapists theorize that behavioral responses to sensory stimuli are reflective of a child’s underlying ability to process sensory information in a manner that allows the child to engage in childhood occupations meaningfully. If a child’s ability to process sensory information is compromised, then occupational performance is compromised. Similarly if coping skills are less than adequate, successful engagement in occupations is limited. What is less clear is how sensory modulation and coping interact to influence occupational performance. This study examined the interplay between sensory modulation, coping, and occupational performance in a sample of children referred for sensory processing difficulties. Two …
Factors For Selecting A Consumer Directed Health Care Plan, David Jordan
Factors For Selecting A Consumer Directed Health Care Plan, David Jordan
Theses and Dissertations
Health Reimbursement Arrangements (HRAs) and Health Savings Account (HSA) eligible High Deductible Health Plans (HDHPs) emerged as a new health care insurance models referred to as Consumer Directed Health Plans (CDHPs) in the early 2000s. The purpose of this study is to examine the association between enrollees’ prior financial experiences as they relate to health care access and use with plan choice when a Managed Care Preferred Provider Organization (PPO), HRA, and HSA eligible HDHP are offered concurrently in an ESI program. It is important to examine new health insurance structures, such as CDHPs, to better understand their impact on …
The Role Of Nicotinic Acetylcholine Receptors In Ethanol Responsive Behaviors And Drinking, Anton Dawson
The Role Of Nicotinic Acetylcholine Receptors In Ethanol Responsive Behaviors And Drinking, Anton Dawson
Theses and Dissertations
The high co-morbidity between alcohol (ethanol) and nicotine abuse suggests that nicotinic acetylcholine receptors (nAChRs), which are thought to underlie nicotine dependence, may also be involved in alcohol dependence. A genomic region that encodes the Alpha5* nAChR subtype has recently been shown to be associated with alcohol dependence phenotypes in humans. Therefore, the aim of this study was to determine the role of Alpha5* nAChRs in ethanol-responsive behaviors upon acute administration in mice as well as in their drinking behavior. We conducted tests in mice lacking the Alpha5 coding gene (Chrna5) in ethanol-induced hypothermia, hypnosis, anxiolysis, and conditioned place preference. …
Examining Caregiver Appraisal Of Functional Capacity In Family Members With Dementia, Catherine Verrier Piersol
Examining Caregiver Appraisal Of Functional Capacity In Family Members With Dementia, Catherine Verrier Piersol
Theses and Dissertations
The vast majority of persons with Alzheimer’s disease and related dementias live at home and are cared for by families or close friends/neighbors. An essential element to daily care decisions is the caregiver’s appraisal of function in the family member with dementia. This dissertation comprises three separate papers exploring caregiver appraisal of functional capacity, using secondary data from a study conducted at Thomas Jefferson University of 88 patient-caregiver dyads, funded by the Alzheimer’s Association (L. Gitlin, PhD, principal investigator; Grant # IIRG-07-28686). The caregivers were primarily female (88.6%), white (77.3%), and spouses (55.7%), with a mean age of 65.8. All …
Rehabilitation Service Utilization Among African American Women Living With Hiv/Aids: Using The Behavioral Model For Vulnerable Populations, Aisha Shamburger-Rousseau
Rehabilitation Service Utilization Among African American Women Living With Hiv/Aids: Using The Behavioral Model For Vulnerable Populations, Aisha Shamburger-Rousseau
Theses and Dissertations
African American women represent one of the largest groups disproportionately living with and affected by HIV/AIDS yet African American women have largely been unrepresented in the federal-state rehabilitation system. As pharmaceutical treatment options improve and individuals with HIV/AIDS are living longer and healthier lives, research exploring the appropriateness of rehabilitation services has increased. Accordingly, it has become more necessary to address the needs of this population. As the largest service provider for people with disabilities, the state-federal rehabilitation system has the potential to be a vital resource for African American women living with HIV/AIDS. The purpose of this study is …
Uncovering The Molecular Pathways Of Mbd5 In Neurodevelopmental Disorders, Sureni Mullegama
Uncovering The Molecular Pathways Of Mbd5 In Neurodevelopmental Disorders, Sureni Mullegama
Theses and Dissertations
Neurodevelopmental disorders (NDs) are a growing public health concern. These complex disorders cause failure of normal brain development, which leads to intellectual disability (ID) or autism in 3% of children. Accurate diagnosis of NDs is difficult due to complex overlapping phenotypes. Moreover, associations between phenotypically similar NDs and their overlapping molecular mechanisms remain unidentified. The chromosome 2q23.1 region is a newly discovered disease region. We have recently identified a novel ND, 2q23.1 deletion syndrome. The phenotype includes severe ID, significantly delayed speech, behavioral problems, seizures and short stature. This syndrome shares characteristics in common with other genetic syndromes, including Smith-Magenis …
Kinetic And Thermodynamic Studies Of Thrombin Inhibitors, Aziz May Abdel
Kinetic And Thermodynamic Studies Of Thrombin Inhibitors, Aziz May Abdel
Theses and Dissertations
Sulfated low molecular weight lignins (LMWLs), CDSO3 and FDSO3, designed recently as macromolecular mimetics of heparin, were found to exhibit potent anticoagulant activity. Small molecules based on the same scaffold, SBD and SBT, showed promising thrombin inhibition. We were able to address the mechanism of the inhibition using Michaelis-Menten kinetics. All the molecules were found to be allosterically impairing thrombin activity using either noncompetitive or uncompetitive mechanism. Absence of competition with hirugen, an exosite 1 ligand, and competition with polymeric heparin points to exosite 2 as the site of interaction for these inhibitors. Yet mixed competition results with other exosite …
Positive Allosteric Modulators Of Alpha4beta2 Neuronal Nicotinic Receptors: Synthesis And In Vitro Studies, Atul Jain
Theses and Dissertations
des-Formylflustrabromine (dFBr), isolated from the marine organism Flustra foliacea, is the first selective, positive allosteric modulator (PAM) of α4β2 nicotinic acetylcholine receptors that potentiates the action of the neurotransmitter acetylcholine (ACh). Most agonists for this receptor population are not selective and can activate other nACh receptors. A selective PAM, which activates α4β2 nACh receptors only in the presence of ACh, might find application in the treatment of of various neurological diseases such as Alzheimer’s disease or autism. dFBr was examined and found to produce a biphasic dose-response curve over a wide concentration range (i.e., potentiation at low concentration, but inhibition …
Characterization Of Potential Interactions Between Transferrin Binding Proteins In Neisseria Gonorrhoeae, Shreni Mistry
Characterization Of Potential Interactions Between Transferrin Binding Proteins In Neisseria Gonorrhoeae, Shreni Mistry
Theses and Dissertations
Neisseria gonorrhoeae requires iron for survival and establishment of infection in the human host. Pathogenic Neisseriae have evolved a repertoire of high-affinity iron acquisition systems to facilitate iron uptake in the human host. This requires specific outer membrane receptors and energy-harnessing cytoplasmic membrane proteins. The transferrin receptor proteins of Neisseria gonorrhoeae are necessary for iron uptake from transferrin in the host. The iron uptake system consists of two transferrin binding proteins, (Tbp) A and B. TbpA is an integral outer membrane, TonB-dependent transporter that forms the pore for iron internalization. TbpB is a surface exposed lipoprotein that makes the iron …
Impacts Of Black Box Warning, National Coverage Determination, And Risk Evaluation And Mitigation Strategies On The Inpatient On-Label And Off-Label Use Of Erythropoiesis-Stimulating Agents, Arpamas Seetasith
Theses and Dissertations
Background: FDA black box warning, Risk Evaluation and Mitigation Strategies (REMS), and CMS national coverage determination (NCD) aim to reduce inappropriate use of erythropoiesis-stimulating agents (ESAs) that are widely used in anemic patients. Previous studies have not linked specific safety interventions to changes in ESA utilization patterns in the inpatient settings nor assessed such interventions on off-label use of the drugs. Ineffectiveness of the intervention and lag time between such interventions and the observed change in clinical practice could lead to serious clinical outcomes. In addition, such interventions may unintentionally reduce on-label and some off-label use of ESAs considered “appropriate” …
Design, Syntheses, And Biological Evaluation Of 14-N-Substituted Naltrexone Derivatives As Opioid Receptor Ligands, Orgil Elbegdorj
Design, Syntheses, And Biological Evaluation Of 14-N-Substituted Naltrexone Derivatives As Opioid Receptor Ligands, Orgil Elbegdorj
Theses and Dissertations
Opium, the dried resin obtained from the unripe seedpods of the poppy flower, has been used for medicinal and euphoric purposes since ancient times. Morphine, the main active ingredient of opium, and other clinically useful opioid analgesics all mediate their effects through activating the mu opioid receptor. Studies involving the mu opioid receptor knockout mice showed that the interaction with the mu opioid receptor is also responsible for many notorious side effects associated with these drugs including dependence and addiction. Therefore, selective antagonists for the mu opioid receptor are needed to study its function in drug abuse and addiction. Previously, …
Klf2 Is Required For Normal Mouse Cardiovascular Development, Aditi Raghunath Chiplunkar
Klf2 Is Required For Normal Mouse Cardiovascular Development, Aditi Raghunath Chiplunkar
Theses and Dissertations
Krüppel-like factor 2 (KLF2) is expressed in endothelial cells in the developing heart, particularly in areas of high shear stress, such as the atrioventricular (AV) canal. KLF2 ablation leads to myocardial thinning, high output cardiac failure and death by mouse embryonic day 14.5 (E14.5) in a mixed genetic background. This work identifies an earlier and more fundamental role for KLF2 in mouse cardiac development in FVB/N mice. FVB/N KLF2-/- embryos die earlier, by E11.5. E9.5 FVB/N KLF2-/- hearts have multiple, disorganized cell layers lining the AV cushions, the primordia of the AV valves, rather than the normal single layer. By …
Defining A Simplified Pharmacophore For Simocyclinone D8 Inhibition Of Dna Gyrase, Lauren Gaskell
Defining A Simplified Pharmacophore For Simocyclinone D8 Inhibition Of Dna Gyrase, Lauren Gaskell
Theses and Dissertations
The type II topoisomerase subfamily of enzymes has been clinically targeted by the widely used, broad-spectrum quinolone class of antibacterials. Due to emerging drug-resistant strains of bacteria, the quinolones’ effectiveness is threatened. The natural product simocyclinone D8 (SD8) has shown the ability to inhibit the type II topoisomerase, DNA gyrase, even when mutated to be resistant to the quinolones. In order to determine the pharmacophore required for SD8 binding to DNA gyrase, 16 compounds were synthesized. These compounds were then tested by surface plasmon resonance for their ability to inhibit the DNA – DNA gyrase binding interaction. It was found …
The Relationship Between Marital Status And Psychological Resilience In Chronic Pain, James B. Wade, Robert P. Hart, James H. Wade, Jasmohan S. Bajaj, Donald D. Price
The Relationship Between Marital Status And Psychological Resilience In Chronic Pain, James B. Wade, Robert P. Hart, James H. Wade, Jasmohan S. Bajaj, Donald D. Price
Psychiatry Publications
We examined the relationship between marital status and a 2-stage model of pain-related effect, consisting of pain unpleasantness and suffering. We studied 1914 chronic pain patients using multivariate analysis of covariance (MANCOVA) to clarify whether marital status was a determinant factor in the emotional or ideational suffering associated with chronic pain after controlling for pain sensation intensity, age, and ethnicity. Marital status was unrelated to immediate unpleasantness (). We found a strong association with emotional suffering () but not with negative illness beliefs (). Interestingly, widowed subjects experienced significantly less frustration, fear, and anger than all other groups (married, divorced, …