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Articles 3811 - 3840 of 4193
Full-Text Articles in Medicine and Health Sciences
The Determinants Of Hospital Adoption And Expansion Of Bariatric Procedures: A Resource Dependence Perspective, Wenquiang Tian
The Determinants Of Hospital Adoption And Expansion Of Bariatric Procedures: A Resource Dependence Perspective, Wenquiang Tian
Theses and Dissertations
New medical technologies have been viewed as the primary cause of rising health are expenditures by health policy researchers in the United States. Since the mid 1990s, with the prevalence of obesity among Americans, the utilization of bariatric surgery, a medical innovation, has increased rapidly among U.S. hospitals. Generally, current literature only states that the volume of bariatric procedures is increasing dramatically.Very limited studies have been conducted to investigate the growth of bariatric procedures.The objective of this study is (1) to provide a detailed description about the adoption and utilization of bariatric procedure in hospitals in 11 states, and (2) …
Parent And Therapist Perceptions Of Sensory Based Strategies Used By Occupational Therapists In Family-Centered Early Intervention Practice, Juliet Bertaut Copeland
Parent And Therapist Perceptions Of Sensory Based Strategies Used By Occupational Therapists In Family-Centered Early Intervention Practice, Juliet Bertaut Copeland
Theses and Dissertations
A qualitative approach was used to explore the perceptions of parents and therapists in early intervention regarding sensory diets and their efficacy, particularly their goodness of fit within family routines and occupations. Open-ended interviews were conducted with therapist and parent participants and analysis of the data resulted in a model depicting how sensory diets became a "way of life" for families. The Sensory Diet "Way of Life" Model revealed seven themes that illustrated how occupational therapists in early intervention enter the homes of the families they serve and establish a "partnership" with parents to address a child's needs. Once this …
Information Technology Outsourcing In U.S. Hospital Systems, Mark L. Diana
Information Technology Outsourcing In U.S. Hospital Systems, Mark L. Diana
Theses and Dissertations
The purpose of this study was to determine the factors associated with outsourcing of information systems (IS), and if there is a difference in IS sourcing based on the strategic value of the outsourced functions. The theoretical framework is based upon a synthesis of strategic management theory (SMT) and transaction cost economics (TCE) as they apply to vertical integration in the health care sector; therefore, IS sourcing behavior was conceptualized as a case of vertical integration. The conceptual model proposed that sourcing behavior would be determined by asset specificity, uncertainty, the interaction of asset specificity and uncertainty, bargaining power, corporate …
The Influence Of A Single Nucleotide Polymorphism In The Matrix Metalloproteinase-1 Promoter On Glioma Biology, Jessica Mccready
The Influence Of A Single Nucleotide Polymorphism In The Matrix Metalloproteinase-1 Promoter On Glioma Biology, Jessica Mccready
Theses and Dissertations
Glioblastomas are an incurable type of brain tumor with a mean survival time of 9-12 months following diagnosis. One of the reasons for this poor prognosis is the ability of tumor cells to invade the surrounding normal brain tissue. Enzymes responsible for this invasive nature include the matrix metalloproteinase family. MMP-1 is a member of this family which has been well studied in many types of invasive tumors, with gliomas being an exception. We studied a single nucleotide polymorphism (SNP) in the MMP-1 promoter that may influence glioma biology. This SNP consists of the presence (2G) or absence (1G) of …
Perceived Deprivation In Active Duty Military Nurse Anesthetists, Julie Ann Pearson
Perceived Deprivation In Active Duty Military Nurse Anesthetists, Julie Ann Pearson
Theses and Dissertations
Problem: There is a shortage of military certified registered nurse anesthetists (CRNAs). The exodus from military service to civilian careers could be a result of relative deprivation (the discrepancy that one perceives between what one has and what one could or should have). Relative deprivation is a perception of unfairness dependent on feelings (subjective data) as well as facts (objective data). Purpose: The purpose of this study was to measure relative deprivation in active duty military nurse anesthetists, to explore variables which correlate with relative deprivation, and to validate or refute the theory of relative deprivation in active duty military …
Action Of Tyrosyl Dna Phosphodiesterase On 3'-Phosphoglycolate Terminated Dna Strand Breaks, Haritha Tatavarthi
Action Of Tyrosyl Dna Phosphodiesterase On 3'-Phosphoglycolate Terminated Dna Strand Breaks, Haritha Tatavarthi
Theses and Dissertations
Free radical-mediated DNA double strand breaks (DSBs) are induced either directly by ionizing radiation or by certain chemicals like bleomycin. These breaks are terminated by 3'-PG (PO4CH2COOˉ) or 3'-phosphate groups formed as a result of fragmentation of deoxyribose. To study the nature of repair of these 3'-blocked breaks, we constructed substrates mimicking free-radical induced DSBs. Human and yeast tyrosyl DNA-phosphodiesterase (Tdpl) efficiently processed substrates with 3'-PGs, in either the presence or absence of magnesium, to give a 3'-phosphate. Gel filtration chromatography and western blotting codmed that the putative enzyme in human extracts that efficiently processed PG was indeed tyrosyl DNA-phosphodiesterase. …
A Determination Of The Association Of Competition And Regulation With Hospital Strategic Orientation, Kathleen B. Heatwole
A Determination Of The Association Of Competition And Regulation With Hospital Strategic Orientation, Kathleen B. Heatwole
Theses and Dissertations
This research study examines the influence of two major forces, competition and regulation, on the strategic orientation of hospitals. This is a particularly relevant subject, as the effectiveness of competition versus the effectiveness of regulation in the health care market has been called one of the Bellwether issues in health care policy, and the most controversial and far reaching philosophical battle facing the health care industry. Even after three decades of research and debate, there is still no consensus on how the hospital industry responds to either a competitive environment or a regulated environment. There continues to be significant variation …
Glutamate Excitotoxicty Activates A Novel Calcium Permeable Ion Channel In Cultured Hippocampal Neurons, Laxmikant Sudhir Deshpande
Glutamate Excitotoxicty Activates A Novel Calcium Permeable Ion Channel In Cultured Hippocampal Neurons, Laxmikant Sudhir Deshpande
Theses and Dissertations
Glutamate excitotoxicity is the predominant mechanism implicated in neuronal cell death associated with neurological disorders such as stroke, epilepsy, traumatic brain injury and ALS. Excessive stimulation of NMDA subtypes of glutamate receptors leads to protracted intracellular calcium elevations triggering calcium mediated neurotoxic mechanisms culminating in delayed neuronal cell death. In addition, glutamate excitotoxicity induces a NMDA dependent extended neuronal depolarization mediated by continuous calcium influx that correlates with delayed neuronal death. Attempts to prevent neuronal death by blocking calcium entry into the neurons using calcium channel blockers or NMDA receptor antagonists have failed to provide any beneficial effects in clinical …
What Cost Hospital Quality: Performance Uncertainty Under Market Reform, Ronald L. Fisher
What Cost Hospital Quality: Performance Uncertainty Under Market Reform, Ronald L. Fisher
Theses and Dissertations
Healthcare is an organizational field that has undergone profound change in the last few decades, an era characterized by market reform. Healthcare production has revealed both economic and quality problems in past eras, and reporting on these problems can be seen to have contributed to pressures for social reform. Yet, the move toward more market-oriented governance structures and design solutions also reflects a wider isomorphic institutional tendency for organizing social order.The conceptual frame work of this study takes a pessimistic stance on whether the market reform has achieved the intended goals with respect to advancing organizational quality performance. The framework …
Discovery Of Lignin Sulfate As A Potent Inhibitor Of Hsv Entry Into Cells, Jay N. Thakkar
Discovery Of Lignin Sulfate As A Potent Inhibitor Of Hsv Entry Into Cells, Jay N. Thakkar
Theses and Dissertations
The herpes virus family consists of more than hundred members that infect organisms, of which eight, differing markedly in the biology are known to infect humans. HSV- I is the most common one, causing oral lesions and sporadic encephalitis. These infections are highly prevalent affecting at least one in three individuals in the United States.The entry of the herpes virus into the cell is a two-step process. The initial step involves the cell surface heparan sulfate and glycoproteins in the viral envelope which enables the virus to penetrate into the cell. The second step is the fusion step. Depending on …
Hospitals' Decision To Vertically Integrate Skilled Nursing Units Before And After The Balanced Budget Act, Betty C. Lucente
Hospitals' Decision To Vertically Integrate Skilled Nursing Units Before And After The Balanced Budget Act, Betty C. Lucente
Theses and Dissertations
The decision to vertically integrate services and deliver care has both management and policy concerns for healthcare in the United States. The change in reimbursement, which was enacted with the Balanced Budget Act of 1997, influenced the availability of post acute services for acute hospital inpatients. Prior to this change, post acute services were reimbursed based on cost similar to the pre DRG era of Medicare reimbursement. The change in payment had the potential to make discharging patients more difficult resulting in a prolonged length of stay without additional payment and at increased costs for hospitals. As a result of …
Relationships Among Stress, Blood Pressure, And Heart Rate Variability In Meditators, Sangthong Terathongkum
Relationships Among Stress, Blood Pressure, And Heart Rate Variability In Meditators, Sangthong Terathongkum
Theses and Dissertations
PROBLEM STATEMENT: Growing evidence indicates that psychological stress contributes to cardiovascular diseases through complex neuroendocrine mechanisms. Psychological stress leads to several physiological responses including increased heart rate (HR) and blood pressure (BP) as well as decreased heart rate variability (HRV) through alterations in the autonomic nervous system (ANS), specifically increased sympathetic nervous system (SNS) activity and decreased parasympathetic nervous system (PNS) activity. Meditation is thought to induce an innate relaxation response leading to reduced psychological stress. Findings from past studies have provided inconclusive evidence regarding the direction and strength of relationships among stress, BP, HRV, and meditation practice. PROCEDURES: A …
An Exploration Of How And Why Primary Care Providers Educate Infant Caregivers About Positioning, Amy Greenspon Choffin
An Exploration Of How And Why Primary Care Providers Educate Infant Caregivers About Positioning, Amy Greenspon Choffin
Theses and Dissertations
A review of the literature indicates that how infants are positioned is related to the risk of SIDS, the incidence and severity of plagiocephaly, torticollis, and developmental delays. A quantitative approach with survey methodology was used with 66 pediatric primary care providers responding to 26 questions. Overall, PCPs are educating caregivers about sleep positioning with a high frequency. There was a relationship between practice site, and the frequency of sleep positioning education is provided. While the participants provide education about awake positioning, and the use of positioning devices, it was with less frequency than they do about sleep positioning; there …
The Role Of Dna Methylation And Methyl Binding Domain Protein 2 In The Regulation Of Human Embryonic And Fetal Beta Type Globin Genes, Jeremy William Rupon
The Role Of Dna Methylation And Methyl Binding Domain Protein 2 In The Regulation Of Human Embryonic And Fetal Beta Type Globin Genes, Jeremy William Rupon
Theses and Dissertations
The genes of the human β-globin locus are located on chromosome 11 in the order of their expression during development: 5' ε, γ, β 3'. During development, silencing of the 5' gene occurs with activation of the immediate 3' gene. This process occurs twice and is termed hemoglobin switching. The exact mechanism(s) of this process have not been fully described. Herein, we describe a role for DNA methylation and methyl binding domain protein 2 in the transcriptional regulation of the human embryonic and fetal beta type globin genes. Adult mice containing the entire human β-globin locus as a yeast artificial …
Studies On The Molecular Biology Of Naegleru Fowleri And Identification Of N. Fowleri In The Environment, Rebecca Carmean Maclean
Studies On The Molecular Biology Of Naegleru Fowleri And Identification Of N. Fowleri In The Environment, Rebecca Carmean Maclean
Theses and Dissertations
Naegleria fowleri, a free-living ameboflagellate, is the causative agent of primary amebic meningoencephalitis. Healthy humans sporadically become infected with N. fowleri and develop fatal PAM after recreational or work exposure to freshwater; accordingly, there is a need for monitoring the presence of pathogenic amebeflagellates in public freshwater. The present study was conducted to determine whether a nested PCR assay could be used for detection of N. fowleri in freshwater habitats. PCR analysis was used to test samples from Virginia, Connecticut, Arizona, and Oklahoma for the presence of N. fowleri in lakes, ponds, soil, and domestic water supplies. The amebae were …
Pathological Upregulation Of A Calcium-Stimulated Phosphatase, Calcineurin, In Two Models Of Neuronal Injury, Jonathan Elledge Kurz
Pathological Upregulation Of A Calcium-Stimulated Phosphatase, Calcineurin, In Two Models Of Neuronal Injury, Jonathan Elledge Kurz
Theses and Dissertations
Excitotoxic calcium influx and activation of calcium-regulated systems is a common event in several types of neuronal injury. This mechanism has been the focus of intense research, with the hope that a more complete understanding of how neuronal injury affects calcium-regulated systems will provide effective treatment options. This study examines one such calcium-stimulated enzyme, calcineurin, in the context of two common neurological pathologies, status epilepticus and traumatic brain injury.Status epilepticus was induced by pilocarpine injection. NMDA-dependent increases in calcineurin activity were observed in cortical and hippocampal homogenates. Upon closer examination, the most profound increases in activity were found to be …
Autism Spectrum Disorders And Workplace Discrimination: An Empirical Analysis Of Eeoc-Resolved Ada Title I Charges, Wieren Todd Alan Van
Autism Spectrum Disorders And Workplace Discrimination: An Empirical Analysis Of Eeoc-Resolved Ada Title I Charges, Wieren Todd Alan Van
Theses and Dissertations
The purpose of this quantitative, non-experimental, retrospective research study was to examine the charges of disability-related, private-sector workplace discrimination made by individuals with Autism Spectrum Disorders (ASDs) to the Equal Employment Opportunity Commission (EEOC), under Title I of the Americans with Disabilities Act (ADA). To date, there has been a lack of research regarding the nature, scope and dynamics of employment discrimination affecting individuals with ASDs.A portion of the EEOC's Integrated Mission Systems (IMS) database was analyzed, drawing upon the following five major categories: (1) charging-party demographics, (2) responding-party characteristics, (3), U.S. region, (4) ADA Title I discrimination charge categories, …
Machismo As A Determinant For Hiv/Std Risk Behavior Among Latino Msm, Jacqueline L. Sears
Machismo As A Determinant For Hiv/Std Risk Behavior Among Latino Msm, Jacqueline L. Sears
Theses and Dissertations
Objective: Male-to-male sexual contact is the most common mode of transmission for HIV among Latino men. Psychosocial factors such as machismo, homophobic discrimination, and internalized homophobia have been hypothesized to greatly impact sexual behaviors among Latinos. However, studies investigating the relationship between these psychosocial factors and risky sexual behaviors are limited. This study examined the impact of machismo on risky sexual behaviors among Latino Male who have Sex with Men (MSM).Methods: This study utilized data collected from 254 Latino MSM in 1999 from selected cities within Virginia. The analysis focused on respondent demographic characteristics, psychosocial factors, acculturation, and sexual risky …
Characterization Of Vancomycin Resistance In Staphylococcus Aureus, Paige Mccarthy Fox
Characterization Of Vancomycin Resistance In Staphylococcus Aureus, Paige Mccarthy Fox
Theses and Dissertations
In the past decade, Staphylococcus aureus has developed two distinct vancomycin resistance mechanisms. First, the bacterium is capable of generating a thickened, poorly crosslinked cell wall that creates false targets. These targets cause vancomycin to bind at the periphery of the thickened peptidoglycan, allowing normal cell wall formation to continue at the cell membrane. Second, S. aureus has acquired genes from Enterococcus that encode an alternative stem peptide. The genes, known as van genes, alter the target of vancomycin, rendering vancomycin treatment ineffectual.In this work, we attempted to further characterize both mechanisms of vancomycin resistance. First, a potential link between …
Immunological And Molecular Analyses Of The Borrelia Burgdorferi Ospf Protein Family F, Emily Tran
Immunological And Molecular Analyses Of The Borrelia Burgdorferi Ospf Protein Family F, Emily Tran
Theses and Dissertations
In North America, Borrelia burgdorferi is the primary causative agent of Lymedisease which is a growing health concern. The ability of B. burgdorferi to maintain chronic infection indicates that they are capable of immune evasion. A distinguishing characteristic of B. burgdorferi is the large number of sequences encoding predicted or known lipoproteins, including outer surface protein F (OspF). This study analyzes the specificity of the humoral immune response to B. burgdorferi B3 IMI OspF proteins during murine and human infection. Immunoblot analyses revealed a temporal expression of OspF proteins during infection and mapped the immunodominant epitopes which lie within the …
Association Between Smoking, Chemical Exposure And Hearing Loss In An Occupational Setting, Darlene W. Olive
Association Between Smoking, Chemical Exposure And Hearing Loss In An Occupational Setting, Darlene W. Olive
Theses and Dissertations
Objective: Twenty-two million Americans or roughly 8% of the population are hearing impaired. This affects more than just the ability for one to hear. In the last three decades, younger Americans have shown a sharp increase in hearing impairment. Hearing loss affects social and emotional well being and thus has the ability to decrease one's quality of life. This study was designed to examine the association between smoking, workplace chemical exposure, and hearing loss.Methods: This cross-sectional population-based study was conducted in an occupational health clinic setting in Virginia. The study population consisted of employees from local businesses who visited the …
A Needs Assessment For Annual Physical Examination For Selected Richmond Public School Children, Aimee Gibbs
A Needs Assessment For Annual Physical Examination For Selected Richmond Public School Children, Aimee Gibbs
Theses and Dissertations
Introduction: The following risk factors have found to be associated with inadequate health care and have been found to affect the well-being of children: racial or ethnic minority, poverty status, median family income, family structure of household, maternal education level, and parental employment status. Also, there has found to be health indicators including, teen pregnancy, asthma hospitalization, and lead poisoning cases that affect the well-being of a child and are associated with the presence of these risk factors in a population. Objectives: The objectives of this study is to (1) compare the presence of risk factors and health indicators in …
Predictors Of Primary Elective Cesarean Delivery Among Apparently Healthy Pregnant Women In Virginia, Brooke W. Rossheim
Predictors Of Primary Elective Cesarean Delivery Among Apparently Healthy Pregnant Women In Virginia, Brooke W. Rossheim
Theses and Dissertations
Objectives. The purpose of this cross-sectional study was to evaluate whether certain maternal variables were associated with the performance of a primary cesarean delivery rather than a spontaneous vaginal delivery among apparently healthy pregnant women in the Commonwealth of Virginia.Methods. This study utilized the 2004 Virginia Statistics File for Live Births which contained 103,830 records. From this dataset, the following groups of women were excluded: multiparous women, women who had had a previous delivery by any method, women with medical and obstetric problems, women with any labor and delivery complications, women with premature births and women with multiple gestations. The …
Influence Of Organizational, Operational, Financial Andenvironmental Factors On Hospitals' Adoption Of Computerized Physician Order Entry Systems For Improving Patient Safety: A Resource Dependence Approach, Imre Solti
Theses and Dissertations
This study examines specific organizational, operational, financial and environmental characteristics to identify factors that are associated with increased likelihood of hospitals' CPOE adoption decision in six rollout regions of the Leapfrog initiatives.Resource dependence theory provides theoretical basis for the study. The study is retrospective observational in design. Individual hospitals are the unit of analysis. The Leapfrog Group's 2002-survey collection serves the primary data source. Univariate statistical methods along with bivariate and ordinal logistic regression models are used to analyze the data. The models provided support for multiple hypotheses for both the adoption and early adoption decisions of study hospitals. The …
Small Molecules Binding To Serpins, Junaid Afridi
Small Molecules Binding To Serpins, Junaid Afridi
Theses and Dissertations
Serpins are a unique breed of proteins due to their enzymatic mechanism. Two systems were closely monitored during fluorescent binding studies, the ACT-CHY along with the AT:TRY interaction. Four different conformational variants of each system were studied including the native, cleaved, latent and complex forms. Three different fluorescent dyes were used to identify the conformations including ANS, TNS, and bis-ANS. SI studies and protease assays utilizing both Suc-AAPF-pNA and L-BAPNA were instrumental in determining conformations along with gel electrophoresis studies. The hydrophobic dyes bound to the different serpins with varying KD and ΔFmax due to structural variations among the conformers …
The Role Of Gonadal Hormones On Opioid Receptor Protein Density In Arthritic Rats, Matthew Kren
The Role Of Gonadal Hormones On Opioid Receptor Protein Density In Arthritic Rats, Matthew Kren
Theses and Dissertations
The majority of research on the endogenous opioid system has focused on various pain assays and the efficacy of different opioid agonists. However, minimal attention has been focused on the effects of gonadal hormones and their impact on the opioid peptide system. The present study was designed to determine the effects of modulation of gonadal hormones on the opioid receptor protein levels in Complete Freund's Adjuvant (CFA)-treated arthritic and non-arthritic male and female Lewis rats. Midbrain and spinal cord tissues were collected for comparison of the μ, δ, and κ receptor protein levels in arthritic and non-arthritic animals. Male gonadectomy …
The Effect Of Advertising On Attitudes Toward Tobacco Use And Decisions About Smoking Among Virginia Adolescents, John Rosser Matthews Iii
The Effect Of Advertising On Attitudes Toward Tobacco Use And Decisions About Smoking Among Virginia Adolescents, John Rosser Matthews Iii
Theses and Dissertations
Purpose: This study seeks to determine 1) whether the type of advertising exposure is associated with adolescent health perceptions of tobacco use, and 2) whether the type of media exposure is associated with initiation plans (non-smokers) or quitting plans (smokers). Methods: This was a cross-sectional survey of middle school students (n=l1,128).Psychosocial variables were knowledge of the risks of tobacco use (range: 3-15) and benefits of being tobacco free (range: 7-35) with higher scores indicating greater understanding. Intentions to quit or initiate were construed as binary variables. Exposure variables were tobacco advertisements or anti-tobacco media messages. Covariates were gender, race, grade …
Characterization Of The Tcof1 Gene Using A Neuroblastoma Cell Line And A Mouse Model, Lin Li
Characterization Of The Tcof1 Gene Using A Neuroblastoma Cell Line And A Mouse Model, Lin Li
Theses and Dissertations
Treacher Collins syndrome (TCS) is an autosomal dominant craniofacial development disorder and is caused by mutations in the TCOF1 gene. The TCOFl protein treacle is a nucleolar protein and may function in ribosome biogenesis.Previously, we identified downstream candidate genes using microarray analysis after manipulating Tcofl levels in a murine neuroblastoma (NB) cell line. The list of genes includes cell cycle genes as well as the transcription factors Cnbp and Tbx2, which are known to affect the cell cycle through the c-myc and p19-Mdm2-p53-p21 pathways respectively. To further characterize the cellular effects of Tcofl, stably transfected NB cell lines with overexpression …
C - Reactive Protein, Coronary Heart Disease And Ischemic Stroke In The Elderly: The Cardiovascular Health Study, Xia Li
Theses and Dissertations
Background: C-reactive protein (CRP) has been associated with increased risk of coronary heart disease (CHD) and stroke, but much of the research had focused on middle-aged populations with, limited prospective, population-based, longitudinal data. In this study, we examined data from an elderly population and described the distribution of CRP concentrations and the prevalence of elevated CRP levels (>3 mg/l), examined the association between CRP levels and incidence of CHD or ischemic stroke, and assessed the potential interaction of CRP with sex or race on the incidence of CHD or ischemic stroke.Methods: Baseline CRP levels were measured in a cohort …
A Critical Review Of Telomerase Biology And Model Systems For The Study Of Telomerase, Jeremy Charles Aisenberg
A Critical Review Of Telomerase Biology And Model Systems For The Study Of Telomerase, Jeremy Charles Aisenberg
Theses and Dissertations
The study of telomere and telomerase biology holds substantial promise in uncovering the molecular process of aging and the treatment of cancers. Studies have shown that telomere shortening is directly linked to cellular aging and that telomerase expression is found in over 85% of human cancers, including 95% of all advanced malignancies. Development of effective model systems to elucidate the molecular mechanisms underlying the role of telomeres and telomerase in the processes aging and cancer is of particular importance. While inbred strains of mice have provided a wealth of information for a variety of pathways and diseases, the mouse model …