Medicine and Health Sciences Commons^™

Tumor Immunity Following Adenovirus Mediated Herpes Simplex Thymidine Kinase Gene Transfer To Experimental Rat Gliomas, Maulik Raj Shah

Theses and Dissertations

Previous studies have determined adenovirus mediated herpes simplex thymidine kinase gene transfer (AV-TK) to be effective for the treatment of experimental gliomas. In this study we report three distinct phenomenon. First, animals with complete regression of subcutaneous tumors upon intratumoral injections of AV-TK with concomitant Ganciclovir® (GCV) administration developed tumor immunity. These animals had the ability to reject a subsequent inoculum of lethal doses of tumor cells. This tumor immunity was long standing and protective as far as 6 months from the time of initial tumor ablation. Of interest, adoptive transfer of splenocytes from AV-TK treated-tumor ablated animals to naive …

Clustered Microcalcification Detection Using Optimized Difference Of Gaussians, Edward M. Ochoa

Theses and Dissertations

The objective of this thesis is to design an automated microcalcification detection system to be used as an aid in radiologic mammogram interpretation. This research proposes the following methodology for clustered microcalcification detection. First, preprocess the digitized film mammogram to reduce digitization noise. Second, spatially filter the image with a difference of Gaussians (DoG) kernel. To detect potential microcalcifications, segment the filtered image using global and local thresholding. Next, cluster and index these detections into regions of interest (ROIs). Identify ROIs on the digitized image (or hardcopy printout) for final radiologic diagnosis.

Incidence Of Cesarean Delivery In Nulliparous Patients Based Upon Timing Of Epidural Analgesia Initiation, Wendy H. Sandelin

Theses and Dissertations

Epidural analgesia for the parturient is a safe and effective method of pain relief during labor. This method of pain management permits the pregnant woman to have a virtually pain-free labor while remaining alert and able to participate in the delivery. However, the effect of epidural analgesia on nulliparous labor, and ultimately on the mode of delivery, vaginal or cesarean, remains controversial. Cesarean delivery is associated with greater maternal morbidity and mortality, as well as increased financial cost for the health care system. Therefore, the purpose of this study was to determine the incidence of and circumstances related to cesarean …

Adolescent Tobacco Use : A Generation Up In Smoke, Kay L. Provo

Theses and Dissertations

Adolescent tobacco use is on the rise in the United States. It is a significant health problem. In spite of the fact that adult smoking has decreased dramatically since 1964, the number of adolescent smokers remains high and has not decreased for the last 7 years (Winkelstein, 1992). The purpose of this study was to investigate adolescent tobacco use among ninth-grade students in five rural communities. Specifically, the following questions were addressed:

1. What is the incidence of tobacco use among ninth graders in rural communities?

2. Which variables influence rural adolescents' tobacco use?

3. Where and from whom do …

Lds Counselor Ratings Of Problems Occurring Among Lds Premarital And Remarital Couples, Travis R. Adams

Theses and Dissertations

A fundamental purpose of this study was to provide marriage preparation providers with counselors perceptions of potential marital problem areas. A structured questionnaire was sent to LDS counselors, defined as members of the Association of Mormon Counselors and Psychotherapists (AMCAP). These LDS counselors rated 29 problem areas that LDS couples, (members members of The Church of Jesus Christ of Latter-day Saints), might encounter in a first marriage or remarriage. Results (N=231) were analyzed in an attempt to determine the most frequent, most damaging and most difficult problems to deal with in LDS first marriages and remarriages.

Findings suggest that "communication", …

Induction Into Academia: The Experiences Of New Occupational Therapy Faculty, Catherine R. Acre

Theses and Dissertations

The American Occupational Therapy Association (AOTA) estimates the number of therapists in the nation's occupational therapy workforce at 46,357. Silvergate (1994) estimates a 71% shortage based on the actual vacancies for occupational therapy personnel currently exists. In response to the growing demand for occupational therapists, the number of academic programs in occupational therapy has increased. Currently there are 85 accredited occupational therapy programs and 30 developing programs in the United States. In addition, for every newly available student space in professional-level programs, there were a reported 3.4 applicants. With only five doctoral programs in occupational therapy in the United States, …

Pharmacokinetics And Pharmacodynamics Of Ethanol In Healthy Volunteers: Effects Of Input-Rate And Degree Of Ethanol Exposure On Subjective And Objective Measures Of Impairment, Vijay A. Ramchandani

Theses and Dissertations

The goal of this project was to investigate the effect of input-rate (oral and intravenous) and degree of exposure on the pharmacokinetics of ethanol and on subjective and objective measures of impairment, as well as on the development of acute tolerance to the effects of ethanol in young, healthy volunteers.

The primary objective of this research was to test the following hypotheses: 1) the rate and degree of ethanol exposure (oral and intravenous) in normal healthy males and females affect the pharrnacokinetics (PK) and pharmacodynarnics (PD) of ethanol in a non-linear fashion; 2) the EEG changes after ethanol administration correlate …

Evaluation Of Cannabinoid Receptor Interaction Of Anandamide, The Endogenous Cannabinoid Receptor Ligand, Irma Bateman Adams

Theses and Dissertations

Recent evidence implicates anandamide as the endogenous ligand for the cannabinoid receptor. One purpose of this study was to determine the structural requirements for anandamide's receptor interaction and the influence of phenylmethylsulfonyl fluoride (PMSF), an enzyme inhibitor, on receptor affinity. A second objective was evaluation of the correlation between affinities of the analogs and in vivo pharmacological activities. The ability of anandamide and analogs to displace [3H]- CP 55,940 was determined by a filtration assay. Displacement curves for anandamide in the presence of PMSF produced a Ki of 89 ± 10 nM; without PMSF the Ki increased to 5400 ± …

Computer Modeling Of Anatomical Structure: A Representative Example Of Modeling The Inguinal Canal, Jason Michael Highsmith

Theses and Dissertations

As computers become an increasingly important part of medical education, a proper understanding of the techniques and applications of computer aided modeling is vital. An initial overview of medical imaging and the techniques of computer modeling is presented. Construction of three-dimensional models of anatomical structures is then discussed in great detail with specific focus on modeling structures like the inguinal canal. The inguinal canal is one region where computer modeling efforts should be directed because it presents a special challenge. Understanding the walls, borders and layering of the inguinal canal is especially difficult but vital to accurate clinical diagnoses of …

Physical And Chemical Stability Of Spray Dried Sugars And Protein-Sugar Molecuiar Mixtures For Inhalation, Venkatesh Naini

Theses and Dissertations

The feasibility of producing inhalable microparticles of sugars and protein-sugar molecular mixtures using spray drying was investigated as an alternative to conventional micronization techniques. Four sugars; lactose (L), trehalose (T), sucrose (S) and mannitol (M) were spray dried using a commercial bench-top spray dryer and their physicochemical stability, with respect to particle size, moisture uptake and crystallinity changes, investigated after storage at 23%, 52%, 75% and 93% relative humidity (RH) and 25 °C for 30 days. Two crystalline size fractions (“coarse” = 125-212 μm and “fine” = 44-74 μm) of each sugar, were also characterized, as possible replacements for lactose …

Determinants Of The New Entry Of Hmos Into A Medicare Risk Contract: A Resource Dependence-Diversification Model, Chih-Wen Pai

Theses and Dissertations

The purpose of this study is to examine the determinants of the new entry of an HMO into a Medicare risk contract using a resource dependence—diversification model. This study is conducted through a non-experimental, panel design With one year time lag. An HMO’s market is defined as the service area. The primary sample for this study is composed of 440 HMOS that do not have a Medicare risk contract as of January 1994.

Data for the variables are extracted from the 1994 and 1995 InterStudy and Group Health Association of America (GHAA) directories, the 1996 Area Resource File, the 1994 …

Three Dimensional Localization Of Lesions From Digitized Mammograms, Amy L. Magnus

Theses and Dissertations

This thesis describes new algorithms to localize regions-of-interests (ROIs) three dimensionally from a pair of digitized mammograms. This work is intended to add a layer of sophistication to computer aided diagnosis by putting to use the fixed and measurable parameters of mammographic imaging. The fixed parameters are the source to film orientation and the podium-image distance. Measurable parameters are the rotation angle of the x-ray tube from the horizontal and the compression depth (the distance from compression paddle to contact podium distance) at the time of imaging. As an additional benefit, three dimensional localization algorithms alleviate the confusion radiologists may …

The Effect Of A Self-Care Education Program On A Military Medical Beneficiary Population, Christopher S. Svehlak

Theses and Dissertations

Previous research in the area of self-care has focused on medical beneficiaries in a wide range of settings, but the current or former members of the United States Armed Services have largely been ignored. This research concentrates on designing, implementing, and reporting on a study of the impact of a self-care education program on a military beneficiary population. Specifically, retired and active-duty households, whose medical records are maintained by the Wright-Patterson Air Force Base Medical Center, were systematically randomly sampled and invited to participate in the study. Those households who responded were given their choice of a self-care book, and …

Organizational Slack, Efficiency, And Quality Of Care In Acute Care Hospitals, Kyung Ii Youn

Theses and Dissertations

The relationship between technical efficiency and quality of care in hospitals is studied in the context of resource availability in hospital organizations. The resource availability of hospitals is conceptualized by organizational slack.

An integrated model is developed encompassing the source of organizational slack, its impact on technical efficiency and on quality of care, and its impact on the relationship between efficiency and quality. Organizational threat as an environmental factor affecting the level of slack is measured by the level of competition and regulation. Organizational slack is measured using financial and operational indicators of the hospitals. Technical efficiency is estimated by …

Nmda Receptor-Mediated Synaptic Plasticity In Developing Mammalian Visual Pathways, Gregory S. Perens

Theses and Dissertations

Precise connections in many mammalian nervous systems require a great deal of remodeling during development. In the visual system, many excess synapses are originally formed in the lateral geniculate nucleus and striate cortex. Only the correct set of axon terminals are retained during normal development, while imprecise ones withdraw. The mechanism by which only correct axons are retained requires neural activity, and may be regulated by specific receptors at synapses.

The transmission of neural signals at these synapses is carried out in part by the glutamate-activated NMDA receptor. It is hypothesized that NMDA receptor activation plays a crucial role in …

The Linkage Between Hospitals And Nursing Homes: Alternative Approaches To Minimizing Transaction Costs, Herng-Chia Chiu

Theses and Dissertations

Finding more efficient ways to organize and deliver medical care is a major policy and management concern in the United States. High levels of expenditures for administrative and coordinating functions are attributed to the fact that health care systems are not "seamless" and that excessive transaction or friction costs are incurred in the exchanges between providers and purchasers and among providers. Renewed interest in vertical integration as a means to addressed these problems is being explored in the empirical literature, but rigorous theory-based investigations are rare. This study is a theory-based exploration of how hospitals address the "make-or-buy" decision of …

The Impact Of The Tau Mutation On Reproductive Function In The Golden Hamster, Eliza Leake Thomasson

Theses and Dissertations

The tau mutation affects the circadian system of the golden hamster primarily by decreasing the period of the activity cycle from 24 to 20 hours. To study the effect of this mutation on reproductive function in the golden hamster, 3 experiments have been designed. In the first experiment, wild-type and tau female hamsters will be maintained in conditions of 14:10 LD and 11.7:8.3 LD, respectively. Blood samples will be taken and analyzed by radioimmunoassay (RIA) to determine the timing of the proestrus LH surge. In the second experiment, wild-type and tau males will be transferred to shortened photoperiods of 10:14 …

Determinants Of Continuity Of Care For Persons Transitioning From State Psychiatric Facilities To Communities, Sarah P. Farrell

Theses and Dissertations

When individuals with serious mental illness are discharged to the community, continuous and coordinated care are both desirable and necessary. A lack of continuity places the individual at risk for becoming lost to further services.

This study explores continuity of care for persons discharged from state psychiatric facilities in Virginia to communities. Continuity of care is defined as the successful initiation and maintenance of face-to-face contact by CSB staff with individuals to be discharged from state hospitals, and the subsequent provision of services post-discharge. This study identifies factors that influence continuity of care, examines the degree to which these factors …

Development Of A Mammographic Image Processing Environment Using Matlab, John L. Kelley

Theses and Dissertations

Breast cancer is a disease that accounts for a disturbingly large number of deaths in females each year. Its prevalence is a topic of concern to all of us since it can affect our families, friends, and coworkers. Although mammographic screening is the most effective method currently available for the early detection of breast cancer, it is far from being an infallible procedure. Mammographic reading is error prone, partly because of the complexity of the task and partly because of the variability in human performance. Computers offer high reproducibility, and when used as an adjunct by the radiologist, may improve …

A Retrospective Quantitative Assessment Of Trichloroethylene Exposure Of Workers At Aircraft Maintenance Facilities At Hill Air Force Base Through The Use Of Modeling, Anthony O. Copeland

Theses and Dissertations

Monte Carlo simulation and source-receptor modeling are used to estimate the TCE exposures encountered by select workers at aircraft maintenance facilities at Hill Air Force Base between 1955 and 1979. An epidemiological study of this group, a retrospective cohort study of 14,457 workers who were employed at the base for a minimum of one year between 1952 and 1956, was headed by Dr. R. Spirtas of the National Cancer Institute to evaluate mortality associated with occupational exposure. One of the major conclusions of the study was that TCE 'probably does not pose a strong carcinogenic risk for man.' In the …

A Comparative Pharmacokinetic Study Of The Role Of Gender And Developmental Differences In Occupational And Environmental Exposure To Benzene, Elizabeth A. Brown

Theses and Dissertations

The purpose of this study is two-fold. First, it shows that physiological differences between men and women result in gender-specific exposures with respect to benzene. Second, it assesses the potential for a lactating woman's occupational and personal benzene exposure to impact a nursing infant's exposure, highlighting the possibility of subjecting an infant to the effects of industrial chemicals via breast feeding. This study employs physiologically based pharmacokinetic (PBPK) modeling to investigate the influence of physiological parameters and to evaluate the ability of inhaled benzene to transfer from mother to infant through breastmilk. The models are run through scenarios that simulate …

Review Of The P53 Tumor Suppressor Gene And Its Role In Gliomas, James Dearing Christian

Theses and Dissertations

The following review of the p53 tumor suppressor gene will be discussed with particular attention to its role in human gliomas, as well as the various advances that have brought this molecule to the forefront of cancer research. A review of tumorigenesis focuses on the molecular mechanisms that convey neoplastic characteristics upon a normal cell. It is discussed how the coordinate advances in chromosome analysis and molecular techniques enabled the p53 gene to be categorized as a "tumor suppressor gene" and applied to various forms of cancer, including colorectal and lung carcinoma. The focus of the review will be on …

A Causal Model Of Hospital Volume, Structure And Process Indicators, And Surgical Outcomes, Myra Boles

Theses and Dissertations

This research developed and tested a conceptual model to explain why higher volumes of certain surgical procedures lead to better patient outcomes. The model incorporated hospital structural characteristics and process of care indicators to explain the volume-outcome relationship. The volume-outcome relationship was further examined longitudinally to determine stability over time and to substantiate the causality implied by the conceptual model.

A sample (n=1752) of acute-care, general hospitals was selected from hospitals that performed, in 1990, at least one surgical procedure on Medicare patients of the following: reduction of hip fracture, cholecystectomy, hip replacement, carotid endarterectomy, and pacemaker insertion. For the …

Modulation Of The Humoral Immune Response By The Sympathetic Nervous System, Tracey Lynn Spriggs

Theses and Dissertations

The immune system is critical for the maintenance of homeostasis. Due to the fact that a coordinated effort between organ systems is required for internal stability, it has been postulated that the immune system interacts with the neuroendocrine system. Clinical, anatomical, and receptor studies have provided evidence for a bi-directional communication between the nervous and immune systems. The goal of the present studies was to determine the potential influence of the sympathetic nervous system (SNS) on the primary antibody forming cell (AFC) response.

The adrenergic neurotoxin, 6-hydroxydopamine (6-OHDA), has been utilized extensively by researchers to explore the possible relationship between …

Radiosurgery For Malignant Brain Tumors, Michael Jino Yun

Theses and Dissertations

Radiosurgery using the Linear Accelerator or the Gamma Knife has proven to be an effective treatment modality for malignant brain tumors. In comparison to other treatments, radiosurgery can be performed on an outpatient basis and is noninvasive (Table 5). Due to the functional properties of radiosurgical devices, they are ideal for patients who are unable to undergo surgical removal of their brain tumors. The sharp dose drop—off beyond the tumor margin allows for high dosage tumor irradiation while sparing normal brain tissue. Many procedures that involve radiosurgery use it as a ”boost” therapy in conjunction with surgical resection and whole …

Monitoring Neuromuscular Blockade At The Adductor Pollicis And Orbicularis Oculi With Split Dosing Of Mivacurium Chloride, Stephen F. Palmerton

Theses and Dissertations

Twenty ASA class I and II patients between the ages of 15 and 64 years undergoing surgical procedures requiring neuromuscular blockade and general anesthesia were selected at random to participate in this study. Patients taking medication known to interfere with neuromuscular blockade were excluded. All patients were given 2 mg of midazolam IV as a premedication. In the operating room, routine monitors were connected and baseline blood pressure, pulse and respirations were recorded with subsequent recordings at 5 and 10 minutes following induction of anesthesia.

Indirect stimulation of the ulnar nerve was achieved by placing ECG electrodes 2 cm and …

A Risk Assessment Of The Health Liabilities From Exposure To Toxic Metals Found In The Composted Material Of Air Force Municipal Solid Waste, Timothy L. Merrymon

Theses and Dissertations

This thesis assesses the risk of the health liabilities from exposure to toxic metals found in the composted material of Air Force municipal solid waste (MSW). The goal is to determine the probability that the composted MSW could be a health hazard if it were used as a soil amendment. The research limited the assessment of the exposure risk to heavy metals found in raw MSW and its resulting compost. The thesis uses reviews of present literature to examine the food and soil ingestion exposure pathways. These pathways are assessed using the heavy metal concentrations found in MSW compost and …

An Investigation Of The Reliability And Validity Of The Enderle-Severson Transition Rating Scale, Susan J. Severson

Theses and Dissertations

The purpose of this study was to identify the technical characteristics of the Enderle-Severson Transition Rating Scale (ESTR; Enderle & Severson, 1991) and to add to the knowledge base about measurement in transition. Validity ;was examined by evaluating the scale's concurrent criterion-related validity, construct validity, and content validity. A measure of reliability was performed by examining the internal consistency of subscales and the entire scale.

The samples studied were special education teachers in North Dakota and Minnesota as well as the students they served. The student subjects had identified disabilities of learning disability, emotional disturbance, or mental retardation. All students …

Nursing And Health Care Among Mormon Women: An Analysis Of The Relief Society Magazine, 1914-1930, Sarah Walker Barney

Theses and Dissertations

This descriptive study examined the nursing and health care activities of Mormon women in the pre-depression period of 1914 through 1930 through analysis of the official voice of the Relief Society, the Relief Society Magazine. Entries from the Relief Society Magazine that dealt with any nursing or health care topic were coded according to the themes they addressed. Five themes emerged: Nursing, faith, healing, women's health, children's health, and public health.

In each of the themes, the Relief Society Magazine showed that the members of the Relief Society recognized the health care problems of their communities and claimed responsibility …

Pus, Pox, Propaganda And Progress: The Compulsory Smallpox Vaccination Controversy In Utah, 1899-1901, Eric L. Bluth

Theses and Dissertations

This thesis examines the compulsory smallpox vaccination controversy in Utah, 1899-1901. It looks at the two smallpox epidemics during 1899-1901 and follows the boards of health attempts to eradicate smallpox primarily by compelling the vaccination of school children.

Dr. Theodore B. Beatty, secretary of the State Board of Health, championed the effort to vaccinate all Utahns; however, the opposition led by Charles W. Penrose, editor of the Deseret Evening News, produced anti-compulsion and vaccination information which influenced Utahns to generally oppose vaccination. Consequently, the legislature passed an anti-compulsory vaccination statute over the governor's veto to annul the courts decision …