Medicine and Health Sciences Commons^™

Access To Care: The Experience Of Community-Dwelling Older Adults Receiving Medicare And Medicaid, Mary Ann Simanello Phd, Msn, Rn

Dissertations

Access to care represents a leading health indicator for meeting the complex healthcare and social needs of an exploding population of older adults living in the United States. This qualitative study was undertaken to discover the essence of access to care by community-dwelling older adults with Medicare and Medicaid. Participants were recruited from a metropolitan area in Southern California. Thirteen women and men aged 65 to 91 described their experiences with accessing care during a face-to-face, audio-recorded interview. The study aimed to: describe experiences of access to care, identify facilitators and barriers to care, and describe the effects of facilitators …

Isoprenoid Analogs As Chemical Genetic Tools To Provide Insights Into Farnesyl Transferase Target Selection And Cellular Activity, Jerry Troutman

University of Kentucky Doctoral Dissertations

Protein farnesylation is an essential post-translational modification required for the function of numerous cellular proteins including the oncoprotein Ras. The farnesyl transferase (FTase) catalyzed reaction is unique because farnesyl diphosphate (FPP), the farnesyl group donor for the reaction, forms a significant portion of a target protein binding site. The major goal of this research was to exploit this unique property of the FTase reaction and determine if changing the structure of the farnesyl donor group would affect FTase protein targeting. A small library of structural analogues of FPP was synthesized. Michelis-Menten steady-state kinetic analyses and competition reactions were used to …

Contagious Discourse: Germs, Mass Media, And The Shaping Of Reality, Amy Richardson Ballagh

College of Graduate Studies: Theses & Dissertations

Over the past two decades, mass media coverage of certain infectious diseases has become more abundant. News reports of many of these contagious illnesses invoke fear in many people, such as Ebola and pandemic influenza; multidrug-resistant strains of infectious diseases, such as tuberculosis; and agents of biological warfare, a concern that is now at the forefront with many Americans due to the most recent act of bioterrorism on American soil following the events of September 11th. This dissertation focuses on the American public's perception of infectious diseases, particularly as portrayed in the cultural science curriculum. I examine the cyclic nature …

Utility Of Health Belief Model Constructs In Predicting Dietary Behaviors Among Female University Students: A Pilot Investigation, Vanessa Emily Anderson

College of Graduate Studies: Theses & Dissertations

This study examined the relationship between Health Belief Model constructs as they related to dietary behaviors in a sample of university women 18-to-25 years of age (n=182). A cross-sectional, non-experimental design was utilized. Independent sample t-tests compared the mean of body mass indices (BMI) to dietary risk and race. Odds ratios amassed relationships between race and healthy food choices. Nearly one-third (32.4%) of participants were either overweight or obese. Black females had significantly higher BMI than white females; however, dietary risk from less-than-adequate fruit and vegetable consumption and consumption of high-fat foods were not related to race. Focus group participants …

Other People's Country: A Memoir; And, Developing A Trustworthy Narrator: An Essay, Maureen Helen

Theses: Doctorates and Masters

This thesis comprises two interrelated sections. The first section is a substantial piece of creative writing, which l have cailed 'Other People's Country: A Memoir, in the genre of travel memoir, and an essay. The memoir borrows techniques from fiction, drama and poetry to tell a story of a middle-aged, middle-class city nurse, who travels to a remote settlement at the edge of the Western Desert of Western Australia to provide health care for a fluctuating population of around 400 people, for whom English is a third or fourth language.

Writing that includes stories about vulnerable people from another culture, …

Effects Of Hypoxia On Exercise Induced Muscle Damage, Trevor M. Farr

Theses: Doctorates and Masters

The present study investigated the hypothesis that maximal voluntary contractions (MVC) peak torque, VJ, muscle tenderness, and plasma creatine activity would be significantly less for the condition that subjects were exposed to hypoxic (H) condition for 4 hours after eccentric exercise compared with the normoxic (N) condition.

A Case Study Investigation Of The Development And Treatment Of Alter Personalities In Dissociative Identity Disorder, Ian Brown

Theses: Doctorates and Masters

Progress in the study and treatment of Dissociative Identity Disorder (DID) has been hampered by ideological debate regarding its validity. This is particularly the case when patient's suffering from DID also report ritualistic abuse. Part of the difficulty has been that past studies have not established independent checks to assess whether alters are artefacts introduced by therapeutic bias. This study addressed this issue by using independent judges to test the validity of a patient being treated for DID who claimed ritualistic abuse. The judges were 16 clinicians with an average of 21 years experience in their respective disciplines. The study …

Resistance Exercise In Men Receiving Androgen Deprivation Therapy For Prostate Cancer, Daniel A. Galvao

Theses: Doctorates and Masters

This thesis encompasses two literature reviews (chapter 2 & 3) and two experimental chapters (4 and 5) examining the available literature on exercise and cancer, resistance training and its anabolic responses in older men and women, the side effects of Androgen Deprivation Therapy (ADT) for prostate cancer and finally, the role of resistance exercise as a clinical intervention to counteract such changes as an adjuvant therapy.

Grammatical Morphology Of Children Reared In Poverty: Implications For Specific Language Impairment, Sonja L. Pruitt

LSU Doctoral Dissertations

In the current study, the past tense systems of children reared in poverty were examined. Guiding the study was Rice and Wexler’s (1996) Extended Optional Infinitive (EOI) account, which makes a number of predictions about the past tense systems of children with specific language impairment (SLI). The goal of the current study was to determine if these predictions apply to other children with weak language systems, such as those reared in poverty. The participants included 15 six-year-olds from low-income backgrounds (LSES), 15 age-matched peers from middle-income backgrounds (AM), and 15 language-matched peers from middle-income backgrounds (LM). All were African American …

Characterization Of Equine Pulmonary Endothelin Receptors In Health And Disease, Sumanth Polikepahad

LSU Doctoral Dissertations

Endothelin-1 (ET-1) has been implicated in allergic type of respiratory inflammatory diseases in various species of animals including horses. This peptide elicits its actions by acting through endothelin-A (ET-A) and endothelin-B (ET-B) receptor sub-types. In this project, we have hypothesized that endothelin receptors (both ET-A and ET-B) are altered in terms of affinity and expression, in the lungs of summer pasture-associated obstructive pulmonary disease (SPAOPD)-affected horses. Objective of this dissertation was to determine the alterations in the affinity and expression of endothelin receptors in the lungs of healthy and SPAOPD-affected horses. To pursue our hypothesis, we have employed pharmacological, immunohistochemical …

Genetically Modified Ifn-Alpha For Gene Therapy Treatment Of Squamous Cell Carcinoma, Ryan Craig

LSU Master's Theses

In the last twenty years, interferon-α (IFN-α) has gained success as an immunotherapy for treating such cancers as hairy cell leukemia, malignant melanoma, and renal cell cancer. Our goal was to improve the effectiveness of IFN-α therapy by genetically modified the IFN-α gene to encode a tumor-targeting peptide fused to a functional IFN-α protein. To ensure the targeting peptide worked, a genetically modified reporter gene encoding a secreted alkaline phosphatase (SEAP) gene and different mini-peptides were used to determine distribution and targeting ability. The DNA fragment encoding the most effective peptide was selected to modify the IFN-α gene construct for …

Examining Middle School Students Learning Language Arts Skills In Context, Erica L. Dinkins

LSU Doctoral Dissertations

The purpose of this study was to investigate whether the embedded language approach is effective in teaching the traditional language arts curriculum, and whether it holds any advantages over the more traditional approach. Twelve teachers in ten different schools taught language skills using the embedded language approach, while twelve matched teachers explicitly taught the same skills using traditional workbook practice activities for six weeks. Treatment efficacy was assessed using gain scores between pretest and posttest using a battery of informal and standardized measures. In addition, weekly comprehension probes were administered to examine whether language arts skills taught during the week …

The Epidemiology Of West Nile Virus In Louisiana, Karen Ruth Gruszynski

LSU Doctoral Dissertations

West Nile virus (WNV), a member of the genus Flavivirus transmitted by mosquitoes, first appeared in the New York in 1999. Within five years WNV was detected throughout the contiguous 48 states causing disease in reservoirs and accidental hosts alike. In Louisiana, WNV was first detected in 2001 with one human case, ten equine cases, and six dead birds reported. The introduction of WNV into Louisiana presented an unique opportunity to observe an emerging disease unfold, so a study was launched to gain insight into the epidemiology of WNV in Louisiana. The first component, an environmental predictive model for West …

Racial Disparities, Birth Outcomes, And Changing Demographics Of East Baton Rouge Parish, Louisiana, Misty D. Richard

LSU Doctoral Dissertations

Racial and socioeconomic disparities persist throughout the country regardless of which specific disparity is studied; however, some geographic regions experience more significant racial disparities. East Baton Rouge Parish, Louisiana has a large racial disparity among birth outcomes. Many factors impact the degree of racial disparities, some of which include racial segregation, isolation, or centralization, access to and quality of medical care, and factors of the neighborhood environment. EBRP has undergone dramatic shifts in the demographics of its residents. The purpose of this dissertation was to study the demographic changes in the population; as well as to study the disparities among …

The Macarthur-Bates Communicative Development Inventory As An Assessment Tool For Low-Income, African American Children, Elizabeth Waters Wooden

LSU Master's Theses

The purpose of this study was to examine the usefulness of the MacArthur- Bates Communicative Development Inventory (CDI) as an assessment tool for low-income, African American (AA) children. The data were from eighty-seven typically developing AA children, aged 8 to 30 months; these children were recruited from childcare centers that served low-income populations in Baton Rouge, Louisiana. Each participant’s primary caregiver completed a biographical sketch and a CDI inventory. Two analyses were completed. The first analysis examined the distribution of the CDI scores relative to the child’s age, gender, birth order, and level of maternal education. The second analysis involved …

Power Analysis For A Mixed Effects Logistic Regression Model, Yinmei Li

LSU Doctoral Dissertations

In herd health studies, the mixed effects logistic regression model with random herd effects are commonly used for modeling clustered binary data. These models are well developed and widely used in the literature, among which is the logistic-normal regression model. In contrast to the rich literature in modeling methods, the sample size/power analysis methods for such mixed effects models are sparse. The sample size/power analysis method for the logistic-normal regression model is not readily available. This study is to develop a power analysis/sample size estimation method for the logistic-normal regression model. Extended from the sample size method for the likelihood …

Validity Of The Reflux Symptoms Index For Post-Pubescent Female Vocalists, Natalie Herpin Overall

LSU Master's Theses

The Reflux Symptoms Index (RSI), a nine-item self-rated questionnaire, has been suggested as a way of monitoring severity of laryngopharyngeal reflux (LPR) symptoms during treatment. However, limited research has been conducted to assess the validity of the RSI as a way of identifying severity of laryngopharyngeal reflux (LPR) symptoms as differentiated from gastroesophageal reflux (GER) symptoms. Twenty-five post-pubescent female vocalists participated by completing a one-hour voice evaluation, including a Voice Handicap Index (VHI), an RSI, a Reflux Finding Score (RFS) completed with videostroboscopy for visualization of the laryngeal cavity, and analysis of an acoustic sample with the Multi-Dimensional Voice Profile …

Brugia Phangi: Effects Of Third Stage Larvae Es Immunization On Early Migration And Parasite Establishment In Mongolian Gerbils (Meriones Unguiculatus), Ginger Ann Robertson

LSU Master's Theses

Brugia infections occur via the bite of an infected mosquito. Third stage infective larvae (L3) deposited on the skin during feeding migrate into the bite wound, through skin and into the lymphatic system. It is hypothesized that L3 excretory/secretory products (ES) are important in this initial phase of the infection. A model for these early migrations has been established by inoculating L3s into the dermis (ID) of the permissive gerbil host. In this model, most L3s injected ID in the louer hind limb travel to the popliteal lymph node by 3 days post infection. Adult parasites are located primarily in …

Effect Of Vaccination Of Goats With H-Gal-Gp And H11 Antigens From Intestinal Membrane Cells Of Haemonchus Contortus, Donya Dupree Olcott

LSU Master's Theses

Extracts of adult Haemonchus contortus were purified and used as a vaccine against the blood feeding parasite in goats as previously studied in sheep. The proteins used were H11 and H-gal-GP, hidden gut antigens from the microvillar membrane of the gut of the worm and combined with Quil A as adjuvant, then administered to a group of goats kept on concrete then artificially infected with H. contortus. The control group received Quil A injections and also infected. This study was performed to analyze the effects of the H11/H-gal-GP vaccine when given to goats as compared to sheep. The trial showed …

Why Undergraduate Nurses Choose Not To Pursue Mental Health Nursing As A Career In Western Australia : A Descriptive Study, Therese Howell

Theses : Honours

Not only are fewer undergraduate nursing students opting to pursue a career in mental health nursing (Arnswald, 1987; Clinton & Hazelton, 2000; Happell, 1998; Lam, McMaster & Troup, 1993), but nursing students continue to rank mental health nursing as their lowest preference of career choice. Instead, nursing undergraduates appear to be opting for positions within the surgical or critical care specialties (Durkin, 2002; Happell, 1999; Happell1999; Happell, 2001). The aim of this descriptive study was to investigate and identify the potential reasons why undergraduate nursing students do not take up mental health nursing as a career. This descriptive study implemented …

Nurses' Decision Making Processes Regarding Indwelling Catheter Insertion And Removal, Helen Hull

Theses : Honours

Urinary catheterisation remains a common procedure conducted by nurses often as a result of autonomous decision making. This research aimed to identify and describe the lived experience of nurses' decision making processes regarding the insertion and removal of urinary catheters. The research was believed to be important as there is a myriad of literature on what is best practice but very little on what is actually taking place in nursing practice. A qualitative phenomenological study design was chosen, where nurse participants were interviewed using open-ended questions. Descriptive phenomenology was the chosen method which follows in Heidegerr's tradition that allowed nurses …

Enrolled Nurses' Attitudes, Subjective Norms, Intentions And Behaviour Related To Independent Medication Administration, Donna Sayers

Theses : Honours

The purpose of this quantitative descriptive research study was to investigate Enrolled Nurses' attitudes, intentions and behaviour in relation to independent medication administration (IMA). This research was necessary as a significant number of Enrolled Nurses (ENs) are now able to administer medications up to Schedule Four level, without supervision when they have completed a medication administration programme (MAP). This change in the scope of practice for the EN will eventually be introduced nationally as recommended by the National Review of Nursing Education (2002). Anecdotal reports suggest that IMA is causing concern for the EN but little or no research has …

Sex Differentiation And Sexually Dimorphic Disease, Emily A. Jefferson

Theses : Honours

Sexual dimorphism of the central nervous system is a still widely debated and an area of much research. Conclusive evidence that anatomical and physiological differences in the CNS exist has been reported by post-mortem studies and magnetic resonance imaging (MRI). This present study seeks to contribute to the understanding of the differences in the brain between genders and to ascertain reasons as to why the literature is so varied. A number of structures such as the cerebral cortex, hypothalamic nuclei and the amygdala have proven to be significantly larger within males as opposed to females. The nuclei of the hypothalamus …

Interhemispheric Modulation Of Corticomotor Excitability Following I-Wave Periodicity Transcranial Magnetic Brain Stimulation (Itms), Lucy Catherine Millar

Theses : Honours

AIMS: Transcranial Magnetic Stimulation (TMS) has been recently demonstrated to have potential therapeutic benefits by promoting cortical plasticity through modulation of corticospinal excitability. We have previously shown in healthy adult subjects that paired-pulse TMS (1.5ms ISI) applied over Ml at 0.2Hz for 15min (known as iTMS), can raise corticospinal excitability for a period (~10min) that outlasts the intervention. Since interhemispheric changes in corticomotor excitability are considered to have fundamental importance in the control of voluntary movement, and recovery of motor function following unilateral damage, importance is placed on understanding the mechanisms involved. The aims of the current study were therefore …

Neck Loading In High Performance Combat Pilots During Aerial Combat Manoeuvres And Specific Neck Strengthening Exercises, Kevin J. Netto

Theses: Doctorates and Masters

Background: Neck pain and injury is a common occurrence in high performance combat pilots (HPCP) around the world. The cause of this has been attributed to exposure to the unavoidable high mechanical loading related to the neck being positioned in non-neutral head postures whilst being exposed to moderate to high +Gz levels. Specific neck conditioning exercises have been proposed as being a possible method to decrease the incidence of neck pain and injury in this population. However, there has been sparsely published research examining the suitability of selected exercises for HPCP who participate in regular aerial combat manoeuvres (ACM).

An Investigation Of The Effect Of Exercised Arm, Training Status, And Racial Background On Changes In Markers Of Muscle Damage Following Maximal Eccentric Exercise Of The Elbow Flexors, Michael J. Newton

Theses: Doctorates and Masters

Despite the substantial body of research accumulated on exercise-induced muscle damage, there remain several areas that warrant further investigation. Study groups comprised of individuals from differing racial background and /or training status have the potential to influence the intra-group variability in damage markers following eccentric exercise. In addition, if a contralateral arm model is employed, intra- and inter-group variation could be influenced by the formation of groups based on limb dominance and /or the order in which the arms are exercised. Currently there is a dearth of research addressing these factors, however, these types of studies are important as they …

Controlling And Constraining The Participation Of The Hepatitis C-Affected Community In Australia: A Critical Discourse Analysis Of The First National Hepatitis C Strategy And Selected News Media Texts, Judith D. Pugh

Theses: Doctorates and Masters

The construction of texts that place hepatitis C-positive persons at social risk (Candlin, 1989, p. ix), informs this study of the ways in which public health policy makers and journalists in Australia communicate about hepatitis C. The institutions of public health and the news media form part of the cultural context within which persons construct their illness narratives. The privileged perspectives and framing of public health policy and news media discourses; the discursive practices associated with the institutions of public health and the media around hepatitis C and hepatitis C-positive persons, the “objects” of knowledge (Foucault, 1969/2002, p. 81); and …

Process Evaluation Of A School- And Home-Based Sun Safety Education Intervention, Robyn S. Johnston

Theses: Doctorates and Masters

Effective interventions that reduce children's sun exposure are likely to reduce melanoma incidence in the longer term. However, for such interventions to have an impact they must be adequately implemented. School-based sun protection programs have been evaluated to determine their effectiveness in changing behaviours, however, few studies have assessed the implementation of such programs, or the effect of their implementation on outcomes. Kidskin was a five-year intervention trial designed to assess the effectiveness of a multicomponent intervention in reducing sun exposure in children in Perth, Western Australia. This thesis describes the process evaluation of the school- and home-based educational components …

Networks And Narratives: An Exploration Of Their Relationship And Potential For Understanding The Actual Experiences Of Women With Hiv/Aids, Purity N. Irungu

Theses: Doctorates and Masters

This study set out to examine literature relating to social network theory and narrative theory in order to explore how their potential connection could be used in future to understand and improve the actual life-experiences of women infected by the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). The thesis was done entirely by library research using secondary sources but is original in its intent. It includes a critical examination of some of the work of earlier researchers, including Lockhart's (2000) anthropological study of the social construction of `risk' of AIDS in urban Tanzania. Much previous research studied …

Controlling Involvement To Promote Confidence In Palliative Care Decisions - A Grounded Theory From The Patient's Perspective, Susan F. Lee

Theses: Doctorates and Masters

Decision making in the context of palliative care is particularly complex given the unpredictable illness trajectories experienced by patients and the number of individuals who may be part of the decision making process. This grounded theory study explored and described from the perspective of patients with advanced illness, their experiences of making care decisions. A review of literature at the commencement of the study indicated that there was a lack of evidence to support the best way of ascertaining patient's preferences for involvement in decisions in a palliative care context and almost no research to guide clinicians about the involvement …