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Articles 1261 - 1290 of 3703
Full-Text Articles in Medicine and Health Sciences
Recombinant Mycobacteria Overexpressing D-Alanine Ligase Gene And Uses Therefore: United States Patent No. Us 7,371,571 B2, Raul G. Barletta, Zhengyu Feng
Recombinant Mycobacteria Overexpressing D-Alanine Ligase Gene And Uses Therefore: United States Patent No. Us 7,371,571 B2, Raul G. Barletta, Zhengyu Feng
School of Veterinary and Biomedical Sciences: Faculty Publications
Recombinant mycobacterial strains which overproduce essential biosynthetic enzymes of pathogenic mycobateria are provided. These strains overproduce enzymes involved in the synthesis and incorporation of D-alanine into mycobacterial peptidoglycan, the backbone of the mycobacterial cell wall. These overproducing strains may be used as reference strains in in vitro screening methods to identify antimycobacterial agents.
Atf4 Is An Oxidative Stress–Inducible, Prodeath Transcription Factor In Neurons In Vitro And In Vivo, Philipp Lange, Juan Chavez, John T. Pinto, Giovanni Coppola, Chiao-Wang Sun, Tim Townes, Rajiv Ratan
Atf4 Is An Oxidative Stress–Inducible, Prodeath Transcription Factor In Neurons In Vitro And In Vivo, Philipp Lange, Juan Chavez, John T. Pinto, Giovanni Coppola, Chiao-Wang Sun, Tim Townes, Rajiv Ratan
NYMC Faculty Publications
Oxidative stress is pathogenic in neurological diseases, including stroke. The identity of oxidative stress-inducible transcription factors and their role in propagating the death cascade are not well known. In an in vitro model of oxidative stress, the expression of the bZip transcription factor activating transcription factor 4 (ATF4) was induced by glutathione depletion and localized to the promoter of a putative death gene in neurons. Germline deletion of ATF4 resulted in a profound reduction in oxidative stress-induced gene expression and resistance to oxidative death. In neurons, ATF4 modulates an early, upstream event in the death pathway, as resistance to oxidative …
Grantee-Level Estimates Show That 31 Percent Of All Health Centers Would Fail To Meet Tier Two Status Under Hrsa's Proposed Mua/Mup/Hpsa Designation Regulations, Peter Shin, Leighton C. Ku, Emily Jones, Sara J. Rosenbaum
Grantee-Level Estimates Show That 31 Percent Of All Health Centers Would Fail To Meet Tier Two Status Under Hrsa's Proposed Mua/Mup/Hpsa Designation Regulations, Peter Shin, Leighton C. Ku, Emily Jones, Sara J. Rosenbaum
Geiger Gibson/RCHN Community Health Foundation Research Collaborative
In April of 2008, we issued a research brief which analyzed the impact on various federal programs of a February 29, 2008 Notice of Proposed Rulemaking (NPRM) regarding the designation of Medically Underserved Populations and Health Professional Shortage Areas. Among its findings, the report estimated that resources for one-third of community health center sites would be jeopardized by this rule change because they could not attain a sufficiently high priority status, even under the newly-proposed, higher-scoring Tier 2 methodology. On May 1, 2008, we issued a revision in response to an April 21, 2008 clarification notice from the Health Resources …
A New Age In Dementia Care: Turning Evidence Into Practice
A New Age In Dementia Care: Turning Evidence Into Practice
Center for Applied Research on Aging and Health Conferences
A New Age in Dementia Care: Turning Evidence into Practice Come celebrate the opening of the new Living Laboratory for Elder Care.
September 17, 2008 7:30 am - 4:30 pm Thomas Jefferson University, Dorrance H. Hamilton Building 1001 Locust St., Philadelphia, PA 19107
Speakers Include:
Christine Arenson, MD Associate Professor Director, Division of Geriatric Medicine Department of Family and Community Medicine Jefferson Medical College Director, Eastern-Pennsylvania Delaware Geriatric Education Center Co-Director Jefferson InterProfessional Education Center Thomas Jefferson University
Louis D. Burgio, PhD Harold R. Johnson Endowed Chair in Gerontology, Professor of Social Work Research Professor, Institute of Gerontology School …
The Synthetic Triterpenoid Cddo-Methyl Ester Modulates Microglial Activities, Inhibits Tnf Production, And Provides Dopaminergic Neuroprotection, Thi A. Tran, Melissa K. Mccoy, Michael B. Sporn, Malú G. Tansey
The Synthetic Triterpenoid Cddo-Methyl Ester Modulates Microglial Activities, Inhibits Tnf Production, And Provides Dopaminergic Neuroprotection, Thi A. Tran, Melissa K. Mccoy, Michael B. Sporn, Malú G. Tansey
Dartmouth Scholarship
Recent animal and human studies implicate chronic activation of microglia in the progressive loss of CNS neurons. The inflammatory mechanisms that have neurotoxic effects and contribute to neurodegeneration need to be elucidated and specifically targeted without interfering with the neuroprotective effects of glial activities. Synthetic triterpenoid analogs of oleanolic acid, such as methyl-2-cyano-3,12-dioxooleana-1,9-dien-28-oate (CDDO-Me, RTA 402) have potent anti-proliferative and differentiating effects on tumor cells, and anti-inflammatory activities on activated macrophages. We hypothesized that CDDO-Me may be able to suppress neurotoxic microglial activities while enhancing those that promote neuronal survival. Therefore, the aims of our study were to identify specific …
Designing A Successful Practice-Based Research Network In Public Health: Key Concepts, Glen P. Mays, Sharla A. Smith
Designing A Successful Practice-Based Research Network In Public Health: Key Concepts, Glen P. Mays, Sharla A. Smith
Health Management and Policy Reports
Successful public health practice-based research networks (PBRNs) will require organizational, financial, and intellectual resources that allow practitioners and researchers to mount relevant studies in real-world public health settings. This brief outlines characteristics likely to be important to the success of public health PBRNs, based on the experience of PBRNs in other practice settings
Assessment Of Physician Workforce Supply And Demand In The Us, Michael E. Samuels, Elmer T. Whitler
Assessment Of Physician Workforce Supply And Demand In The Us, Michael E. Samuels, Elmer T. Whitler
Center of Excellence in Rural Health Presentations
Rural community and migrant health centers face major problems in attracting and retaining physicians. This presentation addresses that issue by projecting health services demands, physician specialty distribution and physician supply, as well as suggesting methods for increasing physician supply and reducing consumer demand.
The Mercury Connection: Autism And Childhood Vaccines, Sarah Rossi
The Mercury Connection: Autism And Childhood Vaccines, Sarah Rossi
Pell Scholars and Senior Theses
A literature survey of government and private studies have found that Thimerosal not to be a cause of auism. The reliance on limited, flawed and outdated studies on the effect of ethyl-mercury suggest that more research is needed to understand the effects of ethyl-mercury and particularly Thimerosal. In the meantime efforts should be increased to remove Thimerosal from vaccines world-wide.
Rest Maintains Self-Renewal And Pluripotency Of Embryonic Stem Cells, Sanjay K Singh, Mohamedi N Kagalwala, Jan Parker-Thornburg, Henry Adams, Sadhan Majumder
Rest Maintains Self-Renewal And Pluripotency Of Embryonic Stem Cells, Sanjay K Singh, Mohamedi N Kagalwala, Jan Parker-Thornburg, Henry Adams, Sadhan Majumder
Faculty, Staff and Student Publications
The neuronal repressor REST (RE1-silencing transcription factor; also called NRSF) is expressed at high levels in mouse embryonic stem (ES) cells, but its role in these cells is unclear. Here we show that REST maintains self-renewal and pluripotency in mouse ES cells through suppression of the microRNA miR-21. We found that, as with known self-renewal markers, the level of REST expression is much higher in self-renewing mouse ES cells than in differentiating mouse ES (embryoid body, EB) cells. Heterozygous deletion of Rest (Rest+/-) and its short-interfering-RNA-mediated knockdown in mouse ES cells cause a loss of self-renewal-even when these cells are …
2,6-Disubstituted Piperidines And Piperazine Compounds, Peter A. Crooks, Linda P. Dwoskin, Marlon D. Jones, Dennis Keith Miller, Seth Davin Norholm, Guangrong Zheng, Sairam Krishamurthy
2,6-Disubstituted Piperidines And Piperazine Compounds, Peter A. Crooks, Linda P. Dwoskin, Marlon D. Jones, Dennis Keith Miller, Seth Davin Norholm, Guangrong Zheng, Sairam Krishamurthy
Pharmaceutical Sciences Faculty Patents
The preparation of novel microemulsions to be used as precursors for solid nanoparticles is described. The microemulsion precursors consist of either alcohol-in-fluorocarbon microemulsions, liquid hydrocarbon-in-fluorocarbon microemulsions, or liquid hydrocarbon-in-water microemulsions. The formed solid nanoparticles have diameters below 200 nanometers and can be made to entrap various materials including drugs, magnets, and sensors. The solid nanoparticles can be made to target different cells in the body by the inclusion of a cell-specific targeting ligand. Methods of preparing the novel microemulsion precursors and methods to cure solid nanoparticles are provided.
Ross, Nancy (Fa 239), Manuscripts & Folklife Archives
Ross, Nancy (Fa 239), Manuscripts & Folklife Archives
Folklife Archives Finding Aids
Finding aid and full-text scan of paper (Click on “Additional Files” below) for Folklife Archives Project 239. Paper: "[Family Health Traditions]" written by Nancy Ross for a Western Kentucky University folk studies collection.
Early Diagnosis Of Pancreatic Cancer: Neutrophil Gelatinase-Associated Lipocalin As A Marker Of Pancreatic Intraepithelial Neoplasia., N. Moniaux, S. Chakraborty, M. Yalniz, J. Gonzalez, Valerie K. Shostrom, J. Standop, Subodh M. Lele, Michel M. Ouellette, Parviz M. Pour, Aaron Sasson, R. E. Brand, Michael A. Hollingsworth, Maneesh Jain, Surinder K. Batra
Early Diagnosis Of Pancreatic Cancer: Neutrophil Gelatinase-Associated Lipocalin As A Marker Of Pancreatic Intraepithelial Neoplasia., N. Moniaux, S. Chakraborty, M. Yalniz, J. Gonzalez, Valerie K. Shostrom, J. Standop, Subodh M. Lele, Michel M. Ouellette, Parviz M. Pour, Aaron Sasson, R. E. Brand, Michael A. Hollingsworth, Maneesh Jain, Surinder K. Batra
Journal Articles: Biochemistry & Molecular Biology
Pancreatic cancer is a highly lethal malignancy with a dismal 5-year survival of less than 5%. The scarcity of early biomarkers has considerably hindered our ability to launch preventive measures for this malignancy in a timely manner. Neutrophil gelatinase-associated lipocalin (NGAL), a 24-kDa glycoprotein, was reported to be upregulated nearly 27-fold in pancreatic cancer cells compared to normal ductal cells in a microarray analysis. Given the need for biomarkers in the early diagnosis of pancreatic cancer, we investigated the expression of NGAL in tissues with the objective of examining if NGAL immunostaining could be used to identify foci of pancreatic …
Ada News - 05/05/2008, American Dental Association, Publishing Division
Ada News - 05/05/2008, American Dental Association, Publishing Division
ADA News
Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.
Cif Is Negatively Regulated By The Tetr Family Repressor Cifr, Daniel P. Maceachran, Bruce A. Stanton, George A. O'Toole
Cif Is Negatively Regulated By The Tetr Family Repressor Cifr, Daniel P. Maceachran, Bruce A. Stanton, George A. O'Toole
Dartmouth Scholarship
We previously reported that the novel Pseudomonas aeruginosa toxin Cif is capable of decreasing apical membrane expression of the cystic fibrosis transmembrane conductance regulator (CFTR). We further demonstrated that Cif is capable of degrading the synthetic epoxide hydrolase (EH) substrate S-NEPC [(2S,3S)-trans-3-phenyl-2-oxiranylmethyl 4-nitrophenol carbonate], suggesting that Cif may be reducing apical membrane expression of CFTR via its EH activity. Here we report that Cif is capable of degrading the xenobiotic epoxide epibromohydrin (EBH) to its vicinal diol 3-bromo-1,2-propanediol. We also demonstrate that this epoxide is a potent inducer of cif gene expression. We show that the predicted TetR family transcriptional …
Feeling Overwhelmed: The Lived Experience Of Nurse Managers., Teresa Potter England
Feeling Overwhelmed: The Lived Experience Of Nurse Managers., Teresa Potter England
Electronic Theses and Dissertations
Multiple studies have addressed registered nurse turnover in recent years. There is little research specifically addressing nurse manager turnover. The nurse manager is addressed in current research as being in a pivotal position to affect nurse retention. Research has focused on the skills necessary for nurse managers to affect turnover; however, there is little research addressing the pressure placed upon the nurse manager as he or she struggles to maintain the nursing workforce. This qualitative study explored the lived experience of feeling overwhelmed by 6 nurse managers currently working in an inpatient hospital environment. Interviews were analyzed using a modified …
Toward The Synthesis Of Nuclease Models., Enni Nina Fomumbod
Toward The Synthesis Of Nuclease Models., Enni Nina Fomumbod
Electronic Theses and Dissertations
Nucleases are enzymes that can specifically recognize nucleic acids and hydrolyze their phosphodiester bonds effectively. As is the case with many hydrolases, nucleases often carry one or more metal centers. Cooperation between such metal centers and other interactions involving general acid-base activities are believed to be essential in multifunctional catalyses. Combination of such interactions in model compounds often resulted in larger than additive effects.
This work is aimed at synthesizing nuclease models that combine the ability to recognize phosphate groups and/or nitrogen bases of DNA together with the ability to catalyze phosphodiester hydrolysis. These models were designed to achieve optimum …
Expression, Purification, And Characterization Of The Mast Cell Proteases Chymase And Cathepsin G., Brent E. Lockhart
Expression, Purification, And Characterization Of The Mast Cell Proteases Chymase And Cathepsin G., Brent E. Lockhart
Electronic Theses and Dissertations
Human mast cells have been associated with wound healing, allergies, inflammation, and defense against pathogens and have been detected in tissues close to blood vessels especially in the areas between the inside of the body and the external environment, such as the skin, lungs, digestive tract, mouth, and nose. Previous studies have shown that mast cells contain large granules filled with histamine, heparin, cytokines, eicosanoids, and the serine proteases, tryptase, Chymase, and cathepsin G (CatG). These proteases are stored and released from mast-cell granules upon activation by antigen binding to IgE immunoglobulins on the cell surface or by direct injury. …
Assessing The Reliability Of Scores Produced By The Substance Abuse Subtle Screening Inventory (Sassi)., Joshua A. Woodson
Assessing The Reliability Of Scores Produced By The Substance Abuse Subtle Screening Inventory (Sassi)., Joshua A. Woodson
Electronic Theses and Dissertations
The fundamental principle that reliability is a property of scores and not of instruments provides the foundation of a meta-analytic technique called reliability generalization (RG). RG studies characterize the reliability of scores generated by a given instrument and identify methodological and sample characteristics that contribute to the variability in the reliability of those scores. The present study is an RG of the Substance Abuse Subtle Screening Inventory (SASSI). Reliability estimates were obtained from 19.8% of studies using the SASSI. Bivariate correlations revealed strong, positive correlations between SASSI score reliability and score variability of the Subtle Attributes (r = .877, …
Promoting Speech And Vocabulary Development Through Specialized Storybooks In Children With And Without Cleft Palate., Joellyn Ruth Smith
Promoting Speech And Vocabulary Development Through Specialized Storybooks In Children With And Without Cleft Palate., Joellyn Ruth Smith
Electronic Theses and Dissertations
This study investigated changes in vocabulary and speech production in response to storybooks embedded with specialized language prompts and speech recasts. Six children received intervention, 3 with cleft palate (CLP), displaying speech-language delays, and 3 with nonclefts, each 12-24 months of age. A multiple baseline design across behaviors was implemented by a clinician. Results indicated all children increased use of target vocabulary and production of stop consonants, while reducing compensatory articulation errors. Generalization of targets to a picture-naming task, a free-play task, and to the home was observed. Effect sizes were moderate-to-high. Children with CLP required more sessions to achieve …
Étudier Et Travailler En Région À 18 Ans : Quels Sont Les Risques De Sst? Une Étude Exploratoire, Élise Ledoux, Luc Laberge, Chloé Thuilier, Pascale Prud'homme, Suzanne Veillette, Marco Gaudreault, Michel Perron
Étudier Et Travailler En Région À 18 Ans : Quels Sont Les Risques De Sst? Une Étude Exploratoire, Élise Ledoux, Luc Laberge, Chloé Thuilier, Pascale Prud'homme, Suzanne Veillette, Marco Gaudreault, Michel Perron
Rapports de recherche scientifique
Le taux d’activité des jeunes travailleurs a augmenté de façon importante au cours des dernières années passant de 58 % en 1998 à 66 % en 2002 (Gervais et coll., 2006). Il rejoint ainsi le taux d’activité de la population totale. Depuis une vingtaine d’années, plusieurs études ont mis en évidence le fait que les jeunes de moins de 25 ans se blessent très souvent au travail, faisant de cette situation une préoccupation de santé publique tant au Canada qu’aux États-Unis et en Europe (Brooks et coll., 1993; Layne et co ll., 1994; Millar, 1995; Hendricks et Layne, 1999; Dupré, …
Cdc45 Function Alters Cell Sensitivity To Dna Topoisomerase I Poisons, Cynthia Sue Lancaster
Cdc45 Function Alters Cell Sensitivity To Dna Topoisomerase I Poisons, Cynthia Sue Lancaster
Theses and Dissertations (ETD)
Eukaryotic DNA topoisomerase I (Top1) is a highly conserved enzyme that functions to manage the torsional strain of DNA during cellular processes such as transcription, replication, chromatid condensation and recombination. The enzyme binds duplex DNA and through a series of strand cleavage and religation reactions removes positive or negative supercoils relieving torsional strain. Top1 is the sole cellular target of the anticancer agent camptothecin, which stabilizes the covalent complex. CPT cytotoxicity is S-phase dependent. It has been suggested that the mechanism of this S-phase toxicity is due to the advancing replication forks either colliding with the stabilized drug-enzyme-DNA intermediate or …
Transcriptional Regulation Of Azole Antifungal Resistance In Candida Albicans, Teresa T. Liu
Transcriptional Regulation Of Azole Antifungal Resistance In Candida Albicans, Teresa T. Liu
Theses and Dissertations (ETD)
Candida albicans is a pathogenic fungi found in the mucosa, gastrointestinal, and urogenital tracts of humans. Oropharyngeal candidiasis (OPC), an opportunistic mucosal infection caused by C. albicans, occurs most frequently in patients infected with human immunodeficiency virus (HIV). OPC is usually treated with azole antifungals, a class of antifungals that target ergosterol biosynthesis, at low doses over long periods of time. This course of treatment allows for the development of azole resistance.
Two major mechanisms of azole resistance exist in C. albicans, the up-regulation of genes encoding efflux pumps and the up-regulation of ERG11, a gene encoding the azole drug …
Factors Influencing Topotecan Cns Penetration In Mouse Models, Jun Shen
Factors Influencing Topotecan Cns Penetration In Mouse Models, Jun Shen
Theses and Dissertations (ETD)
Camptothecin analogs such as topotecan are currently tested in clinical trials for brain tumors. However the clinical outcome is far below the expectations, which are derived from the promising preclinical studies. This discrepancy could be partially attributed to the presence of two barrier systems in the brain, the blood brain barrier (BBB) and blood cerebrospinal fluid (CSF) barrier (BCB). Further investigations have demonstrated multiple ATP-binding cassette (ABC) transporters are present at the two barriers. Camptothecin analogs are well known substrates for several of the transporters. This work defined the role of two ABC transporters, Bcrp1 and P-gp in determination of …
Social-Emotional Screening Status In Early Childhood Predicts Elementary School Outcomes, Margaret J. Briggs-Gowan
Social-Emotional Screening Status In Early Childhood Predicts Elementary School Outcomes, Margaret J. Briggs-Gowan
UCHC Articles - Research
OBJECTIVE—The goal was to examine whether children who screen positive for socialemotional/ behavioral problems at 12 to 36 months of age are at elevated risk for social-emotional/ behavioral problems in early elementary school.
METHODS—The sample studied (N = 1004) comprised an ethnically (33.3% minority) and socioeconomically (17.8% living in poverty and 11.3% living in borderline poverty) diverse, healthy, birth cohort from a metropolitan region of the northeastern United States. When children were 12 to 36 months of age (mean age: 23.8 months; SD: 7.1 months), parents completed the Brief Infant-Toddler Social and Emotional Assessment and questions concerning their level of …
Analysis Of The Cyc1 Promoter In Candida Albicans, Tomica Blocker
Analysis Of The Cyc1 Promoter In Candida Albicans, Tomica Blocker
McCabe Thesis Collection
Scientists are considering two factors that may be important in the pathogenesis of C. albicans', it's capability to morph from yeast to hyphal phase, and its differences in colony morphology, cell shape, cell surface and cell permeability. (5) Unfortunately, unlike the bacteria, yeasts do not yet have proven virulence factors. However, science is suggesting that some of the major factors which contribute to the virulence of Candida are its ability to form hyphae, its ability to resist phagocytosis, its ability to adhere to epithelial cell surfaces, its ability to grow well at 37 degrees Celsius, and its ability to secrete …
Reducing Inpatient Falls And Fall Related Injuries In Acute Care Settings, Channing Williams, Nikita Lewis, Victoria Thomas
Reducing Inpatient Falls And Fall Related Injuries In Acute Care Settings, Channing Williams, Nikita Lewis, Victoria Thomas
McCabe Thesis Collection
Falls are a continually rising issue in today's healthcare. In acute care settings, patient falls make up 38% of all adverse events in which include physical injury, undesirable emotional and financial outcomes for the client (Angn, Mordiffi, Wong, Devi, & Evans, 2007). Falls in the hospitals lead to fear, pain, decreased healing, longer in-patient stays, further health-related complications. Falls may also cause patient discomfort and affect quality of life. Prevention of falls is an important goal of hospitals world-wide. Research has been conducted to determine the clinical effectiveness and implementation of a fall prevention. Although falls in hospitals cannot always …
Medical Education Digest, Vol. 10 No. 3 (May/June 2008), Nova Southeastern University
Medical Education Digest, Vol. 10 No. 3 (May/June 2008), Nova Southeastern University
Medical Education Digest
No abstract provided.
Tendinopathy Discrimination By Use Of Spatial Frequency Parameters In Ultrasound B-Mode Images, Gregory R. Bashford, Nicholas Tomsen, Shruti Arya, Judith M. Burnfield, Kornelia Kulig
Tendinopathy Discrimination By Use Of Spatial Frequency Parameters In Ultrasound B-Mode Images, Gregory R. Bashford, Nicholas Tomsen, Shruti Arya, Judith M. Burnfield, Kornelia Kulig
Biomedical Imaging and Biosignal Analysis Laboratory
The structural characteristics of a healthy tendon are related to the anisotropic speckle patterns observed in ultrasonic images. This speckle orientation is disrupted upon damage to the tendon structure as observed in patients with tendinopathy. Quantification of the structural appearance of tendon shows promise in creating a tool for diagnosing, prognosing, or measuring changes in tendon organization over time. The current work describes a first step taken towards this goal—classification of Achilles tendon images into tendinopathy and control categories. Eight spatial frequency parameters were extracted from regions of interest on tendon images, filtered and classified using linear discriminant analysis. Resulting …
Information Interface - Volume 36, Issue 2 - May/June 2008, George Washington University, Himmelfarb Health Sciences Library
Information Interface - Volume 36, Issue 2 - May/June 2008, George Washington University, Himmelfarb Health Sciences Library
Information Interface (1976 - 2009)
News and information about Himmelfarb Health Sciences Library of interest to users.
A Wellness Guide For Recruiting Non-Participants Into A Worksite Health Promotion Program, Lorenzo Patrick Cassella Jr.
A Wellness Guide For Recruiting Non-Participants Into A Worksite Health Promotion Program, Lorenzo Patrick Cassella Jr.
Graduate Theses
Rising costs of healthcare have motivated employers to offer comprehensive health promotion programs to their employees, to reduce health risk factors such as physical inactivity, poor nutrition, high stress, etc., thereby lowering both direct (i.e., medical) costs and indirect (i.e., absenteeism) costs. The majority of worksite health promotion (WHP) programs only show short-term (i.e., under 12 weeks) employee improvement in any one type of program for a few reasons; > Employers develop action-oriented tools. > Employers do not match current programs with the condition of their population. ^ Employers do not integrate the Transtheoretical Model (TTM) and the Processes of Change into …