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1
Mayer, Patricia Lynn Sorci. "Self-care knowledge that informs mothers' behaviors during the enculturation of their daughters regarding breast self-examination." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276622.
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Five Tucson, Arizona, mothers of adolescent daughters participated in exploratory, descriptive nursing research employing ethnographic interviews during July, 1987, to determine what cultural knowledge informs the behaviors of mothers as they enculturate their daughters regarding Breast Self-Examination (BSE). Five major taxonomies of cultural knowledge emerged: "Caring For Yourself Means Surviving As A Species"; "Being Unsure, Thinking 'Why Bother?' "; "It Can't Happen To Me"; "If I Don't Know About It, It Isn't There"; and "It's Unnatural To Touch Yourself." Six pairs of conflicting cultural themes both presented BSE as a self-care means to promote human-species survival and simultaneously accounted for women's BSE non-compliance via their uncertainty over BSE techniques, sense of invulnerability to cancer, fear of uncovering disease, and unease with their own bodies. Nursing intervention should reinforce positive cultural knowledge about the female breasts which could be communicated by mothers to their daughters along with procedural knowledge in promoting BSE practice.
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Stenman, Carina. "New workflow method for ultrasound examinations." Licentiate thesis, Linköpings universitet, Medicinsk radiologi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-67050.
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Background: Growing demand for ultrasound examinations and higher quality requirements motivate searching for routines combining the diagnostic accuracy of radiologist-performed examinations with the economical advantages of sonographerperformed examinations. One possible approach is to use strictly standardized examination protocols and documentation made by cine-loops that will give the radiologist access to all relevant information after the examination. Ultrasound examinations are usually regarded as observer dependent, but using documentation with cine-loops acquired in a standardized way attempts to reduce this problem. Aims: The aim of study I was to compare a recently introduced routine, combining acquisition by a radiographer, documentation as standardized cine-loops, and review by a radiologist (“standardized method”), with the formerly used routine where the diagnosis is made bed-side by the radiologist (“traditional method”). The aim of study II was to evaluate the intra-observer and inter-observer agreement of the standardized method in ultrasound liver examinations. Material and Methods: In study I there was 64 policlinic patients examining the kidneys ( n = 27) or the gallbladder ( n =37) by both the standardized and the traditional method. The radiologists’ findings of hydronephrosis, tumors, cysts, echogenicity changes, and cortical thickness (in the kidneys), and wall thickness, concrements, and polyps (in the gallbladder) were compared between the methods with respect to agreement as well as systematic differences. In study II 98 out-patients were examined by a radiographer using the standardized method. Three radiologists with 10 – 20 years of experience of ultrasound reviewed the cine-loops retrospectively and independently filled out a predetermined protocol. After 4 weeks, the review was repeated, blinded to the initial reading. Results: Study I showed for the gallbladder examination a median agreement of 97% (86 – 100%; kappa =0.64 – 1.00) and for the kidney examination an agreement of 90% (78 – 100%; kappa = 0.69 – 1.00). There were no significant systematic differences between the two methods. In study II, the intra-observer agreement was highest for concrements in the gallbladder (kappa = 0.91 to 0.96) and lowest when assessing the need for further examination (kappa = 0.38 to 0.64). For increased liver echogenicity, kappa varied between 0.51 and 0.85, and for skip areas between 0.73 and 0.90. The interobserver agreement was also highest for concrements in the gallbladder (kappa = 0.84 to 1.00) and lowest for need for further examination (kappa = -0.12 to 0.46). For most other findings, substantial intra-observer agreement (kappa ≥ 0.61) was found. Conclusion: The satisfactory agreement in study I indicates that the new workflow with ultrasound examinations performed by a radiographer and analyzed off-line by a radiologist is promising. Study II shows a fairly good inter-observer agreement for ultrasound examinations acquired with a standardized technique by an experienced radiographer and reviewed by experienced radiologists. In general, intra-observer agreement was higher than inter-observer agreement.
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Lapere, Jan Noel Romain. "Occupational medical examinations and labour law." Thesis, University of Port Elizabeth, 2003. http://hdl.handle.net/10948/302.
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South Africa’s Constitution and the Employment Equity Act have a major impact on the performance of medical examinations within the employment relationship. Health and safety statutes list a number of occupational medical examinations, which an employer must perform. Other legislation permits the execution of medical examinations. After listing the different statutory references to occupational medical examinations, this treatise examines under which conditions medical testing is required or permissible. The fairness of employment discrimination based on medical facts, employment conditions, social policy, distribution of employee benefits and inherent job requirement is analysed through a study of the legal texts, experts’ opinions and case studies. The particularities of the ethical and legal duties of the medical professional, performing the occupational medical examination, are also examined. Finally, a comprehensive analysis of the different forms of occupational medical examinations is compiled by combining legal and policy-related job requirements and is attached as an annexure. This is the practical result of the research in this treatise combined with the personal experience of the author.
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Heiman, Diana L. "Preparticipation Examinations and Special Olympics Medical Issues." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/8169.
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Sternberger, Carol S. "An exploration of the health belief model, motivation and exercise related to breast self-examination." Virtual Press, 1988. http://liblink.bsu.edu/uhtbin/catkey/546140.
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The focus of the research study was breast selfexamination. A randomized sample of 400 women living in Fort Wayne, Indiana and employed by a large corporation were surveyed to determine the relationship between frequency of breast self-examination and Health Belief Model variables. Susceptibility, seriousness, benefits, barriers and health motivation were measured by scales developed by Champion (1984). The instrument had been tested for reliability and validity.The variable of exercise was examined to determine if a relationship existed between exercise and frequency of breast self-examination. Individual items measured the frequency of breast self-examination and the methods of instruction.Multiple regression analysis demonstrated that the variables of barriers and seriousness accounted for 27% of the variance for prediction of breast selfexamination. An insignificant Chi Square was obtained for the relationship between exercise and breast selfexamination. No demographic variables evidenced significance with breast self-examination.The findings of the study evidenced a relationship between the Health Belief Model and breast self-examination, thus supporting the theoretical framework of the study.School of Nursing
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Page, Michael Thomas John. "Workplace-based assessment in clinical radiology in the UK : a validity study." Thesis, University of Stirling, 2016. http://hdl.handle.net/1893/24790.
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In 2010, the Royal College of Radiologists introduced workplace-based assessments to the postgraduate training pathway for clinical radiologists in the UK. Whilst the system served the purpose of contributing to high-stakes annual judgements about radiology trainees’ progression into subsequent years of training, it was primarily intended to be formative. This study was prompted by an interest in whether the new system fulfilled this formative role. Data collection and analysis spanned the first three years of the new system and followed a multi-methods approach. Descriptive statistical analysis was used to explore important parameters such as the timing and number of assessments undertaken by trainees and assessors. Using the literature and an iterative analysis of a large sample of trainee data, a coding framework for categories of feedback quality enabled assessors’ written comments to be explored using deductive and inductive qualitative analysis, with inferential statistical analysis of coded assessor feedback statements. For example, Ragin’s (1987, 2000, 2008) qualitative comparative analysis, QCA, was used to explore whether the assessments met necessary and/or sufficient conditions for high quality feedback. Pairs of assessor-trainee feedback comments were also analysed to establish whether any dialogic feedback interactions occurred. The study presents evidence that despite its intentions, the new system is generally failing to meet its primary, formative aim. As a consequence, the influence of negative washback on assessment practice was reflected in a number of findings. For example, there was evidence of trainees taking an instrumental approach to the assessments, undertaking only the prescribed minimum of assessments or completing assessments in the later stages of placements. Combined with evidence of retrospective assessment, i.e. after completion of the placements, the observed patterns of assessment over the three years are consistent with a box-ticking approach. This study explores the contextual policy and practice dimensions underpinning these and related findings and discusses the implications and recommendations for future arrangements.
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Cetnar, Ashley. "Valued Discourse in Oral Examinations for Medical Physicists." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1606920639129938.
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Cammack, Susan E. "An examination of firms charged with medicare and medicaid fraud : does corporate governance matter? /." free to MU campus, to others for purchase, 2002. http://wwwlib.umi.com/cr/mo/fullcit?p3060090.
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Seago, Brenda. "UTILIZATION OF SIMULATION TO TEACH PELVIC EXAMINATION SKILLS TO MEDICAL STUDENTS: IMPLICATIONS FOR MEDICAL EDUCATION." VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/2290.
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Medical education is changing. Physicians have less time for teaching clinical skills and for direct observation of medical students, due to sicker patients in the hospital, shorter hospital stays, competing demands of research and patient care, and implementation of the eighty hour work week for residents. The consumer movement increased awareness of medical errors, patient safety and quality of healthcare. Teaching the pelvic examination is ethically complex. Questions have arisen about medical students learning to conduct the pelvic examination on actual patients. This study utilizes the pelvic examination simulator and genital teaching associates (GTAs) to teach pelvic exam skills to optimize limited resources, as well as address safety and ethical concerns. The purpose of the study was to provide medical students with more practice in pelvic examination skills, to test a pelvic examination simulator, and to explore a new model for teaching pelvic examination skills to second year medical students. After IRB approval, one hundred sixty eight second year medical students at Virginia Commonwealth University School of Medicine participated in the study. A two-armed trial design provided all medical students with pelvic exam training on the pelvic exam simulator and genital teaching associate. Data were gathered via an experience and demographic questionnaire, blood pressure readings, the Fear of Pelvic Examination Scale scores and performance scores after the training. Data analysis consisted of descriptive statistics, paired and independent sample t-tests and the linear mixed model. Statistical tests determined the relationship between fear, blood pressure and performance. The findings revealed that the GTA training group had significantly more fear than the pelvic exam simulator group and significantly higher performance scores than the simulator group. The gender analysis indicated that males had significantly more fear than females. Prior experience with pelvic exam simulators did not appear to reduce anxiety among medical students when first conducting pelvic exams with humans. Completion of pelvic exam training with a GTA may reduce fear substantially and make later training with the pelvic exam simulator the optimal first experience. Use of simulation in medical education reduces ethical concerns, optimizes limited resources and reduces patient safety issues.
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Parks, Wendy J. "Independent medical examinations, a tool of the rehabilitation process." Online version, 2000. http://www.uwstout.edu/lib/thesis/2000/2000parksw.pdf.
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Reid, Lindsay Eleanor Margaret. "An examination of acute medical care in Scottish hospitals." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/25726.
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Acute medical patients constitute the single largest group of patients in hospitals. The processes by which they are cared for in the United Kingdom (UK) have changed over the past few decades and now the majority of acute medical care is delivered within acute medical units (AMUs). The AMU model is also increasingly being adopted outside of the UK, including in Ireland, Australasia and Europe. AMUs emerged as a result of local service innovations and there is evidence to suggest that care within AMUs varies across settings. Although there are published recommendations for care delivery, empirical evidence is lacking. In this thesis I aim to examine the concept of the AMU model with regard to the literature; its definition; its components; and how these components are delivered across Scottish sites. This is with the aim of informing service provision and contributing to the development of an evidence base relating to AMUs. Firstly, I undertook a systematic review of the evidence relating to the effectiveness of and variation in the AMU model. I found limited, observational and possibly confounded evidence that the AMU model was associated with reductions in hospital length of stay and mortality compared to other models of care in European and Australasian settings. I also found variation in the admission criteria, entry sources, functions and staff work patterns across the 12 AMUs described in the literature. Given this finding that AMUs do not operate in a uniform way, I undertook a second systematic review to assess the published evidence evaluating different methods of delivery of care within AMUs. I identified nine studies of ten interventions. From this I concluded that there was little discerning evidence pertaining to how best to deliver care in AMUs. This led me to undertake a qualitative descriptive study of all the AMUs in Scotland with the aim of further delineating the AMU model. During a visit to each AMU, I collected data through semi-structured interviews with healthcare professionals working in the units. This totalled 171 interviews of 275 participants across 29 sites. I used this data to provide a report detailing how care was delivered in each AMU. I then thematically analysed these reports using framework analysis. There were three principal findings from this qualitative study. Firstly, I found that acute medical care was delivered in acute medical services rather than single AMUs. Secondly, I identified a framework of 12 key components of AMU care that were integral to the functioning of the AMU irrespective of the setting. Examples include nurse staffing and the physical areas contained within the AMU. Lastly, I described how these components were delivered across Scottish AMUs and, where possible, identified distinct models of care delivery. For example, I identified 13 models of AMU functions and seven models of consultant work patterns. In summary, I found that care in Scottish AMUs is delivered variably. The reasons for the variation are unclear. The findings of this thesis are the first in-depth study into AMUs. They provide a useful foundation for discussions and onward planning of resources, capacity and standards of care at both a national and local level. These findings are also an impetus for further research to delineate how best to deliver care in AMUs, and form an essential precursor to such work.
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Ramirez-Fernandez, Luis. "The evaluation of Chilean medical educators' perceptions about establishing a national medical examination in Chile /." The Ohio State University, 1986. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487266362336727.
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Human, Hans Jurie. "Die geldigheid van prestasie-evaluering van kliniese tegnologie studente." Thesis, Cape Technikon, 1996. http://hdl.handle.net/20.500.11838/1891.
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Thesis (MTech( Education)) -- Cape Technikon, Cape Town, 1996Clinical technology as a profession has been part of the rapid development of modem medical technology in South Africa. From the start the training of clinical technologists consisted of practical in-service training at an academic hospital and a theoretical component completed at a technikon. Questions about the standard of training of clinical technologists have often been raised by members of the profession. An initial opinion pole amongst recently qualified clinical technologists about the evaluation of their theoretical knowledge and practical skills showed that they were not certain what they were tested for in the examinations, or what the practical year mark was awarded for at the end of their experiential training. The question thus arose whether the evaluation of theoretical knowledge and practical skills were really appropriate and relevant. In order to investigate validity of the training process, namely the 'evaluation of clinical technology students, three literature studies were conducted. The first was to determine what acceptable evaluation practice is as regards the evaluation of theoretical content and practical skills. It was apparent from the literature that the inclusion of learning objectives should be the norm for effective goal orientated training and evaluation. The second literature study was conducted to determine the validity of the evaluation of clinical technology students. As a result of this literature study a description was made of the task of professions in the USA similar to clinical technology, the health worker in general and the profession of clinical technology specifically. From this task description it was apparent that the evaluation of clinical technologists' skills should not just include knowledge, comprehension and application, but that one should also test for analysis, synthesis and evaluation. The third literature study conducted was to determine whether Bloom's taxonomy for cognitive objectives could be used to provide a measure of the validity of test items. As a result of this literature study a classification of test items from final year papers was done to determine the cognitive level on which questions were formulated. v This analysis of test items showed that questions were mainly formulated on the knowledge level and did not provide for higher order skills as demanded by the task analysis of the clinical technologist. Referring to the evaluation of practical skills an analysis of the methods used by trainers to award the practical yearmark showed that training and evaluation are not being performed in an effective goal orientated manner. The reason is that trainers do not use training objectives for the development of cognitive, psychomotor and affective skills of students. The conclusion is made that performance evaluation of the theoretical content and practical skills of clinical technology students do not satisfy the criteria of validity. To improve the training and evaluation practice, it is recommended that training objectives for theoretical content and practical skills are formulated, that practical performance tests are designed, and that attention is given to the improvement of the training and evaluation skills of trainers and examiners.
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Sjukriana, Juke, and n/a. "Ergonomics and user inclusivity : developing design critieria and specifications for a medical examination couch." University of Canberra. Industrial Design, 1999. http://erl.canberra.edu.au./public/adt-AUC20061113.160732.
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A medical examination couch is a primary piece of equipment in the health care
delivery system. Unfortunately, the current design of examination couches used
by Australian general and nursing practitioners is inadequate. Incompatibility of
the couches with physical (anthropometric) dimensions and a majority of
medical procedures contribute to risks of Cumulative Trauma Disorders (CTDs)
or musculoskeletal problems among practitioner-users. The inappropriate
height, width and gynaecological attachments of the existing couches also
cause patient discomfort.
This research aimed to develop a new examination couch design in order to
improve practitioners' effectiveness, efficiency, health and safety while
enhancing patient comfort. Ergonomics and user inclusivity were implemented
in the vital stages of the couch development process. Practitioner and patient
surveys, reviews of patient positions, medical procedures and equipment,
Hierarchical Task Analysis (HTA) and an ergonomic analysis of couches in the
Australian market were conducted to develop design criteria. The design
criteria development demonstrated that adjustable height, head, body and foot
sections were the major features, and adjustable gynaecological footpads and
instrument placement (drawers) were the most important attachments. A wide
variety of anthropometric data was applied to the development of design
specifications and adjustments.
To produce a prototype for a new examination couch design developed from
the ergonomic research and initial user surveys, the researcher collaborated
with a medical couch manufacturer, Metron Medical Australia Pty Ltd. Through
this collaboration, the developed criteria and specifications were applied to
actual production processes.
User trials (a focus group, practitioner and patient surveys and personal
communication) were conducted to investigate the effectiveness and efficiency
of the couch prototype in a real clinical environment.
From the trials, modifications to
particular couch features were
identified if they were considered
difficult to operate, unnecessary or
uncomfortable for patients. For
example, the mechanism of the
gynaecological footpads, which
comprised three different adjustment controls, had to be simplified in order to
avoid confusion and time consumption. The footpads had also to be equipped
with straps or half a shoe to increase patient comfort and security.
The collaborating manufacturer will need to adapt the design modifications from
the user trials and conduct more extensive engineering research and value
analysis for a final production couch model. Nevertheless, this research
succesfully demonstrated the significance of ergonomics and user-centred
design in developing design criteria more effectively, detecting usability
problems before the couch is brought to the market, and in saving the
manufacturer's overall product development costs.
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Slider, Cara L. "Encouraging testicular self-examination behaviors in college males examining the role of fear appeals in protection motivation theory /." Morgantown, W. Va. : [West Virginia University Libraries], 2009. http://hdl.handle.net/10450/10148.
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Thesis (M.S.)--West Virginia University, 2009.Title from document title page. Document formatted into pages; contains iii, 76 p. : ill. Includes abstract. Includes bibliographical references (p. 40-43).
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Reigle, Beverly Sue. "The development and testing of the breast self-examination questionnaire /." Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.
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Bergman, Gerald R. "Evaluation of Exposure to Optical Radiation in Medical Diagnostics and Treatment." University of Toledo Health Science Campus / OhioLINK, 2004. http://rave.ohiolink.edu/etdc/view?acc_num=mco1095952844.
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Hidayah, Rachmadya Nur. "Impact of the national medical licensing examination in Indonesia : perspectives from students, teachers, and medical schools." Thesis, University of Leeds, 2018. http://etheses.whiterose.ac.uk/20215/.
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Introduction: The national examination has been increasingly used worldwide for both licensing and certification purposes. In Indonesia, the national licensing examination (NLE) was implemented in 2007 where it serves as a method of quality assurance for both graduates’ competence and medical schools. Indonesia is a developing country which heightens the impact of introducing the NLE. The high cost and resource intensive demands of the NLE are proportionally higher than they would be for Western countries. This adds to the already high stakes nature of the examination for all stakeholders. Consequently, since its implementation, there have been changes in medical education systems and medical schools. However, the research on how the NLE affects medical education is limited. The aim of this study was to understand the consequences of the introduction of the NLE on Indonesian medical education as perceived by three groups of stakeholders: medical schools, teachers, and students. Methods: This study was a qualitative study using a modified grounded theory approach to understand the consequences of NLE from multiple stakeholders’ perspectives. A sampling framework was designed to capture important characteristics of Indonesian medical schools based on region, accreditation status, and ownership (public/ private). Interviews were conducted with 18 medical schools’ representatives (vice deans/programme directors), while focus groups were conducted with teachers and students from 6 medical schools. The interviews and focus groups were audio-recorded and transcribed. Data was analysed in a rigorous method using open coding and thematic analysis to generate cross-cutting themes and concepts. Results: This study looked at the intended and unintended consequences of the NLE, which strongly related to the context in Indonesia. Intended consequences were mostly related to the intended outcome of the NLE: achieving a common standard for education, improvement in education practice (including curricula, assessment, and faculty development), improvement learning resources and facilities, which were prominent in new and private schools. Unintended consequences were related to the competition led by the NLE, collaboration, financial impact, and students’ failure. This study revealed cross-cutting themes such as diversity in a rich context of education, the coopetition, and the concept of patient safety in Indonesia. Discussion The current literature on the impact of NLEs were limited to developed countries and Western medical education system. The discourse was mostly based on opinion rather than evidence. This is the first study exploring the impact of the NLE in a developing country and ASEAN network. Some findings on the intended consequences of the NLE confirmed the literature, while some others were a contrast. Indonesia’s unique context as a developing country in Southeast Asia, made it possible for the NLE to create competition leading to collaboration between medical schools and stake holders. This was best explained by the concept of coopetition, which enabled medical schools to overcome challenges, make changes, and improve their quality. This study offers new evidence on how the NLE holds significant role in the improvement of medical education. Conclusion: Context matters in the discourse of the NLE. This study demonstrates a novel approach to sampling and analysis of the NLE’s impact. The evaluation of the NLE needs to consider the importance of understanding local factors and consequences. New insights were added to the literature on how the coopetition acts as a key for the impact of the NLE. Moving forward, the future of the NLE is expected to hold an important role in the development of medical education in Indonesia. This study opens opportunities for other area of research, mainly on the impact of the NLE on patient safety, collaboration of stake holders, and students’ failure.
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Miller, Deborah Ann 1952. "Critical Thinking Skills Related to Pre-Clinical Medical School Course Examinations." Thesis, University of North Texas, 1992. https://digital.library.unt.edu/ark:/67531/metadc279394/.
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The major purpose of this study was to determine if pre-clinical medical school course examinations reflect critical thinking skills. The entire second year class from a medical school in the southwest made up the population. Student examination results from the first two years as well as scores on the Watson-Glaser Critical Thinking Appraisal were used in this study.
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Wong, Chui-chui, and 黃翠翠. "A re-examination of the roles of medical social work." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1990. http://hub.hku.hk/bib/B31248767.
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Raikou, Maria. "Estimating medical care costs : an examination under conditions of censoring." Thesis, City University London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269356.
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Elmberg, Fanny. "Examination of serum leptin- and lipid levels and gender differences in a population with symptomatic knee osteoarthritis." Thesis, Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-36841.
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González, Judith T. "Predictors of Breast Self-Examination Among Mexican American Women: A Path Analytic Model." University of Arizona, Mexican American Studies and Research Center, 1990. http://hdl.handle.net/10150/219031.
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This paper is a test of several hypothesized predictors of frequency of breast self-examination among low-income Mexican American women. Current research points to several factors as important predictors of preventive care. Among these are self-efficacy – one’s perceived capacity to perform a given action – and social support from significant others. For Mexican Americans, environmental barriers to health care are important factors. While findings are inconclusive regarding the role of language proficiency as a predictor of preventive care, the model includes this as a hypothesized predictor of frequency of breast self-examination. The findings show a strong relationship between self-efficacy and frequency of breast self-examination. Barriers to health care have a weaker direct effect upon breast self-examination. The effects of English-language proficiency are indirect and mediated by self-efficacy.
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Sultan, Ahmad Hasane. "Prediction of medical technologists' scores on the MT (ASCP) certification examinations." Diss., This resource online, 1992. http://scholar.lib.vt.edu/theses/available/etd-07282008-134142/.
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Hauser, Jonathon Charles. "Toxicological examination of metallic and organometallic nanoparticles for potential medical applications." Thesis, University of Bristol, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.665462.
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This thesis examines the toxicity of metallic and organometallic nanoparticles which have applications in the medical field. Commercially available Silver particles} used to create bactericidal surfaces} are tested against two human in vitro cell models to investigate the sensitivity of the models and the toxicity of the particles. No toxicity to a human blood brain barrier in vitro cell model arises from concentrations of particles likely to be encountered. Significant toxicity however is demonstrated in a human placental in vitro cell model} raising concerns for maternal exposure to Silver particles and selecting the placental cell model for further study. A novel polymer nanoparticle drug delivery system capable of encapsulating a wide variety of lipophilic drugs is described. Extensive characterisation demonstrates successful encapsulation of fluorescent} water insoluble} Tris-(8-hydroxyquinolinato) Aluminium (III) (AlQ3) a molecule with antibiotic potential. The AlQ3 nanoparticles are tested against a human placental in vitro cell model} at physiologically relevant doses} finding no significant toxicity to the cell membrane} metabolism} nucleus or viability. Confocal experiments with concomitant organelle staining confirm cellular internalisation and examine the AlQ3 intracellular localisation. The antibacterial properties of AlQ3 nanoparticles are then demonstrated by the treatment of human keratinocytes infected with Methicillin Resistant Staphylococcus Aureus (MRSA). The polymer nanoparticle delivery system is then further examined by synthesising nanoparticles of the chemotherapeutic analogue} Tris-(8-hydroxyquinolinato) Gallium (lit) (Ga~). Ga~ having undergone phase I human clinical trials} provides an ideal example of an insoluble drug molecule whilst allowing for direct comparison to the AlQ3 nanoparticles. Characterisation confirms the formation of nanoparticles suitable for passive disease targeting with the potential for extended blood circulation. Toxicity testing against a human placental in vitro cell model shows significant toxicity to the cell membrane} metabolism} nucleus and viability. Confocal experiments confirm the GaQ3 nanoparticles follow the same intracellular pathway as the AlQ3 nanoparticles elucidating further the mechanism of toxicity.
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Ramineni, Chaitanya. "Rater contrast effects in performance assessments using the medical licensure examination." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 167 p, 2009. http://proquest.umi.com/pqdweb?did=1654488081&sid=3&Fmt=2&clientId=8331&RQT=309&VName=PQD.
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Chumbler, Neale. "Relationships Between Podiatrists & Medical Doctors: An Examination through Network Analysis." TopSCHOLAR®, 1991. https://digitalcommons.wku.edu/theses/2222.
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This thesis examines how a more powerful and a less powerful profession --allopathic medicine and podiatry -- are linked in a series of networks through patient referrals and practice activities. The importance of professional networks is that they link different professions such as podiatry and allopathic medicine in ways which direct attention away from ranking the power of fields or viewing them as endlessly in conflict over occupational turf (traditional research questions) to questions of the actual and regularized relationships diverse professions have with one another. This thesis analyzes professional training and activity variables related to the emergence of networks and another set of conditions that results once occupational networks become established.
Data were obtained from a mailed questionnaire survey of podiatrists who practice in the Chicago metropolitan area (N-168). Analysis consists of comparisons between podiatrists who are in networks with physicians and those who are not: and between DPM's who are in heterophilous (general referral) versus homophilous (surgical) networks with MD's. T -tests are the major form of statistical analysis used in this thesis.
The findings of this thesis support the conclusion that the educational training and podiatric practice mandates (e.g., hospital staff appointment) are important determinants of the formation of networks with MD's. Friendship and social interaction patterns between DPM's and MD's and attitudes of DPM's toward podiatry were found to be highly related to network relationships between podiatrists and medical doctors. Profiles of podiatrists' professional activities and the extensiveness of their referral communication with MD's also were found to be related to the type of network podiatrists are in with medical doctors. Overall, results of this thesis clearly show that networks do link podiatrists and physicians and that such networks have important consequences for the professional activities and orientations of DPM's.
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Duncan, Terrence. "An Examination of Physician Resistance Related to Electronic Medical Records Adoption." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1257.
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The 2009 American Recovery and Reinvestment Act, signed under the Obama administration, mandated physicians to complete certification for electronic medical records (EMRs). Despite these mandates and the increased access to information technology, slow adoption rates persist on the use of EMRs. Guided by the theory of planned behavior and the technology acceptance model, the purpose of this quantitative study was to examine the relationship between the independent variables perceived ease of use, perceived usefulness, perceived behavioral control, perceived social influence, attitudes toward EMR, and the dependent variable user acceptance. This study identified physicians in the United States as end-users of EMRs. In this study, 76 randomly selected physicians in the United States, identified as end-users of EMRs, completed an electronic survey requiring responses to a 5-point Likert Scale model. Standard multiple regression analysis served as the means used to analyze the regression model. Despite the regression model being statistically significant, none of the individual independent variables had statistical significance in predicting user acceptance. Interdependence and homoscedasticity likely contributed to this phenomenon. Social change implications include understanding of physician perceptions and beliefs--how physician perceptions and beliefs affect EMR adoption. Because adoption rates did not achieve 100% certification by end-users, another social change implication includes the necessity of examining how end-user acceptance could decrease medical errors, increase efficiencies in physician workload, and improve communication within the health care industry.
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Ansah, Mavis Bobie. "Female students’ knowledge, beliefs, attitude and practice of breast self-examination in a university in the Western Cape." Thesis, Cape Peninsula University of Technology, 2015. http://hdl.handle.net/20.500.11838/2260.
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Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2015.The most common cancer in women worldwide is breast cancer. It is also the leading cancer affecting women in South Africa. When breast cancer is detected early, it improves the outcome of the disease and reduces mortality. The aim of this study was to determine the knowledge, beliefs, attitude and practice of breast self-examination among female university students. The objectives were, to explore the levels of knowledge of female university students on breast cancer and breast self-examination; to ascertain the beliefs of female university students on breast cancer and breast self-examination; to examine the attitudes of female university students toward breast cancer and breast self-examination and to determine if female university students regularly practice breast self-examination. A Mixed method descriptive design was used for this study. The selected site for this study was a higher education institution in the Western Cape. The population included all female university students in the Western Cape. The sample was female university students studying in the selected higher education institution who reside on the institution’s campus. Convenience sampling was used to select the sample. Two methods were used to collect data; these were questionnaires and face-to-face interviews. Questionnaires were analysed by the use of Microsoft Excel and Statistical Package for Social Sciences. Frequency Distribution was used to analyse descriptive statistics. Interviews were transcribed and analysed by using coding and thematic analysis. Participants lacked knowledge on breast cancer risk factors, as majority of them only knew about family history being a risk factor. Majority of the participants had never been educated by their healthcare provider on breast cancer and its screening. Most of the participants had never examined their breast before. Most of the participants who did not examine their breast did not have any knowledge on how to do BSE. Education on breast cancer and cancer as a whole should be initiated in high schools and higher institutions of learning as part of their curriculum. Posters on breast cancer screening and breast self-examination should be put up at public places and campuses. Breast awareness campaigns must be done every month not only in October which is the breast cancer awareness month. Health care professionals should give information on breast cancer to women when they visit the hospital or health centre
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Dorkin, Elton. "Do routine medical examinations result in improved health for company senior executives?" Diss., University of Pretoria, 2015. http://hdl.handle.net/2263/52380.
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The provision of routine comprehensive medical examinations as part of the executive
health management programme of company senior executives is controversial in
academic and business literature. A difference between outcomes predicted in theory
and those achieved in practice is evident. Programme design had a bearing on what
outcomes could be achieved. This study was conducted to examine the change in
health risks experienced by a group of company senior executives attending a
commercially available executive health programme in Durban, South Africa. The study
assessed the evidence base for screening tests offered as part of the programme, the
health risk outcomes of participants on the programme and the perceptions of
participants of the intervention and the employer.
The study showed that executives perceive employers who provide executive medical
examinations very positively. A high prevalence of health risk factors was noted,
indicating the need for such an intervention. Although perceived to be comprehensive,
only 29 per cent of recommended preventative health screening tests were offered. Of
the tests offered 49 per cent were not considered preventative in nature. No statistically
significant changes were found for all health risks studied, over a two year period,
although the improvement in blood pressure might be considered clinically significant.
Individuals displayed significant natural risk flow, some at low risk remained so, others
became high risk; some at high risk became low, others remained high. These findings
are similar to those of other studies where behaviour based interventions are not
prominent. The findings suggest that an executive health programme based on medical
examinations alone cannot reliably and consistently improve health risk of company
senior executives. Evidence is provided that theory based and evidence-led
interventions are required to address the real health concerns of executives.Mini Dissertation (MBA)--University of Pretoria, 2015.
sn2016
Gordon Institute of Business Science (GIBS)
MBA
Unrestricted
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Hess, Rick, Nicholas E. Hagemeier, Reid B. Blackwelder, Daniel Rose, Nasar Ansari, and Tandy Branham. "Teaching Communication Skills to Medical and Pharmacy Students Using a Blended Learning Course." Digital Commons @ East Tennessee State University, 2016. https://doi.org/10.5688/ajpe80464.
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Objective. To evaluate the impact of an interprofessional blended learning course on medical and pharmacy students’ patient-centered interpersonal communication skills and to compare precourse and postcourse communication skills across first-year medical and second-year pharmacy student cohorts.
Methods. Students completed ten 1-hour online modules and participated in five 3-hour group sessions over one semester. Objective structured clinical examinations (OSCEs) were administered before and after the course and were evaluated using the validated Common Ground Instrument. Nonparametric statistical tests were used to examine pre/postcourse domain scores within and across professions.
Results. Performance in all communication skill domains increased significantly for all students. No additional significant pre/postcourse differences were noted across disciplines.
Conclusion. Students’ patient-centered interpersonal communication skills improved across multiple domains using a blended learning educational platform. Interview abilities were embodied similarly between medical and pharmacy students postcourse, suggesting both groups respond well to this form of instruction.
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FONSECA, JOSE NIVALDO DA. "A PHILOSOPHICAL VIEW OF MEDICAL THOUGHT: AN EVALUATION OF THE INTERACTION BETWEEN PHILOSOPHICAL AND MEDICAL KNOWLEGDE, UNDER THE EXAMINATION OF THE DEVELOPMENT OF MEDICAL ANALOGY." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2004. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=5211@1.
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PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRONesta tese, à luz do prisma filosófico, empreendemos um olhar que abrangeu o pensamento médico filosófico desde a Antiguidade até a Revolução Terapêutica. Nosso olhar contemplou: na Antiguidade, uma época em que houve uma estreita colaboração entre Filosofia e Medicina, baseada na pesquisa mútua dos aspectos etiológicos, quer da enfermidade da alma, quer daquela do corpo; foi a época do nascimento e apogeu da Analogia Médica; na Idade Média, identificou um estado de hibernação da Analogia Médica no século XII, seguido de um leve despertar no século XIII, a volta a um estado de adormecimento e o despertar definitivo, no século XV; na Renascença, captou a retomada dos textos médicos e a queda do saber galênico tradicional; na Modernidade, finalmente, diagnosticou o início do distanciamento entre os saberes filosófico e médico, com o respectivo definhamento da Analogia Médica. Desde então, nosso olhar aprofundou se nas idas e vindas do saber médico filosófico, especulando as causas e consequências desse distanciamento, e chegou à conclusão de que o legado deixado pelo pensamento médico moderno orientou e orienta a Medicina contemporânea para um sentido de desumanização em relação à pessoa do paciente. Por fim, depois de tanto ver, nossa razão assentiu para a necessidade de uma reforma na Medicina, principalmente em sua paidéia, baseada numa próxima colaboração com a Filosofia a fim de receber subsídios quando à questão central de qualquer procedimento terapêutico: qual é o ser do ser humano?
In this Thesis, using the light of the philosophical prism, we undertake an examination embracing medical philosophical thought beginning in antiquity, continuing up until the Therapeutic Revolution. Our view contemplates: in antiquity, a time during which there was a strict collaboration between Philosophy and Medicine, based upon mutual research of the etiological aspects of disease not only of the soul but also of the body; it was the time of the birth and apogee of the Medical Analogy; during the Middle Ages it was possible to identify that the Medical Analogy had entered a state of hibernation in the twelfth century, followed by a slight awakening in the thirteenth century, returning to a state of sleep, with the final awakening occurring in the fifteenth century; during the Renaissance it captured a return to the medical texts and the fall of traditional Galenic knowledge; finally during the Modern era we have diagnosed the initial phases of a distancing between philosophical and medical knowledge, with a respective weakening of Medical Analogy. Since the Modern era our examination has focused upon the vacillations of medical philosophical knowledge, speculating upon the causes and consequences of this distancing, and our examination found that the legacy left by modern medical thought has oriented and continues to orient Modern Medicine towards a dehumanization in relation to the person of the patient. Finally, we concluded that medical reform is needed, principally, in its Paideia, based upon a closer collaboration with philosophy, with the intent to provide subsidies to help answer the central question of any therapeutic procedure, which is: what is the nature of the being of the human being?
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Schachman, Alan. "An examination of current Navy medical professionals management oriented service short courses /." Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1993. http://handle.dtic.mil/100.2/ADA268522.
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Schachman, Alan Jr. "An examination of current Navy medical professionals management oriented service short courses." Thesis, Monterey, California. Naval Postgraduate School, 1993. http://hdl.handle.net/10945/39840.
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Approved for public release; distribution is unlimited.This thesis describes and analyzes the Navy's service short courses available to medical professionals. The description covers course content (subjects being taught), describes contact hours (time a class is taught), and evaluates the depth and breadth of content. The information from each course is compared to the needs of a medical treatment facility (MTF) manager, as determined by the Naval Postgraduate School 'Needs Assessment'. This examination shows that many Navy medical professional service short courses cover parts of the knowledge and skills needed to manage a medical treatment facility. The courses examined focus mainly on leadership and management skills. In order to more accurately describe and analyze these courses, obtaining more detailed information, observing the courses being taught, and interviewing course instructors is recommended.
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Zmiyevska, Yu G. "Possibilities of the multidimensioanl remodelling during forensic-medical examination of gunshot injuries." Thesis, БДМУ, 2021. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18461.
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Carlsson, Fredrik, and Sebastian Vusak. "Gamified CoGNIT: cognitive assessment with added game elements : Gamification of medical examination." Thesis, Blekinge Tekniska Högskola, Institutionen för datavetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-19662.
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Background. CoGNIT is a computerized test battery for cognitive assessment, used in diagnosing and treating patients with idiopathic normal pressure hydrocephalus (INPH). The disorder causes symptoms of dementia, among other things. Apart from other diseases with similar symptoms, like Alzheimer’s, INPH can be countered. CoGNIT is performed by a patient before and after drainage of cerebrospinal fluid. If a significant improvement in cognition is detected after the extraction, the patient receives shunt surgery which reduces all symptoms. The test battery is long and tedious, which makes it difficult for people with cognitive impairments to complete. Objectives. The objectives of this study are to rework original CoGNIT with carefully selected game design elements and analyze the effects of the alteration on performance and user experience. If users perform better in a gamified environment, the validity of gathered data will have improved as the data should better reflect their cognitive capabilities. Another objective is to introduce gamification to the medical field. Methods. Game design elements were picked and designed based on suitability for elderly people and with the impairments of INPH patients in mind. A gamified prototype was developed and put to test with healthy individuals against the original version in an experiment. The effects of gamification on performance was examined by comparing resulting score values from both versions of the test. Participants also filled in a questionnaire as proxy for the test’s target group, meaning that questions were answered with how the participants expected a cognitively impaired person to answer. Answers were used to investigate the effect of gamification ofuser experience. Results. The gamified version of CoGNIT shows an improvement in test segments regarding attention, psychomotor speed, executive function, and manual dexterity, but a negative inclination in segments regarding memory. Results from the user experience questionnaire indicates that the gamified version feels less dramatic, more playful, less "test-like" and less tedious compared to the non-gamified version. This suggests that the added game elementsare affecting the user experience in the desired way. Conclusions. An overall positive impact on both performance and user experience from gamification is concluded. The negative effect on memory tests could not be determined to be a cause of the gamification per se.Bakgrund. CoGNIT är ett datoriserat testbatteri för kognitiv bedömning som används vid diagnos och behandling av patienter med idiopatisk normaltryckshydrocefalus (INPH). Sjukdomen orsakar bland annat symptom som demens. Till skillnad från andra sjukdomar med liknande symptom, som Alzheimers, kan INPH motverkas. CoGNIT utförs av en patient före och efter dränering av cerebrospinalvätska. Om en förbättring av patientens kognitiva förmågor upptäcks efter dräneringen, shuntoperaras patienten och alla symptom minskas. Testbatteriet är långt och tråkigt, vilket gör det svårt för personer med kognitiva nedsättningar att slutföra. Syfte. Syftet med denna studie är att omarbeta CoGNIT med noggrant utvalda speldesignelement och analysera hur prestation och användarupplevelse påverkas av förändringen. Om användare presterar bättre i en spelifierad miljö kommer validiteten av insamlad data att förbättras eftersom datan borde bättre återspegla deras kognitiva förmågor. Ett annat mål är att introducera spelifiering till det medicinska området. Metod. Speldesignelement valdes ut och utformades baserat på dess lämplighet för äldre och med de funktionsnedsättnigar som INPH-patienter har i åtanke. En spelifierad prototyp utvecklades och testades med friska individer mot originalversionen i ett experiment. Effekterna av spelifiering på prestation undersöktes genom att jämföra poängvärden från båda versionerna av testet. Deltagarna fyllde också i ett frågeformulär som "proxy" för testets målgrupp, vilket innebär att frågorna besvarades med hur deltagarna förväntade sig att en kognitivt nedsatt person hade svarat. Svaren användes för att undersöka effekten av spelifiering på användarupplevelsen. Resultat. Den spelifierade versionen av CoGNIT visar en förbättring i testsegmenten som utvärderar uppmärksamhet, psykomotorisk hastighet, exekutiva funktioner och fingerfärdighet, men en försämring i segmenten som utvärderar minne. Resultat från frågeformuläret indikerar att den spelifierade versionen upplevs mindre dramatisk, mer lekfull, mindre "testliknande" och mindre tråkig jämfört medden icke-spelifierade versionen. Detta visar att de tillagda spelelementen påverkar användarupplevelsen som önskat. Slutsatser. En övergripande positiv inverkan på både prestanda och användarupplevelse från spelfiering fastställs. Den negativa effekten på minnestesterna kunde inte bedömas vara en orsak av spelifiering i sig.
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Van, der Venter Riaan. "Reporting on radiographic images in after-hours trauma units :Experiences of radiographers and medical practitioners." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/23779.
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Globally there is a lack of radiologists, which results in unreported radiographic examinations, or a delay in reporting on radiographic images even in emergency situations. In order to mitigate and alleviate the situation, and optimise the utilisation of radiographers a red dot system was introduced in the United Kingdom, which later aided in the transformation of the role of radiographers in terms of formal reporting of various radiographic examinations. Although there is a shortage of medical practitioners and radiologists in South Africa the extended role of radiographers has not been yet realised for radiographers. At present, radiographers and medical practitioners work in collaboration to interpret and report on radiographic examinations informally, to facilitate effective and efficient patient management, but this is done illegally because the regulations defining the scope of the profession of radiography does not allow for such practice, putting radiographers and organisations at risk of litigation. In order to gain an in-depth knowledge of the phenomena, to enable the researcher to provide recommendations to the Professional Board of Radiography and Clinical Technology (PBRCT) of the Health Professions Council of South Africa (HPCSA), a qualitative, exploratory, descriptive, and contextual research study was undertaken. Radiographers and medical practitioners were interviewed in order to elicit rich descriptions of their experiences regarding reporting of trauma related radiographic images in the after-hours trauma units. Data were gathered using in-depth semi-structured interviews, and the data were analysed using kesch’s method of thematic synthesis. Three themes emerged from the data, namely the challenges radiographers and medical practitioners face in the after-hours trauma units respectively, with regards to reporting of trauma related adiographs, and suggestions were proposed to optimize the participation of radiographers with regard to trauma related radiographs in these units. A thick description and literature control was done using quotes from participants. Measures to ensure trustworthiness and ethical research practices were also implemented. Thereafter, recommendations were put forward for the PBRCT of the HPCSA, using current literature and inferences made from the findings of the study.
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Siwe, Karin. "Learning the Pelvic Examination." Doctoral thesis, Linköping : Univ, 2007. http://www.bibl.liu.se/liupubl/disp/disp2007/med1031s.pdf.
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Plant, Nigel. "The interaction achievement of consent for medical examinations and investigations by healthcare professionals." Thesis, University of Nottingham, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.493338.
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Consent has gained an increasing innportance in both health care policy and practice. Research in this subject has focused on information needs of patients (McKeague and Windsor, 2003), and their understanding of information (Turner and Williams 2002). There has been little or no consideration as to how the health professional interactionally seeks the patients consent.
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Gore, Shanda Laine. "An Examination of Involvement Behaviors and Minority Student Retention at Academic Medical Institutions." Bowling Green State University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1236199762.
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Proctor, Keith E. "Answer Distortion on the Epworth Sleepiness Scale During the Commercial Driver Medical Examination." Scholar Commons, 2010. https://scholarcommons.usf.edu/etd/1744.
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Commercial vehicle drivers are required to maintain Department Of Transportation medical certification which entails a Commercial Driver Medical Examination (CDME) and optimally leads to a two-year certification. The examination must be performed by a licensed "medical examiner" administered by a variety of health care providers including physicians, advanced registered nurse practitioners, physician assistants and doctors of chiropractic. Unfavorable findings in the examination can yield either a shortened medical certification period or denial of certification. Sleep disorders including sleep apnea are assessed by a single question located in the health history portion of the CDME form which is filled-out by the examinee. A positive response to this single item often prompts the medical examiner to further supplement this question using a subjective questionnaire, such as the Epworth Sleepiness Scale. This particular questionnaire generates a total score based on the examinee's subjective responses to eight items regarding the propensity to doze-off or fall asleep in different scenarios, thus indicating daytime sleepiness. Commercial drivers depend on the medical certification for their livelihood and it is hypothesized that subjective responses regarding daytime sleepiness are distorted in an effort to attain optimal DOT certification.
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Jotterand, Fabrice 1967. "Does virtue ethics contribute to medical ethics? : an examination of Stanley Hauerwas' ethics of virtue and its relevance to medical ethics." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33292.
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The aim of this thesis is to examine the concept of virtue ethics in Stanley Hauerwas's understanding of virtue and delineate how that contributes to his ethical reasoning and his comprehension of medical ethics. The first chapter focuses on the shift that occurred in moral theory under the stance of the Enlightenment that eroded the traditional idea of morality as the formation of the self, allowing space for new concepts that dismissed the importance of the agent in the ethical task of seeking the good. In the second chapter, the three main ideas (character, vision, and narrative) that make up Hauerwas' ethical theory are examined with a particular attention to the importance of agency in moral life. The third chapter describes how Hauerwas' medical ethics, informed by his moral theory based on character, vision, and narrative, is relevant to medical ethics. Hauerwas argues that because medicine is a form of human activity with internal goods and standards of excellence intrinsic to its practice, it requires taking into account the notion of agency in the healing relationship. Finally, in the last chapter the specific religious discourse of Hauerwas' ethics is discussed in relation to secular medical ethics. In other words, this thesis raises the question of whether the reduction of medical ethics to a set of principles, as it is mostly the case today, represents a suitable picture of the reality of moral life in medicine.
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Josif, Dina. "Cognitive assessment of certification examination in endocrinology." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=61300.
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The study focuses on the cognitive assessment of certification examination in medicine. The purpose was to investigate the relationship between the structure of the examination questions and the examinees' written responses. The responses from three groups of residents with undergraduate degrees from McGill (3), Toronto (2) and Manitoba (2) medical schools were used. A sample of one basic science and two clinical question in Endocrinology were selected. The responses were analyzed using cognitive methods which provided a qualitative assessment of subjects' knowledge structures relative to task.The results showed that the responses did not always correspond to task requirements. There was a general tendency to focus on specific details that the subjects understood at the expense of the global aspect of the question. There was a greater variation in performance within groups than between groups. The results also suggest that undergraduate education may have less influence on the performance in certification examination than residency training. The importance of developing examination questions with high construct and criterion validity is discussed.
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Clark, Diane E. "Screening for medical referral attitudes, beliefs, and behaviors of physical therapists with greater than 10 years experience /." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2007. https://www.mhsl.uab.edu/dt/2009r/clark.pdf.
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Prince, Yvonne. "Improving laboratory techniques to detect M. tuberculosis complex and C. neoformans as the causative agents of chronic meningitis in cerebrospinal fluid of adult patients." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/4110.
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Thesis (MScMedSc (Pathology. Medical Microbiology))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: INTRODUCTION Mycobacterium tuberculosis (MTB) and Cryptococcus neoformans are the most common causes of chronic meningitis in South Africa. Conventional microbiology has limited utility in diagnosing these pathogens due to the paucibacillary nature of cerebrospinal fluid (CSF) and the diagnostic delay associated with culturing methods. This study aimed to evaluate the utility of an in-house polymerase chain reaction (PCR) method for the detection of the etiological agent of chronic meningitis. METHODS CSF samples (where volume exceeded 5ml) were submitted to the Medical Microbiology diagnostic laboratory of the Tygerberg Hospital from patients with suspected tuberculosis meningitis (TBM). Following routine bacteriology, the sample was used to inoculate two mycobacterial growth indicator tubes (MGIT A and B) and subsequently incubated in the BACTEC 960 automated system. MGIT A followed standard operating procedures and the time to culture positivity was noted. Weekly aliquots (up to 6 weeks) were removed from MGIT B. These samples were boiled to inactivate the bacteria and then the DNA was extracted using the Promega Wizard SV Genomic DNA kit. The DNA was then speciated by PCR and high-resolution melting analysis (HRM) by using primers specific to either the RD9 region of MTB complex or primers specific to the partial internal transcribed spacer 1 (ITS1), 5.8S rRNA gene and partial ITS2 sequence of C. neoformans. RESULTS Routine CSF microscopy indicated that 14 of the 78 patients (17.9%) had typical CSF findings of TBM (lymphocytes predominant, increased protein levels and decreased glucose levels). IV Ziehl-Neelsen (ZN) stains were positive for 12 (15.4%) samples, and MTB was cultured from 19 samples (24.4%). Our optimized PCR and HRM method was able to detect M. tuberculosis in 17 of the 19 culture positive specimens with a sensitivity of 89.5% and a specificity of 62.7%. The sensitivity of this method was higher than that of direct microscopy. In all of the PCR positive samples, the time to detection, compared to culture, could be shortened by 1 to 2 weeks. Only one sample was positive for Cryptococcus culture and another sample was positive with a Cryptococcus latex test. PCR for Cryptococcus was positive in 2 cases (n=78), sensitivities and specificities could not be reported due to the low number of positive cases. CONCLUSION We demonstrated that a short culture period and the use of commercial DNA extraction kit on CSF samples increases the sensitivity of molecular tests to diagnose tuberculosis. Furthermore, the molecular techniques could significantly reduce the time to positivity of results, when compared to culture. Due to the low occurrence of Cryptococcus in the samples included in our study, we could not comment on the diagnostic utility of PCR in the diagnosis of Cryptococcal meningitis, when compared to the conventional methods.
AFRIKAANSE OPSOMMING: INLEIDING Mycobacterium tuberculosis (MTB) en Cryptococcus neoformans is die mees algemeenste oorsake van kroniese meningitis in Suid-Afrika. Routine mikroskopie dra beperkte waarde in die diagnose van hierdie patogene as gevolg van die klein hoeveelhede organismes wat in die SSV (serobrospinale vog) voorkom en die lang tyd wat dit benodig om hierdie organisms te kweek. Hierdie studie beoog om die diagnostiese waarde van ‘n polymerase ketting reaksie (PKR) metode wat intern ontwerp is te evalueer vir die identifikasie van patogene verantwoordelik vir kroniese meningitis. METODES SSV monsters (waarvan die volume 5ml oorskry) en waar daar ‘n kliniese vermoede van tuberkulose meningitis (TBM) was, is na die diagnostiese Mediese Mikrobiologie laboratorium van Tygerberg hospitaal gestuur vir roetine bakteriologiese ontleding. Die oorblywende monsters is gebruik om twee mikobakteriële groei-indikasiebuise (MGIT A en B) te innokuleer en hulle is geïnkubeer in ‘n BACTEC 960 geautomatiseerde sisteem. MGIT A is volgens roetine diagnostiese metodes geanaliseer en die tyd tot ‘n positiewe resultaat is aangeteken Weeklikse monsters (tot en met week 6) is uit MGIT B verwyder en die monsters is gekook om sodoende die bakterië te inaktiveer. Die Promega Wizard SV Genomiese DNS ekstraksiemetode is gebruik om die DNS te versuiwer. Spesiëring van die DNS is deur middel van ‘n intern ontwerpte PKR en hoëresolusiesmeltingsmetode (HRS) gedoen met inleiers wat spesifiek is tot die RD9 gedeelte van die MTB kompleks en inleiers spesifiek tot die gedeeltelike interne getranskribeerde spasieerder 1 (ITS1), 5.8S rRNS geen en die gedeeltelike ITS2 DNS volgorde van C. neoformans. VI RESULTATE Roetine SSV mikroskopie het aangedui dat 14 uit 78 (17.9%) pasiënte tipiese SSV bevindings van TBM (oorwegend limfosiete, verhoogde proteïene en verlaagde glukose) gehad het. Ziehl- Neelsen (ZN) kleurings was positief vir 12 (15.4%) monsters, en MTB is gekweek in 19 (24.4%) van hierdie monsters. Ons geoptimaliseerde PKR en HRS metode het daarin geslaag om M. tuberculosis in 17 van die 19 kultuurpositiewe monsters aan te toon met ‘n sensitiviteit van 89.5% en ‘n spesifisitiet van 62.7%. Die sensitiwiteit van die direkte PKR was hoër in vergelyking met mikroskopie. In al die PKR positiewe monsters was die tyd tot aantoning, in vergelyking met kultuur, verkort met 1 tot 2 weke. Slegs een monster het C. neoformans gekweek en ‘n ander monster was positief met die kriptokokkale latekstoets. PKR vir C. neoformans was positief in 2 gevalle (n=78). Die sensitiwiteit en spesifisiteit van die C. neoformans PKR kon nie bepaal word nie weens te min gevalle. GEVOLGTREKKINGS Ons het aangetoon dat ‘n verkorte inkubasieperiode en die gebruik van ‘n kommersiële DNS ekstraksiemetode op SSV monsters die sensitiwiteit van die molekulêre tegniek vir die diagnose van tuberkulose verhoog en dat hierdie metode die tyd na positiwiteit aansienlik verkort in vergelyking met kultuur. Weens die lae getalle van kriptokokkale meningitis in ons studie kon ons nie kommentaar lewer op die akkuraatheid van PKR in die diagnose van kriptokokkale meningitis, in vergelyking met meer konvensionele metodes, nie.
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Kylås, Jessika, and Anna Modigh. "Linking self-perceived oral health to background factors and clinical status. - An epidemiological study in the Swedish county of Kalmar." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19940.
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Syftet med studien var att undersöka självupplevd oral hälsa (SPOH) och faktorer som påverkar den, i en vuxen population i Kalmar län, Sverige. Studien är en del av en epidemiologisk studie som genomfördes under 2010-2012. Urvalet för denna studie bestod av 380 slumpvis utvalda personer som deltog i en omfattande klinisk undersökning och svarade på en enkät. Enkäten bestod av 56 frågor angående bl.a. patientens självupplevda orala hälsa och socioekonomiska situation. Den studerade populationen bestod av 189 kvinnor (49,9%) och 190 män (50,1%). Individerna var 20-90 år, med en genomsnittlig ålder av 52 år. Självupplevd oral hälsa definierades statistiskt utifrån en av frågorna i enkäten: självupplevd oral hälsa jämfört med jämnåriga, och benämndes SPOH. De kliniska variabler som analyserades var antal egna tänder, DMFT (Decayed, Missed, Filled Teeth), tandluckor och riskbedömning (summa av tandläkarens bedömning av kariesrisk, parodontal risk, teknisk risk och allmän risk). Bakgrundsvariablerna var ålder, kön, utbildning och etnicitet. Bivariata korrelationer och en regressionsanalys utfördes med SPOH som beroende variabel och med bakgrundsfaktorer och kliniska variabler som oberoende variabler. Signifikanta korrelationer påvisades mellan SPOH och ålder (p<0,01), DMFT (p<0,01), antal egna tänder (p<0,01) och tandläkarens riskbedömning (p<0,01). Högre SPOH korrelerade med ökande ålder, fler egna tänder och lägre DMFT. En överensstämmelse mellan tandläkarens bedömning av patientens orala status och SPOH påvisades i sambandet mellan dessa två variabler, vilket indikerar att högre bedömd risk är förknippat med en lägre SPOH.The aim of this study was to investigate self-perceived oral health (SPOH) and factors affecting it, among adults in the Swedish county of Kalmar. The study is part of an epidemiologic study conducted in 2010-2012. The sample for this study was comprised of 380 individuals, randomly selected, who participated in a clinical examination with a concomitant questionnaire. The questionnaire consisted of 56 questions concerning e.g. patient perception of oral health and socio-economic situation. The final study population consisted of 189 women (49.9%) and 190 men (50.1%). The individuals were 20-90 years, with a mean age of 52 years. Self-perceived oral health was statistically defined by one question of the questionnaire: self-assessed oral health as compared to contemporaries of the same age, and termed SPOH. The clinical variables analysed were number of own teeth, DMFT (Decayed, Missed, Filled Teeth), gaps between teeth and risk assessment (sum of the dentists assessment of caries risk, periodontal risk, technical risk and general risk). The background variables were age, gender, education and ethnicity. Bivariate correlations and regression analyses were conducted with SPOH as dependent variable, and with background factors and clinical variables as independent variables. Significant correlations were found between SPOH and age (p<0.01), DMFT score (p<0.01), number of own teeth (p<0.01) and the dentists’ risk assessment (p<0.01). Higher SPOH was associated with increased age, increased number of own teeth and decreased DMFT. A consistency between the clinician’s assessment of the patient’s oral status and SPOH was shown in the correlation between these two variables, which implies that a higher risk assessment is associated with a lower SPOH.
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Budyn, Cynthia Lee. ""Great Expectations" communication between stadardized patients and medical students in Objective Structured Clinical Examinations." Connect to resource online, 2007. http://hdl.handle.net/1805/1187.
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Thesis (M.A.)--Indiana University, 2007.Title from screen (viewed on January 9, 2008). Department of Communication Studies, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Stuart M. Schrader, Kim D. White-Mills, Elizabeth M. Goering, Jane E. Schultz. Includes vitae. Includes bibliographical references (leaves 85-94).
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Bachinskyi, V. T., O. V. Pavliukovych, V. V. Malyshev, and N. D. Pavliukovych. "Features of forensic medical examination of corpses at shot with pneumatic weapons (case report)." Thesis, Collection of scientific papers. 100 years of Institute of Forensic Medicine. – 2019. – P. 168-172, 2019. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/15096.
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Due to processing of large numder of pneumaticweapons by the population there is a significant incriase in the number of injury both in Ukraine and in the world with shots from it, and therefore, the number of expert assesments of these cases in the practice in forensic experts in increasing
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Whitman, Marilyn V. Permaloff Anne. "An examination of cultural and linguistic competence in health care." Auburn, Ala., 2006. http://repo.lib.auburn.edu/2006%20Fall/Dissertations/WHITMAN_MARILYN_10.pdf.
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Castro, André Peres Barbosa de [UNESP]. "Produção de antígeno de Toxoplasma gondii em células de sarcoma murino TG180." Universidade Estadual Paulista (UNESP), 2007. http://hdl.handle.net/11449/98347.
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A toxoplasmose é uma protozoonose causada pelo Toxoplasma gondii, de distribuição mundial e que acomete todos os animais homeotérmicos, incluindo o homem. Apresenta desde quadros assintomáticos a manifestações sistêmicas graves. Nos seres humanos a infecção atinge com maior gravidade principalmente indivíduos imunocomprometidos e gestantes, sendo que a primoinfecção, pode levar a óbitos, abortamentos, natimortos além de lesões severas do sistema nervoso central. Técnicas sorológicas precisas de fácil aplicação a campo e de menores custos, podem auxiliar na promoção de medidas de prevenção e controle, mas para isso é importante garantir a produção de antígenos em quantidade e de qualidade, a fim de atender as necessidades do método empregado, para garantir a sua padronização. A produção in vitro de taquizoítos de T.gondii usando células de sarcoma murino TG180 em histoculturas, mostra-se uma alternativa viável para a produção de antígeno de T. gondii, em quantidade e qualidade para uso no diagnóstico dessa infecção utilizando-se o Método de Aglutinação Direta, o que pode permitir sua difusão como um teste rápido a campo, possibilitando a sua utilização por profissionais autônomos ou unidades de saúde, podendo-se assim agilizar com uma maior rapidez as ações de prevenção dessa zoonose.
Toxoplasmosis is one protozoonosis caused by Toxoplasma gondii, of world-wide distribution and that acomete to all the animals, including the man. It presents since without symptoms until serious clinical manifestations. In the human beings the infection reaches with bigger gravity immunocompromised patients individuals mainly and pregnant woman, being that the primary infecction, it can take the deaths, abortions, stillborn beyond severe injuries of the central nervous system. Serologicals techniques of easy application in the field and of lesser costs, can assist in the promotion of measures of prevention and control, but for this it is important to guarantee the production of antigens in amount and quality, in order to take care of the necessities of the employed method to guarantee its standardization. The production in vitro of taquizoitos of T.gondii using cells of sarcom murine TG180 in histoculture, reveals to a viable alternative for the antigen production of T. gondii, in amount and quality for use in the diagnosis of this infection by the Direct Agglutination Test, what it can allow its diffusion as a fast test in the field, allowing its use for independent professionals or units of health, and thus allowing to a bigger rapidity in the actions of prevention of this zoonose.