Дисертації з теми "Therapeutic health"
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1
Vincent, Ellen Anita. "Therapeutic benefits of nature images on health." Connect to this title online, 2009. http://etd.lib.clemson.edu/documents/1252938030/.
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Brown, Malgorzata. "Therapeutic relationships in acute inpatient mental health settings." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12508/.
Повний текст джерелаАнотація:
This work considers the nature of therapeutic relationships between nursing staff and patients on acute mental health inpatient wards. Section A is a literature review, exploring the psychological theories behind the care delivered by nurses through the medium of therapeutic relationships in inpatient settings and providing a meta-synthesis of studies investigating the nature of therapeutic relationships between nursing staff and patients from the perspectives of nurses. Section B presents a phenomenological study in which nursing staff completed in-depth interviews providing descriptions of their therapeutic relationships with patients. The results suggest a great variance in the nursing staff ability to get to know and understand patients and their needs from a psychological perspective. The knowledge gained about patients through the medium of relationships did not seem to be shared by the staff team and did not seem to be integrated into a coherent treatment plan.
3
Becoña, Iglesias Elisardo, and Guadalupe Luis Armando Oblitas. "The psychology of health and addictions: therapeutic perspective." Pontificia Universidad Católica del Perú, 2003. http://repositorio.pucp.edu.pe/index/handle/123456789/101835.
Повний текст джерелаАнотація:
The addiction subject is nowadays a valid one, as well as in the past century. Not only because of the increase of people that are addict, but also because of the important effects that cause on people and their environments. There are many theoretical perspectives to approach the addiction problem, but the most convenient because of its therapeutic results is the one that issupported by the psychology of health. lt is based on the integral approach to the person. This paper describes a general therapeutic scheme to work with addicts from the cognitive behaviora lperspective.El tema de las adicciones sigue tan vigente como en el siglo pasado, no solo por el incremento del número de personas que lo padecen sino también por las importantes secuelas que produceen el individuo y en su entorno. Existen diferentes enfoques teóricos para abordar la problemáticade las adicciones, sin embargo el que nos parece más conveniente por sus resultados terapéuticos es el que proviene desde la Psicología de la salud, basado en un enfoque integral en el abordaje del sujeto. El artículo fundamentalmente describe un esquema terapéutico general de su aplicación a los adictos, desde el enfoque cognitivo-conductual.
4
Raïs, Ali Setti. "Diagnostic and therapeutic odyssey : essays in health economics." Thesis, Paris 1, 2019. http://www.theses.fr/2019PA01E019/document.
Повний текст джерелаАнотація:
Cette thèse de doctorat met l’emphase sur les défis rencontrés par les patients atteints de maladies rares. Elle est structurée en trois parties, chacune d’entre elles dédiée aux enjeux d’un acteur au cœur de l’Odyssée diagnostique et thérapeutique des patients atteints de maladies rares. La première partie de la thèse s’intéresse au patient et à son réseau social. Le chapitre 1 considère les sources de délai à l’accès au diagnostic, et explore notamment l’effet du capital social sur le délai d’obtention du diagnostic. Le chapitre 2 évoque les externalités négatives sur la santé maternelle d’un diagnostic d’une maladie chronique chez l’enfant. La seconde partie de la thèse est dédiée à l’industrie pharmaceutique et s’intéresse aux décisions d’investissements de R&D ciblant les maladies rares. Le chapitre 3 évalue l’effet causal de l’Orphan Drug Policy sur l’effort de recherche, et le chapitre 4 envisage les inégalités d’allocation des investissements de R&D entre les maladies rares. La partie 3 est dédiée aux décideurs publics et discute des enjeux d’évaluation des bénéfices de l’innovation thérapeutique et de la définition des conditions d’accès à cette innovation. Le chapitre 5 évalue l’effet causal de l’innovation thérapeutique sur la longévité des patients atteints de maladies rares. Le chapitre 6 est une discussion critique relative à l’utilisation d’outilsThis dissertation emphasizes the challenges raised by the management of rare diseases and is structured around three key actors of the diagnostic and therapeutic “odyssey” of patients with rare diseases. Part I is devoted to patients and their social networks. Chapter 1 considers demand-side sources of delay in receiving a diagnosis; Chapter 2 explores the health spillover effects from patients’ health to their direct support structure. Part II considers pharmaceutical firms and examines how firms’ decisions to allocate R&D investment to rare diseases are impacted by innovation policies in rare arenas. Chapter 3 evaluates the causal impact of the EU Orphan Drug policy on R&D efforts in orphan drugs, while Chapter 4 investigates the inequality in allocation of R&D investment within rare diseases. Part III focuses on policymakers and addresses the issues in measuring pharmaceutical innovation benefits along with costs in rare disease arenas, while considering the opportunity cost of healthcare expenditures. Chapter 5 measures the causal impact of pharmaceutical innovation in rare diseases on longevity, while Chapter 6 is a critical discussion of decision-making tools for rational allocation of healthcare resources, and the use of a cost-effectiveness threshold
5
Vicich, Alexandra Devin. "Therapeutic change for women in collective performance." Thesis, New York University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1549235.
Повний текст джерелаАнотація:
This phenomenological study describes the therapeutic potential of change for women who come together in collective creative process to perform their stories. The author examines women, aged 30-72, and their experiences of collective performance, spanning 29 years, in response to their life circumstances, emotional health, personal relationships, professional life, and community connections. Roles inside and outside of the group are explored, as are their group and individual processes. Research on women, collectives, applied theatre, and therapeutic theatre is presented. Perspective is gained through the lenses of feminist theory, social constructivism, and psychodramatic role theory. Comparisons are made between applied theatre and drama therapy, and the mutual exclusion of group versus individual, socio-political versus therapy, is questioned. Implications for the use of socio-political community drama in a therapeutic theatre format in drama therapy are formulated.
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Batelli, Penny Lynn 1963. "The therapeutic values of gardens and landscapes." Thesis, The University of Arizona, 1998. http://hdl.handle.net/10150/291627.
Повний текст джерелаАнотація:
Research has shown that plants, gardens, and nature can promote and enhance human health and well-being. A review of the relevant literature examined human-environment relationships and the possible therapeutic benefits derived from these relationships. In addition to the research literature, therapeutic gardens designed by landscape architects were examined. A comparative analysis between various theories within the research literature, and between the research literature and executed designs was performed. This analysis resulted in design suggestions and guidelines from the point of view of fostering human health and well-being.
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Walker, Teneille. "Therapeutic Drugs in Cancer." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1722.
Повний текст джерелаАнотація:
The first study examined the interaction between low doses of the multi-kinase inhibitor sorafenib and the histone deacetylase inhibitor vorinostat in colon cancer cells. Sorafenib and vorinostat synergized to kill HCT116 and SW480 cells. In SW480 cells, sorafenib+vorinostat toxicity correlated with CD95 activation and CD95-stimulated autophagy. Drug lethality in SW480 cells was blocked by knock down of CD95. In SW620 cells that are patient matched to SW480 cells, sorafenib+vorinostat toxicity was significantly reduced that correlated with a lack of CD95 activation and lower expression of ceramide synthase 6 (LASS6). Overexpression of LASS6 in SW620 cells enhanced drug-induced CD95 activation and tumor cell killing, whereas knock down of LASS6 in SW480 cells suppressed CD95 activation. In HCT116 cells, sorafenib+vorinostat did not increase CD95 plasma membrane levels, weakly induced caspase 8 association with CD95, and knock down of CD95 enhanced drug lethality. In HCT116 cells sorafenib+vorinostat treatment caused CD95-dependent autophagy that was a protective signal. Thus, treatment of tumor cells with sorafenib+vorinostat activates CD95 that promotes viability via autophagy or degrades survival via extrinsic or intrinsic pathways. Drug-induced activation of the de novo ceramide synthesis pathway plays a key role in CD95 activation. The second project explores the mechanism by which the combination of 17AAG, an hsp90 inhibitor, and PD184352, a MEK1/2 inhibitor alters survival in colon cancer cells. 17AAG and PD184352 synergized to kill HCT116 and SW480 cells. In HCT116 cells drug-exposure increased CD95 plasma membrane levels In SW620 cells, 17AAG and PD184352 toxicity was significantly reduced that correlated with a lack of CD95 activation and lower expression LASS6. Overexpression of LASS6 in SW620 cells enhanced drug-induced CD95 activation and tumor cell killing. In Mia Paca2 cells, a pancreatic cell line, inhibition of caspase 8 or overexpression of c-FLIP-s suppressed cell killing by PD184352 and 17AAG exposure. Drug lethality in Mia Paca2 cells was blocked by knock down of CD95. Additionally, overexpression of Bcl-xL or knockdown of caspase 9 decreased cell killing in 17AAG and PD184352 combination treatment. Thus, 17AAG+PD184352 exposure activates the extrinsic and intrinsic apoptotic pathways to kill Mia Paca2 cells. This document was created in Microsoft Word 2000.
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Simmons, Robert Earl. "African therapeutic systems : their place in health care in Liberia." Thesis, University of Liverpool, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387349.
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Johnson, Loree Anitra. "The early therapeutic relationship with MFT trainees /." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2006. http://proquest.umi.com/login?COPT=REJTPTU0NWQmSU5UPTAmVkVSPTI=&clientId=3739.
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Guibinga, Ghiabe H. "Molecular therapeutic interventioan for dystrophin-deficient muscles." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=36945.
Повний текст джерелаАнотація:
Duchenne muscular dystrophy (DMD) is common and fatal X-linked genetic disorder. The overall objective of this thesis was to carry out a prospective study for dystrophin gene therapy in dystrophic muscles, using the X-linked muscular dystrophy (mdx) mouse model. Recombinant adenovirus (AdV) is presently the vehicle of choice for gene therapy for a number of diseases including DMD. However AdV possess two major limitations when utilized as vectors in skeletal muscles: (i) the maturation-dependency of AdV-infectivity in skeletal muscles, (ii) the host immune response against adenoviral proteins as well as the transgene product. Thus, the work presented in this thesis addresses these two major limiting factors. By modifying either the host or the vectors, we have attempted to optimize AdV-mediated therapeutic gene transfer in dystrophic muscle. Our strategy has consisted firstly to evaluate the regenerative response of dystrophic muscle with advanced disease after experimentally-induced regeneration, in an attempt to recapitulate the myogenic program. We report that mdx mice with severe dystrophic pathology can still show a substantial level of muscle repair with attendant generation of immature myofibers. Secondly, by taking advantage of this level of regeneration and the concomitant generation of immature myofibers, we have upregulated expression of the coxsackie adenovirus receptor (CAR) present in mdx muscles. We have delivered AdV containing a dystrophin gene (AdV-Dys) at a period corresponding to this peak level of CAR expression and we have reported a significant increase of the number of dystrophin expressing myofibers with a net trend toward muscle function amelioration.The work of this thesis also reports that the combined blockade of calcineurin and CD28 signaling, two key and distinct elements needed for an effective immune response, effectively blunted the immune-mediated destruction of dystrophin expressing myofibers expressed after AdV-Dys delivery. As an alternative to host modification (regeneration and immunosuppression) that can be associated with potential toxic effects, we have explored a strategy where by the recombinant AdV vector contains a less immunogenic transgene utrophin. We report that overexpression of utrophin and dystrophin by AdV-mediated gene transfer in adult immunocompetent mdx mice produces differential effects on muscle cell function in adult immunocompetent (mdx) mice. (Abstract shortened by UMI.)
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McGurie-Snieckus, Rebecca. "Understanding and assessing the therapeutic relationship in community mental health care." Thesis, Queen Mary, University of London, 2006. http://qmro.qmul.ac.uk/xmlui/handle/123456789/1773.
Повний текст джерелаАнотація:
The clinician-patient relationship is at the core of community mental health care and impacts on outcome, but no instrument has been specifically developed for its assessmentE. xisting scalesh ave either unproven psychometric properties in community mental health care settings, or have been designed for other therapeutic settings, or both. My aim in this thesis is to develop a scale to assess the therapeutic relationship in community mental health care (STAR) that has both clinician and patient versions. In part one, understanding the therapeutic relationship in community care, I considered the rationale for mental health care in the community and explore theoretical presuppositions, pre-existing measures, and influences on the therapeutic relationship. In part two, assessing the therapeutic relationship in community care, I developed an assessment tool in four stages. In stage one I generated an item pool using semi-structured interviews and existing scales. In stage two I administered this item pool to 133 community care patients and their 26 clinicians. I constructed subscales based on principal components analyses. In stage three, for final item selection, I assessed retest-reliability. In stage four the scales were administered to a new sample of 180 patients and their 84 clinicians. The factorial structure of the scale was confirmed with a good fit. The end result is both a patient and clinician version of STAR which has 12 items comprising 3 subscales: positive collaboration (6 items) and positive clinician input (3 items) in both versions, non-supportive clinician input in the patient version and emotional difficulties in the clinician version (3 items each). Psychometric properties are satisfactory. STAR is a specifically developed, brief scale to assess therapeutic relationships in community care. The two versions cover three similar factors each, and may be used in research and routine care.
12
Ngudiankama, Adrien Nginamau. "Concepts of health and therapeutic options among Congolese refugees in London." Thesis, University College London (University of London), 2001. http://discovery.ucl.ac.uk/10020365/.
Повний текст джерелаАнотація:
This thesis is about the perception and experience of health, illness and health care among Congolese refugees. It discusses the role of education, with a particular emphasis on schools, in promoting health in the Congolese refugee community, alongside the role of the Home Office, the health care sector and the Congolese refugee community itself. The thesis identifies three therapeutic systems used by Congolese refugees. These are the Congolese traditional therapeutic systems, the Christo-spiritual therapeutic systems and biomedicine. Analyses of the data demonstrate that in the quest for health, Congolese refugees develop six approaches or options. This is due to their perceptions of illness/disease or predicament, their experiences in the British health care sector as well as their concepts of risk. Moreover, analyses of the fieldwork data establish a correspondence between the conditions in exile and the Congolese refugees' health. Thus, to promote Congolese refugees' health in London, the thesis argues that their culture, their socio-economic and political conditions as well as their experiences in British health care sector must be considered. This, however, cannot be the concern of a single group. It requires the intervention of schools, the Home Office, the health care sector, and the Congolese refugees themselves. The thesis ends by evaluating its main arguments in the light of Congolese refugees' therapeutic options as well as its methodological stances.
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Pryde, Kirsti. "Eating disorders nursing: Roles, skills, and the therapeutic alliance." Thesis, University of Ottawa (Canada), 2009. http://hdl.handle.net/10393/28184.
Повний текст джерелаАнотація:
A mixed method study was conducted to gain an understanding of the role of the eating disorders (ED) nurse and to explore the nurse-patient therapeutic alliance in this context. Thirty-five nurses from six ED treatment centres in Canada and America participated. The qualitative component involved manifest and latent content analyses of semi-structured interviews. From this, nine nursing roles were identified in addition to the skills, challenges and rewards of ED nursing. Three themes emerged in relation to the therapeutic alliance: creating a therapeutic environment, establishing a connection, and empowering patients. The quantitative component consisted of an established measure of therapeutic alliance in questionnaire form. Results from the survey supported the qualitative findings in identifying differences between Canadian and American nurses.
14
Lee, Boon Ooi. "Therapeutic outcomes and the Process of Healing by Dang-Ki in Singapore." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=19288.
Повний текст джерелаАнотація:
As most models of psychotherapy have been developed based on Western worldviews, they may need to be adapted when applied in other cultures. One way to make psychotherapy culturally sensitive is to study the indigenous healing systems of specific cultural groups. This study focuses on dang-ki, which is a form of Chinese shamanism in Singapore. It seeks to understand whether dang-ki is perceived as helpful, and the explanations for such perception. Interviews were conducted with patients, dang-kis, and interpreters in three phases: immediately before and after the healing, and approximately one-month later. Results suggest that dang-ki healing is helpful probably due to three interrelated factors: restoration of psychosocial functioning through regulation of emotion and cognition, and mobilization of social supports; a positive patient-healer relationship; and use of culturally relevant meanings and intervention strategies. Implications for developing culture-specific psychotherapy with Chinese patients will be discussed.Puisque la plupart des modèles de psychothérapie reposent sur des conceptions occidentales du monde, leurs applications à d'autres cultures nécessitent parfois des adaptations. Une façon d'adapter culturellement la psychothérapie est d'étudier les systèmes indigènes de guérison propres à certains groupes culturels. Cette étude porte sur le dang-ki, une forme de chamanisme chinois pratiqué à Singapour. Elle vise à déterminer si le dang-ki est perçu comme utile et à comprendre les raisons qui expliquent cette perception. Des entrevues ont été menées auprès de patients, de dang-kis et d'interprètes en trois phases successives : immédiatement avant et après la guérison, et environ un mois plus tard. Les résultats donnent à penser que l'utilité de la guérison dang-ki est sans doute attribuable à trois facteurs interdépendants : la restauration du fonctionnement psychosocial à travers la régulation de l'émotivité et de la cognition ainsi que par la mobilisation des soutiens sociaux; une relation patient-guérisseur positive; et l'utilisation de significations et de stratégies d'intervention culturellement pertinentes. On discutera des implications pour le développement d'une psychothérapie spécifique à la culture des patients chinois.
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Carystinos, George D. "Molecular studies on the therapeutic implications and regulation of connexin 43." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=36887.
Повний текст джерелаАнотація:
Gap junctional intercellular communication (GJIC) allows for the transport of small signaling molecules between adjacent cells. Gap junctions and their constituents, connexins, are often impaired in cancer. Restoration of connexins and GJIC in cancer cells leads to reversal of the transformed phenotype, reduction of the rate of cell growth, and inhibition of in vivo tumorigenicity. In addition, restoration of connexin43 (Cx43), one of the most abundant connexins that is often reduced in cancer, allows for the transfer of chemotherapeutic agents among neighboring cells, a phenomenon known as the "Bystander Effect". In chapter 2, I'm reporting evidence that induction of Cx43 and GJIC with cyclic-AMP (cAMP) can enhance the cytotoxic effect of the prodrug ganciclovir following infection of breast cancer cells with an adenovirus expressing the ganciclovir-activating enzyme viral thymidine kinase (vTK). This induction may provide a therapeutic advantage in suicide gene therapy due to the bystander effect when a small proportion of the cell population is expressing vTK. In chapter 3, I'm reporting that breast tumor tissue samples from patients had low to undetectable Cx43 levels, in contrast to their matched normal tissues. In addition, Cx43 protein and RNA levels were undetectable in a panel of human breast cancer lines and in rat breast tumors induced by the carcinogen dimethylbenz[a]anthracene. Together, these observations indicate that the loss of Cx43 is a common marker of cancer cells. In chapter 4, I examined the hypothesis that Cx43 downregulation occurs primarily at the transcriptional level. To determine the mechanisms behind the transcriptional regulation of Cx43, the human Cx43 promoter was investigated. Overexpression of the H-Ras oncogene in NIH3T3 cells leads to the induction of the human Cx43 promoter activity, as well as Cx43 RNA and protein levels. This stimulation involves the MEK-ERK pathway downstream of H-Ras. The promoter sequence responsible for
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Jang, Seong Hoon. "Intracellular pharmacokinetics of Paclitaxel : relationship with Pharmacodynamics and therapeutic implications /." The Ohio State University, 1999. http://rave.ohiolink.edu/etdc/view?acc_num=osu1488192960167348.
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Al-Khaldi, Abdulaziz A. "Therapeutic angiogenesis using autologous bone marrow stromal cells." Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=32749.
Повний текст джерелаАнотація:
Objectives. To study marrow stromal cells (MSCs) induced angiogenesis. To examine the possible mechanisms involved in the process. To evaluate neovascularization following implantation of MSCs in ischemic hind limb model.Methods and result. Using murine Matrigel angiogenesis model, we compared MSCs related angiogenesis to that produced by vascular endothelial growth factor (VEGF) and basic fibroblast growth factor. We found that MSCs result in an efficient and organized angiogenesis, arteriogenesis and vasculogenesis. MSC-related angiogenesis is VEGF dependent. MSCs in vivo produce VEGF that through paracrine effect induces local angiogenesis and through an autocrine loop stimulates FLK1+MSCs to differentiate into endothelial cells. MSCs implanted into ischemic hind limb resulted in marked improvement in blood flow and collateral vessels formation.
Conclusion. MSCs spontaneously induce efficient and mature angiogenesis in ischemic/hypoxic tissues with significant arteriolar component resulting in increased blood flow. They are also capable of spontaneous differentiation into endothelium. VEGF appears to be necessary for MSC-related angiogenesis and vasculogenesis.
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Lake, Linda Louise. "The relationship of race to the therapeutic alliance." Online full text .pdf document, available to Fuller patrons only, 2002. http://www.tren.com.
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Ng, Kelvin S. "Manufacturing and engineering of therapeutic extracellular vesicles." Thesis, Massachusetts Institute of Technology, 2017. https://hdl.handle.net/1721.1/122535.
Повний текст джерелаАнотація:
Thesis: Ph. D., Harvard-MIT Program in Health Sciences and Technology, February 2019Cataloged from student-submitted PDF version of thesis.
Includes bibliographical references (pages 71-81).
Originally viewed as 'garbage bags' which cells release to dispose of unwanted material, extracellular vesicles (EVs) have emerged as potent messengers that package and disseminate biochemical signals. This newly recognized mode of communication between cells has brought unprecedented therapeutic opportunities; at least 8 clinical trials and 7 companies are investigating or developing EVs as therapeutic products. As the EV industry rapidly grows, there is a rising demand for strategies that facilitate EV manufacturing. In this thesis, we address several challenges in EV manufacturing. By quantifying how many EVs a cell can release before it divides, we discovered that EV output increases as cells divide more slowly, providing a new way to maximize EV output from cells. Using our mathematical description of EV output, we built a computational model to estimate costs of EV manufacturing. Selecting cells with higher EV output despite slower proliferation can drastically lower costs. Meanwhile, although ultracentrifugation is the current standard for purifying EVs, we found that ultrafiltration-specifically tangential-flow filtration-is a more economical and scalable alternative, and we experimentally determined its utility for scaling up EV purification. For quality control, we established a suite of potency assays to measure the overall inflammatory action of EVs derived from human stem cells. Significant variability in EV potency between cells of different donors was detected, substantiating the need to robustly screen for appropriate cell sources when manufacturing EVs. Towards controlling EV function, we genetically constructed a versatile, multi-domain ligand that localizes to and modifies the surface of vesicles. Integrating biological, processing, and economic aspects of EV manufacturing, this thesis recommends strategies that may accelerate commercialization and clinical translation of EV therapy.
by Kelvin S. Ng.
Ph. D.
Ph.D. Harvard-MIT Program in Health Sciences and Technology
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Kochenderfer, Mary Anne. "Music after war : therapeutic music programmes in Bosnia and Herzegovina." Thesis, University of Edinburgh, 2006. http://hdl.handle.net/1842/1956.
Повний текст джерелаАнотація:
This thesis is a study of therapeutic music programmes in post-war Bosnia and Herzegovina. This study focuses on how different participant groups perceive programme aims and benefits and what these different perceptions reveal about the programmes as well as ways in which the local context impacts the programmes. Analysis is based on data gathered through interviews, observation, participant observation, and questionnaires obtained during five fieldwork visits undertaken between November 2003 and November 2004. While all participant groups agree that the programmes are beneficial, there are important differences in the ways different participant groups perceive programme benefits and the different ways in which the programmes approach sessions. Constructions of therapy appear to differ both between programmes and between international and local staff. All participant groups identified improved client communication and social skills as primary session outcomes. Clients appear to be largely unaware of the therapeutic aims of their sessions. Parents appear to have little influence and are not always notified that their children are involved with the programmes. International staff members appear to be intolerant of parents who do not heed their advice or reinforce progress made during sessions. In addition to running therapeutic sessions, these programmes work to increase inter-ethnic tolerance and to improve the skills of other local professionals. Programme success appears to be hindered by uncertainties inherent in working in a post-war environment. Developed and largely influenced by internationals, the programmes also face uncertainty as to whether they possess the necessary local leadership and ownership for long-term sustainability. There is evidence that tensions within, between, and outwith the programmes limit programme potential. Many of these tensions appear to be tied to local-international relations within programmes, which are exacerbated by national local-international tensions. A funding shortage has contributed to a competitive rather than a cooperative relationship between programmes. As the first detailed study of post-war therapeutic music programmes, this study has the potential to impact similar work in other regions and provides a more informed backdrop against which judgements can be made regarding the role and appropriateness of music as a form of therapy in post-war regions.
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Pennington, Margaret Sue. "Breaching the nurse-patient therapeutic relationship: A grounded theory study." Diss., The University of Arizona, 2002. http://hdl.handle.net/10150/280243.
Повний текст джерелаАнотація:
The therapeutic nurse-patient relationship is the core of nursing practice. This grounded theory study used symbolic interactionism, identity theory and ethics as a theoretical perspective to examine nurse-patient relationships. The opinions and experiences of twelve professional nurses were explored to discover the process and events involved when a nurse engaged in a nontherapeutic relationship with a patient. A core process, Breaching the Nurse-Patient Relationship, was identified from the interviews. The core process identified three stages in the process with conditions in each stage that showed progression from each condition in each stage to the next stage. The first stage in the process revealed five conditions that make the nurse vulnerable for engaging in nontherapeutic activities with a patient. Stage one, with the five conditions, was the preliminary process that lead to stage two. In stage two, the nurse engaged in nontherapeutic activities/relationships with the patient. The nurse was either under-involved or over-involved in the nurse-patient relationship but clearly the nurse deviated from the therapeutic realm of the relationship. There were eight conditions in stage two that identified the process of the nurse leaving the therapeutic role to engage in a nontherapeutic role with the patient. The last stage was characterized by the consequences that the nurse, patient and profession of nursing had to face as a result of the nontherapeutic nurse-patient relationship.
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Abrishami, Golee Farshbaf. "Therapeutic Alliance and Outcomes in Children and Adolescents Served in a Community Mental Health Setting." Diss., CLICK HERE for online access, 2009. http://contentdm.lib.byu.edu/ETD/image/etd2804.pdf.
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Alsabti, Hilal. "Delivery of marrow stromal cells for angiogenesis : therapeutic implications." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97891.
Повний текст джерелаАнотація:
There is tremendous enthusiasm for the utilization of angiogenesis as a therapeutic modality for atherosclerotic arterial disease. Augmentation of physiological neo-vascularization in cardiovascular disease can be achieved through different pathways. Marrow stromal cells may serve as an ideal cellular vehicle for the in vivo delivery of therapeutic proteins or production of these proteins by the cells themselves. The use of autologous marrow stromal cells is highly desirable since marrow stromal cells are abundant and available in all human of all ages and they are easy to harvest and reimplant without the fear of rejection. Our primary data showed that marrow stromal cells injected locally into ischemic animals promote angiogenesis. Exploring various routes of delivery is important for developing these cells as a novel therapeutic tool for treatment. We found that injecting these cells intravenously in high doses has a beneficial effect in restoring blood flow into the ischemic area in the ischemic hind limb animal model. Implantation of these cells into distant organs did not show any local or remote effects.
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Moy, Gretchen Michelle. "The Efficacy of Felony Mental Health Court Combined With Mental Health Probation." Thesis, NSUWorks, 2009. https://nsuworks.nova.edu/cps_stuetd/53.
Повний текст джерелаАнотація:
The present study examined felony mental health court and mental health probation used in conjunction and whether those on mental health probation had a reduced rate of rearrest and psychiatric hospitalization as compared to participants on regular probation or not on either form of probation. The research explored whether specific variables predicted a reduced rate of hospitalization and arrest among the participants on mental health probation. Results found mental health probationers did not significantly differ from the probationers in their rate of rearrest, and were rearrested more frequently then participants not on probation. Mental health probationers did not differ significantly from regular probationers or those without probation in psychiatric hospitalization frequency. Within the mental health probationers type of crime, presence of a violent crime, age, gender, education level, history of substance abuse, prescription of psychiatric medication, diagnosis, mental retardation and prior psychiatric hospitalizations did not predict arrest. The above variables also did not predict psychiatric hospitalization, with the exception of a history of psychiatric hospitalization which predicted a higher rate of
hospitalization while on mental health probation. Factors influencing these results and limitations of the present study were offered.
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O'Callaghan, Dana M. "Exploratory Study of Animal Assisted Therapy Interventions Used by Mental Health Professionals." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc6068/.
Повний текст джерелаАнотація:
The purpose of this study was to explore the various animal assisted interventions mental health professionals incorporate in the therapeutic treatment process, as well as the various therapeutic purposes intended with each technique. Participants were recruited from animal assisted therapy related databases. Participants included professionals who practiced in the mental health field. Thirty one participants qualified for the study. A survey was developed based on information found reviewing literature related to animal assisted therapy. Nineteen animal assisted therapy techniques and ten therapeutic intentions were identified from a review of the literature. Participants were asked to rate on a Likert scale how often they incorporated each technique in their treatment process. Additionally, participants were asked to identify which therapeutic purposes they intended with each technique. Results indicated participants incorporated a variety of animal assisted techniques for various therapeutic intentions. Results indicated seven animal assisted techniques were incorporated by more than 50% of the participants. Building rapport in the therapeutic relationship was the most common therapeutic intention reported with a variety of animal assisted techniques.
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Martin, Aditi Pandya. "Therapeutic drugs in cancer and resistance." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1717.
Повний текст джерелаАнотація:
We investigated the mechanism of toxicity and resistance development of small molecule tyrosine kinase inhibitor lapatinib in HCT 116 colon cancer cells. Lapatinib mediated cell death in HCT 116 cells was caspase independent and involved cytosolic release of apoptosis inducing factor. Treatment of HCT 116 cells with 10µM Lapatinib lead to the outgrowth of lapatinib resistant HCT 116 cells. Our studies show that alterations in the expression and activation of Bcl-2 family proteins allow lapatinib resistant HCT 116 cells to resist cytotoxic effects of lapatinib as well as of other commonly used chemotherapeutic agents. In hepatoma and pancreatic cancer cells, the effects of combining multi-kinase inhibitor sorafenib with histone deacetylase inhibitors (HDACIs) namely, vorinostat and sodium valproate were investigated. It was found that sorafenib synergizes with HDACIs resulting in enhanced cell death compared to death induced by the drugs individually. The mechanism of action of sorafenib and vorinostat combination treatment as well as sorafenib and sodium valproate combined treatment was shown to involve activation of the CD95 death receptor pathway. Alterations in the CD95 pathway can render cancer cells resistant to chemotherapeutic agents. Hence, we combined sorafenib+sodium valproate with a BH-3 domain mimetic named obatoclax (GX-15-070) which resulted in enhanced toxicity to cancer cells. More importantly, knock-down of CD95 (to mimic non-functional CD95 pathway) reduced cell death induced by sorafenib+sodium valproate combined but failed to protect cells from cell death induced by sorafenib+sodium valproate+obatoclax combined. This suggests that combining sorafenib+HDACI with obatoclax may not only enhance toxicity to cancer cells but may also reduce chances of resistance development via alterations in the CD95 pathway. These studies enhance our knowledge of existing treatment strategies for cancer as well as throw light on how current approaches can be improved in order to better diagnose and treat cancer. Understanding mechanisms of drug action as well as resistance development will allow us to combine existing therapies effectively in order best target cancer cells as well as provide us with information that can help us design new cancer treatment strategies.
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Perrin, David Benjamin. "Peter, the Pirate, and Me| A Drama Therapeutic Revelation of the Actor Within." Thesis, New York University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1549232.
Повний текст джерелаАнотація:
Lost roles are an important part of the equation for any healthy individual. Often drama therapists focus on role expansion as well as flexibility and spontaneity within the role repertoire. However investigating lost roles and the implications of lost roles paves the way for therapeutic progress and discovery. In this manner cycles of loss and gain work in tandem to produce wholeness. In seeking such wholeness as a drama therapist my quest led me back into one of the traumatic losses of my youth: losing the supporting lead of Captain Hook in my first-grade school play. Exploring how and why I was denied this part in the school play led me further into facets of my personality that predominated as a youngster, as well as the suppressed characteristics that resulted from Hook being taken away. Engaging the arts-based methodology of self-revelatory performance I experience this loss from the inside - inside the roles, characters, and interactions of my youth through adulthood. Along the way I discover that in fact I am in search of the role I was most ashamed to lose: the Actor. Reclaiming and coming to terms with the Actor proves a crucial step on my journey to becoming a drama therapist. Working in the field of drama therapy - where performance may be used either for ego confirmation or self-discovery - we learn the responsibility of the drama therapist to clarify his intentions when engaging his inner Actor.
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Kirk, Patricia Ann. "Evaluating therapeutic landscape design elements of urban plazas in the southwestern United States." Thesis, The University of Arizona, 2002. http://hdl.handle.net/10150/278783.
Повний текст джерелаАнотація:
Previous research on the therapeutic effectiveness of well-designed outdoor spaces in healthcare settings (OSHS) indicates psychological and physiological benefits for patients, staff, and visitors. Beyond the medical environment, well-designed urban open space is thought to possibly provide a healing effect for the urban dweller or office worker. This study evaluated therapeutic effectiveness of existing urban plazas compared to OSHS (used as control sites) in the southwestern U.S. Methods involved summarizing recommendations based on literature and noted designs in the field, and developing evaluation criteria termed Therapeutic Landscape Design Elements (TLDE). Presence of 27 TLDE and calculation of site coverage was determined at 13 urban plazas and six outdoor spaces in healthcare settings. Ranked correlation and t-test analyses were used to determine significant differences between the two types of sites. Urban plazas had significantly greater percent hardscape than OSHS, whereas OSHS had greater presence of moveable furniture and designated smoking areas.
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Leckey, Donna. "Therapeutic Non-pharmacological Interventions and PRN Psychotropic Medication Administration Practices of Mental Health RNs." Thesis, Carlow University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3681319.
Повний текст джерелаАнотація:
PRN psychotropic medication administration is a common practice used by psychiatric RNs in acute inpatient mental health settings to manage anxiety and agitation in patients, and as a result, there are high incidences of PRN psychotropic medication administration (Mugoya & Kampfe, 2010). There is limited documentation indicating that therapeutic non-pharmacological interventions are utilized prior to PRN psychotropic medication administration (Curtis et al., 2007). The purpose of this scholarly project was to determine what non-pharmacological interventions are used by mental health RNs prior to or in lieu of administering PRN psychotropic medication to manage anxiety and agitation in adult psychiatric hospitalized patients. Another aim of this project was to determine what factors influence mental health RNs' decisions to administer PRN psychotropic medications. A descriptive study was conducted. Two survey-type self-reporting tools were used. Twenty RNs completed Nursing Surveys. Thirteen RNs completed both Nursing Surveys and Nursing Intervention Tracking Forms. Findings from this study revealed that non-pharmacological interventions successfully resolved problems over 1/3 of the time and may prevent the use of PRN psychotropic medications. In cases where PRN psychotropic medication was not administered, distraction was the non-pharmacological intervention most often used. The most common factor influencing RNs' decisions to administer PRN psychotropic medications was a high level of anxiety persistent after non-pharmacological interventions were used. This study reinforces the importance of RNs using non-pharmacological interventions to manage patients exhibiting signs or symptoms of anxiety or agitation.
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Ridha, Joober. "Neuroleptic therapeutic response and genetics of schizophrenia." Thesis, McGill University, 1998. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=35930.
Повний текст джерелаАнотація:
Schizophrenia is a complex disease that affects up to 1% of the general population. It is manifested by a variable number of negative, positive and disorganisation symptoms giving rise to an important diversity in the expression of this syndrome. The treatment of schizophrenia is mainly based on neuroleptic drugs that alleviate, to a variable extent, psychotic symptoms in the majority but not all the patients. Although its aetiology is still unknown, it is now well established that schizophrenia is a brain disease resulting from the combination of environmental and genetic risk factors. In spite of intensive research, no specific genes were convincingly associated with schizophrenia possibly because of the presence of genetic heterogeneity. In this work, it was hypothesised that schizophrenic patients with excellent long-term response (R) and those with very poor long-term response to conventional neuroleptics (NR) may differ, at least partially, with respect to the pathogenesis of their disease. In this thesis we aimed at validating this classification scheme and illustrating its usefulness for genetic studies. In accordance with this hypothesis, it was found that NR differ from R patients with respect to age at onset, premorbid social adjustment, neuropsychological profiles and family history of psychiatric disorders. Molecular genetic investigations identified 2 genes, the hGT1 and 5-HT2a-receptor genes, that were associated respectively with responsive and nonresponsive schizophrenia, thus showing the utility of categorising patients according to their therapeutic response. A third gene, called hSWI2/SNF2 was also found to be associated with schizophrenia irrespective of therapeutic response to neuroleptics. In addition, a potentially abnormal protein was detected in two schizophrenic patients but not in controls. In conclusion, the distinction of schizophrenic patients belonging to the two extremes of long-term responsiveness to neuroleptics may help in iden
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Edwards, Keith. "A study of pre-registration nursing students and users of mental health services." Thesis, University of Birmingham, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366161.
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Liu, Xuelai, and 劉雪來. "The role of silver nanoparticles on skin wound healing, tissue remodeling and their potential cytotoxicity." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/195985.
Повний текст джерелаАнотація:
The advance of nanotechnology has made it possible that pure silver can be engineered into nano scale level with less than 100 nm in size. So far many studies have confirmed anti-bacterial and anti-inflammatory efficacy of silver nanoparticles (AgNPs). In our previous study we have revealed that AgNPs could promote wound healing through modulation of cytokines in a burn wound model in mice. Nonetheless, the exact effects mediated by AgNPs on various cell types in skin, including keratinocytes and fibroblasts, during wound healing still remain unknown. Therefore, in the present study we targeted a full-thickness excisional wound model in mice to explore the action and potential toxicity of AgNPs on keratinocytes and fibroblasts.
Immunohistochemistry staining and molecular assay were conducted to explore AgNPs-induced re-epithelization and cell differentiation in both in vivo and in vitro studies. We next targeted the healed skin after AgNPs-mediated wound healing using tensile test to compare their mechanical function. Meanwhile, immunohistochemistry staining and quantitative assay were utilized to further investigate and compare collagen deposition, and scanning electron microscopy (SEM) was used to observe the morphology and distribution of collagen fibrils in healed skin. Moreover, AgNPs of different sizes and doses were studied to investigate the potential toxicity, their influence on cell migration, and extracellular matrix (ECM) production.
Key results:
1. AgNPs could accelerate excisional wound healing in mouse skin when compared with other formats of silver.
2. AgNPs mediated differential cellular response in skin cells. They promoted proliferation and migration of keratinocytes in epidermal layer, through which the re-epithelization process during wound healing was enhanced; while proliferation of fibroblasts in dermal layer was inhibited and they were driven into the differentiation of myofibroblasts, through which wound contraction process was strengthened.
3. AgNPs could suppress the proliferation of human keloid fibroblasts and ECM production including collagen, fibronectin and heat shock protein, which would suggest that AgNPs had anti-fibrosis effect.
4. The AgNPs could stimulate the proliferation of epidermal progenitors and their differentiation into keratinocytes during wound healing. This biological event further contributed to the re-epithelization process.
5. AgNPs-mediated healed skin possessed comparable mechanical function, collagen deposition and fibril alignment to normal skin, which suggested AgNPs could modulate collagen production during skin wound healing.
6. The inhibitory effect on fibroblasts and cytotoxicity mediated by AgNPs showed a dose-dependent and size-dependent manner.
In conclusion, AgNPs not only contribute to healing of infected skin wounds through antibacterial activity, but can also accelerate wound healing through mediating differential cellular responses in different skin cell types and modulate collagen production during wound healing. Furthermore, there should be an optimal concentration and size to exert maximal biological action with minimal toxicity for each specific cell type. Present studies further extended our knowledge of AgNPs and have implications for treatment of wounds in clinical setting.published_or_final_version
Surgery
Doctoral
Doctor of Philosophy
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Faxas, Jesse A. "The effect of therapeutic touch in patients with cancer pain." FIU Digital Commons, 1996. http://digitalcommons.fiu.edu/etd/3287.
Повний текст джерелаАнотація:
Therapeutic touch has been shown to help reduce pain in several ailments. Cancer patients experience considerable pain during their illness. The purpose of this study is to evaluate the effect of therapeutic touch on pain experienced by cancer patients. The study uses a quasi-experimental design. A sample of sixteen hospitalized cancer patients was selected. The patients were randomly assigned to two groups: the experimental and the placebo control group. The patients assigned to the experimental group received a therapeutic touch treatment on two consecutive days, each day the treatment lasted for a period of 20 to 30 minutes. The patients in the placebo control group received mimicked therapeutic touch for 20 - 30 minutes.. A Visual Analogue Scale (VAS) was used to measure pain before and after the therapeutic touch treatment. At the end of the second day of the study, a Patient Touch Questionnaire (PTQ) was administered to measure the subjects' responses to the therapeutic touch treatment. The hypothesis that Therapeutic vi Touch would significantly decrease pain in cancer patients is supported by the observations made in this study.
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Clarke, William Francis Eugene. "Therapeutic community principles and practice within a secure environment." Thesis, University of Brighton, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.304526.
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Ersser, Steven Jeffrey. "An ethnographic study of the therapeutic effect of nursing." Thesis, King's College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.336408.
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Kjellin, Jessica, and Sara Norman. "Arbetsterapeutstudenters utvecklande av ”therapeutic use of self” - En litteraturstudie." Thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-84409.
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McSherry, Anthony. "What is the need, if any, for therapeutic education in mental health nursing? : an empirical phenomenological study of mental health nurses' responses to this question." Thesis, University of Roehampton, 2018. https://pure.roehampton.ac.uk/portal/en/studentthesis/what-is-the-need-if-any-for-therapeutic-education-in-mental-health-nursing(1ed74cad-0689-4622-ba3e-d870407e9f4e).html.
Повний текст джерелаАнотація:
This study explores how some mental health nurses are therapeutic, in terms of the art of healing, and how they have learned to be this way. The study originated in my experience of feeling abject while working as a mental health nurse. The research question addressed this situation through exploring whether or not therapeutic education was needed in mental health nursing. Ten mental health nurses participated in the study. Giorgi’s (2009) empirical phenomenological method was chosen because of its established status, and its grounding in Husserlian phenomenology which places a primacy on experience. A review of the literature included commentaries, qualitative empirical studies, case studies, and theoretical models, and indicated that mental health nurses may be therapeutic in idiosyncratic ways. A crucial aspect to these ways unfolded in this study as openness, through which the other may come to be in her own truthfulness. Significant methodological considerations were how we ‘constitute’ meaning, how meaning can ‘force itself’ like a gestalt, empathy may be self-alienating, and words ‘sedimented’ in tradition. These linked to how we can question being captivated in ‘experiences of truth’. Findings from Giorgi’s (2009) method were that mental health nurses are therapeutic through ‘being with’ others, through innate characteristics, that learning is through openness, and is facilitated through a therapeutic environment. Giorgi’s (2009) method is critiqued, and compared to a phenomenology of the therapeutic in relation to the research interviews (after Husserl and Merleau-Ponty). It was shown that the phenomenological ‘opens up’ language while method narrows meaning. The phenomenology showed that allowing an uncertain relation between two people was crucial, and how recognising the sensual aspect of meaning opened a healing space for another to be, through which a person’s own truthfulness may emerge. Openness appears to be innate, indicating one question for further study.
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Barley, C. ""Putting into words my experience" : mental health service users' experiences of therapeutic groups." Thesis, City, University of London, 2016. http://openaccess.city.ac.uk/15933/.
Повний текст джерелаАнотація:
This study explores the experiences of attending a therapeutic group from the perspective of the group participants who have a severe and enduring mental illness. The study aims to illuminate previously hidden personal experiences of the psychological processes involved in engaging with a therapeutic group, which appear absent from mental health literature and research. This qualitative research involved nine secondary care mental health service users, five men and four women, aged from thirty to seventy, who took part in semistructured interviews which were transcribed and analysed using Interpretative Phenomenological Analysis. The analysed data is therefore ideographic, from a bottom-up perspective, consisting of the researcher’s interpretations of the participants’ experiences. The research participants attended a range of facilitated therapeutic groups which were run for several months or more and which did not include agenda-led, time-limited psycho-education and behavioural groups. An independent audit of themes was included to increase validity. Three superordinate themes emerged: ‘Emerging from the Maelstrom’; ‘Unveiling’ and ‘Resoluteness in Life’, and each superordinate theme consists of several interrelated subordinate themes. Participants experienced their groups as ‘sanctuaries’ and presented their own recovery more positively than their group peers. Participants’ experiences included challenging their group facilitators’ leadership skills and enacting recovery and independence from their group. Participants experienced managing the intrusion of mental health symptoms and developed shared strategies to deal with feelings of invalidation, allowing them to become future focused and able to fulfil their goals. Participants’ experiences of their therapeutic groups are considered in relation to literature, research findings and theoretical models applied to mental health. Limitations, further research and clinical implications for group facilitators are discussed.
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Dutro, Anna Rae. "Light Image Therapy in the Health Care Environment." Digital Commons @ East Tennessee State University, 2007. https://dc.etsu.edu/etd/2060.
Повний текст джерелаАнотація:
Use of positive distraction in the built healthcare environment to assist in alleviating stress in a patient was investigated. A backlit light image was mounted in the ceiling of an examination room to create a positive distraction for patients in the ETSU Pediatric Clinic in Johnson City, TN. Survey instruments were used to collect sample data from patients and physicians in a randomized, balanced controlled study designed to determine if patients experienced less stress in the room with the backlit image as compared to other rooms (treatments). Although a statistical difference was not determined between the room with the backlit image and positive and negative control rooms, patients in rooms containing nature art tended to exhibit less anxiety. Researched based knowledge for creating positive distractions in the built healthcare environment helps designers create environments that benefit the patients, their families and medical staff of healthcare facilities.
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Liu, Dongfang 1969. "Investigations into therapeutic discovery and delivery of heparin-like glycosaminoglycans." Thesis, Massachusetts Institute of Technology, 2001. http://hdl.handle.net/1721.1/29952.
Повний текст джерелаАнотація:
Thesis (Ph. D. in Pharmacology and Toxicology)--Massachusetts Institute of Technology, Division of Bioengineering and Environmental Health, 2001.Includes bibliographical references (p. 131-153).
Heparin-like glycosaminoglycans (HLGAGs) are complex polysaccharides found both in extracellular matrix (ECM) and at the cell surface where they, in a sequence-specific manner, bind to and regulate the biological activity of numerous proteins. Due to a lack of effective tools to study structure-function relationship of these complex molecules, the role(s) of HLGAGs in cancer remains largely indirect and poorly understood. To study the role(s) of HLGAGs in cancer growth, metastasis and angiogenesis, tumor systems were studied using heparinases I and III which have distinct substrate specificities. Studies, focusing on the biochemistry of the heparinase active site, elucidated key interactions important for enzymatic activities, thus enabling the biological studies presented here. In vitro cell culture study with heparinases as tools clearly showed that cell surface HLGAGs are involved in regulating fundamental cellular activities including cell proliferation, invasion and adhesion. Significantly, heparinase I and III demonstrated distinct effect on these cellular activities with heparinase III inhibiting tumor cell proliferation, invasion and adhesion in selected model systems and heparinase I inhibiting these processes. Further in vivo studies in animal tumor models confirmed and expanded the distinct responses to heparinase I and III treatment. HLGAG fragments generated from heparinase treatment were found to be responsible for the effect of heparinase treatment in tumor models. Moreover, cell surface HLGAGs containing cryptic activatory and inhibitory sequence information were identified and characterized. In contrast to heparinase I- generated HLGAG fragments, heparinase III- generated HLGAG fragments were shown here to inhibit both primary tumor growth and secondary lung metastasis.
(cont.) The inhibition of tumor by heparinase III treatment was attributed to inhibition of specific signaling pathways such as FGF2 signaling. In an effort to develop a non-invasive and efficient delivery strategy for HLGAG-based therapeutics, HLGAGs were prepared as dry aerosol of defined characteristics for pulmonary inhalation. Pharmacokinetics study revealed efficient absorption for both formulated and unformulated dry aerosolized HLGAGs after pulmonary inhalation. Significantly, pulmonary inhalation of aerosolized HLGAGs was demonstrated to be effective in treating both local respiratory diseases including tumor metastasis and systemic thrombosis.
by Dongfang Liu.
Ph.D.in Pharmacology and Toxicology
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Bennett, Jessie Lynn. "An examination of therapeutic recreation programs for veterans with combat-related disabilities and their families." Thesis, Indiana University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3599145.
Повний текст джерелаАнотація:
The unique characteristics of the Global War on Terror have increased the number of troops returning with combat-related disabilities (CRD). Veterans with these CRD experience a variety of negative impacts on their functioning. Not only are the veterans' lives being negatively impacted by CRD, the families of veterans with CRD are also being affected. Therapeutic recreation (TR) programs are currently being used to reduce the negative impacts of CRD for veterans and their families. This study examined the influences of TR programs for veterans with CRD and their significant others (SOs) based on the ICF components of participation, body structure, function, and environmental factors. This study also examined the perceptions of veterans and their SOs about the benefits and important components of TR programs. The influences of the TR programs were examined by using a pretest, posttest, and one month follow-up to determine the impacts to the veterans' and SOs' PTSD symptoms, depression symptoms, family functioning and family recreation involvement along with the veterans' community reintegration. In addition, eight interviews were conducted with participants of the TR programs to determine the benefits and important components. There was a significant decrease in the veterans PTSD symptoms, the SOs depression symptoms, and trending towards an increase in family recreation involvement. The benefits of participation were identified as social reconnection, distraction, positive emotions, increased competence, and learning new skills; whereas, the important components were staff and a safe environment.
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Malik, Umm ie Salma. "Effect of therapeutic interventions on skeletal growth & development in paediatric inflammatory bowel disease." Thesis, University of Glasgow, 2013. http://theses.gla.ac.uk/4421/.
Повний текст джерелаАнотація:
Crohn’s disease (CD) is a chronic inflammatory bowel disease. Once considered rare in the paediatric population, it is recognized with increasing frequency among children of all ages. Approximately 20-30% of all patients with CD present when they are younger than 20 years. With its increasing recognition, CD has become one of the most important chronic diseases that affect children and adolescents. In addition to the common gastrointestinal (GI) symptoms (diarrhoea, rectal bleeding, and abdominal pain) children often experience growth retardation, pubertal delay, and bone demineralization. In these children, maintenance of skeletal health is a complex process that is influenced by a number of different mechanisms including steroid therapy, the disease process, nutritional status, endocrine status and the response of the body to inflammatory mediators. The recent introduction of biologic therapy that targets specific mediators of the proinflammatory process is a promising adjunct in the therapeutic management of the child with chronic inflammation. These drugs may also exert beneficial effects on the adverse effects of inflammation on growth and skeletal development. It is unclear whether these beneficial effects are due to improvement in overall disease or due to a direct ‘anti-cytokine’ effect at the level of the target tissue involved in growth and skeletal development. The hypothesis of this study was that the biologic therapy improves linear growth, puberty, bone health, body composition and muscle function in children with CD and this is associated with changes in the IGF-1 axis and markers of bone formation and bone resorption. Chapter 1 is an extensive literature review about the effects of biologic therapy on growth and skeletal development in paediatric patients with chronic inflammatory conditions particularly inflammatory bowel disease (IBD). The main aim of this review was to summarize and evaluate effects of inflammation and biologic therapy on growth and skeletal development in children with chronic inflammatory conditions and to explore the areas of interest for further research. Chapter 2 is the study about the growth in children receiving contemporary disease specific therapy in children with CD. The aim of this study was to assess the frequency of short stature and poor growth and their relationship to disease course and therapy in children with CD. Clinical records of all children with a confirmed diagnosis of CD, who were between 2yrs and 18yrs at the Royal Hospital for Sick Children, Glasgow were examined retrospectively. Data were collected at diagnosis, 1-yr, 2-yr and 3-yr after diagnosis and at maximum follow-up. The relationship of a number of factors including therapeutic modalities to two commonly used anthropometric markers of growth height velocity standard deviation scores (HVSDS) and change in height standard deviation scores (∆HtSDS) was examined. This study suggested that ∆HtSDS may be a more valid method of assessing and reporting longitudinal growth in children with chronic disease, particularly when there is a high prevalence of children of a peri-pubertal age. This study provides clear evidence that despite advances in therapy, short stature and slow growth continue to be encountered in a sub-group of children with CD. Chapter 3 is about the effect of Infliximab therapy on growth, puberty and disease activity in children with CD. The aim of this study was to assess growth, puberty, markers of disease and concomitant therapy over the six months prior to starting Infliximab and for the 6 and 12 months following treatment. Clinical records of all children with IBD who were started on Infliximab therapy between 2003 and 2008 at the Royal Hospital for Sick Children were examined retrospectively. This study has shown an average improvement of approximately 50% in HV in the 6 months after the initiation of Infliximab therapy which was further sustained for a further 6 months. Improvement in growth was found to be better in those children who were responders as compared to non-responders suggests that growth improved as a result of disease control. Improvement in growth was also observed in children who remained pre-pubertal and those who had never been on glucocorticoids (GC) compared to those who had been on GC. This study suggests that increase in height may not be simply due to progress in pubertal status or reduction in glucocorticoid dose. Chapter 4 is about the effect of Adalimumab therapy on growth in paediatric patients with CD. This is the one and only world wide multicentre study that adequately assess the effect of Adalimumab on linear growth in children with CD. The aim of this study was to assess the effect of Adalimumab therapy on growth, puberty and disease activity over the 6 months prior to and 6 months after starting Adalimumab treatment in children with CD. This study provides evidence that Adalimumab is associated with improvement in short term linear growth in children with CD who enter remission but not in those who do not. It is also more likely to happen in children who are on immunosuppression and those in early puberty but seems to be relatively independent of steroid use. These findings suggest that growth improves as a result of several interrelated factors, including improved disease control. It was also interesting to note that the growth response to Adalimumab varied dependent on the reason for discontinuing Infliximab; those who had an allergic reaction to Infliximab fared best. Chapter 5 is Longitudinal observational prospective study of changes in physical growth, IGF-1 axis, bone health, body composition, muscle function and disease activity at baseline (BL), 2 weeks (2wk), 6 weeks (6wk), 6 and 12 months (6M & 12M) following biologic therapy in paediatric patients with CD. The aim of this longitudinal observational prospective study was to assess changes in physical growth, puberty, IGF-1 axis, bone health; body composition and muscle function following biologic therapy in paediatric patients with CD. Patients either newly diagnosed or patients with long-lasting disease in clinical relapse, who started treatment with biologic therapy as part of their standard clinical management, were recruited. A non significant improvement was observed in both ∆HtSDS and HVcms/yr at 12M as compared to BL. Individually, the majority of the children experienced improvement in clinical activity and improvement of the systemic inflammatory markers. A significant increase in biomarker of bone formation bone specific alkaline phosphatase (BALP) and a non-significant increase in a biomarker of bone resorption cross-linked c-terminal telopeptides (CTX-1) was observed from BL to 12M. This observation suggests the beneficial effect of biologic therapy on bone formation. This study showed a significant change in fat mass (FM (kg) in paediatric patients with CD following biologic therapy an effect that has not been reported extensively in previously published studies. A significant change in both fat free mass (FFM (kg) and fat free mass index (FFMI(kg/m²) shows that the treatment with anti-TNF-α therapy also had a significant impact on fat mass accrual. This is the first study that charts the effect of biologic therapy on changes in lower limb muscle function using jumping mechanography in paediatric patients with CD. A non significant change was observed in jump height (m), V-max (m/s), EFI (%), efficiency % from BL to 12M following biologic therapy and a significant increase in both F-max (kN), and P-max (kW) at 12M. Despite the fact that the increase in efficiency % of the movement was not significant but however, the change was likely to be through improvements in jump height and velocity thereby indicating higher muscular flexibility. These data are suggestive of an effect of biologic therapy on lower limb muscle function through improvements in the mechanical efficiency of the muscle.
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Hartman, Jesse G. N. "Therapeutic Spaces For Veterans With PTSD." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1338353523.
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Svien, Harold Thomas. "Describing Therapeutic Relationship Change and Failure in Group Psychotherapy." BYU ScholarsArchive, 2019. https://scholarsarchive.byu.edu/etd/8570.
Повний текст джерелаАнотація:
Objectives. This study reanalyzed data from Burlingame and colleagues’ (2018) randomized controlled trial on the effect of adding Group Questionnaire (GQ) to Outcome Questionnaire (OQ-45) feedback. These data were assessed for the feedback effect using the amount of GQ alerts in one session reported by the group member to track change in GQ subscales as a measure of reversing therapeutic relationship failure.Methods. 374 participants engaged in 58 psychotherapy groups. Every participant provided GQ measurements after every group session. These GQ measurements formed ‘person-session units’ representing whether or not each type of alert was present following each group meeting. Person-session units showing one, two, and three or more GQ alerts were selected for analysis. The GQ subscales of positive bond (PB), positive work (PW), and negative relationship (NR) were tracked over the following two sessions using hierarchical linear models (HLMs) to correct for group membership and analyze slopes of change between GQ feedback and no-feedback conditions.Results. Insignificant results were shown in condition by session interactions for every GQ subscale following every specified amount of co-occurring GQ alerts. These results contrast with Burlingame and colleagues’ (2018) findings that half of all condition by session interactions shown were significant using GQ change and status alerts to trigger analyses.Conclusions. The results of this study do not appear to better discriminate the effect of adding GQ to OQ feedback for group leaders. Thus, it does not appear that group leaders can better reverse the tide of relationship failure in psychotherapy groups when there are specific numbers of GQ alerts presented to them versus the alert types offered in GQ feedback reports.
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Bailey, Kate M. "Manipulating the Tumor Microenvironment for Therapeutic Benefit." Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5175.
Повний текст джерелаАнотація:
The physical tumor microenvironment contributes significantly to carcinogenesis, cancer progression and metastatic dissemination. Two main components of the tumor microenvironment, hypoxia and acidosis, are present in nearly every solid tumor and act as powerful selection forces against the tumor. Hypoxia and acidosis promote tumor heterogeneity and contribute to chemotherapy and radiotherapy resistance. This dissertation interrogates methods to target the tumor microenvironment including two novel studies describing mechanisms of buffer therapy resistance and targeting tumor hypoxia with vasodilators to enhance the efficacy of a hypoxia activated prodrug, TH-302.
In the first study, mechanisms of buffer therapy resistance were identified and detailed. Many studies have shown that the acidity of solid tumors contributes to local invasion and metastasis. Oral pH buffers can specifically neutralize the acidic pH of tumors and reduce the incidence of local invasion and metastatic formation in multiple murine models. However, this effect is not universal as we have previously observed that metastasis is not inhibited by buffers in some tumor models, regardless of the buffer used. B16-F10 (murine melanoma), LL/2 (murine lung) and HCT116 (human colon) tumors are resistant to treatment with lysine buffer therapy, whereas metastasis is potently inhibited by lysine buffers in MDA-MB-231 (human breast) and PC3M (human prostate) tumors. In the current work, I confirmed that sensitive cells utilized a pH-dependent mechanism for successful metastasis supported by a highly glycolytic phenotype that acidifies the local tumor microenvironment resulting in morphological changes. In contrast, buffer-resistant cell lines exhibited a pH-independent metastatic mechanism involving constitutive secretion of matrix degrading proteases without elevated glycolysis. These results have identified two distinct mechanisms of experimental metastasis, one of which is pH-dependent (buffer therapy sensitive cells) and one which is pH-independent (buffer therapy resistant cells). Further characterization of these models has potential for therapeutic benefit.
In the second study, improving the efficacy of hypoxia activated prodrug, TH-302, through induction of hypoxia was investigated. Pancreatic ductal adenocarcinomas are desmoplastic and hypoxic tumors, both of which are associated with poor prognosis. Hypoxia activated prodrugs, such as TH-302, are specifically activated in hypoxic environments and are now in a Phase III clinical trial in pancreatic cancer. Using animal models, we show that tumor hypoxia can be exacerbated using a vasodilator, hydralazine, improving TH-302 efficacy. Hydralazine reduces tumor blood flow through the "Steal" phenomenon, where atonal immature tumor vasculature fails to dilate in coordination with normal vasculature. The current study shows that MiaPaCa-2 tumors exhibit a "Steal" effect in response to hydralazine, resulting in decreased tumor blood flow and subsequent tumor pH reduction. The effect is not observed in SU.86.86 tumors with mature tumor vasculature, as measured by CD31 and smooth muscle actin (SMA) immunohistochemistry staining. Combination therapy of hydralazine and TH-302 resulted in a reduction in MiaPaCa-2 tumor volume growth after 18 days of treatment. Further optimization of hypoxia-inducing agents and dosing regimens may lead to increased TH-302 activity, potentially improving clinical outcome.
The data presented here demonstrate methods to effectively target the tumor microenvironment for therapeutic benefit. Further investigation into mechanisms of action and biomarkers for therapy response may have important implications on clinical treatment regimens for cancer patients.
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Williams, A. E. "An interpretive phenomenological study of user experiences of therapeutic footwear." Thesis, University of Salford, 2008. http://usir.salford.ac.uk/2080/.
Повний текст джерелаАнотація:
Therapeutic footwear is provided to patients with the primary aims of reducing foot pain and improving foot health. Therefore, it is of concern that patients choose not to wear it. This choice has been attributed to its poor appearance. However, there may be other reasons for this choice and the reasons may be more complex than previously acknowledged. Therefore, the aim of this study was to investigate the users’ experiences of this footwear. In the context of this study the ‘users’ are women with rheumatoid arthritis. This study was based on an interpretive phenomenological approach (IPA) that employed conversational style interviews to gather data. Ten women with RA and experience of wearing the footwear were recruited and following ethical approval the interviews were carried out, transcribed, organised and analysed. Five organising themes emerged as findings. These were the participants: • feelings about themselves, • feelings about the footwear, • unmet needs and expectations, • behaviour with the footwear and • feelings about the consultation with the practitioner. The final, global theme was that the patient/practitioner consultation has a powerful influence on the women’s feelings about themselves, the footwear, their expectations of it and their behaviour with it. This study has provided insight into their experiences of this footwear in that, unlike any other intervention, it replaces something that is normally worn and is part of an individual’s perception of self and their perception of how others see them. The footwear impacts more on women’s emotions than previously acknowledged and in addition, it has been found that the consultation influences their emotions and behaviour with the footwear. As well as improvements in footwear design and the service that delivers it, the training of the practitioners in a more patient focussed consultation style could improve the women’s experience and engagement in the footwear as a health intervention, as well as something that is ‘worn’.
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Spandler, Helen. "Asylum to action : Paddington Day Hospital, therapeutic communities and beyond." Thesis, Manchester Metropolitan University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247203.
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Kangas, Beth E. "Therapeutic itineraries in a global world: Yemeni biomedical treatment abroad." Thesis, The University of Arizona, 1996. http://hdl.handle.net/10150/292064.
Повний текст джерелаАнотація:
This study examines various sites of international travel for medical care. Focusing primarily on Yemenis' medical travel to Jordan and other countries, the study explores a variety of issues and experiences of care-seeking abroad. Topics covered include state and institutional support for treatment outside the country, linkages between countries that facilitate movements, medical travellers' funding and logistical decisions, and therapeutic reputations leading to destination selection. The following examples of medical travel are also considered: the special receptions of Arab royalty, an advanced care facility in Scotland, and organ donors and recipients. This study is set within a context of increasing globalization, where advances in medical procedures and devices, communication, and transportation all contribute to people's ideas about where to go for medical care.
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Forman, D. "Shared learning : monitoring the attitudinal changes of staff and students on undergraduate health care professional programmes." Thesis, Sheffield Hallam University, 2000. http://shura.shu.ac.uk/19656/.
Повний текст джерелаАнотація:
The aim of this investigation was to monitor attitudinal changes of staff and students participating in undergraduate professional programmes to the implementation of shared learning over a four-year period. The programmes being studied were the BSc. Occupational Therapy, BSc. Diagnostic Radiography and BSc. Therapeutic Radiography Honours degrees. Each validated programme contained some syllabus areas that were taught together i.e. were shared across the professions. Initially, after a review of the existing literature on this issue, a questionnaire was designed as a research tool to enable both qualitative and quantitative data to be collected and analysed. The quantitative sections of the questionnaire were checked for reliability throughout the four years and achieved positive Cronbach Alpha results ranging from .7083 to .8984 in the four main concepts under investigation, namely the Pitfalls, Benefits, Curriculum Aspects and Social Aspects of the shared programmes. Over the four year period a total of 418 student questionnaires were collected and analysed. In addition to the quantitative data collected, qualitative data were also collected from the questionnaire from extracts of the minutes of Course Committee and Examination Board meetings and from videos of tutorials and seminars. All of these were analysed. The results showed fluctuations in the attitudes of both staff and students to shared learning over the four year period, but all those who participated showed a net favourable change in attitude by the end of the research investigation.
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Farrelly, Simone. "Therapeutic relationships in community mental health : the impact of the Joint Crisis Plan intervention." Thesis, King's College London (University of London), 2013. https://kclpure.kcl.ac.uk/portal/en/theses/therapeutic-relationships-in-community-mental-health(522a86f6-0fbd-463a-8b4f-cb706078f541).html.
Повний текст джерелаАнотація:
Policy and professional guidance in England have emphasised the importance of Therapeutic Relationships (TRs) in community mental health care, yet there is no comprehensive model to guide practice or understand the process through which stronger TRs are generated. This thesis investigated TRs in community mental health for individuals with psychotic disorders and was embedded within the CRIMSON trial: a randomised controlled trial of the Joint Crisis Plan (JCP) intervention. JCPs contain service users’ treatment preferences for future care, which are jointly decided with clinicians. Qualitative analyses addressed participants’ views of TRs and JCPs. Quantitative analyses addressed the predictive utility of TRs for outcomes, associations of TRs and the effect of JCPs on service user and clinician-rated TR. Results suggested that significant ambiguity persists regarding what can and should be provided in community mental health, resulting in unhelpful experiences for service users and clinicians. A new model of TRs - Consistent Respect - was developed; it presents TRs as bi¬directional processes, jointly affected by clinicians’ and service users’ experiences of interactions and their roles defined by the wider context; the latter often being a barrier to the development of strong TRs. JCPs significantly improved service users’ appraisals of TRs by providing a structured protocol through which routine role enactments were limited and clinicians could demonstrate Consistent Respect. Positive effects were lost when there were deficiencies in the implementation of JCPs and/or engagement of clinicians. In conclusion, improving TRs through JCPs could facilitate better outcomes and more satisfactory treatment experiences for service users and clinicians. Changes in policy and practice are indicated to facilitate transparent goals and roles for clinicians and respectful interactions with service users.