Thesis (M.S.)--Boston University

Down's syndrome (DS) is a congenital disorder caused by trisomy of chromosome 21, giving rise to symptoms including intellectual disability, poor muscle tone and characteristic facial features. Located on chromosome 21 is a gene encoding ubiquitin specific protease 25 (USP25), a member of the deubiquitinating family of enzymes. Studies of partial trisomies have revealed that although the USP25 gene is situated outside the critical region of chromosome 21 required to be triplicated to induce full DS symptoms, it is in a region linked to mild mental retardation and muscle hypotonia. Previous data has shown that, when overexpressed, USP25 forms novel rod shaped structures approximately 3-5 μm in length and 0.3-0.6 μm wide, and with a copy number, on average, of no more than 1-2 per cell. These structures do not associate with any known cellular organelle or with any component of the cytoskeleton. In this work, endogenous USP25 rods were detected in cultures of primary human foetal astrocytes, and a comparison of healthy and DS human primary foetal astrocytes revealed that in the DS culture a higher percentage of astrocytes contain rods. The domains of USP25 required for rod formation were identified using a series of GFP-tagged deletion constructs. USP25 rods could be purified from HEK293 cells using subcellular fractionation techniques and were assayed for deubiquitinating activity; however, none was detected suggesting that rods may be catalytically inactive. Interacting partners of USP25 were identified using mass spectrometry, but none were found to localise in rods. Additionally, a USP25 null human embryonic stem cell line was generated in order to interrogate the function of USP25 in astrocytes, and was found to be deficient in maintaining the integrity of an epithelial cell layer in an in vitro model of the blood brain barrier.

The purpose of this study was to determine whether differences in health beliefs exist between participants attending worksite prenatal education classes and participants receiving only prenatal education self-help materials. A multiple treatment study was performed on a sample of convenience of 169 women enrolled in Fruit of the Loom's worksite prenatal education program. Group 1 subjects received class and materials while Group 2 subjects received materials only. Study participants were asked to complete an 18-item Likert scale questionnaire prior to enrolling in the program and again upon completion. Sixty-two subjects completed both the pre- and posttest questionnaires. Analysis of covariance comparing posttest scores between groups using the pretest score as a covariate revealed no significant difference. Results from t test analysis on the questionnaire items revealed significant change in three of the items concerning importance of prenatal care, knowledge of healthy food choices, and abstinence from smoking.

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Thesis (M.S.)--University of Wisconsin--Madison, 1993 / Typescript. Includes bibliographical references (leaves 81-85).

Antibiograms are aggregates of susceptibility testing data of pathogens over a period of time. Bacteria are cultured from infected patients. Once identified, a pathogen undergoes testing against common antibiotics, indicating the effectiveness of specific antibiotics to the pathogen identified. This data gives clinicians an understanding of which antibiotics face increasing resistance in their communities. This project involved the development of a pediatric outpatient antibiogram which was compared against a regional inpatient pediatric antibiogram. The goal was to identify a significant difference in susceptibility between inpatient and outpatient pediatric infections. All urine cultures ordered within the ETSU Health pediatrics department over the course of 1 year between September 2018 and September 2019 were examined. There were 251 such cultures, of these 52 were abnormal, and required antibiotic treatment. All abnormal urine cultures were examined for pathogen identity, and susceptibility data. Pathogens were stratified by species and their susceptibility to commonly utilized antibiotics was aggregated and expressed as a percentage. This analysis did not distinguish between intermediate and resistant strains of bacteria, both results were marked resistant. There were 3 patients that presented with repeat cultures. Two of these patients presented with a single species of bacteria on follow-up cultures, and subsequent samples were excluded. One patient presented with two different urine cultures at different points in the year, and both samples were included. When stratified based on species, only E. Coli, with 30 unique samples, presented enough statistical power for analysis. We compared community and hospital pediatric antibiograms and found no statistical difference in susceptibility in E. Coli. However, analysis showed significant difference between both pediatric antibiograms and the inpatient adult antibiogram. We found significant difference in susceptibility between samples for ampicillin 11%, ampicillin-sulbactam 34%, tetracycline 21%, levofloxacin 21%, and Trimethoprim-sulfamethoxazole 12%. The adult antibiogram demonstrated lower susceptibility against all of these antibiotics. Additional research is necessary in this area. Based on this analysis, we cannot recommend pediatric community antibiogram creation. However, the differences observed between adult and pediatric antibiograms indicate a utility for continued stratification of antibiograms by age.

Mortality and morbidity due to low birth weight and pre-term birth are high, especially in developing countries where resources and qualified neonatal staff are scarce. There is a need to find measures that reduce the cost of care for low birth weight and pre-term babies without sacrificing quality. Conventional methods of care, where infants are exclusively cared for by the nursing staff using incubators, are very costly. In addition~ morbidity and mortality are adversely affected by some conventional low birth weight care procedures and better means of care are needed to avoid these extra risks. It is therefore important to find a substitute for conventional care without putting infants' lives in danger. The Kangaroo Mother Care (KMC) method could be a viable solution, since it addresses many of the problems encountered with the conventional method. KMC is the practice of caring for low birth weight neonates by keeping them in skin-to-skin contact with their mother's chest. The length of time that the infants are placed in this position can vary from a few hours a day, to 24 hours a day. KMC provides warmth and care; it promotes bonding, breastfeeding and early discharge. Published studies of this method also indicate that KMC decreases mortality and costs while improving health outcomes. Much research has been done on the use of KMC with low birth weight children in different settings, but less has been done on its practice from the mother's point of view. This study explores the quality of the mothers' experiences with KMC in the East London Hospital Complex, consisting of the Cecilia Makiwane Hospital (CMH) and the Frere Hospital (FH), where it has been practised since July 1999. The aim of the study was to identify factors that influenced mothers' knowledge, attitudes and opinions regarding the practice of KMC. In order to make recommendations for improving the quality of KMC practice, the study also examines hypotheses that (1) Mothers' receptivity and responsiveness are critical to the implementation and practice of KMC and (2) Mothers receptivity and responsiveness are affected by (a) education and information, (b) nature and levels of support, and (c) general hospital conditions. In-depth interviews were conducted with thirty mothers in the East London Complex. Twenty participants were at CMH and ten at FH. One participant at each hospital was practising intermittent KMC. The findings of this qualitative study demonstrate clear consensus for the questions posed. The findings confirmed that KMC was positively received by mothers in a public hospital setting in South Africa but in order for the practice of KMC to be successful, attention should be paid to the following: (a) information received early and effectively, (b) KMC support in hospital and at home after discharge (c) improvement of hospital conditions. Recommendations based on these findings are included to improve the practice of KMC in hospital and at home after discharge.

The relationship between involvement in children's health care, the moderating effects of parenting beliefs between involvement and child health status and use, and the mediating effects of family integrity in fathers' involvement and child health were examined in two separate studies. The first study includes 760 fathers from a national survey project. Involvement, parenting beliefs, and demographic variables were used to predict child health and health use. Fathers' residency status was correlated with the number of times the doctor was consulted and predicted the child's height-to-weight ratio. Participation in fun activities and shopping was associated with sickness and child height-to-weight ratio. No moderation effects were found for parenting beliefs. The second study uses a mixed methods design to which fathers' perceptions of involvement, motivations, barriers, and support by their child's mother are examined qualitatively. The associations between father demographic variables, barriers to attendance, family integrity, and modernity in predicting involvement are and child health status are tested. The mediating effects of family integrity between involvement and child health were also studied quantitatively. Seventeen fathers were included in the qualitative analysis. Fathers perceived that participation in their child's health care is important and felt supported by their child's mother. Barriers to involvement included work-related difficulties and a poor relationship with their child's mother. A total of 52 fathers were included in the quantitative analysis. Fathers' biological relationship to the child was associated with involvement. Additionally, family integrity and parenting beliefs predicted involvement. No evidence was found for mediation effects of family integrity between involvement and child health. These results have implications for community programs and practitioners with the aim of improving child health. / Ph. D.