The purpose of this study was, first, to further our understanding of the experience of dying in a long-term care (LTC) facility from the perspective of family members and second, to identify the relationships between the various factors which may influence satisfaction with end-of-life care. Using a sequential mixed methods design, a convenience sample of 87 family members completed a survey interview using a modified version of the Toolkit of Instruments to Measure End-of-life Care (TIME) Nursing Home Version in the first phase of the study. Findings from the parametric and non-parametric analyses indicated that family satisfaction with end-of-life care was best predicted by contact and communication with nursing staff, feeling that care provided at the end of life met expectations, staff providing consistent care, feeling that the health care aide listened to their concerns about care and that respondents felt they had received enough emotional support. Being transferred to hospital in the last month of life, dying in a place other than the LTC facility, and respondent age and employment status were all associated with significant mean differences in satisfaction scores. In the second phase, three focus groups were conducted to further explore areas of satisfaction and dissatisfaction with end-of-life care. Focus groups provided confirmation of the findings of the first phase of the study and were instrumental in developing a list of ten recommendations for improvements in end-of-life care delivery. Recommendations for future research are made based on the study results.

This study set out to evaluate a small scale model of care for people with dementia that aimed to support residents within a daily household routine (termed household care). Stemming from a pluralistic evaluation, this thesis examines issues identified as important to residents' experience, namely the ability of the care houses to provide a home for life, the process and effectiveness of recreating a homely environment and the implications of group-living. Three case studies were investigated with multiple methods, including semi-structured interviews with staff, relatives and representatives of managing agencies, structured observation and assessment of dependency. Respondents believed care housing was superior to its alternatives and attributed perceived improvements in residents' well-being to the nature of staff support and the 'homely' setting. Agency representatives were preoccupied with their relationships with each other and how to sustain and expand this model of care. Staff focused on the nature and conditions of the work. Kin were keen that residents should settle and stay in the care houses. Residents' support needs at least matched entry criteria but over half had to move out to hospital because of physical illness and behavioural problems. This study suggests that it was very difficult for residents to accept the houses as 'home'. Residents' and their relatives' participation was, in practice, limited but one house was particularly successful in implementing household care; reasons are suggested for this. Residents' interactions with each other seemed to be increased by household care but their relationships were influenced by a number of factors, including the presence of dementia. The latter exacerbated the tensions of group-living. The challenge for care houses was to sustain care as dementia progressed and extend good quality care to those with more substantial behavioural and physical support needs.

The respiratory system is attentive, adaptive, learns and has memory. The respiratory system remembers repeated respiratory challenges to fine tune its motor activity by modulating neuronal synaptic strength. This phenomenon, respiratory long term facilitation (LTF), functions to strengthen the ability of respiratory motor neurons to enhance contraction of breathing muscles. LTF could serve as a protective mechanism against obstructive sleep apnea, a disease characterized by the collapse of upper airways, by restoring upper airway patency. LTF can be induced through modulation of vagal afferent feedback via repeated apneas. Here, we used reverse microdialysis, electrophysiology, neuropharmacology, and histology to determine if the nucleus of the solitary tract (NTS), a brain region exclusively receiving vagal afferents, is the origin of the neural circuit responsible for apnea-induced plasticity. My work shows bilateral injection of 5% lidocaine into the NTS prevented LTF. We conclude the NTS is required for triggering apnea-induced LTF.

The respiratory system is attentive, adaptive, learns and has memory. The respiratory system remembers repeated respiratory challenges to fine tune its motor activity by modulating neuronal synaptic strength. This phenomenon, respiratory long term facilitation (LTF), functions to strengthen the ability of respiratory motor neurons to enhance contraction of breathing muscles. LTF could serve as a protective mechanism against obstructive sleep apnea, a disease characterized by the collapse of upper airways, by restoring upper airway patency. LTF can be induced through modulation of vagal afferent feedback via repeated apneas. Here, we used reverse microdialysis, electrophysiology, neuropharmacology, and histology to determine if the nucleus of the solitary tract (NTS), a brain region exclusively receiving vagal afferents, is the origin of the neural circuit responsible for apnea-induced plasticity. My work shows bilateral injection of 5% lidocaine into the NTS prevented LTF. We conclude the NTS is required for triggering apnea-induced LTF.

Typescript. / Thesis (D.P.H.)--University of Hawaii at Manoa, 1987. / Bibliography: leaves 174-182. / xvii, 182 leaves, bound ill. 29 cm

GABAergic interneurons in the basolateral complex (BLC) of the amygdala are a part of the emotional-learning circuitry of the brain and receive excitatory inputs from all sensory modalities via cortex and thalamus. Although the BLC, which is made up of the lateral amygdala (LA), basal amygdala (BA) and accessory basal nucleus, is under the influence of a strong inhibition brought about by local interneurons, little is known about the diversity, characteristics and functioning of these interneurons. In this study, I have characterised the BLC interneuron population using a transgenic mouse model in which enhanced green fluorescent protein has been tagged to the GAD67 promoter. This promoter is specifically expressed in all GABAergic interneurons, enabling us to visualise interneurons under UV light. Whole-cell recordings were made from GAD67 interneurons in the BLA to study their membrane and synaptic properties. On the basis of their firing properties, interneurons in the BLC were classified into six distinct groups. The calcium-binding proteins calbindin, calretinin and parvalbumin were found to be expressed differently in the LA and BA interneurons, with the majority of the interneurons in the LA expressing calretinin, whereas those in the BA mostly expressed parvalbumin. We also found diversity in the expression of postsynaptic glutamate receptors in the BLC. Long-term potentiation induced at the interneurons was specific to the cortical inputs in the LA. LTP was expressed only in interneurons that either lacked NMDA receptors or had NMDA receptors with fast decay kinetics. This form of LTP was mediated by calcium-permeable AMPA receptors and required a postsynaptic calcium rise for its induction This study shows that the interneurons in the BLC are a heterogenous population with respect to the expression of calcium-binding proteins, axonal morphology, synaptic and membrane properties. This heterogeneity in interneuron population may be essential for the specialised roles various types of interneurons play in the functioning of the amygdala and in emotional learning.

This thesis examines the impact of announcements of syndicated loans on the share prices of borrowing firms. I use a sample of 5,465 loan observations reported in the International Financing Review Platinum database to study this impact. Event study methodology is used. My overall results show significantly positive wealth effects on the borrowing firms. However, when I partition my data set into revolving credit agreements, term loans and hybrid loans, I find that the results are driven primarily by revolving credit agreements. I also observe that the size of the event window plays an important role in identifying the wealth effects for the borrowers. A five-day event window (-2, +2) shows share price response to revolving credit announcements to be significantly positive. A three-day event window (-1, +1) reveals that announcements are statistically positive for revolving credit agreements and statistically negative for term loan announcements. My results are consistent with previous studies in this area. I also distinguish between financial press announcements and information provider (IFR) announcements to cater for the potential for reporting bias. I find that both the IFR and financial press announcements are significant for the five-day window, but only the financial press results are significant for the three-day window. My study is unique in that I differentiate the impact of different sources of information on the market reaction to borrower share price. In addition to the examination of the wealth effect, I also use the structure of the loans to examine the uniqueness of bank loans and their ability to provide financial slack. Specifically, I examine whether revolving credit loans or term loans or hybrid loans make bank loans unique and their ability to provide financial slack. I observe that out of the three structures of bank loan, only revolving credit loans allow the borrower to more precisely match the funds acquired with the firm’s investment needs and to market time by borrowing at times when financing costs are attractive. Revolving credit loans are positively valued by the market both initially and over the longer term. Bank loans reduce information asymmetry, but the renegotiation characteristics of revolving credit loans allow borrowers to exploit changes in the interest rate environment, thus providing support for the market timing theory of capital structure. In contrast to puzzling results of previous studies, I present evidence of long-term positive performance following bank loans.

Thesis (M.S.)--University of North Carolina at Greensboro, 2007. / Title from PDF t.p. (viewed Mar. 11, 2008). Directed by Jennifer L. Etnier; submitted to the School of Health and Human Performance. Includes bibliographical references (p. 40-43).

Thesis (Ph.D.)--Memorial University of Newfoundland (Canada), 2007. / Includes bibliographical references.

Thesis (Ph. D.)--University of Louisville, 2009. / Department of Leadership, Foundations, and Human Resource Education. Thesis (Ph. D.)--Western Kentucky University, 2009. College of Education and Behavioral Sciences. Vita. "May 2009." Includes bibliographical references (leaves 118-124).