Thesis (Ph. D.)--Case Western Reserve University, 1999. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--Case Western Reserve University, 1999. / Includes bibliographical references.

Thesis (M.S.)--University of Wisconsin--Madison, 1972. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Introduction: Older persons usually suffer from multiple chronic disorders and consequently use more medications than younger adults and often polypharmacy. Polypharmacy is, unfortunately, one of the risk factors for negative outcomes in the old age. The aim of this diploma thesis was to summarize by narrative literature review the negative outcomes of polypharmacy in older adults documented in pharmacoepidemological studies published between 2005 and 2015 years. The outputs of this diploma thesis create part of results of the research subgroup "Aging and Changes in the Therapeutic Value of Medications in the Aged" (Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles Univerzity) and the EU COST Action initiative IS1402 (2015-2018). Methods: Using datasets of Web of Science, PubMed and Embase, the narrative literature review was conducted in the period 2014 - 2015, in which we summarized outcome studies dealing with negative outcomes of polypharmacy in older patients published between 2005- 2015 years. Key words for the literature review were: "seniors, older patients, elderly, older age, polypharmacy, polymedication, multiple drug use, negative outcomes, impact, hospitalization, mortality, averse reactions, averse drug events, costs, expenditures. We identified 563 studies...

We used a combined multi-element, ABCBC reversal design to examine whether qualities of various negative reinforcers can be assessed under progressive-ratio schedules. Two adults with disabilities participated in this study. We assessed five sounds three times using progressive-ratio schedules to obtain mean break points for each stimulus and ranked negative reinforcers according to their mean break points. We called the stimulus with the highest mean break point the high-quality escape (HQE) stimulus and the stimulus with the lowest break point the low-quality escape (LQE) stimulus and examined responding according to different schedules of reinforcement for each stimulus: FR2, FR4, and FR8 for Jenny and FR1 and FR11 for April. We identified preferred and nonpreferred sounds for both participants.We observed differential responding for both participants between preferred and nonpreferred sounds. We observed differential responding between HQE and LQE stimuli for April but not for Jenny; a larger range in break points was observed for April. These results demonstrate a method to identify preferred and nonpreferred sounds and provide support for the possibility of using progressive-ratio schedules to rank negative reinforcers of various qualities.

Quelle que soit la nature des ondes utilisées et des milieux traversés, le contrôle de la propagation ondes est d'un intérêt majeur pour de nombreuses applications. D'une part, la complexité du milieu peut être exploitée en exerçant un contrôle cohérent du front d’onde incident. D'autre part, on peut forcer une onde à se propager suivant un chemin désiré en concevant soi-même le milieu de propagation. Dans cette thèse, nous étudions ces deux aspects à partir d'expériences ultrasons-laser mettant en jeu la propagation d'ondes de Lamb dans des plaques.La propagation des ondes à travers un milieu diffusant est tout d’abord étudiée à partir de sa matrice de diffusion. Une prédiction théorique importante est l’existence de canaux de propagation totalement ouverts ou fermés. Une première partie de ces travaux consiste à démontrer expérimentalement ce résultat en mettant en évidence la possibilité de transmettre totalement une onde à travers un milieu désordonné. Dans un second temps, la mesure d’une matrice des temps de vol nous permet d’étudier ces canaux dans le domaine temporel. Ceux-ci donnent lieu à des paquets d’onde dont la cohérence spatiale et temporelle est conservée tout au long de leur propagation dans le milieu.Le second volet de cette thèse consiste à tirer profit des phénomènes de réflexion et réfraction négative afin de contrôler la propagation des ondes de Lamb. D’une part, la réflexion négative est mise à profit pour réaliser une conjugaison de phase passive des ondes de Lamb. D’autre part, le concept des milieux complémentaires est exploré afin d’annuler la diffraction des ondes et ainsi camoufler certaines zones du milieu de propagation. / Whatever their nature or the propagation medium, controlling the propagation of waves is of fundamental interest for many applications. On the one hand, one can tame wave-fields in order to take advantage of the complexity of the medium. On the other hand, one can force waves along desired paths through a careful design of manmade materials. In this thesis, we study those two aspects on the basis of laser-ultrasonic experiments involving the propagation of Lamb waves in elastic plates.The control of wave propagation through complex systems is first investigated by means of the scattering matrix approach. In diffusive media, theorists have demonstrated the existence of propagation channels either closed or open through which the wave can travel. The first part of this work present a direct experimental evidence of this result as well as the ability to fully transmit a wave through a disordered medium. In a second part, the measurement of the time-delay matrix allows the study of such channels in the time domain. They are shown to give rise to particle-like wave packets that remain focused in time and space throughout their trajectory in the medium.The second part of this thesis consists in studying the concepts of negative reflection and refraction for the manipulation of Lamb wave propagation. On the one hand, negative reflection is taken advantage of to perform a passive phase conjugation of Lamb waves. On the other hand, the notion of complementary media is investigated in order to cancel the diffraction of waves and cloak some areas of the plate.

Sleep problems are common among college students and are associated with numerous negative outcomes including anxiety, depression, executive dysfunction, and poor academic performance. When sleep is limited, individuals may suffer impaired cognitive capacities, such as reduced memory and difficulty focusing attention. Difficulty with these cognitive functions can result in difficulty disengaging from negative thoughts, thereby contributing to negative mood. Poor sleep contributes to negative mood states, but few studies have examined in what way poor sleep may exacerbate negative mood. The purpose of this study was to examine cognitive factors as explanatory variables between sleep and state affect. Participants were undergraduate students from a university in the Midwest. Participants (N = 150, completed baseline questionnaires and wore an actigraphy watch for one night. They returned to the lab the following day to complete additional self-report measures and a computerized cognitive control task. Participants were primarily female (66.67%, n = 100) and white (67.33%, n = 101). To test the hypothesis that the relationship between sleep and affect is explained by cognitive factors, a path analytic model was fit to the data. It was hypothesized that cognitive factors (i.e., Posner task performance, repetitive negative thinking, and self-report attention control) would explain the relationship between sleep (as measured by objective total sleep time and self-report sleepiness) and state affect. The hypothesized model yielded poor global and local fit to the data. While several direct effects emerged in the model, no indirect effects were statistically significant. The model was re-specified, adding paths where large magnitude correlational residual statistics coincided with statistically significant standardized residual statistics. The final model yielded good global and local fit to the data, with primary modifications being added covariances among control variables (e.g., GAD-7 and PHQ-8 scores) with cognitive factors. Overall, the results of this study indicate that the relationship between sleep and next-day affect is complex and cannot be simply explained by cognitive factors. However, the current study found several significant relationships among study variables, suggesting that sleep, cognitive functioning, and emotion are highly related constructs that warrant further study. Future research should examine alternative models incorporating these constructs to find a comprehensive model with utility that can explain the relationships among these constructs.

Published Article / The LPS, endotoxin of Gram-negative organisms in communal growth as compared to pure culture was the focus of this research. The experiment aimed to show pure and communal samples grown in the presence of the extrinsic stresses. The change in toxicity was measured using the Limulus Amoebocyte Lysate (LAL) test. The overall sensitivity of organisms was similar for the same sanitiser and the same detergent. Growth in community was found not to be the arithmetic sum of the individual growth patterns. The detergents had a marked effect on the growth of all samples throughout the growth cycle. This finding reveals that the acceptable refrigeration temperatures still allows for pathogen growth and thus for biofilm formation. The quantification by LAL showed that the enumeration of the food-borne pathogens isolated from households might not be indicative of acclimatisation obtained over short periods of time and the causal stress could turn these organisms into more or less toxic pathogens.

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