This thesis proposes a new conceptual framework for studying functional consequences of disease, the Activity Space model of disability, and describes the development and empirical validation of a new disability measure for patients with back pain, the Quebec Back Pain Disability Scale. / The scale has been developed in several stages, including a literature review, two studies seeking the opinions of patients and experts, pilot testing, and a large, longitudinal study of back pain patients. / After an extensive analysis of 48 items that were initially selected, a final, 20-item disability scale was derived. The scale assesses the level of difficulty in simple daily activities. It has a clear theoretical orientation, is acceptable to patients, reliable, empirically valid, responsive to change, and able to discriminate between individuals over a wide range of disability levels. The scale can be recommended as an outcome measure in clinical trials and other studies of back pain patients.

<p> Obesity in the United States should be of great concern to all Americans. The rates of obesity among children and adolescents have been on the rise, demonstrating the need for action now. Obesity at a young age can lead to obesity into adulthood, thereby also increasing the risk of health issues such as the development of high blood pressure and diabetes. Many factors go into play when dealing with obesity, yet the factors that will be considered in this study are the effects of decrease activity and the impact of BMI of a child or teen. Another factor that will be consideed in this study is the consumption of sugar sweetened beverages and how this also affects a child or teens BMI.</p>

<p> Although clinical trials are essential for the development of cancer treatments, only approximately 3% of cancer patients in the U.S. participate in them. While 55% of these patients are enrolled in cancer clinical trials through community-based practices and around 80% of all cancer patients are seen at this type of practice, there is a lack of knowledge about the enrollment barriers at these sites. This study evaluates enrollment barriers at a community-based cancer clinic at the levels of the investigative site, healthcare provider, and patient. Barriers to enrollment and strategies to increase enrollment are evaluated through historical data analyses and results from a survey assessing the opinions of healthcare providers on enrollment and research practices. </p>

In this study we have shown that translocation of intestinal LPS into the portal and systemic circulatory systems during graft-versus-host disease (GVHD) is predictive of morbidity and mortality. Randomized C57BL/6 x AF1 (B6AF$ sb1$) mice were injected with C57BL/6 (B6) lymphoid cells and sacrificed at predetermined times after transplantation for bacterial lipopolysaccharide (LPS) tissue analysis. The liver, the spleen and the sera from some acute GVH reactive mice first tested positive for LPS from day 2, 4 and 16 post transplant, respectively. Total hepatic and splenic LPS in acute GVH reactive mice peaked, and LPS was first detected in the sera of these same animals, at a time coincident with the onset of mortality. These results show that LPS is present to initiate tumour necrosis factor alpha (TNF-$ alpha$) release from interferon gamma (IFN-$ gamma$) primed macrophages, resulting in the manifestations of acute GVHD.

Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2007. / Source: Dissertation Abstracts International, Volume: 68-11, Section: A, page: 4523. Adviser: Carole L. Palmer. Includes bibliographical references (leaves 292-315) Available on microfilm from Pro Quest Information and Learning.

Thesis (Ph.D.)--University of California, San Francisco, 2010. / Source: Dissertation Abstracts International, Volume: 71-02, Section: A, page: . Adviser: Adele E. Clarke.

Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2008. / Source: Dissertation Abstracts International, Volume: 69-05, Section: B, page: 2883. Advisers: Karl Rosengren; Elizabeth Hsiao-Wecksler. Includes bibliographical references (leaves 133-142) Available on microfilm from Pro Quest Information and Learning.

Cam femoroacetabular impingement (FAI) is caused by decreased concavity of the femoral head-neck junction which results in a jamming of the proximal femur into the acetabulum within normal range of motion (ROM). This condition is known to decrease hip ROM, and has been reported to cause hip pain in a variety of daily activities including sitting and walking, and activities requiring large hip mobility. It is important to determine the effect of cam FAI on self-generated dynamic ROM and common daily activities in order to ascertain its influence on hip functionality. This study measured the effect of cam FAI on total dynamic hip ROM, and the biomechanics of the hip and pelvis during walking, sitting, standing and maximal depth squats. A cam impingement group (n = 17) was compared to a matched control group (n = 14) using between-group one-way ANOVAs. The level of variability for sitting and standing strategies was also compared between the two groups using F-tests. For maximal dynamic hip mobility, the FAI group had a decreased flexed internal rotation, external rotation and total transverse ROM, as well as decreased hip abduction and total sagittal ROM compared to the matched control group. For walking, the FAI had significantly lower peak hip abduction, frontal ROM, and sagittal ROM than the controls, as well as attenuated pelvic frontal ROM. Reduced hip mobility during gait may be caused by soft tissue restriction, and FAI participants may have decreased pelvic mobility in the frontal plane. For the sit-to-stand and stand-to-sit manoeuvres there were no significant differences in peak kinematic or kinetic values of the hip and pelvis between the two groups. However, the cam FAI group had significantly higher variability in peak angles in the frontal plane, and peak hip extension moments of force during both sitting and standing. This likely resulted from the FAI group having varying sit and stand compensatory strategies. For the 2 maximal depth squat the FAI group had decreased sagittal pelvic range of motion and could not squat as deep as the control group. Limited pelvic ROM in FAI patients reduces their capacity to perform motions requiring large amplitudes at the hip joint such as maximum squat. Restricted pelvic sagittal ROM could represent a key factor in the pathomechanics of FAI.

Improving the quality of care provided by the U.S. healthcare system is an important societal goal. Policymakers who wish to operationalize this goal must navigate an increasingly polarized health policymaking environment. In this dissertation, I examine three stakeholders who can influence this environment: the public, state governors, and health care providers. In Chapter 1, I explore attitudes of and experiences with health care quality among Democrats and Republicans. Relying on a national survey of 1,508 American adults, I find that regardless of having a recent medical issue, Democrats express greater concerns about national quality of care problems relative to Republicans. At the same time, I find no difference in their personal experiences with quality of care received while hospitalized or with healthcare providers. In Chapter 2, I examine how gubernatorial candidates treat health policy in the 2012 and 2014 elections given the states’ increasing role in ACA implementation, which can collectively impact the quality of care provided nationally. After generating a novel database of all gubernatorial candidates’ campaign websites, I summarize the presence of healthcare content, framing of health system problems, and issue engagement with the ACA and its key coverage provisions in these two elections. I find the majority of gubernatorial candidates discuss health policy but are selective in their focus. Republicans, who are more likely than Democrats to express their views specifically regarding the ACA (which they nearly all refer to as “Obamacare”), won the majority of these 47 gubernatorial seats. Winning candidates from both parties discussed the Medicaid expansion decision of their state, with some expressing intentions to reverse course relative to their current expansion status. In Chapter 3, I examine a trend expected to grow under the ACA: hospital-physician integration. Using national hospital and Medicare data from 2003-2012, I document the rise of hospital employment of physicians and examine whether or not this yields improvements in mortality, readmission rates, length of stay or patient satisfaction. Though I find that a plurality of hospitals now enter into employment relationships with physicians, this study provides no evidence that these changes are associated with improvements in quality of care. / Health Policy

Mirror drawing is a challenging task because appropriate hand actions must be planned and directed despite receiving visual feedback that is reversed by the mirror. The purpose of this study was to investigate whether visual transformation impacts the timing and spatial variability of explicitly and implicitly timed bimanual drawing tasks differently. To examine these issues, ten healthy participants bimanually drew various template shapes (circles, lines, vertical triangles and horizontal triangles) under normal (untransformed) and mirror-reflected vision conditions. Drawing movements were paced by a metronome and all templates were drawn in both symmetrical and asymmetrical coordination modes. Our results show that mirror feedback increased timing errors on implicit timing tasks but not explicit timing tasks. Mirror feedback also resulted in greater spatial variability and decreased interlimb coordination. These results provide insight into the role of visual information in the timing and performance of different types of bimanual drawing tasks.