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Clinical Issue Health Canada recommends exclusive breastfeeding for the first 6 months post birth and then the addition of complementary foods with breastfeeding extending to a minimum of two years. Breastfeeding initiation rates in Canada are currently at around 87% but, by one month, about 21% of women have stopped breastfeeding. Engorgement and edema in breast tissue can lead to breastfeeding challenges which may contribute to early weaning. Purpose The purpose of this pilot research study was to explore the relationship between intravenous (IV) fluids given to mothers during the peripartum period and postpartum breast or nipple swelling in the first ten days postpartum and determine if a larger study was warranted and feasible. The research question for this pilot study was, "What is the relationship between the amount of IV fluids given to labouring women and edema of the breast and areola complex experienced by breastfeeding women in the first 10 days postpartum?" Methods It is a prospective, longitudinal, observational cohort pilot study with repeated measures and a within-subjects design. Participants are first time mothers who planned to exclusively breastfeed and gave birth to a single, healthy newborn by means of a spontaneous vaginal birth, Mother and baby were discharged home together with no contraindications to exclusive unrestricted breastfeeding. Descriptive statistics are reported and linear regression analysis is used to model the relationship between IV therapy and postpartum breast edema. Results Women who received IV fluids during labour had higher levels of edema postpartum and rated their breasts as firmer as and more tender than women who did not receive IV fluids. Participants who had IV fluids appeared to be less aware of the fullness associated with lactogenesis II, and the pattern of fullness they described appeared to be related to edema noted. Participants who did not have IV fluids appeared to have unrelated patterns of fullness and edema, and therefore appeared more aware of the onset of lactogenesis II. The results support a larger study about the relationships between maternal perinatal IV fluids and breast or nipple changes.

Neisseria meningitidis is a causative agent of meningitis and septicaemia. Pili are one of the major virulence factors that contribute to the pathogenicity of N. meningitidis. Pili of Neisseria are type IV fimbriae composed primarily of thousands of identical pilin subunits. Pilin of N. meningitidis is post-translationally modified by trisaccharide, phosphorylcholine and -glycerophosphate. The genes involved in pilin expression, pilin glycosylation and phosphorylcholine modification are phase variable (high frequency ON/OFF switching of expression). The function of pilin post-translational modifications and their phase variable expression in host:pathogen interactions is unknown. The phase variable expression of glycosylation in bacteria has been proposed to function in bacterial adherence and immune avoidance. However, the function of pilin glycosylation in N. meningitidis is unclear. Phosphorylcholine is expressed in a number of respiratory organisms including P. aeruginosa (on teichoic acid), S. pneumoniae (on lipoteichoic acid) and H. influenzae (on LPS). Phosphorylcholine in these organisms is important in colonisation of the nasopharynx and invasion of the epithelium. Studies on N. meningitidis pilin post-translational modifications have been restricted by difficulties in purification of pilin protein. In this thesis, we evaluated current pilin purification methods and established an efficient method of purifying pilin from N. meningitidis by Flag-tag purification system. Flag-tag purified pilin is post-translationally modified. The LC-ESI/MS/MS analysis performed in this thesis using Flag-tag purified pilin successfully determined the phosphorylcholine post-translational modification sites. Based on the MS data and the mutagenesis analysis, phosphorylcholine is covalently linked to serine 157 and serine 160 of pilin. The colony immunoblot of a serine 157/160 to alanine mutant revealed that phosphorylcholine modifications of these sites on pilin are the only surface exposed phosphorylcholine and is responsible for binding to TEPC-15 (the monoclonal antibody which binds to phosphorylcholine). In this thesis, molecular modelling demonstrated that surface exposure of pilin phosphorylcholine could be altered by the phase variation of pilin glycosylation on the adjacent pilin monomer. Furthermore, the sites for phosphorylcholine modification are commonly observed in N. meningitidis strains but not in N. gonorrhoeae indicating the importance of phosphorylcholine in pathogenisis of N. meningitidis. In addition, the biosynthesis of phosphorylcholine for pilin post-translational modification still remains a mystery. Bacteria generally obtain choline from the environment. In this thesis, we demonstrated that pilin phosphorylcholine post-translational modification could be endogenously synthesized in N. meningitidis. In summary, this thesis describes the purification method of obtaining pure post-translationally modified pilin from N. meningitidis. The phosphorylcholine post-translation modification sites on pilin have been determined and showed the importance of these sites in antibody binding specificity.

Thesis (Ph. D.)--Bob Jones University, 1976. / Includes bibliographical references (leaves 245-254).

Thesis (Ph. D.)--Bob Jones University, 1976. / Includes bibliographical references (leaves 245-254).

abstract: The Wechsler Intelligence Scale for Children – ; Fourth Edition (WISC – IV) is one of the most popular intelligence tests used for special education eligibility purposes in the United States. Despite the large prevalence of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD), the factor structure of the WISC – IV among this population has not been explored. Thus, the factor structure of WISC – IV scores among students with ADHD was investigated via replicatory factor analysis followed by a comparison with the factorial structure of the normative sample using the coefficient of congruence. The four factor model proposed by Wechsler was consistent with the factor structure found in the sample of students with ADHD for all subtests except Picture Concepts and Matrix Reasoning. The Verbal Comprehension and Processing Speed factors appeared to measure the same construct in the study sample as in the normative sample, while the Perceptual Reasoning and Working Memory factors were only fairly similar to the normative sample. It is recommended that clinicians interpret Perceptual Reasoning and Working Memory index scores of students with ADHD cautiously. Limitations of the study, future directions for research, and implications for practitioners are discussed. / Dissertation/Thesis / M.A. Educational Psychology 2011

Made available in DSpace on 2014-06-12T18:01:48Z (GMT). No. of bitstreams: 2 arquivo117_1.pdf: 2215223 bytes, checksum: 92515c24edbb2a62877d416352b9315a (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2011 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A indústria contemporânea ainda opera em grande escala com recursos energéticos não renováveis. Uma das alternativas para obtenção de combustíveis renováveis é a hidrogenação de óleos vegetais, que requer catalisadores metálicos, sendo os de níquel suportado os mais utilizados para a produção de hidrocarbonetos na faixa de diesel através de craqueamento térmico e catalítico. O craqueamento térmico caracteriza-se pelo processo de pirólise dos óleos ou gorduras enquanto o craqueamento catalítico pode favorecer determinadas rotas e alterar a composição final dos produtos. Este último processo envolve duas etapas principais, sendo a primeira, o craqueamento primário, responsável pela formação de espécies ácidas, enquanto a segunda etapa, o craqueamento secundário, responsável pela degradação dos ácidos produzidos na primeira etapa. O objetivo deste trabalho foi avaliar através da hidrogenação do óleo vegetal, a formação de hidrocarbonetos na faixa do diesel. Foi utilizada a técnica de impregnação úmida na preparação dos catalisadores com diferentes teores de níquel suportados em alumina (1, 3 e 5%) os quais foram caracterizados por análise térmica, análise química, difração de raios-X, área específica e microscopia eletrônica de varredura (MEV). No processo de hidrogenação foi utilizado óleo de soja em um reator de alta pressão (tipo PARR) em condições pré-estabelecidas: 350 ºC, 40 bar e 500 rpm, na ausência e presença de catalisadores. Os resultados da caracterização mostram que o teor de níquel ficou próximo do planejado e a adição de metal praticamente não alterou a área específica e a cristalinidade dos catalisadores. A morfologia dos catalisadores, observada por MEV, também não foi alterada. Os resultados da caracterização do material por infravermelho (IV) evidenciou que o aumento do teor de níquel presente no catalisador não interferiu no desenvolvimento do processo reacional de hidrogenação do óleo de soja. Isto tem sua possível explicação na baixa área de dispersão do metal sobre o suporte, já que não ocorreu uma alteração significativa na área específica. Os resultados da caracterização dos reagentes e produtos da reação por Ressonância Magnética Nuclear (RMN) mostram uma redução nas áreas de integração sob os sinais atribuídos aos grupos olefínicos, carbinólicos e metilenos vizinhos à carboxila, evidenciando a ocorrência dos processos de craqueamento tanto primário como secundário. A análise por cromatografia gasosa (CG) foi usada para se determinar a concentração de ácidos graxos no óleo comercial e no óleo hidrogenado demonstrando que o grau de saturação do sistema aumenta mais rapidamente do que a conversão de ácidos em hidrocarbonetos. Este fato é comprovado por análises realizadas por ambos IV e RMN. O emprego do modelo cinético de acoplamento foi adotado permitindo representar de modo satisfatório o perfil das concentrações dos ácidos graxos em função do tempo, com avaliação das respectivas constantes de velocidades envolvidas nas diferentes etapas da hidrogenação catalítica do óleo de soja

Class of 2015 Abstract / Objectives: To determine if a change in the amount of sodium bicarbonate (NaHCO3) in 5 different IV solutions will help prevent phenytoin from falling out of solution (i.e. precipitating). Our working hypothesis is that the stability of the phenytoin solution will change with different IV solutions and will increase with increasing the amount of sodium bicarbonate. Methods: A constant amount of phenytoin injection solution was mixed with a constant amount of one IV solution per beaker. Different amounts of alkalizing agents were then added to each phenytoin and IV mixture. Precipitation of the mixtures was observed every 30 minutes for 4 hours, then again in 24 hours. Results: When different IV solutions were added to the phenytoin and alkalizing agent mixture , the pH of the mixture dropped from 10 to 9 independent of the amount of alkalizing agent present in the mixture. All phenytoin mixtures precipitated within 60 minutes; 0.9% NaCl and phenytoin mixture being the one with the most delayed precipitation. Conclusions: Based on the result of this experiment, we rejected both of our specific aim hypotheses. Our hypothesis is rejected because the stability of the phenytoin solution will not change by using different IV solutions or by changing the amount of sodium bicarbonate.

Clinical Issue Health Canada recommends exclusive breastfeeding for the first 6 months post birth and then the addition of complementary foods with breastfeeding extending to a minimum of two years. Breastfeeding initiation rates in Canada are currently at around 87% but, by one month, about 21% of women have stopped breastfeeding. Engorgement and edema in breast tissue can lead to breastfeeding challenges which may contribute to early weaning. Purpose The purpose of this pilot research study was to explore the relationship between intravenous (IV) fluids given to mothers during the peripartum period and postpartum breast or nipple swelling in the first ten days postpartum and determine if a larger study was warranted and feasible. The research question for this pilot study was, "What is the relationship between the amount of IV fluids given to labouring women and edema of the breast and areola complex experienced by breastfeeding women in the first 10 days postpartum?" Methods It is a prospective, longitudinal, observational cohort pilot study with repeated measures and a within-subjects design. Participants are first time mothers who planned to exclusively breastfeed and gave birth to a single, healthy newborn by means of a spontaneous vaginal birth, Mother and baby were discharged home together with no contraindications to exclusive unrestricted breastfeeding. Descriptive statistics are reported and linear regression analysis is used to model the relationship between IV therapy and postpartum breast edema. Results Women who received IV fluids during labour had higher levels of edema postpartum and rated their breasts as firmer as and more tender than women who did not receive IV fluids. Participants who had IV fluids appeared to be less aware of the fullness associated with lactogenesis II, and the pattern of fullness they described appeared to be related to edema noted. Participants who did not have IV fluids appeared to have unrelated patterns of fullness and edema, and therefore appeared more aware of the onset of lactogenesis II. The results support a larger study about the relationships between maternal perinatal IV fluids and breast or nipple changes.

Background: Acute postoperative pain can develop into chronic pain if not managed well. Nurse anesthetists consider many factors when developing an anesthetic plan to provide optimal postoperative pain management. Multimodal pain management is recommended for managing pain in the perioperative period and this may include administering medications such as intravenous (IV) acetaminophen and IV non-steroidal anti-inflammatory drugs (NSAIDs) to the patients if not contraindicated. Even though these are valuable and daily considerations for nurse anesthetists, there is not a standard of care for addressing postoperative pain management in adult abdominal surgical procedures. Objective: The purpose of the project is to determine the perspectives of nurse anesthetists for developing postoperative pain management in adult patients having abdominal surgical procedures. Design: This is a descriptive study designed to determine if current nurse anesthetist practices are being guided by evidence-based practices and if the findings can be used to develop a standard of care. Participants: Nurse anesthetists from a local Tucson, AZ health care facility Measurements: Nurse anesthetists were interviewed in-person. They were asked six semi-structured questions and the answers were recorded and transcribed into the program NVivo. Each answer was then coded and compared for emerging common themes. Results: Five out of eleven nurse anesthetists participated in this project. Thirty-five themes were discovered and three main categories developed: 1. Nurse anesthetists consider multimodal pain management an integral part of the anesthetic plan. IV acetaminophen and IV NSAIDs are considered for every surgical patient if they are not contraindicated; 2. IV acetaminophen is used more frequently for abdominal procedures compared to IV NSAIDs because of risks for bleeding associated with IV NSAIDs; and 3. Each anesthetic plan is individualized to safely address both the patient and surgical factors. Conclusion: A multi-center study should be considered for a future project to determine if these common themes would be found consistently across health care facilities. Eventually, this information could be used to develop a standard of care for managing postoperative pain in adults having abdominal surgery. Other methods for addressing multimodal pain management such as regional blocks should be considered for future studies as well.