Abstract Central venous access devices (CVADs) have become essential interventions for pediatric patients. However, their use is associated with serious complications. The most common and potentially preventable complication is catheter related blood steam infections (CRBSIs). Despite the implementation of interventions that have been shown to decrease their risk, CRBSIs still occur. Pediatric nurses were surveyed regarding their knowledge and application of recommended CVAD care practices, and their perspectives on possible factors that could contribute to the incidence of CRBSIs. Donabedian’s (1966) Structure-Process-Outcome Model guided the study. A cross-sectional, descriptive and exploratory mixed-methods survey design was used. The convenience sample consisted of 93 pediatric nurses. Findings indicate areas of concern related to adherence to CVAD care guidelines and situations that could interfere with the provision of recommended CVAD care. The primary factor identified was the use of improper technique by members of the healthcare team and the patients’ families.

This thesis examines and describes children's and adolescent's responses to burn injuries, with a specific focus on traumatic responses. Fifty five children, adolescents and their parents took part in this longitudinal study, a recruitment rate of 35% of the total population. All of the children had sustained accidental burn injuries of varying severity at least one month before their first assessment. Children were aged between three and eighteen years, and the mean age was seven years. Children under 6 years were not personally assessed. Parents reported on these children using the Child Behaviour Checklist (CBCL), and the Posttraumatic Stress Reaction Index- parent version (PTS-RI). Children over six years took part in the Diagnostic Interview for Children and Adolescents (DICA), and completed the Impact of Events Scale (IES), the Children's Posttraumatic Stress Reaction Index (C-PTS-RI), the Fear Survey Schedule (FSS) and the Depression Self-Rating Scale (DSRS). Parents of these children also completed DICA, the PTS-RI and the CBCL. At six months, all procedures were repeated. Generally, children and adolescents adjusted well following their burn injuries. Traumatic symptoms had been experienced by over half the children, with intrusive symptoms most common. 14% had a PTSD diagnosis at some time since their burn injury. A quarter of the children were reported to have general borderline or clinical behavioural problems using the CBCL. Over half the children reported symptoms of depression. The results are described with reference to the existing literature on children's traumatic responses and children's responses to burn injuries. It is suggested that there may be a "normal" acute trauma response following burn injury. Theory surrounding children's response to burn injury is examined and directions for a new theory encompassing trauma and injury in the context of development are proposed. The methodological limitations to the study are discussed and recommendations are made.

Pediatric overweight has become a topic of interest primarily due to the severity of potential physical and socioemotional consequences and escalating rates of weight status in children. Legislative initiatives have called for the creation of intervention and prevention programs; however, the efficacy and effectiveness of most of these programs have either not been established or are limited. The limited effect programs have on pediatric obesity may be due to a lack of understanding of the complexity of risk and protective factors associated with weight status. Pediatric overweight occurs when social, familial, psychological, and biological factors interact to disrupt the balance of energy intake and energy expenditure. In order to impact weight status, it is important to understand specific factors that are associated with overweight and obesity. Research has started to examine social, familial, and psychological factors that can be addressed in prevention and intervention programs. The present study examines potential relations between aspects of executive function and pediatric weight status as well as obesity-prone eating behaviors. Executive function is operationally defined as a problem-solving construct with four steps that work together to solve a problem: recognizing the problem, planning a course of action, executing the action, and evaluating the success of the action. Participants (78 children and their caregivers) between the ages of four and seven had their heights and weights measured, completed language-appropriate receptive language assessments, and were engaged in four tasks that theoretically correspond to the four aspects of problem-solving. Caregivers of the participating children completed demographic, economic hardship, child eating behaviors, and child daily executive functioning measures. No significant findings were indicated between problem-solving phases of executive function and current weight status. Using multiple linear regression analyses, findings indicated that children who have high general appetites for food demonstrated deficits in the problem recognition and plan execution phases of executive function on caregiver-report measures even when accounting for racial/ethnic membership and socioeconomic hardship. In addition, children who cope with their emotions through eating (i.e., Emotional Overeating) rather than through other means also exhibit deficits in problem recognition, problem analysis, and plan execution on caregiver-report measures even when accounting for racial/ethnic membership and socioeconomic hardship. The findings presented in this study are discussed in light of the current literature and their implications for the future direction of intervention and prevention programs for pediatric overweight and obesity.

Doctor of Philosophy / Pup mortality is reported to be a significant problem in the dog. The purpose of this thesis was to identify the extent and causes of the mortality and the risk factors. Mortality was classified according to the clinical condition of the pup at birth and the pathological investigation was designed to investigate the validity of this classification. Total pup mortality, excluding elective euthanasia for show reasons, was 18.5%. Perinatal mortality, that is, stillbirths and deaths that occurred in the first week, accounted for 90.9% of these losses. Each breed surveyed exhibited a specific mortality pattern and the results of one breed could not be used to anticipate the outcome in another breed. As a consequence of this, there was a marked difference in the predictor variables, or risk factors, identified for each breed. Birth weight and inter-pup whelping intervals were the most consistent variables that increased the odds of a pup dying. The principal cause of pup mortality was attributed to foetal asphyxia, that is, apparently normal pups subjected to excessive hypoxia during the birth process and they were either still born or born in a distressed condition and subsequently died. Death attributed to foetal asphyxia accounted for 7.8% of all pups born and 42.5% of the total mortality. The majority of these pups (82.2%) died during whelping or in the first 24 hours after birth. The death of just over half of these pups could be directly attributed to dystocia. The remaining pups were compromised during what appeared to be a normal whelping. Neonatal atelectasis, pulmonary congestion, inhalation of amniotic fluid and meconium, leptomeningeal and generalised systemic congestion were the principal pathological findings in these pups. Average birth weights, inter-pup whelping intervals, parity, pup presentation and litter position were all significant predictors of mortality due to foetal asphyxia. The abnormal pup was defined as a pup at birth that was mummified, had died prior to birth, was small for date or had gross congenital defects present. These accounted for the death of 4.9% of all pups born and 26.3% of all losses. The only significant predictors of mortality due to the birth of an abnormal pup were the inter-pup interval and birth weight. Since the abnormality occurred in utero and was not related to the birth process this result had no bearing on the outcome. The death of live born, apparently normal pups, in the neonatal period accounted for 5.7% of all pups born and 31.2% of the total mortality. Over half these losses were attributed to fading puppy syndrome. The remainder were due to mismothering / mismanagement and other miscellaneous causes. The majority of fading pups examined were not normal at birth. Growth retardation and the consequent increased susceptibility to foetal hypoxia, lung pathology indicative of foetal asphyxia and intrauterine and/or very early neonatal infections were the principal causes of mortality attributed to fading puppy syndrome identified in this study. The canine perinate is totally dependent on the bitch both in the uterus and in the immediate post partum period. The investigation of pup mortality can not be divorced from the assessment of maternal health, the influence of the whelping process and the post whelping care of the immature pups by the bitch. These factors must be correlated with gross and histological changes identified in dead pups to determine the sequence of events that contributed to the death of the whelp.

Doctor of Philosophy / Pup mortality is reported to be a significant problem in the dog. The purpose of this thesis was to identify the extent and causes of the mortality and the risk factors. Mortality was classified according to the clinical condition of the pup at birth and the pathological investigation was designed to investigate the validity of this classification. Total pup mortality, excluding elective euthanasia for show reasons, was 18.5%. Perinatal mortality, that is, stillbirths and deaths that occurred in the first week, accounted for 90.9% of these losses. Each breed surveyed exhibited a specific mortality pattern and the results of one breed could not be used to anticipate the outcome in another breed. As a consequence of this, there was a marked difference in the predictor variables, or risk factors, identified for each breed. Birth weight and inter-pup whelping intervals were the most consistent variables that increased the odds of a pup dying. The principal cause of pup mortality was attributed to foetal asphyxia, that is, apparently normal pups subjected to excessive hypoxia during the birth process and they were either still born or born in a distressed condition and subsequently died. Death attributed to foetal asphyxia accounted for 7.8% of all pups born and 42.5% of the total mortality. The majority of these pups (82.2%) died during whelping or in the first 24 hours after birth. The death of just over half of these pups could be directly attributed to dystocia. The remaining pups were compromised during what appeared to be a normal whelping. Neonatal atelectasis, pulmonary congestion, inhalation of amniotic fluid and meconium, leptomeningeal and generalised systemic congestion were the principal pathological findings in these pups. Average birth weights, inter-pup whelping intervals, parity, pup presentation and litter position were all significant predictors of mortality due to foetal asphyxia. The abnormal pup was defined as a pup at birth that was mummified, had died prior to birth, was small for date or had gross congenital defects present. These accounted for the death of 4.9% of all pups born and 26.3% of all losses. The only significant predictors of mortality due to the birth of an abnormal pup were the inter-pup interval and birth weight. Since the abnormality occurred in utero and was not related to the birth process this result had no bearing on the outcome. The death of live born, apparently normal pups, in the neonatal period accounted for 5.7% of all pups born and 31.2% of the total mortality. Over half these losses were attributed to fading puppy syndrome. The remainder were due to mismothering / mismanagement and other miscellaneous causes. The majority of fading pups examined were not normal at birth. Growth retardation and the consequent increased susceptibility to foetal hypoxia, lung pathology indicative of foetal asphyxia and intrauterine and/or very early neonatal infections were the principal causes of mortality attributed to fading puppy syndrome identified in this study. The canine perinate is totally dependent on the bitch both in the uterus and in the immediate post partum period. The investigation of pup mortality can not be divorced from the assessment of maternal health, the influence of the whelping process and the post whelping care of the immature pups by the bitch. These factors must be correlated with gross and histological changes identified in dead pups to determine the sequence of events that contributed to the death of the whelp.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Thesis (Psy. D.)--Indiana University of Pennsylvania. / Includes bibliographical references.

Dissertation (Ph.D.)--University of South Florida, 2007. / Title from PDF of title page. Document formatted into pages; contains 90 pages. Includes vita. Includes bibliographical references.

Thesis (Ph.D.)--University of California, San Francisco, 2004. / Bibliography: leaves 260-274. Also available online.

Thesis (doctoral)--Universität, St. Gallen, 2007. / Description based on print version record. Includes bibliographical references and index.