Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Thesis (Ph. D.)--University of Texas at Austin, 1997. / Vita. Includes bibliographical references (leaves 267-276).

Thesis (M.S.)--University of Michigan, 1986.

OBJECTIVE: Premature ovarian failure is a disease with many far reaching and serious consequences. Little is known about the complete etiology of the disease or what women may be at an increased risk for developing it. We sought to evaluate the prevalence of premature ovarian failure among women born in the United States and women not born in the United States who were patients of Boston Medical Center. We compared the prevalence of POF in these two groups to evaluate any relationships that may exist between birthplace and premature ovarian failure. METHODS: We collected data from the data warehouse of Boston Medical Center. We used data from women who had an FSH test done between the ages of 18 and 40 before June 30, 2013 as the control. We also compiled data of women who had an FSH level over 15mIU/ml as well as those who had diagnoses in SDK and Logician. Birthplaces data was also compiled for those women who had an FSH level>15mIU/ml. RESULTS: Women born outside of the U.S had a slightly higher prevalence of POF when compared to women born in the United States. Data analysis showed a significant difference among the two groups with p<0.0001 for each group. When birthplace data was compiled, Haiti had the highest number of women with FSH>15mIU/ml with Cape Verde and the Dominican Republic having the next highest amounts of women. CONCLUSION: Our study highlights the possible relationship that exists between premature ovarian failure and birthplace. This was a preliminary study to gather data that may be used in future, more specific studies to be done on the topic. These future studies should further investigate the reason this relationship exists, other causes that may be associated with premature ovarian failure, and further analysis of the prevalence of POF in various areas of the world.

Bacterial sepsis is a frequently occurring disease in the first weeks of life, posing a significant threat particularly to those born prematurely. The incidence of sepsis is determined by laboratory surveillance, only taking into account culture positive episodes of sepsis. However, in up to 80% of neonates treated for sepsis, blood cultures fail to grow an organism. Therefore a variety of molecular techniques have been trialled to overcome these diagnostic difficulties. To describe the current incidence and causal pathogens of neonatal sepsis in Europe in this thesis, systematic literature reviews on neonatal bacterial and fungal infections were conducted. The review highlighted in particular the discrepancy between incidences of culture positive and clinical sepsis. A further literature review assessed molecular diagnostic techniques that have been employed to determine pathogens of neonatal sepsis. Based on the results obtained from the systematic reviews, a series of molecular tests, including quantitative multiplex PCRs, a 16S rDNA broad range PCR and a Candida multiplex PCR were developed. These tests were applied to two sets of samples obtained from neonates with suspected and confirmed early and late onset sepsis in Europe, collected in two separate clinical trials. Results identified a large amount of bacteria (74% in EOS and 50% in LOS), however failed to detect all cultured pathogens. A large number of samples were positive for CoNS and Enterobacteriacae in both sample sets. In particular, in EOS, S. pneumoniae was shown to be more predominant than anticipated from the literature, and in LOS Enterococci were more prevalent. Of concern is a high number of polymicrobial infections detected by PCR. Universal definitions for clinical sepsis need to be established to enable surveillance and comparison across countries. Molecular diagnostics have the potential to become an important additional tool to describe the epidemiology of neonatal sepsis.

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing

No description available.

M.A. / In this study an attempt is made to understand the phenomenological experience of women in spontaneous premature menopause. There is very little literature available about spontaneous premature menopause and even less about the experiences of women in spontaneous premature menopause. Spontaneous premature menopause is viewed as a negative experience in the woman’s life and medical staff recommend that she should receive treatment for spontaneous premature menopause. In this study the woman, herself, was asked how she feels about spontaneous premature menopause and how it affects her life. Phenomenological research procedures are used in this study. Interviews were conducted with three participants. They were asked to tell the researcher about their experience of spontaneous premature menopause and how it affected their lives. Hermeneutic phenomenology is used to analyse the participants’ experience of spontaneous premature menopause. Themes and categories that stood out during analyses are discussed and interpreted. Results of the study show that spontaneous premature menopause can cause bodily changes in women; it can lead to several different menopausal symptoms and it can have a negative effect on her relationship with her family, friends and other people. Bodily changes that can occur, because of spontaneous premature menopause include weight gain, changes in the breasts, changes to the vagina, skin changes, bladder changes, itchy skin, heart palpitations and changes to the pelvic floor. Symptoms that can occur during spontaneous premature menopause include hot flushes, night sweats, headaches, sleep difficulties, tiredness, depression, forgetfulness, mixed emotions and pain in different areas of the body. Participants felt that their bodies, their doctors and their family and friends failed them. They had no one to turn to, because significant people in their lives did not believe that they are in spontaneous premature menopause. They were told that it must be something else like depression. The participants had shock reactions due to feelings of loss. They no longer had the body of a young woman. They had lost their youthful appearance, their sexuality, their abilty to bear children and to function satisfactorily in their daily duties. These women had to come to grips with the fact that their youthful days were over and that they were aging before their time. It is suggested that cross-cultural research be done in the future to establish how women in other cultures experience spontaneous premature menopause. Comparisions can be made and if there are any differences efforts can be made to establish what causes these differences. Cultures where spontaneous premature menopause is viewed as a positive event in a woman’s life can be researched to establish how this experience can be turned into a positive experience in cultures where it is viewed negatively.