Thesis (M.A.)--University of Toronto, 2004. / Adviser: Thomas Humphries.

Thesis (Ph. D.)--Drexel University, 2004. / Includes abstract and vita. Includes bibliographical references (leaves 106-117).

In a study of the natural history of homozygous sickle cell (SS) disease 154 of 160 Jamaican children in whom SS genotype had been diagnosed by cord blood haemoglobin electrophoresis were followed to age 1 to 5 years. Seventeen girls and five boys died. Severe bacterial infections and acute splenic sequestration (ASS) were the principal causes of death. The incidence of each of these complications of SS disease was studied in relation to the natural history of splenomegaly and of splenic reticuloendothelial function. Splenomegaly was assessed by physical examination at each clinic visit. 37% SS children had had palpable spleens by age 6 months, 66% by age 12 months, 79% by age 24 months and 85% by age 36 months. Splenic reticuloendothelial function was assessed by estimating the percentage of pitted blood cells (pit count) using differential interference contrast microscopy. Pit counts in 139 control children with normal haeomoglobin genotype AA were always below 9%. Pit counts performed serially in 130 of the SS children (in 46 from birth) rose with age, and were greater than 9% in 23 SS children at age 1 year, 42% at age 2 years and 52% at age 3 years. Radioactive colloid spleen scans showed no splenic uptake of colloid in 11 SS children with palpable spleens and pit counts greater than 9%, confirming impairment of their splenic reticuloendothelial activity.

Thesis (Ph. D.)--Florida State University, 2003. / Advisor: Dr. Marcia L. Rosal, Florida State University, College of Visual Arts and Dance, Dept. of Art Education. Title and description from dissertation home page (viewed Jan. 31, 2005). Includes bibliographical references.

Thesis (Ph. D.)--Alliant International University, California School of Professional Psychology, San Francisco, 2005. / Includes bibliographical references (61-64) and abstract.

This study investigated the relationship between stress and pain crisis incidence in pediatric Sickle Cell Anemia (SCA). It was hypothesized that SCA children were exposed to higher levels of stress than healthy children. It was also hypothesized that a significant positive correlation existed between level of stress and pain crisis incidence both within and between years. The sample consisted of 20 Black elementary school children with SCA. There were 12 female and 8 male children. The period of investigation included the calendar years 1983 and 1984. Pain crisis incidence was determined through parent interviews and verified by a review of medical records.

While sickle cell disease (SCD) primarily affects those of African heritage, Latinos, the second most commonly affected group, are often not included in studies of youth with SCD. The purpose of this mixed methods study was to complete the linguistic translation validation of the PedsQL SCD Module, a recently validated disease specific quality of life (QOL) instrument, for use in Spanish speaking parents and youth with SCD (Aim 1). Using this instrument, QOL of Latino and African American youth with SCD who participated in an NIH funded study to improve adherence to hydroxyurea therapy (R21 NR013745) were compared (Aim 2) and factors associated with QOL examined (Aim 3). For Aim 1, 10 Latino youth with SCD (n = 5 age, 8-12 years; n = 5 age, 13-18 years) and their parents completed a demographic survey, Spanish version of PedsQL SCD Module and an audio-taped cognitive interview. Across age groups, all reported that the translated PedsQL Sickle Cell Disease Module was easy to understand and had minimal suggestions for further improvement. For Aims 2 and 3, secondary baseline data from 28 youth (mean age 13.6  2.4 years) with sickle cell disease and their parents who participated in the HABIT feasibility trial were analyzed using descriptive statistics, Wilcoxon Signed Rank and Mann-Whitney test, and linear regression modeling. Latino youth reported higher QOL scores than non-Latino youth for all QOL measures except for the Worry II subscale of the disease-specific QOL measure while Latino parents reported higher QOL scores than non-Latino parents for all subscales except for three: the disease-specific Worry I, Worry II, and Communication I subscales. Poorer disease specific QOL was predicted by greater youth-parent discordance regarding sickle cell disease responsibility for parents (β = -3.07, p = 0.04) but not youth. Poorer disease-specific QOL was predicted by greater number of both emergency room visits during the prior year for both youth (β = -2.89, p = 0.005 [self-report]; β = -5.07, p = 0.002 [electronic medical records]) and parents (β = -3.41, p = 0.002 [self-report]; β = -6.93, p = <0.001 [electronic medical records]) and hospitalizations during the prior year (youth β = -5.72, p = <0.001 [self-report]; β = -7.56, p = 0.03 [electronic medical records]; parents β = -6.48, p = <0.001 [self-report]; β = -9.16, p = 0.02 [electronic medical record]). Based on these findings, greater youth-parent discordance regarding sickle cell family responsibility and greater utilization of emergency rooms and/or hospitals were associated with poorer disease-specific QOL.