TOPIC. Complementary and alternative medicine agents (CAMs). Purpose. To summarize the current empirical data about the major CAMs purporting to have psychotherapeutic value. Sources of information. Extant literature. Conclusions. Available evidence indicates that CAMs, while generally safe, are not risk free. While CAM use grows, nurses and other health professionals have a limited knowledge base about the action, side effects, and interactions of common CAM agents. Nurses need to increase their knowledge base about CAMs in order to help patients in decision making regarding the use of these agents to treat common psychiatric symptoms.

Marinade treatments of normal broiler breast meat (NOR) and severe woody breast broiler meat (SEV) included 0.7% salt, 0.4% agglomerated blend sodium polyphosphate and one of the following water treatments (12%) (n=4; mg/L CaCO3): reverse osmosis (RO; 20); tap (TW; 60); FIJI (FJ; 120), and Evian (EV; 340). Color, marination uptake, pH, shear force, cook loss, and thaw loss were not affected by water hardness (P>0.05). TW breasts were more metallic than RO (P<0.05), but not different than FJ and EV (P>0.05). EV was crunchier than TW (P<0.05), but neither were different from RO and FJ (P>0.05). Between severity, NOR had greater marination uptake, lower pH, and higher shear force than WB (P<0.05). WB breasts were lighter color (L*), more metallic, chewy, crunchy, rubbery, juicy than NOR. Overall, results indicated that water hardness treatments had minimal impact on broiler breast meat quality and yield for both NOR and WB meat.

Propensity score methods (PSM) that have been widely used to reduce selection bias in observational studies are restricted to a binary treatment. Imai and van Dyk extended PSM to estimate non-binary treatment effect using stratification with P-Function, and generalized inverse treatment probability weighting (GIPTW). However, propensity score (PS) matching methods on multiple treatments received little attention, and existing generalized PSMs merely focused on estimates of main treatment effects but omitted potential interaction effects that are of essential interest in many studies. In this dissertation, I extend Rubin’s PS matching theory to general treatment regimens under the P-Function framework. From theory to practice, I propose an innovative distance measure that can summarize similarities among subjects in multiple treatment groups. Based on this distance measure I propose four generalized propensity score matching methodologies. The first two methods are extensions of nearest neighbor matching. I implemented Monte Carlo simulation studies to compare them with GIPTW and stratification on P-Function methods. The next two methods are extensions of the nearest neighbor caliper width matching and variable matching. I define the caliper width as the product of a weighted standard deviation of all possible pairwise distances between two treatment groups. I conduct a series of simulation studies to determine an optimal caliper width by searching the lowest mean square error of average causal interaction effect. I further compare the ones with optimal caliper width with other methods using simulations. Finally, I apply these methods to the National Medical Expenditure Survey data to examine the average causal main effect of duration and frequency of smoking as well as their interaction effect on annual medical expenditures. Using proposed methods, researchers can apply regression models with specified interaction terms to the matched data and simultaneously obtain both main and interaction effects estimate with improved statistical properties.

The purpose of this study is to investigate an animal model of distress (conditioned suppression) to assess the effects of magnesium (MAG) and nicotinamide (B3) administration on recovery of anxiety-like behavior following traumatic brain injury (TBI). Post-traumatic stress disorder (PTSD) is comorbid with TBI and both affects a victim’s ability to maintain daily activities and have a good quality of life. Administration of MAG decreases swelling of the brain considerably and lessens cell death. B3 is a neuroprotective precursor to NAD+ and enhances energy levels as well has help reduce free radicals after TBI. A conditioned suppression procedure is an established method for generating disruptive fearful anxiety-like responses in animals and these treatments may help to reduce anxiety responses.

Thesis advisor: Stephen Pfohl / Assisted reproductive technologies have transformed the way medicine responds to infertility, as well as the ways those who go through difficulty conceiving understand their bodies and their experiences. In many capacities, however, the biomedical model is insufficient: recognition is contingent upon attempts to conceive, diagnosis is often imprecise or unexplained, and treatments strive for solutions without cures - and are frequently incapable of providing even the former. Interviews with 26 participants with current or recent histories of infertility revealed the ways they negotiate the biomedical model: 1) going beyond medical treatment in making lifestyle changes; 2) pursuing alternative treatments; 3) questioning doctors and playing active roles in determining courses of treatment; 4) using religion, spirituality, or magical thinking to develop other, non-bodily ways of controlling infertility; 5) extracting meaning from the experiences, infusing the objective idea of "disease" with subjective purpose; 6) building personal, alternate models that encompass a wide range of ways of thinking about infertility; and 7) directly challenging the scientific authority of the biomedical model, resisting the terms of treatment, or questioning the ability of medicine to offer them solutions. No participants showed pure compliance - as all included at least one of the negotiations - and none showed full resistance - as all had sought at least some medical treatments. Understanding these negotiations leads to a better concept of patient identity and the "illness" experience; it can inform policy in regards to prevention, education, and insurance mandates; and it better reveals who society permits to pursue parenthood in what ways. / Thesis (MA) — Boston College, 2009. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Sociology.

As distrofias musculares são doenças genéticas causadas por mutações em diferentes genes caracterizadas por degeneração muscular, prejuízos locomotores e, geralmente, morte precoce. Dentre elas, a de Duchenne, causada por mutações no gene que codifica para a proteína distrofina, é a mais comum e grave, tendo os camundongos MDX como modelo experimental mais utilizado. O objetivo do presente estudo foi testar quatro abordagens terapêuticas potencias neste modelo animal, divididas em dois experimentos: 1. treinamento físico voluntário em roda de atividade e/ou drogas agonistas das proteínas AMPK e PPAR em dias alternados (AICAR: 100 mg.Kg-1.dia-1, ip; GW 1516: 5 mg.Kg-1.dia-1, gavagem); 2. células-tronco estromais humanas provenientes de lipoaspiração (um milhão a cada injeção intravenosa; uma injeção a cada 10 dias nos dois primeiros meses de tratamento e injeções mensais nos quatro meses subsequentes) e/ou suplementação com os aminoácidos alanina e glutamina (10 mg.kg-1.dia-1, injeção diária intraperitoneal). Em relação ao primeiro experimento, o principal achado foi que os animais submetidos ao treinamento físico associado às drogas apresentaram índices de função muscular superiores aos outros grupos. Já em relação ao segundo grupo de análises, foi observado que os animais submetidos à terapia celular apresentaram tempo de vida significativamente maior quando comparados aos animais não tratados e aos tratados com ambas as terapias. Tais resultados, nunca demonstrados previamente pela literatura científica, podem contribuir para o entendimento da fisiopatologia das distrofias musculares e para o avanço de potenciais abordagens terapêuticas. / Muscular dystrophies are genetic diseases caused by mutations in different genes. They are characterized by muscle degeneration, motor prejudices and, generally, early death. Among them, Duchenne muscular dystrophy (DMD) is the most common and severe form and it is caused by mutations in the dystrophin gene. The most widely used animal model of DMD is the MDX mouse. The aim of this study was to test four potential therapeutic approaches assigned in two experiments: 1. voluntary exercise training in activity road and/or AMPK and PPAR agonists drugs every other day in MDX mice (AICAR: 100 mg.Kg-1.day-1, IP; GW 1516: 5 mg.Kg-1.day-1, gavage); 2. Intravenous injection of stromal stem cells from human adipose tissue (106 cells every 10 days in the first two months and monthly injections in the following four months) and/or alanine and glutamine amino acids supplementation (10 mg.Kg-1.day-1, daily IP injections). In the first experiment we demonstrated that mdx mice submitted to exercise training associated to drugs presented improved muscle function when compared to the other groups. In the second experiment, on the other hand, it was observed that the animals submitted to cell therapy presented increased survival when compared to non injected animals and animals treated with both approaches. These results, here demonstrated for the first time, can contribute to understand the physiopathology of muscular dystrophies and may give insights for future therapeutic approaches

Area burned in boreal forests is increasing due to climate change effects and regional increases in fuels due to a history of successful fire suppression. An increase in area burned threatens valuable resources and infrastructure in timber resources areas and communities. The ecological integrity of protected areas may also be threatened if fires increase in frequency and size beyond what would have occurred prior to effective fire suppression and the effects of climate change. Fuel management is one strategy being tested by fire management agencies and researchers to address these concerns. However the pattern of fuel management that best regulates area burned has yet to be determined. This thesis investigates random fragmentation of highly flammable fuels in the boreal forests of North-western Ontario. A case study of Quetico Provincial Park is used. Using the fire growth simulation model, Prometheus, I tested whether, under extreme fire behaviour conditions, fuel isolation (FI) and fuel conversion (FC) were effective at reducing average area burned in the park. Through the simulation of over 21,000 large fires, I determined that FI and FC are effective in significantly reducing area burned for this case study. Based on these findings, random FI and FC should be studied further on a regional basis and as a prescriptive, proactive method of reducing area burned in boreal forests.

Area burned in boreal forests is increasing due to climate change effects and regional increases in fuels due to a history of successful fire suppression. An increase in area burned threatens valuable resources and infrastructure in timber resources areas and communities. The ecological integrity of protected areas may also be threatened if fires increase in frequency and size beyond what would have occurred prior to effective fire suppression and the effects of climate change. Fuel management is one strategy being tested by fire management agencies and researchers to address these concerns. However the pattern of fuel management that best regulates area burned has yet to be determined. This thesis investigates random fragmentation of highly flammable fuels in the boreal forests of North-western Ontario. A case study of Quetico Provincial Park is used. Using the fire growth simulation model, Prometheus, I tested whether, under extreme fire behaviour conditions, fuel isolation (FI) and fuel conversion (FC) were effective at reducing average area burned in the park. Through the simulation of over 21,000 large fires, I determined that FI and FC are effective in significantly reducing area burned for this case study. Based on these findings, random FI and FC should be studied further on a regional basis and as a prescriptive, proactive method of reducing area burned in boreal forests.

Cancer was the most common cause of the death in Taiwan in the past two decades. The recent advanced improvements of cancer treatment took endless encouragements and hopes to patients and their families, so they intended aggressively while dealing with the issue of death because of the decline of mortality rate and prolonged mean lifespan. It was difficult for families and doctors to decide whether to prolong life by life sustaing treatments (including cardiopulmonary resuscitation) or to sign Do-Not-Resuscitate (DNR) consent for terminal cancer patients .We want to analyze the related factors toward terminal cancer patients DNR and point out some ones correlated closely with the time of signing consent in this restrospective research. We corrected 80 DNR consents signed by terminal cancer patients or their families from one general teaching hospital in south Taiwan and analyzed factors toward the time of signing consents. Results of this study showed that the time of signing consents was very close with that of their death . Only 12.5% of the patients with survival more than 2 weeks after signing DNR consents, 55% of the patients or their families did not sign the consents until five days before their death, 30% of the patients died in 6-14 days after signing DNR consents, and there were even more twenty percent (21.25%) of the patients died in the day of which the consents were just signed by their families. The patients¡¦age, gender, kinds of their primary cancer, whether the pulmonary or pleural metastasis were present or not, and the treatments of these patients had no significant correlations with the time of signing DNR consents. Only three factors including of education level of patients, whether the patients¡¦illness was critical while signing consents and kinds of patients¡¦painkiller use contributed to the time of DNR signing significantly in this research. 72.5% of these patients had the degree for the primary school, and 80% of the patients or their families signed the consents just when the patients¡¦illness was critical. There were 32 patients with degree of the primary school and only 4 with degree of the junior high school within the patients wih survival more than 6 days after signing DNR consents (p value =0.003); There were 53.75% of the patients had ever used opioid painkillers while siging DNR consents, 25% of them had even received morphine for pain control. For the patients with survival more than 6 days after signing DNR consents, there were 18 patients prescribed opioid painkillers, and 26 patients without taking painkillers that meaned significant difference (p value =0.011); For the patients with critical illness while signing DNR consents, it meaned statistic difference for that 42 patients got survival more than 6 days and 23 patients with survival less than 6 days. (p value =0.000). We highly suggest to inforce the knowledge of hospice care to people in community and the colleagues of doctors and nurses by any kinds of education and introduction. We all need to pay more attentions to psychiatric status of terminal cancer patients and supply adequate help and care for them, so we could all get more close to meanings of human life.

The multi-billion dollar per year lithography industry relies on the fusion of chemistry, materials science, and engineering to produce technological innovations that enable continual improvements in the speed and storage density of microelectronic devices. A critical prerequisite to improving the computers of today relies on the ability to economically and controllably form thin film structures with dimensions on the order of tens of nanometers. One class of materials that potentially meets these requirements is block copolymers since they can self-assemble into structures with characteristic dimensions circa three to hundreds of nanometers. The different aspects of the block copolymer lithographic process are the subject of this dissertation. A variety of interrelated material requirements virtually necessitate the synthesis of block copolymers specifically designed for lithographic applications. Key properties for the ideal block copolymer include etch resistance to facilitate thin film processing, a large interaction parameter to enable the formation of high resolution structures, and thin film orientation control. The unifying theme for the materials synthesized herein is the presence of silicon in one block, which imparts oxygen etch resistance to just that domain. A collection of silicon-containing block copolymers was synthesized and characterized, many of which readily form features on approximately the length scale required for next-generation microelectronic devices. The most important thin film processing step biases the orientation of block copolymer domains perpendicular to the substrate by control of interfacial interactions. Both solvent and thermal annealing techniques were extensively studied to achieve orientation control. Ultimately, a dual top and bottom surface functionalization strategy was developed that utilizes a new class of "top coats" and cross-linkable substrate surface treatments. Perpendicular block copolymer features can now be produced quickly with a process amenable to existing manufacturing technology, which was previously impossible. The development of etching recipes and pattern transfer processes confirmed the through-film nature of the features and the efficacy of both the block copolymer design and the top coat process. / text