The cervical spine must provide structural support for the head, allow large range of motion and protect both the spinal cord and branching nerves. There are two types of spinal joints: the intervertebral discs which are flexible connections and the facets, which are articulating synovial joints. Both types degenerate with age. Current surgical treatments include spinal fusion and articulating disc replacement implants. If both disc and facet joints are degenerated, fusion is the only option. In spinal fusion, the disc is removed and the adjacent vertebrae are fused which causes abnormally high stress levels in adjacent discs. In disc replacement, an articulating device is inserted to restore intervertebral motion and mimic healthy spinal kinematics. Disc arthroplasty does not significantly increase adjacent level stress but the lack of rotational constraint causes increased facet contact pressures. Thus, there is a need for a cervical total level arthroplasty system (CTLAS) that has a disc implant specifically designed to preserve the facet joints and implants for facet arthroplasty that can act independently or in-unison with the disc replacement. The conceptual design of a CTLAS implant system was proposed that would replace the disc and the facet joints. To facilitate medical imaging, PEEK (polyetheretherkeytone) was selected as the structural and bearing material. In the present thesis, multi-station pin-on-plate wear testing was initiated for pairs of unfilled (OPT) and carbon-fiber-reinforced (CFR) PEEK. Wear is important in arthroplasty implant design because wear particles can cause osteolysis leading to loosening. A variety of experiments were performed to investigate the effects of load, contact geometry and lubricant composition on wear. CFR PEEK was found to have much lower and more predictable wear than OPT PEEK in the present experiments. The wear of OPT PEEK pairs showed sensitivity to lubricant protein concentration. The coefficient of friction during testing was found to be quite high (up to 0.5), which might have clinical implications. Also, some subsurface fatigue was found, exposing carbon fibers of CFR PEEK. This remains a concern for its long-term application. Further wear testing is recommended using actual implants in a spine wear simulator.

The cervical spine ligaments play an essential role in limiting the physiological ranges of motion in the neck; however, traumatic loading such as that experienced in automotive crash scenarios can lead to ligament damage and result in neck injury. The development of detailed finite element models for injury simulation requires accurate ligament mechanical properties at relevant loading rates. The objective of this research was to provide detailed mechanical properties for the cervical spine ligaments, by performing tensile tests at elongation rates relevant to automobile crash scenarios, using younger specimens (less than 50 years old), and to provide a comprehensive investigation of spinal level and gender effects. The five primary ligaments (present between C2-T1) investigated were: the anterior longitudinal ligament, posterior longitudinal ligament, capsular ligament, ligamentum flavum, and interspinous ligament. The craniovertebral ligaments (Skull/C0-C2) investigated were the tectorial membrane/vertical cruciate/apical/alar ligament complex, transverse ligament, anterior atlanto-occipital membrane, posterior atlanto-occipital membrane, anterior atlanto-axial membrane, and posterior atlanto-axial membrane. Tests were performed within an environmental chamber designed to mimic in vivo temperature and humidity conditions, and specimens were preconditioned for 20 cycles at 10% strain prior to testing to failure. Ligaments were tested at quasi-static (0.5s-1), medium (20s-1) and high (150-250s-1). These strain rates were predicted by an existing cervical spine finite element model under typical crash scenarios. Two hundred sixty-one total primary ligament tests were performed, with approximately even distribution within elongation rate, spinal level, and gender. Another forty-four craniovertebral ligaments were tested. Results were plotted as force-displacement curves and the response characteristics determined from the curves were: failure force, failure elongation, stiffness of the linear region, toe region elongation, failure stress, failure strain, modulus and toe region strain. The measured force-displacement data followed expected trends when compared with previous studies. The younger ligaments had less scatter, and were both stiffer and stronger than the older specimens that were reported in previous studies at both quasi-static and comparable higher elongation rates. Statistical analysis was performed on the results to establish significant effects. Strain rate effects were most significant whereas spinal level effects were not found. In general, gender effects were not found to be significantly different, but consistent trends were identified with male ligaments having a higher stiffness and failure force than female ligaments. The post-ultimate load region of the curves was reported to offer insight into the ligament failure mechanism. The characteristic values obtained were used to develop average curves for each ligament, with the intention to eventually be directly integrated into finite element models to better represent the ligament structures. Curves were developed to incorporate the strain rate, spinal level and gender effects for each ligament based on the statistical analyses. Post-failure response was incorporated into these curves because this region has been shown to have an effect on neck behaviour in mathematical models. Recommendations for future studies include measuring accurate cross sectional areas of ligaments during tensile testing to obtain true stress and true strain measurements to better understand if differences in mechanical properties are structural or material. Other possible improvements would be further testing of young cervical spine ligaments with larger sample sizes to further explore spinal level and gender effects. Additional testing performed under identical testing conditions as the current study would allow for pooling of the results effectively increasing the sample size.

Background: In Canada, the prevalence of cervical cancer in Aboriginal women continues to increase with a significantly higher mortality rate than women of non-Aboriginal ancestry. Despite that invasive cervical cancer is highly preventable with regular cervical cancer screening, participation in screening remains lower among Aboriginal women. Since limited information exists on the way cervical cancer screening is perceived and experienced, the purpose of this study was to gain an understanding of Saskatchewan Aboriginal womens perceptions related to and experiences with cervical cancer screening.<p> Methodology: This qualitative exploratory study used an interpretive descriptive approach. Perceptions related to and experiences with cervical cancer screening were elicited through individual interviews with eleven Dakota First Nation women. Women were recruited through purposive sampling techniques. Initially direct quotes from individual transcripts were coded, and then organized with other participant quotes that reflected thematic similarities.<p> Findings: Shared insights reflected a main theme that described perceptions of, experiences with, and factors influencing cervical cancer screening participation among Saskatchewan Aboriginal women. This theme, transitioning from experiencing the negatives of cervical cancer screening participation to living healthier, consisted of the womens mind-set (attitudes and cultural beliefs), knowledge, encounters with the health care system, and sharing information across the generations, which included patterns of communication and a community oriented approach.<p> Discussion: Findings of this study suggest that improving knowledge about cervical cancer screening and cervical cancer may increase screening utilization. Emphasis on health promotion and prevention should be considered when designing education programs. Interventions designed to improve screening rates are more effective when community members are involved in each phase, ensuring cultural relevance. Improving knowledge about, experiences with, and stories shared regarding cervical cancer screening among Aboriginal women may increase screening rates.

Syfte: Syftet var att undersöka unga kvinnors inställning till hur de kan förebygga livmoderhalscancer. Vidare var syftet att undersöka vad de unga kvinnorna har för åsikter om information kring livmoderhalscancer.  Metod: Explorativ kvalitativ studie med semistrukturerade intervjuer användes. Kvinnor i åldern 16-18 år rekryterades på Ungdomshälsan i Uppsala med ett medvetet urval. Totalt genomfördes 20 intervjuer. Innehållsanalys med manifest ansats användes för att analysera data.  Resultat: Kvinnornas inställning till preventionsarbetet baserades på deras kunskap. Majoriteten av kvinnorna hade hört talas om ”ett vaccin” och de flesta hade en positiv inställning till det. De hade även en positiv inställning till kondom men det var ett flertal som inflikade att de inte trodde att den användes i praktiken. Den främsta anledningen till att unga kvinnor har kunskaper om livmoderhalscancer är på grund av informationen kring HPV vaccinet. Kvinnorna har främst erhållit informationen om vaccinet från media, mamma och kompisar. De önskade att skolan skulle ta ett större ansvar att ge information.  Slutsats: De unga kvinnorna som ingår i denna studie var positiva till att förebygga livmoderhalscancer. De anser att de inte har fått tillräckligt med information om livmoderhalscancer och att den kan förbättras. / Aim: The purpose of this study was to investigate young women´s attitudes to cervical cancer prevention. The aim was also to examine the young women´s opinions of information about cervical cancer.  Method: Explorative qualitative study using semi-structured interviews were used. Women aged 16-18 years were recruited at Youth Clinic in Uppsala and 20 interviews were performed. Conscious selection was used. Manifest content analysis was used to analyze data.  Results: Women's attitudes to prevention were based on their knowledge. The majority of women had heard of "a vaccine" and most had a positive attitude towards it. The majority of participants had a positive attitude towards condom but a number of informants mentioned that they did not believe that it was used in practice. The main reason that young women have knowledge of cervical cancer is due to the HPV vaccine. Women are primarily received information about the vaccine from the media, mother and friends. They wanted the school to take more responsibility to provide information.  Conclusion: The participants in this study were positive to prevention methods to cervical cancer. They think that they have not received enough information about cervical cancer and that the information can be improved.  Keywords:

<p>Traumatic injuries are the leading cause of death to children between the ages of one to nineteen years in the United States. The primary source of these traumatic injuries is motor vehicle traffic, with the head being the primary region of the body to suffer injury. While the pediatric neck is also prone to injury, it is particularly notable since it governs head excursion and acceleration, thus influencing head impacts and injuries. Pediatric fatalities can be prevented through safety improvements to vehicle compartments and child restraints by way of advanced biofidelic pediatric anthropomorphic testing devices (ATDs) and a more complete understanding of pediatric biomechanics. Computer models of the pediatric head and neck provide a valuable tool to combine results from pediatric postmortem human specimen (PMHS), radiological, and human volunteer studies to investigate the dynamics of the pediatric head and neck. The current study produced the first validated computer model of the pediatric head and neck which were created using the framework of a validated adult model. Radiology studies were conducted to determine pediatric cervical muscle cross sectional areas, vertebral anthropometry, and vertebral inertial properties. The results of these studies were combined with available pediatric PMHS properties to create the six and ten year old models. The models were validated against pediatric volunteer low speed frontal impacts and were then used to simulate higher rate and injurious inducing loading scenarios. The six and ten year old flexion bending stiffnesses were found to be 36% and 45% of the adult bending stiffness, respectively. The pediatric tensile stiffnesses were found to be 67% and 76% of the adult tensile stiffness. The tensile failure tolerance of the six year old was between 1490 and 2300 N and of the ten year old between 2040 and 3170 N. The adult and pediatric Hybrid III ATDs were found to be on average 2.5 times stiffer in flexion bending than the computer models. Biofidelity corridors were created with the models to be used to guide future ATD designs. Overall, the pediatric models provide a general tool that can be used to assess the safety of children during motor vehicle crashes.</p> / Dissertation

Human telomerase is a ribonucleoprotein complex that adds hexameric TTAGGG repeats to the ends of chromosomes in order to prevent their shortening. Telomerase activity has been evaluated for its diagnostic and prognostic value in cancer since it is observed in most malignancies but not in most normal somatic tissues. In this study telomerase activity was examined in tumor specimens obtained from cervix, endometrium and their non-cancerous regions by an improved telomeric repeat amplification protocol (TRAP) &ndash / silver staining assay. Appearance of characteristic TRAP leader with 6 base pair increments indicate a positive result and was observed in all cancerous and some of the non-cancerous tissues. Telomerase activities of carcinoma tissues and normal counterparts were compared by densitometric analysis after PCR. Significantly higher telomerase activity was observed in cervical carcinoma samples compared to normal adjacent tissue. No significant difference was observed between endometrium carcinomas and normal endometrial tissue in terms of telomerase activity. High telomerase activity in normal endometrium restricts the use of assay for detection of carcinogenesis. However, in cervical tissues an accurate quantification of telomerase activity by TRAP &ndash / silver stain assay may be valuable as a confirmatory assay.

No description available.

Thesis (PhD) - Swinburne University of Technology, Faculty of Engineering and Industrial Sciences, 2009. / A thesis submitted for the degree of Doctor of Philosophy, Faculty of Engineering and Industrial Sciences, Swinburne University of Technology, 2009. Typescript. "February 2009". Includes bibliographical references (p. 291-313)

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 71-78).

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 120-128).