Book Summary: Provides the information and tools neccessary for nurses to express themselves more effectively using financial principles and data while interfacing with financial personnel.

Disabled-2 (Dab2) is a mitogen-responsive adaptor protein playing a key role in multifaceted cellular functions, such as endocytosis, epithelial-mesenchymal transition (EMT), immune function, stem cell differentiation, oncogenesis, cell signaling, and inflammatory responses. The adenosine deaminase RNA-specific binding protein (ADAR1) is a multifunctional RNA-editing enzyme that can convert adenosine to inosine, which can modulate gene expression and cellular functions in multiple pathways, such as mRNA translation by changing codons and the subsequent protein sequence, pre-mRNA splicing by changing splice site sequences, RNA stability by altering sequence for nuclease recognition, and RNA structure-dependent functions by altering RNA-protein interactions. ADAR1 has displayed a largely pro-tumorigenesis role, especially its immunosuppressive function in cancer cells, which attributes ADAR1 as a potential novel immune checkpoint for cancer treatment. In our lab, we employed an F9 mouse teratocarcinoma stem cell differentiating model and confirmed that Dab2 is an indispensable element for retinoic acid (RA)-induced F9 cell differentiation. Interestingly, our new findings indicated that during the process of RA-induced F9 cell differentiation, both the protein levels of Dab2 and ADAR1 are significantly upregulated, and siRNA-mediated Dab2 silence results in the silence of ADAR1. In addition, results from EMT models and statistical analysis from the human TCGA database further indicated that there is a positive correlation between the expression of Dab2 and ADAR1. Our results imply that Dab2 and ADAR1 may cooperate with each other to modulate cellular functions, which will present a novel mechanism for the mechanistic study of Dab2 in tumorigenesis.

Thesis (O.T.D.)--Boston University / Healthcare workers are reported to have a higher rate of work-related injuries than workers in private industry and most these injuries have been attributed to client handling tasks (BLS, 2009). Client handling tasks for all healthcare workers can include tasks such as: transfers, bed mobility, activities of daily living (ADL), sitting and standing balance training, ambulation/gait, wound care, lymphedema care and splinting. Research on the nursing profession indicates at least 12% of nurses are injured during client handling tasks and that at least 12% of nursing staff will leave client care or the profession because of an injury or fear of an injury (ANA, 20 12). Occupational therapists are conducting research to understand the injury rates of occupational therapy practitioners and the impact on the profession. The current research appears to mirror the nursing profession's findings. At least 12% of occupational therapy practitioners are injured during client care tasks and at least 12% will leave client care or the profession because of an injury or out of fear of an injury (Campo & Darragh, 2010; Darragh, et al., 2009; & Rice, et al., 2011). The nursing profession has found that the use of safe patient handling and movement (SPHM) devices and techniques can reduce the incidents of client care related injuries among nursing staff (ANA, 2012). However, the use of SPHM devices has been primarily limited to surface to surface transfers and rarely used for therapeutic purposes. In fact, research indicates that therapy practitioners, for many reasons, currently do not believe that SPHM is appropriate for therapeutic interventions (Campo & Darragh, 2010; & Darragh, Campo, & Olson, 2009). This research also indicates therapy practitioner beliefs that the SPHM providers have not met the needs of therapy practitioners to use the devices therapeutically. The Program is a face-to-face hands-on continuing education program designed to help occupational therapy practitioners investigate the causes and impacts of client care related injuries, problem-solve alternative direct care options and practice therapeutic use of SPHM devices and techniques.

Non-communicable diseases are on the increase worldwide, causing more than 36 million deaths each year. Evidence of the link between the role of nutrition and reducing non-communicable diseases is predominant in the literature. The factors influencing intervention strategies/policies and activities, however, need attention. AIM: The study aims to examine the factors that influence nutrition interventions within the United Arab Emirates’ healthcare system. METHOD: This research adapts an interdisciplinary approach where a triangulation mixed methodology is applied. Both qualitative and quantitative methods are used, through the analysis of ten interviews with policy makers, four case studies and 161 questionnaires. Furthermore, the research framework, which emerged from the literature search and qualitative analysis, is tested and validated by rigorous quantitative analysis using SPSS. The statistical analysis, using factor analysis, MANCOVA and ranking analysis aims to provide solid support for the resulting factors. MAIN FINDING: The study identifies five factors that influence nutrition interventions in a healthcare system, and could enhance the effectiveness of nutrition interventions. The factors are 1) quality and processes, 2) training and use of technology, 3) senior management involvement and responsibility, 4) patient diversity, and 5) multidisciplinary teams. CONCLUSION: This study contributes to the emerging literature on management in nutrition interventions and the theory and importance of preventative measures in relation to nutrition. This study provides a roadmap for policy makers to adopt in order to enhance the role of nutrition interventions in healthcare settings. / Culture Department of the Emirates’ Embassy and Ministry of Higher Education (UAE)

<p>This study examines the advent of state public health and medical services in Trinidad in the post-emancipation colonial period, to 1916. Britain's sugar-producing plantation societies were structured to allow the small white Creole plantocracy to exploit the labour of the African and East Indian lower orders and keep the people in a perpetual state of poverty. Trinidad established the Government Medical Service (GMS) in 1870 in response to an edict from the Colonial Office. The civilising mission had clearly gone awry and state-provided western medical services would henceforth be mandatory to mitigate the excessive mortality and morbidities amongst the subject peoples.</p><p>The GMS rapidly evolved into a major provider of medical care services. However, the form and function of the GMS remained contested terrain, due to the enduring disagreements about the causes of the widespread impoverishment and illhealth amongst the people. The Creole plantocracy used the poverty and poor health of the Africans as proof of their regression into barbarism after emancipation. Conversely, some British officials believed that plantation society colonialism created adverse conditions of life, thus obligating the state to alleviate its effects. The Afro-and IndoTrinidadian people emerged as a powerful force in the process of creolising the colonial state's social policies, as tens of thousands of sufferers sought assistance from the government doctors each year. The GMS thus developed as a distinctly creolised West Indian entity providing western public health and medical services to the African and East Indian residents.</p> / Thesis / Doctor of Philosophy (PhD)

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ABSTRACT When examining disparities in healthcare, notably those facing black men (Danaei et al. 2010; Thorpe Jr et al 2013), trust formation (Smith 2010; Levine 2013), internalization of stigma (Goffman 1963; Becker 2008), and identity construction (Hill Collins 2009, Crenshaw 2010) are three potentially important social processes worthy of consideration. Research has often sought to explore racialized differences in healthcare utilization and health outcomes by operationalizing trust (Adegbembo, Tomar, and Logan 2006; Carpenter et al. 2009), stigma (Wailoo 2006; Stuber, Meyer, and Link 2008), and identity (Mimiaga et al. 2009), but there is little research that speaks to the dynamic relationship between all three processes as they pertain to healthcare (Eaton et al. 2015). Furthermore, previous research on the three processes has not focused on new healthcare interventions and new medical technologies. This dissertation expands the conversation on trust, stigma, and identity by exploring how technological advances—namely, the use of virtual agents—can be employed to potentially increase engagement in healthcare for black men. This dissertation discusses the reciprocal nature of identity construction and internalization of stigma and the impact that both processes have on the health maintenance behaviors of black men, especially insofar as there exists an avenue for technology to mitigate current disparities. With stigma inherently being affixed to characteristics associated with identity, such as race or sexual orientation, and with stigmatized populations sometimes internalizing the negative labels society casts upon them (Becker 2008), understanding the manner in which these two social processes may serve to reinforce each other is key. Next, adopting a position consistent with Eaton et al. (2015), who argued that medical distrust mediates the effect of stigma on engagement in care, I highlight the process of trust and explore the roles of identity construction and internalization of stigma with respect to its formation. This dissertation explores the proactive use of distrust (Levine 2013), as well as what black men I spoke with are reporting that healthcare can do to (re)earn and maintain their trust. Finally, I detail the impact that (dis)trust has on healthcare utilization and the potential ability of embodied conversational agent (ECA) technology (virtual agents) to reduce the social and structural barriers that impact black men’s access to healthcare. In analyzing the relationship between trust and healthcare utilization, which is captured via patients’ healthcare experiences and their activation behaviors (Hibbard and Greene 2013), the impact of both processes on health outcomes are also examined. This dissertation utilizes a mixed methods research frame (Creswell and Creswell 2017), employing both qualitative and quantitative strategies. Focus groups (N=11; participants N=67), key informant interviews (N=12), and interviews (N=5) with participants who pilot test an online health promotion system (Gabe) are integral in providing this research with valuable insight into the ways in which trust, stigma, and identity impact the health behaviors of black men. Quantitative data from a pilot test (N=30) of the Gabe system, an ECA operated health promotion program designed for black men, are also analyzed. Data from risk assessments, demographic surveys, and participant use of the Gabe system serve to buttress the qualitative analysis. By employing an interdisciplinary approach, and exploring the dynamic relationships that exist across identity, stigma, and trust as they pertain to healthcare utilization, this dissertation presents a unique discussion surrounding the capacity of ECA technology to improve access to healthcare for marginalized populations. / Sociology

Paramedicine in Canada and throughout the developed world is currently undergoing unprecedented transformation to its service delivery model, largely driven by the need to relieve healthcare systems from overcrowding, and ensure its availability for all citizens. These changes are facilitated by the ability of paramedic services to adopt a number of innovative technologies, and their ability to respond by adopting new service delivery models, which may entail the deployment of paramedics in various non-emergency roles or integration with other healthcare services. The purpose of this dissertation is to determine how paramedic services innovate, and how that innovation is influenced by technology in particular. To fulfill this purpose, a two-phase sequential explanatory mixed-methods study is conducted, with a quantitative phase followed by a qualitative phase. In the first phase a multilevel theoretical model consisting of constructs that measure Service Innovation Performance, Dynamic Capabilities, Information Technology (IT) Capabilities and Group-Level Healthcare Informatics Competencies was evaluated with WarpPLS 5.0. A dataset with participation from paramedic leaders of Canadian land-based paramedic services (n=43) and paramedics employed at these services (n=502) was used for this purpose. Findings from this phase indicate that the information technology related knowledge and skills possessed by paramedics have an impact on various organization level dynamic capabilities, as do various IT Capabilities that focus on the relationship between the paramedic service leadership and the IT service provider. In the second phase, a qualitative approach was taken to explore contextual and other factors that facilitate or inhibit the ability of a paramedic service to innovate. Results from this phase suggest that Canadian paramedic services primarily undertake innovative activities with a strong focus on assuring and improving patient care. The use of an electronic patient care record (ePCR) is an important resource, as it enables activities such as the improvement of the clinical skills of paramedics, as well as facilitates the generation of business cases for equipment investment. Further, the informatics competencies of paramedics greatly facilitate the adoption of technology and equipment by individual services, as paramedics with a high amount of these competencies assist other paramedics when adopting technology, communicate innovative ideas within a service, and identify areas in need of change. The results of this dissertation underline the value of technology-related knowledge and skills for paramedics, and the importance of technology in ensuring that paramedic services provide a high and continually improving standard of patient care. / Thesis / Doctor of Philosophy (PhD) / Paramedicine in Canada is currently undergoing unprecedented transformation. These changes are driven by the need to relieve emergency healthcare resources from overcrowding, the increase in number of innovative technologies adopted by paramedic services, deployment of paramedics in various non-emergency roles, and increased integration with other healthcare services. The purpose of this dissertation is to determine how paramedic services innovate, and how innovation is influenced by technology. To this end, a two-phase sequential explanatory mixed-methods study is conducted, producing a few key findings that underline the value of technology in paramedicine. First, paramedics with information technology related skillsets can better identify opportunities for improvement in service delivery, and facilitate the organizational adoption of technology. Second, electronic patient care records are a vital source for a variety of innovative activities in paramedic services, such as organization-wide improvement of clinical skills and identification of areas where patient care can be improved.

The Canadian identity narrative typically centres on two features: universal healthcare and a longstanding tradition of welcoming newcomers – in particular, refugees. In 2012, this mythology was troubled when, without warning, asylum seekers’ healthcare access was dramatically limited. In an equally dramatic fashion, physicians and the greater healthcare community took to the streets, occupied offices, and interrupted politicians in an effort to restore refugee claimants’ access to healthcare. While this physician-led response was unprecedented in Canada, physicians had previously rallied in a similar fashion in two other universal healthcare countries: England (2003) and Germany (1993). Across all three cases, formidable physician responses emerged following efforts to remove or restrict asylum seekers’ healthcare access. In Canada, asylum seeker health restrictions, and the successful social movement they spurred were unexpected entirely. In England, attempts to restrict access are expected, but the government’s failure to implement wide-scale reforms are not. Finally, in Germany, restrictions are potentially expected, but one also expects the decades-long advocacy movement to have created national-level change; instead, ripples of impact are seen unevenly across the country. This prompts two central questions: what conditions are necessary for a national government to successfully implement restrictions on asylum seeker healthcare? And, what conditions will support physician-led social movements’ efforts to reverse these legislative changes? This thesis examines these two questions in a three-case comparison of Canada, England and Germany. Drawing on over 60 qualitative interviews with physicians, policymakers, and politicians, this study takes an ecological approach to understanding what factors facilitate reform, and what factors shape advocacy movements. In particular, this study identifies factors at each of the macro, meso, and micro-levels of analysis to map advocacy movements against their institutional contexts and political climates. By examining social movements as creatures of their policy and ideational contexts, this thesis provides a holistic examination of the people, organizations, and institutions that shape asylum seeker healthcare. This study identifies features of movements and contexts that will impact advocacy efforts; these findings are of use to scholars of social movements but also everyday advocates and persons driving change in asylum seeker social policy. / Dissertation / Doctor of Philosophy (PhD)