<p>Collagen crosslinking with a polypropyleneimine octaamine dendrimers, via carbodiimide chemistry, was further exploited to demonstrate the ability of this technology for various tissue engineering strategies, including tissue engineered corneal equivalents (TECE) and blood-contacting biomaterials. In addition, modification with extracellular matrix components and other biomimetic molecules may enhance tissue-host interactions for greater <em>in vivo </em>compatibility.</p> <p>First, the efficacy of the dendrimer crosslinking technology was further validated with commercially available collagen-based materials, from bovine or human sources (Chapter 4: Paper 1), as determined via transmittance, water uptake, differential scanning calorimetry, collagenase stability and <em>in vitro </em>cell compatibility. Despite gel formation, the matrix integrity was compromised with collagen-based materials manufactured under acidic conditions and purified via freeze-drying.</p> <p>To continue the theme of dendrimer crosslinked collagen gels as TECE materials, growth factor incorporation was investigated with epidermal growth factor (EGF) and heparin-binding EGF (HB-EGF), as a method for improving device epithelialization and subsequent host integration. However, given the short half lives of these growth factors, an effective growth factor delivery system is necessary to protect growth factor bioactivity. As heparan sulphate proteoglycans sequester and release heparin-binding growth factors <em>in vivo</em>, the use of heparinized dendrimer crosslinked collagen (CHG) gels for HB-EGF delivery would provide prolonged, controlled delivery, while maintaining growth factor effectiveness (Chapter 5: Paper 2). HB-EGF release was prolonged and capable of inducing human cornea epithelial cell (HCEC) proliferation. Thus, HB-EGF delivery from CHG gels could aid in TECE device retention through enhanced device-host integration via epithelialization.</p> <p>Alternatively, tethering EGF or HB-EGF to dendrimer crosslinked collagen (CG) gels could also supply growth factor stimulation in a manner that maintains bioactivity, while stimulating growth factor receptors continually with minute concentrations (Chapter 6: Paper 3). Growth factor uptake and bioactivity was assessed with radiolabeled growth factor and through <em>in vitro </em>epithelial cell culture, respectively. Surface-modification of CG gels with growth factors demonstrated greater bioactivity, compared to growth factor bulk-modification of CG gels.</p> <p>Finally, dendrimer crosslinked collagen gels, with pre-activated heparin (PH gels) were investigated as a tissue engineered blood-contacting biomaterial (Chapter 7: Paper 4), as we hypothesized that biomaterial induced coagulation is not only influenced by an anticoagulant surface, but also by the underlying material and that improved blood-biomaterial interactions may be achieved by utilizing a natural polymer that emulates biomimetic properties. Pre-activation of heparin was utilized to increase heparin gel content, while antithrombotic properties were evaluated via antithrombin and fibrinogen adsorption and plasma recalcification times. PH gels had increased heparinization, but extensive crosslinking compromised antithrombin-heparin interactions, compared to CHG gels. CHG gels demonstrated improved antithrombotic properties and further evaluation of these gels for blood-contacting applications is warranted.</p> / Doctor of Philosophy (PhD)

類胰島素生長因子1(IGF1)是一種負責代謝、細胞生長、身體發展的多肽激素。微衛星和單核苷酸多態性(SNP), 與循環IGF1水平顯著相關。然而，目前沒有研究指出微衛星和SNPs的綜合影響，且這些遺傳變異對IGF1的調控機制仍是未知。本研究的假設是，微衛星和SNPs在啟動子區域可能有相互作用從而調控IGF1水平。因此，本研究的目的是找出影響IGF1表達的主要元素，並研究每個基因變異的作用。 / 在這項研究中，整個IGF1的基因，包括上游和下游的5萬鹼基對(bp)，可分為4個單體型區段，而IGF1的調控區在第3和第4個區段。與其它重復序列的微衛星相比，有21個重復序列的微衛星(IGF1上游969bp)與一套獨特的SNPs有關連。此外，有19個重復序列的微衛星有較低的循環IGF1。 / 功能性細胞分析進一步分析在生長激素(GH)依賴模型和GH獨立模型中，每個基因變異的角色。在GH獨立模型中，常見的單體型之間有不同的轉錄活性。與以前的研究結果相一致的是，有19個重複序列的單倍型轉錄活性最低。當單倍型為C-T-T，啓動子的轉錄活性受微衛星長度影響，較長的單體型有較低的轉錄活性。微衛星的長度效應或倚賴功能性SNP 1411C> T（rs35767）和叉頭蛋白A3（FOXA3）。以前研究發現在不同基因調控中，一個只結合C等位點並含有CCAAT /增強子結合蛋白delta（CEBPD）的轉錄激活複合物與FOXA3並存。因此，CEBPD可能與FOXA3相互作用從而調控IGF1的表達。而微衛星長度可能通過調節上游CEBPD轉錄複雜和下游FOXA3的相互作用從而影響IGF1的表達。單倍型T-C-A可能採取另一種調控機制，該機制或許被長約178鹼基對，含有“CA“部分的片段調控。GH依賴模型是模擬幼年時期IGF1的表達。在這個階段中，常見的單體型之間有不同的轉錄活性，但每個基因變異的調節作用均不強。 / 總括而言，IGF1的表達主要是由微衛星和SNPs組成的單體型調控。在幼年和成年，常見的單體型之間有差別顯著的轉錄活動。然而，GH獨立模型和GH依賴模型的調控機制是不同的。 / Insulin-like growth factor 1 (IGF1) is a polypeptide hormone responsible for metabolism, cell growth, and somatic development. Microsatellite and SNPs have been demonstrated to be significantly associated with circulating IGF1 level. However, no studies have ever investigated the combined effects of microsatellite and SNPs, and regulatory mechanisms of IGF1 expression by these genetic variants are yet unknown. The hypotheses of this study were that the microsatellite and SNPs may have certain regulatory functions in the promoter region, and interact with each other in the regulation. Therefore, the objectives were to identify the primary regulatory element in the regulation of IGF1 expression and to investigate the role of each genetic variant. / In this study, the whole IGF1 gene, including 50kb upstream and downstream, was divided into four haplotype blocks, in which the regulatory region of IGF1 lied in haploblock 3 and 4. Results of high-resolution melting analysis showed that a microsatellite (969bp upstream) with 21 repeats was associated with a different set of SNPs, compared to microsatellite with other repeat numbers. Also, haplotype with 19 CA repeats was significantly associated with a lower level of circulating IGF1. / Functional cellular assays were performed to further analyze the roles of each genetic variant in growth hormone (GH)-independent and GH-dependent models. In GH-independent model, it was found that common haplotypes showed differential transcriptional activities, and, consistent with previous findings, haplotype with 19 repeats was the least activated. On the background of haplotype C-T-T, transcriptional activity was regulated by microsatellite length, in which the haplotype with a longer microsatellite length tended to have a lower transcriptional activity. Further analysis showed that the microsatellite length effect depended on a functional polymorphism -1411C>T (rs35767) and forkhead box A3 (FOXA3), whose binding sites were several base pairs upstream of IGF1 transcription start site. Telgmann et al found a transcription activator complex containing CCAAT/enhancer binding protein delta (CEBPD) bound exclusively to the C allele and CEBPD often coexisted with FOXA3 in the regulation of various genes. Therefore, in the activation of IGF1, microsatellite length might regulate the interaction between the upstream CEBPD transcription complex and the downstream FOXA3. Haplotype T-C-A showed a yet unknown regulatory mechanism of IGF1 expression, which might be accounted for by the “C-A“ portion. In GH-dependent model, common haplotypes also showed differential transcriptional activities. However, further analysis revealed that the regulatory effects of each genetic variant alone (microsatellite or SNPs) were not strong. / To conclude, haplotype effect, which was contributed by both microsatellite and SNPs, played an important role in the regulation of IGF1 expression. Common haplotypes showed significantly differential transcriptional activities. However, the regulatory mechanisms were different in GH-independent model and GH-dependent model. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Chen, Yu Holly. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 127-140). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese. / Abstract --- p.i / 摘要 --- p.iii / Acknowledgement --- p.v / LIST OF ABBREVIATIONS --- p.vi / LIST OF FIGURES --- p.viii / LIST OF TABLES --- p.x / PUBLICATIONS --- p.xi / Chapter CHAPTER 1 --- INTRODUCTION TO INSULIN-LIKE GROWTH FACTOR 1 (IGF1) --- p.1 / Chapter 1.1 --- Production of IGF1 --- p.1 / Chapter 1.2 --- Other factors affecting IGF1 level --- p.5 / Chapter 1.2.1 --- Nutritional status --- p.5 / Chapter 1.2.2 --- Ethnicity --- p.5 / Chapter 1.2.3 --- Age --- p.8 / Chapter 1.2.4 --- Gender --- p.8 / Chapter 1.2.5 --- IGFBP --- p.9 / Chapter 1.2.6 --- Other growth factors --- p.10 / Chapter 1.3 --- Cellular functions of IGF1 --- p.10 / Chapter 1.4 --- Physiological functions of IGF1 --- p.13 / Chapter 1.4.1 --- Metabolism --- p.14 / Chapter 1.4.2 --- Somatic growth --- p.17 / Chapter 1.4.3 --- Longevity --- p.18 / Chapter CHAPTER 2 --- PATHOLOGY OF IGF1 --- p.20 / Chapter 2.1 --- IGF1 and cancer predisposition --- p.20 / Chapter 2.1.1 --- Evidences in genetic studies --- p.21 / Chapter 2.1.2 --- Evidences in lifestyle factors --- p.21 / Chapter 2.1.3 --- Evidences from population studies --- p.22 / Chapter 2.1.4 --- Miscellaneous evidence --- p.22 / Chapter 2.2 --- IGF1 and diabetes mellitus (DM) --- p.23 / Chapter 2.3 --- IGF1 and other diseases --- p.24 / Chapter CHAPTER 3 --- HYPOTHESES AND AIMS OF THE STUDY --- p.26 / Chapter 3.1 --- Hypotheses of the study --- p.26 / Chapter 3.2 --- Aims of the study --- p.26 / Chapter CHAPTER 4 --- RELATIONSHIP BETWEEN GENETIC VARIANTS AND IGF1 EXPRESSION --- p.28 / Chapter 4.1 --- Introduction --- p.28 / Chapter 4.2 --- Materials and methods --- p.31 / Chapter 4.2.1 --- Study subjects --- p.31 / Chapter 4.2.2 --- tagSNP selection and haplotype block construction --- p.32 / Chapter 4.2.3 --- Genescan analysis of the CA repeat microsatellite --- p.32 / Chapter 4.2.4 --- Genotyping assay of tagSNPs --- p.34 / Chapter 4.2.5 --- Statistical analysis --- p.36 / Chapter 4.3 --- Results --- p.37 / Chapter 4.3.1 --- Characteristics of the subjects --- p.37 / Chapter 4.3.2 --- Determination of haplotype blocks --- p.38 / Chapter 4.3.3 --- Selection of tagSNPs --- p.41 / Chapter 4.3.4 --- Genotyping analysis of tagSNPs --- p.43 / Chapter 4.3.5 --- Genescan analysis of -969bp CA repeat microsatellite --- p.46 / Chapter 4.3.6 --- Phased haplotype consisting of SNP / SNP and microsatellite --- p.48 / Chapter 4.3.7 --- Correlation between haplotypes in IGF1 promoter and circulating IGF1 level --- p.50 / Chapter 4.4 --- Discussion --- p.53 / Chapter CHAPTER 5 --- Transcriptional regulation of GENETIC VARIANTS IN different haplotypeS --- p.57 / Chapter 5.1 --- Introduction --- p.57 / Chapter 5.1.1 --- IGF1 gene structure --- p.57 / Chapter 5.1.2 --- Regulatory elements in IGF1 promoter --- p.58 / Chapter 5.1.3 --- Functional variant -1411C>T (rs35767) in IGF1 promoter --- p.60 / Chapter 5.1.5 --- Objectives of the study --- p.62 / Chapter 5.2 --- Materials and methods --- p.64 / Chapter 5.2.1 --- Comparative genomics --- p.64 / Chapter 5.2.2 --- Study subjects --- p.64 / Chapter 5.2.3 --- tagSNP selection and genotyping assay --- p.64 / Chapter 5.2.4 --- Primers and standard polymerase chain reaction (PCR) --- p.65 / Chapter 5.2.5 --- Enzyme digestion --- p.68 / Chapter 5.2.6 --- Ligation --- p.68 / Chapter 5.2.7 --- Transformation of DNA ligation products --- p.68 / Chapter 5.2.8 --- Preparation of E.coli supercompetent cells --- p.69 / Chapter 5.2.9 --- Construction of plasmids --- p.70 / Chapter 5.2.10 --- Cell lines --- p.71 / Chapter 5.2.11 --- Nucleic acid extraction --- p.72 / Chapter 5.2.12 --- Reverse transcription polymerase chain reaction (RT-PCR) --- p.73 / Chapter 5.2.13 --- Transient transfection --- p.73 / Chapter 5.2.14 --- Luciferase reporter assay --- p.73 / Chapter 5.2.15 --- Optimization of a saturated luciferase reporter system --- p.74 / Chapter 5.2.16 --- Electrophoretic mobility shift assay (EMSA) --- p.74 / Chapter 5.2.17 --- Western blot analysis --- p.74 / Chapter 5.2.18 --- Prediction of putative functional SNPs --- p.76 / Chapter 5.2.19 --- Statistical analysis --- p.77 / Chapter 5.3 --- Results --- p.77 / Chapter 5.3.1 --- Evolutionarily conserved region (ECR) --- p.77 / Chapter 5.3.2 --- Frequency distribution of haplotypes of IGF1 promoter in the Chinese population --- p.79 / Chapter 5.3.3 --- Optimization of luciferase reporter system --- p.81 / Chapter 5.3.3.1 --- Gene expression level of different cell lines --- p.81 / Chapter 5.3.3.2 --- Cell line selection --- p.81 / Chapter 5.3.3.3 --- Saturation of expression plasmids in the luciferase reporter system --- p.83 / Chapter 5.3.3.4 --- Western blot analysis of gene expression level after transfection --- p.86 / Chapter 5.3.4 --- Possible functional SNPs in IGF1 regulatory region beyond ECR --- p.89 / Chapter 5.3.4.1 --- In silico analysis of putative functional SNPs --- p.89 / Chapter 5.3.4.2 --- Binding capacity of possible functional SNPs --- p.92 / Chapter 5.3.5 --- Transcriptional activities of common haplotypes and their derivatives --- p.95 / Chapter 5.3.5.1 --- GH-independent (GH-) model --- p.95 / Chapter 5.3.5.1.1 --- Common haplotypes --- p.95 / Chapter 5.3.5.1.2 --- Effect of microsatellite length on transcriptional activity of IGF1 promoter --- p.97 / Chapter 5.3.5.1.3 --- Effect of SNP on transcriptional activity of IGF1 promoter --- p.99 / Chapter 5.3.5.1.4 --- Summary --- p.101 / Chapter 5.3.5.2 --- GH-dependent (GH+) model --- p.101 / Chapter 5.3.5.2.1 --- Common haplotypes --- p.101 / Chapter 5.3.5.2.2 --- Effect of microsatellite length on transcriptional activity of IGF1 promoter --- p.103 / Chapter 5.3.5.2.3 --- Effect of SNP on transcriptional activity of IGF1 promoter --- p.105 / Chapter 5.3.5.2.4 --- Summary --- p.106 / Chapter 5.3.6 --- Putative mechanism of the interaction between microsatellite and SNPs --- p.106 / Chapter 5.3.6.1 --- Microsatellite length effect in C-T-T haplotype relied on rs35767 (-1411C>T) --- p.107 / Chapter 5.3.6.2 --- The interaction of SNP and microsatellite was dependent on FOXA3 --- p.110 / Chapter 5.3.6.3 --- Summary --- p.112 / Chapter 5.3.7 --- Serial deletion of IGF1 promoter fragment --- p.112 / Chapter 5.4 --- Discussion --- p.116 / Chapter 5.4.1 --- Distal regulatory mechanism of IGF1 expression --- p.116 / Chapter 5.4.2 --- Localized regulatory mechanism of IGF1 expression --- p.117 / Chapter CHAPTER 6 --- CONCLUSIONS AND FUTURE STUDIES --- p.125 / Chapter 6.1. --- Conclusions --- p.125 / Chapter 6.2. --- Future studies --- p.126 / Reference --- p.127

<p>This study investigates the most important reasons behind the rst-year students' decision to select University of the Western Cape (UWC) as higher education institution.<br /> These reasons were organized into a few factors for easy interpretation. The data to be analyzed for this project is a subsection of the data collected during the orientation period of 2008. During the orientation week of 2008, the questionnaires were completed on a voluntary basis by new rst-year students. All questionnaires were anonymously completed and therefore the data does not contain any information that could be linked to any individual. For the purpose of this study, only the black African and coloured students were considered. The other racial groups were not analyzed due to too small sample sizes. Questionnaires with missing information on the reasons for selecting UWC were not&nbsp / nalyzed. We ended up with a sample of size 600. The data were statistically analyzed, using descriptive statistics, bivariate analyses, factor analysis, coefficient of congruence and bootstrap factor analysis. The results indicated that the most important reasons aecting students to choose UWC were identied as good academic reputation, family member's advice, UWC graduates are successful and UWC graduates get good jobs. The least important reasons were found to be not accepted anywhere, parents / family members graduated from UWC, recruited by UWC and wanted to study near to home. The results also indicated that there were significant differences among students according to population groups, parent's monthly income and grade 12 average. Factor analysis of 12 variables yielded three extracted factors upon which student decisions were based. Similarities of these three factors were tested, and a high similarity among demographic characteristics and grade 12 average were found. Additional analyses were conducted to measure the accuracy of factor analyses models constructed using Spearman and Polychoric correlation matrices. The results indicated that both correlation matrices were&nbsp / nbiased, with higher variance and higher loadings when the Polychoric correlation matrix was used to construct a factor analysis model for categorical data.</p>

Handwashing is a well known practice to prevent the hospital-acquired infections, and it is also a basic procedure of the nosocomial infection control programs. This research is conducted to use PRECEDE model to investigate the factors affecting nurses¡¦ performance in handwashing practices. We conducted a cross-sectional study to investigate 212 nurses working patients` heaithcare from a medical center of north Taiwan, and a quota sampling method was used to analyze nurses¡¦ handwashing practices. The results of this research includes (1) the major causes affect nursing staffs¡¦ performance in handwashing practices include attitudes (enthusiastic and passive), encouragements from colleagues, and feedback of the nosocomial infection rate or density. (2) different perfessional department and different ward type also affect the performance of nurses¡¦ handwashing practices. (3) nurses washed their hands often after contacting patients¡¦ body substances, and they usually forget to wash their hands after checking patients¡¦ medicine charts. (4) seif-reported factors for poor adherence with handwashing are heavy work loading and taking patients¡¦ needs priority. The suggestions of this research are (1) providing nurses the routine feedback information regarding the changes in nosocomial infection rate versus their performance in handwashing practices. (2) making nursing supervisors and their colleagues to understand the importance of handwashing practice as well as encouragement, reminding, and supporting. (3) the above two suggestions should be executed continually. From the positive feedback, it shall enhance nursing staffs` attitudes to improve their handwashing practices, and then, nursing staffs will be willing to keep excellent performance in handwashing practices.

This study aimed to examine the internal structure, score reliability, scoring, and interpretation of the Short Grit Scale (Grit-S; Duckworth & Quinn, 2009) using a sample of engineering students (N = 610) from one large southeastern university located in the United States. Confirmatory factor analysis was used to compare four competing theoretical models: (a) a unidimensional model, (b) a two-factor model, (c) a second-order model, and (d) a bi-factor model. Given that researchers have used Grit-S as a single factor, a unidimensional model was examined. Two-factor and second-order models were considered based upon the work done by Duckworth, Peterson, Matthew, and Kelly (2007), and Duckworth and Quinn (2009). Finally, Reise, Morizot, and Hays (2007) have suggested a bi-factor model be considered when dealing with multidimensional scales given its ability to aid researches about the dimensionality and scoring of instruments consisting of heterogeneous item content. Findings from this study show that Grit-S was best represented by a bi-factor solution. Results indicate that the general grit factor possesses satisfactory score reliability and information, however, the results are not entirely clear or supportive of subscale scoring for either consistency of effort subscale or interest. The implications of these findings and future research are discussed.

No description available.

<p>This study investigates the most important reasons behind the rst-year students' decision to select University of the Western Cape (UWC) as higher education institution.<br /> These reasons were organized into a few factors for easy interpretation. The data to be analyzed for this project is a subsection of the data collected during the orientation period of 2008. During the orientation week of 2008, the questionnaires were completed on a voluntary basis by new rst-year students. All questionnaires were anonymously completed and therefore the data does not contain any information that could be linked to any individual. For the purpose of this study, only the black African and coloured students were considered. The other racial groups were not analyzed due to too small sample sizes. Questionnaires with missing information on the reasons for selecting UWC were not&nbsp / nalyzed. We ended up with a sample of size 600. The data were statistically analyzed, using descriptive statistics, bivariate analyses, factor analysis, coefficient of congruence and bootstrap factor analysis. The results indicated that the most important reasons aecting students to choose UWC were identied as good academic reputation, family member's advice, UWC graduates are successful and UWC graduates get good jobs. The least important reasons were found to be not accepted anywhere, parents / family members graduated from UWC, recruited by UWC and wanted to study near to home. The results also indicated that there were significant differences among students according to population groups, parent's monthly income and grade 12 average. Factor analysis of 12 variables yielded three extracted factors upon which student decisions were based. Similarities of these three factors were tested, and a high similarity among demographic characteristics and grade 12 average were found. Additional analyses were conducted to measure the accuracy of factor analyses models constructed using Spearman and Polychoric correlation matrices. The results indicated that both correlation matrices were&nbsp / nbiased, with higher variance and higher loadings when the Polychoric correlation matrix was used to construct a factor analysis model for categorical data.</p>

Background: There are innumerable diabetes studies that have investigated associations between risk factors, protective factors, and health outcomes; however, these individual predictors are part of a complex network of interacting forces. Moreover, there is little awareness about resilience or its importance in chronic disease in adulthood, especially diabetes. Thus, this is the first study to: (1) extensively investigate the relationships among a host of predictors and multiple adaptive outcomes; and (2) conceptualise a resilience model among people with diabetes. Methods: This cross-sectional study was divided into two research studies. Study One was to translate two diabetes-specific instruments (Problem Areas In Diabetes, PAID; Diabetes Coping Measure, DCM) into a Chinese version and to examine their psychometric properties for use in Study Two in a convenience sample of 205 outpatients with type 2 diabetes. In Study Two, an integrated theoretical model is developed and evaluated using the structural equation modelling (SEM) technique. A self-administered questionnaire was completed by 345 people with type 2 diabetes from the endocrine outpatient departments of three hospitals in Taiwan. Results: Confirmatory factor analyses confirmed a one-factor structure of the PAID-C which was similar to the original version of the PAID. Strong content validity of the PAID-C was demonstrated. The PAID-C was associated with HbA1c and diabetes self-care behaviours, confirming satisfactory criterion validity. There was a moderate relationship between the PAID-C and the Perceived Stress Scale, supporting satisfactory convergent validity. The PAID-C also demonstrated satisfactory stability and high internal consistency. A four-factor structure and strong content validity of the DCM-C was confirmed. Criterion validity demonstrated that the DCM-C was significantly associated with HbA1c and diabetes self-care behaviours. There was a statistical correlation between the DCM-C and the Revised Ways of Coping Checklist, suggesting satisfactory convergent validity. Test-retest reliability demonstrated satisfactory stability of the DCM-C. The total scale of the DCM-C showed adequate internal consistency. Age, duration of diabetes, diabetes symptoms, diabetes distress, physical activity, coping strategies, and social support were the most consistent factors associated with adaptive outcomes in adults with diabetes. Resilience was positively associated with coping strategies, social support, health-related quality of life, and diabetes self-care behaviours. Results of the structural equation modelling revealed protective factors had a significant direct effect on adaptive outcomes; however, the construct of risk factors was not significantly related to adaptive outcomes. Moreover, resilience can moderate the relationships among protective factors and adaptive outcomes, but there were no interaction effects of risk factors and resilience on adaptive outcomes. Conclusion: This study contributes to an understanding of how risk factors and protective factors work together to influence adaptive outcomes in blood sugar control, health-related quality of life, and diabetes self-care behaviours. Additionally, resilience is a positive personality characteristic and may be importantly involved in the adjustment process among people living with type 2 diabetes.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Oct. 13, 2008). Includes bibliographical references (p. 56-64).

Stuttgart, Univ., Diss., 2002.