Thesis (Ph. D.)--School of Nursing. University of Missouri--Kansas City, 2004. / "A dissertation in nursing." Advisor: Peggy Ward-Smith. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed feb. 27, 2006. Includes bibliographical references (leaves 124-131). Online version of the print edition.

The aim of this thesis was to assess whether platelet, endothelial and coagulation biomarkers of thrombotic risk are increased in ECKD-HD patients. Five individual studies were performed (1) venous blood samples between controls and resting HD patients, (2) simultaneous blood samples between vascular access (VA) and venous samples in HD patients (3) pre and post dialysis from the VA, (4) samples pre and post dialysis in venous samples, (5) a retrospective study of VA thrombosis in HD patients. Venous blood samples were taken from 78 resting healthy volunteers and from 78 HD patients immediately before and 30 minutes after dialysis. We also took blood samples from the VA of 55 patients immediately before and after dialysis. In 26 patients venous and VA samples were taken simultaneously. Our results have shown HD patients potentially have evidence of a prothrombotic state compared to controls. This is further increased by each session of dialysis and is present in both VA and venous samples distant from the site of haemodialysis. We have shown some differences in platelet activation and inflammatory markers between simultaneous VA and venous samples. Furthermore, some of these biomarkers may be associated with a retrospective history of VA occlusion. Our study has shown that in patients with ECKD on HD there may be evidence of an underlying prothrombotic tendency. There is a need to determine the optimal anti-platelet and anti-coagulation therapy in these patients.

BACKGROUND: Patients receiving haemodialysis (HD) treatment experience a significant symptom burden and their needs are multifaceted. In HD unit, patients receive treatment in a diverse cultural and open ward setting. However, patients‟ experiences of receiving HD treatment in an open ward setting are not known. OBJECTIVES: The central aim of this study was to explore and describe the experiences of patients receiving HD treatment in an open setting environment at an academic hospital in Johannesburg. DESIGN: A qualitative, exploratory and descriptive study was conducted at a public, tertiary level academic hospital in Johannesburg after obtaining ethical approval from Wits University and relevant authorities. SETTING: The research setting for this study was an adult Chronic Renal Dialysis Unit. POPULATION: Sixteen adult (age 18 and above) patients receiving chronic HD treatment were recruited purposively in this study. INTERVENTIONS: An in-depth semi-structured interview was conducted either before or after receiving HD treatment, which was audio-recorded, transcribed then analysed by using Giorgi Phenomenological method. FINDINGS: A mood enhancer appeared a major theme as participants positively valued the open setting environment for their overall and psychological well-being. Participants expressed by being with others and sharing experiences, a sense of community likened to a family developed. Common to all participants‟ language was the use of the “we” in relation to being in the open setting environment. This expression of the “we” by participants was interpreted as a community concept. The use of “we” associated with the concept of community described as a space to which every patient receiving HD belonged. They described their experiences in a collective manner. This was evident in repetitive reference to their common space, being together, sharing experiences, and finding identity from one another, being understood and a sense of being protected with personal relations that extend beyond 10 years for some. This open space contributed to shaping their perception of body image and illness. The nurse‟s role in timeously providing HD care was appreciated by many. However, being exposed to multiple situations of chronic illness and treatment a sense of fear developed. Any negative event experienced, watched, observed, or heard in the HD unit triggered fear in the patients. Two common fears were of HD complications and the constant threat of death. Complications such as clotting, muscle cramps and collapsing because of hypotension as well as watching somebody dying on the machine were all reported in this study and so psychological counselling was felt to be very important. CONCLUSION The recommendations proposed in this study hopefully will assist HD staff to intervene and make adjustments to support patients‟ holistic needs. Further studies into patients receiving HD in open settings and mixed-gender space are required for diversity of experiences and knowledge from different settings. Keywords: Haemodialysis, hospital environment, open setting, patient experiences

by Leung Cheuk Wa. / Thesis (M.Sc.)--Chinese University of Hong Kong, 1994. / Includes bibliographical references (leaves 97-106). / ACKNOWLEDGEMENTS --- p.i / LIST OF FIGURES --- p.v / LIST OF TABLES --- p.vi / SUMMARY --- p.1 / Chapter 1. --- INTRODUCTION --- p.3 / Chapter 2. --- BASIC ASPECTS OF CARNITINE / Chapter 2.1 --- BIOSYNTHESIS OF CARNITINE --- p.5 / Chapter 2.2 --- CARNITINE TRANSPORT --- p.8 / Chapter 2.3 --- THE ROLE OF CARNITINE IN INTRACELLULAR METABOLISM --- p.10 / Chapter 2.4 --- THE ROLE OF KIDNEY IN CARNITINE METABOLISM --- p.16 / Chapter 3. --- CARNITINE DEFICIENCY --- p.18 / Chapter 3.1 --- PRIMARY CARNITINE DEFICIENCY --- p.20 / Chapter 3.1.1 --- MYOPATHIC CARNITINE DEFICIENCY --- p.21 / Chapter 3.1.2 --- SYSTEMIC CARNITINE DEFICIENCY --- p.21 / Chapter 3.2 --- SECONDARY CARNITINE DEFICIENCY --- p.22 / Chapter 4. --- CARNITINE METABOLISM IN SELECTED DISEASES / Chapter 4.1 --- CARDIOMYOPATHY --- p.23 / Chapter 4.2 --- ORGANIC ACIDURIAS --- p.24 / Chapter 4.3 --- VALPROIC ACID THERAPY --- p.26 / Chapter 4.4 --- RENAL DIALYSIS ANDTRANSPLANTATION --- p.28 / Chapter 5. --- ANALYTICAL METHODS FOR CARNITINE ASSAYS --- p.30 / Chapter 6. --- DETERMINATION OF TOTAL AND FREE CARNITINE / Chapter 6.1 --- PRINCIPLE OF THE ASSAYS --- p.32 / Chapter 6.1.1 --- FREE CARNITINE DETERMINATION --- p.32 / Chapter 6.1.2 --- TOTAL CARNITINE DETERMINATION --- p.33 / Chapter 6.2 --- INSTRUMENTATION --- p.34 / Chapter 6.3 --- PREPARATION OF REAGENTS AND STANDARDS --- p.36 / Chapter 6.4 --- SPECIMEN COLLECTION --- p.42 / Chapter 6.5 --- SAMPLE PREPARATION --- p.43 / Chapter 6.6 --- ASSAY PROTOCOL FOR FREE CARNITINE --- p.44 / Chapter 6.7 --- ASSAY PROTOCOL FOR TOTAL CARNITINE --- p.46 / Chapter 6.8 --- FACTORS AFFECTING THE PERFORMANCE OF ASSAYS --- p.48 / Chapter 6.9 --- EVALUATION OF FREE AND TOTAL CARNITINE ASSAYS --- p.50 / Chapter 7. --- RESULTS OF EVALUATION OF TOTAL AND FREE CARNITINE ASSAYS / Chapter 7.1 --- CALIBRATION --- p.52 / Chapter 7.2 --- PRECISION --- p.55 / Chapter 7.3 --- LINEARITY RANGE --- p.56 / Chapter 7.4 --- RECOVERY --- p.58 / Chapter 7.5 --- INTERFERENCE OF ACETYLCARNITINE ON FREE CARNITINE ASSAY --- p.59 / Chapter 7.6 --- DISCUSSION --- p.59 / Chapter 8. --- STUDY IN NORMAL SUBJECTS / Chapter 8.1 --- SUBJECTS --- p.61 / Chapter 8.2 --- RESULTS OF THE NORMAL SUBJECTS --- p.61 / Chapter 8.3 --- DISCUSSION --- p.63 / Chapter 9. --- PATIENTS STUDY / Chapter 9.1 --- PATIENTS WITH CARDIOMYOPATHY / Chapter 9.1.1 --- SUBJECTS --- p.66 / Chapter 9.1.2 --- RESULTS OF THE STUDY --- p.66 / Chapter 9.1.3 --- DISCUSSION --- p.69 / Chapter 9.2 --- PATIENTS WITH METABOLIC DISEASES / Chapter 9.2.1 --- SUBJECTS --- p.71 / Chapter 9.2.2 --- RESULTS OF THE STUDY --- p.71 / Chapter 9.2.3 --- DISCUSSION --- p.74 / Chapter 9.3 --- PATIENTS ON VALPROIC ACID THERAPY / Chapter 9.3.1 --- SUBJECTS --- p.75 / Chapter 9.3.2 --- RESULTS OF THE STUDY --- p.75 / Chapter 9.3.3 --- DISCUSSION --- p.77 / Chapter 9.4 --- PATIENTS ON RENAL DIALYSIS AND AFTER TRANSPLANTATION / Chapter 9.4.1 --- SUBJECTS --- p.79 / Chapter 9.4.2 --- RESULTS OF THE STUDY --- p.79 / Chapter 9.4.3 --- DISCUSSION --- p.81 / Chapter 10. --- GENERAL DISCUSSION --- p.84 / Chapter 11. --- REFERENCES --- p.97

Diss. (sammanfattning) Stockholm : Karol. inst., 2001. / Härtill 5 uppsatser.

Thesis (M.H.S.A.)--University of Michigan, 1976.

Thesis (M.H.S.A.)--University of Michigan, 1976.

Thesis (M.S.)--University of Wisconsin--Madison, 1981. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 97-106).

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 54-59).

Thesis (doctoral)--Katholieke Universiteit te Nijmegen.