Philosophiae Doctor - PhD / The aim of the study was to detect the prevalence of AV and its associated bacteria with preterm delivery in the Western Cape, South Africa. Furthermore, it sought particularly to examine and investigate the predictive value of GBS and E. faecalis for preterm delivery (PTD). It also aimed to establish other factors which may predict adverse pregnancy outcomes. Three hundred and one pregnant women were recruited from four different antenatal in the Western Cape, South Africa. The study conformed with the Declaration of Helsinki (2013). Maternal data was collected from a questionnaire and maternal medical records. Vaginal and rectal swabs were collected and microscopically examined for AV, followed by culture characterization of GBS and E. faecalis. Antimicrobial susceptibility testing was also performed. In this study, AV was detected in 79 (26.2%) of the 301 pregnant women, and GBS and E. faecalis isolated from 50 (16.6%) and 21 (7.0%) respectively. GBS serotype V was the predominant serotype, followed by serotype III. Pulse field gel electrophoresis (PFGE) profile analysis for both GBS and E. faecalis yielded a total of 24 restrictions profiles for GBS and 16 for E. faecalis. Multivariable analysis revealed that parity, gravidity, vaginal discharge, urinary tract infection, and smoking were significantly associated with PTD. The results from the study provides improved guidelines maternal screening of pregnant women. The early detection of AV-related bacteria may significantly reduce maternal and neonatal morbidity.

Introdução: A Bioimpedância Elétrica (BIA) é um método fácil de usar, rápido, barato, não invasivo e de fácil reprodutibilidade utilizado para verificar as mudanças na composição corporal. O Ângulo de Fase (AF), obtido através da BIA, reflete a relativa contribuição dos fluidos e membranas para o corpo humano, sendo associado como um marcador prognóstico em diversas situações clínicas. Objetivos: Avaliar o AF como indicador de desfechos negativos em pacientes cirúrgicos (ocorrência de infecção e/ou morte e tempo de permanência hospitalar). Metodologia: Foram avaliados pacientes com idade de 18 a 80 anos internados no Hospital de Clínicas de Porto Alegre com indicação de cirurgia eletiva. As avaliações foram realizadas no momento da internação, 48 e 72 horas após a cirurgia. Foram avaliados peso, altura e Índice de Massa Corporal (IMC), estado nutricional através da Avaliação Nutricional Subjetiva Global (ANSG) e Ângulo de Fase através da BIA. Resultados: Foram avaliados 142 pacientes, segundo o IMC, 59,2% dos pacientes foram classificados como eutróficos, 3,5% moderadamente desnutridos e 37,3% apresentaram algum grau obesidade. A avaliação por ANSG verificou que 76,1% dos pacientes estavam eutróficos, 23,2% moderadamente desnutridos e 0,7% desnutridos graves. Os baixos valores para o AF obtidos nas 3 avaliações não se apresentaram como indicadores de desfechos negativos em pacientes cirúrgicos. Conclusões: O AF não se demonstrou um indicador para desfechos negativos em pacientes cirúrgicos. / Introduction: Electrical Bioimpedance (BIA) is an easy to use, fast, inexpensive, noninvasive and highly reproducible used to verify the changes in body composition. The Phase Angle (PA), obtained by BIA reflects the relative contribution of fluid and membranes for the human body, being associated as a prognostic marker in various clinical situations. Objectives: To evaluate the AF as an indicator of negative outcomes in surgical patients. Methodology: We studied patients aged 18 to 80 years at the Hospital de Clínicas de Porto Alegre with indication of elective surgery. Evaluations were performed at admission, 48 and 72 hours after surgery. Body weight, height and Body Mass Index (BMI), nutritional status by Subjective Global Assessment (SGA) and Phase Angle through the BIA. Results: According to BMI, 59.2% of patients were classified as eutrophic, 3.5% moderately malnourished and 37.3% had some degree obesity. The assessment by SGA found that 76.1% of patients were eutrophic, 23.2% moderately malnourished and 0.7% severely malnourished. The low values obtained for the AF in three evaluations were not presented as indicators of negative outcomes in surgical patients. Conclusions: AF is not an indicator to show negative outcomes in surgical patients.

This study attempted to determine whether perceptions of reactions to disclosure are related to psychological and physical outcomes among individuals with a history of youth sexual abuse (YSA). It was expected that receiving more hurtful responses overall would be related to higher levels of internalizing, somatic, and PTSD symptoms. It was also predicted that perceptions of response to disclosure would predict psychological and physical outcomes beyond the influence of relevant abuse characteristics. Eighty-six female undergraduates recruited from a large Midwestern university completed a series of questionnaires assessing YSA, non-sexual trauma, depression, anxiety, PTSD, somatic symptoms, disclosure, and social reactions to disclosure. Results indicated that those who reported experiencing YSA had higher levels of psychological and physical symptoms than those who reported a non-sexual traumatic event. Also, those who reported receiving more hurtful responses to disclosure overall had higher levels of PTSD and internalizing and physical symptoms. However, this relationship was only true for survivors of YSA. In addition, response to disclosure predicted internalizing and physical symptoms beyond the influence of the duration of abuse, accounting for 23 percent of the variance. These findings suggest that many survivors of YSA may need psychological services, and that an important focus of treatment may be assessing and strengthening social support.

The purpose of this study was to investigate the relationship between college students' social class and their academic outcomes. A structural equation model was proposed, hypothesizing that a student's socioeconomic status (SES) is related to their motives for attending college, thus influencing their perception of fit at the university, their satisfaction with the university, their academic self-efficacy, and their grades, attendance, and likelihood for retention.. The results from a sample of 500 undergraduate students show that overall, the hypothesized model was a borderline good fit of the data. While SES was negatively related to interdependent motives for attending college, it was not related to independent motives for college. Independent motives for attending college were positively related to perceptions of fit at the university, while interdependent motives were not. Finally, fit at the university was positively related to satisfaction, which was related to intention for retention, class attendance, and academic self-efficacy. Academic self-efficacy was significantly related to students' grade point average. These results suggest that students from low SES backgrounds are more interdependent. Further, those who are more independent feel a greater sense of fit with the university and are more likely to be satisfied, express commitment to continuing at the university, and attend their classes. These results provide support for a proposition that higher education institutions should value students who have different types of motives and to consider what is communicated to students through programs and expectations that are focused on independent values.

xvi, 90 p. : ill. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / Empirical support for the efficacy of CBT in treating depression suggests that the majority of clients will respond to this intervention. However, the more nuanced, and clinically relevant, question of "Which clients will respond to CBT for depression?" has been difficult to answer. Research efforts have focused on two different approaches to this question. One approach focuses on trajectories of symptom change within the first weeks of treatment to identify clients who are most likely to achieve response. A second approach looks to pretreatment client variables such as hopelessness and dysfunctional attitudes to identify clients who are more likely to respond. The current study is the first to simultaneously compare these two approaches to the prediction of treatment outcome. The sample consists of 222 clients (65.32% female, 92.79% Caucasian), ages 18 through 64 (M =27.85, SD = 11.28), receiving treatment for mood and anxiety disorders (59% met criteria for comorhid disorders) in a CBT oriented psychology training clinic. Results suggest that the rate of change in depressive symptoms over the first five treatment sessions significantly and consistently predicted outcome over and above the majority of pretreatment variables, except for precontemplation stages of change scores and initial severity of depression and anxiety symptoms. Similarly, rate of change in anxiety symptoms significantly predicted outcome on two of the three measures over and above the majority of pretreatment variables, except for hopelessness and initial severity of anxiety symptoms. Post hoc analyses revealed different predictors of outcome when trajectories of change and pretreatment variables were examined separately. Both rates of change and a number of pretreatment variables predicted outcome. Finally, pretreatment predictors of rate of early symptom change such as a contemplative orientation to change and therapist experience, were identified which may suggest that therapists should target these factors to potentially maximize rapid early symptom change, and in turn outcome. The findings are discussed in terms of their implications regarding methodological approaches to treatment outcome research and treatment planning for adults with comorbidities. / Committee in charge: Anne Simons, Chairperson, Psychology; Philip Fisher, Member, Psychology; Hyoun Kim, Member, Not from U of O; Jane Mendle, Member, Psychology; Jeff Todahl, Outside Member, Counseling; Psychology and Human Services

Introduction Liver resection offers curative treatment to a number of malignant conditions. It has traditionally been associated with poor post-operative outcomes. More recently a mortality rate of less than five per cent has become established but morbidity remains high. Enhanced Recovery After Surgery (ERAS) has become established practice in a number of surgical specialties and has shown improvement in post-operative outcomes. ERAS has been introduced for liver resection however practice is less well established and liver surgery has several complexities that need to be accommodated in order to optimise post-operative care. The following thesis aims to identify areas that require clarification and investigate peri-operative care components to establish optimum practice. Methods Systematic review and meta-analysis were performed to identify areas that required clarification and were lacking in sufficient evidence to guide practice. A randomised controlled trial was performed to compare established areas of practice. Prospective observational studies were performed when exploratory investigation was required. Retrospective analysis of a prospectively collected database was performed to identify risk factors for post-operative morbidity. Patients included in the above trials underwent liver resection at the Royal Infirmary of Edinburgh, UK, between December 2012 and August 2014. Results Post-operative analgesia after liver resection was identified as being an area that was controversial. Continuous wound infiltration was shown to offer improved recovery times when compared to epidural with no significant associated disadvantages. After retrospective review of 603 liver resections, extended resection was observed to be associated with high morbidity rates. It was hypothesised that post-operative nutritional requirements might be higher in these patients. This was not found to be the case but post-operative energy requirements were found to be difficult to predict after liver resection, suggesting the benefits of real-time monitoring of energy expenditure. Finally acetaminophen metabolism was suspected of being altered after major resection. An observational study suggested that despite altered metabolism, glutathione deficiency was not observed after major resection and so liver volume was not a contra-indication to acetaminophen administration. Summary Liver resection offers a complex set of conditions on which to base an enhanced recovery protocol. Current ERAS literature does not completely address these issues. This thesis has investigated several aspects of care unique to liver surgery in an attempt to optimise peri-operative care and improve post-operative outcome after liver surgery.

Using data from the 1979 cohort of the National Longitudinal Survey of Youth (NLSY97), I examine the impact of birth order on occupational outcomes within the managerial/professional field. I first assess the impact of birth order within the entire managerial/professional field in the United States and then decompose the field into male-dominated, female-dominated, and mixed gender occupations to provide a specific and nuanced analysis of birth order effects within the field. Finally, I also isolate the impact of birth order specifically within the STEM managerial/professional field, given recent and rising interest in STEM occupations. In general, I find limited evidence that birth order has a significant effect across the entire managerial/professional field, male-dominated, female-dominated, and STEM managerial/professional occupations and that first born children are more likely to be in managerial/professional occupations than later born children. However, on average, these effects disappear as additional demographic, education and family characteristic related controls are added.

Introdução: A Bioimpedância Elétrica (BIA) é um método fácil de usar, rápido, barato, não invasivo e de fácil reprodutibilidade utilizado para verificar as mudanças na composição corporal. O Ângulo de Fase (AF), obtido através da BIA, reflete a relativa contribuição dos fluidos e membranas para o corpo humano, sendo associado como um marcador prognóstico em diversas situações clínicas. Objetivos: Avaliar o AF como indicador de desfechos negativos em pacientes cirúrgicos (ocorrência de infecção e/ou morte e tempo de permanência hospitalar). Metodologia: Foram avaliados pacientes com idade de 18 a 80 anos internados no Hospital de Clínicas de Porto Alegre com indicação de cirurgia eletiva. As avaliações foram realizadas no momento da internação, 48 e 72 horas após a cirurgia. Foram avaliados peso, altura e Índice de Massa Corporal (IMC), estado nutricional através da Avaliação Nutricional Subjetiva Global (ANSG) e Ângulo de Fase através da BIA. Resultados: Foram avaliados 142 pacientes, segundo o IMC, 59,2% dos pacientes foram classificados como eutróficos, 3,5% moderadamente desnutridos e 37,3% apresentaram algum grau obesidade. A avaliação por ANSG verificou que 76,1% dos pacientes estavam eutróficos, 23,2% moderadamente desnutridos e 0,7% desnutridos graves. Os baixos valores para o AF obtidos nas 3 avaliações não se apresentaram como indicadores de desfechos negativos em pacientes cirúrgicos. Conclusões: O AF não se demonstrou um indicador para desfechos negativos em pacientes cirúrgicos. / Introduction: Electrical Bioimpedance (BIA) is an easy to use, fast, inexpensive, noninvasive and highly reproducible used to verify the changes in body composition. The Phase Angle (PA), obtained by BIA reflects the relative contribution of fluid and membranes for the human body, being associated as a prognostic marker in various clinical situations. Objectives: To evaluate the AF as an indicator of negative outcomes in surgical patients. Methodology: We studied patients aged 18 to 80 years at the Hospital de Clínicas de Porto Alegre with indication of elective surgery. Evaluations were performed at admission, 48 and 72 hours after surgery. Body weight, height and Body Mass Index (BMI), nutritional status by Subjective Global Assessment (SGA) and Phase Angle through the BIA. Results: According to BMI, 59.2% of patients were classified as eutrophic, 3.5% moderately malnourished and 37.3% had some degree obesity. The assessment by SGA found that 76.1% of patients were eutrophic, 23.2% moderately malnourished and 0.7% severely malnourished. The low values obtained for the AF in three evaluations were not presented as indicators of negative outcomes in surgical patients. Conclusions: AF is not an indicator to show negative outcomes in surgical patients.

abstract: Recent reports have indicated that there are both mental health and educational disparities between Latino youth and their European American counterparts. Specifically, Latin youth are at a heightened risk for negative mental health outcomes in comparison to their non-Latino youth (e.g., Eaton et al., 2008). Further, 16.7% of Latino adolescents dropped out of high school compared to 5.3% of European American youth over the past several decades (1960-2011; U.S. Department of Education, 2013). Mexican American (M.A. youth in particular, have the lowest educational attainment among all Latino ethnic groups in the U.S. (U.S. Census Bureau, 2010). While these mental health and educational disparities have often been attributed to discrimination experiences that Latino youth encounter, there is also consistent empirical evidence linking discrimination with these maladjustment problems. These studies confirmed that discrimination directly related to depressive symptoms (e.g., Umana-Taylor et al., 2007), externalizing behaviors (Berkel et al., 2010), self-esteem (e.g., Zeiders et al., 2013), and academic outcomes (e.g., Umana-Taylor et al., 2012). Few studies to date have examined the underlying mechanisms (i.e., moderation and mediation) that help us to better understand resiliency paths for those Latino youth that display positive adjustment outcomes despite being faced with similar discrimination encounters that their maladjusted peers face. Therefore, the following two studies examined various mechanisms in which discrimination related to adjustment to better understand potential risk and resiliency processes in hopes of informing intervention research. Paper 1 explored cultural influences on the association between discrimination, active coping, and mental health outcomes in M.A. youth. Paper 2 examined how trajectories of discrimination across 5th, 7th, and 10th grades related to cultural values, externalizing behaviors, and academic outcomes in M.A. youth. Taken together, these studies provide a culturally informed overview of adjustment processes in M.A. adolescents who face discrimination in addition to identifying critical directions for future research in efforts to gaining a more contextualized and comprehensive understanding of the dynamic processes involved in discrimination and adjustment in M.A. youth. / Dissertation/Thesis / Ph.D. Family and Human Development 2014

Introdução: A Bioimpedância Elétrica (BIA) é um método fácil de usar, rápido, barato, não invasivo e de fácil reprodutibilidade utilizado para verificar as mudanças na composição corporal. O Ângulo de Fase (AF), obtido através da BIA, reflete a relativa contribuição dos fluidos e membranas para o corpo humano, sendo associado como um marcador prognóstico em diversas situações clínicas. Objetivos: Avaliar o AF como indicador de desfechos negativos em pacientes cirúrgicos (ocorrência de infecção e/ou morte e tempo de permanência hospitalar). Metodologia: Foram avaliados pacientes com idade de 18 a 80 anos internados no Hospital de Clínicas de Porto Alegre com indicação de cirurgia eletiva. As avaliações foram realizadas no momento da internação, 48 e 72 horas após a cirurgia. Foram avaliados peso, altura e Índice de Massa Corporal (IMC), estado nutricional através da Avaliação Nutricional Subjetiva Global (ANSG) e Ângulo de Fase através da BIA. Resultados: Foram avaliados 142 pacientes, segundo o IMC, 59,2% dos pacientes foram classificados como eutróficos, 3,5% moderadamente desnutridos e 37,3% apresentaram algum grau obesidade. A avaliação por ANSG verificou que 76,1% dos pacientes estavam eutróficos, 23,2% moderadamente desnutridos e 0,7% desnutridos graves. Os baixos valores para o AF obtidos nas 3 avaliações não se apresentaram como indicadores de desfechos negativos em pacientes cirúrgicos. Conclusões: O AF não se demonstrou um indicador para desfechos negativos em pacientes cirúrgicos. / Introduction: Electrical Bioimpedance (BIA) is an easy to use, fast, inexpensive, noninvasive and highly reproducible used to verify the changes in body composition. The Phase Angle (PA), obtained by BIA reflects the relative contribution of fluid and membranes for the human body, being associated as a prognostic marker in various clinical situations. Objectives: To evaluate the AF as an indicator of negative outcomes in surgical patients. Methodology: We studied patients aged 18 to 80 years at the Hospital de Clínicas de Porto Alegre with indication of elective surgery. Evaluations were performed at admission, 48 and 72 hours after surgery. Body weight, height and Body Mass Index (BMI), nutritional status by Subjective Global Assessment (SGA) and Phase Angle through the BIA. Results: According to BMI, 59.2% of patients were classified as eutrophic, 3.5% moderately malnourished and 37.3% had some degree obesity. The assessment by SGA found that 76.1% of patients were eutrophic, 23.2% moderately malnourished and 0.7% severely malnourished. The low values obtained for the AF in three evaluations were not presented as indicators of negative outcomes in surgical patients. Conclusions: AF is not an indicator to show negative outcomes in surgical patients.