Thesis (M. Sc.)--University of Hong Kong, 1998. / Includes bibliographical references (leaf 133-136).

Thesis (M.Sc.)--Memorial University of Newfoundland, Faculty of Medicine, 2001. / Typescript. Bibliography: leaves 127-132.

Thesis (M.N.)--Memorial University of Newfoundland, School of Nursing, 2002. / Typescript. Bibliography: leaves 97-104.

Thesis (D. Min.)--Temple Baptist Seminary, 1999. / Abstract. Includes bibliographical references (leaves 174-177).

Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2007. / Title from first page of PDF document. Includes bibliographical references (p. 33-35).

Thesis (Ed.D.)--University of West Florida, 2005. / Title from title page of source document. Document formatted into pages; contains 208 pages. Includes bibliographical references.

Background: This thesis examines the impact of dream or wish fulfilment on seriously ill children and their families. Dream or wish fulfilment is operationalised as the actualisation of a seriously ill child’s wish by a charity that provides desired experiences. Anecdotal reports suggest that the experience of having a dream or a wish fulfilled can provide seriously ill children and their families with a sense of hope and time away from illness. However, little empirical research has been conducted in this area. This thesis reports the impact of dream fulfilment on the psychosocial well-being of ill children and their families. The research questions are: what is the experience of having a dream fulfilled for the child? What is the impact of dream fulfilment on the family? Methods: A constructivist grounded theory methodology was adopted, using theoretical sampling to recruit families from across the UK. Twenty-one families were interviewed, including 15 dream recipients, 8 siblings, and 24 parents. Analysis followed the grounded theory methodology of simultaneous data collection and development of theory, resulting in analytic interpretations of participants’ worlds. Results and Conclusions: This thesis reports for the first time a theory and accompanying theoretical model, that explain the impact of dream fulfilment on families’ lives. The generated theory suggests that dream fulfilment was conceptualised as an alternative milestone in seriously ill children and their families’ lives. Additionally, the dream experience shifted perceptions of illness by providing instances and experiences where illness did not underscore family life. Findings additionally suggest that the dream fulfilment process provided families with ill children, who often felt excluded and stigmatised from services, with a period of much needed support. Findings also highlight the unintended negative consequences of dream fulfilment. Implications for Dreams Come True, and other dream and wish fulfilment organisations are discussed.

OBJECTIVE: To understand dental service utilization by frail older adults residing in a long-term care (LTC) setting in the last two years of their life. To understand the types of dental services utilized by this demographic, the frequency of utilization and determine the characteristics that may be predictors of ‘higher dental service utilization’. METHODS: A retrospective cohort study was conducted by an electronic chart review of all LTC patients at two sites who died between 11/1/2014 - 12/30/2016 and had a dental visit in the two-year period prior to death, resulting in a sample of 369 patients. Based on the number of dental appointments attended prior to death, the patients were categorized into five groups: 0,1-2,3-5,6-9 and10 or more appointments. A multivariate logistic regression model was created to identify the factors associated with higher dental service utilization. RESULT: The study found that 84% of patients who died in the study period, utilized on-site dental services in the last two years of their life. Approximately 66% had 3 or more dental appointments. Diagnostic and preventive procedures were most commonly utilized (utilized by 81% and 73% of patients respectively). Multivariate analysis suggested that dentate patients and patients wearing removable dental prosthesis were about 7 and 12 times more likely respectively to have a higher utilization of dental services (OR=6.5 and OR=11.7). Medicaid beneficiaries were more likely (OR=1.9) to have a higher utilization of dental services than the others. CONCLUSIONS: This study showed that a large percentage of frail older adults utilized dental services even in the last years of their lives when given access to these services. As people are living longer and retaining their teeth longer, there is a rising need and subsequent demand for end-of-life dental services. Certain administrative and policy implementation strategies need to be developed to provide dental services to LTC patients in the last years of their lives.

Factors affecting the use of research evidence by nurses in long-term care (LTC) settings are largely unknown. In this thesis nurses referred to registered nurses (RNs) and licensed practical nurses (LPNs). A secondary analysis of data (n=756 nurses) from the Translating Research in Elder Care program was performed to construct Generalized Estimating Equation models of the predictors of nurses' self-reported instrumental, conceptual and persuasive research use. Positive attitudes towards research and better access to structural and electronic resources predicted all three kinds of research use. Additional statistically significant predictors suggest that individual variables play a more prominent role than contextual variables in predicting conceptual and persuasive use of research evidence, while instrumental research use is predicted equally by individual and organizational variables.

Objetivos: Comparar o efeito do controle estrito do biofilme supragengival (SUPRA), em comparação ao controle combinado dos biofilmes supra e subgengival (SUPRA+SUB), na microbiota subgengival de pacientes durante a fase de manutenção periódica preventiva (MPP), ao longo de 1 ano. Materiais e métodos: Sessenta e dois pacientes com periodontite moderada ou avançada (idade média 50.97 ± 9.26 anos, 40 mulheres, 24 fumantes) foram tratados de acordo com um protocolo não-cirúrgico. Finalizada a fase terapêutica, os pacientes iniciaram a fase de MPP e foram randomicamente alocados para receber a intervenção SUPRA ou SUPRA+SUB. Exames periodontais, instruções de higiene bucal, e as respectivas intervenções (SUPRA ou SUPRA+SUB) foram realizados em consultas trimestrais. Biofilme subgengival foi coletado ao baseline, 3, 6 e 12 meses. Técnica de PCR em Tempo Real foi utilizada para quantificar as espécies bacterianas Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), e o domínio Eubacteria (Bactérias totais). Equações de estimação generalizadas foram usadas para se estimar os efeitos dos tratamentos considerando-se a avaliação longitudinal. Resultados: Não foram observadas diferenças significativas entre os grupos para as contagens de Pg, Td, Tf, e Bactérias totais ao longo de 1 ano. Contudo, a partir dos 3 meses, as contagens de Pg e Tf aumentaram significativamente em ambos os grupos. As contagens de Bactérias totais e Td foram mantidas longitudinalmente. Por outro lado, as contagens médias das espécies bacterianas alvo permaneceram em baixos níveis (≤ 103) durante todo o estudo. Paralelamente, os parâmetros clínicos foram mantidos sem alterações significativas. Conclusões: As intervenções de manutenção investigadas produziram resultados microbiológicos semelhantes ao longo do tempo, o que demonstra o grande e importante impacto do controle do biofilme supragengival durante a fase de MPP. / Aim: Compare the effects of supragingival scaling alone (SPG) against the combined supra and subgingival scaling (SPG+SBG), on subgingival microbiota from patients during periodontal maintenance period (PMP), along 1 year. Material and Methods: Sixty-two patients with moderate or severe periodontitis (mean age 50.97 ± 9.26, 40 females, 24 smokers) were treated according to a non-surgical protocol. Ended the therapy phase, they entered a PMP and were randomly allocated to receive SPG or SPG+SBG interventions. Periodontal exams, oral hygiene instructions, and the respective intervention (SPG or SPG+SBG) were performed at quarterly appointments. Subgingival biofilm was sampled at baseline, 3, 6 and 12 months. Real-time PCR technique was used to quantify the bacteria species Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), and Eubacteria domain (Total bacteria). Generalized estimating equations were used to estimate treatment effects while accounting for longitudinal evaluation. Results: No significant inter-groups differences were observed to Pg, Td, Tf, and Total bacteria counts over 1 year. However, from 3 months onward, Pg and Tf counts increased significantly in both groups. Total bacteria and Td counts were maintained overtime. Still, the mean counts of target bacteria species remained at low levels (≤ 103) throughout the study. In parallel, the clinical parameters were maintained without significant changes. Conclusions: The PMP interventions yielded similar microbiological results along time, demonstrating the great impact and importance of supragingival biofilm control during PMP.