identifier: Diao, Jingyu <https://research.library.mun.ca/view/creator_az/Diao=3AJingyu=3A=3A.html>   (1996) Pathogenesis of liver injury : virus-induced autoantibody response against asialoglycoprotein receptor in woodchuck (Marmota Monax) viral hepatitis.  Masters thesis, Memorial University of Newfoundland.

abstract: The purpose of this research was to recognize the induction and pathogenic potential of autoantibodies against a liver-specific asialoglycoprotein receptor (ASGPR) in the course of hepadnavirus infection. Three sections of research work by using a woodchuck model of hepatitis B as an experimental  system are presented in this thesis. -- First, woodchuck hepatic ASGPR (wASGPR) was purified and its polypeptide subunit composition, ligand binding properties and antigenicity were characterized. The isolated receptor is a hetero-oligomeric complex constituted of two subunits with molecular masses of 40- and 47-kDa. Antisera were generated in guinea pigs by challenge with the affinity-purified, bioactive wASGPR and rabbit ASGPR (rASGPR) preparations and in woodchucks by immunization with purified rASGPR. With the  help of these antisera, a strong antigenic cross-reactivity of the wASGPR polypeptides with the ASGPRs from other species was demonstrated. Further, using antisera raised against isolated rASGPR polypeptides, the distinct antigenic  specificity of each of the wASGPR subunits was revealed. Surface expression of wASGPR on the woodchuck hepatocytes was demonstrated by immunofluorescent staining of the isolated cells. Detailed analyses of the purified woodchuck hepatic plasma membranes (HPMs) showed that both subunits of  wASGPR were present in the HPM preparations, although the membrane-bound 47-kDa subunit was identifiable only after exposure of HPMs to the ligand of the ASGPR. -- Second, the induction, dynamic patterns and specificity of autoantibodies to hepatic wASGPR were studied in animals with experimental woodchuck hepatitis virus (WHV) infection.  Results showed that WHV infection induced anti-ASGPR autoantibodies or led to the rise in their levels in almost all animals experimentally infected with WHV (12 of 13). This demonstrated that the induction of this hepatocyte-specific autoreactivity was a common consequence of WHV infection. The relationship between anti-ASGPR reactivity existing prior to WHV inoculation and the outcome of experimental WHV hepatitis was also investigated. The results revealed that the occurrence of chronic hepatitis was significantly greater in the group of animals with pre-existing anti-ASGPR autoantibodies (54.6%) than that among woodchucks without autoantibodies in preinoculation sera (15.6%, P < 0.05), suggesting that the outcome of WHV infection might be influenced by the status of anti-ASGPR autoreactivity. Western blot analyses showed that WHV-induced anti-ASGPR autoantibodies recognized both 40- and 47-kDa subunits of wASGPR and rASGPR, implying that both receptor polypeptides may serve as targets for the pathogenic immune reactions. Furthermore, no antigenic cross-reactivity between wASGPR and WHV antigens could be identified by using antibodies against ASGPR or WHV envelope, suggesting that mechanisms other than viral protein mimicry could be involved in the induction of anti-ASGPR autoantibody in the course of WHV infection. -- Third,  in vitro investigations of the pathogenic effects of the WHV-induced anti-ASGPR autoantibodies showed that these antibodies had the ability to inhibit specific ligand binding to the hepatocyte surface ASGPR. Also, Ig fractions from the same anti-ASGPR reactive sera were hepatocytotoxic in the presence of active complement. These findings indicate that virus-induced autoantibodies against hepatic ASGPR have the potential to directly contribute to liver injury and to the distortion of the hepatocyte clearance of asialoglycoproteins in viral hepatitis. Further careful studies are required to determine the significance of anti-ASGPR autoimmunity in the pathogenesis of liver injury in viral hepatitis. The woodchuck model of virus-induced ASGPR-specific autoimmunity could play an important role in these investigations.


identifier: Satishchandran, C. <https://research.library.mun.ca/view/creator_az/Satishchandran=3AC=2E=3A=3A.html>   (1985) The regulation of the putrescine biosynthetic gene, speB, encoding agmatine ureohydrolase in Escherichia coli.  Doctoral (PhD) thesis, Memorial University of Newfoundland.

type: Thesis NonPeerReviewed

format: application/pdf application/pdf

abstract: Agmatine ureohydrolase (EC.3.5.3.11) was purified 3,300 fold  from an E.coli strain by ammonium sulphate precipitation, heat treatment, ion-exchange column chromatography, gel permeation column chromatography and chromatofocusing. The active enzyme is probably a dimer of identical subunits with  a molecular weight of 38,000, and a pI of 8.3. The Km for agmatine was 1.3 mM, L-arginine was a competitive inhibiter and ornithine inhibited in a mixed manner. In crude extracts  the enzyme was associated with another factor, probably a protein, which reduced the pI to 5.5 and decreased the activity of the enzyme. This factor also blocked reaction with antibodies raised against the purified enzyme in rabbits. In a strain known to express both biosynthetic and biodegradative ornithine decarboxylase and arginine decarboxylase, there was evidence for only the biosynthetic form of agmatine ureohydrolase. -- Agmatine ureohydrolase was negatively regulated by cAMP and the cAMP receptor protein, CRP. The specific activity of agmatine ureohydrolase was determined in crude extracts prepared from  wild type strains of E.coli, from strains carrying a mutation in the structural gene for adenylcyclase (EC.4.6.1.1) (cya) or from strains carrying mutations in both cya and cAMP receptor protein gene (crp). Cyclic AMP when added to a glucose based medium repressed the specific activity of agmatine ureohydrolase, in contrast, cAMP induced the specific activity of β -galactosidase in both the wild type and the cya mutant, but not in the crp mutant.  Addition of 1 mM agmatine to a glucose based medium induced an the specific activity of agmatine ureohydrolase in wild type, ∆cya or ∆cya, ∆crp strains. Chloramphenicol (150 μg/ml) abolished the inducibility of agmatine ureohydrolase by agmatine. In mutants blocked in the steps leading to the biosynthesis of polyamines, the addition of putrescine repressed the specific activities of arginine decarboxylase and ornithine decarboxylase, but did not affect agmatine ureohydrolase activity. The negative regulation of speA, speB and speC (encode arginine decarboxylase, agmatine ureohydrolase and ornithine decarboxylase respectively) by cAMP was shown not to be mediated by the repressive effect of cAMP on glutamine synthetase (EC.6.3.1.2), as cAMP repressed the expression of all three genes in a strain deleted for glnA (encodes glutamine synthetase). -- The speB gene was cloned into the plasmid vector pBR322 at the BamHI  site, and was localised by exonuclease digestion of the plasmid pKA5. The extent of digestion of the plasmid was determined and was related to the ability of these religated plasmids to restore agmatine ureohydrolase activity to an speBsup- strain of E.coli. Using a cell-free transcription and translation system the direction of transcription and the approximate location of the promoter was determined. The  direction of transcription was also determined by cloning fragments in both directions into the promoterless genes of lacZ (encodes β -galactosidase) and galK {encodes galactokinase). The ability of these hybrid genes to confer enzymatic activities (β -galactosidase or galactokinase) to strains deleted in their respective genes confirmed the location of the speB promoter. -- cAMP:CRP was shown to interact with the promoters of speA and speB using a cell-free transcription and translation system in which cloned copies of the genes served as templates. This was also shown  in vivo, by demonstrating that cAMP, inhibited the expression of β -galactosidase and galactokinase in plasmids  carrying fusions of the speA and speB promoters to the structural genes of these enzymes. In addition, cAMP supplementation of minicells carrying the plasmid pKA5 (carries speB) caused repression of agmatine ureohydrolase synthesis. Cyclic AMP decreased and agmatine increased the steady state mRNA concentrations of speB, while those of lacZ were increased by cAMP in the ∆cya strain. In contrast,  cAMP did not affect the steady state concentrations of lacZ or speB mRNAs in the ∆crp strain.


identifier: Clarke, Lisa <https://research.library.mun.ca/view/creator_az/Clarke=3ALisa=3A=3A.html>   (2002) A descriptive study of traumatic head injury discharges in Newfoundland and Labrador, 1985-1998.  Masters thesis, Memorial University of Newfoundland.

abstract: Background: In the last decade the number of traumatic head injuries (THIs) admitted to Newfoundland's main neurosurgical referral centers has noticeably declined, particularly those resulting from motor vehicle accidents (MVAs).  Objectives: To describe the epidemiology of THIs over the period 1985-98 and to assess any relationship between the incidence of THIs and use of helmets, seatbelts and alcohol.  To determine the occurrence of these preventative measures.  Methods: The charts of 2,739 patients from the greater eastern area of Newfoundland were reviewed.  Other etiological factors affecting the incidence of THIs such as animal attacks, fall, brawls, sports/play, abuse, pedestrians, moose-MVAs, plane crashes, explosions, suicide attempts, being struck with a foreign object and work injuries were also examined.  Sex, age, dates of injury and admission, ICD codes assigned, physiological outcome, hospital outcome and geographic location of injury were also collected.  Results: Falls accounted for 31.2 percent of all THIs; MVAs, the second most common cause, accounted for 27.4 percent of all THIs.  Most injuries were incurred by people ages 15 and younger (26 %).  They were typically male and lived in the urban eastern area of Newfoundland.  Enforcement and legislation on helmet and seatbelt use and drinking and driving were temporally associated with the observed decline in THIs.  A great deal of safety education and public awareness, however, is still needed.


identifier: Beresford, Kathie L. <https://research.library.mun.ca/view/creator_az/Beresford=3AKathie_L=2E=3A=3A.html>   (1998) Assessment of drug prescription in the community: utilization of criterion-based guidelines.  Masters thesis, Memorial University of Newfoundland.

abstract: Pharmaceuticals are a fundamental component of health care delivery in today's society.  Yet the necessity and appropriateness of their prescription is sometimes questionable.  We performed two pilot studies to determine the feasibility of: (1) collecting patient specific data from physicians, (2) applying clinical practice guidelines to family physicians' therapeutic decisions and (3) using a trained research team versus an expert panel to measure the appropriateness of these decisions.  These studies (a) examined the utilization of drugs for upper gastrointestinal (GI) disorders and (b) antimicrobial agents.  In both studies two panels assessed the physicians' diagnostic and treatment decisions.  To assess appropriateness of these decisions an expert panel used implicit clinical judgement and a research team applied explicit criterion-based guidelines.  Comparisons of the decisions made by these two panels determined that it is feasible for a research team to apply guidelines to patient specific data and make decisions regarding the optimal treatment regime for patients examined. -- The first study examined the use of drugs effective in the treatment of upper GI disorders as prescribed by six family physicians.  The treatment decisions made by the physicians and subsequently judged by two panels showed that the panels agreed 95% of the time on the optimality of the physicians' decisions.  From the high level of agreement we conclude that it is feasible to assess therapeutic decisions through the application of guidelines by a research team versus by an expert panel.  However, the decisions made by the expert panel were used to assess the appropriateness of physicians' therapeutic decisions.  Of the four drug categories analyzed, the overutilization and underutilization rates were: proton pump inhibitors 12 and 35%; H2 receptor antagonists 22 and 14%; antibiotics 3 and 55%; and prokinetics 8 and 0% respectively. -- The second study investigated infection-related illnesses and the utilization of antibiotics by four family physicians.  Two panels were involved in assessing the necessity for antibiotics and appropriateness of choice, using the Ontario Anti-infective Guidelines for Community-acquired Infections (1997).  Patient interviews were performed and the congruency between patient and physicians' description of primary symptoms was 90%.  Of the 98 patients included in the assessment, 22 were prescribed an antibiotic.  When compared to the expert panel's decisions the subsequent application of the guidelines to the physicians' treatment decisions by a research team was highly sensitive and specific regarding the necessity for antibiotics but there was less agreement regarding the appropriateness of the type of antibiotic prescribed. -- We conclude from both studies that it is feasible to collect patient specific data from physicians sufficient to assess therapy using a research team versus an expert panel and for the research team to judge prescribing appropriateness by applying explicit criterion-based guidelines.  As a result of these pilot studies, two studies were designed to identify inappropriate prescription in the community, and to assess the impact of educational interventions on improving the prescribing practices of family physicians.


identifier: Baldeh, Mansajang P. <https://research.library.mun.ca/view/creator_az/Baldeh=3AMansajang_P=2E=3A=3A.html>   (1992) Characterization and isolation of a β-cell surface receptor for diabetogenic EMC-D virus and studies on the relationship between receptor number and pathogenesis in virus-induced IDDM in mice.  Doctoral (PhD) thesis, Memorial University of Newfoundland.

abstract: The diabetogenic variant of EMC virus, EMC-D, can infect mouse pancreatic β-cells and may induce a type 1 diabetes-like syndrome in SJL/J mice, but not in C57BL/6J mice. A number of reports suggest an association between pathogenicity and the number of β-cell receptors available for EMC-D virus binding. Yet a great deal more is known about EMC-D virus, than about the receptor structures that allow its entry into β-cells. The aim of this project was to  characterize the virus receptor on BMP cells and to see if the receptor plays a role in EMC-D virus-induced diabetes in  SJL/J mice. -- The nature of the EMC-D virus receptor was investigated by in vitro attachment of ³H-labelled EMC-D virus to BMP cells. Virus binding was saturable and reached equilibrium after 2 h at 4°C. Although Scatchard analysis revealed only a single high affinity (Kd = 1.2 nM; 4 X l0⁵ sites/cell) binding site, Hill analysis of the saturation binding data strongly suggested that EMC-D virus has more than one binding site on BMP cells. Pretreatment of the cells with protease, neuraminidases, or with lectins, showed  that the receptor is a protein and that sialic acids are required for virus binding to BMP cells. Pretreating cells with phospholipases C and D or with enzymes specific for N-linked carbohydrates had no significant effect on virus binding. BMP cell surface receptor regeneration after protease treatment took about 6 h, and was inhibited by cycloheximide, but not by tunicamycin. HPLC analyses of total and neuraminidase-releasable sialic acids suggested that about 30% of the total sialic acid on BMP cells is Neu5Ac; Neu5Gc on BMP cells seemed resistant to V. cholerae neuraminidase. It is concluded that the receptor for EMC-D virus on BMP cells is a sialylated glycoprotein, and virus binding involves Neu5Ac, and possibly Neu5Gc, but not N-linked sugars. -- The Hill analysis result is supported by the detection of two affinity purified putative receptor proteins (M.W. 97,000 & 70,000 daltons) from BMP cells. Chromatofocusing studies on these proteins confirmed that the putative virus receptor contains Neu5Ac. Monoclonal antibodies raised against the putative receptor blocked EMC-D virus infection of BMP cells and virus binding to β-cells from SJL/J mice. FACS analyses of virus binding and anti-EMC  virus anti-idiotypic antibody binding to β-cells, showed that cells from SJL/J and C57BL/6J mice contain about the same number of EMC-D virus receptors. It is concluded that the inability of EMC-D virus to cause IDDM in C57BL/6J may not be due to lack of, or a reduction in the number of virus  receptors on β-cells from C57BL/6J mice. It is speculated that anti-idiotypic antibodies may play a role in the initiation of β-cell destruction in virus-infected SJL/J mice, possibly by molecular mimicry.


identifier: Ryan, Paula <https://research.library.mun.ca/view/creator_az/Ryan=3APaula=3A=3A.html>   (1999) Characterization of the FGF receptor signaling complex in Xenopus laevis during early embryonic development.  Masters thesis, Memorial University of Newfoundland.

abstract: A stable complex is formed between the fibroblast growth factor receptor (FGFR) and SH2-containing proteins, during early development in Xenopus laevis.  The results presented in this thesis demonstrate that phosphorylation of PLCγ1 and  its association with FGFR1 occurs during mesoderm induction in vitro.  PLCγ1 is involved in intracellular signaling pathway of FGF during the time mesoderm induction is occurring in the embryo.  PLCγ1 is specifically phosphorylated during early- to mid-blastula stages, yet the expression level of PLCγ1 protein is constant throughout these stages of development.  It is speculated that PLCγ1 is  involved in a negative feedback loop, down-regulating the FGFR.  The timing of the in vitro experiments (30-minute treatment of FGF) provides evidence that FGF may be a component of the vegetal inducing signal.  There were seven other phosphorylated bands co-immoprecipated with PLCγ1 or FGFR during early embryo development.  These substrates were identified as phosphatidylinositol 3-kinase (PI3'K), GTPase-activating protein (Gap), SHP2 phosphatase, Nck and three nck-associated proteins: NAP123, NAP 81 and NAP65.  Son of Sevenless (SOS) and growth factor receptor binding protein2 (GRB2) were identified in this complex.  Neither SOS nor GRB was phosphorylated.  This report provides evidence for the importance of these substrates for FGFR signaling during early embryonic development.


identifier: Simms, Michelle <https://research.library.mun.ca/view/creator_az/Simms=3AMichelle=3A=3A.html>   (1999) Characterization of the TNFa microsatellite's reliability, MHC associations and occurrence in two ethnically different SLE populations.  Masters thesis, Memorial University of Newfoundland.

abstract: The major histocompatibility complex (MHC) encodes a diverse selection of genes, many of which have immunological functions.  Several of these genes are polymorphic but are maintained in strong linkage disequilibrium as conserved extended haplotypes.  Particular alleles at these loci or particular haplotypes have been found to be associated with increased susceptibility to various diseases.  The TNFa microsatellite, with a variable number of dinucleotide repeats, is found 3.5 kb upstream of the tumour necrosis factor loci in the central region of the MHC.  This project examined the reliability of the TNFa typing assay adapted for use in this laboratory.  The TNFa microsatellite was then used to -- a) further characterize extended haplotypes -- b) investigate possible associations of alleles of TNFa with null alleles of the fourth component of complement (C4) -- c) examine the possibility of disease susceptibility genes for systemic lupus erythematosus (SLE) in the TNFa region in two separate ethnic groups. -- Fourteen TNFa alleles were identified and named in accordance with published literature.  Repeat typings of samples and analysis of a large kindred were used to test reliability of results obtained using TNFa microsatellite typing.  A high level of consistency was demonstrated.  The only errors in typing were in distinguishing heterozygosity with two consecutive alleles from homozygosity of the larger allele. -- The presence of extended haplotypes, i.e. haplotypes sharing alleles at HLA-B,Bf,C4A,C4B and TNFa, was demonstrated.  Although several extended haplotypes did exist, the most common extended haplotype in the population studied was HLAB8;TNFa2;BfS;C4AQ0;C4B1.  It occurred in 15 of 75 unrelated chromosomes.  There were examples of specific haplotypes sharing alleles at all loci except TNFa.  There were five separate instances where this occurred in this data set.  In the absence of HLA-DR data, the reasons for this are difficult to ascertain but possible explanations include multiple historic recombinations, rare extended haplotypes, and mutations of the original TNFa alleles occurring on the extended haplotypes. -- The possible association of TNFa alleles with null alleles of C4 was investigated.  If a strong association could be demonstrated, the TNFa allele could serve as a useful marker of the null alleles of C4 which are sometimes difficult to ascertain.  Although TNFa2 occurred frequently with C4AQ0 on the extended haplotype HLA-B8;BfS;C4AQ0;C4B1 known to contain a deleted C4A gene, no other clear association between particular TNFa alleles and C4 null alleles was observed.  Similarly, in a population with null alleles identified by densitometry, there was no one TNFa variant occurring in all people with low C4A levels (relative to C4B).  None of these "nulls" represented the 30 kb deletion commonly observed in Caucasians carrying the HLA-B8 extended haplotype. -- The frequency of alleles of the TNFa microsatellite in Caucasian and Korean SLE patients was examined and compared to the appropriate ethnically matched controls.  Both ethnic groups are known to have MHC associations with SLE, although not necessarily the same associations.  We wished to use the TNFa microsatellite as a marker for the central region of the MHC to investigate whether there may be genes in the vicinity of the microsatellite, and in linkage disequilibrium with it, that may influence susceptibility to this disease.  Our results demonstrated a significantly increased frequency of the TNFa2 allele in both ethnic groups.  Although other genes exist in this region, the tumour necrosis factor loci, located 3.5 kb from this microsatellite, may be good candidate genes for susceptibility to SLE and are worthy of further study.


identifier: Wang, Yu Tian <https://research.library.mun.ca/view/creator_az/Wang=3AYu_Tian=3A=3A.html>   (1992) Brainstem mechanisms subserving oesophageal peristalsis in the rat.  Doctoral (PhD) thesis, Memorial University of Newfoundland.

abstract: Functional organization and neurotransmitter mechanisms of the central oesophagomotor pathway from the subnucleus centralis of the nucleus tractus solitarii (NTSc) to the compact formation of the nucleus ambiguus (AMBc) were investigated in vivo in the anaesthetized rat and in vitro in a rat brainstem slice preparation. Techniques utilized included micropneumophoresis, extra- and intracellular recording, neuronal tracing and immunocytochemistry. -- Results from neuropharmacological investigations indicate solitarial GABA neurons exert a tonic inhibition of oesophageal premotor elements in the NTSc. Moreover, these GABAergic neurons are involved in pharyngoesophageal coupling of primary peristalsis as well as generation of secondary peristalsis. -- Activation of muscarinic cholinoceptors in the NTSc is necessary for generation of both fictive primary and secondary peristalsis. Such activation is functionally confined to ipsilateral AMBc motoneurons. The rat brainstem appears to lack excitatory commissural connections between the oesophagomotor circuits in each hemi-medulla. -- Results from in vivo and in vitro experiments demonstrate NTSc premotoneurons utilize an excitatory amino acid (EAA)-like substance, which activates N-methyl-D-aspartate (NMDA) and non-NMDA receptor subtypes on AMBc neurons. Activation of NMDA receptors is required for functional information transfer in this oesophagomotor pathway and, in turn, this system is dependent on the integrity of somatostatinergic input originating from the NTSc. -- Apart from solitarial input, NTSc-AMBc synaptic transmission is subject to modulation by nicotinic cholinoceptor-mediated input originating from the zona intermedialis reticularis parvicellularis (ZIRP). By augmenting the depolarizing response to glutamate and inhibiting nicotinic cholinoceptor-mediated excitation, somatostatin presumably plays a critical role in oesophagomotor control at the AMBc level. -- Taken together,  the present work lends strong credence to the hypothesized role of the NTSc-AMBc projection as the common premotor substrate of oesophageal peristaltic control. NTSc premotoneurons are involved in initiating and organising the  sequence of peristaltic activity, whereas AMBc motoneurons are intricately involved in modifying the final oesophagomotor output.


identifier: Abedi, Masomeh Seyeda <https://research.library.mun.ca/view/creator_az/Abedi=3AMasomeh_Seyeda=3A=3A.html>   (2002) A study of the impact of lifestyle clinic attendance on individual behaviour modification.  Masters thesis, Memorial University of Newfoundland.

abstract: Cardiovascular diseases (CVD) accounted for 36% of all deaths in Canada in 1997 (Heart and Stroke Foundation of Canada, 2000).  Different methods of communication have been employed to increase CVD risk awareness.  The purpose of this study was to generate knowledge regarding the association between one method of communication, interpersonal communication (specifically LifeStyle (LS) Clinics) and individual behaviour modification.  This study also served as a pilot project for the province-wide evaluation of this communication approach by the Newfoundland & Labrador Heart Health Program.  A quasi-experimental study with one pretest and two post-tests was conducted in Stephenville, Newfoundland and Labrador.  Thirty individuals participated in this study.  Consenting LS Clinic participants completed 2 pre-coded questionnaires (pre-and post-LS Clinic attendance) and were interviewed one-month post-LS Clinic.  Participant responses were analyzed using SPSS 8.0.  A key informant interview was conducted with the LS Clinic public health nurse.  Participants modified certain lifestyle behaviours post-LS Clinic attendance, such as increasing daily physical activity levels (p=0.015).  LS Clinic attendance, however, was not associated with a change in participants' CVD risk knowledge and attitudes.  Additional variables, including: personal health; spouse's health; physicians' advice; gender; and, season of year were also associated with behaviour modification.  Recommendations were suggested for the province-wide evaluation of the LS Clinics.


identifier: Goldberg, Mark T. <https://research.library.mun.ca/view/creator_az/Goldberg=3AMark_T=2E=3A=3A.html>   (1980) A study of the pharmacological reactivity of aortae from spontaneously hypertensive rats.  Doctoral (PhD) thesis, Memorial University of Newfoundland.

abstract: Increased vascular reactivity to pressor agents has often been observed in hypertensive states. A widely accepted hypothesis for this phenomenon attributes the reactivity changes to structural changes, such as vascular smooth muscle hypertrophy, that are thought to take place subsequent to the onset of hypertension. The work presented here studied vascular reactivity in an animal model of essential hypertension and offers an alternative explanation  for this phenomenon. -- Spontaneously hypertensive rats (SHR) treated from conception with timolol, a β-adrenergic blocker, did hot develop high blood pressure. Thoracic aorta  from these normotensive SHR exhibited increased reactivity to raised extracellular K⁺, when compared with tissues from timolol-treated Kyoto Wistar control rats. The normotensive SHR aorta also showed significant responsiveness to La³⁺ and  to high extracellular Ca²⁺ concentrations without previously  depolarizing the tissue with high K⁺. The response to La³⁺ was shown to be primarily mediated through a precipitation of the buffer in normal Krebs solution, resulting in a decrease in the pH of the bathing media. A large contractile  response was recorded when these conditions were mimicked by  the addition of HC1 to the Krebs solution bathing the SHR aorta. -- These observations indicate that altered reactivity in SHR aorta is not a consequence of hypertension. Reactivity changes were attributed to a deficient control of Ca²⁺ homeostasis in this tissue, which may prove to be a causative factor in the etiology of hypertension in the SHR.


identifier: Daniel, Syble P. S. <https://research.library.mun.ca/view/creator_az/Daniel=3ASyble_P=2E_S=2E=3A=3A.html>   (1999) A study of the relationship of apoptosis and proliferation to local recurrence in breast cancer.  Masters thesis, Memorial University of Newfoundland.

abstract: This retrospective study on breast cancer investigated the inter-relation of the apoptotic factors, Bcl-2, Bax, and proliferation factors Ki-67, PCNA, together with their potential as predictors of local recurrence of tumour.  Tumour specimens of patients with local recurrence (defined as recurrence of tumour within a period of 5 years following diagnosis, at the site of original surgery or adjacent axillary region) were expected to show increased proliferation and decreased apoptotic behavior thereby substantially increasing the risk of local recurrence.  In addition, loss of function of the tumour suppressor gene, p53, which normally functions as the inhibitor of the proliferation and an activator of the apoptosis, was expected to play an integral part in promoting tumour growth. -- Immunohistochemical analysis of the apoptotic and proliferative markers showed several significant associations between the biological parameters.  Analysis of the association between p53 and Bcl-2 expression indicated no statistical significance.  Further analysis of the raw data revealed a general trend towards an inverse association between the two markers.  Thus, suggesting that p53 in its mutant form behaves in a similar manner as the wild type p53 which functions to inhibit the expression of Bcl-2.  Loss of p53 function was also associated with an increase in the proliferative rate as measured by the expression of Ki-67 and PCNA. -- The Bcl-2 protein, known to inhibit apoptosis, failed to display an inverse association with the rate of apoptosis (as measured by the TUNEL method) and the pro-apoptotic protein, Bax.  In addition, Bcl-2, also known to promote the retention of cells in the G0/G1 phase of the cell cycle did not exhibit an inverse relationship with expression of Bcl-2 expression and the proliferative markers, Ki-67 and PCNA. -- Among the clinicopathological parameters such as tumour grade and lymph node status, only tumour size showed a significant association with local recurrence where tumour size greater than 2 cm indicated an increased likelihood of local recurrence.  In an analysis of the inter-relation between the biological parameters and clinicopathological features, tumour grade and not tumour size exhibited significant positive associations with Bcl-2 and p53 expression.  As expected, Bcl-2 positive tumours were associated with low tumour grade while loss of p53 function was associated with high tumour grade.  The presence of lymph node status indicated a positive association with the proliferative marker, PCNA. -- Contrary to our expectations, the expression of Bcl-2 and p53 failed to predict local recurrence of breast cancer.  The results obtained from the study confirm the need for further analysis of the inter-relations of the biological markers using more quantitative laboratory techniques namely, quantitative RT-PCR and flow cytometry.


identifier: Collins, Lori Ann <https://research.library.mun.ca/view/creator_az/Collins=3ALori_Ann=3A=3A.html>   (1989) Glutathione S-transferases of the rodent pancreas : their response to inducing agents and to manipulation of pancreatic mass.  Masters thesis, Memorial University of Newfoundland.

abstract: Glutathione S-transferases (GSH-T) are a family of enzymes with both detoxifying and transport capacities.  Their main role is in the catalysis of detoxification pathways.  The enzymes are found in many tissues, with high concentrations in the mammalian liver and the gastrointestinal tract.  Significant amounts of the enzyme have also been discovered in the rat pancreas, its function there being currently unknown.  Previous studies have demonstrated that GSH-T levels are inducible in the liver with oral administration of certain compounds, such as the dietary antioxidant 2(3)-tert-butyl-4-hydroxyanisole (BHA).  In the present study, rats, mice, and hamsters were fed a diet containing 0.75% BHA for 14 days.  Pancreatic GSH-T activity and levels in response to this were significantly increased over control animals only in hamsters.  It is possible that this induction may provide protection against pancreatic carcinogens. -- Three other groups of hamsters were given either 0.03 mmol a-angelica lactone (a-AL)/g of diet or 0.03 mmol coumarin (COU)/g of diet, two naturally occurring plant compounds, or 20% green coffee beans (GCB).  Although all three of these are known to induce liver and small intestinal mucosal GSH-T in rats and mice, none caused any significant induction of pancreatic GSH-T in the hamster, further exemplifying the difficulty in manipulating these enzymes in the pancreas as compared to other tissues. -- In addition to these experiments, groups of rats were fed a diet containing 40% raw soya flour (RSF) for 14 or 21 days.  RSF contains trypsin inhibitor (TI) which has been shown to cause pancreatic enlargement, a phenomenon attributed to increased levels of the gastrointestinal hormone cholecystokinin (CCK).  Pancreatic mass increased significantly in response to RSF; however DNA content as related to body weight increased only in the animals on the 3 week feeding schedule, indicating hyperplasia or an increase in cell number in this group.  The activity of GSH-T in the enlarged pancreas was not found to be significantly different from that of the control pancreas. -- In an additional study, which utilized the compound FOY-305, also a trypsin inhibitor, hamsters were gavaged with 400 mg/kg body weight of FOY-305 once daily for 14 days.  Both pancreatic weight and DNA content were significantly increased in these animals with a significant reduction in GSH-T activity.  This reduction may be involved in the higher incidence of pancreatic neoplasms observed when trypsin inhibitors are fed for longer periods.  Total GSH-T levels in the pancreas remained unchanged in these animals. -- Finally, the CCK antagonist L-364.718 was administered orally to hamsters at 1 mg/kg body weight, twice daily for 14 days.  This compound was not found to cause a reduction in pancreatic mass or DNA content, thereby indicating that CCK does not seem to be a requirement for normal pancreatic maintenance and growth in this species.  Furthermore, no changes in GSH-T activity or levels were observed. -- KEY WORDS: a-Angelica Lactone; 2(3)-tert-butyl-4-hydroxyanisole; Coumarin; Detoxification; FOY-305; Glutathione S-transferases; Hypertrophy/Hyperplasia; Induction; Kahweol; L-364,718; Pancreas; Raw Soya Flour


identifier: Yamashita, Mineko <https://research.library.mun.ca/view/creator_az/Yamashita=3AMineko=3A=3A.html>   (1986) Ethnography: primary nursing, an investigation into the nature of one type of patient care modality.  Masters thesis, Memorial University of Newfoundland.

abstract: The purpose of this study was to describe the nature of primary nursing by using five core elements under which nurses' activities were described by observing nurses on a unit and interviewing them over a period of three months. -- The study was based on the ethnographical approach. Through the method of participant observation, the interactions taking place between the nurses and their patipnts, the family, members, peers and other health care personnel were examined. The main focus was placed on the nurse-patient interaction as occurred on the unit. Documents, such as Progress Notes (Nurses' Notes), kardex and communication books, which were related to patient-care delivery, were also examined. From the literature review, the following five core elements were identified. These core elements were: Responsibility, accountability, autonomy, caring and decentralized communication. The data were analyzed on an ongoing basis to identify, sort and categorize the nurses' activities under appropriate core elements. -- Each participant practised her primary nursing care delivery mode  with definite, identified constructs which formed a conceptual framework to guide her practice. While the constructs identified and the outcome of care delivered by the participants were similar, the mode of patient care delivery was found to be unique to each individual nurse. -- Despite each participant's diverse approach to patient care,  a similar pattern of activities and behavior occurred consistently among all participants under the identified constructs and the pattern was examined as a group behavior to derive a definition of primary nursing. Based on the data  obtained from this study using these constructs to describe the nature of primary nursing, the following definition of primary nursing emerged. -- Primary nursing is a nursing care delivery system whereby each primary nurse is assigned to a group of four to six patients. The primary nurse is responsible and accountable for her patients' individualized  total care. She carries out a comprehensive patient care in an autonomous and caring manner by coordinating and collaborating with the family and other health care members through direct and open communication. As a multidisciplinary member of the health care system, the primary nurse acts as the patient advocate. She is empowered  to delegate responsibility, in her absence, to her peers by the nursing care plan. In this way, continuity of care on a 24-hour basis is ensured throughout the patient's hospitalization.


identifier: Blair, Charles E. <https://research.library.mun.ca/view/creator_az/Blair=3ACharles_E=2E=3A=3A.html>   (1985) Effect of therapeutic milieu on self-care behaviors of nursing home residents.  Masters thesis, Memorial University of Newfoundland.

abstract: Evidence points to dependency in clients in health care institutions such as nursing homes and psychiatric hospitals. This study investigated the effects of three nursing care approaches [(a) combination of mutual goal setting, prompting, and reinforcement (b) mutual goal setting only (c) normal routine care] on selected morning self-care behaviors of nursing home residents. Subjects were  four male and 11 female residents who depended on staff for 100% assistance with self-care tasks. Mean age and length of  institutionalization for males were 79.2 years and 10.5 months respectively; for females 84.3 years and 16.5 months respectively. An experimental double blind design was used. Also, each subject served as his/her own control. Subjects and nurses were divided into three groups each. Nurses were assigned to subjects in a corresponding group. The study was   divided into a 6 week attainment of skills period and a 16 week follow-up period. The dependent variables in the study were subjects' independent performance of selected self-care  tasks and nurses' and subjects' satisfaction with care given  and received respectively. Results showed that subjects in the mutual goal setting, prompting, and reinforcement group scored significantly higher on goal attainment and satisfaction, as measured by Goal Attainment Scaling and Patient Satisfaction Questionnaire respectively, than subjects in the other two groups. Nurses in the mutual goal setting, prompting, reinforcement group scored significantly  higher on satisfaction, as measured by Nurse Satisfaction Questionnaire, than those in the other two groups. The .05 level of significance was used in interpreting all statistical tests. The overall conclusion of the study was that the combination of mutual goal setting, prompting, and reinforcement was significantly more effective in motivating  subjects towards self-care with resultant increase in satisfaction. Details of the study are reported. Interpretation of the findings and implications of the research, for nursing practice with nursing home residents and psychiatric patients, and for clinical nursing research in general, are discussed. Suggestions for future pertinent research are made.


identifier: Jiwani, Gulrosebegum Nurdin <https://research.library.mun.ca/view/creator_az/Jiwani=3AGulrosebegum_Nurdin=3A=3A.html>   (1988) Self-esteem, family perception, and therapy preferences of depressed individuals : an exploratory study.  Masters thesis, Memorial University of Newfoundland.

abstract: This exploratory study investigated the relationship between depressive symptomatology, self-esteem, and perception of family environment of depressed adults.  In addition, the study identified the depressed adults' preferences for support and therapy when experiencing depressive episodes.  A convenience sample of 25 male and female adults from two health care facilities participated in the study.  Data was obtained on admission, discharge, and one month post-discharge.  The Beck Depression Inventory measured depressive symptomatology; Tennessee Self Concept Scale assessed self-esteem; Family Environment Scale reflected family perception of cohesion, expressiveness, and conflict among members; and the Subject Profile form provided demographic data and subjects preferences for support and therapy. -- Findings revealed a persistently low self-esteem among subjects and a fairly constant perception of the family environment over time, even with great alleviation of depressive symptomatology at discharge and one month follow-up.  An interesting finding was that depressed adults perceived their families as lacking in expressiveness.  Subjects also indicated several preferences for support and therapy.  A noteworthy observation was the subjects' insistence of empathy from staff and others.  The results clearly suggest depressed individuals need empathic understanding from care-givers.  Both the depressed member and the family must be included in the assessment and treatment process for effective interventions.


identifier: Bennett, Lorna Ruth <https://research.library.mun.ca/view/creator_az/Bennett=3ALorna_Ruth=3A=3A.html>   (1989) The lived experience of witnessing marital violence in adolescent girls : a phenomenological study.  Masters thesis, Memorial University of Newfoundland.

abstract: The primary aim of this study was to gain access to experiential aspects of living in a violent home through exploring the impact of family violence from the perspective of adolescent girls.  The essential question asked was "What is it like to grow up in a violent home and what is the meaning of this experience?"  The study included five participants between the ages of 15 and 24 years (only one participant was over the age of 20), who were recruited through the local shelter.  Unstructured interviews that facilitated spontaneous verbal descriptions was the method of data collection. -- A phenomenological method of data analysis was used following the general outline of Giorgi (1975) with some procedural suggestions by Wertz (1985) and Fischer and Wertz (1979).  This method involved a meaning unit approach based on analysis of transcribed audiotaped interview data. -- Common essential themes identified were: (a) participants experienced lived violence as an integrated whole, which encompassed different dimensions of family life, (b) participants described a sense of enduring the experience for a lifetime but paradoxically had difficulty recalling the violence.  Participants also described, (c) the emotional reactions of fear, helplessness and loss, (d) behavioral reactions aimed at preventing or escaping from the violence, (e) a close bond with mother and/or siblings, (d)[sic] a need to make sense of or understand the violence and finally, (f) a need to resolve or "settle" the experience. -- Implications of the findings stress the need for assessment to take into account lived dimensions of the experience, in order to determine both the immediate and long term risk for mental health problems in this group.


identifier: Matthews, Mary Kathleen <https://research.library.mun.ca/view/creator_az/Matthews=3AMary_Kathleen=3A=3A.html>   (1987) The relationship between maternal labour analgesia and infant breastfeeding in the first four days after birth.  Masters thesis, Memorial University of Newfoundland.

abstract: The Relationship between Maternal Labour Analgesia and Infant Breastfeeding in the First Four Days After Birth. -- This prospective ex post facto study explored the relationship between two commonly used labour analgesics, meperidine and alphaprodine, and delay in establishing effective breastfeeding in healthy neonates from birth to four days post-birth. -- The major purposes of the study were to describe the pattern of initiation of breastfeeding in healthy neonates whose mothers received no analgesia in labour and to compare the patterns of initiating breastfeeding in babies of mothers who received no medication in labour with those babies whose mothers received labour analgesic medication. -- Infant suckling was assessed by an Infant Breastfeeding Assessment Tool (IBFAT).  The IBFAT is a new instrument which was developed for the purpose of the study to assess and measure infant breastfeeding competence. -- The subjects of the study were 60 healthy fullterm newborn infants who were delivered spontaneously following uncomplicated labours and deliveries.  Selection was on an as-they-come basis on admission to the well-baby, nursery.  Final sample was 86.9% of the total eligible population. -- The IBFAT was completed by the mother for every feeding and by the researcher at some randomly selected feedings until effective feeding was established.  Inter-rater reliability was assessed by comparing the researcher's scores with the mother's scores.  Inter-rater reliability was 91%. -- The researcher was blind to the medication status of each baby until data collection was completed.  Following completion of data collection the babies were divided into three groups depending upon whether or not medication had been administered to the mother.  The final groups were two medicated groups and one non-medicated comparison group. -- First, a descriptive analysis was done on the pattern of initiation of breastfeeding in babies of unmedicated mothers.  Then the hypothesis, that babies of mothers who received analgesia during labour would take longer to establish effective breastfeeding than babies of unmedicated mothers, was tested with oneway analysis of variance and Dunnett’s t-test.  To rule out parity as a confounding variable, the analysis was repeated on the babies of multiparous mothers only in the alphaprodine (n = 20) and the non-medicated (n = 18) groups. -- The results of the study showed that 66.6% of babies of mothers who received no analgesia during labour were breastfeeding effectively by 12.5 hours after birth and that 85.7% had established breastfeeding by 24 hours. A statistical analysis of inter-group scores in both the mixed parity and the multiparous only groups, suggested that babies of mothers who received a standard dose of analgesic medication within one to four hours prior to delivery took significantly longer to establish effective breastfeeding than those whose mothers received no medication.  There was no statistically significant difference when the mother received the medication within one hour prior to delivery.  Babies of primiparous mothers took significantly longer than babies of multiparous mothers in all groups.  A   number of possible explanations are advanced for this result. -- Delay in initiation of breastfeeding has potentially deleterious effects on both mother and baby. From the results of the study a number of suggestions for further nursing research, practice and education are put forward.


identifier: Thibeault, Catherine Ann <https://research.library.mun.ca/view/creator_az/Thibeault=3ACatherine_Ann=3A=3A.html>   (1989) An investigation of the occupational health status of nurses working in an isolated setting.  Masters thesis, Memorial University of Newfoundland.

abstract: An ethnographic method was used to examine the occupational health status of nurses working in an isolated community on the coast of Labrador.  The researcher spent two months observing two nurses as they worked in the community, and collected data relating to the nurses' perceptions of their own work-related health.  Data was collected using open-ended, unstructured interviews and participant-observation.  Each nurse was found to experience different levels of work-related stress and job satisfaction.  Both nurses, however, identified physical environment, role structure and role responsibilities as external variables affecting their work-related health.  The effect of these variables appeared to be mediated by the internal variables of job satisfaction, stress response, physical health status and coping styles.  The author recommended a re-evaluation of the nurses' role structure to reduce role conflict and role overload, and also recommended that specific educational preparation and professional support programs be established for these nurses.


identifier: Jacobs, Velma Mitchelmore <https://research.library.mun.ca/view/creator_az/Jacobs=3AVelma_Mitchelmore=3A=3A.html>   (1995) Informational needs of post-surgical patients following discharge.  Masters thesis, Memorial University of Newfoundland.

abstract: This study evolved from changes in the health care system resulting in early discharge of patients from hospital and the need for information by surgical patients in order to manage their care at home.  Since professionals and patients often do not perceive the same priorities for teaching content, the informational needs as perceived by patients, were explored in this study.  The relationship between personal and illness-related factors and informational needs was examined.  Patient reports of information given and satisfaction with information were also explored. -- A questionnaire was mailed to patients who were discharged home from hospital following appendectomy, inguinal hernia repair or cholecystectomy.  Data were collected using the Patient Learning Need Scale.  Subjects were asked to rate each item according to how important the information was in order to manage their care at home.  For each item in the scale, subjects were also asked to indicate if the information was given and, for information given, to indicate how satisfied they were with this information.  Demographic and illness-related data were collected from subjects and hospital records.  Analysis was completed for a sample of 45 subjects. -- Highly rated informational items for the subjects in this study were those related to physical activity, complications, wound care, pain management, elimination and guidelines for bathing.  Age, education and gender were not related to total informational needs.  However, subjects with a lower level of education needed more information about community resources.  Type of surgical procedure, length of hospital stay, and medications were not related to total informational needs.  Subjects who were discharged with a prescription for medications needed more information in two areas-medications and community resources. -- Information which was rated as important and identified as given by the subjects in this study was also reported as satisfactory.  Information considered as important and reported as not given by at least 40% of the subjects related to complications, elimination and recommendations for rest and physical exercise.  Approximately 30% of subjects perceived that information about pain control, prevention of complications and guidelines for bathing were not given. -- Implications for nursing practice and education include suggested content for developing teaching programs for short term surgical patients or for setting teaching priorities for patients in preparation for discharge.  Areas for further research are outlined.


identifier: Kelly, Colleen M. E. <https://research.library.mun.ca/view/creator_az/Kelly=3AColleen_M=2E_E=2E=3A=3A.html>   (1993) A nursing investigation of factors identified by Newfoundland women that may influence screening for cancer of the cervix.  Masters thesis, Memorial University of Newfoundland.

abstract: A descriptive, correlational investigation was conducted in two physicians' clinics in an urban setting in Newfoundland.  The investigation sought to document pap smear frequency and identify factors that may influence a woman's decision to have a pap smear.  Cancer of the cervix is considered preventable and amenable to successful treatment when detected early.  In order to be successful in primary and secondary prevention strategies for this cancer, nurses need to be aware of factors that may influence a woman's decision to have a pap smear according to recommended intervals. -- The conceptual framework used in this investigation was the Health Belief Model (HBM).  The major elements included:  individual perceptions, modifying factors, and likelihood of action.  Data were collected using the Pap Test Questionnaire.  Ninety-two women comprised the sample population. -- The sample consisted of women who were younger and well educated and was not representative of the general population.  Most were screened within a five year interval, with two thirds screened less than one year ago.  Most of the women of childbearing age were screened less than one year ago as compared to one half of those past childbearing. -- The major elements of the HBM were not found to influence screening practice.  Only one third of the sample perceived themselves to be susceptible for cancer of the cervix.  The majority reported their husband or boyfriend influenced their decision to have a pap smear.  Mother, close friends, and sister were also reported to be influential.  The majority believed the recommended screening interval was annually.  This has implications for education programs prior to the implementation of the revised screening guidelines which recommend screening every three years regardless of age or risk.  Subjects were not knowledgable of risk factors for cancer of the cervix and of particular concern over two thirds of the youngest age group reported early onset of sexual intercourse was not high risk.  Cues to action variables, the doctor and the media, were perceived to be highly influential and greater than that reported for individuals in a woman's family and social network.  The majority indicated they should remember when to have a pap smear, yet two thirds indicated the doctor should remind them.  Many of the women who had a pap smear less than one year ago were reminded by the doctor.  Almost all of the women reported they felt relieved to have a pap smear and that changes would be found early.  The barrier most frequently reported was unpleasantness. -- The findings of this investigation suggest replication for various subsets of the Newfoundland population including older women, women considered to be disadvantaged, and aboriginal peoples.  It is recommended nurses take an active role in prevention activities for cancer of the cervix and offer pap smear screening as a part of Well Womens' Clinics.


identifier: Davis, M. Elizabeth <https://research.library.mun.ca/view/creator_az/Davis=3AM=2E_Elizabeth=3A=3A.html>   (1992) An investigation of the educational preparation of nurses prior to working in land-based multiplace hyperbaric chambers in Canada.  Masters thesis, Memorial University of Newfoundland.

abstract: An Investigation Of The Educational Preparation Of Nurses Prior To Working In Land-based Multiplace Hyperbaric Chambers In Canada -- The purpose of this study was to describe the hyperbaric nurses working in clinical multiplace hyperbaric chambers in Canada, to determine their  age, sex, marital status and educational preparation, and to  identify the topics that they perceive should be included in  an introductory educational program offered prior to working  in multiplace hyperbaric chambers. -- Data for this descriptive study were gathered by means of author-constructed questionnaires and personal interviews. The questionnaires identified eight demographic variables, and asked participants to rate the importance of 37 topics for inclusion in a hyperbaric nursing course. The personal interview lasted approximately thirty minutes and was guided  by five open-ended questions. The interview tapes were scrutinized, and content analysis was used to extract common  themes which were organized into five categories. -- The sample was made up of 32 of the 33 English-speaking nurses who worked full-time, part-time or on an on-call basis in the three Canadian Hyperbaric units which were operational during January/February, 1990. These nurses were found to share many similar demographic characteristics. The interview data showed that the number of factors contributing to job satisfaction far exceeded those contributing to job dissatisfaction. -- The most frequently cited concern mentioned spontaneously by 12/32 nurses in the  category of personal and lifestyle adaptations was the occurrence of significant fatigue after a hyperbaric treatment. It was noteworthy and warrants attention because this sensation has not been reported previously by hyperbaric caregivers in the literature and it is known to be associated with decompression sickness. -- Other findings  were obtained in relationship to educational and professional concerns and focused on the challenges of infrequent dives and communication. The discussion includes the design of an Introductory Hyperbaric Nursing Course. At the conclusion of the study a number of recommendations related to nursing practice, education and research were made.


identifier: Snow Lono, Kathryn M. I. <https://research.library.mun.ca/view/creator_az/Snow_Lono=3AKathryn_M=2E_I=2E=3A=3A.html>   (1993) An investigation of the relationships among meaning, psychological well-being and caregiver burden.  Masters thesis, Memorial University of Newfoundland.

abstract: Investigation of the Relationships Between Meaning, Psychological Well-Being, and Caregiver Burden -- A descriptive, correlational investigation of 45 informal family caregivers of institutionalized Alzheimer care-recipi -ents was conducted to explore relationships between meaning, psychological well-being, caregiver burden. Home interviews were conducted using the following instruments: Life Attitude Profile - Revised (LAP-R), Memorial University  of Newfoundland Scale of Happiness (MUNSH), Caregiver Burden  Inventory (CBI). A correlational matrix was created, followed by stepwise multiple regression. The results are as  follows: (a) length of illness was an influential variable, related to meaning, psychological well-being, caregiver burden; (b) psychological well-being was the only predictor of caregiver burden; and (c) psychological well-being was predicted by: purpose, existential vacuum, age, length of illness, number of visits, and relationship to care-recipient, respectively. Implications for nursing practice, education, and research are discussed.


identifier: Pike, Sandra <https://research.library.mun.ca/view/creator_az/Pike=3ASandra=3A=3A.html>   (1990) Assessing the impact of a specially designed cardiovascular health education program for adolescents.  Masters thesis, Memorial University of Newfoundland.

abstract: The purpose of this study was to assess the impact of a specially designed Cardiovascular Health Education Program (C.H.E.P.), on the cardiovascular health knowledge of junior  high school adolescents. The program consisted of seven educational modules implemented within seven of the health classes in one grade eight class of junior high school adolescents. The impact of the program was assessed using the Cardiovascular Health Knowledge Questionnaire (C.H.K.Q.)  with an experimental group and control group. The C.H.K.Q. was administered prior to the implementation of the C.H.E.P.  (pretest), immediately after its implementation, (post test 1) and four months later(post test 2). -- Both the experimental and control groups scored poorly on the pre test. The experimental group significantly improved their mean scores on the post test 1 (p < .05) and this improvement was maintained on the post test 2. The control group however did not demonstrate any significant improvement on any of the post tests. -- The findings of this study demonstrate that a specially designed school-based cardiovascular health education program can have an impact on adolescent cardiovascular health knowledge. Further research is warranted to replicate the study with a larger sample and to assess the impact of the program on adolescent cardiovascular health attitudes and behaviors.


identifier: Nowe, Margaret Elizabeth <https://research.library.mun.ca/view/creator_az/Nowe=3AMargaret_Elizabeth=3A=3A.html>   (1993) Concerns of mothers of preterm low birth weight infants during the first week of the infants' discharge from hospital.  Masters thesis, Memorial University of Newfoundland.

abstract: In this qualitative study the purpose was to explore and describe the concerns of mothers of preterm Low Birth Weight  (LBW) infants during the first week following the infants' discharge from hospital. Concepts from role theory formed the conceptual framework for the study. -- Fourteen mothers of preterm LBW infants participated in the study. A structured diary and an audio-taped interview were used to collect data. Data were analyzed for themes and then categorized. -- The analysis of the data revealed that mothers' major concerns were related both to the infants and  to themselves. Over half of the concerns raised were related  to the infants; the most frequent were infants' health, feeding, growth and development, and elimination. Mothers' concerns about themselves focused on feeling tired, their emotional state, and schedules. Mothers also had concerns about their partners and their families. The findings suggested that taking on the role of mother of a preterm LBW  infant was facilitated by clear role expectations, positive learning experiences, and support from partners, family, and  health professionals. These factors may have helped reduce mothers' concerns and therefore, role strain.


identifier: Hawkins, Heather Marion Matthews <https://research.library.mun.ca/view/creator_az/Hawkins=3AHeather_Marion_Matthews=3A=3A.html>   (1990) Concerns of primiparous mothers during the first forty-eight to seventy-two hours following hospital discharge and the availability of support systems.  Masters thesis, Memorial University of Newfoundland.

abstract: The purpose of this study was to describe the concerns of primiparous mothers during their first 48-72 hours at home following hospital discharge and the availability of support  during this time period. This research could assist nurses in determining the need to provide continuing nursing support to healthy primiparous mothers immediately following  hospital discharge. -- An exploratory descriptive methodology was used for the study. The sample of 41 healthy  primiparous mothers were interviewed using a structured questionnaire. The initial post hospital discharge concerns of these mothers were identified as well as the availability  and utilization of support systems. Data were analyzed using  descriptive statistics. -- The results indicated that new mothers have concerns soon after they go home from hospital.  For healthy, well-educated mothers who had readily available  sources of support, the frequency and intensity of concerns was relatively low. Mothers indicated they frequently knew there would be changes occuring and they were prepared for them and thus not concerned. The most frequent concerns were  infant-related with maternal-self and situational concerns somewhat less frequent. The utilization of support was low. However, when mothers did seek support it was most frequently obtained for infant-related concerns. For maternal-self and situational concerns the most frequent source of support was the partner. For infant-related concerns, the family doctor and public health nurse were consulted equally. -- Currently public health nurses make postpartum home visits to all mothers. The timing and the necessity of all of these visits is being questioned. The results of this study suggest that all mothers should be assessed in hospital for their potential concerns and the availability of support systems, and that those deemed in need of immediate continuing nursing support receive an early home visit. Mothers assessed to be ready for discharge  home should be assured of the accessibility of nursing support and that their need for professional support be reassessed periodically.


identifier: Goodridge, Janet Murphy <https://research.library.mun.ca/view/creator_az/Goodridge=3AJanet_Murphy=3A=3A.html>   (1989) Maternal perception of postpartal nursing support for breastfeeding offered during hospitalization.  Masters thesis, Memorial University of Newfoundland.

abstract: There is wide agreement that breastfeeding mothers require adequate support for their breastfeeding efforts if they are  to achieve a satisfying and successful breastfeeding experience. During the critical period immediately following  birth, the postpartal nurse has a significant role to play in the initiation and establishment of breastfeeding. The purpose of this research was to describe the nature of postpartal nursing support for breastfeeding in hospital and  to assess the maternal perception and satisfaction with the quality of this support. House's (1981) conceptualization of  social support was used to provide the framework for the study. -- This descriptive, exploratory study surveyed a non-random sample (n=40) of primiparous breastfeeding mothers at an urban hospital over a three month period. Two standardized interview schedules were developed to yield the  desired information. -- The results revealed that mothers generally felt they received adequate emotional support for breastfeeding, although a substantial proportion reported that the nurses did not spend time with them during their initial breastfeeding sessions. The majority of mothers felt  that they received adequate instrumental support in the area  of demonstration of techniques of breastfeeding. The results  indicated that the instrumental component of modifying the hospital environment to facilitate a positive breastfeeding experience was inadequate. Practices such as rooming-in, demand feeding and the early initiation of breastfeeding were not encouraged by nurses. The majority of mothers received informational support regarding various topics of breastfeeding. However, several mothers reported that they did not receive information on avoiding formula supplements and criteria for assessing the adequacy of the milk supply. Conflicting advice was a predominant source of complaint. Appraisal support behaviors by nurses were reported less frequently than the other categories of support. -- Emotional and instrumental support behaviors by nurses were found to be most helpful to the mothers' early breastfeeding  experiences in hospital. Informational support tended to be more helpful to the mothers after discharge from the hospital. -- The data indicated that the large majority (95%) of mothers expressed satisfaction with the quality of nursing support received for breastfeeding in hospital. However, their satisfaction with the quality of nursing support was significantly lower when measured in the follow-up at two to three weeks. -- The findings from this study suggest that nurses need to have a clear understanding of the various types of support offered to and perceived as helpful by breastfeeding mothers. Nurses would then be able to prepare mothers for realistic breastfeeding experiences and assist those mothers who without adequate support might otherwise choose to discontinue breastfeeding prematurely.


identifier: O'Driscoll, Elizabeth Mary <https://research.library.mun.ca/view/creator_az/O=27Driscoll=3AElizabeth_Mary=3A=3A.html>   (1989) Maternal responses to infant crying during the first postpartum month.  Masters thesis, Memorial University of Newfoundland.

abstract: The purpose of this research was to investigate and describe how primiparous mothers interpret and respond to their infants’ crying during the first postpartum month in order to assist nurses in providing anticipatory guidance and/or therapeutic intervention associated with infant crying as a maternal caretaking concern. -- An exploratory descriptive design was selected for this study.  The sample consisted of 40 healthy primiparous mothers and their healthy, full-term neonates.  A structured diary designed by the investigator, was used to collect data on the mothers’ responses to their infants’ crying during the third postpartum week.  Mothers’ perceptions and expectations of their infants' crying were measured using the Neonatal Perception Inventories.  Data were analyzed using descriptive and inferential statistics. -- The study revealed that infant crying causes a considerable amount of worry for mothers during the first postpartum month.  There was a significant positive correlation between the amount of worry and the average number of daily crying episodes.  Mothers most often attributed the cause of crying to physical needs rather than social needs.  Maternal behavioral responses consisted of picking up the infant and trying different soothing interventions of which feeding was considered to be the most effective.  A variety of emotional maternal responses were evoked by the infant’s crying.  Mothers whose infants were difficult to console expressed negative feelings such as worry, anxiety and frustration.   There was a positive correlation between high worry scores and negative perception of the infant at 4 weeks postpartum. -- Although nurses actively participate in postpartum mother-infant care, they were infrequently identified as resource people.  The few mothers who discussed their infants' crying with nurses did not find the advice very helpful for managing their infants' crying. -- Findings indicate that perinatal nurses need to be aware of neonatal crying as a maternal caretaking concern and be prepared to utilize current, research-based information to assist mothers with the management of their neonates' crying.


identifier: Coady, Regina <https://research.library.mun.ca/view/creator_az/Coady=3ARegina=3A=3A.html>   (1995) Factors influencing medication taking behaviours of a sample of Newfoundland elderly with hypertension.  Masters thesis, Memorial University of Newfoundland.

abstract: Hypertension has been internationally recognized as a key risk factor for cardiovascular, cerebrovascular and renal disease in adults, particularly in the elderly population. The prevalence of hypertension in the Newfoundland population over 65 year old was 54% for females and 47% for males (Newfoundland Department of Health & Department of National Health & Welfare, 1990); the second highest provincial rate in Canada. Adherence to antihypertensive medication regimens was estimated at approximately 50% in North American adult populations examined. -- The purpose of  this study was to determine the factors associated with adherence to antihypertensive medications in a convenience sample of 51 hypertensive patients over 65 years old attending a family practice in St. John's, Newfoundland. The  Health Belief Model was used as the conceptual model for the  study. Ten selected factors from the Model were examined. Data were collected by structured interviews with participants in their homes using three instruments; (a) modified Weissfeld, Kirscht, and Brock Health Belief Scale, (b) the General Questionnaire, and (c) the Medication Evaluation Record. Adherence was measured using the Medication Evaluation Record which included an examination of medication containers, a medication count, chart review, and questionnaire developed by the interviewer. -- Only 43.1% of the sample were adherent to their antihypertensive medication regimen. General health threats was the only factor from the Health Belief Model which demonstrated a significant association with adherence. Increases in General  Health Threats were significantly associated with greater nonadherence using Spearman's rank correlation coefficient (p = .004). Mean diastolic and systolic blood pressures were  also significantly associated with adherence (p = .033 and p  = .018 respectively). Increased mean blood pressures were associated with greater nonadherence. -- The findings of this study indicated a significant negative relationship between General Health Threats and adherence, suggesting those with greater health threats adhered less to antihypertensive medications. Adherence was also significantly associated with mean diastolic and systolic blood pressure, indicating those who adhered more to antihypertensive medications had better blood pressure control. The implication for nursing and other health care professionals, therefore, includes recognition of the need for continued efforts toward improving adherence. Further research using a larger and more representative elderly population may provide more generalizable findings.


identifier: Jacobs, Yvonne M. <https://research.library.mun.ca/view/creator_az/Jacobs=3AYvonne_M=2E=3A=3A.html>   (1995) Factors influencing the use of physical restraints on elderly patients in acute care settings in St. John's, Newfoundland.  Masters thesis, Memorial University of Newfoundland.

abstract: This exploratory study was an attempt to determine the prevalence of physical restraint use on elderly patients in acute care settings in St. John's, Newfoundland, and to determine factors that influence the use of physical restraints in those settings. The sample consisted of 242 registered nurses working on medical and surgical ward units. Each nurse anonymously completed an investigator devised questionnaire which consisted of: 1) demographic questions; 2) a 42 item Likert scale composed of positive and negative statements concerning nurses' knowledge about restraints, and their perceptions about the physical and organizational environment; and 3) nurses' self-report of the number of elderly patients restrained by different types  of physical restraints on their ward unit at that time. Factor analysis was performed and factor scores were correlated with average restraint use per elderly patient. Correlations of four factors were statistically significant.  These concerned the ward environment, including both the physical layout and staffing levels; lack of time to carry out nursing care; support of staff from both administration and coworkers for non-restraint decisions; and preference for working with the elderly. -- There were differences in types of restraints used by hospitals and by medical and surgical ward units. The most common types of restraints used were side rails, geriatric chairs, chest restraints, mitts, and chair belts. -- The reliability of the Likert scale was quite high (alpha = .8), but there were problems with verifying the accuracy of the measurement of restraint use, which was by self-report and may have been influenced by social desirability. In addition, the correlations between average restraint use and significant factors were low. However, the results indicate that these factors do have some influence on restraint use and need to be explored  further. -- Three areas of considerable concern were revealed by the study. 1) Nurses' perception of the lack of support from administration and their fear of being blamed if they decide not to use restraints and a patient falls or wanders away. Thus, nurses felt pressured to use restraints when they were unable to observe patients closely due to the  physical environment or to perceived shortage of staff or lack of time to carry out their tasks. 2) Due to time constraints, activities such as ambulation, position changing, and frequent observation of restrained patients may not be carried out. 3) Many nurses lacked knowledge about the danger of death resulting from restraint use and felt their patients were safe when restrained. -- Due to problems in measuring restraint use accurately and the low correlations, further research and instrument refinement are  recommended. Other recommendations are made for nursing practice, education, and research.


identifier: Smith, Sharon <https://research.library.mun.ca/view/creator_az/Smith=3ASharon=3A=3A.html>   (1996) A study of patient falls in a long term care institution before and after the implementation of a fall prevention program.  Masters thesis, Memorial University of Newfoundland.

abstract: This descriptive study was conducted to assess the fall rate  before and after the implementation of a fall prevention program in a local long term care facility. The sample consisted of all patients who were residents on the study units, and fell while hospitalized at the local long term care facility during the periods studied. Data regarding falls during the six months prior to the implementation of the fall prevention program, and six months following its implementation were collected, through a review of patient charts, incident report forms and the follow-up report form.  Falls were categorized as accidental, anticipated and unanticipated. -- The results indicated that falls were a significant problem, as 351 falls were reported during the study periods. Fall rates actually increased, although not significantly, following the implementation of the fall prevention program, but injury rates did not increase. A number of factors were felt to affect fall rates, including the implementation of a facility wide policy of least restraint and the implementation of measures that were probably inadequate to address the fall rates. -- Implications for nursing practice, nursing education and nursing research arising from the results of the study are discussed.


identifier: Baker, Pamela Margeret Faulkner <https://research.library.mun.ca/view/creator_az/Baker=3APamela_Margeret_Faulkner=3A=3A.html>   (1994) Illness meanings and perceptions of control and uncertainty in women with breast cancer.  Masters thesis, Memorial University of Newfoundland.

abstract: Illness Meanings and Perceptions of Control and Uncertainty in Women with Breast Cancer -- A descriptive correlational study with longitudinal and cross-sectional components was conducted to (a) describe the factors shaping meanings of breast cancer, and how meanings changed during treatment, and (b) investigate relationships among illness meanings, perceptions of control, uncertainty, feelings about the illness, and attitudes toward chemotherapy. Fifteen women were included in the longitudinal portion of the study and nine in the cross-sectional component. The Multidimensional Health Locus of Control (MHLC) Scales, Meaning of Illness Questionnaire Self-Report (MIQ-SR), Personal Profile Record and the Cancer Meaning Questionnaire (CMQ) were the data collection instruments. Descriptive and inferential statistics were used for data analysis. Qualitative data were analyzed using the Constant Comparative Method of Analysis. -- Appraisals of the illness and treatment varied from initial treatment to follow-up and were influenced by perceptions of control, feelings about the illness, uncertainty and attitudes toward chemotherapy. Results from repeated measures AN0VA analyses indicated significant changes in Chance Health Locus of Control (X² 7.65, p <.02) and attitudes toward chemotherapy (X² 6.61, p <.03) . Step-wise multiple regression analysis indicated that internal locus of control beliefs and feelings about the illness and chemotherapy treatment were significant predictors of illness meanings. Attitudes toward chemotherapy were significant predictors of illness meaning over time. Qualitative data analyses supported findings from the Meaning of Illness factors as measured by the MIQ-SR Questionnaire. Results also suggest that nurses are perceived as primary sources of information and support. -- Key Words: breast cancer; meaning of illness; control; uncertainty; primary appraisal; secondary appraisal; coping;  feelings/attitudes.


identifier: Adams, Barbara <https://research.library.mun.ca/view/creator_az/Adams=3ABarbara=3A=3A.html>   (1996) Information needs, informational support and psychosocial adjustment in persons with head and neck cancer.  Masters thesis, Memorial University of Newfoundland.

abstract: Head and neck cancer has been described as one of the most emotionally traumatic types of cancer. Individuals often cope with stressful events by seeking information. However, recent studies have reported that information was identified  as an unmet need by persons with cancer. There has been very  little published research that explored the specific information needs of persons with head and neck cancer or that investigated outcomes of informational support. -- This  descriptive correlational study investigated information needs, informational support and psychosocial adjustment in a convenience sample of 65 persons with head and neck cancer. Based on the time since diagnosis, the sample was divided into three subgroups, representing different phases of the cancer experience. Data were collected by interviewing outpatients at the local ambulatory cancer centre and a few inpatients in the acute care facility. A structured questionnaire, consisting primarily of rating scales and structured questions, was developed by the researcher and used for data collection. -- The findings indicated that 75% of the sample wanted to be well informed.  The importance and type of information needed varied throughout the phases of the cancer experience and differed significantly (p = .0005) among the three subgroups. Participants expressed a high level of satisfaction with informational support received and, in general, adjusted well to their head and neck cancer. A significant positive correlation (p = .02) between informational support and psychosocial adjustment was found in two of the subgroups. -- This study identified phase-specific information needs of persons with head and neck cancer that can guide nurses in their patient teaching, and thereby facilitate the process of psychosocial adjustment. The results of this study can be  used in basic and continuing education programs to illustrate the changing nature of information needs and the importance of ongoing assessment. This study paves the way for future studies to investigate similar needs in other populations, explore different intervention approaches, or evaluate outcomes of various modes of information delivery.


identifier: Lundrigan, Doris Elizabeth <https://research.library.mun.ca/view/creator_az/Lundrigan=3ADoris_Elizabeth=3A=3A.html>   (1991) Information seeking of pregnant women : a grounded theory approach.  Masters thesis, Memorial University of Newfoundland.

abstract: The primary aim of this study is to define the processes of information seeking used by pregnant women. The questions asked are "How and when do pregnant women seek information, who do they seek information from, and what information do they seek." The study involves 11 participants recruited through a Public Health Nursing District Office. Data collection is achieved using a semi structured interview schedule and tape recorded interviews. -- A grounded theory method of data analysis is used. The data analysis process is adapted from Glaser and Strauss (1967) with procedural guidelines from Chenitz and Swanson (1986). -- Two main processes of information seeking are identified: (a) the Health/Wellness Information Seeking Process (HWISP), that is  concerned with information about activities participants used to achieve a healthy pregnancy, and (b) the Problem Initiated Information Seeking Process (PIISP), that is concerned with information about participants' signs and symptoms and suitable remedies. A third process identified is "making sure," the specific process used to confirm the pregnancy. The determinants of information seeking is the pregnant woman's attitude toward the information source, their valuing of a healthy pregnancy outcome, recognition of  salient indicators and receiving cues to action. -- The implications of these findings for nurses planning prenatal education programs and other prenatal services are discussed, as well as implications for future research.


identifier: Olsson, Karen Mary <https://research.library.mun.ca/view/creator_az/Olsson=3AKaren_Mary=3A=3A.html>   (1988) Information-sharing : a nursing strategy to facilitate informed prenatal decision-making on infant feeding.  Masters thesis, Memorial University of Newfoundland.

abstract: The fact that women are still choosing to bottlefeed in spite of the scientific evidence on the benefits of breastfeeding supports further research on the promotion of breastfeeding. The incidence of breastfeeding varies regionally; Newfoundland, where this study was conducted, has the lowest incidence of breastfeeding in Canada. Thus, one problem for nurses in Newfoundland is to find a means to  increase the incidence of breastfeeding. The present study examined the relationship between a nursing intervention (information-sharing on infant feeding) and decision-making on an infant feeding method. -- This descriptive study examined the responses of a convenience sample (n=18) of primigravidous women to a nursing intervention. Primigravidous women in their third trimester of pregnancy were contacted through prenatal classes of two urban maternity hospitals and general practitioners. -- The nursing intervention included an initial interview and two information-sharing sessions on infant feeding. The initial interview consisted of an assessment of the woman's knowledge and values of infant feeding, developed by the researcher, and a pre-test investigating attitudes towards infant feeding, developed by Manstead (1984). The two information-sharing sessions covered information on breast and bottle feeding, including feelings, attitudes and practical information about each method of infant feeding. The second information-sharing session concluded with a post-test (a repeat of the pre-test) and feedback from the participants regarding the two sessions. -- The results concurred with other studies in that (a) information-sharing  alone has no significant effect on either a woman's attitudes or intention towards breast or bottle feeding, (b)  attitudes are not the only influential factor in a woman's decision to breast or bottle feed, (c) a woman's prenatal intention to breast or bottlefeed is a good indicator of her  postnatal choice, and (d) most women, prior to conception or  in early pregnancy, have decided on an infant feeding method. -- One of the assessment tools, Values and Knowledge  on Infant Feeding (VKIF), emerged as a potential instrument for practice, education, and research. The tool more clearly  delineated the differences between the women with intentions  to breastfeed and the women who were either undecided or had  intentions to bottlefeed than did the Manstead (1984) tool, A Questionnaire to investigate Attitudes to Infant Feeding (QIAIF). The VKIF tool also indicated the areas that might be potential problems for breastfeeding mothers. The VKIF tool, as a nursing research instrument, shows potential as a  mechanism to indicate the barriers to breastfeeding.


identifier: Harkins, Patricia Klimashko <https://research.library.mun.ca/view/creator_az/Harkins=3APatricia_Klimashko=3A=3A.html>   (1995) Immediate postdischarge concerns and coping of benign posthysterectomy patients.  Masters thesis, Memorial University of Newfoundland.

abstract: The purpose of this study was to identify and describe the concerns and coping abilities of women following a hysterectomy during their first four weeks after hospital discharge. Findings from this study could assist nurses in determining what kind of information and support are needed to prepare women for their recovery after hospital discharge. -- The conceptual framework for this study was based on the theory that women coping with a stressful illness experience, such as having a hysterectomy, is a process that is interpreted differently based on women's perceptions of this event (Cohen & Lazarus, 1979; Lazarus & Folkman, 1984). This would help to explain differences in women's concerns and coping abilities related to having a hysterectomy. -- An exploratory descriptive method was employed for this study. The sample consisted of 60 premenopausal women who had an elective benign hysterectomy.  Women with complete or partial ovarian tissue remaining were  included. Data were collected from women using a two part structured interview guide constructed by the researcher. Section A included data about biological/demographic information, resources for surgery, hospital experience, expectations, and resources available after surgery. Section  B identified women's concerns and severity of concerns and coping actions. Descriptive statistics were used to analyze the data. -- The results indicated women did have concerns about themselves during their first four weeks at home after  hospital discharge. Most women were able to cope with their concerns, particularly in light of resources available to them. The most frequent concerns identified by women were related to bodily integrity and comfort, and emotions and feelings. -- Despite the fact women coped fairly well with their concerns during the recovery process, deficiencies were identified. Teaching or information prior to discharge was not sufficient. Lack of information about the recovery process, lack of information about specific concerns, and lack of knowledge related to anatomy and physiology were the   three major areas of deficiency identified. -- These women returned home early after discharge without benefit of health care support services. Women relied largely on information provided prior to discharge to manage their recovery. Family and friends were also available to help the  majority of women after discharge from hospital. However, a number of women also required additional professional services from doctors, nurses, or hospitals. These findings have implications for discharge planning and suggest that women need more information and support services than were provided to them after discharge from hospital. Therefore, nurses need to reassess the kind of information and support services that are provided to women and base discharge planning on patients' concerns.


identifier: Power, Judy Elizabeth Hicks <https://research.library.mun.ca/view/creator_az/Power=3AJudy_Elizabeth_Hicks=3A=3A.html>   (1990) Social support and community functioning of clients with schizophrenia : a nursing investigation.  Masters thesis, Memorial University of Newfoundland.

abstract: The purpose of this study was to increase knowledge regarding the concept of social support and its role in contributing to a better understanding of clients with schizophrenia and their ability to function in the community. The conceptual framework based on Norbeck's model  of social support (Norbeck, 1981) suggested that individual and situational properties combine to impact on the need for  social support and its actual and perceived availability from the social network surrounding the individual. Adequate, appropriate social support is expected to be more likely to result in satisfactory levels of functioning in the community. -- A convenience sample of 30 subjects between the ages of 18 and 61 participated in the study. They each had a diagnosis of schizophrenia, attended an Ambulatory Care service and had been discharged from a psychiatric hospital within the past year. The study instruments utilized were the Norbeck Social Support Questionnaire, the Global Assessment of Functioning Scale and a Client Profile, designed by the investigator. The study was designed to obtain information related to subjects' perceptions of their social networks, their perceptions of social support available from those networks,  and their levels of community functioning. Relationships between community functioning and social support were analyzed. -- Social support was conceptualized on the Norbeck Social Support Questionnaire as two variables: functional social support, composed of affect, affirmation and aid; and network properties, composed of network size, duration of relationships with network members and frequency  of contact with network members. Community functioning was measured by the Global Assessment of Functioning Scale. -- The results of the study demonstrated that this sample of clients with schizophrenia had social networks which were small and family-dominated. Relationships outside the family  were not long-standing and contact with network members was limited. Recent loss of network members was relatively common. Subjects perceived that they received less social support than other groups. Eight subjects indicated serious problems with their level of functioning in the community while 22 subjects had mild or moderate difficulties. -- A significant positive relationship was found between social support as measured by the Norbeck Social Support Questionnaire and community functioning as measured by the Global Assessment of Functioning Scale. Because the relationship between social support and community functioning may operate bidirectionally, it was suggested that enhancing social support may improve community functioning and alternatively that improving community functioning may improve social support. -- Based on the information provided by this study, guidelines for incorporating the concept of social support in clinical practice were addressed as well as implications for nursing theory and research.


identifier: Ludlow, Anita J. Penney <https://research.library.mun.ca/view/creator_az/Ludlow=3AAnita_J=2E_Penney=3A=3A.html>   (1993) Self-efficacy, self-care and glycemic control in individuals with noninsulin dependent diabetes mellitus.  Masters thesis, Memorial University of Newfoundland.

abstract: Self-Efficacy, Self-Care and Glycemic control in Individuals with Noninsulin Dependent Diabetes -- The purpose of this study was to investigate the relationships among diabetes self-efficacy, diabetes self-care and glycemic control in a sample of individuals, with a diagnosis of noninsulin dependent diabetes mellitus. Bandura's self-efficacy theory was used to guide the study. -- A convenience sample of 136 subjects participated in the study. All participants completed the three questionnaires: (a) the modified Insulin  Management Diabetes Self-Efficacy Scale (modified IMDSES), (b) the modified Insulin Management Diabetes Self-Care Scale  (modified IMDSCS) and (c) the Demographic Questionnaire. Glycemic control was assessed by the participants' glycosylated hemoglobin (HbAlc) levels. -- The results of the study demonstrated statistically significant relationships among diabetes self-care, diabetes self-efficacy and glycemic control. Diabetes self--efficacy beliefs were highly correlated with diabetes self-care behaviors. Each of the subscale scores and the total score of the modified IMDSES correlated with its counterpart of the modified IMDSCS (r values ranged from .77 to .89, p<.01). Diabetes self-care behaviors (general, diet, exercise and total) were negatively correlated with glycemic control (r values ranged from -.21 to -.38, p<.01). Diabetes self-efficacy (general and diet) were negatively correlated with glycemic control: general (r = -.26, p<.01) and diet (r  = -.19, p<.05). Diabetes self-efficacy and gender contributed significantly to the prediction of diabetes self-care (F(5,130) = 31.74, p<.0001) accounting for 55% of the variance in total self-care. Total self-efficacy (Beta = .72) was a stronger predictor of self-care than was gender (Beta = .12). Each of the subscale scores (general, diet, exercise, insulin and medication) of the modified IMDSES emerged as the best predictor of their counterpart of the modified IMDSCS. Total self-care behaviors and gender together accounted for 15% of the variance in glycemic control. -- The findings of this study indicated that incorporating the concept of self-efficacy in diabetes education programs may be of benefit. Further research is warranted using nursing interventions to increase self-efficacy and examining its impact on both diabetes self-care  behaviors and glycemic control.