Experimental Deformation of Olivine Aggregates

Meyers, Cameron David University of Minnesota ProQuest Dissertations & T 2023 해외박사(DDOD)

Charge Nurse Expertise: Implications for Decision Support of the Nurse-Patient Assignment Process

Meyers, Elizabeth Lillian ProQuest Dissertations & Theses University of Minn 2019 해외박사(DDOD)

Each day, across thousands of medical-surgical inpatient nursing units, charge nurses make decisions about which nurse will care for each patient. Recent attempts have been made to introduce health information technology (HIT) solutions to automate the nurse-patient assignment process. This research investigated charge nurse decision making during the nurse-patient assignment process as an exemplar of the larger question: How can we leverage information technology to improve decision making in healthcare, while respecting individual clinician expertise and the unique context of individualized patient care? Four primary questions were used to guide research of the process, decision factors, goals and context of nurse-patient assignments. A mixed-methods approach of qualitative interviews (N = 11) and quantitative surveys (N = 135) was used.Findings related to the charge nurse decision making process indicate that measurable, nurse-sensitive indicators of patient outcomes have not yet been standardized for nurse-patient assignments. HIT solutions and quality improvement efforts should define, collect and analyze measurable outcome criteria prior to attempting to improve or augment existing nurse-patient assignment practices to prevent unintended consequences.When clear outcome measurements have been identified, informatics researchers and professionals should investigate the ability of machine learning to recognize goal priorities and factor weighting from patient, nurse and environmental factors within existing HIT solutions. Until that time, HIT solutions augmenting the nurse-patient assignment process should be designed with flexible configurations, to enable goals, decision factors and factor weights can be varied by hospital, unit, charge nurse and shift, in order to best meet the needs of charge nurses.

Preclinical Models of Dystrophic Cardiomyopathy and Therapies for the Dystrophic Heart

Meyers, Tatyana A ProQuest Dissertations & Theses University of Minn 2019 해외박사(DDOD)

Muscular dystrophies are a diverse group of genetic diseases characterized byprogressive muscle weakness and deterioration with wide variability in severity and affectedmuscle groups. Some of the more devastating muscular dystrophies result from the absenceof components of the dystrophin-glycoprotein complex (DGC). Disruption of the DGCcompromises sarcolemmal integrity in striated muscle, leading to increased myocyte injuryand death. These forms of muscular dystrophy often feature both skeletal muscle wastingand marked cardiomyopathy. The most common of these muscular dystrophies is Duchennemuscular dystrophy (DMD), caused by mutations in the dystrophin gene that result in theloss of this large membrane-stabilizing protein. DMD features a childhood onset and leads topremature death at ages ranging from the teens into the 30's, often from cardiorespiratoryfailure. DMD is an X-linked disorder, and is usually inherited from carrier mothers who alsoface a high risk of cardiomyopathy.Sarcoglycanopathies are a rarer group of autosomal recessive Limb Girdle musculardystrophies (LGMD) that arise from mutations in the sarcoglycan genes, sometimes leadingto an aggressive Duchenne-like disease course in patients of both sexes. Theheterotetrameric sarcoglycan complex is a key component of the DGC, and its loss inducessignificant myocyte pathology that can trigger childhood disease onset and premature death.Muscles and hearts devoid of the sarcolgycan complex display hallmark dystrophicpathology, including muscle wasting, loss of ambulation, and a high incidence of lethaldilated cardiomyopathy.The work presented here is driven by efforts to quantify the susceptibility ofdystrophic hearts to acute injury caused by increased cardiac workload, and to understandthe contribution of angiotensin signaling to dystrophic heart injury. It describes the followingkey findings: 1) angiotensin receptor blockers (ARBs) can markedly reduce acute injury indystrophin-null and sarcoglycan-null mouse hearts.

Preparing their death: Examining variation in co-occurrence of cremation and inhumation in early medieval England

Meyers Emery, Kathryn Michigan State University ProQuest Dissertations & 2016 해외박사(DDOD)

Cremation, the deliberate burning of the body prior to burial, and inhumation, burial of the body without treatment by fire, can occur within the same mortuary space during the same time period. Despite the fact that this phenomenon is found throughout history and within our own modern population, there has been little investigation into this type of behavior. This can be attributed to a number of factors, including the historic lack of attention to cremation, as well as major differences in the theoretical and methodological approaches to each burial type. Due to this, co-occurrence cremation and inhumation is often examined as separate behaviors and programs, or as transitional behavior. This dissertation seeks to document the relationship between cremation and inhumation burials in order to develop an integrated approach to co-occurrence that can be used broadly. Early medieval England is the perfect period to develop and test this approach due to the presence of both cremation and inhumation burials within the same cemeteries from the mid 5th to early 7th century, precise temporal and geographical limit of the study area, high quality excavations and numerous available collections. Further, the study of co-occurrence of burial forms in this period has the potential to aid answering broader questions of migration, identity, and religion in early Anglo-Saxon England. Five cemeteries have been selected as case studies based on access to materials, presence of both burial types in the same time period, and their geographic locations in England- they provide a representative sample of the types of cemeteries where cremation and inhumation co-occur and are representative of a different sub-regions. Using a combination of spatial and statistical analysis, the relationship between the both cremation and inhumation could be explored further at each cemetery. In general, cemeteries were organized primarily into household groups that were spatially clustered and internally varied by age, sex, artifacts, and varying preference for burial type. Cremation and inhumation burials were found with a similar range of artifacts, with the exception of hair implements with the former and weapons with the latter. The differences in the funerary programs and the divisions, both physical and symbolic, between cremation and inhumation were varied by cemetery, with some like Alwalton having strict divisions or Mucking where diversity flourished. Regardless, at all five cemeteries, the most important choice made was to bury within the limits of the cemetery, despite the fact that there was variation in disposal type. The addition of fire as an element to the funerary process was likely an important choice, but how different this choice was from inhumation was dictated at different scales within the family, household or community. More broadly, this study demonstrates that we cannot assume cremation and inhumation are separate mortuary programs, the direct comparison of the two burial types allowed for interesting questions and more nuanced interpretation, and the importance of examining variation at the local scale rather than as part of a large unified dataset.

Investigation of treatment dose schedule for children with specific language impairment

Meyers, Christina N The University of Arizona 2015 해외박사(DDOD)

Dosage has been identified as important element of intervention that has the potential to affect intervention efficacy. The purpose of this study was to examine the role of dose schedule for treatment of grammatical morphology deficits in children with Specific Language Impairment (SLI). Sixteen 4-5 year old children with SLI participated in a 6-week intervention program during which children received equivalent daily Enhanced Conversational Recast treatment targeting grammatical morpheme errors. Half of the children received treatment in one 30-minute session (massed condition). The other half received treatment in three 10-minutes sessions (spaced condition) over a 3-hour period. Progress was assessed three times weekly by probing a child's use of his/her treatment morpheme and untreated morpheme (a maturational control) in untreated contexts. Pre-to-post treatment morpheme usage differed significantly for children regardless of dosage condition, demonstrating overall treatment efficacy. There were no differences in treatment effects for the massed and spaced conditions. In addition, nonverbal IQ and receptive vocabulary test scores correlated with treatment effect sizes. The study adds to evidence that Enhanced Conversational Recast can produce positive results, in a relatively short period of time, for children with specific language impairment. Moreover, it appears that clinicians may have some flexibility in terms of the dose schedule they employ to deliver this treatment in an evidence-based manner.

The Arukah Project: Collaborating with the Church to Improve African American Mental Health

Meyers, Tracie G ProQuest Dissertations & Theses University of Sout 2019 해외박사(DDOD)

The health disparities that exist in America are a significant challenge that affect all aspects of life and progress as they result in the most vulnerable populations having poor health outcomes and unmet needs. Blacks in America have been found to be particularly vulnerable and affected in larger numbers by health inequality. The underutilization of Behavioral Health Services by African Americans is a significant concern in the effort to close the health gap in America. This paper proposes an initiative that addresses a significant number of these barriers that would serve to integrate mental health services within the church to better address the needs of the Black community by training lay health workers within the congregation to provide problem solving based support services.

Patient-Specific Factors Associated with Surgical Delay in a Large Academic Hospital

Meyers, Natalie ProQuest Dissertations & Theses University of San 2020 해외박사(DDOD)

The high cost of healthcare is driving the search for more efficient practice, especially in high-stakes locations like the operating room. In addition to financial losses, patients suffer physical and emotional distress, including an increased risk of morbidity or mortality when surgical cases are delayed due to inefficiency. While patient-related causes of delay have been implicated, it is unclear which specific factors are most significant. This study aimed to identify specific patient factors correlated with surgical delay and develop a predictive risk algorithm that describes the relationship between patient-specific factors and surgical delay. A retrospective review of 36,543 patients’ charts who underwent surgery at a large academic hospital over a 5-year period was conducted. Patient-specific factors, including demographics, insurance type, proximity to the hospital, anesthesia type, American Society of Anesthesiologists (ASA) classification, system-specific comorbidities, and medication usage, were identified. Bivariate analysis using chi-square analysis was conducted to determine if any of these factors were significantly correlated with surgical delay. The significant patient-specific factors were entered into a logistic regression model.Black race, ASA =>3, renal failure, insulin, steroid, and several surgical specialties (colorectal, gynecologic oncology, hepatobiliary, neurosurgery, ophthalmology, and plastic surgery) were associated with an increased odds of surgical delay in this sample. Obesity, general anesthesia, and cardiovascular anesthesia were associated with a decreased odds of surgical delay. The model explains approximately 3.8-5.3% of surgical delays in this sample. The overall predictive rate of the model was 57.1%. Despite previous studies attributing a significant amount of surgical delay to patient factors, reasons other than patient factors were responsible for 94-95% of surgical delay in this sample. Further research in other populations or studies using different methods such as a prospective approach are necessary to fully understand the role of patient-specific factors in surgical delay. On the other hand, the power of this study permitted the discovery of seemingly small disparities that are nonetheless clinically significant. This study demonstrates that there are certain types of patients more at risk for surgical delay and therefore a diminished access to care.

Ancient future: The compensatory function of filmic heroes in the paradigmatic shift toward cultural balance

Meyers, Charlene Mary Wayne State University 2001 해외박사(DDOD)

The function of dreams, according to Carl G. Jung, is to produce material that will restore psychological balance. This material, symbolic and archetypal in nature, is produced by the unconscious which, Jung believed, exists on a collective as well as individual basis. Consequently, the function of archetypal imagery at the cultural level, in narrative for example, may also be compensatory; that is, an attempt to correct many of the harmful imbalances which currently plague contemporary Western society. In an effort to explore this possibility, this study will examine the archetype of the hero as it appears in selected American mainstream films released over the last decade. In particular, it will make a case for the fact that the inclusion of individuals from previously suppressed social groups as heroes is both reflective of, and a model for, a paradigmatic shift currently taking place in Western culture. The design of the study is provided by Jung's process of individuation, while the method of analysis is based on a blending of Campbell's theory of the hero's journey and Ricoeur's hermeneutical arch, which involves the dialectical interplay of structural analysis and semantic interpretation. In the final step of the process, the texts are examined in the self-reflexive context of performance. The works of anthropologists Victor Turner and Barbara Myerhoff, along with Schechter's work on popular culture, are used to assess the transformative potential of the texts which, as contemporary forms of narrative, myth and ritual, can help us to both create and understand our-selves. The results of my hypothesis are heuristic in nature, seeking only to establish a plausible connection between the types of heroes that are currently appearing on the screen and the concurrent shift in world view which is taking place in Western society. And while any ethnographic evidence as to the specific effects of the films discussed is beyond the scope of this study, I hope that its blend of scholarly and experiential knowledge will contribute to the growing literature which deals with the importance of narrative in the creation of identity, whether individual or cultural.

Development of novel subtype selective ligands for the estrogen receptor: I. 5,6-diakyl-5,6,11,12-tetrahydrochrysenes as estrogen receptor-beta selective antagonists. II. Diarylpropionitriles as estrogen receptor-beta potency selective agonists

Meyers, Marvin Jay University of Illinois at Urbana-Champaign 2000 해외박사(DDOD)

In an effort to develop ligands which have novel subtype selectivity for the estrogen receptors alpha (ERα) and beta (ERβ) we have found that racemic <italic>cis</italic>-5,11-diethyl-5,6,11,12-tetrahydrochrysene-2,8-diol (cis-THC) acts as an agonist on ERα and as a complete antagonist on ERβ and that 2,3-bis(4-hydroxyphenyl)propionitrile (DPN) acts as an agonist on both ER subtypes but has a 70 fold higher binding affinity and transcriptional potency on ERβ. A series of cis and trans dialkyl-THCs were synthesized in a highly enantio- and diastereoselective manner by the acyloin condensation of enantiopure α-alkyl-β-arylpropionic esters, followed by a Lewis acid-mediated dicyclization. Nearly all THCs examined were found to be affinity selective for ERβ. All these THCs are agonists on ERα, and THCs with small substituents are agonists on both ERα and ERβ. As substituent size was increased, ERβ selective antagonism developed first in the (<italic>R,R</italic>)-cis enantiomer series, and finally in the trans diastereomer and (<italic>S,S</italic>)-cis enantiomer series. The most potent and selective ligand was identified as (<italic>R,R</italic>)-enantiomer of cis-THC. This study illustrates that the antagonist character in THC ligands for ERβ depends in a progressive way on the size and geometric disposition of alkyl substituent groups without basic side chains. A series of ERβ selective DPN analogs were prepared where the both the ligand core and the aromatic rings were modified by the repositioning of phenolic hydroxy groups and by the addition of alkyl substituents and nitrile groups. Another series of DPN analogs were synthesized where the nitrile functionality was replaced with acetylene groups or polar groups to mimic the linear geometry or the polarity of the nitrile. All of the analogs are affinity selective for ERβ to varying degrees, but many are not potency selective. <italic> meso</italic>- and <italic>dl</italic>-2,3-bis(4-hydroxyphenyl)succinonitrile are among the highest ERβ affinity selective ligands and have somewhat greater ERβ potency selectivity than DPN. The nitrile functionality was found to be critical to ERβ selectivity as it is the optimal combination of linear geometry and polarity. Furthermore, the addition of another nitrile group β to the nitrile or ortho methylation of the aromatic ring increases the affinity and selectivity of these compounds for ERβ.

The Nature and Impact of Information Problem Solving in the Middle School Classroom

Meyers, Eric Matthew University of Washington 2011 해외박사(DDOD)

Essential skills for the 21st Century involve the ability to work with others to find information, learn, and solve problems. Given the emphasis on group work and peer learning in many schools and workplaces, educators frequently assign young people to work in groups. However, we know little about the processes and outcomes of group work including whether it leads to better search practices or more efficacious problem solving. This research project addressed this challenge through a mixed method study situated in the middle school classroom. One hundred twenty students (ages 13--14 years) in four classrooms participated in two information-seeking tasks. In each task, students sought online information on health and wellness topics. Half of the students worked in groups of three and half as individuals across the two tasks using a crossover experimental design. Data were gathered on students' learning outcomes using pre- and posttest instruments, on their task performance using task worksheets, and on their socio-affective responses to the two experimental conditions using a survey. Eight individuals and eight groups in the first task agreed to have their problem solving process recorded (screen capture and audio). The findings indicate that working in groups activates several important learning processes during search, such as strategy discussion, resource pooling, and cognitive conflict. However, groups did not produce better products than individuals working on the same task. Groups encountered more process losses than gains; as a result, they showed significantly lower performance on information problem solving tasks than students who worked alone. Despite students' apparent preference for working in groups, this arrangement does not always provide cognitive benefits or improved learning outcomes. The major contribution of this work is the explication of the relationship between group information seeking processes and the products of that activity, in terms of students' problem solutions and measures of conceptual development. The empirical findings contributed to the emergence of the Group6 Problem Solving model, which builds on existing models of information seeking and use. This study further advances our understanding of group information work, and provides needed guidance to educators and information professionals who work with youth.