Health Care Benefits -- Creating the Optimal Design

Explores the role of benefit design and market innovations such as consumer-driven health plans and value-based insurance design to maximize beneficial coverage and offer incentives for better health and efficiency. Outlines implications for reform

Investigation of the Electro-Mechanical Properties of a Carbon Fiber-Sodium Composite Material for the Purpose of Structural Health Monitoring

A thesis presented to the faculty of the College of Science and Technology at Morehead State University in partial fulfillment of the requirements for the Degree of Master of Science in Industrial Technology by Sharon Austin on November 15, 2005

Doctor of Philosophy

dissertationRisk factors for colon (or colorectal) cancer mortality for American Indians/Alaska Natives (AI/AN) has been understudied. This project's overall aim is to determine colon and colorectal cancer risk factors among AI/AN. Colorectal cancer risk factors from the literature were determined utilizing systematic review methods. Comorbidities, travel times to screening and treatment, were also explored as risk factors for colon cancer mortality using cox proportional hazards modeling to determine hazard ratios. The systematic review revealed that race was the only risk factor explored for colon or colorectal cancer among AI/AN, whereas numerous colon or colorectal cancer risk factors have been explored for Non-Hispanic Whites (NHW). Next was examining risk for colon cancer mortality by building models. An increasing Charlson comorbidity index had higher risk for mortality among NHW. Models examining travel times that were race specific resulted in greater risk for AI/AN and mortality for those having to travel longer to a chemotherapy facility. Longer travel time to a screening facility increased NHW risk for mortality. NWH increased travel time to a surgical center had a decreased risk for mortality. The regional and distant stage model showed that AI/AN living a distance from chemotherapy had increased risk for mortality. For NHW, living a distance from a screening facility had increased mortality. The all stage model for NHW showed that living further to a screening facility increased mortality risk but living further from a surgical center decreased one's risk for mortality

Nicotinamide treatment in a murine model of familial tumoral calcinosis reduces serum Fgf23 and raises heart calcium

Mutations in the GALNT3 gene result in familial tumoral calcinosis, characterized by persistent hyperphosphatemia and ectopic calcific masses in soft tissues. Since calcific masses often recur after surgical removal, a more permanent solution to the problem is required. Nicotinamide is reported to lower serum phosphate by decreasing sodium-dependent phosphate co-transporters in the gut and kidney. However, its effectiveness in tumoral calcinosis remains unknown. In this study, we investigated nicotinamide as a potential therapy for tumoral calcinosis, using a murine model of the disease-Galnt3 knockout mice. Initially, five different doses of nicotinamide were given to normal heterozygous mice intraperitoneally or orally. Treatment had no effect on serum phosphate levels, but serum levels of a phosphaturic hormone, fibroblast growth factor 23 (Fgf23), decreased in a dose-dependent manner. Subsequently, high-dose nicotinamide (40mM) was tested in Galnt3 knockout mice fed a high phosphate diet. The radiographic data pre- and post-treatment showed that nicotinamide did not reverse the calcification. However, the treatment retarded calcification growth after 4weeks, while in the untreated animals, calcifications increased in size. The therapy did not affect serum phosphate levels, but intact Fgf23 decreased in the treated mice. The treated mice also had increased calcium in the heart. In summary, nicotinamide did not alter serum phosphate levels, likely due to compensatory decrease in Fgf23 to counteract the phosphate lowering effect of nicotinamide. Although increased calcium accumulation in the heart is a concern, the therapy appears to slow down the progression of ectopic calcifications

Habits of Mind and the Split-Mind Effect: When Computer-Assisted Qualitative Data Analysis Software is Used in Phenomenological Research

When Marshall McLUHAN famously stated "the medium is the message," he was echoing Martin HEIDEGGER's assertion that through our use of technology we can become functions of it. Therefore, how does adopting computer-assisted qualitative data analysis software affect our research activities and, more importantly, our conception of research? These questions are explored by examining the influence NVivo had upon an interdisciplinary phenomenological research project in health ethics. We identify the software's effects and situate our decision to use it within the Canadian health sciences research landscape. We also explore the challenges of remaining true to our project's philosophical foundations, as well as how NVivo altered our being-in-the-world as researchers. This case demonstrates McLUHAN's claim that new technologies invariably initiate new practices and modes of being, and urges researchers to attend to how we are both shaping and being shaped by software.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs120227Cuando Marshall McLUHAN afirmo "El medio es el mensaje" estaba haciendo eco a la afirmación de Martín HEIDEGGER de que a través de nuestro uso de la tecnología podemos convertirnos en funciones de ello. Por consiguiente, ¿Cómo afecta el análisis cualitativo de datos con asistencia de una computadora nuestras actividades de investigación y aún más importante, nuestra concepción de la investigación? Se exploran estas preguntas al examinar la influencia que NVivo tuvo sobre un proyecto de investigación fenomenológica interdisciplinaria en ética de salud. Identificamos los efectos del software y situamos nuestra decisión de usarlo en el horizonte de la investigación de ciencias de la salud canadienses. Exploramos los desafíos de mantenernos fieles a los fundamentos filosóficos del proyecto, así como también la forma en que NVivo alteró nuestro ser-en-el-mundo como investigadores. Este caso demuestra la afirmación de McLUHAN sobre que invariablemente las nuevas tecnologías inician nuevas prácticas y modos de ser, y urge a que los investigadores pongan atención sobre como forman, a la vez que se van formando, por el software.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs120227Als Marshall McLUHAN seinen berühmten Satz "Das Medium ist die Botschaft" formulierte,  fand sich eine ähnliche Vorstellung in Martin HEIDEGGERs Behauptung, dass wir durch die Nutzung von Technologie zu deren Teil werden.  Unsere Frage ist – von hier ausgehend – in welcher Weise die Nutzung computergestützter qualitativer Analyse-Software unsere Forschungsaktivitäten affiziert und  – noch zentraler – unser Konzept von Forschung? Zu deren Beantwortung haben wir uns mit dem Einfluss von NVivo auf ein interdisziplinäres phänomenologisches Forschungsprojekt befasst, das in der Gesundheitsethik angesiedelt ist. Wir identifizieren die Effekte der Software auf unsere Forschung, indem wir bereits unsere Entscheidung für ihre Nutzung in dem aktuellen Stand der kanadischen Gesundheitswissenschaften situieren. Wir befassen uns auch mit der Herausforderung, den philosophischen Grundlagen unserer Forschung treu zu bleiben und mit der Frage, wie NVivo unser "In-der-Welt-sein" als Forschende verändert hat.  Unser Beispiel zeigt, McLUHAN folgend, dass neue Technologien notwendig neue Praktiken und Seinsweisen hervorbringen, und es verweist Forschende darauf zu reflektieren, wie Software für Forschungsarbeiten angepasst wird und wie sie umgekehrt uns selbst "anpasst".URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs12022

Content Analysis of Expressive Writing Narratives About Stressful Relational Events Using Interpersonal Decentering

Article from a study completed using secondary analysis of data from two studies of expressive writing about stressful relational events to first describe the relations of word use to social-cognitive maturity of role-taking using Feffer’s Interpersonal Decentering scoring system and then to test hypotheses about active processing of relational information versus event closure. This is the Accepted Manuscript version of a published article

An Assessment Of Attitudinal Rigidity In Relation To Age And Abstract Intelligence

Although older adults are often characterized as rigid in both beliefs and behavior, research is often confounded by cohort differences and is usually not directed specifically to attitudes

RCS2 J232727.6-020437: An Efficient Cosmic Telescope at z=0.6986z=0.6986

We present a detailed gravitational lens model of the galaxy cluster RCS2 J232727.6-020437. Due to cosmological dimming of cluster members and ICL, its high redshift ($z=0.6986$) makes it ideal for studying background galaxies. Using new ACS and WFC3/IR HST data, we identify 16 multiple images. From MOSFIRE follow up, we identify a strong emission line in the spectrum of one multiple image, likely confirming the redshift of that system to $z=2.083$. With a highly magnified ($\mu\gtrsim2$) source plane area of $\sim0.7$ arcmin$^2$ at $z=7$, RCS2 J232727.6-020437 has a lensing efficiency comparable to the Hubble Frontier Fields clusters. We discover four highly magnified $z\sim7$ candidate Lyman-break galaxies behind the cluster, one of which may be multiply-imaged. Correcting for magnification, we find that all four galaxies are fainter than $0.5 L_{\star}$. One candidate is detected at ${>10\sigma}$ in both Spitzer/IRAC [3.6] and [4.5] channels. A spectroscopic follow-up with MOSFIRE does not result in the detection of the Lyman-alpha emission line from any of the four candidates. From the MOSFIRE spectra we place median upper limits on the Lyman-alpha flux of $5-14 \times 10^{-19}\, \mathrm{erg \,\, s^{-1} cm^{-2}}$ ($5\sigma$).Comment: 14 pages, 9 figures, submitted to ApJ on 3/06/201