MS

thesisA questionnaire study was carried out to identify the causal factors in the selection of a source of health care by women residents of a rural county. Two research questions were posed: 1. What are the demographic characteristics associated with existent patterns of utilization of women's health services in this community? 2. What are the consumer's perceptions of the factors that influence the choice of care? The questionnaire consisted of 117 items divided into descriptive, objective, and subjective data. A comparison of birth certificate data with respondent data was done to establish sample tool validity. The 214 women in the sample were drawn form women residents of Tooele County, Utah, who gave birth in 1975. Respondents ranged in age from 16 years to 43 years. Twenty percent of the sample reported this as their first pregnancy. Length of residency in the County ranged between 1 and 37 years, with a mean of 13.17 years. Chi-square analyses computed between site and last delivery and descriptive data were not significant. However, some positive tendencies were revealed. A higher proportion of women between the ages of 20 and 29, who reported more than a high school education tended to seek obstetrical care for their last deliver outside the county. Residency of three to five years was reported with a higher frequency of women selecting care outside of the county. Questionnaire items dealing with sources of care showed a clustering of care. Women who sought obstetrical services in Tooele also tended to get their general health needs and those of their children met in Tooele. Women, who chose obstetrical care outside the County, also chose other sources of care for themselves and their children outside the County. Those women who sought obstetrical care outside the County tended to select an obstetrician as the care provider. There was little difference reported in health problems between the two groups. Consumer data showed that women who sought care in Tooele ranked convenience and economic factors as major determinants in their selection of a source of care; while women who sought care outside the County, ranked care quality factors as major determinants in the selection process. A two-tailed t-test indicated these relationships were significant findings. In the responses to the open-ended questions asking for recommendations about health services in Toole County, the population surveyed indicated a primary concern with care quality factors such as professional competency and equipment available. Socio-psychological factors such as personalized care were also identified as a high priority by the respondents

Creating Online Lessons: A Faculty Development Seminar Series

The World Wide Web is being used increasingly to deliver instruction in medical education. Consequently, there is a need to train faculty in developing and implementing online instruction. We developed and implemented a seminar series to teach faculty to create educationally sound, well designed online instruction. Instruction was delivered to 15 participants via a six session seminar on developing web based lessons, supplemented with web-based instruction. First, the participants learned the basics of instructional design via a web based module. They then completed content outlines for their online lessons prior to the first seminar. Lesson development, web site development and the use of a web based instructional shell to implement the online lessons were each taught in two two hour sessions. Eight participants developed online lessons and four actually implemented them. Feedback was mostly positive, with suggestions for improvement. All eight participants who completed the series said they would recommend it to their colleagues. Because a longitudinal workshop type of seminar series requires a large amount of participant time outside of class, a six month seminar series may be too long. It is important at the beginning of the series to help participants select topics suitable for online instruction and to help them narrow their topics. We may change the attendance guidelines so faculty would attend only the session on instructional design and have their staff attend the technical sessions on web site design, HTML editing and online course delivery systems. This would better match the actual practice of faculty designing the instruction and staff developing it

Oxidative Stress Response to Short Duration Bout of Submaximal Aerobic Exercise in Healthy Young Adults

The purpose of this study was to investigate the oxidative stress response to a short duration bout of submaximal exercise in a cohort of healthy young adults. 15 apparently healthy college age males and females completed a modified Bruce-protocol treadmill test to 75–80% of their heart rate reserve. Blood samples collected immediately before (pre-exercise), immediately after, 30, 60 and 120 minutes post-exercise were assayed for total antioxidant capacity (TAC), superoxide disumutase (SOD), thiobarbituric acid-reactive substances (TBARS), and protein carbonyls (PC). SOD activity was significantly increased from pre-exercise levels at 30 minutes (77%), 60 minutes (33%), and 120 minutes (37%) post-exercise. TAC levels were also significantly increased from pre-exercise levels at 60 minutes (30%) and 120 minutes (33%) post-exercise. There were no significant changes in biomarkers for reactive oxygen/nitrogen species (RONS) mediated damage (TBARS and PC) across all post-exercise time points. In a cohort of healthy young adults, a short duration bout of submaximal aerobic exercise elicited increases in antioxidant activity/concentration, but did not evoke changes in oxidative stress-induced damage. These results may suggest that: (1) short duration bouts of submaximal aerobic exercise are sufficient to induce RONS generation; and (2) the antioxidant defense system is capable of protecting against enhanced RONS production induced by a short duration, submaximal exercise bout in healthy young adults

A Performer's Analysis of Lili Boulanger's Clairières dans le ciel: Song Cycle for High Voice and Piano; a Lecture Recital Together with the Role of Blanche in Dialogues of the Carmelites by F. Poulenc and Two Recitals of Selected Works by H. Purcell, F. Schubert, S. Prokofieff, E. Chausson, W. A. Mozart, R. Schumann and G. Fauré

Lili Boulanger was an important composer of early twentieth century French music. Her compositional style represents a development and mastery of musical techniques of the great composers of her time including Fauré, Debussy and Wagner combined with her own creative expression. The result is a compelling musical language that was uniquely her own. She held an important place among her contemporaries in Paris and her accomplishments were considered newsworthy during her lifetime (1893- 1918). She obtained a much sought-after publishing contract with Ricordi. Her more famous sister, Nadia Boulanger, felt that Lili was the better composer of the two, and her peers and music professors clearly felt that both her musical and personal qualities were extraordinary. Evidence of her intelligence, creativity, and artistic growth can be seen in her music. As the first woman to win the Prix de Rome (July 5, 1913), Lili Boulanger, unlike Clara Schumann, Fanny Mendelssohn, or Alma Mahler, was acknowledged and acclaimed during her lifetime for her skill as a composer. Yet, nearly a century later the music of this talented French composer is not as well known as it deserves to be. In an effort to discover the reasons for this relative anonymity, this document will examine Lili Boulanger's life including her family and childhood influences, musical training, preparation for the Prix de Rome and the influence of Claude Debussy and other composers. This document will discuss her mature compositional style, specifically as it is reflected in her song cycle, Clairières dans le ciel. The text will be examined in conjunction with the literary movement of symbolism in 20th century France and the symbolist poet, Francis Jammes, with special attention to the composer's personal identification with the poetry. Considerations of the musical setting of the cycle will include the melodic style as it relates to the text, the harmonic idiom and its relation to the poetry, rhythmic and metrical devices used, formal devices and the relationship of the piano accompaniment and the voice. Performance considerations for this cycle include the recommended transpositions if performed by soprano rather than the tenor voice for which it was originally composed and the level of difficulty from an interpretative as well as technical standpoint

“It's always on the safe list”: Investigating experiential accounts of picky eating adults

Previous research into severely restricted eating for reasons which are not cultural, medical, due to a lack of food or due to concerns about body image has focused predominantly on “picky/fussy eating” in children. Despite evidence that picky eating does continue into adulthood and recognition in the new diagnostic category Avoidant Restrictive Food Intake Disorder (ARFID) that problematically avoidant and restrictive patterns of eating affect people across the lifespan, relatively little is known about the challenges and consequences faced by older adolescents and adults. This research employs qualitative methods to explore the experience of living as an adult with picky eating behaviours. Semi-structured interviews were undertaken with thirteen adults who identify as picky eaters and eat a highly limited diet, as determined by a checklist food questionnaire. Data were analysed using interpretative phenomenological analysis (IPA). Two themes are presented in this paper: “Constructions of food” and “Motivators for and barriers to change”. These themes show the importance of how individuals perceive food, their diet and themselves, and implications for clinical practice and future research in light of these findings are considered

An interpretative phenomenological analysis of the psychosexual identity development in adolescent and young adult survivors of testicular cancer

Background Qualitative research has explored how some testicular cancer survivors (TCS) experience the psychological impacts of diagnosis and treatment. More research into the impacts of testicular cancer (TC) on adolescent and young adults (AYA) is needed due to the critical period of identity development. The present study aimed to explore how AYA with TC appraise and make sense of their experience and to develop a greater understanding of psychosexual identity development in AYA TCS. Method Eight AYA TCS were interviewed. The results were analysed using Interpretative Phenomenological Analysis. The questions explored the experiences relating to diagnosis and treatment, how it affected their psychosexual identity development (e.g., sexual relationships and self-image) and the meanings attached to the experiences. Analysis Four Group Experiential Themes were developed from the data; ‘Dealing with the shock’, ‘Fear and weight of responsibility’, ‘those closest to me’ and ‘sense of change’. Discussion The AYA TCS experiences may result in adoption of traditional masculine traits (e.g., stoicism) or abandonment of traditionally masculine traits (E.g. violence and aggression). AYA TCS also described feelings of insecurity when compared to other men. Psychology input could help manage stoicism and feelings of inferiority when compared to men with two testicles

The roles of family members, health care workers, and others in decision-making processes about genetic testing among individuals at risk for Huntington disease

Purpose: To understand how individuals at risk for Huntington disease view the roles of others, e.g., family members and health care workers, in decision making about genetic testing. Methods: Twenty-one individuals (eight mutation-positive, four mutation-negative, and nine not tested) were interviewed for approximately 2 hours each. Results: Interviewees illuminated several key aspects of the roles of family members and health care workers (in genetics and other fields) in decision making about testing that have been underexplored. Family members often felt strongly about whether an individual should get tested. Health care workers provided information and assistance with decision making and mental health referrals that were often helpful. Yet health care workers varied in knowledge and sensitivity regarding testing issues, and the quality of counseling and testing experiences can range widely. At times, health care workers without specialized knowledge of Huntington disease offered opinions of whether to test. Input from families and health care workers could also conflict with each other and with an individual's own preferences. Larger institutional and geographic contexts shaped decisions as well. Conclusion: Decision-making theories applied to Huntington disease testing have frequently drawn on psychological models, yet the current data highlight the importance of social contexts and relationships in testing decisions. This report, the first to our knowledge to explore individuals' perceptions of social factors (particularly family and health care worker involvement) in Huntington disease testing decisions, has critical implications for practice, education, research, and policy

Use of Dog Parks and the Contribution to Physical Activity for Their Owners

This study described the use of dog parks in several diverse locations and explored the contribution dog parks made to physical activity of the dog owners