Here, we show that training with multiple noncommunicable diseases (NCDs) is both feasible and beneficial to modeling this class of diseases. We first use data from the Cancer Genome Atlas (TCGA) to train a pan cancer model, and then characterize the information the model has learned about the cancers. In doing this we show that the model has learned concepts that are relevant to the task of cancer classification. We also test the model on datasets derived independently of the TCGA cohort and show that the model is robust to data outside of its training distribution such as precancerous legions and metastatic samples. We then utilize the cancer model as the basis of a transfer learning study where we retrain it on other, non-cancer NCDs. In doing so we show that NCDs with very differing underlying biology contain extractible information relevant to each other allowing for a broader model of NCDs to be developed with existing datasets. We then test the importance of the samples source tissue in the model and find that the NCD class and tissue source may not be independent in our model. To address this, we use the tissue encodings to create augmented samples. We test …

The purpose of this study was to identify factors that predict quality of life (QOL) for aging adults and to examine and compare Baby Boomers', Older Adults' and Younger Adults' responses to the 2010 National Health Interview Survey/QOL Functioning and Disability. Significant findings included several significant values based on the multivariate regression to estimate a model to predict QOL. In particular, being male, four ethnicities other than white, being older than Boomer, age in 10 years, the Functional Difficulty Index, the Functional Limitation Index scores, chronic heart disease, asthma, and arthritis all had significant p values. Adults with chronic heart disease, asthma, or arthritis scored lower on the QOL index, but cancer, stroke, or diabetes were not associated with the QOL index. Two hypotheses had strong support. Lower scores on both the Functional Difficulty Index and the Functional Limitation Index yielded lower QOL scores. Further research recommendations include establishing reliability and validity of the QOL index; running additional regressions for demographics (ethnicity, marital status, etc.) to predict possible combinations of variables predicting QOL or barriers to QOL; and investigating the viability of incorporating the QOL index into an electronic medical record (EMR) dashboard parameter to serve as a screening mechanism …

There is increasing evidence indicating that exposure to air pollutants may be associated with the onset of several respiratory diseases such as allergic airway disease and chronic obstructive pulmonary disorder (COPD). Many lung diseases demonstrate an outgrowth of pathogenic bacteria belonging to the Proteobacteria phylum, and the incidence of occurrence of these diseases is higher in heavily polluted regions. Within the human body, the lungs are among the first to be exposed to the harmful effects of inhaled pollutants and microbes. Research in the past few decades have expounded on the air-pollution-induced local and systemic inflammatory responses, but the involvement of the lung microbial communities has not yet been well-characterized. Lungs were historically considered to be sterile, but recent advances have demonstrated that the lower respiratory tract is replete with a wide variety of microorganisms - both in health and disease. Recent studies show that these lung microbes may play a significant role in modulating the immune environment by inducing IgA and mucus production. Air pollutants have previously been shown to alter intestinal bacterial populations that increase susceptibility to inflammatory diseases; however, to date, the effects of traffic-generated air pollutants on the resident microbial communities on the lungs have not …

The sequence of events leading to the implementation of a change in emergency physicians' practice and the learning activities and processes undertaken are examined and described in this study. A qualitative case study design was utilized and semi-structured interviews were employed as the primary means of data collection. Thirty emergency physicians were interviewed in face-to-face or telephone interviews. One change that required learning was selected per physician for an in-depth interview. The following factors were examined: motivation to change a practice behavior, time to implementation of changes, source of awareness, barriers to change, use of learning resources, stages in the change process, and method of learning.

Relationships of negative psychological conditions with general status of cell-mediated and humoral immune systems were investigated. A unique approach was utilized in that indexes representing multiple aspects of each branch of the immune system were employed to better indicate general immunological status. Differences in emotion-immune interactions between males and females were demonstrated. Results indicated a positive relationship between Trait Anger and Cell-Mediated Immunological Index. Particular criticisms of previous psychoneuroimmunological research were met by addressing sex differences and differences in various conditions of anger and depression, as well as through assessment of cumulative effects of negative emotions on immune system status. Directions for future research in eddressing similar issues are suggested. In general, results provide support for validity of mindbody interactionism and imply the need for revision of standard medical and psychological treatment.

Prescription drug direct-to-consumer advertising (DTCA) has been a subject of controversy in recent years. Though government regulations require equivalent prominence of risks and benefits, there is concern about the ability of consumers with limited health literacy to fully comprehend the risks and benefits associated with drug use. Evaluating the images in DTCA is important because individuals may rely on the visual message if the wording is overly complex. Using semiotics, this study aims to evaluate whether there is functional equivalence in the presentation of risk and benefit information in prescription drug direct-to-consumer television advertising. A new analytical method is created and used to assess the consistency between the messages contained in the voice track, the primary visual images, and the superscript/ subscript text. The results indicate that risk and benefit messages in this DTCA sample lack functional equivalence. However, it is important to properly frame these findings as the study does not evaluate viewer comprehension of the various message structures.

This dissertation presents a categorization of existing methodologies of upper register development for euphoniumists with evaluation of effectiveness and current use of these methodologies. The purpose of this study is to provide euphonium musicians as well as educators with essential references and guides to applicable methods for developing the upper register more effectively with greater efficacy. The assessments of current methodologies include three steps: categorization, summarization, and evaluation. To support the significance why it could be more beneficial than the methodology alone, the dissertation will include the examination of the aspect of biomechanics and ergonomics, suggestions, and discussion of particular issues of the upper register.

COPD is the third leading cause of death in the United States and is the sixth leading cause of death for low-to middle income countries (Downs & Appel, 2006; GOLD, 2011). COPD is a largely preventable disease due to the lifestyle factors that heavily contribute to disease onset and severity. Although traditionally COPD research has focused on health outcomes related to risk factors, compliance, comorbid psychological and physical conditions, and treatment interventions, a growing body of research suggests religious and spiritual factors may play an equally important role in health outcomes for several medical conditions, including pulmonary disease. However, studies of this kind have not specifically examined COPD nor have they examined the role of religious and spiritual beliefs in COPD management among ethnic minority patients. As such, the current study aimed to examine whether spiritual ethnic minority patients with COPD hold religious fatalistic attitudes and less active religious problem solving . A sample of 35 ethnic minority patients from the Louis. B. Stokes Cleveland VA Medical Center (LSCVAMC) Outpatient Pulmonary Clinic in Cleveland, OH. were recruited to participate in the study. Due to the acknowledgeable limitations of the present study, results are preliminary but convey associations between religious health …

This study is a qualitative analysis and a quantitative analysis of all peripheral biofeedback client data files of the University of North Texas Biofeedback Research and Training Laboratory since its establishment in 1991 and through the year of 2002. The purpose of this study is to evaluate the clinical and educational efficacy of the BRTL. Clients' electromyography and temperature measures, self-report of homework relaxation exercises and progress, and the pre- and post-Stress Signal Checklist were reviewed and analyzed. In regard to clinical efficacy, results indicate statistically significant changes in both temperature training and muscle tension training as a whole group. When divided into subtypes based on the clients' primary presenting problem, findings indicate statistical significance in chronic pain, tension headache, and temporomandibular jaw pain on temperature training, and show statistical significance in chronic pain, tension headache, hypertension, migraine headache, stress, and temporomandibular jaw pain on muscle tension training. When analyzing the Stress Signal Checklist, only 25% of clients had complete information on both pre- and post-Stress Signal Checklist. For these 25%, 87.5% reported symptoms decreased. When reviewing the clients' self-reported progress in therapist's session notes, there is no procedure for computing a treatment success to failure ratio due to the …

This research explored the information needs of patient families and hospital staff at a pediatric hospital system in Dallas, Texas. Library statistics recorded in four hospital libraries from 2011 - 2013 were used to analyze the information requests from patient families and hospital staff. Crosstabulations revealed the extent to which patient families and hospital staff used the libraries to satisfy their information needs. The data showed that patient families used the libraries very differently than hospital staff. Chi-square tests for independence were performed to identify the relationships between the Classification (Patient Family, Hospital Staff) and two descriptors of information needs (Request Type, Resources Used). There were a total of 1,406 information requests analyzed. The data showed that patient families and hospital staff information requests differed greatly in the number of information requests, the type of information requested, the resources used and the time the library staff spent on the requests. Chi-square analyses revealed relationships statistically significant at the p < .05 level; however, the strength of the relationships varied.

In urban environments, ozone air pollution, poses significant risks to respiratory health. Fixed site monitoring is the primary method of measuring ozone concentrations for health advisories and pollutant reduction, but the spatial scale may not reflect the current population distribution or its future growth. Moreover, formal methods for the placement of ozone monitoring sites within populations potentially omit important spatial criteria, producing monitoring locations that could unintentionally underestimate the exposure burden. Although air pollution affects all people, the combination of underlying health, socioeconomic and demographic factors exacerbate the impact for socially vulnerable population groups. A need exists for assessing the spatial representativeness and data gaps of existing pollution sensor networks and to evaluate future placement strategies of additional sensors. This research also seeks to understand how air pollution monitor placement strategies may neglect social vulnerabilities and therefore, potentially underestimate exposure burdens in vulnerable populations.

Lecture presented at the UNT College of Music M322 in partial fulfillment of the Doctor of Musical Arts (DMA) degree.

The purpose of the present study was to objectively verify psychological and behavioral changes in a group of identifiably susceptible patients who were treated for environmental sensitivities in a highly controlled environment. The subjects were 71 Environmental Control Unit (ECU) patient volunteers and 16 nonpatient volunteers for a total of 87. The patients were divided into a short-treatment (fasting 3-4 days) group (n = 35) and a long-treatment (fasting 5-7 days) group (n = 36). A third group, consisting of the 16 nonpatients, formed a nonpatient/no-treatment control group. All subjects were administered tests for assessment of intellectual/cognitive functioning, neurological/cerebral functioning, perceptual-motor skills, mood states, and general psychopathology.

The primary focus of the current study was to identify health disparities between sexual minority subgroups by examining differences of health indicators in lesbians, gay men, and bisexual individuals, and compare these to their heterosexual counterparts. Data was drawn from the National Health and Nutrition Examination Survey (NHANES), and variables examined in sexual minorities were related to health care access and utilization, risky health behaviors, and overall disease prevalence and outcomes. Findings suggest there are still some current health disparities in terms of insurance coverage, access to medical care, substance use, and prevalence of certain health conditions. However, a trend analysis conducted to examine three NHANES panels, suggests a mild improvement in some of these areas. Further findings, discussion, limitations of the study, current implications, and future directions are addressed.

Spinal cord injury (SCI) is an acute and devastating event that results in significant and permanent life changes for the individuals who are injured, as well as their families and friends. Depression has received more attention from clinicians and researchers than any other psychological issue among persons with SCI. Measurement of depression in this population has a variety of methodological issues, including inconsistent assessments used (self-report versus clinical interviews), varying definitions of depression, inclusion and exclusion of physical symptoms in the assessment process, and use of measures that do not represent DSM-IV criteria for major depressive disorder. The primary goal of this study was to evaluate the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) and provide descriptive analyses of this measure with persons with SCI. Results showed that somatic symptoms were more frequently endorsed than psychological symptoms in this population. Additionally, scores on the QIDS-SR were significantly associated with a depression diagnosis in the patient's medical chart. However, QIDS-SR scores were not found to be correlated inversely with quality of life scores as predicted. The QIDS-SR was shown to have good internal consistency and convergent validity with patients with SCI. However, it failed to demonstrate construct validity. The QIDS-SR …

The problem with which this study is concerned is to determine if the System of Interactive Guidance and Information (SIGI), which is a computer-based career guidance system that is employed with non-handicapped individuals, can be adapted to serve the needs of physically handicapped individuals. One hundred forty eight career and guidance professionals responded to a survey instrument, which was designed by the investigator, indicating their perceptions of the limiting effects of twelve specified handicapping conditions on the SIGI-programmed occupations. These respondents also listed their specific occupations, average time spent in career counseling with each handicapped individual, resources used in career counseling, incidence of use of SIGI, and opinions of needed changes to SIGI to make it a viable instrument in counseling the handicapped.

A psychological intervention involving relaxation training and biofeedback training for the control of peripheral skin temperature was investigated in this study with 27 female rheumatoid arthritics as participants. Based on analysis of the temperature data, it was concluded that the biofeedback response was not learned. From electromyographic data, it was concluded that participants did learn to relax. The hypothesis that the two treatment components would have beneficial effects on the physical, functional, and psychological aspects of rheumatoid arthritis was answered partially. No differential effects as a function of biofeedback training were found as the data for the temperature increase and temperature decrease groups were statistically combined in multiple analyses of variance for repeated measures. Although no differential effects were obtained, numerous positive changes were found. Correlated with the relaxation training were decreases in reported subjective units of discomfort, percentage of time hurting, percentage of body hurting, and general severity of pain. Improved sleep patterns were reported as was increased performance of activities of daily living. Reductions were also found in psychological tension, and in the amount of time mood was influenced by the disease. Shifts were not found in imagery, locus of control, and other psychological dimensions. Constitutional improvements were …

The purpose of this non-positivistic mixed-methods study is to examine parental attitudes towards the use of computer and video games in their child’s classroom and to investigate how the sociocultural contexts in which parents live affect those attitudes. The research was conducted using a mixed-methods triangulation design, including both quantitative and qualitative techniques. First, the study tried to identify which groups of parents were better positioned to accept and support digital game-based learning and which groups were less likely to have a positive attitude toward integrating digital games into the classroom. This study tried to determine if socioeconomic status, age, education level, and/or cultural background could serve as a predictor of parental attitudes toward digital game-based learning. Second, the study tried to recognize how social and cultural contexts in which parents live affect their attitudes toward digital games in the classroom. Many researchers agree that parents play an important role in students’ and eventually, educators’ attitudes toward gaming. It has been argued that if parents accept a certain non-traditional (digital) learning tool, then their children would most likely have a similar attitude toward it. Parents might be the support system that educators need in order to ensure that students are …

The purpose of this study was to delineate those variables which are indicative of the patient whose health may be adversely affected by sensitivity to chemicals. In stage One analysis, the files of 10 chemically sensitive and 10 non-chemically sensitive patients were used to establish criterion variables as previously defined by legal proceedings prior to the study. Chemically sensitive and non-chemically sensitive patients were compared on all variables included in the study to empirically determine those variables which demonstrated significant differences by chi square analysis.

The purpose of this study was to analyze the impact of alternative school intervention on subsequent student performance. The literature review examined the history and development of alternative schools, the legislation pertaining to alternative schools, and related studies. The population consisted of students placed in the discipline alternative education program (DAEP) of an alternative school located in a large suburban school district in north Texas. Students placed in DAEP in the spring semester of 2001 in grades 7, 8, 9, and 10 were included in the sample. Data on student success was gathered for the one semester prior to placement (pre-intervention) and for the two semesters after placement (post-intervention). Student success was measured in terms of course grade averages and attendance. The student sample was divided into the following subgroups: grade level, sex, ethnicity, and qualification for the school meal program. The students' grade averages were compared within the subgroups utilizing a one-way analysis of variance (ANOVA). Tukey's post hoc comparison was utilized on the groups when ANOVA was found to be significant. The students' attendance was analyzed by comparing the proportion of days attended in each of the three semesters included in the study. A normal test of two …

This study briefly reviews both historical and recent conceptualizations of dependency. In particular, it focuses on this concept's applicability to patients with chronic illnesses, especially those with allergies. Type and degree of dependency were seen as an important factor in the approach to the medical and psychological treatment of clinical ecology patients. The purpose of the study was to develop an objective measure of dependency which could quickly identify patients whose dependency conflicts interfere with the treatment process. The study was divided into three phases. In the first phase test responses by 84 inpatients to the CAQ, MMPI, and the HAT as well as historical and demographic data were analyzed by a series of stepwise discriminant analysis. The 53 resulting items were examined for those which most concisely discriminated between the two identified groups (pathologically dependent and nonpathologically dependent). These 15 items were used to test 120 additional patients in phase II. Fourteen items were retained and the coefficients obtained classified the patients in phase I and II with a 98.81 percent and 94.17 percent degree of accuracy respectively. These classification coefficients were used to classify another 30 patients in phase III with a 96.67 percent rate of accuracy. These …

According to the U.S. Department of Health and Human Services (HHS), patients and providers do not understand the Health Information Privacy and Accountability Act (HIPAA). Non-compliance with HIPAA is primarily due to confusion, along with insufficient understanding. HSS has taken measures to simplify the language they use to communicate HIPAA, however, they have not taken steps that consider if one's culture, religious and social perspectives, institutional training, credentials, and comprehension of legal terminology affects medical providers and non-clinical administrative personnel's abilities to understand HIPAA. This research uses bibliometrics to examine the literature from January 2010 – September 2020 that addresses HIPAA's use of legal terminology, literacy level, and institutional training, along with religious and social perspectives, and credentials of medical providers and non-clinical administrative personnel. A total of 107 articles were examined, 42 were assigned article influence scores with values that were less than 1.00, which is a below-average influence score for the article. There were 29 articles with values equal to or above 1.00, which translates to an equal or above-average influence score. The remaining 36 articles did not have article influence scores and were assigned values as not available. Results of the review of the literature indicate that …

This study was design to determine the efficacy of intensive individual play therapy as a method of intervention for children diagnosed with insulin-dependent diabetes mellitus. The purpose of this study was designed to study the effectiveness of an intensive play therapy intervention in: a) reducing symptoms of childhood depression in children with IDDM; b) reducing symptoms of anxiety in children with IDDM; c) reducing the overall behavior difficulties in children with IDDM; d) increasing healthy adjustment in children with IDDM; e) increasing diabetic's children's adherence to their diabetic regime; and f) impacting these emotional and behavioral symptoms over time. The 15 children in the experimental group received 12, daily play therapy sessions while attending a summer camp for children with diabetes. The control group, consisting of 15 children who attended the diabetic summer camp, received no play therapy. Children and parents in both groups completed pretest, post-test and three-month follow-up data, consisting of: the Children's Depression Inventory, the Revised Children's Manifest Anxiety Scale, the Filial Problems Checklist and the Diabetes Adaptation Scale. Analysis of covariance revealed that the children in the experimental group significantly improved their adaptation to their diabetes following intensive play therapy as reflected by the Diabetes Adaptation …

Flutists have reported musculoskeletal pain from practicing and performing their instrument. This study was a statistical approach to investigate potential causal risk factors for flute related pain among high school and college students. The study focused on the relationship between flute related pain and musical background or anthropometric measurements including size, strength and flexibility. Subjects included thirty high school and college-aged flutists who were assessed using a questionnaire, bi-lateral anthropometric measurements of the upper-extremities, upper-extremity performance tests for range of motion, isometric strength and rotation speed, and instrument specific questions. Four questions regarding pain associated with flute playing were treated as dependent variables and used for correlation and regression analyses with other independent variables. A six-factor regression model was created and each model was statistically significant. Results of this study show that strength, flexibility, pain spots, and exposure are risk factors for flute related pain. Both left and right pinch strength and right isometric pronation strength were significantly correlated to flutists experiencing pain while playing. Knowledge of these factors in relationship to pain is needed in flute pedagogy to help teachers and performers understand why flutists report pain during and after playing. Additional studies are warranted for replication of this …