Medicine and Health Sciences Commons^™

The Influence Of Ambient Lighting Levels On Postural Sway In Healthy Children Ages 9 To 11, Yvette Blanchard, Rebecca Mcveigh, Megan Graham, Melissa Cadet, Kabulo Mwilambwe, Christi Scott

All PTHMS Faculty Publications

The purpose of this study was to determine whether postural sway in healthy children varied in different levels of ambient lighting. Twelve boys and 26 girls with a mean age of 118 months stood on a force platform under three conditions: eyes closed, eyes opened in regular light (200 lx) and eyes opened in dim light (3 lx). Analysis of variance and pairwise comparisons revealed significantly more postural sway with the eyes closed condition compared to the regular and dim light conditions but no differences between the regular and dim light conditions. While our results on postural sway during the …

Symptom Clusters In Acute Myocardial Infarction: A Secondary Data Analysis, Catherine J. Ryan, Holli A. Devon, Rob Horne, Kathleen B. King, Kerry A. Milner, Debra K. Moser, Jill R. Quinn, Anne Rosenfeld, Seon Young Hwang, Julie J. Zerwic

Nursing Faculty Publications

Background: Early recognition of acute myocardial infarction (AMI) symptoms and reduced time to treatment may reduce morbidity and mortality. People having AMI experience a constellation of symptoms, but the common constellations or clusters of symptoms have yet to be identified.
Objectives: To identify clusters of symptoms that represent AMI.
Methods: This was a secondary data analysis of nine descriptive, cross-sectional studies that included data from 1,073 people having AMI in the United States and England. Data were analyzed using latent class cluster analysis, an atheoretical method that uses only information contained in the data.
Results: Five distinct clusters of symptoms …

The Influence Of Concurrent Cognitive Tasks On Postural Sway In Children, Yvette Blanchard, Shannon Carey, Jocelyn Coffey, Alison Cohen, Trisha Harris, Stephanie Michlik, Geraldine Pellecchia

All PTHMS Faculty Publications

Purpose: The purpose of this study was to examine the influence of concurrent tasks on postural sway in children.

Methods: Nineteen fourth-grade students, while standing on a balance platform, were asked to stand still, count backward, and read second-grade level sentences. The AMTI Accusway System was used to calculate the length of center of pressure path (LCOP), sway range (SR), and variability (SV) in mediolateral (ML) and anteroposterior (AP) directions of sway.

Results: Analysis of variance revealed a main effect of cognitive task condition for SR-AP, SR-ML, SV-AP, and SV-ML. Post hoc comparisons revealed lower values of those four dependent …

Determinants Of Balance Confidence In Community-Dwelling Elderly People, Janine Hatch, Kathleen M. Gill-Body, Leslie G. Portney

All PTHMS Faculty Publications

Background and Purpose. The fear of falling can have detrimental effects on physical function in the elderly population, but the relationship between a persons' confidence in the ability to maintain balance and actual balance ability and functional mobility is not known. The extent to which balance confidence can be explained by balance performance, functional mobility, and sociodemographic, psychosocial, and health-related factors was the focus of this study.

Subjects. The subjects were 50 community-dwelling elderly people, aged 65 to 95 years (X̄=81.7, SD=6.7).

Methods. Balance was measured using the Berg Balance Scale. Functional mobility was measured using the Timed Up & …

Effects Of Tensioning Errors In Split Transfers Of Tibialis Anterior And Posterior Tendons, Stephen J. Piazza, Matthew F. Moran, Neil A. Sharkey, Robert L. Adamson, James O. Sanders

All PTHMS Faculty Publications

Background: Split transfers of the tibialis anterior and posterior tendons are commonly performed to address hindfoot varus deformities in patients with cerebral palsy, stroke, or brain injury. Poor outcomes from these procedures are often attributed to a failure to tension the transferred tendon properly, but the mechanical effects of this aspect of the procedure have not been quantified, to our knowledge. The purpose of the present study was to use a cadaver model to examine changes in the actions of these muscles that occur when the tensions in the halves of the split tendon are intentionally balanced or unbalanced to …

L’Observation Du Comportement Du Nouveau-Ne: Une Source Pertinente D’Informations Medicales, N. Ratynski, G. Cioni, L. Franck, Yvette Blanchard, J. Sizun

All PTHMS Faculty Publications

L’observation du comportement du nouveau-né est une source importante d’informations d’ordre médical. Trois domaines bénéficient des données de l’observation : 1) l’analyse du développement grâce à l’utilisation de l’Assessment of Preterm Infant Behavior (évaluation du comportement de l’enfant prématuré) ; 2) l’évaluation de la douleur dominée par l’analyse de l’expression faciale grâce à des échelles validées, telle que le Neonatal Facial Coding System (système néonatal de codage facial) ; 3) la recherche de lésions cérébrales par le Quality Assessment of General Movements (évaluation de la qualité des mouvements généraux). L’observation comportementale fondée sur des outils validés par la recherche …

Typical Symptoms Are Predictive Of Acute Coronary Syndromes In Women, Kerry A. Milner, Marjorie Funk, Amy L. Arnold, Viola Vaccarino

Nursing Faculty Publications

Background: Previous research suggests that the presentation of acute coronary syndromes (ACS) may differ in women and men. No study has prospectively evaluated the role of a comprehensive set of typical and atypical symptoms and whether different symptoms on presentation predict ACS diagnosis in women and men. Methods and Results: We directly observed 246 women and 276 men seen in the emergency department with symptoms suggestive of ACS and documented their symptoms verbatim. ACS was eventually diagnosed in 89 (36%) women and 124 (45%) men on the basis of standard electrocardiogram and cardiac enzyme criteria. Presence of typical symptoms (chest …

Preparing Students For Ebp, Pamela Levangie

All PTHMS Faculty Publications

Describes one particular approach to teaching evidence-based practice in physical therapy. At Sacred Heart University students begin course work that is foundational to preparing them for evidence-based practice. In the first semester of study, they take a Concepts in Measurement unit. During the second semester, I teach a semester-long Clinical Research course that focuses on understanding concepts of clinical research and on critical review of physical therapy literature. During the third and fourth semesters of study, when they are doing their clinical coursework, the emphasis is on the concepts of validity and reliability of the tools they use. The students …

Sex And Race Differences In Electrocardiogram Use (The National Hospital Ambulatory Medical Care Survey), Amy L. Arnold, Kerry A. Milner, Viola Vaccarino

Nursing Faculty Publications

There are sex and race differences in many aspects of health care delivery. For example, blacks and women are less likely to receive aspirin and thrombolytic drugs. Blacks and women presenting with chest pain are less likely to be referred for cardiac catheterization. Blacks and women diagnosed with acute myocardial infarction (AMI) are also less likely to undergo cardiac catheterization. The gender differences in diagnostic evaluation after AMI appear more pronounced among younger women. The American College of Cardiology and the American Heart Association joint electrocardiography guidelines state that all patients presenting to the emergency department (ED) with chest pain …

Presentation And Symptom Predictors Of Coronary Heart Disease In Patients With And Without Diabetes, Marjorie Funk, Janice B. Naum, Kerry A. Milner, Deborah Chyun

Nursing Faculty Publications

The aims of this prospective, observational study were to compare: (1) symptom presentation of coronary heart disease (CHD) between patients with and without diabetes and (2) symptom predictors of CHD in patients with and without diabetes. We directly observed 528 patients with symptoms suggestive of CHD as they presented to the ED of a 900-bed cardiac referral center in the northeastern United States. There were no significant differences in symptom presentation of CHD between patients with and without diabetes, although patients with diabetes were slightly more likely to present with shortness of breath (P =.056). Patients with diabetes reported …

Differences Between Blacks And Whites With Coronary Heart Disease In Initial Symptoms And In Delay In Seeking Care, Sally B. Richards, Marjorie Funk, Kerry A. Milner

Nursing Faculty Publications

BACKGROUND: Mortality rates for coronary heart disease are higher in blacks than in whites. OBJECTIVES: To examine differences between blacks and whites in the manifestation of symptoms of coronary heart disease and in delay in seeking treatment. METHODS: Patients were directly observed as they came to an emergency department with symptoms suggestive of coronary heart disease. The sample included 40 blacks and 191 whites with a final diagnosis of angina or acute myocardial infarction. RESULTS: After controlling for pertinent demographic and clinical characteristics, logistic regression analysis revealed that blacks were more likely than whites to have shortness of breath (odds …

Neurobehavioral And Neuromotor Long-Term Sequelae Of Prenatal Exposure To Cocaine And Other Drugs: An Unresolved Issue, Yvette Blanchard

All PTHMS Faculty Publications

When the cocaine epidemic began, predictions were made that the children of cocaine users would demonstrate devastating negative developmental sequelae. In infants and young children prenatally exposed to cocaine most frequently the neurobehavioral and neuromotor systems have been studied. Although clinically described as irritable, difficult to console, and jittery as infants, research findings have not been able to clearly describe a pattern of long-term developmental sequelae. The mechanisms of action of drug exposure on developmental outcome have shown to be more complex than originally suspected. Many factors, other than the drug use, can influence developmental outcome. In most studies of …

Effects Of Prenatal Drug Exposure On Neurobehavioral Functioning In Young Infants, Yvette Blanchard, Patricia E. Suess, Marjorie Beeghly

All PTHMS Faculty Publications

In the newborn period, infants prenatally exposed to cocaine and other drugs show low scores on the Neonatal Behavioral Assessment Scale. Beyond that period, research is limited on the effects of prenatal drug exposure on neurobehavioral functioning. In this study we compared infants exposed to cocaine and other drugs and control infants from low socioeconomic backgrounds on measures of neurobehavioral functioning during neuromotor assessment at 1, 4 and 7 months of life. None of the measures of neurobehavioral functioning showed any significant group differences. This study did not support the hypothesis of disrupted neurobehavioral functioning beyond the neonatal period in …

The Relationship Between Health Locus Of Control And Health Behaviors Of Women Who Have Undergone Coronary Artery Bypass Grafting, Heather Ferrillo

Nursing Master’s Theses and Projects

Due to the increasing number of women who are diagnosed with heart disease and who are undergoing coronary artery bypass grafting, it is important to explore the psychosocial aspects involved in the recovery process of these women. This study examined the relationship between locus of control and health behaviors of women who underwent coronary artery bypass grafting.

Enteric Absorption Of Ciprofloxacin During Tube Feeding In The Critically Ill, Stephen M. Cohn, Mark D. Sawyer, Gerard A. Burns, Concertina Tolomeo, Kerry A. Milner

Nursing Faculty Publications

To determine the pharmacokinetic properties of ciprofloxacin in the critically ill, we studied seven mechanically ventilated patients with pneumonia during entcral feedings. Subjects received ciprofloxacin 750 mg every 12 h via nasogastric tube and serial serum drug concentrations were measured after the first and fourth dose. After the initial dose, the maximum serum concentration ranged from 1.24–3.06 mg/L, and the area under the time curve from 0–12 h ranged from 3.2–19.65 mg.h/L. Similar levels were noted after dose four. Gastrointestinal absorption of ciprofloxacin in tube fed critically ill patients was decreased, but well above MIC values for many pathogenic bacteria.

Factors Associated With Emergency Room Choice Among Medicare Patients, Judith L. Mack, Karen M. File, Jeffrey E. Horwitz, Russ Alan Prince

WCBT Faculty Publications

Changing macroenvironmental factors have caused hospital administrators to reassess their positions across all service lines and market segments. This pilot study explores relationships among the service experience, satisfaction and future patronage decisions among 368 Medicare patients, an often overlooked segmaent, who were recent users of a hospital emergency room.