Medicine and Health Sciences Commons^™

Providing End-Of-Life Care To Patients: Critical Care Nurses' Perceived Obstacles And Supportive Behaviors, Renea L. Beckstrand, Karin T. Kirchhoff

Faculty Publications

• Background Critical care nurses care for dying patients daily. The process of dying in an intensive care unit is complicated, and research on specific obstacles that impede delivery of end-of-life care and/or supportive behaviors that help in delivery of end-of-life care is limited.
• Objective To measure critical care nurses' perceptions of the intensity and frequency of occurrence of (1) obstacles to providing end-of-life care and (2) supportive behaviors that help in providing end-of-life care in the intensive care unit.
• Methods An experimental, posttest-only, control-group design was used. A national, geographically dispersed, random sample of members of the American Association of …

Sacred Disease Of Our Times: Failure Of The Infectious Disease Model Of Spongiform Encephalopathy, Vivian Mcalister

Vivian C. McAlister

BACKGROUND: Public health and agricultural policy attempts to keep bovine spongiform encephalopathy out of North America using infectious disease containment policies. Inconsistencies of the infectious disease model as it applies to the spongiform encephalopathies may result in failure of these policies.

METHODS: Review of historical, political and scientific literature to determine the appropriate disease model of spongiform encephalopathy.

PRINCIPAL FINDINGS: Spongiform encephalopathy has always occurred sporadically in man and other animals. Hippocrates may have described it in goats and cattle. Transmission of spongiform encephalopathy between individuals is too uncommon for it to be usefully considered an infection. Spongiform encephalopathy is …

Glutamate Receptors In Perirhinal Cortex Mediate Encoding, Retrieval, And Consolidation Of Object Recognition Memory., Boyer D Winters, Timothy J Bussey

Brain and Mind Institute Researchers' Publications

Object recognition is consistently impaired in human amnesia and animal models thereof. Results from subjects with permanent brain damage have revealed the importance of the perirhinal cortex to object recognition memory. Here, we report evidence from rats for interdependent but distinct stages in object recognition memory (encoding, retrieval, and consolidation), which require glutamate receptor activity within perirhinal cortex. Transient blockade of AMPA receptor-mediated synaptic transmission within perirhinal cortex disrupted encoding for short- and long-term memory as well as retrieval and consolidation. In contrast, transient NMDA receptor blockade during encoding affected only long-term object recognition memory; NMDA receptor activity was also …

The Cns Role Of Toll-Like Receptor 4 In Innate Neuroimmunity And Painful Neuropathy, Flobert Y. Tanga, Nancy Nutile-Mcmenemy, Joyce A. Deleo

Dartmouth Scholarship

Neuropathic pain remains a prevalent and persistent clinical problem because of our incomplete understanding of its pathogenesis. This study demonstrates for the first time, to our knowledge, a critical role for CNS innate immunity by means of microglial Toll-like receptor 4 (TLR4) in the induction phase of behavioral hypersensitivity in a mouse and rat model of neuropathy. We hypothesized that after L5 nerve transection, CNS neuroimmune activation and subsequent cytokine expression are triggered by the stimulation of microglial membrane-bound TLR4. To test this hypothesis, experiments were undertaken to assess tactile and thermal hypersensitivity in genetically altered (i.e., TLR4 knockout and …

Visit Satisfaction And The Use Of Tailored Health Behavior Communications In Primary Care, Chris N. Sciamanna, Scott P. Novak, Thomas K. Houston, Robert Gramling, Bess H. Marcus

College of Population Health Faculty Papers

BACKGROUND: Though studies suggest that computer-tailored health communications can help patients improve health behaviors, their effect on patient satisfaction, when used in health care settings, has yet to be examined. METHODS: A computer application was developed to provide tailored, printed feedback for patients and physicians about two of the most common adverse health behaviors seen in primary care, smoking and physical inactivity. Ten primary care providers and 150 of their patients were recruited to use the program in the office before their visit. After the visit, patients completed a self-report survey that addressed demographics, computer use history, satisfaction with the …

Dual Mechanism Analgesia-Enhancing Agents, Shawquia Elithia Young

Theses and Dissertations

Currently, there is an increasing need for novel analgesics that are potent but lack undesired side effects. Recent studies have shown that both 5-HT3 receptors and α2B- adrenoceptors play a role in antinociception. MD-354, N-(3-chlorophenyl)guanidine, has a high-affinity both for 5-HT3 and α2B- adrenoceptors and could be viewed as the first example of a rather selective 5-HT3/α2B- adrenoceptor ligand. MD-354, inactive by itself, potentiates the antinociceptive effects of an inactive dose of clonidine in the mouse tail- flick assay. An attempt to determine the underlying mechanism of this potentiating effect was the purpose of the present investigation. The studies focused …

Investigating The Effects Of Communication Problems On Caregiver Burden, Marie Savundranayagam, M. Hummert, R. Montgomery

Marie Y Savundranayagam

Objectives. The goal of this study was to explore the relationship between communication problems associated with dementia and caregiver burden, within the context of problem behaviors and cognitive and functional abilities of the care recipient.

Methods. A scale on communication problems associated with dementia was developed and administered to 89 family caregivers. Participants also completed measures of care-recipient cognitive and functional status, problem behavior, and caregiver burden (demand, stress, and objective burden).

Results. Analyses using structural equation modeling showed that care-recipient cognitive and functional status indirectly predicted problem behaviors via communication problems. The status indicators also directly predicted demand burden. …