Medicine and Health Sciences Commons^™

Haematopoietic Stem Cells In Spleen Have Distinct Differentiative Potential For Antigen Presenting Cells., Jonathan Tan, Helen O'Neill

Jonathan Tan

Dendritic cells (DC) are known to develop from macrophage dendritic progenitors (MDP) in bone marrow (BM), which give rise to conventional (c)DC and monocytes, both dominant antigen presenting cell (APC) subsets in spleen. This laboratory has however defined a distinct dendritic-like cell subset in spleen (L-DC), which can also be derived in long-term cultures of spleen. In line with the restricted in vitro development of only L-DC in these stromal cultures, we questioned whether self-renewing HSC or progenitors exist in spleen with restricted differentiative capacity for only L-DC. Neonatal spleen and BM were compared for their ability to reconstitute mice …

Teratogen Use In Women Of Childbearing Potential: An Intervention Study, Karie Morical-Kline, Alison Walton, Tracey Guildenbecher

Alison M. Walton

Purpose: The purpose of this study was to quantify the number of women of childbearing potential who are prescribed angiotensin-converting enzyme inhibitor (ACE inhibitor), angiotensin receptor blocker (ARB), or HMG-coenzyme A reductase inhibitor (statin) and to determine the number of documented teratogenic risk discussions (risk documentation) before and after educational interventions. Methods: The institutional review board–approved retrospective chart review included female patients ages 15 to 45 years who were prescribed an ACE inhibitor, ARB, or statin between January 1, 2007, and March 1, 2009. Exclusion criteria were tubal ligation and hysterectomy. A survey determined physician knowledge of teratogenic risks and …

Patient Perceptions Of Pharmacist-Managed Clinics: A Qualitative Analysis, Jasmine Gonsalvo, Darin Ramsey, Ashley Vincent, Alison Walton, Zachary Weber, Jessica Wilhoite

Alison M. Walton

Background: Pharmacist-managed clinics have consistently demonstrated improvement in patient outcomes. Quantitative research offers the benefit of objective outcomes to track progress toward therapeutic goals at pharmacist-managed clinics. While quantitative studies are readily available in the literature, there is a paucity of qualitative studies to capture the patients' perspectives of pharmacy services. Objective: To assess through the use of qualitative research methods patient perceptions of pharmacist-managed services within ambulatory care clinics that operate under a collaborative practice agreement. Methods: A semi-structured interview questionnaire was developed, pilot tested, and revised using a focus group of clinical pharmacists. The questionnaire was used to …

Redesign Of A Statewide Teaching Certificate Program For Pharmacy Residents, Jasmine Gonsalvo, Darin Ramsey, Amy Sheehan, Tracy Sprunger

Tracy L. Sprunger

Objectives. To identify and assess changes made to the Indiana Pharmacy Resident Teaching Certificate program over 10 years to adapt to the growing number and changing needs of pharmacy educators in the next generation. Design. In 2011, all resident program participants and directors were sent an electronic survey instrument designed to assess the perceived value of each program component. Assessment. Since 2003, the number of program participants has tripled, and the program has expanded to include additional core requirements and continuing education. Participants generally agreed that the speakers, seminar topics, seminar video recordings, and seminar offerings during the fall semester …

Achieving Pharmacy Based Public Health: Call For Public Health Engagement, Beth Meyerson, Priscilla Ryder, Cariann Richey-Smith

Priscilla T. Ryder

The evolution of pharmacy practice in the last 15 years has created expanded public health access. Community pharmacies now provide a range of public health services with promising improvements in health access and outcomes. The observed practice changes call our attention to systemic issues that remain in need of collective attention. As we strengthen our intersectoral public health system, we must focus on the pharmacy-public health partnership and establish collaborative policy and research agendas to guide this system change for maximum public health impact. Our collective effort to assure the health of communities depends upon our seeing opportunities across systems …

Complementary And Alternative Medicine Use Among Older Urban African Americans: Individual And Neighborhood Associations, Priscilla Ryder, Beverly Wolpert, Denise Orwig, Olivia Carter-Pokras, Sandra Black

Priscilla T. Ryder

Purpose: Older African Americans may be vulnerable to risks due to impaired healthcare access and understudied complementary and alternative medicine (CAM) use and other traditions. We describe C AM use among older African Americans in Baltimore, MD, examining associations among CAM and sociodemographic, health status, healthcare utilization and neighborhood factors. Methods: Cross sectional telephone survey of 95 African Americans ages ≥60 on use of CAM modalities (herb/home remedies, prayer, group spiritual practices, meditation/visualization, massage, chiropractic, acupuncture, relaxation/ biofeedback) in prior year. Results: A large majority (88.4%) reported CAM use in the previous year; 50.5% reported CAM use excluding individual prayer. …

Timely Follow-Up Among Multicultural Women With Abnormal Mammograms, Pamela Arnsberger, Patrick Fox, Priscilla Ryder, Brenda Nussey, Xiulan Zhang, Regina Otero-Sabogal

Priscilla T. Ryder

Objective: To examine factors influencing time from screening to final diagnosis among multicultural women with abnormal mammograms using the precede-proceed model. Methods: Staff of 58 clinics and a sample of 436 women served by these clinics were interviewed and their medical records examined. Results: Longer duration from screening to diagnosis was associated with speaking Spanish and having clinic staff make appointments. Ease of access to health care, provision of early morning screening services and higher levels of patient anxiety shortened the time to diagnosis. Conclusion: The precede-proceed model is useful in delineating personal and structural factors that affect timely diagnosis.

Preferences Of Gay And Bisexual Men For Pharmacy-Based Hiv Testing And Over-The-Counter Hiv Tests, Beth Meyerson, Roberta Emetu, Stephanie Sanders, Marlon Bailey, Priscilla Ryder, James Armstrong

Priscilla T. Ryder

A 2013 study among 169 Indiana men aged 18–45 who have sex with men assessed the acceptability of and preferences for pharmacy-based and over-the-counter (OTC) HIV testing. Rural men in general and men who did not know their HIV status were more likely to purchase an OTC HIV test. Men who did not know their HIV status also preferred an OTC HIV test to pharmacy-based testing. Pharmacies should enhance information around the sale of OTC HIV tests, particularly in rural areas. Information should include test results, opportunities for consultation, and linkage to care.

Case Study: Weight Loss Leads To Cost Savings And Improvement In Metabolic Syndrome, Kori Trussell, Debbie Hinnen, Patrick Gray, Sarah Nisly, Karissa Bratcher, Helen Ramsey, James Early

Sarah A. Nisly

Case Study reporting the effects of weight loss as a means of improving Metabolic Syndrome.

Chronic Hypothermia And Energy Expenditure In A Neurodevelopmentally Disabled Patient: A Case Study, Jane Gervasio, Roland Dickerson, Rex Brown, J. Matthews

Jane M. Gervasio

Hypothermia is defined as a core body temperature of <35°C and results in a decrease in measured resting energy expenditure. A 51-year-old mentally disabled patient experienced chronic hypothermia from neurologic sequelae. Because of her continued weight gain and increased body fat in the presence of presumed hypocaloric nutrition, indirect calorimetry measurements were performed twice in a 3-month period. The resting energy expenditure measurements prompted a reduction of her daily caloric intake to prevent further overfeeding. Hypothermia reduces oxygen consumption and, as a consequence, decreases resting energy expenditure. In patients for whom chronic hypothermia is a problem, nutritional intake must be …

Anabolic Agents: Adjuncts To Nutrition Support, Jane Gervasio

Jane M. Gervasio

Anabolic agents as adjuncts to nutrition support therapy have been used to improve malnutrition and establish anabolism. Growth hormone, insulin-like growth factor, and anabolic steroids have been studied for their potential to reverse the catabolic process and promote anabolism. This paper reviews several anabolic agents and their possible role in nutrition support therapy.

Characterization Of Fusobacterium Isolates From The Respiratory Tract Of White-Tailed Deer (Odocoileus Virginianus ), Amit Kumar, Dvm, Ms, Phd

Amit Kumar, DVM, MS, PhD

A total of 23 clinical isolates of Fusobacterium spp. were recovered at necropsy over a 2-year period from the respiratory tract of white-tailed deer (Odocoileus virginianus). Isolates were identified as Fusobacterium varium (18/23),Fusobacterium necrophorum subsp. funduliforme (3/23), and Fusobacterium necrophorum subsp. necrophorum (2/23). Usingpolymerase chain reaction–based detection of virulence genes, all F. necrophorum isolates were positive for the promoter region of the leukotoxin operon and the hemagglutinin-related protein gene, while all F. varium isolates were negative. The presence of the leukotoxin gene in F. necrophorum isolates and the absence of this gene in F. varium isolates were confirmed by Southern …

Microscopic Matrix Remodeling Precedes Endothelial Morphological Changes During Capillary Morphogenesis, Claire Mcleod, John Higgins, Yekaterina Miroshnikova, Rachel Liu, Aliesha Garrett, Alisha Sarang-Sieminski

Alisha L. Sarang-Sieminski

The formation of microvascular networks (MVNs) is influenced by many aspects of the microenvironment, including soluble and insoluble biochemical factors and the biophysical properties of the surrounding matrix. It has also become clear that a dynamic and reciprocal interaction between the matrix and cells influences cell behavior. In particular, local matrix remodeling may play a role in driving cellular behaviors, such as MVN formation. In order to explore the role of matrix remodeling, an in vitro model of MVN formation involving suspending human umbilical vein endothelial cells within collagen hydrogels was used. The resulting cell and matrix morphology were microscopically …

Clients' And Therapists' Stories About Psychotherapy, Jonathan Adler

Jonathan M. Adler

This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection …

Changes In Heart Rate Associated With Contest Outcome In Agonistic Encounters In Lobsters, Jesus Hernandez-Falcon, Alo Basu, Siddhartan Govindasamy, Edward Kravitz

Siddhartan Govindasamy

1. Agonistic contests between lobsters housed together in a confined space progress through encounters of increasing intensity until a dominance relationship is established. Once this relationship is established, losing animals continually retreat from the advances of winners. 2. These encounters are likely to consume much energy in both winning and losing animals. Therefore, one might expect involvement of many physiological systems before, during and after fights. Here, we report effects of agonistic encounters on cardiac frequency in winning and losing adult lobsters involved in dyadic interactions. 3. The results show that: (i) small but significant increases in heart rate are …

Eight Is Enough?: The Ethics Of The California Octuplets Case, Scott Paeth

Scott R. Paeth

The recent California octuplets case raises a number of important issues that need to be addressed in the context of the increasingly widespread practice of in vitro fertilization. This paper explores some of those issues as looked at from the perspective of protestant theological ethics and public theology, examining the moral responsibilities of the various participants in the process, both before and after the octuplets’ birth, including the mother, her doctors, the health care bureaucracy, the wider society, and the media. Each of these participants failed in significant respects to consider the ethical implications of the births in this complicated …

The Distinguishing Characteristics Of Narrative Identity In Adults With Features Of Borderline Personality Disorder: An Empirical Investigation, Jonathan Adler

Jonathan M. Adler

While identity disturbance has long been considered one of the defining features of Borderline Personality Disorder (BPD), the present study marks only the third empirical investigation to assess it and the first to do so from the perspective of research on narrative identity. Drawing on the rich tradition of studying narrative identity, the present study examined identity disturbance in a group of 40 mid-life adults, 20 with features of BPD and a matched sample of 20 without BPD. Extensive life story interviews were analyzed for a variety of narrative elements and the themes of agency, communion fulfillment (but not communion), …

Lumbar Vertebral Density And Mechanical Properties In Aged Ovariectomized Rats Treated With Estrogen And Norethindrone Or Norgestimate, Carla Vanin, Neil Maclusky, Debbie Chachra, Mehran Kasra, Marc Grynpas, Robert Casper

Debbie Chachra

OBJECTIVE: This study was designed to investigate the effects of estrogen alone or combined with two different progestins, norethindrone or norgestimate, on bone density and compressive mechanical properties in an aged rat model.

STUDY DESIGN: Twenty 11-month-old female Sprague-Dawley rats were sham operated (intact control) and 80 wee overiectomized. Three groups of 20 ovariectomized rats were implanted with Silastic silicon rubber (Dow Corning, Midland, Mich.) capsules containing 5% estradiol (wt/wt) in cholesterol. All rats in the intact control (group 1) and the ovariectomized (group 2) and the first of the overiectomized plus estrogen (group 3) groups were injected subcutaneously daily …

The Effect Of Different Hormone Replacement Therapy Regimens On The Mechanical Properties Of Rat Vertebrae, Debbie Chachra, M. Kasra, Carla Vanin, N. Maclusky, R. Casper, Marc Grynpas

Debbie Chachra

The purpose of this study was to examine the effects of estrogen replacement, in concert with three different progestin regimens, on the mechanical properties of rat lumbar vertebrae. Ninety-two Sprague-Dawley rats (11 months old) were divided into six groups for treatment. The first group was an intact control, the second group (OVX) was ovariectomized only, and the third group (estrogen-only) was ovariectomized and received continuous estrogen through a 17-estradiol implant. The remaining groups were ovariectomized and received estrogen and progestin (norethindrone, NET) therapy; 3 g of NET was injected daily (estrogen plus continuous NET), or 6 g of NET was …

Radiation Dose Distributions In Three Dimensions From Tomographic Optical Density Scanning Of Polymer Gels: Ii. Optical Properties Of The Bang Polymer Gel, Yevgeniya Zastavker, Marek Maryanski, John Gore

Yevgeniya V. Zastavker

A newly developed method of radiation dosimetry makes use of the optical properties of polymer gels. The dose-response mechanism relies on the production of light-scattering polymer micro-particles in the gel at each site of radiation absorption. The scattering produces an attenuation of transmitted light intensity that is directly related to the dose and independent of dose rate. For the BANG polymer gel (bis, acrylamide, nitrogen, and gelatin) the shape of the dose-response curve depends on the fraction of the cross-linking monomer in the initial mixture and on the wavelength of light. At 500 nm the attenuation coefficient (μ) increases by …

Allelic Deletion On Chromosome 17p13.3 In Early Ovarian Cancer, Nancy Phillips, Michelle Ziegler, Diane Radford, Keri Fair, Todd Steinbrueck, Francisco Xynos, Helen Donis-Keller

Helen Donis-Keller

Multiple chromosome 17 loci may be involved in ovarian carcinogenesis. Fifty-seven sporadic ovarian epithelial tumors were examined for loss of heterozygosity at 15 loci on chromosome 17p. Eighty % (39 of 49) of informative tumors had allelic loss in 17p13.3 at D17S30, D17S28, or both loci within this region, including 3 of 7 tumors of low malignant potential and 4 of 5 nonmetastatic carcinomas. The smallest region of overlapping deletion extends from D17S28 to D17S30, a distance of 15 kb. Furthermore, several tumors have breakpoints within the region detected by the D17S30 probe. Chromosome 17p13.3 genes with potential tumor suppressor …

The Long-Term Effects Of Water Fluoridation On The Human Skeleton, Debbie Chachra, H. Limeback, T. Willett, Marc Grynpas

Debbie Chachra

Municipal water fluoridation has notably reduced the incidence of dental caries and is widely considered a public health success. However, ingested fluoride is sequestered into bone, as well as teeth, and data on the long-term effect of exposure to these very low doses of fluoride remain inconclusive. Epidemiological studies suggest that effects of fluoride on bone are minimal. We hypothesized that the direct measurement of bone tissue from individuals residing in municipalities with and without fluoridated water would reveal a relationship between fluoride content and structural or mechanical properties of bone. However, consonant with the epidemiological data, only a weak …

Tensional Forces Influence Gene Expression And Sutural State Of Rat Calvariae In Vitro, S. Tholpady, T. Freyman, Debbie Chachra, R. Ogle

Debbie Chachra

BACKGROUND:

Theories regarding the cause of craniosynostosis that are more than 15 years old cite the role that tensional forces play in the normal and abnormal development of the cranial suture. These theories highlight the effect of stress bands originating from the skull base to the vertex, guiding sutural development.

METHODS:

In this study, the normally fusing posterior intrafrontal suture of the rat was subjected to 3 mN of tensional force for 30 minutes per day. The suture was then assessed for patency, proliferation, apoptosis, and transforming growth factor (TGF)-beta signaling components.

RESULTS:

Sutures that were subjected to tensional force …

Letter To The Editor: Adderall Abuse Sets Add Patients Back, Andrew Blitman

Andrew Blitman

No abstract provided.

The Cost Of Treating Addiction From The Client's Perspective: Results From A Multi-Modality Application Of The Client Datcap, Kathryn Mccollister, Michael French, Jeffrey Pyne, Brenda Booth, Richard Rapp, Carey Carr

Michael T. French

There is a considerable disparity between the number of individuals who need substance abuse treatment and the number who actually receive it. This is partly due to the fact that many individuals with substance use disorders do not perceive a need for formal treatment. Another contributing factor, however, is a discrepancy between the real and perceived cost of services. Although many cost evaluations of substance abuse treatment have been conducted from the treatment provider perspective, less is known about the client-specific costs of attending treatment (e.g., lost work and leisure time, transportation, out-of-pocket and in-kind payments). Concerns about financial and …