Digital Commons Network^™

Patient- And Family-Centered Care Of Children In The Emergency Department., Nanette Dudley, Alice Ackerman, Kathleen M. Brown, Sally K. Snow, American Academy Of Pediatrics Committee On Pediatric Emergency Medicine, American College Of Emergency Physicians Pediatric Emergency Medicine Committee, Emergency Nurses Association Pediatric Committee., Gregory P. Conners

Manuscripts, Articles, Book Chapters and Other Papers

Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in a mutually beneficial partnership among patients, families, and health care professionals. Providing patient- and family-centered care to children in the emergency department setting presents many opportunities and challenges. This revised technical report draws on previously published policy statements and reports, reviews the current literature, and describes the present state of practice and research regarding patient- and family-centered care for children in the emergency department setting as well as some of the complexities of providing such care.

Companion Diagnostics At The Intersection Of Personalized Medicine And Healthcare Delivery., Scott A Waldman, Andre Terzic

Department of Pharmacology and Experimental Therapeutics Faculty Papers

This article has been peer reviewed. It is the authors' final version prior to publication in Biomarkers in Medicine, Volume 9, Issue 1, January 2015, Pages 1-3.

The published version is available at DOI: 10.2217/bmm.14.99. Copyright © Future Medicine

A Coding Variant In Tmc8 (Ever2) Is Associated With High Risk Hpv Infection And Head And Neck Cancer Risk, Caihua Liang, Karl T. Kelsey, Michael D. Mcclean, Brock C. Christensen, Carmen J. Marsit

Dartmouth Scholarship

HPV infection is a causal agent in many epithelial cancers, yet our understanding of genetic susceptibility to HPV infection and resultant cancer risk is limited. Epidermodysplasia Verruciformis is a rare condition of extreme susceptibility to cutaneous HPV infection primarily attributable to mutations in TMC6 and TMC8. Genetic variation in the TMC6/TMC8 region has been linked to beta-type HPV infection and squamous cell carcinoma of the skin, cervical cancer, HPV persistence and progression to cervical cancer. Here, we have tested the hypothesis that the common TMC8 SNP rs7208422 is associated with high-risk HPV infection and risk of head and neck …

Acute Kidney Injury Risk Prediction In Patients Undergoing Coronary Angiography In A National Veterans Health Administration Cohort With External Validation, Jeremiah R. Brown, Todd A. Mackenzie, Thomas M. Maddox, James Fly, Thomas T. Tsai, Mary E. Plomondon, Christopher D. Nielson, Edward D. Siew, Frederic S. Resnic, Clifton R. Baker, John S. Rumsfeld, Michael E. Matheny

Dartmouth Scholarship

Background:

Acute kidney injury (AKI) occurs frequently after cardiac catheterization and percutaneous coronary intervention. Although a clinical risk model exists for percutaneous coronary intervention, no models exist for both procedures, nor do existing models account for risk factors prior to the index admission. We aimed to develop such a model for use in prospective automated surveillance programs in the Veterans Health Administration.

Methods and Results:

We collected data on all patients undergoing cardiac catheterization or percutaneous coronary intervention in the Veterans Health Administration from January 01, 2009 to September 30, 2013, excluding patients with chronic dialysis, end‐stage renal disease, renal …

Medical Versus Surgical Methods Of Early Abortion: Protocol For A Systematic Review And Environmental Scan Of Patient Decision Aids, Kyla Z. Donnelly, Rachel Thompson

Dartmouth Scholarship

Introduction: Currently, we lack understanding of the content, quality and impact of patient decision aids to support decision-making between medical and surgical methods of early abortion. We plan to undertake a systematic review of peer-reviewed literature to identify, appraise and describe the impact of early abortion method decision aids evaluated quantitatively (Part I), and an environmental scan to identify and appraise other early abortion method decision aids developed in the US (Part II).

Methods and analysis: For the systematic review, we will search PubMed, Cochrane Library, CINAHL, EMBASE and PsycINFO databases for articles describing experimental and observational studies evaluating …

Joint Impact Of Clinical And Behavioral Variables On The Risk Of Unplanned Readmission And Death After A Heart Failure Hospitalization, Badri Padhukasahasram, Chandan K. Reddy, Yan Li, David Lanfear

Cardiology Articles

Most current methods for modeling rehospitalization events in heart failure patients make use of only clinical and medications data that is available in the electronic health records. However, information about patient-reported functional limitations, behavioral variables and socio-economic background of patients may also play an important role in predicting the risk of readmission in heart failure patients. We developed methods for predicting the risk of rehospitalization in heart failure patients using models that integrate clinical characteristics with patient-reported functional limitations, behavioral and socio-economic characteristics. Our goal was to estimate the predictive accuracy of the joint model and compare it with models …

Air Quality And Respiratory Health Among Adolescents From The United Arab Emirates, Caroline Barakat-Haddad, Sheng Zhang, Ayesha Siddiqua, Rania Dghaim

All Works

© 2015 Caroline Barakat-Haddad et al. Purpose. To examine the role of air quality in relation to chronic bronchitis, emphysema, asthma, wheeze, and dry cough among adolescents from the United Arab Emirates (UAE). Methods. A survey was administered on 6,363 adolescents from 9 UAE regions. Data consists of demographic, socioeconomic, residential, and behavioural variables, such as location of residence, residing near industry/gas stations/dumpsites/construction sites, residing near overhead power line/plants, exposure to tobacco, residential exposure, ethnicity, concern over air pollution, smoking, and purposely smelling gasoline fumes/glue/correctors/car exhaust/burning black ants. Logistic regression modeling was used to determine significant predictors of respiratory health. …

The Effectiveness Of Psychosocial Intervention For Individuals With Cleft Lip And/Or Palate., Alyson Norman, Martin Persson, Nicola Stock, Nichola Rumsey, Jonathan Sandy, Andrea Waylen, Zoe Edwards, Vanessa Hammond, Lucy Partridge, Andy Ness

School of Psychology

OBJECTIVE: The aim of this review was to assess the effectiveness of different psychological interventions for children and adults with cleft lip and/or palate and their parents. DESIGN: We searched six databases including MEDLINE and EMBASE to June 2013 and checked bibliographies. We included research that evaluated any psychological intervention in studies in which at least 90% of the participants had cleft lip and/or palate or were parents of those with cleft lip and/or palate. Studies containing less than 90% were excluded unless they reported results separately for those with cleft lip and/or palate, or raw data were available upon …

A Qualitative Study Of The Impact Of Severe Asthma And Its Treatment Showing That Treatment Burden Is Neglected In Existing Asthma Assessment Scales., Michael E. Hyland, Ben Whalley, Rupert C. Jones, Matthew Masoli

School of Psychology

BACKGROUND: People with severe asthma experience significant respiratory symptoms and suffer adverse effects of oral corticosteroids (OCS), including disturbed mood and physical symptoms. OCS impacts on health-related quality of life (HRQoL) have not been quantified. Asthma HRQoL scales are valid as outcome measures for patients requiring OCS only if they assess the deficits imposed by OCS. AIMS: The aim of this study was to compare the burden of disease and treatment in patients with severe asthma with items in eight asthma-specific HRQoL scales. METHODS: Twenty-three patients with severe asthma recruited from a severe asthma clinic were interviewed about the impact …

Passing Crisis And Emergency Risk Communications: The Effects Of Communication Channel, Information Type, And Repetition., Judy Edworthy, Elizabeth Hellier, Lex Newbold, Kirsteen Titchener

School of Psychology

Three experiments explore several factors which influence information transmission when warning messages are passed from person to person. In Experiment 1, messages were passed down chains of participants using five different modes of communication. Written communication channels resulted in more accurate message transmission than verbal. In addition, some elements of the message endured further down the chain than others. Experiment 2 largely replicated these effects and also demonstrated that simple repetition of a message eliminated differences between written and spoken communication. In a final field experiment, chains of participants passed information however they wanted to, with the proviso that half …

A Multidimensional Data Warehouse For Community Health Centers., Kislaya Kunjan, Tammy Toscos Phd, Ayten Turkcan, Brad N Doebbeling

Mirro Center Articles

Community health centers (CHCs) play a pivotal role in healthcare delivery to vulnerable populations, but have not yet benefited from a data warehouse that can support improvements in clinical and financial outcomes across the practice. We have developed a multidimensional clinic data warehouse (CDW) by working with 7 CHCs across the state of Indiana and integrating their operational, financial and electronic patient records to support ongoing delivery of care. We describe in detail the rationale for the project, the data architecture employed, the content of the data warehouse, along with a description of the challenges experienced and strategies used in …

Differences In Breast-Feeding Initiation And Continuation By Maternal Diabetes Status, Reena Oza-Frank, Ilana Chertok, Adam Bartley

Faculty & Staff Scholarship

To examine (i) the prevalence of and associations between breast-feeding initiation and continuation by maternal diabetes status and (ii) the reasons for not initiating and/or continuing breast-feeding by maternal diabetes status. Secondary data analyses of a population-based cross-sectional study were conducting using data from the US Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS), 2009-2011. Multivariable logistic regression was used to investigate the associations between breast-feeding initiation and continuation by diabetes status. Thirty states and New York City, USA. Mothers of recently live-born infants, selected by birth certificate sampling. Among 72755 women, 8.8 % had gestational …

A Neural Reward Prediction Error Revealed By A Meta-Analysis Of Erps Using Great Grand Averages., Thomas D. Sambrook, Jeremy Goslin

School of Psychology

Economic approaches to decision making assume that people attach values to prospective goods and act to maximize their obtained value. Neuroeconomics strives to observe these values directly in the brain. A widely used valuation term in formal learning and decision-making models is the reward prediction error: the value of an outcome relative to its expected value. An influential theory (Holroyd & Coles, 2002) claims that an electrophysiological component, feedback related negativity (FRN), codes a reward prediction error in the human brain. Such a component should be sensitive to both the prior likelihood of reward and its magnitude on receipt. A …

Endgame For Polio Eradication? Options For Overcoming Social And Political Factors In The Progress To Eradicating Polio., Pavan Ganapathiraju, Christiaan B Morssink, James D. Plumb

College of Population Health Faculty Papers

In 1988, the Global Polio Eradication Initiative (GPEI) was launched with the goal of eradicating polio by the year 2000. After 25 years, several dynamics still challenge this large public health campaign with new cases of polio being reported annually. We examine the roots of this initiative to eradicate polio, its scope, the successes and setbacks during the last 25 years and reflect on the current state of affairs. We examine the social and political factors that are barriers to polio eradication. Options are discussed for solving the current impasse of polio eradication: using force, respecting individual freedoms and gaining …

Effective, Clinically Feasible And Sustainable: Key Design Features Of Psycho-Educational And Supportive Care Interventions To Promote Individualised Self-Management In Cancer Care, P. Schofield, Suzanne Chambers

Research outputs 2014 to 2021

As the global burden of cancer increases healthcare services will face increasing challenges in meet the complex needs of these patients, their families and the communities in which they live. This raises the question of how to meet patient need where direct clinical contact may be constrained or not readily available. Patients and families require resources and skills to manage their illness outside of the hospital setting within their own communities. Aim. To propose a framework for the development and delivery of psycho-educational and supportive care interventions drawing on theoretical principles of behaviour change and evidence-based interventions, and based on …

Comparison Of Individual And Pooled Urine Samples For Estimating The Presence And Intensity Of Schistosoma Haematobium Infections At The Population Level, Abraham Degarege, Berhanu Erko, Zeleke Mekonnen, Mengistu Legesse, Yohannes Negash, Jozef Vercruysse, Bruno Levecke

Journal Articles: Epidemiology

BACKGROUND: There is a lack of cost-effective diagnostic strategies to evaluate whether mass drug administration (MDA) programmes to control Schistosoma haematobium progress as anticipated. The purpose of this study is to provide a proof-of-principle for examination of pooled urine samples as a strategy for rapid assessment of presence and intensity of Schistosoma haematobium infections at the population level.

METHODS: A total of 640 urine samples were collected from 520 school-aged children (520 at baseline and 120 at follow-up) during a clinical trial that was designed to assess the efficacy of praziquantel against Schistosoma haematobium infections in Ethiopia. Individual and pooled …

Smallpox Vaccination Of Laboratory Workers At Us Variola Testing Sites, Sharon J. Medcalf, Laura Bilek, Teresa L. Hartman, Peter C. Iwen, Patricia Leuschen, Hannah Miller, Anne O'Keefe, Harlan Sayles, Philip W. Smith

Journal Articles: Epidemiology

To evaluate the need to revaccinate laboratory workers against smallpox, we assessed regular revaccination at the US Laboratory Response Network's variola testing sites by examining barriers to revaccination and the potential for persistence of immunity. Our data do not provide evidence to suggest prolonging the recommended interval for revaccination.

Clinical Presentation Of Patients With Ebola Virus Disease In Conakry, Guinea, Elhadj Ibrahima Bah, Marie-Claire Lamah, Tom Fletcher, Shevin T. Jacob, David Brett-Major, Amadou Alpha Sall, Nahoko Shindo, William A. Fischer, Francois Lamontagne, Sow Mamadou Saliou, Daniel G. Bausch, Barry Moumié, Tim Jagatic, Armand Sprecher, James V. Lawler, Thierry Mayet, Frederique A. Jacquerioz, María F. Méndez Baggi, Constanza Vallenas, Christophe Clement, Simon Mardel, Ousmane Faye, Oumar Faye, Baré Soropogui, Nfaly Magassouba, Lamine Koivogui, Ruxandra Pinto, Robert A. Fowler

Journal Articles: Epidemiology

BACKGROUND: In March 2014, the World Health Organization was notified of an outbreak of Zaire ebolavirus in a remote area of Guinea. The outbreak then spread to the capital, Conakry, and to neighboring countries and has subsequently become the largest epidemic of Ebola virus disease (EVD) to date.

METHODS: From March 25 to April 26, 2014, we performed a study of all patients with laboratory-confirmed EVD in Conakry. Mortality was the primary outcome. Secondary outcomes included patient characteristics, complications, treatments, and comparisons between survivors and nonsurvivors.

RESULTS: Of 80 patients who presented with symptoms, 37 had laboratory-confirmed EVD. Among confirmed …

Modular Expression Analysis Reveals Functional Conservation Between Human Langerhans Cells And Mouse Cross-Priming Dendritic Cells, Maxim N. Artyomov, Adiel Munk, Laurent Gorvel, Daniel Korenfeld, Marina Cella, Thomas Tung, Eynav Klechevsky

Open Access Publications

Characterization of functionally distinct dendritic cell (DC) subsets in mice has fueled interest in whether analogous counterparts exist in humans. Transcriptional modules of coordinately expressed genes were used for defining shared functions between the species. Comparing modules derived from four human skin DC subsets and modules derived from the Immunological Genome Project database for all mouse DC subsets revealed that human Langerhans cells (LCs) and the mouse XCR1(+)CD8α(+)CD103(+) DCs shared the class I-mediated antigen processing and cross-presentation transcriptional modules that were not seen in mouse LCs. Furthermore, human LCs were enriched in a transcriptional signature specific to the blood cross-presenting …

Thinking About Ebola, David Brett-Major

Journal Articles: Epidemiology

No abstract provided.

Dna Methylation In Humans And Dogs: Evaluating The Impact Of Nutritional And Particulate Exposures, Luke Benjamin Montrose

Graduate Student Theses, Dissertations, & Professional Papers

Asthma is among the most common chronic diseases in children, among the leading causes of hospitalization for children, and one of the leading causes of school absenteeism. Discovery of preventable factors and the underlying mechanisms that exacerbate asthma among prevalent cases is important for mitigating the health burden of this childhood disease. Environmental factors such as exposure to particulate matter (PM) or nutritional deficiencies can lead to poor respiratory health among susceptible children. Recent animal studies suggest that PM exposures and dietary nutrients may influence asthma pathways through epigenetic mechanisms. Epigenetic modifications are heritable changes that can regulate gene activity …

The Role Of Vitamin D In Diabetes And Cardiovascular Disease: An Updated Review Of The Literature, Dimitrios Papandreou, Zujaja Tul Noor Hamid

All Works

© 2015 Dimitrios Papandreou and Zujaja-Tul-Noor Hamid. The dietary reference values for Vitamin D were set primarily considering its role in bone health, but with the discovery of Vitamin D receptors throughout body tissues, new links with other health conditions are now studied, such as for diabetes and cardiovascular diseases (CVD). This paper shall analyze and examine all new research studies carried out, especially in 2013-2015 regarding diabetes mellitus (DM) and cardiovascular diseases (CVD). Vast research has been carried out to establish strong relationship between Vitamin D serum levels, supplementation, diabetes, and CVD. However, the results from researches identified in …

Call Me Alix, Not Elix: Vowels Are More Important Than Consonants In Own-Name Recognition At 5 Months., Camillia Bouchon, Caroline Floccia, Thibaut Fux, Martine Adda-Decker, Thierry Nazzi

School of Psychology

Consonants and vowels differ acoustically and articulatorily, but also functionally: Consonants are more relevant for lexical processing, and vowels for prosodic/syntactic processing. These functional biases could be powerful bootstrapping mechanisms for learning language, but their developmental origin remains unclear. The relative importance of consonants and vowels at the onset of lexical acquisition was assessed in French-learning 5-month-olds by testing sensitivity to minimal phonetic changes in their own name. Infants' reactions to mispronunciations revealed sensitivity to vowel but not consonant changes. Vowels were also more salient (on duration and intensity) but less distinct (on spectrally based measures) than consonants. Lastly, vowel …

Outcome Predictability Biases Learning., Oren Griffiths, Chris J. Mitchell, Anna Bethmont, Peter F. Lovibond

School of Psychology

Much of contemporary associative learning research is focused on understanding how and when the associative history of cues affects later learning about those cues. Very little work has investigated the effects of the associative history of outcomes on human learning. Three experiments extended the "learned irrelevance" paradigm from the animal conditioning literature to examine the influence of an outcome's prior predictability on subsequent learning of relationships between cues and that outcome. All 3 experiments found evidence for the idea that learning is biased by the prior predictability of the outcome. Previously predictable outcomes were readily associated with novel predictive cues, …

Enhanced Visual Statistical Learning In Adults With Autism., Matthew E. Roser, Richard N. Aslin, Rebecca Mckenzie, Daniel Zahra, József Fiser

School of Psychology

OBJECTIVE: Individuals with autism spectrum disorder (ASD) are often characterized as having social engagement and language deficiencies, but a sparing of visuospatial processing and short-term memory (STM), with some evidence of supranormal levels of performance in these domains. The present study expanded on this evidence by investigating the observational learning of visuospatial concepts from patterns of covariation across multiple exemplars. METHOD: Child and adult participants with ASD, and age-matched control participants, viewed multishape arrays composed from a random combination of pairs of shapes that were each positioned in a fixed spatial arrangement. RESULTS: After this passive exposure phase, a posttest …

Posture Affects How Robots And Infants Map Words To Objects., Af Morse, Vl Benitez, T Belpaeme, A Cangelosi, Lb Smith

School of Engineering, Computing and Mathematics

For infants, the first problem in learning a word is to map the word to its referent; a second problem is to remember that mapping when the word and/or referent are again encountered. Recent infant studies suggest that spatial location plays a key role in how infants solve both problems. Here we provide a new theoretical model and new empirical evidence on how the body - and its momentary posture - may be central to these processes. The present study uses a name-object mapping task in which names are either encountered in the absence of their target (experiments 1-3, 6 …

Metals In Boat Paint Fragments From Slipways, Repair Facilities And Abandoned Vessels: An Evaluation Using Field Portable Xrf., Andrew Turner, Sean Comber, Aldous B. Rees, Dimitrios Gkiokas, Kevin Solman

School of Geography, Earth and Environmental Sciences

Paint flaking off abandoned vessels or generated during boat repair is hazardous to human health and wildlife. In this study, a means of screening paint fragments using a field portable-X-ray fluorescence (FP-XRF) spectrometer is described. The technique is capable of delivering rapid, surficial measurements of Ba, Cu, Pb and Zn down to concentrations less than 150 μg g(-1), and Sn and Cr to concentrations of a few hundred μg g(-1). Application of the technique to fragments collected from slipways, yards, hardstandings, abandoned boats and ships undergoing maintenance throughout the EU reveal highly variable concentrations of metals among samples from the …

Uncoupling Protein-2 Attenuates Palmitoleate Protection Against The Cytotoxic Production Of Mitochondrial Reactive Oxygen Species In Ins-1e Insulinoma Cells., Jonathan Barlow, Jensen V Hirschberg, Charles Affourtit

School of Biomedical Sciences

High glucose and fatty acid levels impair pancreatic beta cell function. We have recently shown that palmitate-induced loss of INS-1E insulinoma cells is related to increased reactive oxygen species (ROS) production as both toxic effects are prevented by palmitoleate. Here we show that palmitate-induced ROS are mostly mitochondrial: oxidation of MitoSOX, a mitochondria-targeted superoxide probe, is increased by palmitate, whilst oxidation of the equivalent non-targeted probe is unaffected. Moreover, mitochondrial respiratory inhibition with antimycin A stimulates palmitate-induced MitoSOX oxidation. We also show that palmitate does not change the level of mitochondrial uncoupling protein-2 (UCP2) and that UCP2 knockdown does not …

Antibiotic-Resistant St38, St131 And St405 Strains Are The Leading Uropathogenic Escherichia Coli Clones In Riyadh, Saudi Arabia., Majed F. Alghoribi, Tarek M. Gibreel, Garry Farnham, Johani Sm Al, Hanan H. Balkhy, Mathew Upton

School of Biomedical Sciences

OBJECTIVES: We investigated the molecular epidemiology of uropathogenic Escherichia coli (UPEC) from a tertiary care hospital in Riyadh, Saudi Arabia, revealing, for the first time, the population structure of UPEC in the region. METHODS: A total of 202 UPEC isolates were recovered from hospital and community patients with urinary tract infection in December 2012 and January 2013. Strains were characterized by MLST, antibiotic susceptibility determination and virulence gene detection. RESULTS: The most common lineages were ST131 (17.3%), ST73 (11.4%), ST38 (7.4%), ST69 (7.4%), ST10 (6.4%), ST127 (5.9%), ST95 (5.4%), ST12 (3.5%), ST998 (3.5%) and ST405 (3%). ST131 and ST405 isolates …

Molecular Characterization Of A Multidrug Resistance Incf Plasmid From The Globally Disseminated Escherichia Coli St131 Clone., Minh Duy Phan, Brian M. Forde, Kate M. Peters, Sohinee Sarkar, Steven Hancock, Mitchell Stanton-Cook, Zakour Nl Ben, Mathew Upton, Scott A. Beatson, Mark A. Schembri

School of Biomedical Sciences

Escherichia coli sequence type 131 (E. coli ST131) is a recently emerged and globally disseminated multidrug resistant clone associated with urinary tract and bloodstream infections. Plasmids represent a major vehicle for the carriage of antibiotic resistance genes in E. coli ST131. In this study, we determined the complete sequence and performed a comprehensive annotation of pEC958, an IncF plasmid from the E. coli ST131 reference strain EC958. Plasmid pEC958 is 135.6 kb in size, harbours two replicons (RepFIA and RepFII) and contains 12 antibiotic resistance genes (including the blaCTX-M-15 gene). We also carried out hyper-saturated transposon mutagenesis and multiplexed transposon …