Medicine and Health Sciences Commons^™

Quantitative And Qualitative Findings And Implications Of An Intercultural Sensitivity Assessment Among Employees At A Large Health System, Jarret R. Patton Md, Jay Baglia Phd, Lynn M. Deitrick Rn, Phd, Anthony Nerino Ma, Eric J. Gertner Md, Mph, Judith Sabino Mph, Mary Kay Grim Bs, Debbie Salas-Lopez Md, Mph

Department of Pediatrics

Tuesday, November 10, 2009: 2:45 PM Jarret R. Patton, MD , Department of Pediatrics, Lehigh Valley Health Network, Allentown, PA Jay Baglia, PhD , Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA Lynn M. Deitrick, RN, PhD , Department of Community Health, Health Studies and Education, Lehigh Valley Health Network, Allentown, PA Anthony Nerino, MA , Department of Community Health, Health Studies and Education, Lehigh Valley Health Network, Allentown, PA Eric J. Gertner, MD, MPH , Department of Medicine, Lehigh Valley Health Network, Allentown, PA Judith N. Sabino, MPH , Cultural Awareness, Lehigh Valley Health Network, Allentown, PA …

Today - December 9, 2009, Loma Linda University

TODAY

Inside this issue:

-- New strategic plan created to guide LLUMC through times of economic uncertainty
-- School of Public Health hosts forum for H1N1 flu pandemic
-- Flurry of activities at Loma Linda University School of Pharmacy
-- Loma Linda University trains officials in disaster management
-- Amazon Mission Trip: The Inside Story
-- Faculty link food with climate change at recent conference
-- 101 year-old physician personifies lifestyle and longevity benefits of Adventist lifestyle
-- Santa makes his first stop of the season at LLU Children’s Hospital
-- Church scholar is international authority on the Septuagint and Apocrypha …

Today - November 9, 2009, Loma Linda University

TODAY

Inside this issue:

-- Loma Linda University celebrates the life-saving legacy of Baby Fae and the infant heart transplantation program
-- Chapel service kicks off centennial celebration for School of Medicine
-- 12th Annual Research Symposium leads off new research season
-- Children’s Hospital unveils plaque recognizing Kiwanis Pediatric Emergency Medicine Fellowship
-- LLU Church to host 32nd annual anniversary concert for Cassavant organ
-- Centennial grand opening and ribbon-cutting celebrate campus milestone
-- School of Medicine Centennial Celebration ends with a very big bang
-- School of Medicine centennial weekend events take place at LLU Church
-- School of …

U.S. Facing A Generation Without Playing Host To Olympics, Rick Burton, Norm O'Relly

Sport Management - All Scholarship

No abstract provided.

Baseline Knowledge Assessment Of Cobb County Safe Kids Inspection Station Participants, Laurie Elizabeth Whorton

Public Health Theses

INTRODUCTION: The leading cause of injury and death among children in the United States is motor vehicle crashes. Even though laws have been amended and public awareness campaigns and education has increased, many children are still improperly restrained or not restrained at all. When correctly used, child restraints significantly reduce risk of injury or death in a motor vehicle crash. AIM: The purpose of the questions is to exhibit the baseline knowledge of participants before receiving car seat education from certified technicians. METHODS: Over an eight week period, Safe Kids Cobb County Car Seat Technicians distributed a 16-item survey, with …

Is Extended Volume Of External Beam Irradiation Beneficial In Post-Esophagectomy High Risk Patients Receiving Combined Chemoradiation Therapy?, E. Yu, A. R. Dar, R. Ash, G. Videtic, P. Truong, L. Stitt, A. Tomiak, M. Vincent, R. Malthaner, I. Craig, E. Brecevic, W. Kocha, R. Inculet, M. Lefcoe

Edward Yu

OBJECTIVE: To assess the value of extended volume irradiation with anastomotic coverage in high risk resected esophageal cancer patients. METHOD: A retrospective study was undertaken at LRCC from 1989-1999 for high risk resected esophageal cancer patients. Adjuvant treatments consisted of 4 cycles of chemotherapy (epirubicin/fluorouracil/cisplatin or cisplatin/fluorouracil), and local regional irradiation with or without coverage of the anastomotic site. Radiation dose ranged from 45-60Gy at 1.8-2.0 Gy/fraction given with initial anterior-posterior/posterior-anterior arrangement with either extended (with anastomotic coverage) or small (without anastomotic coverage) field followed by oblique fields for boost. RESULT: One hundred eighty-eight charts were reviewed. Seventy-two patients were …

Robot Assisted Ultrasound Imaged Guided Interstitial Lung Brachytherapy In A Porcine Model, Richard A. Malthaner, Edward Yu, Jerry J. Battista, Chris Blake, Donal Downey, Aaron Fenster

Edward Yu

We set out to see if permanent interstitial brachytherapy seeds could be safely and reproducibly inserted thoracoscopicaly with the ZEUS Robotic system and intraoperative ultrasound into in-vivo porcine lungs.

Post-Operative Extended Volume External Beam Radiation Therapy Is Safe For High Risk Esophageal Cancer Patients, Edward Yu, Patricia Tai, Jawaid Younus, Richard Malthaner, Larry Stitt, Pauline Truong, George Rodrigues, Robert Ash, Rashid Dar, Anna Tomiak, Mark Vincent, Walter Kocha, Brian Dingle, Richard Inculet

Edward Yu

Post-operative radiation therapy (RT) (1) and post-operative chemoradiation (2) have been used for esophageal cancer patients deemed high risk for recurrence after esophagectomy. Defining opitmal RT target volume after esophagectomy is difficult due to significant changes in patient anatomy and function. Some radiationon cologists advocated the inclusion of the anastomotic site within the irradiation volume due to concerns for potential increased relapse risk, while others did not subscribe to this practice due to concerns for increased treatment related toxicity. We have previously reported patient outcome benefit using extended volume RT In management with high risk esophageal cancer patients underwent esopagectomy(3). …

Extended Vs. Small Field Irradiation In High Risk Post Esophagectomy Patients Receiving Combined Chemoradiation Therapy: A Decade Experience In Treatment Of Esophageal Cancer, Edward Yu, Patricia Tai, George Rodrigues, Robert Ash, Larry Stitt, Rashid A. Dar, Pauline Truong, Gregory M. Videtic, Richard Malthaner, Richard Inculet, Anna Tomiak, Jawaid Younus, Brian Dingle, Walter Kocha, Mark Vincent

Edward Yu

OBJECTIVE: To assess the impact of extended field irradiation with anastomotic coverage on local recurrence in high risk resected esophageal cancerpatients. METHODS: From 1989-1999, high risk resected esophageal cancer cases receiving post-resection chemoradiation were reviewed. Adjuvant chemotherapy consisted of four cycles of fluorouracil-based regimens. Loco-regional irradiation with or without coverage of anastomotic site had radiation a dose range from 45-60 Gyat 1.8-2.0 Gy/fraction given with initial anterior-posterior/posterior-anterior arrangement with either extended (with anastomotic coverage), or small (without anastomotic coverage) field followed by oblique fields for boost. RESULTS: One hundred eighty-eight charts were reviewed. Seventy-two patients were eligible for post-resection chemoradiation. …

Evaluation Of Intra-And Inter-Fraction Motion In Breast Radiotherapy Using Electronic Portal Imaging Cine Loops, Chrison Lee, Edward Yu, Tomas Kron

Edward Yu

Parallel tangent breast irradiation is commonly used postbreast conservation surgery for early breast cancer patient without lymph node involvement to improve local disease control. Intra-fractional and inter-fractional variabilities are often presented in daily treatment setup. The present pilot study used Electronic Portal Imaging (EPI) to evaluate intra-and inter-fraction motion in patients undergoing simple breast tangent radiotherapy.

Medical School Watercooler Newsletter - November 8, 2009, Lindsey Lyle

Watercooler Newsletter

This is the November 8, 2009 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler

Contents Include:

• Soap and Water - Your Best Defense
• Stimulating Science - Story to Air Sunday
• USA Pulmonary Hypertension Center Takes Part in National Awareness Effort

• Med School Cafe' - "State of the Art Care for Peripheral Artery Disease"

• November 12th DSS - “Epigenetic Control of Chromatin-Dependent Transcription: Lessons from HPV E2 and E6 Proteins”

Diagnosis In General Practice: Using Probabilistic Reasoning, Jenny Doust

Jenny Doust

Diagnostic tests—whether clinical signs, imaging, or laboratory tests—are imperfect: there is always a possibility that test results are inaccurate and our diagnosis is wrong. However, we need to make decisions about whether to treat or not to treat patients, and so we need to feel confident that our diagnosis is above a certain threshold before we decide to treat a patient and below a certain threshold if we decide to withhold treatment. The threshold depends on the disease and the potential harms and benefits of treating or not treating patients. Unless we have clear strategies to cope with the uncertainties …

Age-Related Genetic And Epigenetic Chromosomal Changes: A Twin Study, Kimberly Jones

Theses and Dissertations

The primary aims of this study were to examine acquired genetic and epigenetic changes that occur in individuals with increasing age and to determine how these changes are influenced by genetic/environmental factors. Acquired genetic changes were assessed by determining the frequency and chromosomal contents of spontaneously occurring micronuclei in identical and fraternal twins. A total of 115 individuals (48 twin pairs and 19 singletons) were evaluated, ranging in age from 7 to 85 years. As expected, micronuclei frequencies, which are indicative of genomic damage, significantly increased with age (p<0.0001, r=0.446). The majority of micronuclei (32%) contained sex chromosomes and the frequency of sex chromosome-bearing micronuclei significantly increased with age (p<0.0001). The frequency of autosome-containing micronuclei was not significantly influenced by age or gender. However, some autosomes were seen more (chromosomes 4, 8, and 9) or less (chromosomes 17 and 22) frequently than expected by chance (p<0.05). An evaluation of the numerical contents of the sex chromosome-containing micronuclei and their corresponding binucleates showed that the majority of the binucleates had an abnormal chromosomal complement (either hypodiploid or hyperdiploid), with the subset of binucleates having a normal chromosomal complement decreasing with age for both the Y chromosome in males and the X chromosome in females. Model fitting, implemented in Mx, showed the variation in the frequency of micronuclei to be best explained by either additive genetic and unique environmental components, or common and unique environmental factors. Specific environmental exposures and health conditions that were shown to influence micronuclei frequencies, included: multivitamins, leafy green vegetables, fruit, vitamin E supplements, arthritis, heart disease, allergies, and alcohol. To assess acquired epigenetic changes, global methylation profiles of two identical twin pairs were compared and found to differ, indicating that individuals do develop alterations in their methylation profiles with age. Furthermore, the twin pair having a significant difference in their micronuclei frequencies and environmental exposures had more differences in their methylation pattern compared to the twin pair whose micronuclei frequencies and environmental factors did not differ. Overall, genetic and epigenetic changes were shown to occur with age and to be influenced by genetic and lifestyle factors.

Hp Newsletter Sept. 09 Download Full Pdf

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

A Comparison Of Frequentist And Bayesian Approaches To The Estimation Of Long-Stay Per-Diems, Jeff Hatcher, Jason M. Sutherland

Dartmouth Scholarship

Within many diagnosis related group (DRG) systems, there is recognition that a single cost weight per DRG is not suitable, and that cost weights should take into account extremely lengthy hospital stays. Long lengths of stay are considered to be due to factors largely beyond the control of the hospital, and a single weight per DRG would potentially place hospitals under financial risk.

Within Canada's acute-care, inpatient grouping methodology - Case Mix Groups (CMG+) - long-stay episodes represent approximately 4.5% of all discharges. Within a CMG (analogous to DRG), the cost weight assigned to long-stay cases consists of the typical …

Lot Quality Assurance Sampling (Lqas) And The Mozambique Malaria Indicator Surveys, Caitlin Biedron, Marcello Pagano, Bethany L. Hedt, Albert Kilian, Amy Ratcliffe, Samuel Mabunda, Joseph J. Valadez

Harvard University Biostatistics Working Paper Series

No abstract provided.

Talk To Me: Issues In Acquiring Spoken Language For Young Children With Autism Spectrum Disorders, Rhea Paul

Communication Disorders Faculty Publications

Speech-language pathologists play a critical role in the treatment of children with autism spectrum disorders (ASD) because communication deficits are a primary component of both the diagnostic criteria and the focus of educational services for children with these conditions. Children with ASD almost always are delayed in speech acquisition (Tager-Flusberg, Paul, & Lord, 2005), as well as in other areas of communication. Lack of speech is often the most obvious symptom and greatest cause for concern of parents of toddlers who are eventually diagnosed with ASD, even though closer observation usually reveals additional problems.

Victims Of Violence Among Indigenous Mothers Living With Dependent Children, Kyllie Cripps, Catherine M. Bennett, Lyle C. Gurrin, David M. Studdert

Aboriginal Policy Research Consortium International (APRCi)

Objective: Toidentifyindividualandhouseholdfactorsassociatedwithviolenceamong Australian Indigenous women with dependent children. Design and participants: Univariate and multivariable analysis of data from the 2002 National Aboriginal and Torres Strait Islander Social Survey, stratified by area.

Main outcome measure: Self-reported experience of being a victim of violence in the previous year. Results: OneinfourIndigenouswomenlivingwithdependentchildrenyoungerthan 15 years reported being victims of violence in the previous year; this corresponds to an estimated 24 221 Indigenous mothers (95% CI, 21 507–26 935) nationwide. Violence was more prevalent in regional areas and cities than remote areas. In remote areas, mothers who had been removed from their natural families during childhood …

Small-Molecule Screening Using A Human Primary Cell Model Of Hiv Latency Identifies Compounds That Reverse Latency Without Cellular Activation, Hung Chih Yang, Sifei Xing, Liang Shan, Karen O'Connell

University Faculty Publications and Creative Works

The development of highly active antiretroviral therapy (HAART) to treat individuals infected with HIV-1 has dramatically improved patient outcomes, but HAART still fails to cure the infection. The latent viral reservoir in resting CD4+ T cells is a major barrier to virus eradication. Elimination of this reservoir requires reactivation of the latent virus. However, strategies for reactivating HIV-1 through nonspecific T cell activation have clinically unacceptable toxicities. We describe here the development of what we believe to be a novel in vitro model of HIV-1 latency that we used to search for compounds that can reverse latency. Human primary CD4+ …

No Powerpoint? Whatever Loys Your Krathong ..., Kimberly D. Acquaviva

National Collaborative on Aging Faculty Publications

The author discusses her experiences teaching a workshop on writing for publication to medicine, nursing and public health faculty in Thailand, without using PowerPoint.

Ada News - 11/02/2009, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Μ-Opioid Receptor Agonist Injections Into The Presumed Pre-Bötzinger Complex And The Surrounding Region Of Awake Goats Do Not Alter Eupneic Breathing, K. L. Krause, Suzanne E. Neumueller, B. D. Marshall, T. Kiner, Joshua M. Bonis, Lawrence Pan, B. Qian, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Opioids are clinically important in the alleviation of pain. An undesirable side effect of opioids is depression of breathing. Data from isolated preparations suggest this effect is due to attenuation of discharge activity of neurons in the pre-Bötzinger complex (preBötzC), a medullary area with respiratory rhythmogenic properties. The purpose of this study was to examine how [d-Ala(2),N-Me-Phe(4),Gly(5)-ol]-enkephalin (DAMGO), a μ-opioid receptor agonist, affected breathing after injection into the presumed preBötzC of the adult awake goat. We hypothesized that DAMGO would cause breathing to decrease and become irregular when injected into the presumed preBötzC and the surrounding region of the conscious …

Barriers Influencing Minority Clients’ Access To Speech Language Pathology Services. Poster, Nidhi Mahendra, Katie Schoneman, Nisha Engineer

Faculty Publications

No abstract provided.

Timing Of Moderate Level Prenatal Alcohol Exposure Influences Gene Expression Of Sensory Processing Behavior In Rhesus Monkeys, Mary L. Schneider, Colleen F. Moore, Julie A. Larson, Christina S. Barr, Onofre T. Dejesus, Andrew D. Roberts

Physics and Astronomy Department Publications

Sensory processing disorder, characterized by over- or under-responsivity to non-noxious environmental stimuli, is a common but poorly understood disorder. We examined the role of prenatal alcohol exposure, serotonin transporter gene polymorphic region variation (rh5-HTTLPR), and striatal dopamine (DA) function on behavioral measures of sensory responsivity to repeated non-noxious sensory stimuli in macaque monkeys. Results indicated that early gestation alcohol exposure induced behavioral under-responsivity to environmental stimuli in monkeys carrying the short (s) rh5-HTTLPR allele compared to both early-exposed monkeys homozygous for the long (l) allele and monkeys from middle-to-late exposed pregnancies and controls, regardless of genotype. …

Ppar Agonists Down-Regulate The Expression Of Atp10c Mrna During Adipogenesis, A Peretich, Maria Cekanova Ms, Rndr, Phd, S Hurst, Sj Baek, Madhu Dahr

Faculty Publications and Other Works -- Biochemistry, Cellular and Molecular Biology

No abstract provided.

Alcohol Use And Gender Effects On Hiv Risk Behaviors In Cocaine-Using Methadone Patients, Carla J. Rash, Nancy M. Petry

UCHC Articles - Research

Injection drug users engage in behaviors that increase the spread of human immunodeficiency virus (HIV) and other infectious diseases. Although methadone maintenance (MM) is highly effective in decreasing heroin use and the spread of HIV, polydrug use, especially the combined use of cocaine and alcohol, is common in MM patients. Alcohol use is independently associated with HIV risk behaviors, and the effects of alcohol use on risk behaviors may vary by gender. This study evaluated the effects of recent heavy alcohol use and gender with respect to HIV risk behaviors in 118 cocaine-abusing methadone patients. Both lifetime and past month …

Individualized Assessment And Treatment Program For Alcohol Dependence: Results Of An Initial Study To Train Coping Skills, Mark D. Litt, Ronald M. Kadden, Elise Kabela-Cormier

UCHC Articles - Research

Cognitive-behavioral treatments (CBT) are among the most popular interventions offered for alcohol and other substance use disorders, but it is not clear how they achieve their effects. CBT is purported to exert its beneficial effects by altering coping skills, but data supporting coping changes as the mechanism of action are mixed. The purpose of this pilot study was to test a treatment in which coping skills were trained in a highly individualized way, allowing us to determine if such training would result in an effective treatment. Conclusions The IATP approach was more successful than PCBT at training adaptive coping responses …

Rna-Guided Rna Cleavage By A Crispr Rna-Cas Protein Complex, Brenton R. Graveley, Sara Olson, Michael O. Duff

UCHC Articles - Research

Compelling evidence indicates that the CRISPR-Cas system protects prokaryotes from viruses and other potential genome invaders. This adaptive prokaryotic immune system arises from the clustered regularly interspaced short palindromic repeats (CRISPRs) found in prokaryotic genomes, which harbor short invader-derived sequences, and the CRISPR-associated (Cas) protein-coding genes. Here we have identified a CRISPR-Cas effector complex that is comprised of small invader-targeting RNAs from the CRISPR loci (termed prokaryotic silencing (psi)RNAs) and the RAMP module (or Cmr) Cas proteins. The psiRNA-Cmr protein complexes cleave complementary target RNAs at a fixed distance from the 3' end of the integral psiRNAs. In Pyrococcus furiosus …

Control Of Electrochemical And Ferryloxy Formation Kinetics Of Cyt P450s In Polyion Films By Heme Iron Spin State And Secondary Structure, Sadagopan Krishnan, Amila Abeykoon, John B. Schenkman, James F. Rusling

UCHC Articles - Research

Voltammetry of cytochrome P450 (cyt P450) enzymes in ultrathin films with polyions was related for the first time to electronic and secondary structure. Heterogeneous electron transfer (hET) rate constants for reduction of the cyt P450s depended on heme iron spin state, with low spin cyt P450cam giving a value 40-fold larger than high spin human cyt P450 1A2, with mixed spin human P450 cyt 2E1 at an intermediate value. Asymmetric reduction–oxidation peak separations with increasing scan rates were explained by simulations featuring faster oxidation than reduction. Results are consistent with a square scheme in which oxidized and reduced forms of …

Tailoring Messages To Individual Differences In Monitoring- Blunting Styles To Increase Fruit And Vegetable Intake, Pamela Williams-Piehota, Amy E. Latimer, Nicole A. Katulak, Ashley Cox, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

Objective

To examine whether messages matched to individuals' monitoring-blunting coping styles (MBCS) are more effective in increasing fruit and vegetable intake than mismatched messages. MBCS refers to the tendency to either attend to and amplify, or distract oneself from and minimize threatening information.

Design/Setting

Randomly assigned messages were tailored to resonate with either monitors or blunters and delivered at baseline, 1 week, 2 months, and 3 months later. Surveys were conducted at baseline and 2 and 4 months later.

Participants

531 callers to a cancer information hotline who did not meet the 5 A Day guideline.

Intervention

A brief telephone-delivered …