Medicine and Health Sciences Commons^™

Environmental Circadian Disruption Elevates The Il-6 Response To Lipopolysaccharide In Blood, Kandis L. Adams, Oscar Castanon-Cervantes, Jennifer A. Evans, Alec J. Davidson

Biomedical Sciences Faculty Research and Publications

The immune system is regulated by circadian clocks within the brain and immune cells. Environmental circadian disruption (ECD), consisting of a 6-h phase advance of the light:dark cycle once a week for 4 weeks, elevates the inflammatory response to lipopolysaccharide (LPS) both in vivo and in vitro. This indicates that circadian disruption adversely affects immune function; however, it remains unclear how the circadian system regulates this response under ECD conditions. Here, we develop an assay using ex vivo whole-blood LPS challenge to investigate the circadian regulation of immune responses in mice and to determine the effects of ECD on these …

Physical Activity Parenting Measurement And Research: Challenges, Explanations, And Solutions, Kirsten K. Davison, Louise C. Mâsse, Anna Timperio, Marilyn Frenn, Julie Saunders, Jason A. Mendoza, Erica Gobbi, Phillip Hanson, Stewart G. Trost

College of Nursing Faculty Research and Publications

Physical activity (PA) parenting research has proliferated over the past decade, with findings verifying the influential role that parents play in children's emerging PA behaviors. This knowledge, however, has not translated into effective family-based PA interventions. During a preconference workshop to the 2012 International Society for Behavioral Nutrition and Physical Activity annual meeting, a PA parenting workgroup met to: (1) Discuss challenges in PA parenting research that may limit its translation, (2) identify explanations or reasons for such challenges, and (3) recommend strategies for future research. Challenges discussed by the workgroup included a proliferation of disconnected and inconsistently measured constructs, …

Concept Analysis Of Empowerment From Survivor And Nurse Perspectives Within The Context Of Cancer Survivorship, Teresa Jerofke-Owen

College of Nursing Faculty Research and Publications

The liberal usage of the concept of empowerment has led to the development of a broad and ambiguous term. In health care, empowerment is a core principle of patient-centered care that promotes patient engagement in health management. This is an analysis of the concept of empowerment within the context of cancer survivorship using both Rodgers' evolutionary concept analysis and Caron and Bower's dimensional analysis. The dimensional analysis followed the evolutionary concept analysis as the perspectives of patients and nurse providers emerged in the analysis. Data sources included a sample of 249 papers from multiple disciplines covering the period 2000–2013. Empowerment …

Spiritual Care Of Couples Practicing Natural Family Planning, Richard Fehring, Dana Rodriguez

College of Nursing Faculty Research and Publications

There are few studies that have investigated the spiritual problems of couples practicing natural family planning (NFP). The purpose of this paper is to analyze the spiritual problems and interventions of couples who were taught NFP by means of a professional online Web-based support system. Responses from this online system and its forums were categorized according to spiritual responses, spiritual problems, and spiritual interventions to the practice of NFP. Themes addressed included spiritual care in regards to decisions about the transmission of new life, difficulties in dealing with chastity and abstinence, bioethical problems related to pregnancy and illness, end of …

Corticosterone Acts In The Nucleus Accumbens To Enhance Dopamine Signaling And Potentiate Reinstatement Of Cocaine Seeking, Evan N. Graf, Robert A. Wheeler, David A. Baker, Amanda L. Ebben, Jonathan E. Hill, Jayme R. Mcreynolds, Mykel A. Robble, Daniel S. Wheeler, John Mantsch, Paul J. Gasser

Biomedical Sciences Faculty Research and Publications

Stressful life events are important contributors to relapse in recovering cocaine addicts, but the mechanisms by which they influence motivational systems are poorly understood. Studies suggest that stress may “set the stage” for relapse by increasing the sensitivity of brain reward circuits to drug-associated stimuli. We examined the effects of stress and corticosterone on behavioral and neurochemical responses of rats to a cocaine prime after cocaine self-administration and extinction. Exposure of rats to acute electric footshock stress did not by itself reinstate drug-seeking behavior but potentiated reinstatement in response to a subthreshold dose of cocaine. This effect of stress was …

Randomized Comparison Of Two Internet-Supported Fertility Awareness Based Methods Of Family Planning, Richard J. Fehring, Mary Schneider, Kathleen Raviele, Dana Rodriguez, Jessica E. Pruszynski

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

Background: The aim was to compare the efficacy and acceptability of two Internet-supported fertility-awareness-based methods of family planning.

Study design: Six hundred and sixty-seven women and their male partners were randomized into either an electronic hormonal fertility monitor (EHFM) group or a cervical mucus monitoring (CMM) group. Both groups utilized a Web site with instructions, charts and support. Acceptability was assessed online at 1, 3 and 6 months. Pregnancy rates were determined by survival analysis.

Results: The EHFM participants (N=197) had a total pregnancy rate of 7 per 100 users over 12 months of use compared with 18.5 for the …

Racial And Ethnic Variations In Waiting Times For Emergency Department Visits Related To Nontraumatic Dental Conditions In The United States, Christopher Okunseri, Elaye Okunseri, Cesar A. Chilmaza, Shazeen Harunani, Qun Xiang, Aniko Szabo

School of Dentistry Faculty Research and Publications

Background

Researchers have documented an association between waiting times in emergency departments (EDs) and quality of care for medical conditions, but little is known about trends and factors associated with waiting times for ED visits related to nontraumatic dental conditions (NTDCs). The authors examined trends in waiting time and associated factors for NTDC-related ED visits in the United States.

Methods

The authors analyzed data from the National Hospital Ambulatory Medical Care survey for 1997 to 2007, excluding 2001 and 2002 owing to lack of information about waiting times. The authors used a survey-weighted linear regression of log-transformed waiting-time model to …

Spirituality, Religiosity, Depression, Anxiety, And Drug-Use Consequences During Methadone Maintenance Therapy, Linda B. Piacentine

College of Nursing Faculty Research and Publications

Substance addiction is damaging to the health of persons, families, and society. Often the person with addiction has decreased spirituality and religiosity and suffers from anxiety, depression, or both, increasing the risk for continued substance use and its concomitant negative consequences. The study purpose was to describe spirituality and religiosity, among persons enrolled in methadone maintenance therapy and to examine associations between spirituality, religiosity, anxiety, depression, and drug-use consequences. Using a descriptive and cross-sectional correlational design, 108 participants completed questionnaires assessing the study variables. Spiritual well-being was similar to other addiction samples and lower than healthy person samples. Most participants …

A Theater Intervention To Prevent Teen Dating Violence For Mexican-American Middle School Students, Ruth Belknap, Kristin Haglund, Holly Felzer, Jessica E. Pruszynski, John Schneider

College of Nursing Faculty Research and Publications

Purpose

To test a theater intervention designed to raise awareness of the dynamics and consequences of teen dating violence (TDV) and to facilitate creation of nonviolent responses to TDV among Latino and Latina adolescents. The intervention was based on Theater of the Oppressed, which advocates the use of theater methods to explore social issues and to allow audiences to experiment with problem-solving, thereby promoting change.

Methods

This study used a pretest–posttest, no control group, mixed-measures design to study 66 Mexican-American adolescents (mean age, 13.4 ± 5 years). Two plays containing subtle and overt signs of control and abuse were written …

Randomized Comparison Of Two Internet-Supported Fertility Awareness Based Methods Of Family Planning, Richard J. Fehring, Mary Schneider, Kathleen Raviele, Dana Rodriguez, Jessica E. Pruszynski

College of Nursing Faculty Research and Publications

Background

The aim was to compare the efficacy and acceptability of two Internet-supported fertility-awareness-based methods of family planning.

Study design

Six hundred and sixty-seven women and their male partners were randomized into either an electronic hormonal fertility monitor (EHFM) group or a cervical mucus monitoring (CMM) group. Both groups utilized a Web site with instructions, charts and support. Acceptability was assessed online at 1, 3 and 6 months. Pregnancy rates were determined by survival analysis.

Results

The EHFM participants (N= 197) had a total pregnancy rate of 7 per 100 users over 12 months of use compared with …

Prefrontal Activity Links Nonoverlapping Events In Memory, Marieke R. Gilmartin, Hiroyuki Miyawaki, Fred J. Helmstetter, Kamran Diba

Biomedical Sciences Faculty Research and Publications

The medial prefrontal cortex (mPFC) plays an important role in memory. By maintaining a working memory buffer, neurons in prelimbic (PL) mPFC may selectively contribute to learning associations between stimuli that are separated in time, as in trace fear conditioning (TFC). Until now, evidence for this bridging role was largely descriptive. Here we used optogenetics to silence neurons in the PL mPFC of rats during learning in TFC. Memory formation was prevented when mPFC was silenced specifically during the interval separating the cue and shock. Our results provide support for a working memory function for these cells and indicate that …

Oral Atypical Cellular Blue Nevus: An Infiltrative Melanocytic Proliferation, Brian S. Shumway, Yeshwant B. Rawal, Carl M. Allen, John R. Kalmar, Cynthia M. Magro

School of Dentistry Faculty Research and Publications

The atypical cellular blue nevus is an extremely rare nevomelanocytic lesion which lacks precise histologic characterization in the current literature. Given the potential for significant architectural and cytologic overlap with melanoma, further study, including molecular analysis, is needed. This is the first description of an atypical cellular blue nevus of the oral cavity.

Quality Improvement Project: Analysis Of Efficiency Of Current Order Set For The Diagnostic Workup Used To Evaluate Neurogenic Stress Myocardium In Aneurysmal Subarachnoid Hemorrhage, Denise Miller Niklasch, Kathleen Bobay

College of Nursing Faculty Research and Publications

Purpose

To evaluate patterns of utilization of the aneurysmal subarachnoid hemorrhage (aSAH) protocol order set for neurogenic stress myocardium (NSM).

Data sources

Retrospective chart review.

Conclusions

The results of this study demonstrate that protocol order sets can be prone to omissions, variations in practice, and delays.

Implications for practice

Education and implementation of an intervening compliance monitor are essential to improve utilization and correctness in use of the aSAH protocol order set for NSM. Advance practice nurses (APNs) or nursing staff could provide this service. This would improve teamwork, improve efficiency of care delivery and utilization of resources, promote leadership …

Children With Autism Spectrum Disorder At A Pediatric Hospital: A Systematic Review Of The Literature, Norah L. Johnson, Dana Rodriguez

College of Nursing Faculty Research and Publications

This review of literature describes the behaviors of hospitalized children with autism spectrum disorder (ASD) that health care providers find challenging. It also identifies strategies used to address these challenging behaviors. The systematic review of literature identified 34 articles from databases on health care of challenging behaviors of children with ASD. The review identified four categories of challenging behaviors (non-compliance, hyperactivity, sensory defensiveness, self-injury) and several strategies for reducing these behaviors. Partnering with parents to develop strategies is important for children with ASD to deliver timely and safe care.

Leisure-Time Physical Activity In Relation To Depressive Symptoms In African-Americans: Results From The National Survey Of American Life, Elisa R. Torres, Carolyn M. Sampselle, David L. Ronis, Harold W. Neighbors, Kimberlee A. Gretebeck

College of Nursing Faculty Research and Publications

Objective

To examine the frequency of leisure-time physical activity (LTPA) in relation to depressive symptoms in a nationally representative sample of African American (AA) women and AA men with guidance by Stokols' Social Ecological Framework.

Method

A secondary analysis of AA women (n = 1811) and AA men (n = 1038) was performed on the National Survey of American Life, where a four stage national area probability sampling was conducted. Interviews were conducted 2001–2003. Clinically depressed AA were excluded from the current study. LTPA was measured by self-report frequency (never, rarely, sometimes, often) of participation in sports/exercise. Depressive symptoms were …

Differences In Kinematic Control Of Ankle Joint Motions In People With Chronic Ankle Instability, Kristof Kipp, Rianna M. Palmieri-Smith

Exercise Science Faculty Research and Publications

Background

People with chronic ankle instability display different ankle joint motions compared to healthy people. The purpose of this study was to investigate the strategies used to control ankle joint motions between a group of people with chronic ankle instability and a group of healthy, matched controls.

Methods

Kinematic data were collected from 11 people with chronic ankle instability and 11 matched control subjects as they performed a single-leg land-and-cut maneuver. Three-dimensional ankle joint angles were calculated from 100 ms before, to 200 ms after landing. Kinematic control of the three rotational ankle joint degrees of freedom was investigated by …

Has The Foundation For Physical Therapy Advanced The Body Of Knowledge?, Sheila Schindler-Ivens, Jan Struhar, Martha G. Jermé

Physical Therapy Faculty Research and Publications

No abstract provided.

Nr2a- And Nr2b-Containing Nmda Receptors In The Prelimbic Medial Prefrontal Cortex Differentially Mediate Trace, Delay, And Contextual Fear Conditioning, Marieke R. Gilmartin, Janine L. Kwapis, Fred J. Helmstetter

Biomedical Sciences Faculty Research and Publications

Activation of N-methyl-D-aspartate receptors (NMDAR) in the prelimbic medial prefrontal cortex (PL mPFC) is necessary for the acquisition of both trace and contextual fear memories, but it is not known how specific NR2 subunits support each association. The NR2B subunit confers unique properties to the NMDAR and may differentially regulate these two fear memories. Here we show that NR2A-containing NMDARs mediate trace, delay, and contextual fear memories, but NR2B-containing NMDARs are required only for trace conditioning, consistent with a role for PL mPFC in working memory.

Effects Of Patient-Directed Music Intervention On Anxiety And Sedative Exposure In Critically Ill Patients Receiving Mechanical Ventilatory Support: A Randomized Clinical Trial, Jill L. Guttormson, Linda L. Chlan, Craig R. Weinert, Annie Heiderscheidt, Mary Fran Tracy, Debra J. Skaar, Kay Savik

College of Nursing Faculty Research and Publications

Importance: Alternatives to sedative medications, such as music, may alleviate the anxiety associated with ventilatory support.

Objective: To test whether listening to self-initiated patient-directed music (PDM) can reduce anxiety and sedative exposure during ventilatory support in critically ill patients.

Design, Setting, and Patients: Randomized clinical trial that enrolled 373 patients from 12 intensive care units (ICUs) at 5 hospitals in the Minneapolis-St Paul, Minnesota, area receiving acute mechanical ventilatory support for respiratory failure between September 2006 and March 2011. Of the patients included in the study, 86% were white, 52% were female, and the mean (SD) age was …

Structured Debriefing And Students' Clinical Judgment Abilities In Simulation, Bette Mariani, Mary Ann Cantrell, Colleen H. Meakim, Patricia Prieto, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

Background

Debriefing is a critical component of clinical simulation, yet there are limited studies that demonstrate the outcomes of debriefing on learners' clinical judgment.

Method

Using the Lasater Clinical Judgment Rubric, this mixed-method study examined the effects of structured debriefing after 2 clinical simulation experiences on 86 junior-level baccalaureate nursing students' clinical judgment. Debriefing for Meaningful Learning© was the method used for the structured debriefing sessions.

Results

The mean clinical judgment scores of the intervention group were higher and improved more over time compared with the mean scores of those in the control group; however, the differences were not statistically …

Nurse Residency Program: Best Practices For Optimizing Organizational Success, Marilyn Meyer Bratt

College of Nursing Faculty Research and Publications

A nurse residency program’s best practice recommendations are presented within this article and are organized around three processes: establishing the program infrastructure, creating a multistaged evidence-based program, and sustaining the program through appropriate evaluation and dissemination of results. These recommendations represent lessons learned and key findings derived from a team of academic and nursing professional development educators after 7 years of residency program implementation at multiple rural and urban hospital sites. Organizations, regardless of size and resources, can use these recommendations to increase the likelihood of building a successful residency program.

Evidence For Covalent Linkage Between Some Plasma Α2-Antiplasmin Molecules And Aα Chains Of Circulating Fibrinogen, Michael W. Mosesson, Trudy Holyst, Irene Hernandez, Kevin R. Siebenlist

Biomedical Sciences Faculty Research and Publications

Plasma alpha₂-antiplasmin (α₂AP) is a single-chain serine protease inhibitor acting mainly through the fibrinolytic system. Its physiological importance is underscored by the observation that homozygous α₂AP deficiency results in a severe hemorrhagic disorder due to rapid fibrin clot lysis (hyperfibrinolysis).

Nontraumatic Oral Health Classification For Alternative Use Of Syndromic Data, Sherry Burrer, Howard Burkom, Christopher Okunseri, Laurie Barker, Valerie Robison

School of Dentistry Faculty Research and Publications

There is increasing demand for ways to use syndromic surveillance data for population health surveillance. The authors developed a nontraumatic oral health classification that could provide timely burden estimates of oral health-related visits to North Carolina (NC) emergency departments (EDs) using BioSense syndromic data. A combination of literature review, input by subject matter experts, and analysis of syndromic data was employed to create a classification that used select chief complaint text and ICD-9-CM codes for visit inclusion and exclusion criteria. Visit estimates created using this classification could contribute to policy decisions aimed at reducing this unnecessary burden on NC EDs.

Dimensional Changes Of Upper Airway After Rapid Maxillary Expansion: A Prospective Cone-Beam Computed Tomography Study, Yoon Hwan Chang, Lisa J. Koenig, Jessica E. Pruszynski, T. Gerard Bradley, Jose A. Bosio, Dawei Liu

School of Dentistry Faculty Research and Publications

Introduction: The aim of this prospective study was to use cone-beam computed tomography to assess the dimensional changes of the upper airway in orthodontic patients with maxillary constriction treated by rapid maxillary expansion.

Methods: Fourteen orthodontic patients (mean age, 12.9 years; range, 9.7-16 years) were recruited. The patients with posterior crossbite and constricted maxilla were treated with rapid maxillary expansion as the initial part of their comprehensive orthodontic treatments. Before and after rapid maxillary expansion conebeam computed tomography scans were taken to measure the retropalatal and retroglossal airway changes in terms of volume, and sagittal and cross-sectional areas. The transverse …

Changes In Orthodontic Treatment Modalities In The Past 20 Years: Exploring The Link Between Technology And Scientific Evidence, T. Gerard Bradley

School of Dentistry Faculty Research and Publications

Statement of the issue: Is there a link between the many perceived advances in orthodontic techniques/therapy and science in the past 20 years? The purpose of this paper is to take five topics and match the perceptions with the scientific evidence. The variety of appliances and the swings in treatment philosophy have been dramatic, including the swing from extraction to non-extraction therapy, the introduction of space-age wires, appliances that grow mandibles, the introduction and extraordinary growth of Invisalign, and reduced friction brackets to reduce treatment time, all with claims by manufacturers of better results than ever before. The focus is …

Methodology Issues In Implementation Science, Robin Newhouse, Kathleen Bobay, Patricia C. Dykes, Kathleen R. Stevens, Marita Titler

College of Nursing Faculty Research and Publications

Background: Putting evidence into practice at the point of care delivery requires an understanding of implementation strategies that work, in what context and how.

Objective: To identify methodological issues in implementation science using 4 studies as cases and make recommendations for further methods development.

Research Design: Four cases are presented and methodological issues identified. For each issue raised, evidence on the state of the science is described.

Results: Issues in implementation science identified include diverse conceptual frameworks, potential weaknesses in pragmatic study designs, and the paucity of standard concepts and measurement.

Conclusions: Recommendations to advance methods in implementation include developing …

Topical Menthol, Ice, Peripheral Blood Flow, And Perceived Discomfort, Robert V. Topp, Elizabeth R. Ledford, Dean E. Jacks

College of Nursing Faculty Research and Publications

Context : Injury management commonly includes decreasing arterial blood flow to the affected site in an attempt to reduce microvascular blood flow and edema and limit the induction of inflammation. Applied separately, ice and menthol gel decrease arterial blood flow, but the combined effects of ice and menthol gel on arterial blood flow are unknown.

Objectives : To compare radial artery blood flow, arterial diameter, and perceived discomfort before and after the application of 1 of 4 treatment conditions.

Design : Experimental crossover design.

Setting : Clinical laboratory.

Participants or Other Participants : Ten healthy men, 9 healthy women (mean …

Conceptualizing Group Dynamics From Our Clients’ Perspective: Development Of The Conceptualization Of Group Dynamics Inventory, Kevin A. Tate Phd, Edil Torres Rivera, William L. Conwill, David Miller, Ana Puig

College of Nursing Faculty Research and Publications

There is a clear call in group counseling practice and training for evidence-based practice (ACA, 2005; ASGW, 2008; CACREP, 2009). At the same time, group counselors also are asked to keep clients' experience at the center of their work (ASGW, 2012). This article outlines the authors' effort to develop and study an instrument designed to measure group counselors' conceptualization skill using group members' subjective perceptions as a foundation. Descriptions of the instrument's internal reliability, construct validity, and generalizability will be presented, as well as suggestions for conducting research on this instrument in future studies.

The Effect Of Either Topical Menthol Or A Placebo On Functioning And Knee Pain Among Patients With Knee Oa, Robert V. Topp, Joseph A. Brosky, David Pieschel

College of Nursing Faculty Research and Publications

Osteoarthritis (OA) is a common health problem with symptoms including reduced functioning and joint pain. Protracted pharmacological management of knee OA is associated with side effects including gastrointestinal, renal, and neurological dysfunction.Menthol gels have been used with limited empirical support to relieve pain and improve functioning among individual with OA. The purpose of this study was to compare the ability to complete functional tasks and knee pain while completing functional tasks among patients with knee OA after topical application of either 3.5% menthol gel or an inert placebo gel. Twenty individuals with knee OA volunteered to complete 2 data collection …

Measuring Nurses’ Impact On Health Care Quality: Progress, Challenges, And Future Directions, Susan L. Beck, Marianne E. Weiss, Nancy Ryan-Wenger, Nancy E. Donaldson, Carolyn Aydin, Gail L. Towsley, William Gardner

College of Nursing Faculty Research and Publications

Background: Quality measurement is central in efforts to improve health care delivery and financing. The Interdisciplinary Nursing Quality Research Initiative supported interdisciplinary research teams to address gaps in measuring the contributions of nursing to quality care.

Objective: To summarize the research of 4 interdisciplinary teams funded by The Interdisciplinary Nursing Quality Research Initiative and reflect on challenges and future directions to improving quality measurement.

Methods: Each team summarized their work including the targeted gap in measurement, the methods used, key results, and next steps. The authors discussed key challenges and recommended future directions.

Results: These exemplar projects addressed cross-cutting issues …