Medicine and Health Sciences Commons^™

Barriers To Effective Implementation Of Programs For The Prevention Of Workplace Violence In Hospitals, James Blando, Marilyn Ridenour, Daniel Hartley, Carri Casteel

Community & Environmental Health Faculty Publications

Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings …

Gene Electro Transfer Of Plasmid Encoding Vascular Endothelial Growth Factor For Enhanced Expression And Perfusion In The Ischemic Swine Heart, Barbara Y. Hargrave, Robert Strange Jr., Sagar Navare, Michael Stratton, Niculina Burcus, Len Murray, Cathryn Lundberg, Anna A. Bulysheva, Fanying Li, Richard Heller

Bioelectrics Publications

Myocardial ischemia can damage heart muscle and reduce the heart's pumping efficiency. This study used an ischemic swine heart model to investigate the potential for gene electro transfer of a plasmid encoding vascular endothelial growth factor for improving perfusion and, thus, for reducing cardiomyopathy following acute coronary syndrome. Plasmid expression was significantly greater in gene electro transfer treated tissue compared to injection of plasmid encoding vascular endothelial growth factor alone. Higher gene expression was also seen in ischemic versus non-ischemic groups with parameters 20 Volts (p

Pkc-Dependent Phosphorylation Of Enos At T495 Regulates Enos Coupling And Endothelial Barrier Function In Response To G(+) -Toxins, Feng Chen, Sanjiv Kumar, Yanfang Yu, Saurabh Aggarwal, Christine Gross, Yusi Wang, Trinad Chakraborty, Alexander D. Verin, John D. Catravas, Rudolf Lucas, Stephen M. Black, David J. R. Fulton

Bioelectrics Publications

Gram positive (G(+)) infections make up similar to 50% of all acute lung injury cases which are characterized by extensive permeability edema secondary to disruption of endothelial cell (EC) barrier integrity. A primary cause of increased permeability are cholesterol-dependent cytolysins (CDCs) of G(+)-bacteria, such as pneumolysin (PLY) and listeriolysin-O (LLO) which create plasma membrane pores, promoting Ca2+-influx and activation of PKC alpha. In human lung microvascular endothelial cells (HLMVEC), pretreatment with the nitric oxide synthase (NOS) inhibitor, ETU reduced the ability of LLO to increase microvascular cell permeability suggesting an endothelial nitric oxide synthase (eNOS)-dependent mechanism. LLO stimulated superoxide production …

Concepts Of Cancer And A Novel Cancer Therapy: Treating Tumors As An Aggressive Organ, Stephen J. Beebe

Bioelectrics Publications

No abstract provided.

Epidemic Surveillance Using An Electronic Medical Record: An Empiric Approach To Performance Improvement, Hongzhang Zheng, Holly Gaff, Gary Smith, Sylvain Delisle

Biological Sciences Faculty Publications

BACKGROUNDS: Electronic medical records (EMR) form a rich repository of information that could benefit public health. We asked how structured and free-text narrative EMR data should be combined to improve epidemic surveillance for acute respiratory infections (ARI).

METHODS: Eight previously characterized ARI case detection algorithms (CDA) were applied to historical EMR entries to create authentic time series of daily ARI case counts (background). An epidemic model simulated influenza cases (injection). From the time of the injection, cluster-detection statistics were applied daily on paired background+injection (combined) and background-only time series. This cycle was then repeated with the injection shifted to each …

Oral Health Promotion: Knowledge, Confidence, And Practices In Preventing Early-Severe Childhood Caries Of Virginia Wic Program Personnel, Lorraine Ann Fuller, Sharon C. Stull, Michele L. Darby, Susan Lynn Tolle

Dental Hygiene Faculty Publications

Purpose: This study assessed the oral health knowledge, confidence and practices of Virginia personnel in the Special Supplemental Food Program for Women, Infants and Children (WIC).

Methods: In 2009, 257 WIC personnel were electronically emailed via an investigator-designed 22-item Survey Monkey® questionnaire. Descriptive statistics, Chi-square and Fishers Exact tests compared personnel demographics and oral health knowledge, confidence and practices at the p≤0.01 and 0.05 significance level.

Results: Response rate was 68%. WIC personnel were knowledgeable about basic oral health concepts. More than half of those reporting were not confident assessing for visual signs of dental decay and do not routinely …

Temperature, Hypoxia, And Mycobacteriosis: Effects On Adult Striped Bass Morone Saxatilis Metabolic Performance, Dominique Lapointe, Wolfgang K. Vogelbein, Mary C. Fabrizio, David T. Gauthier, Richard W. Brill

Biological Sciences Faculty Publications

Mycobacteriosis, a chronic bacterial disease of fishes, is prevalent in adult striped bass from Chesapeake Bay (USA). Although environmental factors may play a role in disease expression, the interaction between the disease and environmental stress remains unexplored. We therefore examined the individual and interactive effects of elevated temperature, hypoxia, and mycobacteriosis on the metabolism of wild-caught adult striped bass from Chesapeake Bay using respirometry. Because the spleen is the primary target organ of mycobacteriosis in striped bass, we hypothesized that the disease interferes with the ability of fish to increase their hemato crit in the face of increasing oxygen demands. …

Role Of Peripheral Immune Response In Microglia Activation And Regulation Of Brain Chemokine And Proinflammatory Cytokine Responses Induced During Vsv Encephalitis, Christina D. Steel, Kimberly Breving, Susan Tavakoli, Woong-Ki Kim, Larry D. Sanford, Richard P. Ciavarra

Biological Sciences Faculty Publications

We report herein that neuroinvasion by vesicular stomatitis virus (VSV) activates microglia and induces a peripheral dendritic cell (DC)-dependent inflammatory response in the central nervous system (CNS). VSV neuroinvasion rapidly induces multiple brain chemokine and proinflammatory cytokine mRNAs that display bimodal kinetics. Peripheral DC ablation or T cell depletion suppresses the second wave of this response demonstrating that infiltrating T cells are primarily responsible for the bimodal characteristics of this response. The robust infiltrate associated with VSV encephalitis likely depends on sustained production of brain CCL19 and CCR7 expression on infiltrating inflammatory cells. © 2013 Elsevier B.V. All rights reserved.

Dimethylarginine Dimethylaminohydrolase Ii Overexpression Attenuates Lps-Mediated Lung Leak In Acute Lung Injury, Saurabh Aggarwal, Christine M. Gross, Sanjiv Kumar, Christiana Dimitropoulou, Shruti Sharma, Boris A. Gorshkov, Supriya Sridhar, Qing Lu, Natalia V. Bogatcheva, Agnieszka J. Jezierska-Drutel, Rudolf Lucas, John D. Catravas, Stephen M. Black

Bioelectrics Publications

Acute lung injury (ALI) is a severe hypoxemic respiratory insufficiency associated with lung leak, diffuse alveolar damage, inflammation, and loss of lung function. Decreased dimethylaminohydrolase (DDAH) activity and increases in asymmetric dimethylarginine (ADMA), together with exaggerated oxidative/nitrative stress, contributes to the development of ALI in mice exposed to LPS. Whether restoring DDAH function and suppressing ADMA levels can effectively ameliorate vascular hyperpermeability and lung injury in ALI is unknown, and was the focus of this study. In human lung microvascular endothelial cells, DDAH II overexpression prevented the LPS-dependent increase in ADMA, superoxide, peroxynitrite, and protein nitration. DDAH II also attenuated …

Adverse Health Effects Of Spousal Violence Among Women Attending Saudi Arabian Primary Health-Care Clinics, H. M. Eldoseri, K. A. Tufts, Q. Zhang, J. N. Fish

Nursing Faculty Publications

This study aimed to investigate the frequency of spousal violence among Saudi women and document the related health effects and injuries, as well as their attitudes to gender and violence. Structured interviews were conducted with 200 ever-married women recruited from primary-care centres in Jeddah. Nearly half of the surveyed women (44.5%) reported ever experiencing physical violence from their spouse. Although 37 women (18.5%) had received violence-related injuries, only 6.5% had reported these injuries to a health-care provider. Victims of spousal violence had poor perceptions of their overall health, and reported pain or discomfort, antidepressant use and suicidal thoughts. Women mostly …

Telehealth: Preparing Advanced Practice Nurses To Address Healthcare Needs In Rural And Underserved Populations, Carolyn M. Rutledge, Tina Haney, Michele Bordelon, Michelle Renaud, Christianne Fowler

Nursing Faculty Publications

Healthcare is being confronted with questions on how to deliver quality, affordable, and timely care to patients, especially those in rural areas, in systems already burdened by the lack of providers. Advanced Practice Registered Nurses (APRNs) have been challenged to lead this movement in providing care to these populations through the use of technologies, specifically telehealth. Unfortunately, APRNs have limited exposure to telehealth during their educational experience, thereby limiting their understanding and comfort with telehealth. To address this problem, a telehealth program was developed at a large university that prepares Doctor of Nursing Practice (DNP) APRN students. The telehealth program, …

Paracrine-Rescued Lobulogenesis In Chimeric Outgrowths Comprising Progesterone-Receptor-Null Mammary Epithelium And Redirected Wild-Type Testicular Cells, Robert D. Bruno, Corinne A. Boulanger, Sonia M. Rosenfield, Lisa H. Anderson, John P. Lydon, Gilbert H. Smith

Medical Diagnostics & Translational Sciences Faculty Publications

We have previously shown that non-mammary and tumorigenic cells can respond to the signals of the mammary niche and alter their cell fate to that of mammary epithelial progenitor cells. Here we tested the hypothesis that paracrine signals from mammary epithelial cells expressing progesterone receptor (PR) are dispensable for redirection of testicular cells, and that re-directed wild-type testicular-derived mammary cells can rescue lobulogenesis of PR-null mammary epithelium by paracrine signaling during pregnancy. We injected PR-null epithelial cells mixed with testicular cells from wild-type adult male mice into cleared fat-pads of recipient mice. The testicular cells were redirected in vivo to …

Measuring Sense Of Presence And User Characteristics To Predict Effective Training In An Online Simulated Virtual Environment, Gianluca De Leo, Leigh A. Diggs, Elena Radici, Thomas W. Mastaglio

VMASC Publications

Introduction: Virtual-reality solutions have successfully been used to train distributed teams. This study aimed to investigate the correlation between user characteristics and sense of presence in an online virtual-reality environment where distributed teams are trained. A greater sense of presence has the potential to make training in the virtual environment more effective, leading to the formation of teams that perform better in a real environment. Being able to identify, before starting online training, those user characteristics that are predictors of a greater sense of presence can lead to the selection of trainees who would benefit most from the online simulated …

Philosophy, Medicine And Health Care - Where We Have Come From And Where We Are Going, Michael Loughlin, Robyn Bluhm, Jonathan Fuller, Stephen Burtow, Rose E. G. Upshur, Kirstin Borgerson, Maya J. Goldenberg, Elselijn Kingma

Philosophy Faculty Publications

The role of philosophy in discussions of clinical practice was once regarded by many as restricted to a very limited version of ‘medical ethics’, one that has been extensively criticized in the pages of this journal and elsewhere for being at once philosophically untenable and practically unhelpful [1–4]. While this uninspiring view of the nature and scope of applied philosophy has by no means been eradicated, over a number of years there has been a resurgence of interest in the philosophy of medicine and health care as an intellectually serious and practically significant enterprise. Controversies about evidence, value, clinical knowledge, …

Drinking Buddies: Who Are They And When Do They Matter?, Cathy Lau-Barraco, Ashley N. Linden

Psychology Faculty Publications

The present study sought to further examine the role of peers on alcohol use and problems among young adults. In particular, we focused on a specific subset of peers in one's social network mostly for activities related to alcohol use called "drinking buddies." The presence of drinking buddies in one's social network has been shown to predict heavy drinking uniquely over time but few studies have focused on potential factors moderating the relationship. Consequently, an aim of present study was to examine the influence of drinking buddies on alcohol outcomes and the extent to which the relationship may be dependent …

How Patients' Self-Disclosure About Sickle Cell Pain Episodes To Significant Others Relates To Living With Sickle Cell Disease, Valerian J. Derlega, Louis H. Janda, Jeannie Miranda, Ian A. Chen, B. Mitchell Goodman Iii, Wally Smith

Psychology Faculty Publications

Objectives: This cross-sectional study examines to whom and how fully sickle cell disease (SCD) patients talk to others about sickle cell pain, how helpful it is to talk with others about these pain episodes, and the association between talking to others about sickle cell pain episodes and patients' psychological adjustment and coping strategies in managing the disease.

Methods: A convenience sample of 73 African American patients with SCD (30 men and 43 women), were recruited from two SCD clinics at the time of routine medical visits. Most participants had been diagnosed with hemoglobin SS, and they reported an average number …

Substance-Abusing Mothers And Fathers' Willingness To Allow Their Children To Receive Mental Health Treatment, Michelle L. Kelley, Gabrielle M. D'Lima, James M. Henson, Cayla Cotton

Psychology Faculty Publications

The purpose of this study was to examine attitudes of substance-abusing mothers and fathers entering outpatient treatment toward allowing their children to participate in individual- or family-based interventions. Data were collected from a brief anonymous survey completed by adults at intake into a large substance abuse treatment program in western New York. Only one-third of parents reported that they would be willing to allow their children to participate in any form of mental health treatment. Results of chi-square analyses revealed that a significantly greater proportion of mothers reported that they would allow their children to participate in mental health treatment …

Profiles Of Binge Eating: The Interaction Of Depressive Symptoms, Eating Styles, And Body Mass Index, Tyler B. Mason, Robin J. Lewis

Psychology Faculty Publications

Binge eating is associated with depressive symptoms, eating styles, and obesity. However, less is known about interactions between these variables and binge eating. This study examined the relationship between depressive symptoms, eating styles, body mass index, and binge eating. Individuals with a higher body mass index, who reported more depressive symptoms and more external eating, reported the greatest binge eating. Similarly, individuals with a higher body mass index who reported more depressive symptoms and more emotional eating reported the greatest binge eating. These findings demonstrate possible profiles of individuals most at risk for binge eating and associated eating disorders. Copyright …

Using Sensewear Armband And Diet Journal To Promote Adolescents' Energy Balance Knowledge And Motivation, Senlin Chen, Xihe Zhu, Gregory J. Welk, Youngwon Kim, Jungmin Lee, Nathan F. Meier

Human Movement Sciences & Special Education Faculty Publications

Purpose: Educating adolescents about energy balance (EB) is essential for effective weight control. This study utilized the Sensewear (SWA) armband and a diet journal to promote adolescents' EB knowledge and motivation.

Methods: Ninety sixth graders were randomly assigned into the experimental group (n = 46) who utilized SWA and diet journal for 7 consecutive days or the control group (n = 44) who did not. Both groups were pre-and post-measured on EB knowledge, situational interest, and weight. The experimental group was tracked on motivation effort, energy expenditure (EE), and energy intake (EI).

Results: EB knowledge significantly increased and situational interest …

#Nbcfail: A Qualitative Review Of The Shared Experience As A Social Movement, Brendan O'Hallarn, Stephen Shapiro

Human Movement Sciences & Special Education Faculty Publications

The XXX Olympic Games in London, England was the most-watched event in U.S. television history, with more than 219 million viewers tuning in during the Games. However, the National Broadcasting Corporation (NBC) elected to show a number of events to U.S. audiences in prime time via tape delay, rather than broadcasting them live. As a result NBC encountered a great deal of criticism about its coverage, particularly on the online microblogging site Twitter. This research surveyed a sample of Twitter users who participated in the Twitter protest via the #NBCFail hashtag, to understand how being part of a shared protest …

Injury Prevention With Physical Therapy, Karen Kott, Margaret F. Lemaster

Rehabilitation Sciences Faculty Publications

(First paragraph) Ergonomics is the study of human performance (positioning and movement) and workplace design, such as equipment, ambience, and placement. The purpose of ergonomics is to maximize productivity by increasing safety, improving work quality, reducing operator fatigue and discomfort, and decreasing the risk of work -related musculoskeletal disorders (MSDs).^1-3

Interaction Between Climatic, Environmental, And Demographic Factors On Cholera Outbreaks In Kenya, James D. Stoltzfus, Jane Y. Carter, Muge Akpinar-Elci, Martin Matu, Victoria Kimotho, Mark J. Giganti, Daniel Langat, Omur C. Elsi

Community & Environmental Health Faculty Publications

Background:

Cholera remains an important public health concern in developing countries including Kenya where 11,769 cases and 274 deaths were reported in 2009 according to the World Health Organization (WHO). This ecological study investigates the impact of various climatic, environmental, and demographic variables on the spatial distribution of cholera cases in Kenya.

Methods:

District-level data was gathered from Kenya’s Division of Disease Surveillance and Response, the Meteorological Department, and the National Bureau of Statistics. The data included the entire population of Kenya from 1999 to 2009.

Results:

Multivariate analyses showed that districts had an increased risk of cholera outbreaks when …

Autologous Platelet Rich Plasma (Platelet Gel): An Appropriate Intervention For Salvaging Cardiac Myocytes Under Oxidative Stress After Myocardial Infarction, Barbara Y. Hargrave

Bioelectrics Publications

Background: The prompt restoration of blood flow (reperfusion) to the ischemic myocardium after an acute myocardial infarction is critical to the survival of non damaged heart tissue. However, reperfusion is responsible for additional myocardial damage. Our objective was to investigate the role of autologous platelet rich plasma or platelet gel prepared using nanosecond pulsed electric fields (nsPEFs) in improving left ventricular mechanical function after ischemic reperfusion.

Methods: The hearts of nine adult female New Zealand White rabbits were perfused using the Langendorff model. The hearts were exposed to global ischemia for 30 min and reperfused for 60 min. The hearts …

Delivery Of Interleukin-15 To B16 Melanoma By Electroporation Leads To Tumor Regression And Long-Term Survival, Bernadette Marrero, Shawna Shirley, Richard Heller

Bioelectrics Publications

Electroporation (EP) is a method used to physically deliver therapeutic molecules such as plasmid DNA directly to tissues. It has been used safely and successfully in clinical studies and preclinical cancer models to deliver genes to a variety of tissues. In cancer research cytokine therapy is emerging as a promising tool that can be used to boost the host response to tumor antigens. The delivery of cytokines as recombinant proteins can result in toxicity and other adverse effects; however the delivery of cytokine genes using EP has been shown to be safe and effective. Interleukin 15 (IL-15) is a cytokine …

Factors That Promote Perceived Usefulness Of And Clinical Outcomes From Sign-Outs At The National University Hospital, Soo-Hoon Lee, Wei-Ping Goh, Dale A. Fisher, Phillip H. Phan

Management Faculty Publications

IMPORTANCE OF THE STUDY. Currently, there is a paucity of evidence in the literature to show that handoff strategies improve the quality of handoff outcomes. Studies that show the usefulness and outcomes obtained from sign-outs may motivate junior clinicians, who have limited time to perform their clinical responsibilities, to support sign-out improvement efforts.

OBJECTIVE. To test a research model that embeds the Technology Acceptance Model and the Theory of Planned Behavior to explore factors that enhance the perceived (a) usefulness of and (b) clinical outcomes from sign-outs among junior medical officers.

DESIGN, SETTING, AND PARTICIPANTS.

A retrospective study was conducted …

A Pilot Study On Nurse-Led Rounds: Preliminary Data On Patient Contact Time, Soo-Hoon Lee, Alice Lee, Siang-Ngim Lim, Mei-Jiao Koh, Benjamin Tan, Phillip H. Phan, Reshma A. Merchant, Aisha Lateef, Dale A. Fisher

Management Faculty Publications

IMPORTANCE OF THE STUDY. Ward rounding has been a historical clinical method of inter-professional collaboration to support inpatient care through the sharing of mental models by exchanging information and discussing plans of care, treatment goals, and discharge plans for the patient. The extant literature reports that rounds are frequently led by doctors with infrequent nurse-physician collaboration and patients’ interactions with doctors during ward rounds tend to be brief.

OBJECTIVE. To explore the effects of nurse-led morning ward rounds on patient contact time.

DESIGN. An ethnographic prospective observational study comparing nurse-led and physician-led rounds. SETTING. A General Medicine ward at the …

Engineering Collaborations In Medical Modeling And Simulation, Frederic D. Mckenzie, Salim Chemlal, Tom Hubbard, Robert E. Kelly, Roderick C. Borgie, David A. Besachio, Michel Audette

Computational Modeling & Simulation Engineering Faculty Publications

Fifty years ago computer science was just beginning to see common acceptance as a growing discipline and very few universities had a computer science department although other departments were utilizing computers and software to enhance their methodologies. We believe modeling and simulation (M&S) is on a similar path. Many other disciplines utilize M&S to enhance their methodologies but we also believe that M&S fundamentals can be essential in making better decisions by utilizing the appropriate model for the problem at hand, expanding the solution space through simulation, and understanding it through visualization and proper analyses. After our students learn these …

Protective Behavioral Strategies, Alcohol Expectancies, And Drinking Motives In A Model Of College Student Drinking, Ashley N. Linden, Cathy Lau-Barraco, Robert J. Milletich

Psychology Faculty Publications

An extensive body of research asserts alcohol expectancies, or beliefs regarding the effects of alcohol, as an important influence on drinking. However, the extent to which expectancies are related to drinking motives and protective behavioral strategies (PBS) has yet to be examined. Existing alcohol mediational models suggest associations between expectancies and drinking motives as well as positive drinking motives and PBS use. Thus, it is possible that drinking motives and PBS use act as intervening factors in the relationship between expectancies and alcohol outcomes. Consequently, the cross-sectional study presented here aimed to test the indirect effect of expectancies (i.e., social …

Physician As Teacher: Promoting Health And Wellness Among Elementary School Students, Jill E. Stefaniak, Victoria C. Lucia

STEMPS Faculty Publications

BACKGROUND: Every day, physicians engage in teaching during their patient encounters. It may be that medical students who are introduced to the principles of teaching and learning are more likely to become good communicators and learners. Service-learning may be an effective way for medical students to practice skills in teaching and communication in a real-world setting, while also filling a need within the community. The purpose of this study was to identify common themes within medical students' reflections on what they learned through participating in a teaching exercise with local elementary school children.

METHODS: As a required component of a …

Caffeinated Alcohol Consumption Profiles And Associations With Use Severity And Outcome Expectancies, Cathy Lau-Barraco, Robert J. Milletich, Ashley N. Linden

Psychology Faculty Publications

Growing evidence suggests that the consumption of caffeinated alcoholic beverages (CAB) may be riskier than alcohol alone. Efforts to identify patterns of CAB use and the correlates of such drinking patterns could further our conceptualization of and intervention for this health issue. Consequently, the current study aimed to (1) identify distinct classes of CAB users, (2) examine differences between classes on measures of alcohol and caffeine problems, and (3) compare distinct classes of CAB users on caffeine and alcohol outcome expectancies. Participants were 583 (31% men) undergraduate students from a psychology research pool. Latent profile analysis models were derived using …