Medicine and Health Sciences Commons^™

Loss-Of-Function Variants In Endothelial Lipase Are A Cause Of Elevated Hdl Cholesterol In Humans, Andrew Edmondson, Robert Brown, Sekar Kathiresan, L. Cupples, Serkalem Demissie, Alisa Manning, Majken Jensen, Eric Rimm, Jian Wang, Amrith Rodrigues, Vaneeta Bamba, Sumeet Khetarpal, Megan Wolfe, Stephanie Derohannessian, Mingyao Li, Muredach Reilly, Jens Aberle, David Evans, Robert Hegele, Daniel Rader

Dr Robert Brown

Elevated plasma concentrations of HDL cholesterol (HDL-C) are associated with protection from atherosclerotic cardiovascular disease. Animal models indicate that decreased expression of endothelial lipase (LIPG) is inversely associated with HDL-C levels, and genome-wide association studies have identified LIPG variants as being associated with HDL-C levels in humans. We hypothesized that loss-of-function mutations in LIPG may result in elevated HDL-C and therefore performed deep resequencing of LIPG exons in cases with elevated HDL-C levels and controls with decreased HDL-C levels. We identified a significant excess of nonsynonymous LIPG variants unique to cases with elevated HDL-C. In vitro lipase activity assays demonstrated …

Prediction Of Radiation Pneumonitis By Dose-Volume Histogram Parameters In Lung Cancer--A Systematic Review, George Rodrigues, Michael Lock, David D'Souza, Edward Yu, Jake Van Dyk

Michael Lock

BACKGROUND AND PURPOSE: To perform a systematic review of the predictive ability of various dose-volume histogram (DVH) parameters (V(dose), mean lung dose (MLD), and normal tissue complication probability (NTCP)) in the incidence of radiation pneumonitis (RP) caused by external-beam radiation therapy.

METHODS AND MATERIALS: Studies assessing the relationship between CT-based DVH reduction parameters and RP rate in radically treated lung cancer were eligible for the review. Synonyms for RP, lung cancer, DVH and its associated parameters (NTCP, V(20), V(30), MLD) were combined in a search strategy involving electronic databases, secondary reference searching, and consultation with experts. Individual or group data …

Mitochondrial Antiviral Signaling Protein Defect Links Impaired Antiviral Response And Liver Injury In Steatohepatitis In Mice, Timea Csak, Angela Dolganiuc, Karen Kodys, Bharath Nath, Jan Petrasek, Shashi Bala, Dora Lippai, Gyongyi Szabo

Gyongyi Szabo

Mitochondrial dysfunction is a pathogenic feature of nonalcoholic steatohepatitis (NASH). NASH complicates hepatotropic viral disease. The mitochondrial antiviral signaling protein (MAVS) is the adapter of helicase receptors involved in sensing double-stranded RNA (dsRNA). We hypothesized that impaired MAVS function may contribute to insufficient antiviral response and liver damage in steatohepatitis. We identified reduced MAVS protein levels and increased MAVS association with the proteasome subunit alpha type 7 (PSMA7) in livers from mice given a methionine-choline-deficient (MCD) diet. Decreased association of MAVS with mitochondria and increased cytosolic cytochrome c indicated mitochondrial damage in steatohepatitis. In vivo administration of the synthetic dsRNA …

An Essential Role For Monocyte Chemoattractant Protein-1 In Alcoholic Liver Injury: Regulation Of Proinflammatory Cytokines And Hepatic Steatosis In Mice, Pranoti Mandrekar, Aditya Ambade, Arlene Lim, Gyongyi Szabo, Donna Catalano

Gyongyi Szabo

The importance of chemokines in alcoholic liver injury has been implicated. The role of the chemokine, monocyte chemoattractant protein-1 (MCP-1), elevated in patients with alcoholic liver disease is not yet understood. Here, we evaluated the pathophysiological significance of MCP-1 and its receptor, chemokine (C-C motif) receptor 2 (CCR2), in alcoholic liver injury. The Leiber-DeCarli diet containing alcohol or isocaloric control diets were fed to wild-type (WT) and MCP-1-deficient knockout (KO) mice for 6 weeks. In vivo and in vitro assays were performed to study the role of MCP-1 in alcoholic liver injury. MCP-1 was increased in Kupffer cells (KCs) as …

Fatty Acid And Endotoxin Activate Inflammasomes In Mouse Hepatocytes That Release Danger Signals To Stimulate Immune Cells, Timea Csak, Michal Ganz, Justin Pespisa, Karen Kodys, Angela Dolganiuc, Gyongyi Szabo

Gyongyi Szabo

The pathogenesis of nonalcoholic steatohepatitis (NASH) and inflammasome activation involves sequential hits. The inflammasome, which cleaves pro-interleukin-1beta (pro-IL-1beta) into secreted IL-1beta, is induced by endogenous and exogenous danger signals. Lipopolysaccharide (LPS), a toll-like receptor 4 ligand, plays a role in NASH and also activates the inflammasome. In this study, we hypothesized that the inflammasome is activated in NASH by multiple hits involving endogenous and exogenous danger signals. Using mouse models of methionine choline-deficient (MCD) diet-induced NASH and high-fat diet-induced NASH, we found up-regulation of the inflammasome [including NACHT, LRR, and PYD domains-containing protein 3 (NALP3; cryopyrin), apoptosis-associated speck-like CARD-domain containing …

The Rbans Effort Index: Base Rates In Geriatric Samples, K. Duff, C. Spering, S. O'Bryant, L. Beglinger, D. Moser, J. Bayless, Kennith Culp, J. Mold, R. Adams, J. Scott

Kennith R. Culp

The Effort Index (EI) of the RBANS was developed to assist clinicians in discriminating patients who demonstrate good effort from those with poor effort. However, there are concerns that older adults might be unfairly penalized by this index, which uses uncorrected raw scores. Using five independent samples of geriatric patients with a broad range of cognitive functioning (e.g., cognitively intact, nursing home residents, probable Alzheimer's disease), base rates of failure on the EI were calculated. In cognitively intact and mildly impaired samples, few older individuals were classified as demonstrating poor effort (e.g., 3% in cognitively intact). However, in the more …

Twelve-Month Mortality Among Delirium Subtypes, S. Decrane, Kennith Culp, B. Wakefield

Kennith R. Culp

This study used data from the Delirium Among the Elderly in Rural Long-Term Care Facilities Study and data from the National Death Index (NDI) to examine mortality among 320 individuals. Individuals were grouped into noncases, subsyndromal cases, hypoactive delirium, hyperactive delirium, and mixed delirium on the basis of scoring using the Confusion Assessment Method (CAM), NEECHAM Scale, Mini-Mental State Examination (MMSE), Clinical Assessment of Confusion-A (CAC-A), and Vigilance A instruments. Risk ratios of mortality using "days of survival" did not reach statistical significance (alpha = .05) for any subgroup. Underlying cause of death (UCD) using International Classification of Disease, 10th …

Comparison Of Selected Teaching Strategies Incorporating Simulation And Student Outcomes, Elizabeth Swanson, Anita Nicholson, Teresa Boese, Ellen Cram, Anita Stineman, Kimberly Tew

Elizabeth A. Swanson

No abstract provided.

Sleeplessness, Deborah Schoenfelder, Keela Herr

Deborah P. Schoenfelder

This article identifies and reviews research related to sleeplessness reported by nurses in the literature. The current state of clinical nursing research as it relates to sleep is evaluated, including the content, methodology, and implications for further research. Although the review indicates current interest in sleep by clinical nurse researchers, the number of nursing studies in the literature is limited, especially within specific areas, such as age groups and setting. Also, directions for future nursing research on sleep are recommended.

An Exercise Program To Improve Fall-Related Outcomes In Elderly Nursing Home Residents, Deborah Schoenfelder, L. Rubenstein

Deborah P. Schoenfelder

This study tested a 3-month ankle-strengthening and walking program designed to improve or maintain the fall-related outcomes of balance, ankle strength, walking speed, risk of falling, fear of falling, and confidence to perform daily activities without falling (falls efficacy) in elderly nursing home residents. Nursing home residents (N = 81) between the ages of 64 and 100 years participated in the study. Two of the fall-related outcomes, balance and fear of falling, were maintained or improved for the exercise group in comparison to the control group.

A Fall Prevention Educational Program For Community Dwelling Seniors, Deborah Schoenfelder, K. Van Why

Deborah P. Schoenfelder

The purpose of this research was to assess participants' responses to a fall prevention educational program. Fourteen persons volunteered to participate in the study conducted at a large senior center. Descriptive statistics were used to characterize the sample and to assess subjects' awareness about falls, attitudes about fall risk, fall prevention behaviors, and incidence of falls before the fall prevention program and again at one month and three months after the program. Forty-six percent of the sample had fallen in the previous year. In general, subjects' perceptions that their risk of falling was lower than others of the same age …

Healthy People 2000. A Fall Prevention Program For Elderly Individuals: Exercise In Long-Term Care Settings, Deborah Schoenfelder

Deborah P. Schoenfelder

No abstract provided.

Traumatic Injury Rates In Meatpacking Plant Workers, Kennith Culp, M. Brooks, Kerri Rupe, C. Zwerling

Kerri A. Rupe

This was a 3-year retrospective cohort study of traumatic injuries in a midwestern pork meatpacking plant. Based on n = 5410 workers, this was a diverse workforce: Caucasian (56.6%), Hispanic (38.9%), African American (2.7%), Asian (1.1%) and Native American (0.8%). There were n = 1655 employees with traumatic injuries during this period. At 6 months of employment, the probability of injury was 33% in the harvest workers who were responsible for slaughter operations. The overall incidence injury rate was 22.76 per 100 full-time employees per year. Women experienced a higher incidence for injury than men. The risk ratio (RR) for …

Perinatal Administration Of Pcp Alters Adult Behaviour In Female Sprague-Dawley Rats, Teresa Du Bois, Xu-Feng Huang, Chao Deng

Xu-Feng Huang

Perinatal phencyclidine (PCP) treatment leads to neuronal damage and causes long-term behavioural alterations in rodents. This study examined the effects of perinatal PCP treatment on behaviour of adult rats in holeboard, elevated plus maze, social interaction and forced swim tests. PCP-treated rats displayed hyperactivity in the holeboard and forced swim tests. These persistent behavioural changes are relevant to the study of psychiatric disorders such as schizophrenia.

Thirty-Year (1975 To 2005) Trends In The Incidence Rates, Clinical Features, Treatment Practices, And Short-Term Outcomes Of Patients [Less Than] 55 Years Of Age Hospitalized With An Initial Acute Myocardial Infarction, David Mcmanus, Stephen Piacentine, Darleen Lessard, Joel Gore, Jorge Yarzebski, Frederick Spencer, Robert Goldberg

Jorge L. Yarzebski

Sparse data are available describing recent trends in the magnitude, clinical features, treatment practices, and outcomes of comparatively young adults hospitalized with acute myocardial infarction (AMI). The objectives of this population-based study were to describe 3 decade-long trends (1975 to 2005) in these end points in adults 1,703 residents of the Worcester (Massachusetts) metropolitan area 25 to 54 years of age who were hospitalized with initial AMIs at all central Massachusetts medical centers during 15 annual periods from 1975 through 2005. Overall hospital incidence rate (per 100,000 residents) of initial AMI in our study population was 66 (95% confidence interval …

Evaluation Of Vehicle Substances On Vitamin D Bioavailability: A Systematic Review, Ruth Grossmann, V. Tangpricha

Ruth E. Grossmann

Vitamin D insufficiency is a common medical condition. Vitamin supplements can be ingested to improve vitamin D status. It is not known if the vehicle substance that is combined with the vitamin D tablet influences the bioavailability of vitamin D. The purpose of this review is to examine the impact of different vehicles on vitamin D bioavailability. A comprehensive literature search identified studies that directly compared the absorption of vitamin D from two or more vehicles. The change in mean serum 25(OH)D per average daily dose of vitamin D supplemented was calculated and compared among the studies. We identified four …

Literacy-Appropriate Educational Materials And Brief Counseling Improve Diabetes Self-Management, Andrea Wallace, H. Seligman, T. Davis, D. Schillinger, C. Arnold, B. Bryant-Shilliday, J. Freburger, D. Dewalt

Andrea S. Wallace

OBJECTIVE: In this pilot study, we evaluated the impact of providing patients with a literacy-appropriate diabetes education guide accompanied by brief counseling designed for use in primary care. METHODS: We provided the Living with Diabetes guide and brief behavior change counseling to 250 English and Spanish speaking patients with type 2 diabetes. Counseling sessions using collaborative goal setting occurred at baseline and by telephone at 2 and 4 weeks. We measured patients' activation, self-efficacy, diabetes distress, knowledge, and self-care at baseline and 3-month follow-up. RESULTS: Statistically significant (p

Race, Care Seeking, And Utilization For Chronic Back And Neck Pain: Population Perspectives, T. Carey, J. Freburger, G. Holmes, A. Jackman, S. Knauer, Andrea Wallace, J. Darter

Andrea S. Wallace

We analyzed a statewide survey of individuals with chronic back and neck pain to determine whether prevalence and care use varied by patient race or ethnicity. We conducted a telephone survey of a random sample of 5,357 North Carolina households in 2006. Adults with chronic (>3 months duration or >24 episodes of pain per year), impairing back or neck pain were identified and were asked to complete a survey about their health and care utilization. 837 respondents (620 white, 183 black, 34 Latino) reported chronic back or neck pain. Whites and blacks had similar rates of chronic back pain. …

Nurses' Perception Of Their Manager's Leadership Style And Unit Climate: Are There Generational Differences?, Amany Farag, S. Tullai-Mcguinness, M. Anthony

Amany A. Farag

AIM: To describe and compare how nurses representing four age cohorts perceive their manager's leadership style and unit climate. BACKGROUND: The current workforce consists of nurses representing four generational cohorts. Nursing literature suggests that nurses from each age cohort think, behave and approach work differently. Limited empirical evidence, however, exists about how nurses from each age cohort perceive two aspects of their work environment: their managers' leadership style and unit climate. METHOD: This cross-sectional, descriptive survey was conducted using a convenience sample of 475 registered nurses working in different inpatient units in three community non-magnet hospitals. RESULTS AND CONCLUSION: Only …

Perceived Stress In Prodromal Huntington Disease, Nancy Downing, M. Smith, L. Beglinger, J. Mills, K. Duff, K. Rowe, E. Epping, J. Paulsen, Group Predict-Hd Investigators Of Huntington Study

Nancy R Downing

This study examines perceived stress and its relationship to depressive symptoms, life changes and functional capacity in a large sample of individuals who are positive for the Huntington disease (HD) gene expansion but not yet diagnosed. Participants were classified by estimated proximity to HD diagnosis (far, mid, near) and compared with a non-gene-expanded comparison group. Persons in the mid group had the highest stress scores. A significant interaction between age and time since HD genetic testing was also found. Secondary analyses using data from a different data collection point and including a diagnosed group showed the highest stress scores in …

Developing Strategic Interventions To Reduce Cardiovascular Disease Risk Among Law Enforcement Officers: The Art And Science Of Data Triangulation, Sandra Ramey, Nancy Downing, A. Knoblauch

Nancy R Downing

The purpose of this study was to use data triangulation to inform interventions targeted at reducing morbidity from cardiovascular disease (CVD) and associated risk factors among law enforcement officers. Using the Precede-Proceed Health Promotion Planning Model, survey data (n = 672) and focus group data (n = 8 groups) from the Milwaukee Police Department were analyzed. Narrative transcripts disclosed that law enforcement officers encounter potential barriers and motivators to a healthy lifestyle. Survey results indicated rates of overweight (71.1% vs. 60.8%) and hypertension (27.4% vs. 17.6%) were significantly (p < or = .001) higher among Milwaukee Police Department law enforcement officers than the general population of Wisconsin (n = 2,855). The best predictor of CVD was diabetes (p = .030). Occupational health nurses are uniquely positioned to identify health risks, design appropriate interventions, and advocate for policy changes that improve the health of those employed in law enforcement and other high-risk professions.

The Disclosure Decisions Of Parents Who Conceive Children Using Donor Eggs, S. Hahn, Martha Craft-Rosenberg

Martha J. Craft-Rosenberg

STUDY OBJECTIVE: To identify variables that influence the disclosure decisions of parents who conceive children using donor eggs and to compare such variables among disclosing, nondisclosing, and undecided families. DESIGN: Exploratory, comparative, descriptive. SETTING: A university hospital-assisted reproductive technology program in the Midwest. PARTICIPANTS: Thirty-one couples with children conceived with anonymously donated eggs. METHODS: Audiotaped telephone interviews, measures of social support and family environment, and a demographic survey. MAIN OUTCOME MEASURES: Content analysis of interview transcripts and comparison of recurring themes among groups. RESULTS: The majority of parents intended disclosure. Dominant themes among disclosing parents included the belief that a …

Invisible, Underserved, And Diverse: The Health Of Women In Prison, Janette Taylor, R. Williams, M. Eliason

Janette Y. Taylor

In the United States of America, women are the fastest growing segment of the criminal justice system. They are entering the system with far greater physical and mental health problems than men, but with fewer health services. Additionally, within this expanding population of incarcerated women, are disproportionately represented poor women of color with serious health needs. This article: a) uses an ecosocial model to examine and critique the health and healthcare of women in prison, b) examines social structures that influence incarceration and health status, and c) proposes reconsideration of current prison health services and education.

Narrative Art And Music Intervention With Incarcerated Abused Women, Janette Taylor, M. Eliason

Janette Y. Taylor

No abstract provided.

Colonizing Images And Diagnostic Labels: Oppressive Mechanisms For African American Women's Health, Janette Taylor

Janette Y. Taylor

The purpose of this article is to present colonizing images of African American women and describe how colonizing images and diagnostic labels function together to serve as oppressive mechanisms for African American women's health. The mammy, the matriarch, the welfare mother, the Jezebel, and the Black lady overachiever are representational images of African American women that contribute to how they are viewed and treated within the health care arena.

Assessing Intimate Partner Violence In Incarcerated Women, M. Eliason, Janette Taylor, S. Arndt

Janette Y. Taylor

The purpose of this study to assess the psychometric qualities of a screening instrument for intimate partner violence, the Index of Spouse Abuse (ISA), for use with incarcerated women. Principal components factor analysis was conducted on data collected from 149 incarcerated women. The ISA demonstrated excellent internal consistency with this population and appears to be a psychometrically sound instrument that can be given in a short period of time.

Sisters Of The Yam: African American Women's Healing And Self-Recovery From Intimate Male Partner Violence, Janette Taylor

Janette Y. Taylor

In this womanist ethnographic investigation African American women (N = 21) survivors of intimate male partner violence were interviewed about their resilience-recovering experiences. This article foregrounds the role of therapeutic support groups in African American women's healing experience and addresses how race and ethnicity shape the lives and the recovering process for many African American women. The findings are important to practitioners who strive to provide assistance and interventions for African American women as well as other women of color.

No Resting Place: African American Women At The Crossroads Of Violence, Janette Taylor

Janette Y. Taylor

Seeking safe places after leaving abusive relationships is often an intricate process for African American women. Survivor-victims of gender violence frequently experience ongoing trauma because of race, ethnicity, class, sexual orientation, and other stigmatizing social identities. All too often, women of color must handle leaving the gender violence simultaneously with the ongoing threat of cultural violence. The intersection of gender and cultural violence (e.g., racism, discrimination) complicate African American women's ability to obtain and sustain safe environments. These intersections are critical crossroads in African American women's lives. The results of this womanist and Black feminist study are presented in an …

Storytelling And Violence Against Women, Janette Taylor, J. Banks-Wallace, Toni Tripp-Reimer

Janette Y. Taylor

Health professionals are frequently the first point of contact for many women who are abused and experience intimate male partner violence. Yet, practitioners often do not have the knowledge and/or feel prepared to address these issues with women. The authors propose the use of storytelling and literature as an educational strategy to challenge and change nurses' conceptualization and practices relative to abuse and violence against women.

Talking Back: Research As An Act Of Resistance And Healing For African American Women Survivors Of Intimate Male Partner Violence, Janette Taylor

Janette Y. Taylor

The purpose of this article is to use a Black feminist/ womanist framework to: (a) explore the historical factors that discourage Black women's participation in the research process; (b) demonstrate how research can be a potential avenue of resistance and healing for African American women survivors of intimate male partner violence; and (c) suggest ways for practitioners and researchers to encourage the participation of this population. Benefits from the research process emerged as three themes: (a) healing the self, (b) helping others, and (c) envisioning new life directions.