Medicine and Health Sciences Commons^™

Multidisciplinary Approach To Reduce Ventilator Associated Pneumonia, James Gibson, Bs, Rrt, Brian Glynn, Bs, Rrt, Raymond Malloy, Linda Earle, Md, Michael Weinstein, Md, Roberta Glenn, Ying Lee, Patricia Nichols, Dennis Delisle, Mhsa, Pmp

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Presented at: Institute for Healthcare Improvement

Context

As part of a quality improvement effort to reduce hospital acquired infections (HAI) at Thomas Jefferson University Hospital (TJUH), a multidisciplinary team consisting of physicians, staff nurses, clinical nurse specialists, respiratory therapists, pharmacists, infection control practitioners and administrators representing all special care units was charged with reducing ventilator associated pneumonia rates to zero.

Ada News - 12/10/2012, 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.

Degeneration Of Phrenic Motor Neurons Induces Long-Term Diaphragm Deficits Following Mid-Cervical Spinal Contusion In Mice., Charles Nicaise, Rajarshi Putatunda, Tamara J Hala, Kathleen A Regan, David M Frank, Jean-Pierre Brion, Karelle Leroy, Roland Pochet, Megan C Wright, Angelo C Lepore

Department of Neuroscience Faculty Papers

A primary cause of morbidity and mortality following cervical spinal cord injury (SCI) is respiratory compromise, regardless of the level of trauma. In particular, SCI at mid-cervical regions targets degeneration of both descending bulbospinal respiratory axons and cell bodies of phrenic motor neurons, resulting in deficits in the function of the diaphragm, the primary muscle of inspiration. Contusion-type trauma to the cervical spinal cord is one of the most common forms of human SCI; however, few studies have evaluated mid-cervical contusion in animal models or characterized consequent histopathological and functional effects of degeneration of phrenic motor neuron-diaphragm circuitry. We have …

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.

From Linkage To Gwas: A Multifaceted Exploration Of The Genetic Risk For Alcohol Dependence, Amy Adkins

Theses and Dissertations

Family, twin and adoption studies consistently suggest that genetic factors strongly influence the risk for alcohol dependence (AD). Although the literature supports the role of genetics in AD, identification of specific genes contributing to the etiology of AD has proven difficult. These difficulties are due in part to the complex set of risk factors contributing to the development of AD. These risk factors include comorbidities with other clinical diagnoses and behavioral phenotypes (e.g., major depression), physiological differences that contribute to the differences between people in their level of response to ethanol (e.g., initial sensitivity) and finally the large number of …

Insights And Blind Spots: A Qualitative Analysis Of Risk In Psychiatric Security Review Board Hearings, Abby Kealani Balfour

Dissertations and Theses

The prevalence and consequences of the insanity plea, titled "guilty except for insanity" in the State of Oregon, are fraught with misconceptions. The use of the plea requires a complex set of interactions between the mental health and criminal justice systems, and comes with severe costs for people who use it. Most of the research on the psychological aspects of the insanity plea emphasizes empirical validity in the form of risk assessment instruments and/or the biomedical model with its focus on disease and illness. This thesis analyzes from community psychology and critical theory perspectives the decision process of hearings held …

Medical School Watercooler Newsletter - December 9, 2012, Lindsey Lyle

Watercooler Newsletter

This is the December 9, 2012 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• USA College of Medicine Hosts Crampton Trust Lecture in Geriatric Medicine
• USA Medical Center Participates in Holiday Toy Drive
• Students Donate Books to USA Children’s Medical Center through Reach Out and Read Program
• December Med School Café - 'The Patient Centered Medical Home'

The Incredible Lightness – And Responsibility – Of Exiting The Huntington's Closet, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

The Use Of Infliximab To Control Recurrent Cytokine Storms In Ebv-Associated Angioimmunoblastic Lymphoma And Hemophagocytic Syndrome, Sameh Gaballa, Emmanuel Besa, Onder Alpdogan

Department of Medical Oncology Faculty Papers

Introduction: Chronic active Epstein-Barr virus infection (CAEBV) has been implicated in several diseases including hemophagocytic lymphohistiocytosis (EBV-HLH) and lymphomas including Angioimmunoblastic T cell lymphoma. The exact mechanism by which EBV infection causes these complications is currently not well understood. EBV-HLH is a syndrome in which T-cells, NK cells and macrophages are aberrantly activated. Cytokine storms play a major role in cellular damage and organ dysfunction. In the event that the body is unable to clear the EBV viremia, dysregulated T, NK cells and macrophages continue to release cytokines leading to the accumulation of lymphohistiocytic infiltrates into organs and organ damage. …

Integration Of Premature Infants Into Family Life, Karen Herzing, Rosalie Mainous Phd.

Explorations – The Journal of Undergraduate Research, Scholarship and Creativity at Wright State

Purpose: To analyze family interactions in the present day of families whose babies were preterm and to determine where possible parental knowledge deficits exist on infant care after hospital discharge in order to develop appropriate nursing interventions.

Background: Many studies reflect that parents who experience prolonged separation from their infant must overcome several obstacles to achieve bonding and attachment. Studies that follow preterm infants also show incidences of poor growth, lower intelligence, rejection of the child by parents, and even at times child abuse. According to the Health Department, almost 900 babies, or 12% of total births, are born …

The Role Of The Nurse Practitioner In The Patient-Centered Medical Home, Patricia M. Sohn

Dissertations

The Patient Centered Medical Home (PCMH) was established to improve patient access to high quality, cost-effective primary care. Critical to this new model of care is the optimal utilization of nurse practitioners (NPs) in performing services traditionally offered by physicians. This study compared the roles of NPs and physicians in providing primary care in two PCMHs in a local health care system. During the calendar year 2011, a total of 50,471 patient visits occurred in the two PCMHs. Each PCMH consisted of a Traditional Clinic that saw patients on a scheduled basis and a Convenient Care Clinic that accepted walk-in …

The Feasibility Of An Advanced Practice Registered Nurse-Managed Adhd Resource Center In Missouri, Kara Janelle Stackley

Dissertations

The primary objective of this project was to develop a survey to determine provider receptiveness to referring patients to an advanced practice registered nurse-(APRN) managed center for the diagnosis and management of Attention Deficit/Hyperactivity Disorder (ADHD). A secondary aim of this project was to develop a business plan for the center, provided feedback from the survey was determined to be supportive. Physicians were more likely to use ADHD clinical guidelines (65%) in their practice and expressed greater comfort managing ADHD. Only 50% of APRNs use the clinical practice guidelines and 50% reported they were uncomfortable diagnosing and managing ADHD. Almost …

Identification And Management Of Vertebral Column Fractures In Primary Care, Christopher Richard Hemmer

Dissertations

The purpose of this project is to perform a program evaluation of current treatment patterns of primary care providers for osteoporotic vertebral compression fractures (VCF). VCF’s result in significant morbidity and long term sequelae following a VCF is not uncommon. Additionally, there is controversy regarding the diagnosis and management of this disorder, especially as these relate to the clinical practice guidelines. This practice evaluation project included a pre and post-test survey and a continuing education offering. Thirty-nine physicians and nurse practitioners completed the survey instruments and attended the continuing education sessions. The educational session resulted in improvement of the provider’s …

Depletion Of Endothelial Or Smooth Muscle Cell-Specific Angiotensin Ii Type 1a Receptors Does Not Influence Aortic Aneurysms Or Atherosclerosis In Ldl Receptor Deficient Mice, Debra L. Rateri, Jessica J. Moorleghen, Victoria Knight, Anju Balakrishnan, Deborah A. Howatt, Lisa A. Cassis, Alan Daugherty

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: Whole body genetic deletion of AT1a receptors in mice uniformly reduces hypercholesterolemia and angiotensin II-(AngII) induced atherosclerosis and abdominal aortic aneurysms (AAAs). However, the role of AT1a receptor stimulation of principal cell types resident in the arterial wall remains undefined. Therefore, the aim of this study was to determine whether deletion of AT1a receptors in either endothelial cells or smooth muscle cells influences the development of atherosclerosis and AAAs.

METHODOLOGY/PRINCIPAL FINDINGS: AT1a receptor floxed mice were developed in an LDL receptor -/- background. To generate endothelial or smooth muscle cell specific deficiency, AT1a receptor floxed mice were bred with …

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Recognition Of Compassion Fatigue Among Medical-Surgical Nurses: The Provision Of Education To Manage The Effects, Kandace Woodruff

Doctor of Nursing Practice (DNP) Projects

The Institute of Medicine (IOM) (2010) recommends that healthcare organizations make the “recruitment and retention of qualified nurses a priority”. The ability to comply with the recommendation is fraught with challenges. Nurses are required to care for patients across the age span with varying medical complexities. There are work related stressors which are inherent to the care of a more acutely ill patient population. The tenuousness produced by this type of environment can predispose the nurse to a stress induced phenomenon known as, Compassion Fatigue. The literature is abounding with information related to compassion fatigue among various nursing specialties. However, …

Text Messaging As Adjunct To Community Based Weight Management Program, Claudia Bouhaidar

Theses and Dissertations

Obesity ascending rates are still a public health priority. The primary aim of the study was to evaluate the effect of tailored text messages on body weight change in overweight and obese adults in a community based weight management program. A secondary aim was to detect behavioral changes in the same population. The study design was quasi-experimental with pre and posttest analysis, conducted over 12 weeks. A total of 28 participants were included in the analysis. Body weight, eating behaviors, exercise and nutrition self-efficacy, attitude toward mobile technology, social support and physical activity were assessed at baseline and at 12 …

Agenda Of 12/07/2012 Hsc Board Of Directors Mtg, Patrice Martin

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Minutes Of 12/07/2012 Hsc Board Of Directors Mtg, Patrice Martin

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Minutes Of 12/07/2012 Hsc Board Of Directors Mtg, Patrice Martin

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

The Economic Burden Of Opioid Poisoning In The United States And Determinants Of Increased Costs In Opioid Poisoning, Timothy Inocencio

Theses and Dissertations

Introduction: Opioid poisoning has been rapidly increasing in the past decade, and has been driven in large part due to increases in opioid prescribing. This has been accompanied by intervention efforts aimed at preventing and reversing opioid poisoning through naloxone prescription programs. Current literature have not quantified the economic burden of opioid poisoning. Understanding this information can help inform these efforts and bring light to this growing problem. In addition understanding various determinants of increased costs can help to identify the types of populations more likely to have greater costs. Main Objectives: The objectives are 1) to quantify the economic …

Medication-Related Problems Experienced By Patients During Transitions To Assisted Living, Deanna Flora

Theses and Dissertations

Medication reconciliation is a systematic and comprehensive review of medication regimens during care transitions aiming to prevent adverse drug events. Poorly executed transitions negatively impact patient welfare and cause financial burden. Medication-related problems (MRPs) experienced during transitions to an assisted living facility (ALF) were evaluated. Data was collected from pharmacy records for transitions to an ALF over three months, including demographics, medications, potentially inappropriate medications, and MRPs. MRPs were categorized and summarized using descriptive statistics. Forty-five patients (71% female) experienced 59 transitions. Average age was 85.6 years. Median length of stay away from the ALF was three days. There were …

Characterization Of The Expression Of The Intercellular Adhesin Locus In Staphylococcus Aureus, Jamie Brooks

Theses and Dissertations

Poly-N-acetylglucosamine (PNAG) is an important Staphylococcus aureus virulence factor. It is a major component of the extracellular polymeric matrix in biofilms, and contributes to resistance to the innate immune response. The proteins encoded in the icaADBC (intercellular adhesin) operon are responsible for PNAG production. Here, we present evidence of a new mechanism of phase variation for switching off PNAG production that involves slipped strand mutagenesis, along with further insight into the regulation and expression of the icaADBC operon. S. aureus strain MN8m (mucoid) is a spontaneous mutant of strain MN8 (non-mucoid). It is characterized by constitutive overproduction of PNAG, resulting …

A Beginning Education In The Anatomy And Function Of The Human Visual Apparatus For Grades 2-4, Evan Andrews

Honors Theses

The human visual apparatus is a remarkable feat of evolution that is nearly a complete mystery to many in the general population. Introducing such a challenging topic is difficult, but, if done in an enjoyable and interactive way to a young audience, the eye can become exciting instead of confusing. The primary objective of this project was to create a short lesson for elementary school students that gave an understanding of the eye's basic anatomy and functions. A fast-paced, interactive format was decided on that included units on the major eye components; color vision and how it can be affected; …

Research Brief: "Provider, Veteran, And Family Perspectives On Family Education In Veterans Affairs Community-Based Outpatient Facilities", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This research examines military family perspectives on community- based outpatient clinics (CBOC) and potential barriers to educational initiatives. Findings from this study indicate that although providers strongly support educating families about mental illness and PTSD, few providers are specifically trained to deliver this kind of education to families. Therefore policies should encourage providers to inform veterans and family members of CBOC family services. Further research in this field should include a more nationally representative and diverse sample of veterans.

Towards Integration: An Autoethnography On The Development Of Identity, Kanchana Henrich

Creative Arts Therapies Theses

This thesis is an autoethnography that explores my own experience of identity development. The intention of this research was to try and find an answer as to why I have not yet been able to develop a cohesive sense of self, in which I am able to accept and embody all of my seemingly disparate parts. I have thus far in my life felt scattered, and unable to accept both the cultures into which I was born, as well as the cultures to which I am organically drawn. Through introspection, reflective writing, and interviewing family members, I have been able …

Molecular Characterization Of A Tetraspanin From The Human Liver Fluke, Opisthorchis Viverrini, Supawadee Piratae, Smarn Tesana, Malcolm K. Jones, Paul J. Brindley, Alex Loukas, Erica Lovas, Veerachai Eursitthichai, Banchob Sripa, Sirikanda Thanasuwan, Thewarach Laha

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Background

The human liver fluke, Opisthorchis viverrini, is designated as a group 1 carcinogen, and is the major risk factor for cholangiocarcinoma in endemic countries throughout Southeast Asia. Proteins in the excretory-secretory products and tegumental surface membranes of the fluke have been proposed to play pivotal roles in parasite survival in the host, and subsequent pathogenesis. These macromolecules are therefore valid targets for the development of vaccines and new drugs to control the infection. Tetraspanins (TSP) are prominent components of the tegument of blood flukes where they are essential for tegument formation, are directly exposed to the immune system, …

A Gap Analysis Of Nursing Systems And Practices In Malaysia: Culturally Appropriate Interventions To Advance Nursing, Chenit Ong-Flaherty

Doctor of Nursing Practice (DNP) Projects

This project comprises a gap analysis of differences between American and Malaysian nursing programs, and additionally, proposes culturally appropriate interventions for Malaysian nursing to adopt American nursing models. The gap analysis was conducted on nursing systems and practices in Malaysia undertaken to identify the differences between Malaysian and American nursing, and the influences that affect Malaysian nursing. The aim is to facilitate the use of the American Nurses Credentialing Center (ANCC) Pathway to Excellence Practice Standard #4: Orientation Prepares New Nurses for the Work Environment, and #6: Professional Development is Provided and Used. The proposal of culturally appropriate interventions as …

The P2y(12) Antagonists, 2mesamp And Cangrelor, Inhibit Platelet Activation Through P2y(12)/G(I)-Dependent Mechanism, Binggang Xiang, Guoying Zhang, Hongmei Ren, Manjula Sunkara, Andrew J. Morris, T. Kent Gartner, Susan S. Smyth, Zhenyu Li

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: ADP is an important physiological agonist that induces integrin activation and platelet aggregation through its receptors P2Y(1) (Gα(q)-coupled) and P2Y(12) (Gα(i)-coupled). P2Y(12) plays a critical role in platelet activation and thrombosis. Adenosine-based P2Y(12) antagonists, 2-methylthioadenosine 5'-monophosphate triethylammonium salt hydrate (2MeSAMP) and Cangrelor (AR-C69931MX) have been widely used to demonstrate the role of P2Y(12) in platelet function. Cangrelor is being evaluated in clinical trials of thrombotic diseases. However, a recent study reported that both 2MeSAMP and Cangrelor raise intra-platelet cAMP levels and inhibit platelet aggregation through a P2Y(12)-independent mechanism.

METHODOLOGY/PRINCIPAL FINDINGS: The present work, using P2Y(12) deficient mice, sought to …

The Adverse Effects Periodontal Disease Has On Women, Jennifer Long

Honors Theses

The Adverse Effects Periodontal Diseases Has on Women Periodontal diseases are challenging to define given the number and variety of different oral diseases. This review sought to answer the question: How does a periodontal disease impact a woman throughout the life span? Specifically, this document discussed how, because of the cycling hormones and the effects those hormones have on the different bacteria, women's periodontal diseases differ from men's. Diseases of the mouth were first discovered during the Egyptian period and the information and knowledge about the different diseases advanced as time progressed. From here, non-surgical and surgical treatments were discussed …