Medicine and Health Sciences Commons^™

History And Development Of The Simulation Effectiveness Tool (Set), Victoria L. Elfrink Corgi, Kim Leighton, Nancy Ryan-Wenger, Thomas J. Doyle, Patricia K. Ravert

Faculty Publications

Background: There has been a lack of reliable and valid instruments measuring human patient simulation effectiveness reported in the literature. Two related studies addressing this concern are described.

Methods: A multi-phased pilot investigation at a single nursing program (N=161) and a follow-up multi-site national study (N=645) evaluated the reliability of the Simulation Effectiveness Tool (SET) as a measure of the effectiveness of a simulated clinical experience (SCE).

Results: Findings from the pilot study resulted in a revision of the original 20-item evaluation tool to a 13-item 3-point ordinal scale instrument. Two subscales, “confidence” and “learning” were noted with Chronbach's alpha …

Medical School Watercooler Newsletter - February 5, 2012, Lindsey Lyle

Watercooler Newsletter

This is the February 5, 2012 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Sneak Peek - USA Health System Patient Shares His Story
• February Med School Café - 'New Developments in the Treatment of Multiple Sclerosis'
• USA Chapter of Gold Humanism Honor Society to Focus on Compassion
• AAMC Representatives to Present Two Workshops

Agenda Of 02/03/2012 Hsc Board Of Directors Mtg, Patrice Martin

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

No abstract provided.

Minutes Of 02/03/2012 Hsc Board Of Directors Mtg, Patrice Martin

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

No abstract provided.

Notice Of 02/03/2012 Hsc Board Of Directors Mtg, Patrice Martin

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

No abstract provided.

Identification Of Functionally Distinct Traf Proinflammatory And Pi3k/Mek Transforming Activities Emanating From The Ret/Ptc Fusion Oncoprotein, Josephine H.F. Wixted, Jay L. Rothstein, Laurence C. Eisenlohr

Kimmel Cancer Center Faculty Papers

Thyroid carcinomas that harbor RET/PTC oncogenes are well differentiated, relatively benign neoplasms compared with those expressing oncogenic RAS or BRAF mutations despite signaling through shared transforming pathways. A distinction, however, is that RET/PTCs induce immunostimulatory programs, suggesting that, in the case of this tumor type, the additional pro-inflammatory pathway reduces aggressiveness. Here, we demonstrate that pro-inflammatory programs are selectively activated by TRAF2 and TRAF6 association with RET/PTC oncoproteins. Eliminating this mechanism reduces pro-inflammatory cytokine production without decreasing transformation efficiency. Conversely, ablating MEK/ERK or PI3K/AKT signaling eliminates transformation but not pro-inflammatory cytokine secretion. Functional uncoupling of the two pathways demonstrates that …

Current Trend Of Off-Pump Coronary Artery Bypass Grafting., Hitoshi Hirose

Department of Surgery Faculty Papers

Published in "Front Lines of Thoracic Surgery", Edited by Stefano Nazari, ISBN 978-953-307-915-8, Published: February 3, 2012 under CC BY 3.0 license

Coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB) and
cardioplegic arrest has been performed safely over several decades. Cardiac surgery under
cardiac arrest provides a bloodless stable operative field, that can facilitate anastomosis. In
last decade, CABG without CPB, off-pump CABG (OPCAB) has become more common with
advances in surgical instruments and technique. This chapter summarizes the surgical
technique, risks and benefits of OPCAB.

The Geographic Value Of Patient-Carried Medical Records In Improving Healthcare In The Us, Lauren Edmundson

The Macalester Review

American medical records have typically been maintained in a single location. However, patient-carried medical records (PCMRs) present an opportunity to alter the space in which health records and information operate. While past research has evaluated PCMRs from a largely economic perspective, this research examines potential benefits of PCMRs through a geographic framework. In total, while further work is needed to perfect the PCMR system, they can ultimately serve as a tool to alleviate four specific complaints made by American patients: lack of communication between provider and patient, lack of communication between providers, medical error, and high costs.

Childhood Obesity And Restrictions Of Parental Liberty. A Response To "Paternalism, Obesity, And Tolerable Levels Of Risk", Kristin Voigt

Democracy & Education

This paper responds to Michael Merry’s recent contribution on childhood obesity. Merry’s analysis highlights the difficulties in finding an appropriate balance between children’s and parents’ interests in antiobesity interventions and emphasizes the importance of weight stigma and its effects on the obesity debate. He concludes by recommending both a greater focus on policies that address society's contribution to childhood obesity and a greater involvement of obese individuals in the policy debate. This response focuses on three points. First, a more explicit recognition of parents’ interests can support the case for the kinds of policies Merry has in mind. Second, while …

Paternalism, Obesity, And Tolerable Levels Of Risk, Michael S. Merry

Democracy & Education

In this article the author examines the relationship between paternalism and childhood obesity. In particular he examines the risks of paternalistic intervention in order to prevent or curtail the occurrence of obesity among young children.

Effects Of Preoperative Aspirin On Cardiocerebral And Renal Complications In Non-Emergent Cardiac Surgery Patients: A Sub-Group And Cohort Study., Longhui Cao, Scott Silvestry, Ning Zhao, James Diehl, Jianzhong Sun

Department of Anesthesiology Faculty Papers

BACKGROUND AND OBJECTIVE: Postoperative cardiocerebral and renal complications are a major threat for patients undergoing cardiac surgery. This study was aimed to examine the effect of preoperative aspirin use on patients undergoing cardiac surgery.

METHODS: An observational cohort study was performed on consecutive patients (n = 1879) receiving cardiac surgery at this institution. The patients excluded from the study were those with preoperative anticoagulants, unknown aspirin use, or underwent emergent cardiac surgery. Outcome events included were 30-day mortality, renal failure, readmission and a composite outcome - major adverse cardiocerebral events (MACE) that include permanent or transient stroke, coma, perioperative myocardial …

Beeckler, Diane M. (Fa 65), Manuscripts & Folklife Archives

Folklife Archives Finding Aids

Finding aid only for Folklife Archives Project 65. [Folk medicine] Collection contains correspondence, magazine entries, and a book concerning traditional cures and preventions for the common cold, flu and other illnesses. There are several responses from Kentuckians from across the state. These cures were collected by Diane Beeckler for a folk studies class at Western Kentucky University.

Effective Leadership To Alter School Food Environments And Improve Public Health, Philip R. Mcnab

Florida Public Health Review

Multiple studies show that many children and adolescents in the United States are overweight or at risk for overweight; moreover, the numbers are still rising. Contributing to the problem is the fact that schoolchildren, on average, are eating too much fast food and well below the recommended amounts offruits and vegetables. From a public health perspective, these are severe problems, as they have been associated with diseases such as heart stroke and heart disease. Not surprisingly, school food environments, which are often saturated with low-nutrient energy-dense foods, are not helping matters and need to be altered. Interventions involving nutrition education …

Epidemiology Of Hepatocellular Carcinoma In Florida – Part I: A Statewide Report, Angel E. Alsina, Aryan Beharry, Narrad Beharry, Nyingi Kemmer, Edson Franco, Haydy Rojas, Guy W. Neff

Florida Public Health Review

The increasing incidence ofhepatocellular carcinoma (HCC) has become a burgeoning public health problem. The effect has been most notable at liver transplant centers. Traditional reports of liver cancer include many non-HCC variants. This study aims at determining the incidence of HCC in the state of Florida, utilizing data from Florida Cancer Data Systems. This study pertains exclusively to HCC. Of 2,296,794 cancer cases, 4,447 HCC and variants were identified (68.7%). Incidence rates were as follows. The incidence of HCC in the state of Florida was 6.1 cases /100,000 population/year; Male: 9.6/100,000 population/year vs. Female: 2.7; Whites: 6.5/100,000 population/year vs. Blacks: …

Leadership To Address Sexual Education In Schools, Shannon Kelley

Florida Public Health Review

This paper will take the strategies ofleadership proposed by Bennis and Nanus (1985) in application to sexual education in schools. The severity and significance of the sexual health of youth will be shown, with an emphasis on contributing risk behaviors and ideologies. An overview ofthe current state ofteenage pregnancy and sexual disease incidence will be included. Next, the factors that contribute to the disparities of sexual health in youth will be addressed. These factors include: race, parental and peer support, participation in a sexual education program, and current policies on sexual education. A discussion about the relation ofthe factors to …

Addressing The Failure Of Abstinence-Only Sex Education Programs: An Emerging Leadership Perspective, Cedric Harville Ii

Florida Public Health Review

Over the past 15 years, abstinence-only sex education has been the sole method of education supported by the federal government as it relates to adolescent sexual health. Despite the exponential increase offunding provided for abstinence-only sex education, few tangible positive results have surfaced. At high rates, teens still take part in risky sexual behaviors, and are at high risks for teen pregnancy, sexually transmitted diseases, and HIV/AIDS. As a result, it is necessary to take an alternative approach that provides adolescents with a comprehensive view of sex education in order to effectively reduce these negative outcomes. A comprehensive education will …

Not Just A Mother’S Decision: A Multifactorial Exploration Of Low Breastfeeding Rates In African American Women, Mackenzie R. Tewell

Florida Public Health Review

The benefits of breastfeeding for both mother and newborns are well established. Yet, black women in the U.S. consistently have the lowest rates ofbreastfeeding initiation and duration. Utilizing the various levels ofthe Social Ecological Model, this paper explores the factors that are thought to be responsible for this disparity. Poverty, a lack of resources, and societal disapproval weigh heavily upon already strained intrapersonal relationships where social support is severely lacking. Familial influence proves pivotal in a mother’s decision ofwhether or not to breastfeed. The role ofWIC clinics are also examined as a source of intervention, though literature demonstrates women receive …

Efficacy And Safety Characteristics Of Mometasone Furoate/Formoterol Fumarate Fixed-Dose Combination In Subjects With Moderate To Very Severe Copd: Findings From Pooled Analysis Of Two Randomized, 52-Week Placebo-Controlled Trials, Donald P. Tashkin, Dennis E. Doherty, Edward Kerwin, Carlos E. Matiz-Bueno, Barbara Knorr, Tulin Shekar, Davis Gates, Heribert Staudinger

Internal Medicine Faculty Publications

Background:

The clinical efficacy and safety of a mometasone furoate/formoterol fumarate (MF/F) fixed-dose combination formulation administered via a metered-dose inhaler was investigated in patients with moderate to very severe chronic obstructive pulmonary disease (COPD).

Methods:

Two 52-week, multicenter, double-blind, placebo-controlled trials with identical study designs were conducted in current or ex-smokers (aged =40 years), and pooled study results are presented herein. Subjects (n = 2251) were randomized to 26 weeks of twice-daily treatment with MF/F 400/10 µg, MF/F 200/10 µg, MF 400 µg, F 10 µg, or placebo. After the 26-week treatment period, placebo subjects completed the trial and 75% …

Effects Of Mometasone Furoate/Formoterol Fumarate Fixed-Dose Combination Formulation On Chronic Obstructive Pulmonary Disease (Copd): Results From A 52-Week Phase Iii Trial In Subjects With Moderate-To-Very Severe Copd, Dennis E. Doherty, Donald P. Tashkin, Edward Kerwin, Barbara Knorr, Tulin Shekar, Sibabrata Banerjee, Heribert Staudinger

Internal Medicine Faculty Publications

RATIONALE: The purpose of this study was to investigate the clinical efficacy and safety of a fixed-dose combination of mometasone furoate/formoterol fumarate (MF/F) administered via a metered-dose inhaler in subjects with moderate-to-very severe chronic obstructive pulmonary disease (COPD).

METHODS: This multicenter, double-blind, placebo-controlled trial had a 26-week treatment period and a 26-week safety extension. Subjects (n = 1196), at least 40 years old, were current or ex-smokers randomized to twice-daily inhaled MF/F 400/10 μg, MF/F 200/10 μg, MF 400 μg, F 10 μg, or placebo. The trial's co-primary endpoints were mean changes from baseline, as area under the curve (AUC), …

Efficacy And Safety Characteristics Of Mometasone Furoate/Formoterol Fumarate Fixed-Dose Combination In Subjects With Moderate To Very Severe Copd: Findings From Pooled Analysis Of Two Randomized, 52-Week Placebo-Controlled Trials, Donald P. Tashkin, Dennis E. Doherty, Edward Kerwin, Carlos E. Matiz-Bueno, Barbara Knorr, Tulin Shekar, Sibabrata Banerjee, Heribert Staudinger

Internal Medicine Faculty Publications

Background: A clinical trial of mometasone furoate/formoterol fumarate (MF/F) administered via a metered-dose inhaler in subjects with moderate to very severe chronic obstructive pulmonary disease (COPD) investigated the efficacy and safety of a fixed-dose combination of MF/F.

Methods: This multicenter, double-blind, placebo-controlled trial had a 26-week treatment period and a 26-week safety extension. Subjects (n = 1055; ≥40 years) were current or ex-smokers randomized to twice-daily treatment with inhaled MF/F 400/10 µg, MF/F 200/10 µg, MF 400 µg, F 10 µg, or placebo. The coprimary endpoints of the trial were mean changes from baseline in forced expiratory volume in 1 …

Influenza Vaccinations: A Leadership Approach, Christine Ann Meister

Florida Public Health Review

Each year thousands of individuals in the United States are diagnosed with cases of seasonal influenza (flu) and the recent pandemic strain ofH1N1 influenza. Complications ofthe flu can lead to serious health issues resulting in hospitalization and even death. Vaccination for seasonal flu and H1N1 can decrease the number ofcases ofthe flu, thus decreasing the number of complications resulting from infection. Unfortunately, a large percentage of the population chooses not to get vaccinated every year for the seasonal flu because they do not trust vaccine safety and effectiveness. To gain the public’s trust and increase the number ofinfluenza inoculations, the …

Printable Schedule, Texas Medical Center Library

Lecture Series on E-Science

No abstract provided.

Tandem Spinal Stenosis: A Case Of Stenotic Cauda Equina Syndrome Following Cervical Decompression And Fusion For Spondylotic Cervical Myelopathy, Brian T. Swanson

Articles - Patient Care

Tandem spinal stenosis is a clinical phenomenon which may cause a functional loss related to neurologic compression in numerous areas of the spinal cord. In this phenomenon, the second area of symptomatic neurologic insult is not revealed until the primary symptomatic area has been treated. This case describes a 71-year-old male referred to physical therapy 4 weeks following a combined anterior/posterior C3/4 decompression and fusion for treatment of cervical spondylotic myelopathy. Approximately 8 weeks post-operatively (4 weeks after initiation of physical therapy), the patient began to complain of bilateral lower extremity weakness, primarily with climbing stairs. At 12 weeks post-operatively, …

Borrelia Burgdorferi Requires The Alternative Sigma Factor Rpos For Dissemination Within The Vector During Tick-To-Mammal Transmission, Star M. Dunham-Ems, Melissa J. Caimano, Justin D. Radolf

UCHC Articles - Research

While the roles of rpoSBb and RpoS-dependent genes have been studied extensively within the mammal, the contribution of the RpoS regulon to the tick-phase of the Borrelia burgdorferi enzootic cycle has not been examined. Herein, we demonstrate that RpoS-dependent gene expression is prerequisite for the transmission of spirochetes by feeding nymphs. RpoS-deficient organisms are confined to the midgut lumen where they transform into an unusual morphotype (round bodies) during the later stages of the blood meal. We show that round body formation is rapidly reversible, and in vitro appears to be attributable, in part, to reduced levels of Coenzyme A …

Global Patterns Of Tissue-Specific Alternative Polyadenylation In Drosophila, Brenton R. Graveley, Gemma May, Michael O. Duff

UCHC Articles - Research

We analyzed the usage and consequences of alternative cleavage and polyadenylation (APA) in Drosophila melanogaster by using >1 billion reads of stranded mRNA-seq across a variety of dissected tissues. Beyond demonstrating that a majority of fly transcripts are subject to APA, we observed broad trends for 3′ untranslated region (UTR) shortening in the testis and lengthening in the central nervous system (CNS); the latter included hundreds of unannotated extensions ranging up to 18 kb. Extensive northern analyses validated the accumulation of full-length neural extended transcripts, and in situ hybridization indicated their spatial restriction to the CNS. Genes encoding RNA binding …

In Vivo Fate Mapping Identifies Mesenchymal Progenitor Cells, Slavica Pejda, Brya G. Matthews, Dario Repic, Liping Wang, Haitao Li, Mark S. Kronenberg, Xi Jiang, Peter Maye, Douglas J. Adams, David W. Rowe, Hector L. Aguila, Ivo Kalajzic

UCHC Articles - Research

Adult mesenchymal progenitor cells have enormous potential for use in regenerative medicine. However, the true identity of the progenitors in vivo and their progeny has not been precisely defined. We hypothesize that cells expressing a smooth muscle α-actin promoter (αSMA) directed Cre transgene represent mesenchymal progenitors of adult bone tissue. By combining complementary colors in combination with transgenes activating at mature stages of the lineage we characterized the phenotype and confirmed the ability of isolated αSMA+ cells to progress from a progenitor to fully mature state. In vivo lineage tracing experiments using a new bone formation model confirmed the osteogenic …

Effects Of Chronic And Acute Oestrogen Replacement Therapy In Aged Animals After Experimental Stroke, Louise D. Mccullough, Fudong Liu, S. E. Benashski, M. Siegel

UCHC Articles - Research

The effect of oestrogen replacement therapy (ERT) on stroke incidence and severity has been extensively debated. Clinical trials of ERT have demonstrated an increased risk of stroke in treated women, although the study participants were well past menopause when therapy was initiated. It has been suggested that detrimental effects of ERT may be unmasked after prolonged periods of hypoestrogenicity. To date, very few studies have examined the effect of ERT in aged animals, although the timing of replacement may be critical to the neuroprotective effects of ERT. We hypothesised that chronic ERT initiated in late middle age would decrease infarct …

Risk Factors For Alcohol Problems In Victims Of Partner Violence, Howard A. Tennen

UCHC Articles - Research

Despite the high prevalence of alcohol problems and disorders among women who experience intimate partner violence (IPV), factors related to current alcohol use are understudied. We examined current risk factors for alcohol problems among 143 substance-using, IPV-exposed women recruited from an urban community from 2007-2010. PTSD symptom severity was associated with alcohol-related problems and a positive alcohol screen; physical IPV severity was related to alcohol dependence. Posthoc analyses revealed that PTSD symptom severity mediated relationships between physical IPV severity and hazardous, harmful, and dependent drinking. Focusing on managing PTSD symptoms and physical IPV in community-based interventions may halt the progression …

Under-Treatment Of Depression In Older Persons, Lisa C. Barry

UCHC Articles - Research

Abstract

Background

Due to the cross-sectional design of most existing studies, longitudinal characterization of treatment for depression in older persons is largely unknown.

Method

754 men and women (aged 70+ years) underwent monthly assessments of mental health professional use and 18-month assessments of antidepressant medication use and depressive symptoms over 9 years. Scores of ≥20 on the Center for Epidemiological Studies-Depression (CES-D) scale denoted depression. We evaluated trends in depression treatment over time in the entire sample and among the depressed participants. Using generalized linear models, we determined characteristics associated with receiving treatment for depression in these groups and among …

Genes And Plays: Bringing Elsi Issues To Life, Karen H. Rothenberg, Lynn W. Bush

Faculty Scholarship

Ethical complexities surround the promise of genomic technology and the power of genetic information as they alter conceptions of identity and dynamics within personal and professional relationships. Creative approaches such as dramatic vignettes offer a unique analytical stage for imagining the bioethical past and future. Dramatic narratives can bring to life images of differing perspectives and values when experiencing innovations in medicine. Although the scientific landscape shifts, concerns expressed in theatre from 50 years ago parallel many contemporary ELSI (ethical, legal and social implications) issues, highlighting the ongoing struggle to appreciate the impact of emerging genetic technologies on relationships. To …