Medicine and Health Sciences Commons^™

From The Editors, Elizabeth Speakman, Edd, Rn, Anef, Fnap, Lauren Collins, Md, Christine Arenson, Md, Shoshana Sicks, Edm

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

As the spring semester comes to a close, we in the Jefferson Center for InterProfessional Education (JCIPE) reflect on the last year. In the Fall 2014 edition of the Interprofessional Education and Care Newsletter, we presented several innovative IPE projects from students, faculty and our colleagues overseas. The articles in this edition build on that progress, high-lighting our efforts, redefined during a January 2015 Jefferson IPE retreat facilitated by Dr. Malcolm Cox, to more closely link IPE and clinical practice. To this end, the spring semester marked the conclusion of the first administration of our revised Jefferson Health Mentors Program …

Exploring Factors Influencing Critical Thinking Skills In Undergraduate Nursing Students: A Mixed Methods Study, Christina Mortellaro

Seton Hall University Dissertations and Theses (ETDs)

Health science education has been moving towards a model of Interprofessional Education in order to meet the increasing demands of Interprofessional Practice in Healthcare, which focuses on delivering high quality patient centered care. This model of Healthcare will lead to improved patient outcomes and overall efficiency of healthcare. Another integral component between effective health care practice and the education of health professional students is the development of critical thinking skills. In order for healthcare professionals to communicate effectively with their patients and their families and also with one another, as in interprofessional practice, critical thinking skills are required. Therefore, critical …

Effects Of Violent Video Games On Sexual Aggression In Males, Elizabeth Ealer

Theses and Dissertations

The purpose of this research was to investigate the link between short-term violent video game play and engagement in sexually aggressive behaviors. In this study, participants were randomly assigned to play 15 minutes of Grand Theft Auto (experimental group) or Tetris Evolution (control group) on an Xbox. After game play, participants engaged in a joke telling paradigm, in which participants were given 10 sexually aggressive jokes, and were instructed to tell between 0-10 of the jokes to a female confederate. The number of jokes told is related to sexually aggressive behaviors outside of the laboratory. The researchers of this study …

Obesity-Induced Adipokine Imbalance Impairs Mouse Pulmonary Vascular Endothelial Function And Primes The Lung For Injury., Dilip Shah, Freddy Romero, Michelle Duong, Nadan Wang, Bishnuhari Paudyal, Benjamin T Suratt, Caleb B Kallen, Jianxin Sun, Ying Zhu, Kenneth Walsh, Ross Summer

Center for Translational Medicine Faculty Papers

Obesity is a risk factor for the development of acute respiratory distress syndrome (ARDS) but mechanisms mediating this association are unknown. While obesity is known to impair systemic blood vessel function, and predisposes to systemic vascular diseases, its effects on the pulmonary circulation are largely unknown. We hypothesized that the chronic low grade inflammation of obesity impairs pulmonary vascular homeostasis and primes the lung for acute injury. The lung endothelium from obese mice expressed higher levels of leukocyte adhesion markers and lower levels of cell-cell junctional proteins when compared to lean mice. We tested whether systemic factors are responsible for …

Visual Feedback Dominates The Sense Of Agency For Brain-Machine Actions, Nathan Evans, Steven Gale, Aaron Schurger, Olaf Blanke

Psychology Faculty Articles and Research

Recent advances in neuroscience and engineering have led to the development of technologies that permit the control of external devices through real-time decoding of brain activity (brain-machine interfaces; BMI). Though the feeling of controlling bodily movements (sense of agency; SOA) has been well studied and a number of well-defined sensorimotor and cognitive mechanisms have been put forth, very little is known about the SOA for BMI-actions. Using an on-line BMI, and verifying that our subjects achieved a reasonable level of control, we sought to describe the SOA for BMI-mediated actions. Our results demonstrate that discrepancies between decoded neural activity and …

An Online Survey Of The Healthcare Needs Of Undergraduate Students At An Urban University, Linda Graf

College of Science and Health Theses and Dissertations

There is a growing body of evidence that reveals mounting need for radical modification of college health services for young adults in the United States. The health issues for this population, which are exacerbated by inadequate access to healthcare include alcoholism, depression, unintended pregnancy, disordered eating, sexual assault and sexually transmitted infections. Utilizing the College Student Health Survey developed by University of Minnesota’s Boynton Health Service, this study specifically focused on analyzing the health care needs of undergraduate students at a large, urban, university. Access and utilization of healthcare services for this population were also examined. An online survey was …

The Use Of Human Factors Training To Improve The Quality Of Decision-­‐Making In Nurse Anesthesia Trainees, Julia T. Feczko

College of Science and Health Theses and Dissertations

In the U.S, an estimated 44,000-­‐98,000 deaths occur annually due to medical errors. Adverse events can occur as anesthesia providers face a complex environment of high acuity patients undergoing interventions in a variety of locations. Production pressure, new equipment and medications, and constant turnover of personnel contribute to a hazardous working environment. Human factors educational training in cognitive errors, metacognition, and de-­‐biasing strategies has been proposed as a solution to help prevent medical errors in anesthesia practice The study of human factors has been integrated into safety culture industries such as aviation and nuclear power plants, but its incorporation into …

Research Brief: "Coping, Family Social Support, And Psychological Symptoms Among Student Veterans", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study is about coping styles among student veterans and what is related to various coping styles. For policy and practice, universities should understand veterans' stigmatization of mental health services and should improve cultural competence; the Department of Veterans Affairs should work with universities to ensure student veteran success. Suggestions for future research include using a larger, more representative sample and looking at the effects of actual versus perceived social support.

Portrait Des Pratiques De Prévention Primaire Et Secondaire En Bureautique Au Québec Chez Les Intervenants Et Dans Les Milieux De Travail, Marie Saint-Vincent, Sylvie Montreuil, Georges Toulouse, Roselyne Trudeau

Rapports de recherche scientifique

Dans la perspective de stimuler la prévention des troubles musculo-squelettiques (TMS) dans le domaine de la bureautique au Québec, et de préparer un guide de bonnes pratiques, une première étape nous est apparue incontournable : documenter les pratiques de praticiens et celles mises en œuvre dans les milieux de travail au Québec. Il s’agissait de décrire ce qui se fait au Québec, de déterminer les approches les plus prometteuses, de décrire les difficultés rencontrées et, inversement, les conditions de succès.

L’étude a été réalisée en deux temps. D’abord, 25 praticiens ont été interrogés, 23 seuls et quatre en binômes pour …

Cloning And Variation Of Ground State Intestinal Stem Cells, Lane H. Wilson, Francisco A. Sylvester, Jeffrey S. Hyams, Thomas Devers, Wa Xian

UCHC Articles - Research

Stem cells of the gastrointestinal tract, pancreas, liver, and other columnar epithelia collectively resist cloning in their elemental states. Here we demonstrate the cloning and propagation of highly clonogenic, “ground state” stem cells of the human intestine and colon. We show that derived stem cell pedigrees sustain limited copy number and sequence variation despite extensive serial passaging and display exquisitely precise, cell-autonomous commitment to epithelial differentiation consistent with their origins along the intestinal tract. This developmentally patterned and epigenetically maintained commitment of stem cells likely enforces the functional specificity of the adult intestinal tract. Using clonally-derived colonic epithelia, we show …

Staying Sharp: The Cutting Edge Of Research On Cognition And Aging, Regula H. Robnett

Occupational Therapy Faculty Presentations

Workshop PowerPoint presentation given June 11, 2015, for the 25th Maine Geriatrics Conference in Bar Harbor, Maine. Presentation reviews the latest evidence on cognition and aging. While there is an overwhelming amount of data out there, it is crucial to be informed consumers so the information can be used to enhance one's own life and the lives of others. As people age, changes occur in the brain that can impact learning, memory, and overall daily performance. However, techniques based on promoting preserved skills, embracing new learning, and providing contextual adaptations can be used to improve overall performance. Workshop presentation included …

Relationships Between Activation Level, Knowledge, Self-Efficacy, And Self-Management Behavior In Heart Failure Patients Discharged From Rural Hospitals., Van Do, Lufei Young, Sue Barnason, Hoang Tran

Journal Articles: College of Nursing

Non-adherence to self-management guidelines accounted for 50% of hospital readmissions in heart failure patients. Evidence showed that patient activation affects self-management behaviors in populations living with chronic conditions. The purpose of this study was to describe patient activation level and its relationship with knowledge, self-efficacy and self-management behaviors in heart failure patients discharged from rural hospitals. Our study populations were recruited from two hospitals in rural areas of Nebraska. We found that two-thirds of the participants reported low activation levels (e.g., taking no action to manage their heart failure condition). In addition, low patient activation levels were associated with inadequate …

Caregivers’ Knowledge, Perceptions And Home Management Practices Of Fever In Children Under The Age Of Five Years Presenting With Acute Febrile Illnesses, Katherine Oyieke

Master of Medicine in Paediatrics and Child Health

Background: Fever in children is one of the most common clinical symptoms and a frequent cause of caregiver concern. It is a normal body response to a variety of conditions, the most common of which is infection. Many childhood illnesses are accompanied by fever, which is often treated at home prior to presentation at a health facility. Nearly every child will develop a febrile episode at some point in life. The challenge for caregivers is to know when to be concerned and how to manage such episodes appropriately when they occur. Caregiver knowledge and perceptions regarding fever are an important …

The Relationship Between Cognitive Inhibition, Mental Illness, And Creativity, Christina Carter

Theses and Dissertations

The current study explored how the symptom severity of the affective and schizophrenia spectrums related to performance on a divergent thinking task and self-reports of creative achievement, as well as the contribution of cognitive inhibition as a moderating factor between these variables. 98 participants completed a 1.5 hour battery of tests that combined measures between this study and another study. Measures pertaining to this study included self-report measures of schizotypy and hypomania, a divergent thinking creativity task, a computerized stimuli-response task, and two self-reports of creative achievement. Correlations were conducted to examine linear relationships, nonlinear regression models were conducted to …

A Rapid Assessment Of Post-Disclosure Experiences Of Urban Hiv-Positive And Hiv-Negative School-Aged Children In Kenya, Grace Gachanja

Walden Faculty and Staff Publications

There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIV-positive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIV-negative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an in-depth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into …

The Impact Of Free Trial Acceptance On Demand For Alternative Nicotine Products: Evidence From Experimental Auctions, Matthew C. Rousu, Richard J. O'Connor, Maans Bansal-Travers, James M. Pitcavage, Jim Thrasher

Faculty Publications

Objectives: This study explored the relationship between product trials and consumer demand for alternative nicotine products (ANP).

Methods: An experimental auction was conducted with 258 adult smokers, wherein participants were randomly assigned to one of four experimental conditions. The participants received the opportunity to try, but did not have to accept, one of three relatively novel ST products (i.e., snus, dissolvable tobacco, or medicinal nicotine), or they were placed into a control group (i.e., no trial). All the participants then bid on all three of these products, as well as on cigarettes. We assessed interest in using ANP based on …

Connectivity Measures Are Robust Biomarkers Of Cortical Function And Plasticity After Stroke, Jennifer Wu, Erin Burke Quinlan, Lucy Dodakian, Alison Mckenzie, Nikhita Kathuria, Robert J. Zhou, Renee Augsburger, Jill See, Vu H. Lee, Ramesh Srinivasan, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Valid biomarkers of motor system function after stroke could improve clinical decision-making. Electroencephalography-based measures are safe, inexpensive, and accessible in complex medical settings and so are attractive candidates. This study examined specific electroencephalography cortical connectivity measures as biomarkers by assessing their relationship with motor deficits across 28 days of intensive therapy. Resting-state connectivity measures were acquired four times using dense array (256 leads) electroencephalography in 12 hemiparetic patients (7.3 ± 4.0 months post-stroke, age 26–75 years, six male/six female) across 28 days of intensive therapy targeting arm motor deficits. Structural magnetic resonance imaging measured corticospinal tract injury and infarct volume. …

Genes Regulating Epithelial Polarity Are Critical Suppressors Of Esophageal Oncogenesis, Xiu-Min Li, Hui Wang, Li-Li Zhu, Run-Zhen Zhao, Hong-Long Ji

Cellular and Molecular Biology Faculty Publications and Presentations

Esophageal cancer is an aggressive disease featured by early lymphatic and hematogenous dissemination, and is the sixth leading cause of cancer-related deaths worldwide. The proper formation of apicobasal polarity is essential for normal epithelium physiology and tissue homeostasis, while loss of polarity is a hallmark of cancer development including esophageal oncogenesis. In this review, we summarized the stages of esophageal cancer development associated with the loss or deregulation of epithelial cell apicobasal polarity. Loss of epithelial apicobasal polarity exerts an indispensable role in the initiation of esophageal oncogenesis, tumor progression, and the advancement of tumors from benign to malignant. In …

Network-Based Stratification Analysis Of 13 Major Cancer Types Using Mutations In Panels Of Cancer Genes., Xue Zhong, Hushan Yang, Shuyang Zhao, Yu Shyr, Bingshan Li

Department of Medical Oncology Faculty Papers

BACKGROUND: Cancers are complex diseases with heterogeneous genetic causes and clinical outcomes. It is critical to classify patients into subtypes and associate the subtypes with clinical outcomes for better prognosis and treatment. Large-scale studies have comprehensively identified somatic mutations across multiple tumor types, providing rich datasets for classifying patients based on genomic mutations. One challenge associated with this task is that mutations are rarely shared across patients. Network-based stratification (NBS) approaches have been proposed to overcome this challenge and used to classify tumors based on exome-level mutations. In routine research and clinical applications, however, usually only a small panel of …

High-Risk Travel Distance And Number Of Primary Care Visits In A North Carolina Medicaid Population, Justin Allred, Christopher Duffrin, Jason Brinkley, John Jones

Frontiers in Public Health Services and Systems Research

Background: With nearly 20% of the U.S. population in rural areas, a lack of access to primary care may cause rural residents to forego recommended preventive care procedures, and suffer higher morbidity rates than their urban counterparts.

Methods: Medicaid billing data from 2009 to 2011 were analyzed to calculate the distance and duration that a Medicaid patient population had to travel when seeking primary care in the 29 rural counties of eastern North Carolina. Primary care codes were analyzed to detect any differences in access patterns for various complexity levels of physician visits. Data were also used to evaluate health …

Sepsis 2015: You Say You Wanted A Revolution, R. Phillip Dellinger, Md, Mccm

Division of Pulmonary, Allergy, and Critical Care Medicine Presentations and Grand Rounds

Objectives:

1. Understand current considerations for changing definitions of sepsis
2. Understand what we should do in the early management of sepsis
3. Understand the questions still to be answered in guiding early management of sepsis
4. Know what’s going on in clinical trials in sepsis

Overall Goals and Objectives:

Following this activity, a participant should be able to:

1. Recognize recent advances and developments in Pulmonary Medicine & Critical Care and translate into clinical practice

2. Integrate perspectives of multiple disciplines into decision-making on behalf of patients through structured plans for patient care.

3. Develop areas for future research and discuss appropriate …

Glad Nanostructured Arrays With Enhanced Carrier Collection And Light Trapping For Photoconductive And Photovoltaic Device Applications, Hilal Cansizoglu

Theses and Dissertations

Solar energy harvesting has been of great interest for researchers over the past 50 years. Main emphasis has been on developing high quality materials with low defect density and proper band gaps. However, high cost of bulk materials and insufficient light absorption in thin films led to utilization of semiconductor nanostructures in photovoltaics and photonics. Light trapping abilities of nanostructures can provide high optical absorption whereas core/shell nanostructured arrays can allow enhanced charge carrier collection. However, most of the nanofabrication methods that can produce uniform nanostructure geometries are limited in materials, dimensions, and not compatible with industrial production systems. Therefore, …

Apoε2 And Education In Cognitively Normal Older Subjects With High Levels Of Ad Pathology At Autopsy: Findings From The Nun Study, Diego Iacono, Peter Zandi, Myron Gross, William R. Markesbery, Olga Pletnikova, Gay Rudow, Juan C. Troncoso

Sanders-Brown Center on Aging Faculty Publications

Asymptomatic Alzheimer's disease (ASYMAD) subjects are individuals characterized by preserved cognition before death despite substantial AD pathology at autopsy. ASYMAD subjects show comparable levels of AD pathology, i.e. β-amyloid neuritic plaques (Aβ-NP) and tau-neurofibrillary tangles (NFT), to those observed in mild cognitive impairment (MCI) and some definite AD cases. Previous clinicopathologic studies on ASYMAD subjects have shown specific phenomena of hypertrophy in the cell bodies, nuclei, and nucleoli of hippocampal pyramidal neurons and other cerebral areas. Since it is well established that the allele APOε4 is a major genetic risk factor for AD, we examined whether specific alleles of APOE …

Trop-2 Is Up-Regulated In Invasive Prostate Cancer And Displaces Fak From Focal Contacts., Marco Trerotola, Kirat K Ganguly, Ladan Fazli, Carmine Fedele, Huimin Lu, Anindita Dutta, Qin Liu, Tiziana De Angelis, Luke W Riddell, Natalia A Riobo, Martin E Gleave, Amina Zoubeidi, Richard Pestell, Dario C Altieri, Lucia R Languino

Department of Urology Faculty Papers

In this study, we show that the transmembrane glycoprotein Trop-2 is up-regulated in human prostate cancer (PCa) with extracapsular extension (stages pT3/pT4) as compared to organ-confined (stage pT2) PCa. Consistent with this evidence, Trop-2 expression is found to be increased in metastatic prostate tumors of Transgenic Adenocarcinoma of Mouse Prostate mice and to strongly correlate with α5β1 integrin levels. Using PCa cells, we show that Trop-2 specifically associates with the α5 integrin subunit, as binding to α3 is not observed, and that Trop-2 displaces focal adhesion kinase from focal contacts. In support of the role of Trop-2 as a promoter …

Doxycycline Down-Regulates Dna-Pk And Radiosensitizes Tumor Initiating Cells: Implications For More Effective Radiation Therapy., Rebecca Lamb, Marco Fiorillo, Amy Chadwick, Bela Ozsvari, Kimberly J Reeves, Duncan L Smith, Robert B Clarke, Sacha J Howell, Anna Rita Cappello, Ubaldo E. Martinez-Outshoorn, Md, Maria Peiris-Pagès, Federica Sotgia, Michael P Lisanti

Kimmel Cancer Center Faculty Papers

DNA-PK is an enzyme that is required for proper DNA-repair and is thought to confer radio-resistance in cancer cells. As a consequence, it is a high-profile validated target for new pharmaceutical development. However, no FDA-approved DNA-PK inhibitors have emerged, despite many years of drug discovery and lead optimization. This is largely because existing DNA-PK inhibitors suffer from poor pharmacokinetics. They are not well absorbed and/or are unstable, with a short plasma half-life. Here, we identified the first FDA-approved DNA-PK inhibitor by "chemical proteomics". In an effort to understand how doxycycline targets cancer stem-like cells (CSCs), we serendipitously discovered that doxycycline …

Akt Inhibition Overcomes Rapamycin Resistance By Enhancing The Repressive Function Of Pras40 On Mtorc1/4e-Bp1 Axis, Wenting Mi, Qing Ye, Side Liu, Qing-Bai She

Markey Cancer Center Faculty Publications

The mTORC1 inhibitors, rapamycin and its analogs, are known to show only modest antitumor activity in clinic, but the underlying mechanisms remain largely elusive. Here, we found that activated AKT signaling is associated with rapamycin resistance in breast and colon cancers by sustained phosphorylation of the translational repressor 4E-BP1. Treatment of tumor cells with rapamycin or the AKT inhibitor MK2206 showed a limited activity in inhibiting 4E-BP1 phosphorylation, cap-dependent translation, cell growth and motility. However, treatment with both drugs resulted in profound effects in vitro and in vivo. Mechanistic investigation demonstrated that the combination treatment was required to effectively …

Characterization Of The Role That Alternative Ribonucleotide Reductases Play In Restoring Replication In The Presence Of Hydroxyurea In Escherichia Coli, Michael Sadek

PSU McNair Scholars Online Journal

DNA replication is essential for cells to grow and divide. Ribonucleotide reductase is an essential enzyme that is responsible for the formation of deoxyribonucleotides that are used in DNA synthesis during replication. Hydroxyurea is a chemotherapeutic agent that is thought to work by specifically inhibiting the ribonuceotide reductase to prevent replication. However, recent studies in E. coli have shown that following an initial period of inhibition, DNA synthesis then recovers in the presence of hydroxyurea, suggesting that the mode of death and cellular response to hydroxyurea is more complex than originally proposed. The E.coli genome encodes three ribonucleotide reductases that …

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The Associations Between Environmental Quality And Preterm Birth In The United States, 2000–2005: A Cross-Sectional Analysis, Kristen M. Rappazzo, Lynne C. Messer, Jyotsna S. Jagai, Christine L. Gray, Shannon C. Grabich, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Background: Many environmental factors have been independently associated with preterm birth (PTB). However, exposure is not isolated to a single environmental factor, but rather to many positive and negative factors that co-occur. The environmental quality index (EQI), a measure of cumulative environmental exposure across all US counties from 2000—2005, was used to investigate associations between ambient environment and PTB.

Methods: With 2000–2005 birth data from the National Center for Health Statistics for the United States (n = 24,483,348), we estimated the association between increasing quintiles of the EQI and county-level and individual-level PTB; we also considered environmental domain-specific (air, …

Use Of The Delphi Technique In Instrument Development To Assess Debriefing Facilitation, E. Adel Herge, Otd, Otr/L, Susan Wainwright, Pt, Phd, Jennifer Saylor, Phd, Rn, Acns-Bc

Thomas Jefferson University Faculty Days

Debriefing is an essential part of the simulation experience because this is where most of the learning occurs (Arafah, Hansen & Nichols, 2010). To date, there are no validated instruments to measure the ability of a facilitator to effectively debrief learners after a patient simulation.

This poster describes phase one of a pilot study to develop and evaluate an instrument that assesses the effectiveness of a debriefing facilitator. The instrument is based on the current scientific literature and was tested to establish reliability and validity. In phase one, the Delphi Technique was selected as it has been shown to be …