Medicine and Health Sciences Commons^™

Renal Replacement Therapy In Patients With Left Ventricular Assist Device: What Do The Cardiologists Need To Know?, Hesham R. Omar

The VAD Journal

Renal failure after left ventricular assist device (LVAD) implantation occurs either due to worsening chronic kidney disease which is common in end-stage heart failure, or due to acute kidney injury in the peri-implantation period, and is associated with high morbidity and short-term mortality. The increased utilization of LVAD in refractory heart failure either as a bridge to transplantation or destination therapy will eventually create a population of patients with LVADs who are dialysis-dependent. There are multiple challenges encountered during dialysis of patients with LVADs including the unfamiliarity of nephrologists with the LVAD technology, difficulty in hemodynamic monitoring with continuous flow …

The Effect Of Education On Portal Personal Health Record Use, Imke Casey Dnp, Crna, Rhit

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

The purpose of this study was to assess the computer-use attitudes among chronically ill adult primary care practice (PCP) patients. The goal was to examine the rate of portal personal health record (PHR) use of middle-aged and older adults, to evaluate the effectiveness of an educational intervention in improving PHR adoption, and to identify patients’ thoughts about the PHR. The quasi-experimental, pre-test/post-test design with a paired matched set was performed with a convenience sample of 50 subjects from a primary care group practice in Central Florida.

Participants were recruited on the day of their provider appointment. After participant’s consent …

Cyclin D1 Silencing Suppresses Tumorigenicity, Impairs Dna Double Strand Break Repair And Thus Radiosensitizes Androgenindependent Prostate Cancer Cells To Dna Damage., F Marampon, G L Gravina, Xiaoming Ju, A Vetuschi, R Sferra, Mathew C Casimiro, S Pompili, C Festuccia, A Colapietro, E Gaudio, E Di Cesare, V Tombolini, Richard Pestell

Department of Cancer Biology Faculty Papers

Patients with hormone-resistant prostate cancer (PCa) have higher biochemical failure rates following radiation therapy (RT). Cyclin D1 deregulated expression in PCa is associated with a more aggressive disease: however its role in radioresistance has not been determined. Cyclin D1 levels in the androgen-independent PC3 and 22Rv1 PCa cells were stably inhibited by infecting with cyclin D1-shRNA. Tumorigenicity and radiosensitivity were investigated using in vitro and in vivo experimental assays. Cyclin D1 silencing interfered with PCa oncogenic phenotype by inducing growth arrest in the G1 phase of cell cycle and reducing soft agar colony formation, migration, invasion in vitro and tumor …

Improving Management Of Inpatient Blood Glucose, Rachael K. Misitano

Master's Projects and Capstones

Epidemiologic studies indicate blood glucose management in the hospitalized patient population is not adequate; with approximately 30% of patients reporting values >180mg/dl. Patients with increased blood glucose levels pose a higher mortality risk as well as increased risks for dehydration, hypotension, renal injury, decreased wound healing, immunosuppression, and an overall increase in hospital length of stay (AACE, 2015). This project aims to improve inpatient management of blood glucose levels by facilitating MD-RN communication through a reduction in the current reportable blood glucose level. This project took place on a 17 bed adult medical-surgical unit at a large academic hospital in …

My Way Or The Highway: The Development And Use Of Behavior Management And School Discipline, Patricia Thomas

University Honors Program

Behavior management is a crucial topic in education. The management of student behavior in a classroom can affect the entire learning experience. As the needs of students and teachers change, the methods of behavior management adapt to accommodate new needs. This thesis identifies behavior management starting in the 1960’s and research determining its effectiveness. The causes of change in classroom and school-wide discipline systems are addressed, including political climates, court involvement, and tragic events within schools. The behavior management methods used in the current day are discussed. Through a review of literature and online sources, the information provided was gathered …

Etiology Of Oppositional Defiant Disorder And Conduct Disorder: Biological, Familial And Environmental Factors Identified In The Development Of Disruptive Behavior Disorders, Eva Kimonis, Paul Frick

Eva Kimonis

Conduct problems are associated with a large number of biological, affective, cognitive, familial, and environmental risk factors. Further, research suggests that there may be multiple developmental pathways to conduct problems, each with their own unique constellation of risk and protective factors. Attempts at disaggregating youth into more homo­geneous subtypes have uncovered groups of youth that show similar risk factors and distinct developmental trajectories. This chapter will provide an overview of these major subtypes of conduct disorder (CD) and the specific risk factors associated with each subtype. Assessment and treatment implications are discussed.

Human Cryptochrome Exhibits Light-Dependent Magnetosensitivity, Lauren Foley, Robert Gegear, Steven Reppert

Robert J. Gegear

Humans are not believed to have a magnetic sense, even though many animals use the Earth's magnetic field for orientation and navigation. One model of magnetosensing in animals proposes that geomagnetic fields are perceived by light-sensitive chemical reactions involving the flavoprotein cryptochrome (CRY). Here we show using a transgenic approach that human CRY2, which is heavily expressed in the retina, can function as a magnetosensor in the magnetoreception system of Drosophila and that it does so in a light-dependent manner. The results show that human CRY2 has the molecular capability to function as a light-sensitive magnetosensor and reopen an area …

Psychosocial Functioning Problems Over Time Among High Risk Youths: A Latent Class Transition Analysis, Richard Dembo, Jennifer Wareham, Norman Poythress, Kathleen Meyers

Norman Poythress

The authors report the results of latent class analyses and latent class transition analyses of antisocial behavior risk factors among 137 youths participating in a juvenile diversion program. The study examined the youths’ latent classifications using baseline and 1-year follow-up measures of family, peer, education, and mental health risk factors. Latent class transition analyses were conducted to determine the stability and change of latent class membership across two time points. For both baseline and follow-up measures, latent class analyses suggested that two latent classes were most appropriate for characterizing the youths using the four domains of risk factors. One class …

Perceived Coercion And Procedural Justice In The Broward Mental Health Court, Norman Poythress, John Petrila, Annette Christy, Roger Boothroyd

Norman Poythress

No abstract provided.

Getting To The Root Of Bacterial Hairs: What Is “S”?, Rebecca Gaddis, Samantha O'Conner, Evan Anderson, Terri Camesano, Nancy Burnham

Nancy A. Burnham

An atomic force microscope (AFM) was used to measure the steric forces of lipopolysaccharides (LPS) on the biofilm-forming bacteria, Pseudomonas aeruginosa. It is well known that LPS play a vital role in biofilm formation. These forces were characterized with a modified version of the Alexander and de Gennes (AdG) model for polymers, which is a function of equilibrium brush length, L, probe radius, R, temperature, T, separation distance, D, and an indefinite density variable, s. This last parameter was originally distinguished by de Gennes as the root spacing or mesh spacing depending upon the type of polymer adhesion; however since …

The Macarthur Adjudicative Competence Study: Diagnosis, Psychopathology, And Adjudicative Competence-Related Abilities, Steven Hoge, Norman Poythress, Richard Bonnie, John Monahan

Norman Poythress

A set of measures assessing abilities related to legal standards for competence in the adjudicative process were administered to mentally-disordered criminal defendants with diagnoses of schizophrenia, affective disorder, other psychiatric disorders, and to criminal defendants without diagnosed mental disorder. Mentally-disordered defendants were recruited from two groups: those who had been committed for restoration of competence and those who had been identified by jail personnel as mentally ill. Significant impairments in competence-related abilities were found for approximately half of the defendants with schizophrenia. Defendants with schizophrenia scored lower on measures of understanding, reasoning, and appreciation related to the adjudication process. The …

Decision-Making In Criminal Defense: An Empirical Study Of Insanity Pleas And The Impact Of Doubted Client Competence, Richard Bonnie, Norman Poythress, Steven Hoge, John Monahan

Norman Poythress

No abstract provided.

Building Capacity In Physical Activity And Public Health, Russell Pate, Jennifer Gay, David Brown, Michael Pratt

David C. Brown

No abstract provided.

Effects Of Non-Aerobic Maximal Effort Exercise On Fatigue In Deconditioned Men And Women With Multiple Sclerosis, Jessica Korsh, Michael Kuchera, R Dombroski, T Vardy, F Thomas, S O’Brien, P Yagnik, K Wenzel, S Stoll, Bruce Stouch, M Wallin, Jeffrey Nelson

Michael Kuchera

Multiple Sclerosis (MS) is a neurodegenerative disease of unknown etiology affecting women more frequently than men. Mental and physical fatigue complaints are often the most disabling symptoms for an MS patient. Both are multifactorial, potentially exacerbated by aerobic exercise, may prevent sustained physical functioning, and significantly interfere with activities of daily living1. A multi-center study was designed to investigate the effects of non-aerobic maximal effort exercise (MEE) for deconditioned persons with MS, with the expectation of minimizing fatigue. The IsoPUMP (Neuromuscular Engineering; Nashville, TN), is a specialized exercise and strength-sensing machine, designed to allow individuals to safely perform and record …

Lessons From The Broward County Mental Health Court Evaluation, Annette Christy, Roger Boothroyd, Norman Poythress, John Petrila

Norman Poythress

The creation of specialty mental health courts has emerged as a strategy to address the impact of persons with mental illness in the criminal justice system by consolidating the management of certain types of cases into a single court. This article describes an evaluation of the nation's first such court, the Broward County Mental Health Court. The purpose is to alert those who may conduct future evaluations of these types of courts to some of the contextual, logistic, and management features of our evaluation and the challenges we have encountered doing field research in this unique legal setting.

Effect Of Prior Anterior Superior Iliac Spine Compression Testing On Second Assessor Findings: Implications For Inter-Examiner Reliability Testing, Frank Casella, Michael Kuchera, Jeffrey Nelson, Veronica Ferencz, Nicole Myers

Michael Kuchera

BACKGROUND: Osteopathic physicians use palpation to diagnose sacroiliac joint somatic dysfunction (SD) -- including the Anterior Superior Iliac Spine (ASIS) Compression Test for dysfunctional side lateralization. (Literature suggests right-sided lateralization in 80% of asymptomatic individuals). Accurate, reliable tests are crucial however to diagnose SD and kappa (κ) analysis is a gold-standard to determine the degree of interexaminer reliability for tests. Few studies have examined the effect the palpatory examination has on subsequent diagnostic findings and therefore on κ-values.

Detection Of Diabetic Foot Ulcers Using Svm Based Classification, Lei Wang, Peder Pedersen, Diane Strong, Bengisu Tulu, Emmanuel Agu, Qian He, Ronald Ignotz, Raymond Dunn, David Harlan, Sherry Pagoto

Emmanuel O. Agu

Diabetic foot ulcers represent a significant health issue, for both patients’ quality of life and healthcare system costs. Currently, wound care is mainly based on visual assessment of wound size, which suffers from lack of accuracy and consistency. Hence, a more quantitative and computer-based method is needed. Supervised machine learning based object recognition is an attractive option, using training sample images with boundaries labeled by experienced clinicians. We use forty sample images collected from the UMASS Wound Clinic by tracking 8 subjects over 6 months with a smartphone camera. To maintain a consistent imaging environment and facilitate the capture process …

A Context-Aware Activity Recommendation Smartphone Application To Mitigate Sedentary Lifestyles, Qian He, Emmanuel Agu

Emmanuel O. Agu

A sedentary lifestyle involves irregular or no physical activity. In this kind of lifestyle, people’s activities do not increase their energy expenditure substantially above resting levels. Long periods of sitting, lying, watching television, playing video games, and using the computer are typical examples. Energy expenditures at 1.0-1.5 Metabolic Equivalent Units (METs) are considered sedentary behaviors. A recent study of sedentary lifestyles found that the length of sedentary times is associated with an increased risk of diabetes, cardiovascular disease, and cardiovascular and all-cause mortality. In this study, we developed a smartphone application called “On11”, which continuously tracks and informs the user …

Health Care Reform: Current Updates And Future Initiatives For Ambulatory Care Nursing, Beth Ann Swan, Phd, Crnp, Faan, Sheila Haas, Phd, Np, Faan

Sheila A. Haas, PhD, NP, FAAN

Executive Summary: While the signing of the Patient Protection and Affordable Care Act was a historical event marking the beginning of health care reform in the United States, it signaled the start of a golden age for ambulatory care nursing. Ambulatory care RNs are well-positioned to fully participate in health care reform initiatives. RNs are well-positioned to lead, facilitate, and/or participate in all patient care medical homes' and accountable care organizations'quality and safety initiatives through enhanced use of major ambulatory care RN role dimensions such as advocacy, telehealth, patient education, care coordination and transitional care, and community outreach. RNs are …

The Effect Of Yoga Postures On Balance, Flexibility, And Strength In Healthy High School Females, Betsy Donahoe-Fillmore, C. Brahler, Mary Fisher, Kelly Beasley

C. Jayne Brahler

Objective: The purpose of this study was to document the effects of yoga interventions on balance, flexibility, and strength in adolescent girls 14 to 18 years. Study Design: Quasi-experimental, nonrandomized. Background: Research on the effects of yoga on balance, flexibility, and strength has focused on adults, although yoga is being marketed to all ages. Methods and Measures: A convenience sample of 33 female adolescents participated in yoga training 2 times per week and a walking program 3 times per week, for 7 weeks. The instructor-led group received instruction from a registered yoga therapist in person, while the video-led group watched …

Criminal Recidivism Among Juvenile Offenders: Testing The Incremental And Predictive Validity Of Three Measures Of Psychopathic Features, Kevin Douglas, Monica Epstein, Norman Poythress

Norman Poythress

We studied the predictive, comparative, and incremental validity of three measures of psychopathic features (Psychopathy Checklist: Youth Version [PCL:YV]; Antisocial Process Screening Device [APSD]; Childhood Psychopathy Scale [CPS]) vis-à-vis criminal recidivism among 83 delinquent youth within a truly prospective design. Bivariate and multivariate analyses (Cox proportional hazard analyses) showed that of the three measures, the CPS was most consistently related to most types of recidivism in comparison to the other measures. However, incremental validity analyses demonstrated that all of the predictive effects for the measures of psychopathic features disappeared after conceptually relevant covariates (i.e., substance use, conduct disorder, young age, …

Broward Mental Health Court: Process, Outcomes, And Service Utilization, John Petrila, Norman Poythress, Annette Mcgaha, Roger Boothroyd

Norman Poythress

Mental health courts are one of a variety of special jurisdiction courts that have been created in a number of countries, including the United States (Petrila, 2003). While there is no prototypical mental health court (Steadman, Davidson, & Brown, 2001; Watson, Luchins, & Hanrahan, 2001), most of those in existence today share several common characteristics. These include (a) the creation of a special docket (usually, but not always, nonviolent misdemeanants with mental illness) that is (b) handled by a particular judge, with (c) a primary goal of diverting defendants from the criminal justice system and into treatment (Goldkamp & Irons-Guynn, …

Metastatic Brain Tumors: Current Therapeutic Options And Historical Perspective, Mark Rivkin, Richard Kanoff

Mark Rivkin

Metastatic brain tumors affect more than 150,000 patients annually in the United States. The therapeutic paradigms for these tumors have evolved over the years and currently encompass numerous modalities implemented by treating physicians across several medical disciplines. The armamentarium of brain tumor treatment involves neurosurgical intervention, whole-brain and focused radiation modalities, chemotherapy, and immunotherapy. Patient selection, however, remains critical to achieve maximal therapeutic benefit and depends on functional status, number and location of lesions, and tissue histologic findings. Best outcomes can be expected with a multidisciplinary approach to patient care where state-of-the-art treatment options are readily available.

Cd4+ Regulatory T Cells Require Ctla-4 For The Maintenance Of Systemic Tolerance, Randall Friedline, David Brown, Hai Nguyen, Hardy Kornfeld, Jinhee Lee, Yi Zhang, Mark Appleby, Sandy Der, Joonsoo Kang, Cynthia Chambers

David C. Brown

Cytotoxic T lymphocyte antigen-4 (CTLA-4) plays a critical role in negatively regulating T cell responses and has also been implicated in the development and function of natural FOXP3(+) regulatory T cells. CTLA-4-deficient mice develop fatal, early onset lymphoproliferative disease. However, chimeric mice containing both CTLA-4-deficient and -sufficient bone marrow (BM)-derived cells do not develop disease, indicating that CTLA-4 can act in trans to maintain T cell self-tolerance. Using genetically mixed blastocyst and BM chimaeras as well as in vivo T cell transfer systems, we demonstrate that in vivo regulation of Ctla4(-/-) T cells in trans by CTLA-4-sufficient T cells is …

Construct Validity Of The Psychopathic Personality Inventory In A Correctional Sample, Ann Marie Sandoval, Danyel Hancock, Norman Poythress, John Edens

Norman Poythress

The relations between the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) and 4 theoretically related constructs (empathy, aggression, work ethic, and borderline personality disorder) were examined. Additionally, the relation between the PPI and heroism was explored. One hundred male inmates were administered the PPI, the Questionnaire Measure of Emotional Empathy (Mehrabian & Epstein, 1972), the Aggression Questionnaire (Buss & Perry, 1992), the Protestant Ethic Scale (Mirels & Garrett, 1971), the Self-Report for Borderline Personality Scale (Oldham et al., 1985), and the Activity Frequency Inventory (Lilienfeld, 1998). As predicted, the PPI was significantly negatively correlated with empathy and significantly positively …

Perioperative Nonopioid Agents For Pain Control In Spinal Surgery., Anna Rivkin, Mark Rivkin

Mark Rivkin

PURPOSE: Commonly used nonopioid analgesic agents that are incorporated into multimodal perioperative pain management protocols in spinal surgery are reviewed. SUMMARY: Spinal procedures constitute perhaps some of most painful surgical interventions, as they often encompass extensive muscle dissection, tissue retraction, and surgical implants, as well as prolonged operative duration. Perioperative nonopioid analgesics frequently used in multimodal protocols include gabapentin, pregabalin, acetaminophen, dexamethasone, ketamine, and nonsteroidal antiinflammatory drugs (NSAIDs). There is evidence to suggest that gabapentin is safe and effective in reducing opioid consumption and pain scores at optimal doses of 600-900 mg orally administered preoperatively. Pregabalin 150-300 mg orally perioperatively …

Middle-Aged Man With Penetrating Trauma To The Pancreaticoduodenal Complex, Thomas Bening, John Bini, Brian Perry, Melanie Richards

John K. Bini

No abstract provided.

Phosphorylation Keeps Pten Phosphatase Closed For Business, Alonzo Ross, Arne Gericke

Arne Gericke

No abstract provided.

Defining Behavioral And Molecular Differences Between Summer And Migratory Monarch Butterflies, Haisun Zhu, Robert Gegear, Amy Casselman, Sriramana Kanginakudru, Steven Reppert

Robert J. Gegear

BACKGROUND: In the fall, Eastern North American monarch butterflies (Danaus plexippus) undergo a magnificent long-range migration. In contrast to spring and summer butterflies, fall migrants are juvenile hormone deficient, which leads to reproductive arrest and increased longevity. Migrants also use a time-compensated sun compass to help them navigate in the south/southwesterly direction en route for Mexico. Central issues in this area are defining the relationship between juvenile hormone status and oriented flight, critical features that differentiate summer monarchs from fall migrants, and identifying molecular correlates of behavioral state. RESULTS: Here we show that increasing juvenile hormone activity to induce summer-like …

The Reported Prevalence Of Mandated Community Treatment In Two Florida Samples, Annette Christy, Roger Boothroyd, John Petrila, Norman Poythress

Norman Poythress

Questions on multiple modes of mandated community treatment (e.g. outpatient commitment, advance directive, representative payee, and special housing) were included in two studies of persons with mental illness, using a mail survey of Medicaid enrollees receiving SSI and interviews conducted as part of an evaluation of a specialty mental health court. Results indicate that the majority of individuals reported no experience with any forms of mandated community treatment. However, respondents from the two samples who had been subject to community mandates reported comparatively similar experiences. Additional studies of the prevalence of mandated community treatment are necessary to garner expanded information …