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Donut Hole Summer 2015, Medicare Donations & Design Committee

Donut Hole Newsletter

No abstract provided.

The Psychosocial Effects Of Dysphagia, Allison Dawn Lotter

ETD Archive

The purpose of this study is to determine the psychosocial effects of dysphagia in adults with a non-terminal, non-progressive medical condition. Additionally, this study aims to provide potential differences in the psychosocial effects of dysphagia given gender and age range. This information is crucial for speech-language pathologists (SLPs) to better understand the psychosocial consequences of dysphagia and provide a more comprehensive and appropriate approach to therapy. This study is a pseudo-qualitative design that includes adults, age 20-90 years old, diagnosed with dysphagia secondary to a non-progressive, non-terminal medical condition. Descriptive statistics revealed that there are psychosocial effects of dysphagia, which …

Communicative Behaviors Of Sibling Dyads With A Child With Autism, Ashley Marie Hodge

ETD Archive

The puropse of this study was to document the communicative behaviors exhibited by sibling dyads comprised of one typically developing child (TDC) and their sibling diagnosed with autism spectrum disorder (SibA). Six families (five families were Caucasian and one family was African American) participated in one 45-minute home observation, one semi-structured interview with the TDCs, and one semi-structured interview with the parents. Sibling dyads varied across birth order, ages, and genders. Observations revealed that the sibling dyads produced a variety of communicative behaviors. Observational data were coded to provide information on the types of communicative behaviors produced and their frequency …

Early Initiation Of Antiretroviral Therapy Can Functionally Control Productive Hiv-1 Infection In Humanized-Blt Mice, Qingsheng Li, For Yue Tso, Guobin Kang, Wuxun Lu, Yue Li, Wenjin Fan, Zhe Yuan, Christopher J. Destache, Charles Wood

Nebraska Center for Virology: Faculty Publications

Background—Recent reports showed that functional control of HIV-1 infection for a prolonged time is possible by early anti-retroviral therapy (ART); however its underlying mechanism needs to be studied with a suitable animal model. Recently, humanized-BLT (bone marrow, liver and thymus) mouse (hu-BLT) was shown to be an excellent model for studying HIV-1 infection. We thus tested the feasibility of studying functional control of HIV-1 infection using hu-BLT mice.

Methods—Animals in three treatment groups (Rx-6h, Rx-24h, Rx-48h) and untreated group were infected with HIV-1, followed by ART initiation at 6, 24 or 48 hours post-infection and continued daily for two weeks. …

The Role Of Dendritic Cell Subsets And Innate Immunity In The Pathogenesis Of Type 1 Diabetes And Other Autoimmune Diseases, Jeffrey D. Price, Kristin V. Tarbell

Nebraska Center for Virology: Faculty Publications

Dendritic cells (DCs) are key antigen-presenting cells that have an important role in autoimmune pathogenesis. DCs control both steady-state T cell tolerance and activation of pathogenic responses. The balance between these two outcomes depends on several factors, including genetic susceptibility, environmental signals that stimulate varied innate responses, and which DC subset is presenting antigen. Although the specific DC phenotype can diverge depending on the tissue location and context, there are four main subsets identified in both mouse and human: conventional cDC1 and cDC2, plasmacytoid DCs, and monocyte-derived DCs. In this review, we will discuss the role of these subsets in …

Analysis Of Lean/Six Sigma Production Model In A Tertiary Care Asthma And Allergy Clinlic, Erika Lynn Bullert, Laura Johnson, Ariel M. Schibilla

All Electronic Theses and Dissertations

In response to demands on healthcare, systems have looked to refine current processes to use time, materials, and finances more efficiently. Lean/Six Sigma (L/SS) is a model that has been used to improve procedural efficiency in various settings. The purpose of this study was to implement L/SS into an outpatient private practice setting and to evaluate the effect on efficiency as measured in the length of individual patient visits who presented to that clinic for routine re-evaluation. In this study, the amount of time between a patient’s entrance and exit from the clinic was documented for 878 patients before implementation …

Records Review Of Musculoskeletal Injuries In Aeromedical Evacuation Personnel, Jennifer L. Serres, Brittany L. Fouts, Susan F. Dukes, Genny M. Maupin, Molly E. Wade

United States Air Force: Publications

Background: Aeromedical evacuation providers care for patients during air transport. By applying standard medical practices, oftentimes developed for ground care, these practitioners perform their mission duties under additional physical stress in this unique medical environment. Awkward postures and excessive forces are common occurrences among personnel operating in this domain. Additionally, anecdotal reports highlight the risk of developing musculoskeletal injuries for these providers. Currently, there is limited research focusing on musculoskeletal injuries in aeromedical evacuation providers.

Purpose: To determine the prevalence of musculoskeletal injuries and associated symptoms in aeromedical evacuation providers to understand the risk and burden of these injuries to …

Vcu Health: Adult & Pediatric Inpatient Pain Communication Guide (Algorithm), Veronica Nolden, Jessica Keiser

VCU Health Nursing

Abstract Related to Algorithm:

Description/Background

Improving pain management is a priority for all healthcare providers, yet the process for how pain is assessed, reported and resolved often lacks a defined process. This lack of structure can lead to delays in pain control for patients and frustrations within healthcare teams. In an effort to facilitate patient-centered care, an interdisciplinary workgroup was constructed to address this process.

Action

In order to eliminate delays and define a process for pain management, an interdisciplinary workgroup utilized performance improvement processes to develop a communication algorithm. The group membership included nurses, physicians, advanced practice providers, nursing …

Beyond The Colonial Divide: African Diasporic And Indigenous Youth Alliance Building For Hiv Prevention, Ciann L. Wilson

Psychology Faculty Publications

African diasporic and North American Indigenous communities have both been greatly impacted by the colonization of the Americas. Historic and contemporary relations between these communities have been fraught with complex commonalities, contradictions and conflicts. These communities have remained connected across time and space through their shared and distinct histories of resistance and oppression. Both communities have suffered the embodiment of systemic violence in the form of elevated rates of communicable and chronic diseases such as HIV. This paper examines the decolonizing potential of collaboration between these two communities in their response to HIV. It begins by unpacking the history of …

Tweeting About Sexism: The Well-Being Benefits Of A Social Media Collective Action., Mindi D. Foster

Psychology Faculty Publications

Although collective action has psychological benefits in non-gendered contexts (e.g., Drury et al., 2005), the benefits for women taking action against gender discrimination are unclear. This study examined how a popular, yet unexplored potential form of collective action, namely tweeting about sexism, affects women’s well-being. Women read about sexism and were randomly assigned to tweet, or to one of three control groups. Content analyses showed tweets exhibited collective intent and action. Analyses of linguistic markers suggested public tweeters used more cognitive complexity in their language than private tweeters. Profile analyses showed that compared to controls, only public tweeters showed decreasing …

The Nichd Protocol: A Review Of An Internationally-Used Evidence-Based Tool For Training Child Forensic Interviewers, David La Rooy, Sonja P. Brubacher, Anu Aromäki-Stratos, Mireille Cyr, Irit Hershkowitz, Julia Korkman, Trond Myklebust, Makiko Naka, Carlos E. Peixoto, Kim Roberts, Heather Stewart, Michael E. Lamb

Psychology Faculty Publications

This article reviews an evidence-based tool for training child forensic interviewers called the NICHD Protocol, and the relevant research on: children’s memory development; communication; suggestibility; the importance of open-prompts, and challenges associated with interview training. We include international contributions from experienced trainers, practitioners, and scientists, who are already using the Protocol or whose national or regional procedures have been directly influenced by the NICHD Protocol research (Canada, Finland, Israel, Japan, Korea, Norway, Portugal, Scotland, and United States). Throughout the review, these experts comment on: how and when the Protocol was adopted in their country; who uses it; challenges to implementation …

Developmental Differences In The Ability To Provide Temporal Information About Repeated Events, Kim P. Roberts, Sonja P. Brubacher, Donna M. Drohan-Jennings, Una Glisic, Martine B. Powell, William J. Friedman

Psychology Faculty Publications

Children (n = 372) aged 4 - 8 years participated in 1 or 4 occurrences of a similar event and were interviewed 1 week later. Compared to 85% of children who participated once, less than 25% with repeated experience gave the exact number of times they participated, although all knew they participated more than once. Children with repeated experience were asked additional temporal questions and there were clear developmental differences. Older children were more able than younger children to judge relative order and temporal position of the four occurrences. They also demonstrated improved temporal memory for the first and …

Observations From Canadian Practitioners About The Investigation And Prosecution Of Crimes Involving Child And Adult Witnesses, Sean Curtis Cameron, Kim P. Roberts

Psychology Faculty Publications

Hundreds of scientific studies on the competencies and limitations of eyewitnesses have been published, but few have sought input from front-line forensic interviewers. In the current study, a research agenda was established with in-depth input from 13 forensic interviewers. Interviewers indicated which techniques they use most often, rated the usefulness of various interview techniques, and disclosed common challenges when interviewing. Although many recommended techniques were used (e.g., the Cognitive Interview and Rapport Building), some techniques shown to be effective in eliciting quality testimony in scientific studies were not always used or considered useful by front-line interviewers (e.g., permission to correct …

Virginia Dental Journal (Vol. 92, No. 3, 2015)

Virginia Dental Journal

No abstract provided.

Is It Time To Consider The "Burnout Syndrome" A Distinct Illness?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The "burnout syndrome" has been defined as a combination of emotional exhaustion, depersonalization, and reduced personal accomplishment caused by chronic occupational stress. Although there has been increasing medical interest in burnout over the last decades, it is argued in this paper that the syndrome cannot be elevated to the status of diagnostic category, based on (1) an analysis of the genesis of the burnout construct, (2) a review of the latest literature on burnout-depression overlap, (3) a questioning of the three-dimensional structure of the burnout syndrome, and (4) a critical examination of the notion that burnout is singularized by its …

Orbitofrontal 18f-Dopa Uptake And Movement Preparation In Parkinson’S Disease, Lucio Marinelli, Arnoldo Piccardo, Laura Mori, Silvia Morbelli, Nicola Girtler, Antonio Castaldi, Agnese Picco, Carlo Trompetto, Maria Felice Ghilardi, Giovanni Abbruzzese, Flavio Nobili

Publications and Research

In Parkinson’s disease (PD) degeneration of mesocortical dopaminergic projections may determine cognitive and behavioral symptoms. Choice reaction time task is related to attention, working memory, and goal-directed behavior. Such paradigm involves frontal cortical circuits receiving mesocortical dopamine which are affected early in PD. The aim of this study is to characterize the role of dopamine on the cognitive processes that precede movement in a reaction time paradigm in PD.We enrolled 16 newly diagnosed and untreated patientswith PDwithout cognitive impairment or depression and 10 control subjectswith essential tremor. They performed multiple-choice reaction time task with the right upper limb and brain …

What Are The Relationships Among Cumulative Trauma, Posttraumatic Stress Disorder, Sleep Quality, And Perinatal Outcomes In African American Women?, Nancy J. Hauff

Wayne State University Dissertations

WHAT ARE THE RELATIONSHIPS AMONG CUMULATIVE TRAUMA, POSTTRAUMATIC STRESS DISORDER, SLEEP QUALITY, AND PERINATAL OUTCOMES IN AFRICAN-AMERICAN WOMEN?

NANCY J. HAUFF, MSN, RN

May 2015

Advisor: Judith Fry-McComish, PhD, RN, FAAN, IMH-IV, E

Major: Nursing

Degree: Doctor of Philosophy

Trauma, primarily in the form of intimate partner violence and automobile accidents, accounts for 6-8% of all pregnancy complications. Much less is known about cumulative trauma (CT) exposure especially in African-American women. Women exposed to several types of trauma including childhood abuse, discrimination, or witnessed family violence may develop symptoms of posttraumatic stress or have difficulty sleeping.

The purpose of this …

College Student Adjustment: Examination Of Personal And Environmental Characteristics, Aleksandra M. Stoklosa

Wayne State University Dissertations

This study used a multi-dimensional model of college adjustment to examine the relationships between multiple layers of personal influences and college adjustment (academic, social, personal/emotional, attachment to the institution, and overall adjustment) among emerging adults in a large urban university. The sample included 177 undergraduate students, ages 18-25, attending Wayne State University, who completed on-line questionnaires. Race and cumulative college GPA were related to academic adjustment. Being Arabic/Middle-Eastern was a consistent predictor of college adjustment. It was found that higher college GPA and being White was related to higher academic adjustment, while being Arabic/Middle-Eastern was related to lower academic adjustment. …

Evidence Of Distinctive Structural Alterations That Differentiate Adhd Boys With And Without A Comorbid Reading Disability, Dhruman Dilip Goradia

Wayne State University Dissertations

Attention deficit hyperactivity disorder (ADHD) and reading disability (RD) are neurodevelopmental disorders that often co-occur. Children with ADHD and co-occurring RD (ADHD/+RD) tend to show greater cognitive deficits than children with ADHD alone (ADHD/-RD). However, the extents to which comorbid RD impact structural alteration in children with ADHD have never been investigated. The overall goal of this study was to assess structural alterations in the subcortical, cortical and white matter that may differentiate ADHD/-RD from ADHD/+RD. The general hypothesis was that ADHD/+RD would show extensive alterations in regions implicated in ADHD than ADHD/-RD as well as show additional abnormalities in …

A Multiple Case Exploration Of Designers And Reflection In The Design Space, Tamme L. Quinn Grzebyk

Wayne State University Dissertations

For decades, scholars have searched for ways to more effectively teach and practice instructional design. A variety of strategies have been employed to address the ambiguity in and challenges of the field. Much of the focus in the education of instructional designers has been on teaching students how best to use the many models developed for the field (Rowling, 1992). These efforts, while meant to help the new instructional designer succeed, have often been stifled by the ever-changing landscape of what instructional designers are asked to do in their roles after graduation (Kenny, Zhang, Schwier, & Campbell, 2005). Other research …

The Experiences Of Black American Older Adults Managing Pain: A Nursing Ethnography, Sheria Grice Robinson

Wayne State University Dissertations

Introduction: Pain can negatively affect quality of life for Black elders. They are less likely to report pain concerns and have voiced pain needs adequately met. To better understand the pain management experiences and concerns of Black elders, an ethnographic study was completed within an urban, low-income, elder housing facility. Methods: 106 participants completed a questionnaire comprised of a demographic tool, the PROMIS Global Health Scale (PROMIS), the Brief Pain Inventory (BPI), and the Psychological Stress Measure (PSM-9). Additionally, participant observation, informal interviews, and 20 formal recorded interviews with individuals identified as having pain were completed. Qualitative and frequency analysis …

Assessing The Impact Of Native American Elders As Co-Educators For University Students In Stem, Sarah Omar Alkholy

Wayne State University Dissertations

Introduction: Minorities are underrepresented in the science, technology, engineering, and mathematics (STEM) workforce, post-secondary STEM education, and show high academic attrition rates. Academic performance and retention improve when culturally relevant support is provided. The interface of Western Science and Indigenous Science provides an opportunity for bridging this divide. This three parts project is an example of Community-based participatory research (CBPR) that aims to support academic institutions that serve minority students in STEM, and implement educational components (pedagogy) to serve the needs of the underserved community. Method: Part 1: was a cross-sectional used a survey given to participants designed to assess …

Novel Incorportation Of Biomedical Engineering Algorithms (Bispectral Index Guided Or Anesthetic Concentration Guided) In Real-Time Decision Support To Prevent Intraoperative Awareness Using An Electronic Anesthesia Information Mananagement System, Amy Melanie Shanks

Wayne State University Dissertations

Background: Intraoperative awareness with explicit recall (AWR) is a feared complication of surgery that can lead to significant psychological distress. Several large prospective trials have been completed comparing two methods of monitoring anesthetic depth [minimum alveolar concentration (MAC) or electroencephalography (EEG) monitoring using the bispectral index (BIS)] for the prevention of AWR. However, these trials were conducted in high risk populations, limiting generalizability.

Research Hypothesis: Real-time decision support with Anesthesia Information Management System alerts based on a novel anesthetic concentration algorithm (incorporating the use of intravenous anesthetics) or an EEG-guided algorithm will reduce the known incidence of AWR.

Methods: First, …

What Impacts Life Satisfaction Of Aging Adults Following Stressful Life Events?: An Examination Of The Buffering Effect Of Personal Resources, Cassandra Barragan

Wayne State University Dissertations

Purpose: Existing research has shown that elders experience changes in their life satisfaction following stressful life events. There is an abundance of literature supporting the predictive nature of not only stressful life events on life satisfaction, but social support, autonomy, and financial security. What the literature is lacking, is examination of the buffering effect of social support, autonomy, and financial security on the relationship between stressful life events and life satisfaction. This study hypothesizes that increases in social support, autonomy, and financial security will buffer the impact of SLEs for elders and thus, they will experience increases in their life …

Neural Alterations Influencing Skilled Reading In Adhd: A Task-Based Fmri Study, Brianne Mohl

Wayne State University Dissertations

Attention-Deficit/Hyperactivity Disorder (ADHD) is a heterogeneous, neurodevelopmental disorder which co-occurs often with Reading Disability (RD). ADHD with and without RD consistently have higher inattentive ratings compared with typically developing controls, with co-occurring ADHD and RD (ADHD/+RD) also demonstrating impaired phonological processing. Accordingly, inattention has been associated with greater phonological impairment, though neither the neural correlates of the co-occurring disorders nor the association are well understood from a functional neuroimaging perspective. The goal was to assess to what extent ADHD/+RD differ from ADHD without RD (ADHD/-RD) and typically developing controls (TDC) in functional activation of attention- and reading-related areas during various …

Modeling And Optimization Of Non-Profit Hospital Call Centers With Service Blending, Yanli Zhao

Wayne State University Dissertations

This dissertation focuses on the operations problems in non-profit hospital call centers with inbound and outbound calls service blending.

First, the routing policy for inbound and outbound calls is considered. The objective is to improve the system utilization under constraints of service quality and operators' quantity. A collection of practical staffing assignment methods, separating and mixing staffing policy are evaluated. Erlang C queuing model is used to decide the minimum number of operators required by inbound calls. Theoretical analysis and numerical experiments illustrate that through dynamically assigning the inbound and outbound calls to operators under optimal threshold policy, mixing staffing …

Cerium Oxide Nanoparticles Attenuate Polymicrobial Sepsis Induced Splenic Damage In Male Sprague Dawley Rats, Venkata Vinay Kumar Bandarupalli

Theses, Dissertations and Capstones

Sepsis is a serious life threatening medical emergency which, if not treated properly, oftentimes results in organ failure and death. Current sepsis treatment protocols are largely centered on the use of antibiotics and supportive care. Recent studies have suggested that antibiotics fail to be effective for sepsis treatment when administered during hypo-dynamic phase of sepsis that is usually characterized by the presence of a cytokine storm. As such, there is an urgent need to develop novel therapeutic drugs that target the inflammatory cytokines that are secreted as a result of increased reactive oxygen species. Cerium oxide nanoparticles (CeO2) have been …

Adipose-Derived Mesenchymal Stem Cells Improve Glucose Homeostasis In High-Fat Diet-Induced Obese Mice, Mingjun Cao, Qingjie Pan, Huanshen Dong, Xinxu Yuan, Yang Li, Zhen Sun, Xiao Dong, Hongjun Wang

Pharmacology and Toxicology Publications

Introduction

Effective therapies for obesity and diabetes are still lacking. The aim of this study was to evaluate whether a single intravenous infusion of syngeneic adipose-derived mesenchymal stem cells (ASCs) can reduce obesity, lower insulin resistance, and improve glucose homeostasis in a high-fat diet-induced obese (DIO) mouse model.

Methods

Seven-week-old C57BL/6 mice were fed a high-fat diet for 20 weeks to generate the DIO mouse model. Mice were given a single intravenous infusion of ex vivo expanded syngeneic ASCs at 2 × 10 ⁶ cells per mouse. DIO or CHOW mice injected with saline were used as controls. Body weights, …

Effects Of Menthol On Nicotine Pharmacokinetic, Pharmacology And Dependence In Mice, Sharki D. Alsharari, Justin R. King, Jacob C. Nordman, Pretal P. Muldoon, Asti Jackson, Andy Z. X. Zhu, Rachel F. Tyndale, Nadine Kabbani, M. Imad Damaj

Pharmacology and Toxicology Publications

Although menthol, a common flavoring additive to cigarettes, has been found to impact the addictive properties of nicotine cigarettes in smokers little is known about its pharmacological and molecular actions in the brain. Studies were undertaken to examine whether the systemic administration of menthol would modulate nicotine pharmacokinetics, acute pharmacological effects (antinociception and hypothermia) and withdrawal in male ICR mice. In addition, we examined changes in the brain levels of nicotinic receptors of rodents exposed to nicotine and menthol. Administration of i.p. menthol significantly decreased nicotine’s clearance (2-fold decrease) and increased its AUC compared to i.p. vehicle treatment. In addition, …

Contribution Of Nrf2 To Atherogenic Phenotype Switching Of Coronary Arterial Smooth Muscle Cells Lacking Cd38 Gene, Ming Xu, Xiao-Xue Li, Lei Wang, Mi Wang, Yang Zhang, Pin-Lan Li

Pharmacology and Toxicology Publications

Background/Aims: Recent studies have indicated that CD38 gene deficiency results in dedifferentiation or transdifferentiation of arterial smooth muscle cells upon atherogenic stimulations. However, the molecular mechanisms mediating this vascular smooth muscle (SMC) phenotypic switching remain unknown. Methods & Results: In the present study, we first characterized the phenotypic change in the primary cultures of coronary arterial myocytes (CAMs) from CD38-/- mice. It was shown that CD38 deficiency decreased the expression of contractile marker calponin, SM22α and α-SMA but increased the expression of SMC dedifferentiation marker, vimentin, which was accompanied by enhanced cell proliferation. This phenotypic change in CD38-/- CAMs was …