Medicine and Health Sciences Commons^™

Provider Reimbursement Following The Affordable Care Act, Brandon Bowling, David Newman, Craig White, Ashley Wood, Alberto Coustasse Dr. Ph, Md, Mba

Management Faculty Research

Decreasing healthcare expenditure has been one of the main objectives of the Affordable Care Act (ACA). To achieve this goal, the Centers for Medicare and Medicaid Services (CMS) has been tasked with experimenting with provider reimbursement methods in an attempt to increase quality, while decreasing costs. The purpose of this research was to study the effects of the ACA on physician reimbursement rates from CMS to determine the most cost effective method of delivering healthcare services. CMS has experimented with payment methods in an attempt to increase cost effectiveness. Medicare has offered shared cost savings incentives to reward quality care …

Long-Term Care Policy: What The United States Can Learn From Denmark, Sweden, And The Netherlands, David P. Paul Iii, D.D.S., M.B.A., Ph.D, K. Chad Schaeffer

Management Faculty Research

Paying for long-term care consumes a substantial, and growing, part of the spending on healthcare in the U.S. We examine the components and payment systems for long-term care systems in Denmark, Sweden and the Netherlands to determine what policy makers in the U.S. can learn from these countries about how to improve long-term care provision and financing in the U.S.

Advocacy Efforts In Trauma And Acute Care Surgery: Learning To Walk, Lewis J. Kaplan, Erik Barquist, Donald Jenkins, Orlando C. Kirton

Abington Jefferson Health Papers

No abstract provided.

Combinatorial Efficacy Of Antimicrobial Peptides And Silver Ions, Christina Lynne Chrom

Theses and Dissertations

Antimicrobial peptides are produced by multicellular organisms as a defense against competing pathogenic microbes. The mechanism of action for positively charged antimicrobial peptides is widely believed to occur when the positively charged peptide interacts with the negatively charged outer lipid membrane followed by the insertion of the peptide into the membrane. This insertion into the outer or cytoplasmic membranes leads to disruption of membrane integrity. Alternatively, silver based antimicrobials, which have been well known for centuries, are thought to act by inhibiting the proton motive force, the respiratory electron transport chain, and by affecting membrane permeability resulting in cell death. …

Effectiveness Of Duloxetine And Pregabalin In Diabetic Peripheral Neuropathic Pain Treatment, Nicole L. Mears

Nursing Capstones

No abstract provided.

Reduction Of Airborne Silica Concentration Using A Novel Sand Coating Technology, Elizabeth Rains Lloyd

USF Tampa Graduate Theses and Dissertations

The health effects of silica and the connection to occupational exposure has been known for years. In March of 2016, the Occupational Safety and Health Administration (OSHA) of the Department of Labor (DOL) published a new standard meant to reduce workers’ exposure to silica. The standard update was set forth to further protect workers; OSHA estimates this revision will prevent more than 600 silica-related deaths each year.

A key feature of the updated OSHA standard emphasizes the use of engineering controls and work practices in certain industries. Material handling of industrial sand is a known cause of silica overexposure in …

A Novel Abi-Domain Protein Controls Virulence Determinant Production In Staphylococcus Aureus, Stephanie Michelle Marroquin

USF Tampa Graduate Theses and Dissertations

A major factor in the success of Staphylococcus aureus as a pathogen is its vast arsenal of virulence determinants and, more importantly, the tight and precisely- timed regulation of these factors. Here we investigate the product of the S. aureus gene, SAUSA300_1984, encoding a putative transmembrane protein. This as yet uncharacterized protein belongs to the Abi (abortive infection) family, which are commonly annotated as CAAX-proteases, and are significantly understudied in prokaryotes. In S. aureus the disruption of SAUSA300_1984 results in a drastic reduction of proteolytic and hemolytic activity, as well as diminished pigmentation. This phenotype appears to be mediated through …

2017 March 21 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Mechanosignaling Activation Of Tgfβ Maintains Intervertebral Disc Homeostasis, Qin Bian, Lei Ma, Amit Jain, Janet L. Crane, Khaled Kebaish, Mei Wan, Zhengdong Zhang, X. Edward Guo, Paul D. Sponseller, Cheryle A. Séguin, Lee H. Riley, Yongjun Wang, Xu Cao

Bone and Joint Institute

Intervertebral disc (IVD) degeneration is the leading cause of disability with no disease-modifying treatment. IVD degeneration is associated with instable mechanical loading in the spine, but little is known about how mechanical stress regulates nucleus notochordal (NC) cells to maintain IVD homeostasis. Here we report that mechanical stress can result in excessive integrin αv β6-mediated activation of transforming growth factor beta (TGFβ), decreased NC cell vacuoles, and increased matrix proteoglycan production, and results in degenerative disc disease (DDD). Knockout of TGFβ type II receptor (TβRII) or integrin α v in the NC cells inhibited functional activity of postnatal NC cells …

Immunotherapy Biomarkers 2016: Overcoming The Barriers., James L Gulley, Jay A Berzofsky, Marcus O Butler, Alessandra Cesano, Bernard A Fox, Sacha Gnjatic, Sylvia Janetzki, Shyam Kalavar, Vaios Karanikas, Samir N Khleif, Ilan Kirsch, Peter P Lee, Cristina Maccalli, Holden Maecker, Jeffrey Schlom, Barbara Seliger, Janet Siebert, David F Stroncek, Magdalena Thurin, Jianda Yuan, Lisa H Butterfield

Articles, Abstracts, and Reports

This report summarizes the symposium, 'Immunotherapy Biomarkers 2016: Overcoming the Barriers', which was held on April 1, 2016 at the National Institutes of Health in Bethesda, Maryland. The symposium, cosponsored by the Society for Immunotherapy of Cancer (SITC) and the National Cancer Institute (NCI), focused on emerging immunotherapy biomarkers, new technologies, current hurdles to further progress, and recommendations for advancing the field of biomarker development.

Fatty Acid Biomarker Detection For Breast Cancer Using Differential Mobility Spectrometry With Non-Radioactive Ion Source, James Joseph Alberti

USF Tampa Graduate Theses and Dissertations

Differential Mobility Spectrometry (DMS) using a non-radioactive ion source (NRIS) is investigated as a possible medical diagnostic instrument for near real-time detection of breast cancer biomarkers. In previous clinical studies, concentrations of Linoleic, Palmitic and Stearic fatty acids have been observed at different levels in women with carcinoma breast cancer versus women with benign tumors or healthy women showing no signs of breast cancer. Present diagnostic methods require a biopsy of the suspect tissue and a microscopic lab analysis performed to determine its disease state. This process can take hours or days before the patient and doctor are informed of …

Lactate Dehydrogenase In Toxoplasma Gondii Controls Virulence, Bradyzoite Differentiation, And Chronic Infection, Abdelbaset E. Abdelbaset, Barbara A. Fox, Mohamed H. Karram, Mahmoud R. Abd Ellah, David J. Bzik, Makoto Igarashi

Dartmouth Scholarship

In the asexual stages, Toxoplasma gondii stage converts between acute phase rapidly replicating tachyzoites and chronic phase slowly dividing bradyzoites. Correspondingly, T. gondii differentially expresses two distinct genes and isoforms of the lactate dehydrogenase enzyme, expressing LDH1 exclusively in the tachyzoite stage and LDH2 preferentially in the bradyzoite stage. LDH catalyzes the interconversion of pyruvate and lactate in anaerobic growth conditions and is utilized for energy supply, however, the precise role of LDH1 and LDH2 in parasite biology in the asexual stages is still unclear. Here, we investigated the biological role of LDH1 and LDH2 in the asexual stages, …

The Zika Virus Threat: How Concerns About Scientists May Undermine Efforts To Combat The Pandemic, Thomas G. Safford, Lawrence C. Hamilton, Emily Whitmore

Carsey Publications

Using data from the University of New Hampshire’s October 2016 Granite State Poll, authors Thomas Safford, Lawrence Hamilton, and Emily Whitmore investigate how New Hampshire residents view the Zika crisis. They report that most New Hampshire residents believe Zika is only a minor threat to public health in the United States, and they generally trust the CDC as a source of information about the virus. The data also show that, while there is doubt about the government’s ability to control the spread of the virus, the public feels that emergency federal funding to combat Zika should be a priority. They …

Facing The Ongoing Challenge Of The Febrile Young Infant., Adrienne G. Deporre, Paul L. Aronson, Russell J. Mcculloh

Manuscripts, Articles, Book Chapters and Other Papers

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2017. Other selected articles can be found online at http://ccforum.com/series/annualupdate2017 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901 .

Assessing Women Caregiving Role To People Living With Hiv/Aids In Nigeria, West Africa, Ekaete Asuquo, Josephine B. Etowa, Margaret I. Akpan

School of Nursing & Midwifery, East Africa

HIV/AIDS scourge remains high in most countries of sub-Saharan Africa such as Nigeria, which is home to about 3.3 million HIV positive individuals and represents the second largest burden of HIV/AIDS care, treatment and demand worldwide after South Africa. Anti-retroviral treatment options though a welcome development, has increased the number of people living with this chronic illness, and most of them depend on family members for physical and emotional support. Traditional gender norms in Nigeria ensure that legitimately, women and girls are the first options for caregiving roles. This mandatory role has in turn imposed psychosocial disruption in the lives …

Pseudomonas Aeruginosa Alginate Overproduction Promotes Coexistence With Staphylococcus Aureus In A Model Of Cystic Fibrosis Respiratory Infection, Dominique H. Limoli, Gregory B. Whitfield, Tomoe Kitao, Melissa L. Ivey, Michael R. Davis, Nora Grahl, Deborah A. Hogan, Laurence G. Rahme, P. Lynne Howell, George A. O'Toole, Joanna B. Goldberg

Dartmouth Scholarship

While complex intra- and interspecies microbial community dynamics are apparent during chronic infections and likely alter patient health outcomes, our understanding of these interactions is currently limited. For example, Pseudomonas aeruginosa and Staphylococcus aureus are often found to coinfect the lungs of patients with cystic fibrosis (CF), yet these organisms compete under laboratory conditions. Recent observations that coinfection correlates with decreased health outcomes necessitate we develop a greater understanding of these interbacterial interactions. In this study, we tested the hypothesis that P. aeruginosa and/or S. aureus adopts phenotypes that allow coexistence during infection. We compared competitive interactions of P. aeruginosa …

An Exposure Assessment Of Paper Dust In A Coupon Manufacturing Facility, Danny C. Fink

USF Tampa Graduate Theses and Dissertations

Purpose. Exposures to paper dust, classified as Particulates Not Otherwise Regulated (PNOR), in an industrial setting can cause irritation to the eyes, skin, throat and upper respiratory tract. An exposure assessment was conducted to evaluate the paper dust exposures in the coupon manufacturing facility during a normal production working period. Methods. Total and respirable personal dust sampling was performed according to NIOSH 0500 and 0600 methods. Six total dust samples and seven respirable dust samples were taken within the sampling areas where airborne paper dust was produced to evaluate the Time Weighted Average (TWA) of the exposed employees. Results. Results …

(Not) Everything Is Good And Easy: Language-Related Healthcare Experiences Of Two Groups Of Low-Income Latina Mothers, Aria Anna Walsh-Felz

USF Tampa Graduate Theses and Dissertations

This cross-sectional, comparative, qualitative study explored language-related issues experienced by low-income Spanish-speaking mothers navigating pediatric care for their children in Hillsborough County, Florida. Hospitals, pediatric clinics, specialists, and dental care have differing degrees of linguistic accessibility and accommodations for limited English proficient families. Two groups of mothers were interviewed: bilingual (n=9) and Spanish-speaking limited-English proficient (SSLEP) mothers (n=21). These groups perceived the effect of language on navigating pediatric healthcare differently, creating tension in perceptions and experience between them. Such tensions included SSLEP mothers expressing satisfaction with pediatric care simultaneously with shortcomings in communication. SSLEP mothers said that everything was easy, …

Targeted Disruption Of Tc-Ptp In The Proliferative Compartment Augments Stat3 And Akt Signaling And Skin Tumor Development, Hyunseung Lee, Mihwa Kim, Minwoo Baek, Liza D. Morales, Ik-Soon Jang, Thomas J. Slaga, John Digiovanni, Dae Joon Kim

School of Medicine Publications

Tyrosine phosphorylation is a vital mechanism that contributes to skin carcinogenesis. It is regulated by the counter-activities of protein tyrosine kinases (PTKs) and protein tyrosine phosphatases (PTPs). Here, we report the critical role of T-cell protein tyrosine phosphatase (TC-PTP), encoded by Ptpn2, in chemically-induced skin carcinogenesis via the negative regulation of STAT3 and AKT signaling. Using epidermal specific TC-PTP knockout (K14Cre.Ptpn2fl/fl) mice, we demonstrate loss of TC-PTP led to a desensitization to tumor initiator 7,12-dimethylbenz[a]anthracene (DMBA)-induced apoptosis both in vivo epidermis and in vitro keratinocytes. TC-PTP deficiency also resulted in a significant increase in epidermal thickness …

Clinical & Translational Research In Pneumonia: Defining A Research Agenda For Today And Tomorrow, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

From the Editor in Chief

The reason for this special supplement of the Journal is to inform readers of a scientific research conference supported by the National Institutes of Health (NHI). The NIH Research Conference Grant (R13) supports high quality scientific conferences in areas that are important to the NIH's mission and to the public health. We just received notification that the National Heart, Lung, and Blood Institute (NHLBI) has approved the application for an international research conference entitled: DzClinical & Translational Research in Pneumonia: Defining a Research Agenda for Today and Tomorrowdz. The conference will be held on Wednesday, …

Symptoms Relevant To Surveillance For Ovarian Cancer, Robert M. Ore, Lauren Baldwin, Dylan Woolum, Erika Elliott, Christiaan Wijers, Chieh-Yu Chen, Rachel W. Miller, Christopher P. Desimone, Frederick R. Ueland, Richard J. Kryscio, John R. Van Nagell, Edward J. Pavlik

Obstetrics and Gynecology Faculty Publications

To examine how frequently and confidently healthy women report symptoms during surveillance for ovarian cancer. A symptoms questionnaire was administered to 24,526 women over multiple visits accounting for 70,734 reports. A query of reported confidence was included as a confidence score (CS). Chi square, McNemars test, ANOVA and multivariate analyses were performed. 17,623 women completed the symptoms questionnaire more than one time and > 9500 women completed it more than one four times for > 43,000 serially completed questionnaires. Reporting ovarian cancer symptoms was ~245 higher than ovarian cancer incidence. The positive predictive value (0.073%) for identifying ovarian cancer based on symptoms …

What's Happening: March 20, 2017, Maine Medical Center

What's Happening

No abstract provided.

Ada News - 03/20/2017, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Patient Perceptions Of Clinician's Empathy: Measurement And Psychometrics., Mohammadreza Hojat, Jennifer Desantis, Joseph S. Gonnella

Department of Psychiatry and Human Behavior Faculty Papers

The prominence of reciprocal understanding in patient–doctor empathic engagement implies that patient perception of clinician’s empathy has an important role in the assessment of the patient–clinician relationship. In response to a need for an assessment tool to measure patient’s views of clinician empathy, we developed a brief (5-item) instrument, the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). This review article reports evidence in support of the validity and reliability of the JSPPPE.

Improving Dementia Care Through Online Training Programs: A Systematic Review And Evaluation, Michelle L. Pleasant

USF Tampa Graduate Theses and Dissertations

Over the next thirty years, Alzheimer’s disease rates will increase alongside global aging. To handle the anticipated increase in demand, knowledgeable and skilled dementia caregivers are in need throughout the long-term care spectrum. Online training programs have emerged as a viable and convenient platform to educate both formal and informal caregivers. The first and second study systematically reviewed online dementia training programs and evaluated the CARES® Dementia Basics Training Program among formal and informal caregivers.

The first study is a systematic review of online dementia-based training programs for both formal and informal caregivers conducted using the Preferred Reporting Items for …

Social Integration Therapy For Autism Spectrum Disorder, Ashley Bourgois

Nursing Capstones

No abstract provided.

Greater Dyspnea Is Associated With Lower Health-Related Quality Of Life Among European Patients With Copd, Jean-Bernard Gruenberger, Jeffrey Vietri, Dorothy Keininger, Donald Mahler

Dartmouth Scholarship

OBJECTIVE:

Dyspnea is a defining symptom in the classification and treatment of chronic obstructive pulmonary disease (COPD). However, the degree of variation in burden among symptomatic COPD patients and the possible correlates of burden remain unclear. This study was conducted to characterize patients in Europe currently being treated for COPD according to the level of dyspnea in terms of sociodemographics, health-related quality of life, work productivity impairment, and health care resource use assessed by patient reports.

METHODS:

Data were derived from the 5-EU 2013 National Health and Wellness Survey (N=62,000). Respondents aged ≥40 years who reported currently using a prescription …

Discordance In Investigator-Reported And Adjudicated Sudden Death In Tiospir., Robert A. Wise, Peter R. Kowey, George Austen, Achim Mueller, Norbert Metzdorf, Andy Fowler, Lorcan P Mcgarvey

Department of Medicine Faculty Papers

Accurate and consistent determination of cause of death is challenging in chronic obstructive pulmonary disease (COPD) patients. TIOSPIR (N=17 135) compared the safety and efficacy of tiotropium Respimat 5/2.5 µg with HandiHaler 18 µg in COPD patients. All-cause mortality was a primary end-point. A mortality adjudication committee (MAC) assessed all deaths. We aimed to investigate causes of discordance in investigator-reported and MAC-adjudicated causes of death and their impact on results, especially cardiac and sudden death. The MAC provided independent, blinded assessment of investigator-reported deaths (n=1302) and assigned underlying cause of death. Discordance between causes of death was assessed descriptively (shift …

Systematic Review Of The Delivery Of Mydriacyl To The Inpatient Pediatric Floors At Lvhn For An Ophthalmology Consultation., Christopher Barron

USF-LVHN SELECT

No abstract provided.

Severe-Range Hypertension In The Peripartum Period: Are We Providing Appropriate And Timely Care?, Tiana M.D. Guillaume, Francine Miranda Rn, Marion B. Nihen Md

USF-LVHN SELECT

No abstract provided.