Medicine and Health Sciences Commons^™

Organizational Characteristics And Restraint Use For Hospitalized Nursing Home Residents., Meg Bourbonniere, Neville E. Strumpf, Lois K. Evans, Greg Maislin

College of Nursing Faculty Papers & Presentations

OBJECTIVES: To examine the effect of organizational characteristics on physical restraint use for hospitalized nursing home residents.

DESIGN: Secondary analysis of data obtained between 1994 to 1997 in a prospective phase lag design experiment using an advanced practice nurse (APN) intervention aimed at reducing physical restraint for a group of hospitalized nursing home residents.

SETTING: Eleven medical and surgical units in one 600-bed teaching hospital.

PARTICIPANTS: One hundred seventy-four nursing home residents aged 61 to 100, hospitalized for a total of 1,085 days.

MEASUREMENTS: Physical restraint use, APN intervention, age, perceived fall risk, behavioral phenomena, perceived treatment interference, mental state, …

Genetic Polymorphisms Of The Interleukin-1 Gene And Early Marginal Bone Loss Around Endosseous Dental Implants, Hitomi Shimpuku, Yasuhiro Nosaka, Tatsuya Kawamura, Yoichi Tachi, Mitsuko Shinohara, Kiyoshi Ohura

Faculty, Staff and Student Publications

Dental implant surgery commonly proceeds in two stages. It is generally accepted that bone loss around implants does not occur at stage-II surgery because implants do not receive mechanical loading. However, early marginal bone loss around implants occasionally does occur during the healing period. Genetic polymorphisms in the interleukin-1 (IL-1) gene have been reported to be important for bone homeostasis and susceptibility to bone disease. We therefore investigated whether the idiopathic early marginal bone loss around implants is related to polymorphisms in the IL-1 gene. We performed a case-control study. Patients demonstrating marginal bone loss around implants at stage-II surgery …

Gaze-Centered Updating Of Visual Space In Human Parietal Cortex., W Pieter Medendorp, Herbert C Goltz, Tutis Vilis, J Douglas Crawford

Brain and Mind Institute Researchers' Publications

Single-unit recordings have identified a region in the posterior parietal cortex (PPC) of the monkey that represents and updates visual space in a gaze-centered frame. Here, using event-related functional magnetic resonance imaging, we identified an analogous bilateral region in the human PPC that shows contralateral topography for memory-guided eye movements and arm movements. Furthermore, when eye movements reversed the remembered horizontal target location relative to the gaze fixation point, this PPC region exchanged activity across the two cortical lobules. This shows that the human PPC dynamically updates the spatial goals for action in a gaze-centered frame.

The Lateral Occipital Complex Subserves The Perceptual Persistence Of Motion-Defined Groupings., Susanne Ferber, G Keith Humphrey, Tutis Vilis

Brain and Mind Institute Researchers' Publications

How are the bits and pieces of retinal information assembled and integrated to form the coherent objects that we see? One long-established principle is that elements that move as a group are linked together. For instance a fragmented line-drawing of an object, placed on a background of randomly distributed short lines, can be impossible to see. But if the object moves relative to the background, its shape is instantly recognized. Even after the motion stops, the percept of the object persists briefly before it fades into the background of random lines. Where in the brain does the percept of the …

Children With Disturbances In Sensory Processing: A Pilot Study Examining The Role Of The Parasympathetic Nervous System., Roseann C. Schaaf, Lucy Jane Miller, Duncan Seawell, Shannon O'Keefe

Department of Occupational Therapy Faculty Papers

This study was a preliminary investigation of parasympathetic nervous system (PNS) functioning in children with disturbances in sensory processing. The specific aims of this study were to (1) provide preliminary data about group differences in parasympathetic functions, as measured by the vagal tone index, between children with disturbances in sensory processing and those without; (2) determine effect size and power needed for future studies; and (3) to lay the foundation for further examination of the relations of parasympathetic functioning and functional behavior in children with disturbances in sensory processing. Participants were 15 children, nine with disturbances in sensory processing and …

Adolescent Violence Prevention: A Case Presentation, Hatim A. Omar, Joan Griffith

Pediatrics Faculty Publications

Violence in adolescence has seen an increase since the 1990s with dramatic statistics on violent death and risk behaviors. School violence has been focused upon by a huge media coverage of especially violent cases that could have had some endemic consequences worldwide. We present a case of a 14 year old white male with change in school behavior, strategies for the case investigation, its results, and long term prevention. Other research has shown that preventive measures during pregnancy, infancy and childhood can prevent adolescent and adult delinquency.

Requirement For The Betai And Betaiv Tubulin Isotypes In Mammalian Cilia., Heather C Jensen-Smith, Richard F Ludueña, Richard Hallworth

Journal Articles: Eppley Institute

Nielsen et al., [2001: Curr Biol 11:529-533], based on studies in Drosophila, have proposed that beta tubulin in axonemal microtubules must contain a specific acidic seven amino acid sequence in its carboxyl terminus. In mammals, the two betaIV isotypes (betaIVa and betaIVb) contain that sequence. In order to test the application of this hypothesis to mammals, we have examined the expression of beta tubulin isotypes in four different ciliated tissues (trachea, ependyma, uterine tube, and testis) using isotype-specific antibodies and indirect immunofluorescence. We find that betaIV tubulin is present in all ciliated cell types examined, but so is betaI tubulin. …

Copper Chelation Represses The Vascular Response To Injury, Lazar Mandinov, Anna Mandinova, Stanimir Kyurkchiev, Dobroslav Kyurkchiev, Ivan Kehayov, Vihren Kolev, Raffaella Soldi, Cinzia Bagala, Ebo D. De Muinck, Volkhard Lindner, Mark J. Post, Michael Simons

Dartmouth Scholarship

The induction of an acute inflammatory response followed by the release of polypeptide cytokines and growth factors from peripheral blood monocytes has been implicated in mediating the response to vascular injury. Because the Cu2+-binding proteins IL-1alpha and fibroblast growth factor 1 are exported into the extracellular compartment in a stress-dependent manner by using intracellular Cu2+ to facilitate the formation of S100A13 heterotetrameric complexes and these signal peptideless polypeptides have been implicated as regulators of vascular injury in vivo, we examined the ability of Cu2+ chelation to repress neointimal thickening in response to injury. We observed that the oral administration of …

Effects Of Ethanol On Anti-Saccade Task Performance., Sarah A Khan, Kristen Ford, Brian Timney, Stefan Everling

Brain and Mind Institute Researchers' Publications

It has been shown that saccade-related neurons in the superior colliculus (SC) display an increased level of prestimulus activity and a higher stimulus-related burst in action potentials preceding direction errors in the anti-saccade task compared with correct anti-saccades. From this, it has been hypothesized that errors occur when the incoming visual signal in the SC passes a threshold and triggers a reflexive saccade. This hypothesis predicts that an attenuated visual signal will reduce the number of direction errors. Since ethanol has been shown to have a suppressive effect on cortical visual event-related potentials (ERPs), the purpose of the present study …

Hierarchical Processing In Spoken Language Comprehension., Matthew H Davis, Ingrid Johnsrude

Brain and Mind Institute Researchers' Publications

Understanding spoken language requires a complex series of processing stages to translate speech sounds into meaning. In this study, we use functional magnetic resonance imaging to explore the brain regions that are involved in spoken language comprehension, fractionating this system into sound-based and more abstract higher-level processes. We distorted English sentences in three acoustically different ways, applying each distortion to varying degrees to produce a range of intelligibility (quantified as the number of words that could be reported) and collected whole-brain echo-planar imaging data from 12 listeners using sparse imaging. The blood oxygenation level-dependent signal correlated with intelligibility along the …

Cell-Cycle Regulatory Proteins In Podocyte Cell In Idiopathic Nephrotic Syndrome Of Childhood., Tarak Srivastava, Robert E. Garola, J M. Whiting, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The podocyte cell is believed to play an important role in idiopathic nephrotic syndrome (INS) of childhood. In adults with cellular and collapsing focal segmental glomerulosclerosis (FSGS), the expression of cell-cycle regulatory proteins such as p27, p57, and cyclin D is decreased and expression of cyclin A, Ki-67, and p21 is observed in podocyte cells suggestive of a dysregulated podocyte phenotype. We investigated for alterations in the expression of cyclin kinase inhibitors, p27, p57, p21, and cyclins D and A in the podocyte cell of children with INS.

METHODS: Forty-two kidney biopsies were investigated; 14 with minimal-change disease (MCD), …

Tacrolimus As A Liver Flush Solution To Ameliorate The Effects Of Ischemia/Reperfusion Injury Following Liver Transplantation., Shawn D. St Peter, David J. Post, Manuel I. Rodriguez-Davalos, David D. Douglas, Adyr A. Moss, David C. Mulligan

Manuscripts, Articles, Book Chapters and Other Papers

The goal of this report is to evaluate in a prospective randomized fashion the effect of flushing hepatic allografts with tacrolimus before transplantation. A prospective, double-blinded, randomized trial was performed. Twenty patients receiving orthotopic liver transplants from October 2000 to October 2001 were randomized into two groups. Group 1 (active) was administered tacrolimus, 20 ng/mL, plus Plasma-lyte A (Baxter Healthcare Corp, Deerfield, IL) liver flush solution; and group 2 (placebo) was administered only Plasma-lyte A. Ischemia/reperfusion injury was assessed in both groups after transplantation by means of serum laboratory values to assess hepatocellular damage, synthetic function, and ion transport capacity. …

Educating Adolescents About Puberty: What Are We Missing?, Hatim A. Omar, Darby H. Mcelderry, Rana M. Zakharia

Pediatrics Faculty Publications

Adolescents undergo significant physical and cognitive changes during their pubertal development. These changes contribute to and impact their future development. Educating adolescents at an early age about their expected development decreases the possible anxiety associated with this period of life and also helps adolescents make better choices in regards to their sexuality. In order to assess the degree of education regarding pubertal development and sexuality, we conducted a survey of late adolescents (Median age 19 years) and parents of adolescents. A total of 409 adolescents (237 females, 172 males) and 124 parents completed the survey. 14.4% of teens (36.6% of …

Sex Education In The Schools: What Role Does It Play?, Darby H. Mcelderry, Hatim A. Omar

Pediatrics Faculty Publications

Information regarding pubertal development, sex, pregnancy, and contraception should be provided to children and adolescents in an age-appropriate manner from parents, health care providers, and schools. This article reviews the medical literature on school sex education programs, adolescents' perception of these programs, and the role played by the media, parents, and health care professionals in sexual education of teens.

Parenting Adolescents, Sandra L. D'Angelo, Hatim A. Omar

Pediatrics Faculty Publications

The period of adolescence is often thought to be one of intense stress and turmoil. Yet many parents and teens negotiate this developmental stage without extreme family conflict and without sacrificing close relationships. This review summarizes a portion of the literature on parent-adolescent relationships, focusing on monitoring and control of adolescent behavior and parenting style. Basic principles to emphasize when working with adolescents and parents are also included.

Family Connectedness And Sexual Risk-Taking Among Urban Youth Attending Alternative High Schools, Christine M Markham, Susan R Tortolero, S Liliana Escobar-Chaves, Guy S Parcel, Ronald Harrist, Robert C Addy

Faculty, Staff and Student Publications

CONTEXT: Youth in alternative high schools engage in risky sexual behavior at higher rates than do their peers in regular schools, placing themselves at an increased risk of sexually transmitted disease and unintended pregnancy. Family connectedness is associated with reduced adolescent sexual risk-taking, although this association has not been tested among alternative school youth.

METHODS: A sample of 976 urban, predominantly minority alternative high school students in Houston, Texas, were surveyed in 2000-2002. Survey data were analyzed using logistic regression to determine whether family connectedness is related to sexual risk-taking.

RESULTS: Overall, 68% of students reported ever having had sex. …

Development And Validation Of A Professional Behavior Assessment., Kristie Koenig, Caryn Johnson, Cathleen K Morano, Joseph P Ducette

Department of Occupational Therapy Faculty Papers

Allied health students must quickly socialize into a professional role as they transition from classroom to clinic. In addition to skill development, students must exhibit a host of professional behaviors that facilitate successful interaction with patients, families, and colleagues. There is a need for a valid, reliable assessment of professional behaviors that contribute to clinical competence. This study reports on the development and validation of a professional behavior assessment for occupational therapy students on a part-time clinical rotation (Level I). The Philadelphia Region Fieldwork Consortium (PRFC) Level I Student Evaluation was developed from an initial survey (n = 75) to …

A 12-Year Prospective Study Of The Long-Term Effects Of Early Child Physical Maltreatment On Psychological, Behavioral, And Academic Problems In Adolescence, Jennifer E Lansford, Kenneth A Dodge, Gregory S Pettit, John E Bates, Joseph Crozier, Julie Kaplow

Faculty, Staff and Students Publications

OBJECTIVE: To determine whether child physical maltreatment early in life has long-term effects on psychological, behavioral, and academic problems independent of other characteristics associated with maltreatment.

DESIGN: Prospective longitudinal study with data collected annually from 1987 through 1999.

SETTING AND PARTICIPANTS: Randomly selected, community-based samples of 585 children from the ongoing Child Development Project were recruited the summer before children entered kindergarten in 3 geographic sites. Seventy-nine percent continued to participate in grade 11. The initial in-home interviews revealed that 69 children (11.8%) had experienced physical maltreatment prior to kindergarten matriculation.

MAIN OUTCOME MEASURES: Adolescent assessment of school grades, standardized …

Effectiveness Of Nutrition Counseling In Young Adult Males, D. R. Williams, Nancy M. Lewis

Department of Nutrition and Health Sciences: Faculty Publications

The purpose of this project was to determine if the addition of a laboratory measurement, i.e., measurement of serum cholesterol, would increase the effectiveness of nutrition counseling in young men. Subjects were a random sample of 45 healthy male students from a Midwestern university, between the ages of 20 and 25 who were consuming >30% of kcal from fat. Men were randomly assigned to one of four groups; nutrition counseling and measurement of serum cholesterol (NC + SC), nutrition counseling only (NC), measurement of serum cholesterol only (SC), or control (C). At weeks 1 and 6, participants completed a 24-hour …

Child, Parent, And Peer Predictors Of Early-Onset Substance Use: A Multisite Longitudinal Study, Julie B Kaplow, Patrick J Curran, Kenneth A Dodge

Faculty, Staff and Students Publications

The purpose of this study was to identify kindergarten-age predictors of early-onset substance use from demographic, environmental, parenting, child psychological, behavioral, and social functioning domains. Data from a longitudinal study of 295 children were gathered using multiple-assessment methods and multiple informants in kindergarten and 1st grade. Annual assessments at ages 10, 11, and 12 reflected that 21% of children reported having initiated substance use by age 12. Results from longitudinal logistic regression models indicated that risk factors at kindergarten include being male, having a parent who abused substances, lower levels of parental verbal reasoning, higher levels of overactivity, more thought …

Reduction In The Incidence Of Type 2 Diabetes With Lifestyle Intervention Or Metformin., William C. Knowler, Elizabeth Barrett-Connor, Sarah E. Fowler, Richard F. Hamman, John M. Lachin, Elizabeth A. Walker, David M. Nathan, P. G. Watson, J. T. Mendoza, K. A. Smith, J. Caro, B. Goldstein, C. Lark, L. Menefee, L. Murphy, C. Pepe, J. M. Spandorfer

Department of Medicine Faculty Papers

BACKGROUND: Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors--elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle--are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes.

METHODS: We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least …

Spectral And Temporal Processing In Human Auditory Cortex, Deborah A Hall, Ingrid Johnsrude, Mark P Haggard, Alan R Palmer, Michael A Akeroyd, A Quentin Summerfield

Brain and Mind Institute Researchers' Publications

Hierarchical processing suggests that spectrally and temporally complex stimuli will evoke more activation than do simple stimuli, particularly in non-primary auditory fields. This hypothesis was tested using two tones, a single frequency tone and a harmonic tone, that were either static or frequency modulated to create four stimuli. We interpret the location of differences in activation by drawing comparisons between fMRI and human cytoarchitectonic data, reported in the same brain space. Harmonic tones produced more activation than single tones in right Heschl's gyrus (HG) and bilaterally in the lateral supratemporal plane (STP). Activation was also greater to frequency-modulated tones than …

Associations Between Water-Treatment Methods And Diarrhoea In Hiv-Positive Individuals, J. N. S. Eisenberg, T. J. Wade, A. Hubbard, D. I. Abrams, R. J. Leiser, S. Charles, M. Vu, S. Saha, C. C. Wright, Deborah A. Levy, P. Jensen, J. M. Colford

Journal Articles: Epidemiology

This manuscript extends our previously published work (based on data from one clinic) on the association between three drinking water-treatment modalities (boiling, filtering, and bottling) and diarrhoeal disease in HIV-positive persons by incorporating data from two additional clinics collected in the following year. We conducted a cross-sectional survey of drinking water patterns, medication usage, and episodes of diarrhoea among HIV-positive persons attending clinics associated with the San Francisco Community Consortium. We present combined results from our previously published work in one clinic (n = 226) with data from these two additional clinics (n = 458). In this combined analysis we …

Risk Factors In Hiv-Associated Diarrhoeal Disease: The Role Of Drinking Water, Medication And Immune Status, J. N. S. Eisenberg, T. J. Wade, S. Charles, M. Vu, A. Hubbard, C. C. Wright, Deborah A. Levy, P. Jensen, J. M. Colford

Journal Articles: Epidemiology

In a cross-sectional survey of 226 HIV-infected men, we examined the occurrence of diarrhoea and its relationship to drinking water consumption patterns, risk behaviours, immune status and medication use. Diarrhoea was reported by 47% of the respondents. Neither drinking boiled nor filtered water was significantly associated with diarrhoea (OR = 0.5 [0.2, 1.6], 1.2 [0.6, 2.5] respectively), whereas those that drank bottled water were at risk for diarrhoea (OR = 3.0 [1.1, 7.8]). Overall, 47% always or often used at least one water treatment. Of the 37% who were very concerned about drinking water, 62% had diarrhoea, 70% always or …

Participant Blinding And Gastrointestinal Illness In A Randomized, Controlled Trial Of An In-Home Drinking Water Intervention, John M. Colford, Judy R. Rees, Timothy J. Wade, Asheena Khalakdina, Joan F. Hilton, Isaac J. Ergas, Susan Burns, Anne Benker, Catherine Ma, Cliff Bowen, Daniel C. Mills, Duc J. Vugia, Dennis D. Juranek, Deborah A. Levy

Journal Articles: Epidemiology

We conducted a randomized, triple-blinded home drinking water intervention trial to determine if a large study could be undertaken while successfully blinding participants. Households were randomized 50:50 to use externally identical active or sham treatment devices. We measured the effectiveness of blinding of participants by using a published blinding index in which values >0.5 indicate successful blinding. The principal health outcome measured was "highly credible gastrointestinal illness" (HCGI). Participants (n=236) from 77 households were successfully blinded to their treatment assignment. At the end of the study, the blinding index was 0.64 (95% confidence interval 0.51-0.78). There were 103 episodes of …

Retrospective Analysis Of Youth Evaluated For Suicide Attempt Or Suicidal Ideation In An Emergency Room Setting, Julie Hagedorn, Hatim A. Omar

Pediatrics Faculty Publications

Suicide is the third leading cause of death in adolescents and a major contributor to morbidity in this age group. The objective of this study was to look at the demographics, major stressors and factors leading to attempting suicide as well as the methods of attempted suicide in adolescents admitted to two hospitals in a medium size city. Medical records were reviewed of adolescents admitted to two area hospitals for attempted suicide between 7/1/97-12/31/99. Coroner's data on completed suicide were also reviewed. In the study period a total of 287 persons aged 21 years or under were admitted for attempted …

Can Meaningful Effective Connectivities Be Obtained Between Auditory Cortical Regions?, M S Gonçalves, D A Hall, Ingrid Johnsrude, M P Haggard

Brain and Mind Institute Researchers' Publications

Structural equation modeling (SEM) of neuroimaging data can be evaluated both for the goodness of fit of the model and for the strength of path coefficients (as an index of effective connectivity). SEM of auditory fMRI data is made difficult by the necessary sparse temporal sampling of the time series (to avoid contamination of auditory activation by the response to scanner noise) and by the paucity of well-defined anatomical information to constrain the functional model. We used SEM (i.e., a model incorporating latent variables) to investigate how well fMRI data in four adjacent cortical fields can be described as an …

Return To Fertility After Extended Chemical Castration With A Gnrh Antagonist, Janusz W. Kostanski, Ge Jiang, Bhas A. Dani, Santos B. Murty, Wei Qiu, Bruce Schrier, B. C. Thanoo, Patrick P. Deluca

Pharmaceutical Sciences Faculty Publications

BACKGROUND: Antagonistic analogues of GnRH for the treatment of prostate cancer may be used clinically in persons for whom return to fertility after such treatment is important or desirable. The purpose of this study was, therefore, to evaluate the effects of a long term treatment with orntide, a GnRH antagonist, on testosterone levels and fertility in male rats.

METHODS: Two groups of male rats received either 120-day orntide microspheres (8.8 mg orntide/kg/120 days) or vehicle alone (control group). Serum orntide and testosterone levels in both groups were monitored at certain intervals for 9 months from the initiation of treatment. After …

Eliciting The Low-Activity Aldehyde Dehydrogenase Asian Phenotype By An Antisense Mechanism Results In An Aversion To Ethanol., E Garver, Tu Gc, Q N Cao, M Aini, F Zhou, Y Israel

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

A mutation in the gene encoding for the liver mitochondrial aldehyde dehydrogenase (ALDH2-2), present in some Asian populations, lowers or abolishes the activity of this enzyme and results in elevations in blood acetaldehyde upon ethanol consumption, a phenotype that greatly protects against alcohol abuse and alcoholism. We have determined whether the administration of antisense phosphorothioate oligonucleotides (ASOs) can mimic the low-activity ALDH2-2 Asian phenotype. Rat hepatoma cells incubated for 24 h with an antisense oligonucleotide (ASO-9) showed reductions in ALDH2 mRNA levels of 85% and ALDH2 (half-life of 22 h) activity of 55% equivalent to a >90% inhibition in ALDH2 …

Expression Of Tumor-Associated Glycoprotein-72 (Tag-72) Antigen In Human Prostatic Adenocarcinomas., Dev Karan, Sonny L. Johansson, Ming-Fong Lin, Surinder K. Batra

Journal Articles: Biochemistry & Molecular Biology

Tumor-specific antigens are usually defined by monoclonal antibodies (MAbs) and can play critical roles in the diagnosis and therapy of carcinomas. Despite advances in the understanding of the molecular genetics of human prostate carcinomas, therapeutic approaches require that tumor-specific markers, preferably on the cell surface, should be defined. In this study, we examined the expression of an oncofetal antigen tumor-associated glycoprotein-72 (TAG-72) in prostatic adenocarcinomas with a Gleason grade of six or higher. Using a second generation MAb CC49 against TAG-72, immunoreactivity was detected in 88% (29/33) of the prostatic cancer tissues. Occasionally, the benign epithelium showed a very faint …