Medical Specialties Commons^™

Anesthesia Clinical Performance Outcomes: Does Teaching Methodology Make A Difference?, Nina E. Mclain

Theses and Dissertations

Researchers have studied memory recall of crisis-oriented or emotional events in non-educational settings. However, within the health care field, there has been a limited study of the the concept of recall of crisis oriented or emotional events in& health care education. Crisis-oriented events such as natural disasters, acts of bioterroism, and industrial accidents, have been reported to impact memory. Patient safety is a primary focus in anesthesia education, appropriate crisis management is imperative to quality anesthesia care. Due to the critical nature of anesthesia delivery, there is a strong, constant need to develop methods that will enhance, support, and improve …

Improving Life Satisfaction Of Elders Through Oral History: The Narrator's Perspective, Mary B. Ligon

Theses and Dissertations

Oral history is a method of preserving historical information through in-depth interviews. Because the process requires narrators to use remote recall while sharing their life experiences, it can also be considered a reminiscence-related activity. Before this study, the positive effects on narrators of providing an oral history were noted in the research literature but had not been evaluated through quantitative methods. Based on theoretical constructs of Erikson and Butler, it was hypothesized that participation in oral history interviews would improve the life satisfaction of narrators. Life satisfaction was operationalized and measured using the Life Satisfaction Index Version A (LSIA). The …

Lactate Versus Non-Lactate Metabolic Acidosis: A Retrospective Outcome Evaluation Of Critically Ill Patients, Kyle J. Gunnerson, Melissa Saul, Shui He, John A. Kellum

Anesthesiology Publications

Introduction

Acid–base abnormalities are common in the intensive care unit (ICU). Differences in outcome exist between respiratory and metabolic acidosis in similar pH ranges. Some forms of metabolic acidosis (for example, lactate) seem to have worse outcomes than others (for example, chloride). The relative incidence of each type of disorder is unknown. We therefore designed this study to determine the nature and clinical significance of metabolic acidosis in critically ill patients.

Methods

An observational, cohort study of critically ill patients was performed in a tertiary care hospital. Critically ill patients were selected on the clinical suspicion of the presence of …

The Shepherd’S Center Of Richmond: Opportunities For Meaning And Personal Growth Through Service, Linda Frank

Case Studies from Age in Action

Educational Objectives

1. To inform Virginians about The Shepherd’s Center of Richmond, a non-profit service organization by, with, and for older adults.

2. To demonstrate the impact of volunteer service as a means to finding a sense of meaning and purpose in later life.

Parish Nursing: A Vital Piece To The Puzzle Of Care For Older Adults, Donna B. Coffman

Case Studies from Age in Action

Educational Objectives

1. To generate awareness of the emerging practice of faith community/parish nursing and its implications for the overall improvement of health care.

2. To explore specific ways parish nursing can help meet the holistic health needs of older adults in local congregations

Elderfriends: Relieving Loneliness Among Elders, Kiersten Seeger Ware, Sarah Coble

Case Studies from Age in Action

Educational Objectives

1. To discuss social isolation among older adults.

2. To promote awareness of the ElderFriends program, an intervention newly established in greater Richmond

3. To seek friendly visitors for the ElderFriends program.

Brain Health: Mending The Mind After Age 50, Susan Hardwicke

Case Studies from Age in Action

Educational Objectives

1. Increase understanding of brain function and its potential to improve with age.

2. Describe an application of neuroscience, cognitive training, and nutrition for solving a problem associated with aging.

3. Evaluate neural plasticity with aging.

The Impact Of An Hematocrit Of 20% During Normothermic Cardiopulmonary Bypass For Elective Low Risk Coronary Artery Bypass Graft Surgery On Oxygen Delivery And Clinical Outcome – A Randomized Controlled Study [Isrctn35655335], Christian Von Heymann, Michael Sander, Achim Foer, Anja Heinemann, Bruce Spiess, Jan Braun, Michael Krämer, Joachim Grosse, Pascal Dohmen, Simon Dushe, Jürgen Halle, Wolfgang F. Konertz, Klaus-Dieter Warnecke, Claudia Spies

Anesthesiology Publications

Introduction

Cardiopulmonary bypass (CPB) induces hemodilutional anemia, which frequently requires the transfusion of blood products. The objective of this study was to evaluate oxygen delivery and consumption and clinical outcome in low risk patients who were allocated to an hematocrit (Hct) of 20% versus 25% during normothermic CPB for elective coronary artery bypass graft (CABG) surgery.

Methods

This study was a prospective, randomized and controlled trial. Patients were subjected to normothermic CPB (35 to 36°C) and were observed until discharge from the intensive care unit (ICU). Outcome measures were calculated whole body oxygen delivery, oxygen consumption and clinical outcome. A …

The Corbett Pain Scale: A Multidimensional Pain Scale For Adult Intensive Care Patients, Gina M. Corbett

Theses and Dissertations

There are no reliable tools that evaluate pain in adult critical care patients who cannot communicate as a result of sedation or illness. This was an observational study in which postoperative cardiothoracic intensive care patients were assessed for pain using both the newly devised Corbett Pain Scale (CPS) and the Numerical Pain Scale (NPS). The CPS was evaluated for content validity, criterion validity, construct validity, test re-test reliability and internal consistency. Thirteen male and seven female patients (n=20) were enrolled and underwent a maximum of five pain assessments each. The mean total scores of the CPS (.740, SD+1.03) and the …

Functional Redistribution Of Hippocampal Cannabinoid Cb1 Receptors In The Rat Pilocarpine Model Of Acquired Epilepsy, Katherine Winslow Falenski

Theses and Dissertations

Cannabinoids, such as the marijuana derivative Δ9-THC, are known to have CBl receptor-mediated anticonvulsant effects in several animal models of seizures and epilepsy, including the rat pilocarpine model of acquired epilepsy. However, the distribution of CBl receptor expression and function in brains of epileptic rats has not been characterized. Therefore, this dissertation was initiated to evaluate the effect of epileptogenesis on the distribution and function of the endogenous CBI receptor system in the rat pilocarpine model, a well-established model of acquired temporal lobe epilepsy. Using immunohistochemistry, we demonstrated that chronically epileptic rats exhibit a unique, long-term, and specific redistribution of …

Factorial Validity Of The Team Skills Scale As Used For Geriatric Interdisciplinary Team Training (Gitt), Myra G. Owens

Theses and Dissertations

Objective: To examine the factorial validity of the Team Skills Scale (TSS). The TSS is a 17-item scale developed by Hepburn, Tsukuda, and Fasser (1996). The Scale is purported to assess self-perceived team skills.Data Source: Data for this study were provided by The New York University Geriatric Interdisciplinary Team Training (GITT) Resource Center and were collected as part of the evaluation of the GITT program. The data were collected between January 1997 and June 2000.Study Design: This quasi-experiential study was focused on the trainee (N=1,715) as the unit of analysis. The Model of Individual-Level Team Competencies (Model of I-LTC) served …

Perceived Deprivation In Active Duty Military Nurse Anesthetists, Julie Ann Pearson

Theses and Dissertations

Problem: There is a shortage of military certified registered nurse anesthetists (CRNAs). The exodus from military service to civilian careers could be a result of relative deprivation (the discrepancy that one perceives between what one has and what one could or should have). Relative deprivation is a perception of unfairness dependent on feelings (subjective data) as well as facts (objective data). Purpose: The purpose of this study was to measure relative deprivation in active duty military nurse anesthetists, to explore variables which correlate with relative deprivation, and to validate or refute the theory of relative deprivation in active duty military …

Passive Immunization During Pregnancy For Congenital Cytomegalovirus Infection, Giovanni Nigro, Stuart P. Adler, Renato La Torre, Al M. Best

Pediatrics Publications

BACKGROUND

Currently, there is no effective intervention for a primary cytomegalovirus (CMV) infection during pregnancy.

METHODS

We studied pregnant women with a primary CMV infection. The therapy group comprised women whose amniotic fluid contained either CMV or CMV DNA and who were offered intravenous CMV hyperimmune globulin at a dose of 200 U per kilogram of maternal weight. A prevention group, consisting of women with a recent primary infection before 21 weeks' gestation or who declined amniocentesis, was offered monthly hyperimmune globulin (100 U per kilogram intravenously).

RESULTS

In the therapy group, 31 women received hyperimmune globulin, only 1 (3 …

Spirituality And The Cognitively Impaired, Kathy Fogg Berry

Case Studies from Age in Action

Educational Objectives

1. Discuss the need to acknowledge and nurture the spirituality of older adults with cognitive impainnent to enhance their health and well-being.

2. Provide tools and suggestions for use in nurturing the spirituality of older adults with cognitive impainnent.

3. Review the response of one resident with cognitive impainnent to spiritually-based programming and support

Case Study For People Who Are Aging: Workworld© Choice Exploration Software, David Ruth, Mark Hill

Case Studies from Age in Action

Educational Objectives

1. To illustrate the usefulness of WorkWORLD, a software package for older Americans with disabilities who have not yet reached retirement age, to determine the financial effects of earnings and the use of work incentives associated with benefits.

2. To show how the software can be accessed and continually updated.

3. To explore the possibility of enhancing WorkWORLD to be useful for those who have reached retirement age but who desire to continue or begin working.

Male Caregivers: Breaking Through The Male Self-Sufficiency Barrier To Help Those In Need, James J. Hutchinson

Case Studies from Age in Action

Educational Objectives

1. To generate awareness of characteristics and issues specific to male caregivers;

2. To examine successful strategies for education and awareness programs that motivate male caregivers to request services when needed;

3. To identify effective services targeted to male caregivers that have been initiated by three Area Agencies on Aging that received funding from the Virginia Department for the Aging.

Partnership For Prescription Assistance Of Virginia (Pparx), Sarah Huddle

Case Studies from Age in Action

Educational Objectives

1. To inform Virginia's older adult population and those who serve them about the Partnership for Prescription Assistance, a new program to help qualifying patients who lack prescription drug coverage get the medicines they need through the public or private program that best suits them, including the new Medicare prescription drug benefit.

2. To demonstrate, to older adults and those who assist them, the accessibility and ease of use of the Partnership for Prescription Assistance of Virginia.

Characterization Of The Zona Incerta, Heather Joyce Green

Theses and Dissertations

Parkinson's Disease affects more than 1 million people in the United States with 60,000 new cases being diagnosed each year. Currently, there is no cure for Parkinson's Disease, but there are several treatment options available. Currently the most popular surgical option is Deep Brain Stimulation. Microelectrode recording helps identify nuclei as the microelectrode passes through them. While the firing frequencies of the target nuclei are well defined, other nuclei are not. This study will attempt to characterize the Zona Incerta, which is the structure directly above the Subthalamic Nucleus, a target nucleus. Characterization of the firing frequency of the Zona …

Epileptogenesis Causes Long-Term Plasticity Changes In Calbindin D-28k In The Rat Pilocarpine Model Of Acquired Epilepsy, Anne Johnston Harrison

Theses and Dissertations

Epilepsy is one of the most common neurological disorders, affecting more than 2% of children and 1% of adults in the U.S. Emerging research has demonstrated that calcium, as a major second messenger system, underlies many of these injury-induced plasticity changes associated with the development of epilepsy. Recent evidence has suggested that long term elevations in neuronal resting calcium levels play a role in initiating and maintaining epileptogenesis (the development of epilepsy). Collaborations between our lab and others have produced microarray data that suggests that a major calcium-binding protein, calbindin D-28k, mRNA levels are decreased in epileptic rats even up …

Evidence For Absence Of Latchbridge Formation In Phasic Saphenous Artery, Shaojie Han

Theses and Dissertations

Tonic arterial smooth muscle can produce strong contractions indefinitely by formation of slowly cycling crossbridges (latchbridges) that maintain force at a high energy economy. To fully understand the uniqueness of mechanisms regulating tonic arterial contraction, comparisons have been made to phasic visceral smooth muscles that do not sustain high forces. This study explored mechanisms of force maintenance in a phasic artery by comparing KCl-induced contractions in the tonic, femoral artery (FA) and its primary branch, the phasic saphenous artery (SA). KCl rapidly (5 N/m2) and [ca2+]i (250 nM) in FA and SA. By 10 min, [ca2+]i declined to 175 nM …

Meeting The Challenges And Opportunities Of Aging With Lifelong Disabilities: The Area Planning And Services Committee, Allison Wilder, Edward F. Ansello

Case Studies from Age in Action

Educational Objectives

1. To generate awareness of needs and capacities of aging adults with lifelong disabilities and their effect upon human services

2. To understand the challenges and opportunities facing aging adults with lifelong disabilities in accessing appropriate community supports and services.

3. To illustrate the benefits of intersystem collaboration among human services providers through the vehicle of an Area Planning and Services Committee.

Mental Fitness And The Lifelong Learning Movement, Jane F. Stephan, Debbie Leidheiser, Edward F. Ansello

Case Studies from Age in Action

Educational Objectives

1. To identify the functional benefits of continued mental activity

2. To examine the role of Lifelong Learning Institutes in later life

3. To describe the motivations of participants in lifelong learning

Law Enforcement And Adult Protective Services Working Together: A Team Approach To Elder Abuse Cases, Anne Douglas Palmer

Case Studies from Age in Action

Educational Objectives

1. Familiarize readers with the different roles and responsibilities of Adult Protective Services and law enforcement in elder abuse cases.

2. Demonstrate the benefits of working collaboratively to resolve complex elder abuse and domestic violence cases.

Congregate Nutrition Programs Can Alleviate Loneliness And Isolation, Carol Cooper Driskill

Case Studies from Age in Action

Educational Objectives

1. Familiarize readers with the Older Americans Act congregate nutrition services provided to community-residing older adults.

2. Demonstrate how congregate nutrition services can alleviate isolation and loneliness in community-residing older adults.

Caregiver Education And Service Utilization In African American Families Dealing With Dementia, Constance L. Coogle

Virginia Center on Aging Publications

For more than a decade attention has been focused on Alzheimer’s family caregivers in African American communities. The Fourth Report of the Advisory Panel on Alzheimer’s Disease to the U. S. Congress and the U.S. Department of Health and Human Services calls for “…public education and outreach efforts specifically targeted to ethnic elders and their families and communities through the development and dissemination of culturally relevant materials emphasizing both the established facts about [Alzheimer’s Disease and Related Disorders] and the efficacy of seeking treatment.” (Advisory Panel on Alzheimer’s Disease, 1993, p. 50). While federal financing and state initiatives have addressed …

Montessori-Based Activities For Dementia: A Walk Down Memory Lane, Janina C. Bognar

Case Studies from Age in Action

Educational Objectives

1. Familiarize readers with the Montessori method as used with participants who have dementia.

2. Demonstrate the role of Montessori-based activities for dementia in an adult day care setting.

The Value Of Multidisciplinary Care In Parkinson's Disease, Miriam Hirsch, Mark Baron

Case Studies from Age in Action

Educational Objectives

1. To recognize the signs and symptoms of Parkinson's disease (PD).

2. To identify key treatment and management strategies for PD.

3. To discuss the importance of multidisciplinary care and the need for individualized treatment of PD.

Abuse, Neglect, And Exploitation Of Vulnerable Elders, Sheila Crossen-Powell, Kira R. Holland, Marjorie L. Marker

Case Studies from Age in Action

Educational Objectives

1. To describe the variety and dynamics of self-neglect and abuse.

2. To illustrate cases of familial self-neglect and of financial exploitation.

3. To demonstrate the roles that Adult Protective Services (APS) plays in the investigation of adult abuse, neglect, and exploitation.

4. To describe the protections available to vulnerable adults in the Commonwealth.

Aging In Place -- Can Universal Design Make It A Reality?, Helen Eltzeroth

Case Studies from Age in Action

Educational Objectives

1. Comprehend the principles of universal design

2. Understand the barriers to aging in place

3. Learn what resources are available to facilitate aging in place

Using Validation As A Consultant In A Richmond, Virginia Continuing Care Retirement Community, John Colletti

Case Studies from Age in Action

Educational Objectives

1. Familiarize readers with the intricacies of setting up a behavioral program for persons diagnosed with Alzheimer's type dementia in a long term care facility.

2. Exemplify importance of interdisciplinary work.

3. Outline the future of the Validation Method in Virginia.