McKenna K.D.,St. Charles County Ambulance District |
McKenna K.D.,National Association of EMS Educators Research Committee |
Carhart E.,Center for Healthcare Simulation Research |
Carhart E.,Roanoke College |
And 4 more authors.
Prehospital Emergency Care | Year: 2015
Objectives. The purpose of this research was to characterize the use of simulation in initial paramedic education programs in order assist stakeholders' efforts to target educational initiatives and resources. This group sought to provide a snapshot of what simulation resources programs have or have access to and how they are used; faculty perceptions about simulation; whether program characteristics, resources, or faculty training influence simulation use; and if simulation resources are uniform for patients of all ages. Methods. This was a cross-sectional census survey of paramedic programs that were accredited or had a Letter of Review from the Committee on Accreditation of Educational Programs for the EMS Professions at the time of the study. The data were analyzed using descriptive statistics and chi-square analyses. Results. Of the 638 surveys sent, 389 valid responses (61%) were analyzed. Paramedic programs reported they have or have access to a wide range of simulation resources (task trainers [100%], simple manikins [100%], intermediate manikins [99%], advanced/fully programmable manikins [91%], live simulated patients [83%], computer-based [71%], and virtual reality [19%]); however, they do not consistently use them, particularly advanced (71%), live simulated patients (66%), computer-based (games, scenarios) (31%), and virtual reality (4%). Simulation equipment (of any type) reportedly sits idle and unused in (31%) of programs. Lack of training was cited as the most common reason. Personnel support specific to simulation was available in 44% of programs. Programs reported using simulation to replace skills more frequently than to replace field or clinical hours. Simulation goals included assessment, critical thinking, and problem-solving most frequently, and patient and crew safety least often. Programs using advanced manikins report manufacturers as their primary means of training (87%) and that 19% of faculty had no training specific to those manikins. Many (78%) respondents felt they should use more simulation. Conclusions. Paramedic programs have and have access to diverse simulation resources; however, faculty training and other program resources appear to influence their use. © 2015 National Association of EMS Physicians.
Seetharaman S.,St Petersburg College |
Andel R.,University of South Florida |
Andel R.,International Clinical Research Center |
McEvoy C.,University of South Florida |
And 5 more authors.
Journals of Gerontology - Series A Biological Sciences and Medical Sciences | Year: 2015
Background. Although evidence indicates that Type II Diabetes is related to abnormal brain aging, the influence of elevated blood glucose on long-term cognitive change is unclear. In addition, the relationship between diet-based glycemic load and cognitive aging has not been extensively studied. The focus of this study was to investigate the influence of diet-based glycemic load and blood glucose on cognitive aging in older adults followed for up to 16 years. Methods. Eight-hundred and thirty-eight cognitively healthy adults aged ≥50 years (M = 63.1, SD = 8.3) from the Swedish Adoption/Twin Study of Aging were studied. Mixed effects growth models were utilized to assess overall performance and change in general cognitive functioning, perceptual speed, memory, verbal ability, and spatial ability as a function of baseline blood glucose and diet-based glycemic load. Results. High blood glucose was related to poorer overall performance on perceptual speed as well as greater rates of decline in general cognitive ability, perceptual speed, verbal ability, and spatial ability. Diet-based glycemic load was related to poorer overall performance in perceptual speed and spatial ability. Conclusion. Diet-based glycemic load and, in particular, elevated blood glucose appear important for cognitive performance/cognitive aging. Blood glucose control (perhaps through low glycemic load diets) may be an important target in the detection and prevention of age-related cognitive decline. © 2014 The Author.
Phipps M.,Intensive Care Unit |
Tittle M.B.,St Petersburg College |
Zuhlke R.,Intensive Care Unit |
Bellanton B.,Intensive Care Unit
Dimensions of Critical Care Nursing | Year: 2014
BACKGROUND:: Depression has been studied in many patient populations and has been found to significantly impact the course of illness, recovery, and outcome. OBJECTIVES:: Depression among the trauma patient population is underrecognized by health practitioners and precludes patient participation with rehabilitation-related activities, which ultimately leads to delayed recovery from traumatic injuries. METHODS:: This descriptive study evaluated in-hospital depression in patients admitted to trauma services in an urban level II trauma center by using a depression scale and chart review. Results were correlated with patients' self-reported degree of recovery during a follow-up phone call 6 months after hospital discharge. RESULTS:: There was no significant correlation between recovery and the Hospital Anxiety and Depression Scale score, Injury Severity Scale, or length of stay. Although no significant correlations were found, more than one-half of the patients who went to a rehabilitation facility reported recovery, whereas only 1 of the 4 patients who did not go to a rehabilitation facility reported recovery. DISCUSSION:: The findings suggest that medical funding with rehabilitation benefits is more predictive of patient's perception of recovery than in-hospital depression. Limitations of this study were significant, including patient population changes and administrative restructuring. Evaluation of those limitations may lead to increased support for bedside nurses to engage in research aimed at contributing to evidence-based practice. © 2014 Wolters Kluwer Health.
Kouzoukas D.E.,Lexington Veterans Affairs Medical Center |
Kouzoukas D.E.,University of Kentucky |
Kouzoukas D.E.,Loyola University Chicago |
Ma F.,Lexington Veterans Affairs Medical Center |
And 7 more authors.
PLoS ONE | Year: 2016
Pain is the significant presenting symptom in Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS). Activation of urothelial protease activated receptor 4 (PAR4) causes pain through release of urothelial macrophage migration inhibitory factor (MIF). High Mobility Group Box-1(HMGB1), a chromatin-binding protein, mediates bladder pain (but not inflammation) in an experimental model (cyclophosphamide) of cystitis. To determine if PAR4-induced bladder hypersensitivity depends on HMGB1 downstream, we tested whether: 1) bladder PAR4 stimulation affected urothelial HMGB1 release; 2) blocking MIF inhibited urothelial HMGB1 release; and 3) blocking HMGB1 prevented PAR4-induced bladder hypersensitivity. HMGB1 release was examined in immortalized human urothelial cultures (UROtsa) exposed to PAR4-activating peptide (PAR4-AP; 100 μM; 2 hours) or scrambled control peptide. Female C57BL/6 mice, pretreated with a HMGB1 inhibitor (glycyrrhizin: 50 mg/kg; IP) or vehicle, received intravesical PAR4-AP or a control peptide (100 uM; 1 hour) to determine 1) HMGB1 levels at 1 hour in the intravesical fluid (released HMGB1) and urothelium, and 2) abdominal hypersensitivity to von Frey filament stimulation 24 hours later. We also tested mice pretreated with a MIF blocker (ISO-1:20 mg/kg; IP) to determine whether MIF mediated PAR4-induced urothelial HMGB1 release. PAR4-AP triggered HMGB1 release from human (in vitro) and mice (in vivo) urothelial cells. Intravesical PAR4 activation elicited abdominal hypersensitivity in mice that was prevented by blocking HMGB1. MIF inhibition prevented PAR4-mediated HMGB1 release from mouse urothelium. Urothelial MIF and HGMB1 represent novel targets for therapeutic intervention in bladder pain conditions. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Kouzoukas D.E.,Lexington Veterans Affairs Medical Center |
Kouzoukas D.E.,University of Kentucky |
Meyer-Siegler K.L.,St Petersburg College |
Ma F.,Lexington Veterans Affairs Medical Center |
And 6 more authors.
PLoS ONE | Year: 2015
Introduction: Macrophage migration inhibitory factor (MIF), a pro-inflammatory cytokine, is constitutively expressed in urothelial cells that also express protease-activated receptors (PAR). Urothelial PAR1 receptors were shown to mediate bladder inflammation. We showed that PAR1 and PAR4 activator, thrombin, also mediates urothelial MIF release. We hypothesized that stimulation of urothelial PAR1 or PAR4 receptors elicits release of urothelial MIF that acts on MIF receptors in the urothelium to mediate bladder inflammation and pain. Thus, we examined the effect of activation of specific bladder PAR receptors on MIF release, bladder pain, micturition and histological changes. Methods: MIF release was measured in vitro after exposing immortalized human urothelial cells (UROtsa) to PAR1 or PAR4 activating peptides (AP). Female C57BL/6 mice received intravesical PAR1- or PAR4-AP for one hour to determine:1) bladder MIF release in vivo within one hour; 2) abdominal hypersensitivity (allodynia) to von Frey filament stimulation 24 hours after treatment; 3) micturition parameters 24 hours after treatment; 4) histological changes in the bladder as a result of treatment; 5) changes in expression of bladder MIF and MIF receptors using real-time RT-PCR; 6) changes in urothelial MIF and MIF receptor, CXCR4, protein levels using quantitative immunofluorescence; 7) effect of MIF or CXCR4 antagonism. Results: PAR1- or PAR4-AP triggered MIF release from both human urothelial cells in vitro and mouse urothelium in vivo. Twenty-four hours after intravesical PAR1- or PAR4-AP, we observed abdominal hypersensitivity in mice without changes in micturition or bladder histology. PAR4-AP was more effective and also increased expression of bladder MIF and urothelium MIF receptor, CXCR4. Bladder CXCR4 localized to the urothelium. Antagonizing MIF with ISO-1 eliminated PAR4- and reduced PAR1-induced hypersensitivity, while antagonizing CXCR4 with AMD3100 only partially prevented PAR4-induced hypersensitivity. Conclusions: Bladder PAR activation elicits urothelial MIF release and urothelial MIF receptor signaling at least partly through CXCR4 to result in abdominal hypersensitivity without overt bladder inflammation. PAR-induced bladder pain may represent an interesting pre-clinical model of Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) where pain occurs without apparent bladder injury or pathology. MIF is potentially a novel therapeutic target for bladder pain in IC/PBS patients.
Zeng L.,University of Chicago |
Zeng L.,Ohio State University |
Ehrenreiter K.,University of Vienna |
Menon J.,University of Chicago |
And 7 more authors.
Cellular Signalling | Year: 2013
MAP kinase (MAPK) signaling results from activation of Raf kinases in response to external or internal stimuli. Here, we demonstrate that Raf kinase inhibitory protein (RKIP) regulates the activation of MAPK when B-Raf signaling is defective. We used multiple models including mouse embryonic fibroblasts (MEFs) and primary keratinocytes from RKIP- or Raf-deficient mice as well as allografts in mice to investigate the mechanism. Loss of B-Raf protein or activity significantly reduces MAPK activation in these cells. We show that RKIP depletion can rescue the compromised ERK activation and promote proliferation, and this rescue occurs through a Raf-1 dependent mechanism. These results provide formal evidence that RKIP is a bona fide regulator of Raf-1. We propose a new model in which RKIP plays a key role in regulating the ability of cells to signal through Raf-1 to ERK in B-Raf compromised cells. © 2013 Elsevier Inc.
Papadopoulos A.,St Petersburg College
Journal of Prosthetics and Orthotics | Year: 2016
Introduction The weight-bearing foot assumes the reference plantar morphology while resting on a functional foot orthosis that is supported by a flat surface. The weight-bearing foot, however, can assume a different plantar morphology from the reference while resting on the orthosis that is inside a shoe in which the shank is a curved surface. If there is a difference in the plantar morphology, then the plantar deformation is abnormal because a functional foot orthosis should not deform along the shank of a shoe. Materials and Methods This technical note describes a procedure to screen for abnormal deformation of the weight-bearing foot at the orthosis-foot interface. Casting the weight-bearing foot at the orthosis-foot interface on a flat surface and inside a shoe is performed to capture the reference and the in-shoe plantar morphology, respectively. Both the reference and the in-shoe plantar surface contour are then superimposed via Bookstein two-point registration to screen for abnormal deformation. Conclusions The procedure described in this note should be implemented to determine the suitability of footwear with a functional foot orthosis in refractory cases of functional foot disorders. © 2016 Lippincott Williams & Wilkins.
Eadens D.M.,Northern Arizona University |
Cranston-Gingras A.,University of South Florida |
Dupoux E.,St Petersburg College |
Eadens D.W.,Northern Arizona University
Policing | Year: 2016
Purpose – The purpose of this paper is to examine police officer perceptions about persons with intellectual disabilities. Design/methodology/approach – In this study, 188 officers from three police districts in the Southeast USA were surveyed using a modified Social Distance Questionnaire. Findings – Results indicate that the majority of police officers surveyed had little or no training with regard to disabilities and that most are willing to interact socially with individuals with intellectual disabilities. Further, this study found that female officers had significantly greater positive attitudes toward individuals with intellectual disabilities than male respondents and that white respondents were more knowledgeable about these individuals than those from minority backgrounds. Research limitations/implications – While these results are significant, it should be noted that the number of female and minority participants was relatively low. Practical implications – The paper includes recommendations for professional development for police officer and criminal justice training programs. Social implications – As individuals with developmental and intellectual disabilities are increasingly integrated into society, their vulnerability to mishandling by the criminal justice system and police officers intensifies. This paper allows police officers and those within the field of criminal justice an opportunity to examine perceptions as they seek to understand how police and general societal perceptions impact the way that people interact with persons with intellectual disabilities. Originality/value – This paper fulfills a need to examine attitudes of police officers toward citizens with intellectual disabilities in the communities in which they live. These attitudes often affect the way that police officers interact with citizens and identify additional training needs to better prepare officers for diverse individuals they may will encounter. © 2016, © Emerald Group Publishing Limited.
Raymond A.,Texas A&M University |
Lambert L.,University of Texas at San Antonio |
Costanza S.,Harvard University |
Slone E.J.,Texas A&M University |
Cutlip P.C.,St Petersburg College
International Journal of Coal Geology | Year: 2010
Cordaiteans in cordaite-dominated permineralized peat from Pennsylvanian coals in Iowa have been reconstructed as mangroves using root anatomy, peat taphonomy, and geochemical data. Macrofloral, palynofloral, and conodont biostratigraphy indicate that these peats come from the latest Atokan Blackoak coal and earliest Desmoinesian Cliffland coal (mid-Moscovian), both in the Kalo Formation. Thus, their depositional setting can be used to evaluate the mangrove hypothesis. In Recent mires, thick mangrove peats have accumulated in tropical to subtropical carbonate systems; in contrast, thick tropical freshwater peats have accumulated in siliclastic systems. Kalo Formation coals, which we interpret as freshwater deposits, formed in siliciclastic depositional settings, similar to those of modern tropical freshwater peat, and to other Pennsylvanian coals in North America interpreted as freshwater deposits. In the late Atokan and earliest Desmoinesian (mid-Moscovian), cordaiteans and tree ferns predominated in the Western Interior and Illinois Basins; lycopsids and cordaiteans predominated in the Appalachian and Donets Basins. The scarcity of lycopsid-only mires in North America during the late Atokan-earliest Desmoinesian (mid-Moscovian) suggests drier climates than during the mid-to-late Desmoinesian (late Moscovian). Rather than indicating mangrove swamps, cordaite-dominated peat may indicate climates with a 'low-rain' season. Although most plants in cordaite-dominated peat probably grew in freshwater, coastal mires in climate zones with seasons of 'low-rain' may harbor mangrove taxa. The Changuinola Swamp of Panama, a modern peat-accumulating wetland that has a 'low-rain' season, is a possible analog of ancient cordaite-dominated mires. In Changuinola, most plants require freshwater; however mangroves, sustained by salt-water influx into the swamp, grow along the seaward edge and along blackwater creeks. The 'low-rain' season hypothesis has implications for understanding rainfall amount and continuity during Pennsylvanian cyclothem deposition. The floral succession in diverse cordaite coals, from cordaiteans to tree ferns to lycopsids, suggests increasingly wet climate during coal accumulation. The position of these coals immediately above the sequence boundary suggests humid climate during early glacial melting for these cyclothems. © 2009 Elsevier B.V.
Zambroski C.H.,University of South Florida |
Buck H.,Pennsylvania State University |
Garrison C.M.,St Petersburg College |
McMillan S.C.,University of South Florida
Journal of Cardiovascular Nursing | Year: 2014
Recent clinical practice guidelines suggest that hospice can be a valuable alternative for patients with advanced heart failure (HF). Unfortunately, there are very few evidence-based nursing interventions to guide symptom management for HF patients in hospice and their caregivers. Nevertheless, conducting clinical research in hospice populations remains fraught with methodological and ethical challenges. Our research team was not naive to the fact that hospice research is difficult. We believed that we had prepared well for a number of contingencies before the beginning of our clinical trial testing the feasibility of delivering a psychosocial intervention to caregivers of patients with HF. Despite the team expertise and well-defined recruitment strategies, the recruitment, both accrual and attrition, remained daunting in this population. The purpose of this article was to report the challenges of recruiting hospice patients with HF and caregivers for our randomized clinical trial, those we anticipated and those we did not. Copyright © 2014 Wolters Kluwer Health.