Looking Forward: The Role of Personal Responsibility in Healthcare Prioritization

Honors (Bachelor's)PhilosophyUniversity of Michiganhttps://deepblue.lib.umich.edu/bitstream/2027.42/139602/1/ddigio.pd

Cephalosporin-resistant pneumococcal pneumonia: does it, affect outcome?

AbstractStudy Objectives: Penicillin resistance has been reported in various studies to have no impact on the outcome of pneumococcal pneumonia. However, the importance of cephalosporin resistance has not been systematically studied. We conducted an analysis of patients with high-level cephalosporin-resistant Streptococcus pneumoniae pneumonia (H-CRSPP)–Design: Retrospective matched, case–control study. Setting: Two inner-city academic hospitals. Patients: Twenty-six patients with H-CRSPP admitted to the hospital between 1995 and 1999 were identified. Each patient was matched with two controls with cephalosporin-sensitive but oxacillin-resistant pneumococcal pneumonia admitted during the same time period. Matching was done based on pneumonia severity of illness index (PSI) and for other factors.Interventions: None. Measurements and Results: We evaluated a number of outcomes including mortality, length of stay in the hospital, and time to respond to treatment. Patients with H-CRSPP took longer to respond to treatment (6.5±0.9 days vs 4.1±0.7 days, P=0.05) and had a longer length of stay in hospital (15.4±2.2 daysvs 9.2±1.6 days, P=0.02), None of the other outcomes were different between the two groups.Conclusions: Overall, we have found that the presence of cephalosporin resistance does impact the course of pneumococcal pneumonia

A patient with an uncommon complication from insertion of a central venous catheter: A case report

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Advancing the Entry-Level Practitioner: A Curricular Model of the Professional Occupational Therapy Doctoral Degree

The recent growth of entry-level occupational therapy doctoral (EL-OTD) programs has been met with mixed opinions from both occupational therapy educators and practitioners. These opinions occasionally have been accompanied by uncertainty about the specific curricular components that differentiate the EL-OTD from the entry-level master’s degree. In an effort to address this uncertainty, the purpose of this article is to present one example of an EL-OTD curricular model and describe its distinct educational components. This curricular model integrates recommendations for doctoral education originally proposed by Case-Smith et al. (2014) and is characterized by the following three components: 1) Advanced Coursework; 2) the Doctoral Capstone Project; and 3) the Doctoral Capstone Experience. We share the lessons learned after matriculating three cohorts of EL-OTD students and describe influences from the field of implementation science that have informed the development of our curriculum

Engrailed2 modulates cerebellar granule neuron precursor proliferation, differentiation and insulin-like growth factor 1 signaling during postnatal development

BACKGROUND: The homeobox transcription factor Engrailed2 (En2) has been studied extensively in neurodevelopment, particularly in the midbrain/hindbrain region and cerebellum, where it exhibits dynamic patterns of expression and regulates cell patterning and morphogenesis. Because of its roles in regulating cerebellar development and evidence of cerebellar pathology in autism spectrum disorder (ASD), we previously examined an ENGRAILED2 association and found evidence to support EN2 as a susceptibility gene, a finding replicated by several other investigators. However, its functions at the cell biological level remain undefined. In the mouse, En2 gene is expressed in granule neuron precursors (GNPs) just as they exit the cell cycle and begin to differentiate, raising the possibility that En2 may modulate these developmental processes. METHODS: To define En2 functions, we examined proliferation, differentiation and signaling pathway activation in En2 knockout (KO) and wild-type (WT) GNPs in response to a variety of extracellular growth factors and following En2 cDNA overexpression in cell culture. In vivo analyses of cerebellar GNP proliferation as well as responses to insulin-like growth factor-1 (IGF1) treatment were also conducted. RESULTS: Proliferation markers were increased in KO GNPs in vivo and in 24-h cultures, suggesting En2 normally serves to promote cell cycle exit. Significantly, IGF1 stimulated greater DNA synthesis in KO than WT cells in culture, a finding associated with markedly increased phospho-S6 kinase activation. Similarly, there was three-fold greater DNA synthesis in the KO cerebellum in response to IGF1 in vivo. On the other hand, KO GNPs exhibited reduced neurite outgrowth and differentiation. Conversely, En2 overexpression increased cell cycle exit and promoted neuronal differentiation. CONCLUSIONS: In aggregate, our observations suggest that the ASD-associated gene En2 promotes GNP cell cycle exit and differentiation, and modulates IGF1 activity during postnatal cerebellar development. Thus, genetic/epigenetic alterations of EN2 expression may impact proliferation, differentiation and IGF1 signaling as possible mechanisms that may contribute to ASD pathogenesis

The role of the g9/2 orbital in the development of collectivity in the A = 60 region: The case of 61Co

An extensive study of the level structure of 61Co has been performed following the complex 26Mg(48Ca, 2a4npg)61Co reaction at beam energies of 275, 290 and 320 MeV using Gammasphere and the Fragment Mass Analyzer (FMA). The low-spin structure is discussed within the framework of shell-model calculations using the GXPF1A effective interaction. Two quasi-rotational bands consisting of stretched-E2 transitions have been established up to spins I = 41/2 and (43/2), and excitation energies of 17 and 20 MeV, respectively. These are interpreted as signature partners built on a neutron {\nu}(g9/2)2 configuration coupled to a proton {\pi}p3/2 state, based on Cranked Shell Model (CSM) calculations and comparisons with observations in neighboring nuclei. In addition, four I = 1 bands were populated to high spin, with the yrast dipole band interpreted as a possible candidate for the shears mechanism, a process seldom observed thus far in this mass region