Exploring Predictors of Influenza Vaccination Among Hospital Based Nurses

The purpose of this study was to explore the attitudes and beliefs of nurses regarding the seasonal influenza vaccine and how these beliefs and demographics predict individuals vaccination status. This comparative descriptive study was conducted using a cross section of nurses working at two acute care hospitals and one palliative care hospital in Windsor,ON during the 2009/2010 influenza season. A sample of 202 nurses participated in an online self-reported survey. Both univariate and multivariate analysis was completed for both the vaccinated and unvaccinated respondents. This study found that being vaccinated in the previous flu season was the strongest predictor of influenza vaccination in the current season. In addition, perception of increased job risk, perception of protection provided by the immune system, workplace clinics and campaigns, and convenience were all found to be independent predictors of influenza vaccination or intent to vaccinate in the current season

Things that matter: insights from structured objectives into the operationalization and evaluation of sustainable fisheries

Objectives reflect values that matter to decision-makers, but can be challenging to articulate. This is particularly true in resource management contexts where high uncertainty amplifies the complexity of satisfying multiple conflicting objectives in an acceptable manner. Structured decision-making recommends structuring objectives into networks to assist with choosing management actions among a suite of alternatives. Here, I used content analysis (where words or concepts are identified in qualitative data, like text) to identify and structure objectives according to implicit relationships among them. Objectives were taken from Canadian laws, policies and plans for sustainable fisheries management. Resulting networks were then compared to the explicit objective structures in integrated fisheries management plans. There was a relatively high level of coherence and multiple connections between different axes of sustainability. Plans typically layered and then connected objectives to management actions regardless of the terms used to describe them. Implicit relationships among objectives may reflect the conceptual model(s) that would have informed law, policy or plan development. Networks can provide a scaffolding with which to compare how jurisdictions choose to fix means or ends objectives into law, pre-operationalize objectives, and evaluate sustainable fisheries performance. Structuring objectives helps to identify circumstances where it may be useful to base decisions on means objectives as proxies for hard-to-define ends, while also clarifying assumptions at play when that choice is made. Operational guidance for setting objectives in resource management contexts could benefit by recommending approaches to structuring objectives, in addition to aiming for measurable and time-bound objectives

Late Quaternary paleoceanography in Kane Basin, Canada and Greenland.

Dept. of Geology and Geological Engineering. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis1988 .M374. Source: Masters Abstracts International, Volume: 40-07, page: . Thesis (M.Sc.)--University of Windsor (Canada), 1988

Perioperative lumbar drain placement: An independent predictor of tension pneumocephalus and intracranial complications following anterior skull base surgery

Objective: To measure the effect of routine perioperative lumbar drain placement during anterior skull base surgery on the frequency of: 1) tension pneumocephalus and 2) total intracranial complications. Design: Retrospective review of a series of patients (n = 161) who underwent the transglabellar/subcranial approach to lesions of the anterior skull base between December 1995 and November 2009. A retrospective cohort (n = 45) underwent routine lumbar drain placement at the time of skull base surgery. The remainder of the series did not undergo routine perioperative lumbar drain placement. Intervention: Transglabellar/subcranial surgical approach to the anterior skull base, with or without routine perioperative lumbar drain placement. Results: Routine placement of perioperative lumbar drains was an independent predictor of tension pneumocephalus ( P =.022, odds ratio = 11.22 [1.218–103.3]). In addition, this practice was also associated with an increased risk of intracranial complications overall ( P =.025, odds ratio = 2.623 [1.104–6.233]). Conclusion: Routine placement of perioperative lumbar drain may be associated with an increased risk of tension pneumocephalus and intracranial complications during surgery of the anterior cranial base. Laryngoscope, 2011Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/84402/1/21409_ftp.pd

Sinonasal undifferentiated carcinoma and esthesioneuroblastoma recurring as nonintestinal adenocarcinoma

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97478/1/lary23746.pd

Mice with genetic deletion of group VIA phospholipase A2β exhibit impaired macrophage function and increased parasite load in Trypanosoma cruzi-induced myocarditis

Trypanosoma cruzi infection, which is the etiological agent of Chagas disease, is associated with intense inflammation during the acute and chronic phases. The pathological progression of Chagas disease is influenced by the infiltration and transmigration of inflammatory cells across the endothelium to infected tissues, which are carefully regulated processes involving several molecular mediators, including adhesion molecules and platelet-activating factor (PAF). We have shown that PAF production is dependent upon calcium-independent group VIA phospholipase A(2)β (iPLA(2)β) following infection of human coronary artery endothelial cells (HCAECs) with T. cruzi, suggesting that the absence of iPLA(2)β may decrease the recruitment of inflammatory cells to the heart to manage parasite accumulation. Cardiac endothelial cells isolated from iPLA(2)β-knockout (iPLA(2)β-KO) mice infected with T. cruzi demonstrated decreased PAF production compared to that by cells isolated from wild-type (WT) mice but demonstrated increases in adhesion molecule expression similar to those seen in WT mice. Myocardial inflammation in iPLA(2)β-KO mice infected with T. cruzi was similar in severity to that in WT mice, but the iPLA(2)β-KO mouse myocardium contained more parasite pseudocysts. Upon activation, macrophages from iPLA(2)β-KO mice produced significantly less nitric oxide (NO) and caused less T. cruzi inhibition than macrophages from wild-type mice. Thus, the absence of iPLA(2)β activity does not influence myocardial inflammation, but iPLA(2)β is essential for T. cruzi clearance

Absence of calcium‐independent phospholipase A2β impairs platelet‐activating factor production and inflammatory cell recruitment in Trypanosoma cruzi‐infected endothelial cells

Both acute and chronic phases of Trypanosoma cruzi (T. cruzi) infection are characterized by tissue inflammation, mainly in the heart. A key step in the inflammatory process is the transmigration of inflammatory cells across the endothelium to underlying infected tissues. We observed increased arachidonic acid release and platelet‐activating factor (PAF) production in human coronary artery endothelial cells (HCAEC) at up to 96 h of T. cruzi infection. Arachidonic acid release is mediated by activation of the calcium‐independent phospholipase A(2) (iPLA(2)) isoforms iPLA(2)β and iPLA(2)γ, whereas PAF production was dependent upon iPLA(2)β activation alone. Trypanosoma cruzi infection also resulted in increased cell surface expression of adhesion molecules. Increased adherence of inflammatory cells to T. cruzi‐infected endothelium was blocked by inhibition of endothelial cell iPLA(2)β or by blocking the PAF receptor on inflammatory cells. This suggests that PAF, in combination with adhesion molecules, might contribute to parasite clearing in the heart by recruiting inflammatory cells to the endothelium

Olfactory groove meningioma: Discussion of clinical presentation and surgical outcomes following excision via the subcranial approach

Objectives/Hypothesis: To describe surgical outcomes and radiographic features of olfactory groove meningiomas treated by excision through the subcranial approach. Special emphasis is placed on paranasal sinus and orbit involvement. Study Design: Retrospective review of a series of patients. Methods: Nineteen patients underwent excision of olfactory groove meningioma (OGM) via the transglabellar/subcranial approach between December 1995 and November 2009. Nine patients had previously undergone prior resection at outside institutions, and four had prior radiotherapy in addition to a prior excision. Transglabellar/subcranial surgical approach to the anterior skull base was performed. Results: Tumor histology included three World Health Organization (WHO) grade III lesions, one WHO grade II lesion, and 15 WHO grade I lesions. Fourteen patients had evidence of extension into the paranasal sinuses, with the ethmoid sinus being most commonly involved. Kaplan‐Meier estimates of mean overall and disease‐free survival were 121.45 months and 93.03 months, respectively. The mean follow‐up interval was 41.0 months, and at the time of data analysis three patients had recurrent tumors. Seven (36.8%) patients experienced a major complication in the perioperative period; there were no perioperative mortalities. Orbit invasion was observed in four patients, with optic nerve impingement in 11 patients. Of these, three patients had long‐term diplopia. No patients experienced worsening of preoperative visual acuity. Conclusions: Olfactory groove meningiomas demonstrate a propensity to spread into the paranasal sinuses, particularly in recurrent cases. Given a tendency for infiltrative recurrence along the skull base, this disease represents an important area of collaboration between neurosurgery and otolaryngology. The subcranial approach offers excellent surgical access for excision, particularly for recurrences that involve the paranasal sinuses and optic apparatus.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87044/1/22174_ftp.pd

A review of studies of adherence with antihypertensive drugs using prescription databases

Poor adherence with antihypertensive therapies is a major factor in the low rates of blood pressure control among people with hypertension. Patient adherence is influenced by a large number of interacting factors but their exact impact is not well understood, partly because it is difficult to measure adherence. Longitudinal prescription data can be used as a measure of drug supply and are particularly useful to identify interruptions and changes of treatment. Obtaining a medicine does not ensure its use; however, it has been established that continuous collection of prescription medications is a useful marker of adherence. We found 20 studies published in the last 10 years that used large prescription databases to investigate adherence with antihypertensive therapies. These were assessed in terms of patient selection, the definition of the adherence outcome(s), and statistical modeling. There was large variation between studies, limiting their comparability. Particular methodological problems included: the failure to identify an inception cohort, which ensures baseline comparability, in four studies; the exclusion of patients who could not be followed up, which results in a selection bias, in 17 studies; failure to validate outcome definitions; and failure to model the discrete-time structure of the data in all the studies we examined. Although the data give repeated measurements on patients, none of the studies attempted to model patient-level variability. Studies of such observational data have inherent limitations, but their potential has not been fully realized in the modeling of adherence with antihypertensive drugs. Many of the studies we reviewed found high rates of nonadherence to antihypertensive therapies despite differences in populations and methods used. Adherence rates from one database ranged from 34% to 78% at 1 year. Some studies found women had better adherence than men, while others found the reverse. Novel approaches to analyzing data from such databases are required to use the information available appropriately and avoid the problems of bias