• Exploration of Two Methodologies for Measuring Clinical Judgment in Baccalaureate Nursing Students.

      Call, Marlene W.; Department of Physiological and Technological Nursing (5/8/2017)
      Introduction: Senior nursing students need a requisite level of preparedness to safely care for an acutely ill, complex patient once they graduate and become independent clinicians. This level of preparedness may be evaluated by measuring clinical judgment (CJ) with the Lasater Clinical Judgment Rubric (LCJR). The LCJR contains 11 indicators that represent the actions and behaviors necessary for demonstrating CJ. Two methods of simulation, high fidelity patient simulation (HFPS) and objective structured clinical examination (OSCE), replicate the healthcare environment so students may safely demonstrate clinical skills without harming an actual patient. The purposes of this study were to 1) explore the use of the LCJR in the OSCE setting, and 2) elicit and compare the number of LCJR indicators that occur in the HFPS and OSCE settings for senior baccalaureate nursing students. Two research questions were explored: 1) comparing the representation of indicators between the OSCE and a single HFPS and question 2) comparing the representation of indicators between the OSCE and two HFPSs. Methods: This study used a two group, randomized crossover design with 23 senior nursing students in their last semester of a Bachelor of Science in Nursing program (n = 11; n = 12). Each participant performed patient care during two HFPS scenarios and 12 OSCE stations, followed by a written debriefing. Clinical performances were video recorded for each participant. CJ was evaluated by the reviewing the video recordings and counting the number of times an LCJR indicator occurred during the HFPS and OSCE settings. Counts for each indicator in each setting were established for the OSCE by adding indicator counts for each and for the HFPS by adding each indicator for the two scenarios. Comparisons of the OSCE to individual HFPSs as well as the combined HFPS means were performed using paired t-tests with an alpha value of 0.05. Results: The mean number of times that the LCJR indicators occurred in the OSCE setting was significantly higher (p < 0.05) than in either individual HFPS setting, indicating that the OSCE setting provided more opportunities for measuring CJ than a single HFPS setting. When comparing the OSCE to the combined HFPSs setting the mean counts of LCJR Indicators 3, 4, 5, 7, and 9 were higher in the OSCE, while counts for LCJR Indicators 2, 6, and 8 were higher in the combined HFPS settings. Indicators 3, 5, and 7 count means were more than five counts higher, indicating a likely impact on the accuracy of CJ scores regarding those indicators and a more favorable environment to measure those indicators within the OSCE setting. Participants reflected on their simulation experiences by answering written questions during the debriefing sessions to measure Indicators 10 and 11. Opportunities to measure Indicator 10 were similar between the two settings, while Indicator 11 occurred more in the students’ written OSCE debriefing than in HFPS debriefing. No variability existed with Indicators 10 and 11, thus statistical significance could not be determined. Conclusions: The overall higher mean count of LCJR opportunities in the OSCE setting suggests that OSCE provides a comparable number opportunities to measure CJ of senior nursing students. While previous research has validated the use of the LCJR tool in the HFPS setting, the results of this study suggest that the LCJR may be used in the OSCE setting and be similarly suitable. The OSCE uses less faculty resources than HFPS and thus may be a more cost-effective mode for evaluating CJ. However, additional research is needed to establish the validity and feasibility of using the LCJR tool in the OSCE setting to measure CJ in senior nursing students prior to graduation.
    • Expression and Characterization of Equine Herpesvirus 1 (EHV-1) ORF19 Product, the Virion-Associated Host Shutoff (VHS) Homolog

      Feng, Xuan; Department of Biochemistry and Molecular Biology (1996-08)
      The ability of herpes simplex virus types 1 and 2 (HSV-1 and -2) to repress host cell protein synthesis early in infection has been studied extensively and found to involve the activities of one or more viral proteins. These viral regulatory proteins are components of infecting virions and influence gene expression during the early stage of viral infection. One of the most obvious effects is rapid suppression of host protein synthesis, which has been termed virion host shutoff (vhs). It has been demonstrated that virion host shutoff is due to disruption of host polyribosomes and accelerated turnover of cellular mRNAs. In general, HSV-1 strains inhibit host protein synthesis somewhat more slowly than HSV-2 strains. This inhibition has been demonstrated using multiplicities of infection (m.o.i.) as low as 4 plaque forming units (pfu) and is apparent in infected cultures within 3 hr postinfection. The phenomenon of HSV-1 virion-associated host shutoff has been studied extensively and shown to be mediated by a tegument protein encoded by the UL41 gene. This process occurs in the absence of de novo viral gene expression. Several HSV-1 vhs mutant viruses have been selected and characterized which are defective in both protein synthesis and cellular mRNA degradation, indicating that the vhs protein is responsible for host protein synthesis shutoff. HSV-1 UL41 homologs have been identified in the genomes of several other alphaherpesviruses, such as pseudorabies virus (PRV), varicella zoster virus (VZV), and equine herpesvirus type 1 (EHV-1). However, little is known about the expression of these vhs homolog genes or the functions of their putative products. To begin investigating EHV-1 vhs activity, initial studies were performed to compare the effect of EHV-1 and HSV-1 infection on cellular protein synthesis and mRNA degradation in four actinomycin-D treated cell types, including equine dermis (ED) cells, rabbit kidney (RK) cells, baby hamster kidney (BHK) cells, and primary hamster embryo (HE) cells. Interestingly, neither virion-associated suppression of cellular protein synthesis nor degradation of mRNA during EHV-1 infection at 10 or 50 pfu/cell was observed, whereas comparable HSV-1 infections resulted in dose-dependent inhibition of host protein synthesis and increased degradation of cellular mRNA. These data demonstrated that EHV-1 infection does not result in virion-associated host shutoff activity comparable to that of HSV-1. There are several possible explanations for the observed differences in host protein synthesis and cellular mRNA stabilities between EHV-1 and HSV-1 infections: (1) EHV-1 ORF19, the HSV-1 UL41 homolog, is not expressed in EHV-1 infection, therefore no ORF19 protein is available for packaging into virions; (2) ORF19 is expressed as an active vhs protein, but that protein is not efficiently packaged into EHV-1 virions; (3) the ORF19 protein is expressed and packaged similarly to HSV-1 vhs, but it is structurally divergent from HSV-1 vhs such that it lacks strong vhs activity; (4) the ORF19 protein is present in EHV-1 viral particles and has intrinsic vhs activity, but that activity is abrogated during viral infection. The purpose of this study was to analyze EHV-1 ORF19 with respect to: (1) expression of ORF19 and its temporal regulation during lytic viral infection; (2) detection of ORF19 protein expression during EHV-1 infection and localization of ORF19 protein in viral particles; (3) determination of the intrinsic vhs activity of ORF19 protein compared to that of HSV-1 vhs; (4) structural, functional, and mutational comparisons of EHV-1 ORF19 protein and HSV-1 vhs; and (5) examination of potential physical association of ORF19 protein with another viral tegument protein, EHV-1 a-TIF, the agene transinducing factor, and of potential regulation of ORF19's vhs activity by a-TIF via this interaction. The results of these analyses will aid in determining which, if any, of these four postulated explanations appears most valid, and provide the first extensive characterization of vhs expression and function in an alphaherpesvirus other than herpes simplex virus.
    • Expression and Purification o f a Secretory Human Liver Carboxylesterase

      Miller, Amanda D.; Department of Biochemistry and Molecular Biology (1998-09)
      Serine-dependent carboxyiesterases (E.C. are found in a variety o f tissues with high activity detected in the liver. Carboxyiesterases (CaE) hydrolyze aliphatic and aromatic esters, and aromatic amides; and play an important role in the detoxification of xenobiotic chemicals that contain organophosphate (OP) compounds. The detoxifying ability of CaE is limited by its low concentration in serum where it encounters OP compounds. Studies in our laboratory have shown that a pRc/CM V-hCaE plasmid construct, stably integrated into 293T cells, expresses a hum an liver CaE in culture. However, the enzyme levels reached a steady state of expression. The goals of this study were to overexpress a functional human liver CaE from a recombinant cDNA in a human cell line, and isolate and purify the recombinant protein. To accomplish these goals, the codon for the terminal leucine (CTG) of the human liver CaE retention signal, HIEL (hisile- glu leu), was mutated to that of arginine (CGG). The terminal G o f the arginine codon was also mutated to C, to produce a unique ECOA11YL restriction site to aid in clone selection. The recombinant plasmid, pRc/CMV-mhCaE, was isolated and stably integrated into human 293T cells. Expression of the altered cDNA resulted in secretion of an active CaE to levels in the range of two to five enzyme units per ten milliliters of growth medium. Secretory CaE displayed isoelectric focusing patterns similar to those of the native enzyme with no observable changes in activity. The secreted enzyme was partially purified by hydrophobic interaction chromatography and cibacron blue affinity chromatography. Partial enzyme purification was achieved, and CaE retained a high level of enzymatic activity.
    • Expression and regulation of hemochromatosis genes in retina

      Gnana Prakasam, Jaya Pranava; Department of Biochemistry and Molecular Biology (2009-04)
    • Expression and regulation of hemochromatosis genes in retina

      Prakasam, Jaya Pranava Gnana; School of Graduate Studies (2009-04)
    • Expression of P8 in Oral Squamous Cell Carcinoma

      Bingham, Christopher M.; Department of Oral Biology; Georgia Regents University (2011-11)
      Oral cancer is a public health problem. Although the oral cavity is easily accessible as is the population at risk, early diagnosis has been painfully slow. As a result, the mortality rate from oral cancer for the past three and half decades remains high (over 50%) in spite of new treatment modalities. Early detection and treatment will increase the survival rates of oral cancer patients. Also the search for reliable predictors of oral cancer progression and prognosis remains a major challenge. The objective of the present study was to investigate the expression of p8, a transcription factor known to exhibit paradoxical expression and role in several human cancers, in archived tissues of human oral squamous cell carcinomas (OSCC) by immunohistochemistry in a retrospective study. Expression was thereafter correlated with clinical/outcome parameters. In addition, the effects of p8 silencing on some key tumorigenic hallmarks of oral carcinogenesis were investigated via lentiviral-mediated shRNA techniques. Results indicated that p8 is upregulated in ~85% of OSCCs. Although there was no correlation between p8 expression and clinical variables/prognostic outcome (except for the degree of tumor differentiation), p8 silencing resulted in decreased cell proliferation and a significant downregulation (>50%) of proliferation marker Ki-67 as well as the downregulation of two other gene products (CEBPβ and Nrf1). In conclusion, these results suggest that p8 may play a role in the pathways involving proliferation markers critical for oral cancer progression and metastatic spread. Moreover, the data provides a framework for future studies elaborating on p8 mechanistic networks involved in oral cancer biology. This is with a view to identifying target points for the design of potent vi biomimetics for intervention in oral cancer. Furthermore, the potential interaction of p8 with Nrf1 and CEBPβ presents another line of inquiry as to the mechanistic and/or functional implications and outcome of such biologic interaction.
    • Factors associated with turnover among nurses in Taiwan

      Yang, Ke-Ping Agnes; School of Nursing (1987-12)
      The purpose of this study wasta examine the factors r~lated to nurses' turnover in Taiwan, the Republiq, of Ghina. Abelson~s (1986) lntegrCllted Turnover a I I ' Process Model, which ass~mes a causal relationship between an-employee's perceptions of indi~idual, organizational, atld environmental factors and that individual's decision to leave thei·r job, provided the theoretical basis for this - r . . study. A retrospective, descriptive correlational study design was-employed. Two h~ndred ar:1d thirty-$eve~ n~wly hi..red registered nurses who nad vo'lu~tarily le~ ~heir last position within the lasj twelve months were chos~n from eight large teac~ing hospitals loqated in the f110St populated areas o.f Taiwan .. A two-part \ questionnaire, an adaptation of--McCios-key's 1974 toolJor studying nursing turnover in the U.~. was used to collect.the da~a. ,A paQel of ~ive experts judged ~ - \, -- ' ' ,.. _.... . tbe final questio,nnaire-to have .conter:1t and translation validity. The Cronbach's alpha reliability score for Part ll_~f the que$tionn~ire us~d in, thi~ st~,Jdy w~s 0.98. Organizational ·level factors considered' most impo~ant when seeking a job were cited by 84.4 percent of t~e respondents. All 45 reward or incentive items in Part II of the questionnaire would have influenced some of the respondents to remain in their last position. Correlation statistics, Pearson r, t-Test, and ·one-way AN OVA were employed to test the relationships between ten selected fndividual, organizational, o~ environmental level variables and . nurses' length of service. Finding$ indicate that there was a significant relationship between length of service and age, marital status, relationship behavior, salary, hospital bed size, and type of hospital (private or public). , - The desire for better financial compensation for their work, opportunities for career advancement through continuing and formal education, more professional recognition from their supervisors, pe·ers, and physicians for their contribution to patient care, and more autonomy in their clinical practice appear to be shared by nurses in the Republic of China and the United States. Recommended approaches based on these findings which will assist administrators in retention as well as recruitment of nurses are presented.
    • Factors in student attrition

      Laird, Lee; Nauright, Lynda; School of Nursing (1973-12)
    • False coverage rate - adjusted smoothed bootstrap simultaneous confidence intervals for selected parameters

      Sun, Jing; Department of Biostatistics and Epidemiology (Augusta University, 2020-05)
      Many modern applications refer to a large number of populations with high dimensional parameters. Since there are so many parameters, researchers often draw inferences regarding the most significant parameters, which are called selected parameters. Benjamini and Yekutieli (2005) proposed the false coverage-statement rate (FCR) method for multiplicity correction when constructing confidence intervals for only selected parameters. FCR for the confidence interval method is parallel to the concept of the false discovery rate for multiple hypothesis testing. In practice, we typically construct FCR-adjusted approximate confidence intervals for selected parameters either using the bootstrap method or the normal approximation method. However, these approximated confidence intervals show higher FCR for small and moderate sample sizes. Therefore, we suggest a novel procedure to construct simultaneous confidence intervals for the selected parameters by using a smoothed bootstrap procedure. We consider a smoothed bootstrap procedure using a kernel density estimator. A pertinent problem associated with the smoothed bootstrap approach is how to choose the unknown bandwidth in some optimal sense. We derive an optimal choice for the bandwidth and the resulting smoothed bootstrap confidence intervals asymptotically to give better control of the FCR than its competitors. We further show that the suggested smoothed bootstrap simultaneous confidence intervals are FCR-consistent if the dimension of data grows no faster than N^3/2. Finite sample performances of our method are illustrated based on empirical studies. Through these empirical studies, it is shown that the proposed method can be successfully applied in practice.
    • Feasibility of immunogold visualization of nuclear antigens by scanning electron microscopy

      Smith, Mary Leverett; Department of Cell and Molecular Biology (1987-09)
    • Fecal Streptococci Determinations In Water From a Small Urban Lake and Tributary

      Bruker, Eugene; Department of Cell and Molecular Biology (1962-06)
    • Female Teens Step It Up with the Fitbit Zip: A Randomized Controlled Pilot Study

      Linck, Donna Teresa; Department of Physiological & Technological Nursing (5/22/2018)
      Physical inactivity is a global pandemic. Six percent of all deaths globally (approximately 3.2 million people) are the result of insufficient physical activity, and 80% of adolescents worldwide do not get the recommended levels of daily physical activity. Depression is a major cause of disability worldwide and is a significant disease of burden for most age groups. Female adolescents are more than twice as likely to experience depressive symptoms as their male counterparts. The primary purpose of this randomized controlled pilot study was to determine if the use of electronic activity monitors, specifically Fitbit Zips, and daily step goals would increase physical activity participation in female adolescents. The secondary purpose was to determine if participation in a 12-week intervention using Fitbit Zips together with step goals would reduce depressive symptoms in female adolescents. The tertiary purpose was to determine the feasibility of recruiting and retaining female adolescents (80% or more) in the study and having them adhere to the research protocol. There were no available research studies examining physical activity and depressive symptoms in female adolescents using Fitbit Zips as an intervention to increase physical activity and decrease depressive symptoms. A convenience sample of 44 female adolescents from two church youth groups in the southeastern United States participated in the study. The mean age of the participants was 16.6 years. Psychosocial variables such as self-efficacy, social support, and commitment to a plan of action were assessed. Using mixed model analysis, no significant differences (p = .678) were found between the experimental (Fitbit-E) and control groups (Fitbit-C) on average median steps per day. The Fitbit-C group had 6,088.3 (SE = 668.6) average median steps per day at baseline, but only had 2,783.7 (SE = 698) average median steps per day at posttest. The Fitbit-E group had a lesser decline with 6,279.1 (SE = 661) average median steps per day at baseline and 4,339.4 (SE = 728) average median steps per day at posttest. Both groups’ depression scores, as measured by the CES-D, decreased from pretest to posttest, indicating an improvement in depressive symptoms. However, the difference between the two groups on depression scores was not statistically significant (p = .425). Post hoc pairwise comparisons yielded statistically significant decreases in depression scores for the Fitbit-C group (p = .002) and for the Fitbit-E group (p < .001) from pretest to posttest. Additionally, 42 out of 44 participants (95%) completed final CES-D surveys, and 35 out of 44 (79.5%) had some final step count data at post-test. Therefore, it was feasible to recruit and retain 80% of the participants in this RCT pilot study, and they did adhere to the protocol. This study helps bring to light the importance of promoting physical activity and assessing for depressive symptoms in the female adolescent population. Although there were no significant differences between the experimental and control groups on depressive symptoms for the 12-week intervention period, within each group there were significant decreases in depressive symptoms. The results from this study provide the groundwork to further investigate the impact of EAMs on physical activity and depressive symptoms in female adolescents.
    • The fenestrations of serious membranes in relation to lymphatic absorption

      Williams, William B.; Department of Anatomy (1971-06)

      Fiedler, Jarred; Department of Biochemistry and Molecular Biology (2018-11)
      Campylobacter jejuni is a leading cause of bacterial gastroenteritis, with an annual incidence of 140 million cases globally and 1.3 million cases in the United States. Approximately 1/1000 of C. jejuni infections lead to the onset of Guillain-Barré Syndrome, the world’s leading cause of acute paralysis. While the pathogenic mechanisms of C. jejuni are incompletely understood, it is known that flagellar motility is a primary virulence factor. Flagella are involved in host cell adherence and invasion, biofilm formation, and chick colonization. Flagellar assembly is dependent on the coordinated regulation of flagellar subunit synthesis via transcriptional and post-transcriptional regulators, as well as flagellar chaperones which maintain flagellar subunits in an unfolded state. In C. jejuni, the post-transcriptional regulator CsrA regulates flagellar biogenesis in C. jejuni by binding to the mRNA for flaA, repressing FlaA synthesis. CsrA regulatory activity on flagellar and non-flagellar targets is predicted to be modulated by protein-protein interactions with the flagellar chaperone FliW. Both FliW and a second flagellar chaperone FliS are predicted to participate in flagellar assembly by binding to FlaA. Therefore, we investigated the roles of FliW and FliS in CsrA regulation and flagellar biogenesis by constructing and characterizing a fliS mutant of C. jejuni strain 81-176, and by testing for the presence of protein-protein interaction(s) among CsrA, flagellin, and flagellar chaperones. We created an in-frame deletion mutant of fliS, and determined that the deletion of fliS resulted in a loss of motility and reduced the capacity of C. jejuni to autoagglutinate and form biofilm. We also used a bacterial two-hybrid system to study possible binding among the flagellarrelated proteins FlaA, FliS, FliW, and CsrA. Additionally, we performed deletion analysis of fliW in pT25, with the goal of identifying the region of FliW that mediates binding to CsrA. CsrA bound to full-length FliW, but no other protein-protein interactions were evident using the two-hybrid system. Surprisingly, CsrA did not interact with fragments of FliW, suggesting that the CsrA-binding site of FliW may be complex. These results show that flagellar biogenesis is accomplished by interactions of flagellar chaperones that link motility with the regulation of Campylobacter pathogenesis-related properties.
    • Fluoride metabolism : effect of caffeinated beverages / by Xiaoyan Chen.

      Chen, Xiaoyan; Department of Oral Biology (1992-05)
    • From Adipokines to Atherosclerosis: The Role of Adipose Tissue in Inflammation and Etiology of Vascular Disease

      Bundy, Vanessa; Vascular Biology Center (2007-04)
      The prevalence of overweight and obese has steadily increased over the years among males and females of all ages, all racial and ethnic groups, and all educational levels. Recent studies have established adipose tissue as a dynamic, endocrine organ with the capacity to secrete a number of adipokines which may act directly upon the vasculature to stimulate adhesion molecule expression and exacerbate vascular disease. Our aim was to elucidate the associations of vasoactive pro- and anti- inflammatory factors, including adhesion molecules, with adiposity, blood pressure and endothelial function, and to distinguish race and sex variations in these relationships. To accomplish this, we expanded upon existing measurements within a Georgia Prevention Institute cross-sectional study entitled Lifestyle, Adiposity & Cardiovascular Health in Youths (LACHY) by adding two cardiovascular disease risk factor domains: inflammation and vascular adhesion. Our model included measurements of adiposity, adiponectin, C-reactive protein, leptin, insulin, resistin, tumor necrosis factor-a, interleukin-6, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, blood pressure and endothelial-dependent arterial dilation. Our findings include numerous race and sex differences in the concentration of circulating risk factors along with significant interactions between them and measurements of adiposity. However, we did not find circulating cardiovascular disease risk factors or their concentration differences to be significantly associated with blood pressure or endothelial function. We believe this to be largely due to the fact that our subjects were young and apparently healthy at time of measurement. Overall, our findings provide insight into the relationships between adiposity, inflammation and cardiovascular outcomes in black and white, male and female adolescents. Future studies are needed to further elucidate these relationships and how they may change over time.