• Partnering With a Formal Program: Expanding the Boundaries of Family Caregiving for Frail Older Adults

      Poole, Deborah K.; Department of Biobehavioral Nursing (1999-12)
      Caring for frail older adults at home is an increasingly common lifestyle among American families. A growing array of community-based programs has been developed to assist family caregivers in this endeavor. Certain of these programs are comprehensive in nature and require a particularly close working relationship between the program’s health professionals and the lay caregiver at home. A paucity of literature exists that can act as a guide to formal and informal caregivers within such a context as they strive to develop an effective working relationship. This study used grounded theory methodology to develop a substantive theory of the process by which family caregivers of frail older adults establish and maintain a working relationship with a comprehensive formal caregiving system. The context of the study was a program belonging to the Program of All-inclusive Care for the Elderly (PACE) network. An initial sample of six primary caregivers of PACE participants was selected. The primary means of data collection was in-depth individual interviews with documents review also being used as a data source. An additional 13 primary caregivers were chosen via theoretical sampling for a total sample size of 19 informants. The method of constant analysis was employed to direct data acquisition and analysis until saturation was complete and the core variable was identified. The basic social-psychological problem identified by informants was termed Helplessness, defines by them as “needing additional help with caregiving.” Partnering with the Program was the basic social-psychological process informants used to relieve their helplessness in caregiving. Partnering with the Program was comprised of three phases: Connecting, Discovering Self, and Transcending Self. The first phase of Connecting represented “the honeymoon phase” of the relationship with the program and was made up of three stages: finding out, “joining up”, and adjusting. Discovering Self, the second phase, had three stages: communicating concerns, evaluating the program’s response, and expecting more. Informants in this phase related with the program in a conflicted manner, wanting to assert their autonomy but realizing their dependence on the program. The final phase, Transcending Self, was also made up of three stages. These stages were monitoring, advocating, and choosing to work it out. The hallmark of the final phase was that informants chose to have a positive, family-like personal relationship with the program staff rather than perpetuate conflict over unmet desires about service provision. This substantive theory provided information heretofore unavailable regarding the trajectory of close healthcare relationships from the perspective of the family caregiver. Implications of the theory related to health and social policy, clinical practice with older adults, and nursing knowledge are made explicit in the final chapter of the report.
    • Patterns of Compensation in Alcohol Dependent Women

      Ambrogne, Janet A.; Department of Physiological and Technological Nursing (1999-04)
      Over the past two decades there has been an increase in the number of research studies addressing alcohol and drug dependent women. Findings from these studies support a number of characteristics unique to women that have implications for treatment. Despite these findings, the majority of existing treatment modalities for substance dependence have continued to be based on traditional models of additions and treatment. Further, few studies have explored women's perceptions of their alcohol use, or the struggles that women encounter in their efforts to temper their alcohol use. The purpose of this qualitative study was to forward an interpretive theory about how alcohol dependent women experience temperance. This study was a focused ethnography, and was guided by a feminist perspective. The techniques of in-depth interviewing and participant observation were employed as a means of eliciting the perspective of a purposive sample of fourteen women. Concurrent data collection and analysis generated an interpretive theory that went beyond the women’s experiences with temperance. The theory: From Chaos to Connection: Patterns of Compensation in Alcohol Dependent Women, answered the questions, “What are women’s experiences with alcohol dependence?” A cultural theme of patterns of compensation was identified. The women used alcohol and other drugs as compensatory mechanisms to alleviate feelings of inadequacy and depression. Through participation in treatment and twelve-step self-help groups such as Alcoholics Anonymous, the women learned to replace their former compensatory mechanisms of drinking and using, with compensatory strategies designed to manage the disease of alcoholism. Even with successful abstinence, the women continued to struggle with feelings of depression and low self-worth. While they had learned purposeful strategies that facilitated abstinence, feelings of depression and inadequacy endured. These findings challenge the utility of dominant models of addiction such as the disease model, which focuses on substance dependence as the primary problem, in adequately meeting the needs of women who use alcohol and other substances to alleviate negative feelings such as depression. Findings from this study support the need to integrate other models of addiction, such as the Self-Medication Hypothesis into treatment programs for women. Implications for nursing, policy and future research directions are forwarded.
    • Patterns of compensation in alcohol dependent women

      Ambrogne, Janet A.; School of Graduate Studies (1999-04)
    • Penalized Least Squares and the Algebraic Statistical Model for Biochemical Reaction Networks

      Linder, Daniel F. II; Department of Biostatistics and Epidemiology (2013-07)
      Systems biology seeks to understand the formation of macro structures such as cellular processes and higher level cellular phenomena by investigating the interactions of systems’ individual components. For cellular biology, this goal is to understand the dynamic behavior of biological materials within the cell, a container consisting of smaller materials such as mRNA, proteins, enzymes and other intermediates necessary for regulating intracellular functions and chemical species levels. Understanding these cellular dynamics is needed to help develop new drug therapies, which can be targeted to specific molecules or specific genes, in order to perturb the system for a desired result. In this work we develop inferential procedures to estimate reaction rate coefficients in cellular systems of ordinary differential equations (ODEs) from noisy data arising from realizations of molecular trajectories. It is assumed that these systems obey the so called chemical mass action law of kinetics, with corresponding deterministic mass action limit as the system size becomes infinite. The estimation and inference is based on the penalized least squares estimates, where the covariance structure of these estimates corresponds to the solution of a system of coupled nonautonomuous ODEs. Another topic discussed here is that of network topology estimation. The algebraic statistical model (ASM) offers a means of performing this topological inference for the special class of conic networks. We prove that the ASM recovers the true network topology as the number of samples grows without bound, a property known in the literature as sparsistency. We propose a method to extend the ASM to a wider class of networks that are decomposable into multiple cones.
    • Perceived Conditions of Employment Among Hospital Registered in Georgia: A Comparative Analysis

      Futch, Joan W.; School of NursinG (1982-03)
      Employment conditions of registered nurses have to date not been studied in the State of Georgia. This investigation was conducted in order to compare ~urses' satisfaction or dissatisfaction with conditions of employment to retention, hospital setting, and hospital size, The present study identified specific factors in ~he work environment that contribute to the registered nurses' satisfaction or dissatisfaction with employment conditions.. This investigation, which is a partial replication of an earlier st ud.y by Wandel t ( 1980) , arose· out of concern for the shortage . of registered nurses in Georgia. A descriptive survey design was used to determine the relationship between perceived conditions of employment o~ register$d n~ses employed in 200- 400 bed acute medical-surgical hospitals. in the State of Georgia and their perceived job. satisfaction. It was hypothesi.zed thata (1) nurses employed in a hospital with a low turnover rate would express greater satisfaction with conditions of employment than nurses employed in a hospital with a high turnover rate; (2) nurses employed in a rural hospital would express greater satisfaction with conditions of employment than nurses employed in an urban hospital; and ( J) nurses employed in a 200 - 2?5 bed hospital would express great,er satisfaction with conditions of employment than nurses employed in a,J25 - 400 bed hospital. The results of ! test values, at the .05 level of significance, demonstrated statistically significant results for all three hypotheses posed.
    • Perceived effects on the family system when a wife/mother returns to school as reported by returnee

      Jackson, Jo Anne Christian; School of Nursing (1986-06)
      The foc~s of this study was the· female's ret~rn to school and her petception of its effect·on the family system. A tota~ of ·twenty females, selected through a snowball effect,· were interviewed ·in their homes. An interview technique· with demographic questionnaire 'Was utilized. The results of the st.udy indicated that the return to school had various similarities for the female. The suppoit 6f . . ·. spouse and f~mily was viewe~ as crucial. Di.~ision.of · labor d-id not change drastically nor did. t'ime spent with families. Quality of time with family.became more important and.the most positive effect of the return to school was seen as the increased interqction between husband and children. The study has implications for educators, counselors, health car~ providers and the families~ The greatest implication of the. study is the fact that the return to school. was viewed by most women in this study as being positive.
    • Perceived Professional Risk of School Nurses Associated with Delegation of Nursing Care Responsibilities to Unlicensed Personnel

      Hamilton, Bernita K; Department of Physiological and Technological Nursing (1997-05)
      The increasing numbers of children who require health care services while attending school have prompted the delegation of nursing care responsibilities to unlicensed personnel. School nurses have expressed legal and professional concerns regarding delegation. The purpose of this study was to describe current delegation practices of school nurses to unlicensed personnel, examine legal and professional standards which impact delegation decisions, and explore the perceived professional risk of school nurses associated with delegation and risk to the health and safety of students. A professional and legal regulation of practice model provided the conceptual framework. A descriptive design was used to investigate the delegation practices of school nurses in Georgia. Eighty-seven (N=193) school nurses returned completed questionnaires. Summary statistics were used to analyze the data. A Demographic Questionnaire provided information about sample characteristics. Analysis of data from the School Health Care Questionnaire determined the performance and delegation of nursing care responsibilities. Approximately 70% of the school nurses reported delegation to unlicensed personnel. Crosstabulation of performance and delegation revealed the most frequently delegated procedures as oral, inhalation, ophthalmic/otic, and topical medication administration; seizure procedures; gastrostomy feedings; vision and hearing screenings; and urinary catheterizations. The investigator-developed Professional Risk Related to Delegation Scale determined the importance of standards used in delegation decisions and the risk associated with delegation practices. The majority of participants rated the legal and professional standards as considerable to extreme importance in delegation decisions. Findings supported that items consistent with appropriate delegation practices had lower risk scores; whereas, items consistent with inappropriate delegation had higher risk scores. Overall, the school nurses reported moderate to very high professional risk and risk to the health and safety of students associated with delegation to unlicensed personnel. Findings show that school nurses in Georgia are concerned about professional risk associated with delegation to unlicensed personnel. These findings have implications for development of delegation practice models and refinement of legal and professional statutes and standards for the regulation of delegation.
    • Perceived Supportive Behaviours and Occupational Stress Among Nurses

      Allanach, Elaine J.; Department of Nursing (1988-04)
    • Perception of Police Encounters: An Investigation of Racial Differences, Anxiety, and Anger, Using Video and Transcript Stimuli

      Omelian, Sam; Department of Psychological Science (2017-06)
      Due to recent nationwide news reports involving police officers shooting and killing unarmed citizens, it is important to investigate the emotional potential impact of viewing these news sources. This study had two aims. The first aim was to investigate racial grouping differences in the perception of police and anxiety and anger levels towards police. Second, the project aimed to investigate whether the form of stimulus materials, video or transcript of a police encounter, affected participants’ responses. The sample consisted of 67 college age students from a southeastern university. Participants completed pretest anxiety and anger measures and a global perception of police scale. After viewing or reading about a police-citizen encounter, they completed posttest anxiety and anger measures. Results suggested that anxiety and anger increased significantly after viewing or reading about a police encounter, with the video stimulus creating stronger affective responses. Race did not significantly influence affective responses; however, Whites perceived police more positively than Non-Whites. In general, college students reported experiencing positive police encounters themselves. Findings confirm the power of visual media on affective responses and suggest that future researchers should think carefully about whether vignettes of police encounters are the best stimulus materials to use.
    • Peripheral Insulin Resistance Mediates Microvascular Dysfunction in Obese Mice via Increase NAD(P)H Oxidase Isoform one Mediated Superoxide Production

      Ali, Mohammed Irfan; Department of Physiology; Georgia Regents University (2010-07)
      The overall goal of the current study was to determine if improving the net glycemic load and lipid derangements associated with IR in obesity by genetically deleting PTP1B in a mouse model of obesity would improve microvascular function.
    • Person Variables, Psychosocial State Variables, and Reported Health Behaviors: Relationship to Preterm Delivery

      Kelley, Maureen; Department of Physiological and Technological Nursing (1993-12)
      The purpose of this study was to use a conceptual model of examine selected possible relationships among person variables, health behavior variables, and psychosocial state variables including anxiety, depression, life events, mastery, self-esteem, stress, and social support. Reported health behavior variables include smoking, drinking, drug use, prepregnant weight for height gain during pregnancy. The dependent variable was preterm delivery, which was defined as delivery before 37 weeks gestation. The dependent variable was preterm delivery, which was defined as delivery before 37 weeks gestation. The analyses used two subgroups of women. The subgroup consisted of 1163 women who delivered moderately preterm infants (32-37 weeks gestation). The second subgroup consisted of 1258 women who delivered both moderately preterm and very preterm infants (27-37 weeks gestation). Data were analyzed utilizing both univariate and multivariate statistics, with logistics regression as the principle multivariate technique. As a group, person variables and psychosocial state variables had direct relationships, as posited in the hypotheses and supported in the literature, to preterm delivery. Health behavior variables were directly related to preterm delivery in the variable set that contained both moderately preterm and very preterm infants. Indirect relationships were supported for the hypothesis that added psychosocial state to health behaviors. Individual variables that were associated with preterm delivery were self-esteem and mastery. Results of this study were significantly different than results of a parallel study using this same data set , but examining the association between psychosocial variables and intrauterine growth retardation
    • Phosphorylation of EPS8 Mediates Its Downstream Signaling and Biological Functions

      Shahoumi, Linah Abdalla; Biomedical Sciences (Augusta University, 2019-05)
      Epidermal growth factor receptor pathway substrate 8 (EPS8) is a scaffolding protein involved in regulating cell proliferation, actin dynamics and receptor trafficking in human cells. EPS8 expression is increased in a range of human cancers including head and neck squamous cell carcinoma (HNSCC). Previous studies have indicated that overexpression of EPS8 enhances mitogenesis and migration of tumor cells and is sufficient to convert non-tumorigenic cells to a tumorigenic phenotype. The non-receptor tyrosine kinase Src is reported to phosphorylate EPS8 at four tyrosine residues, although the impact of this on EPS8 function is unknown. The purpose of this study was to investigate the role of tyrosine phosphorylation of EPS8 at Src target sites in modulating biochemical functions, cell growth, motility, actin dynamics and tumorigenesis in HNSCC. Expression plasmids encoding EPS8 with amino acid substitutions to phenylalanine (F) at the four putative Src phosphorylation sites (Y485F, Y525F, Y602F, Y774F), and all four combined (FFFF), were prepared by site-directed mutagenesis. To evaluate the effect of unphosphorylated EPS8 on downstream signals and biological behavior, mutants were transfected into a model cell line, HN4, which expresses a low endogenous level of EPS8 similar to normal keratinocytes. Additionally, cells were treated with dasatinib, a Src inhibitor, to block phosphorylation of Src substrates. Expression of downstream targets of EPS8 was evaluated by western blotting. Wound closure, proliferation, immunofluorescence and tumorgenicity assays were used to investigate the impact of phenylalanine mutations on the biological functions of EPS8. Forkhead box (FOX) M1 transcription factor (FOXM1), aurora kinase A (AURKA) and aurora kinase B (AURKB) levels were decreased in cells expressing the non-phosphorylatable FFFF- and Y602F-EPS8 mutants, while cells harboring the Y485F-, Y525F- and Y774F-EPS8 mutants showed no differences in the expression of these proteins compared to controls. Consistent with this, dasatinib treatment resulted in a significant decrease in the expression of EPS8 downstream targets. In addition, both Y602F- and FFFF-EPS8 mutants elicited a significant reduction in tumor cell proliferation, motility and actin remodeling. However, blocking Src-mediated EPS8 phosphorylation showed increased tumorigenicity in vivo compared with non-transfected control. Conversely, blocking all putative Src phosphorylation sites except Y602 revealed an increase in the cell cycle mediators, tumor cell proliferation, motility, and a more prominent cortical actin cytoskeleton. These data suggest a crucial role for phosphorylation of EPS8 at Y602 in mediating pro-tumorigenic signal.
    • PHOTOBIOMODULATION AS A MITOCHONDRIAL TARGETED TREATMENT STRATEGY IN NEONATAL HYPOXIC ISCHEMIC ENCEPHALOPATHY

      Tucker, Lorelei; Department of Neuroscience and Regenerative Medicine (Augusta University, 2019-05)
      Neonatal hypoxic ischemic encephalopathy (HIE), initiated by hypoxic-ischemic (HI) injury to the brain in the perinatal period, is a leading cause of infant mortality and disability. HI damage to the developing brain triggers a complex pathology, initiating with mitochondrial insult, which culminates in neuronal cell death. Photobiomodulation (PBM), the application of near-infrared light, is an experimental neuroprotective strategy targeting the activity of mitochondrial cytochrome c oxidase (CCO), but its effect on HIE is unknown. This work was designed to shed light on the effect of PBM on a neonatal rat HI injury model. Postnatal day 10 mixed-sex pups underwent HI insult followed by 7 daily PBM treatment sessions via a continuous wave diode laser (808 nm). HI pups suffered significant ipsilateral hemispheric brain shrinkage and substantial cell death in the cortex and hippocampal CA1 and CA3 subregions. PBM treatment reduced neuronal cell death in the cortex and hippocampal subregions and reduced hemispheric brain shrinkage. HI pups displayed impaired motor function and spatial learning and memory which was ameliorated by PBM. Blood-brain barrier integrity was compromised in HI animals, as evidenced by reduced extravasation of Evans blue, but was reversed by PBM. PBM also mitigated microglial activation and upregulation of pro-inflammatory cytokines in HI pups. PBM treatment induced robust reduction in oxidative damage markers and protein carbonyl production in the cortex and hippocampus. Investigation of mitochondrial function revealed that PBM markedly attenuated mitochondrial dysfunction and preserved ATP production in neonatal HI rats. Furthermore, PBM treatment profoundly suppressed HI-induced mitochondrial fragmentation. PBM administration reduced activation of pro-apoptotic caspase 3/9 and TUNEL-positive neurons in HI pups. Finally, we demonstrated that the neuroprotective action of PBM could be reversed in a primary hippocampal neuronal OGD model by application of low-dose KCN, a CCO inhibitor. Taken together, our findings demonstrated that PBM treatment contributed to a robust neuroprotection via attenuation of mitochondrial dysfunction, oxidative stress, and neuronal apoptosis in the neonatal HI brain. Additionally, we demonstrated that these effects are, in part, mediated by modulation of CCO activity. This suggests that PBM may offer a promising role as a potential treatment strategy for HIE.
    • Physical Dissociation of G Protein Heterotrimers in Living Cells

      Digby, Gregory J.; Department of Neuroscience and Regenerative Medicine (2008-06)
      On the basis of numerous studies using cell membranes, it is commonly assumed that active G protein heterotrimers physically dissociate into GTPbound Gα and Gβγ subunits. However, due to inadequate evidence in vivo, several groups question this hypothesis. To explore this problem, we have developed an assay that measures G protein dissociation in living cells. We examined protein mobility using fluorescence recovery after photobleaching (FRAP) and found that Gβ1γ2 subunits formed heterotrimers with inactive immobile Gα subunits. When we activated heterotrimers with receptors, Gβγ subunits released from Gα, suggesting that G protein heterotrimers physically dissociate in living cells. To our knowledge this is the first definitive measure of this event in vivo. When different Gα isoforms were compared, we found that Gαi/o subunits released Gβγ dimers more readily than Gαs subunits, suggesting that heterotrimers differentially dissociate. To determine if differential release of Gβγ is a mechanism for Gα specific activation of Gated inwardly rectifying potassium (GIRK) channels, we activated GIRKs in cells expressing GαoA or Gαs subunits. We found that GαoA heterotrimers were more effective activators of GIRK channels than Gαs heterotrimers when comparable amounts of each were available. Thus, since GαoA subunits also released Gβγ dimers more efficiently than Gαs subunits, we propose that differential dissociation provides a mechanism for Gα specific activation of GIRK. In addition to providing a clear demonstration of G protein dissociation, we also propose a more complete model of the G protein cycle where active G proteins are in continuous association-dissociation equilibrium. Accordingly, at any given time during activation, G protein heterotrimers can cycle through several dissociation-association events until GTP is hydrolyzed. A model of the G protein cycle where GαGTP + Gβγ and GαGTPGβγ are both present during activation is included.
    • Physiological and biochemical changes from traumatic shock

      Galvin, Michael John; Department of Physiology (1975-06)