Browsing by Subject "Risk assessment"

Now showing 1 - 7 of 7
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    Characterization of Behavioral Profiles for Inbred P and NP and Congenic P.NP and NP.P Rats
    (2012-08-27) Jensen, Meredith; Grahame, Nicholas J.; Stewart, Robert; Czachowski, Cristine; Roman, Erika
    Alcoholism inheritance rates have been estimated as high as 60% in a human population. Many significant features of alcohol dependence have been replicated in rodent animal models of alcoholism, however not in totality. These animal models include inbred preferring (iP) and nonpreferring (iNP) rat types. Congenic rats have been engineered from the iP and iNP strains whereby a P congenic rat has in its genome a well-chosen chromosomal portion taken from an NP rat (P.NP) and, reciprocally, an NP congenic rat has acquired the analogous DNA from a P rat (NP.P). In this case, a quantitative trait locus (QTL) from chromosome 4 is the donor genetic material for the congenic rats. It is of great interest to further study this chromosome 4 QTL because it has been found to control a significant portion of ethanol consumption behavior in iP and iNP rats. This study aimed to behaviorally profile the iP, iNP and reciprocal congenic rats. As a result of the behavioral profiling of these genetically related groups, some conclusions could be made regarding which behaviors appear to be controlled by the chromosome 4 donor DNA.This study primarily utilized the Multivariate Concentric Square Field apparatus (MCSF) to characterize behavioral profiles for the inbred and congenic rats. The Open field (OF) and Elevated plus maze (EPM) supported this effort. The MCSF is valuable in that it allows for the animals to interact within an environment that has ethological value. The 12 different zones that make up the field are characterized by some functional quality in terms of type and duration of behavior performed, etc. The behavioral data is aggregated and finally represented in terms of five functional categories, the elements of the behavioral profile: general activity, exploratory activity, risk assessment, risk taking, and shelter seeking. The study hypotheses were shaped by prior research suggesting that iPs should display lower general activity and risk taking strategy than iNPs in the MCSF. Inbred Ps should be more active in the OF and spend more time in the center of the EPM. Generally, it is expected that the iP QTL confer behavioral phenotypes to the iNP strain that deviate toward a "P" behavioral phenotype and reciprocally, the iNP QTL confer behavioral phenotypes to the iP strain that deviate toward an "NP" behavioral phenotype. The results showed that iP rats performed more risk assessment and risk taking behavior and less shelter seeking and anxiety-like behavior than iNP rats. It followed that P.NP congenic rats significantly downgraded their risk assessment and risk taking behavior when compared to iP rats. This decrease can be attributed to the chromosome 4 QTL donated from the iNP breed. All together this study concludes that risk assessment and risk taking behavior in the iP rats is controlled by the same DNA region that, in part, determines voluntary intake of ethanol consumption. Further fine mapping of the QTL region should help in discovering if the same DNA sequences that influence ethanol intake also significantly influence risk behavior.
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    Clinical presentations and outcomes of bile duct loss caused by drugs and herbal and dietary supplements
    (Wiley, 2017-04) Bonkovsky, Herbert L.; Kleiner, David E.; Gu, Jiezhun; Odin, Joseph A.; Russo, Mark W.; Navarro, Victor M.; Fontana, Robert J.; Ghabril, Marwan S.; Barnhart, Huiman; Hoofnagle, Jay H.; U.S. Drug Induced Liver Injury Network Investigators; Medicine, School of Medicine
    Bile duct loss during the course of drug-induced liver injury is uncommon, but can be an indication of vanishing bile duct syndrome (VBDS). In this work, we assess the frequency, causes, clinical features, and outcomes of cases of drug-induced liver injury with histologically proven bile duct loss. All cases of drug-induced liver injury enrolled into a prospective database over a 10-year period that had undergone liver biopsies (n = 363) were scored for the presence of bile duct loss and assessed for clinical and laboratory features, causes, and outcomes. Twenty-six of the 363 patients (7%) with drug-, herbal-, or dietary-supplement-associated liver injury had bile duct loss on liver biopsy, which was moderate to severe (<50% of portal areas with bile ducts) in 14 and mild (50%-75%) in 12. The presenting clinical features of the 26 cases varied, but the most common clinical pattern was a severe cholestatic hepatitis. The implicated agents included amoxicillin/clavulanate (n = 3), temozolomide (n = 3), various herbal products (n = 3), azithromycin (n = 2), and 15 other medications or dietary supplements. Compared to those without, those with bile duct loss were more likely to develop chronic liver injury (94% vs. 47%), which was usually cholestatic and sometimes severe. Five patients died and 2 others underwent liver transplantation for progressive cholestasis despite treatment with corticosteroids and ursodiol. The most predictive factor of poor outcome was the degree of bile duct loss on liver biopsy. CONCLUSION: Bile duct loss during acute cholestatic hepatitis is an ominous early indicator of possible VBDS, for which at present there are no known means of prevention or therapy.
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    The Creation and Validation of the Activation-Valence Affective Traits Survey (AVATS)
    (2012-07-03) Coskunpinar, Ayca; Cyders, Melissa A.; Devine, Dennis J. (Dennis John); Stewart, Jesse C.
    Aim: The goals of the current studies were to (a) create a measure of affective traits that can assess both the discrete and the underlying dimensions of affective traits and (b) examine the reliability and validity of the scale in two independent samples. Participants: Participants were undergraduate students at a large, public US mid-western university (Study 1 N = 616; Study 2 N = 510). The mean age for Study 1 was 21.10 (SD = 5.05) and 21.02 for Study 2 (SD = 4.96). Design: Exploratory and confirmatory factor analyses were conducted to examine internal factor structure of the scale. A series of correlational, reliability, and hierarchical regression analyses were conducted to examine convergent, divergent, and criterion-related validity of the new scale. Findings: Activation-Valence Affective Traits Survey (AVATS) had good reliability and adequate construct, convergent, and discriminant validity as a measure of affective traits. Conclusions: This study introduces a new scale for measuring affective traits that offers more information on both the categorical and dimensional conceptualizations of affective traits, which also has predictive utility in relation to problem-related alcohol consumption.
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    Opioid-related risk perceptions in chronic pain: influence of patient gender and previous misuse behaviors
    (International Association for the Study of Pain, 2021-07) Grant, Alexis D.; Miller, Megan M.; Anastas, Tracy M.; Quinn, Patrick; Lok, Benjamin; Hirsh, Adam T.; Psychology, School of Science
    Little is known about the factors that influence providers' perceptions of patient risk for aberrant opioid use. Patient gender may interact with previous opioid misuse to influence these perceptions. We asked 131 physicians to view videos and vignettes for 8 virtual patients with chronic pain. Gender (male/female) and previous prescription opioid misuse (present/absent) varied across patients; the vignettes were otherwise balanced on demographic and clinical characteristics. For each patient, providers assessed 4 risk domains: opioid-related adverse events, opioid misuse or abuse, opioid addiction, and opioid diversion. Results indicated a significant gender-by-misuse interaction for risk of opioid misuse orabuse. When previous misuse behaviors were absent, providers rated men at higher risk; there was no gender difference when previous misuse behaviors were present. A significant gender-by-misuse interaction was found for risk of opioid-related adverse events. Providers perceived men to be at higher risk when previous misuse behaviors were absent; there was no gender difference when previous misuse behaviors were present. A significant gender-by-misuse interaction was found for risk of opioid addiction. Providers rated women at higher risk when previous misuse behaviors were present and men at higher risk when previous misuse behaviors were absent. There were significant main effects of gender and misuse for risk of opioid diversion. Providers rated men and those with previous misuse behaviors at higher risk. These results demonstrate that patient gender and previous opioid misuse have unique and interactive effects on provider perceptions of prescription opioid–related risks. Studies are needed to identify the mechanisms underlying these effects, such as gender-based stereotypes about risk-taking and drug abuse.
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    Perceptions and attitudes toward performing risk assessment for periodontal disease: a focus group exploration
    (BMC, 2018-05-21) Thyvalikakath, Thankam; Song, Mei; Schleyer, Titus; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Currently, many risk assessment tools are available for clinicians to assess a patient’s periodontal disease risk. Numerous studies demonstrate the potential of these tools to promote preventive management and reduce morbidity due to periodontal disease. Despite these promising results, solo and small group dental practices, where most people receive care, have not adopted risk assessment tools widely, primarily due to lack of studies in these settings. The objective of this study was to explore the knowledge, attitudes, and beliefs of dental providers in these settings toward risk-based care through focus groups.
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    Progress in Healthcare: Securing a New Common Norm in Medical Technology
    (2016-04-08) Gookins, Alexandra
    In the modern age of Healthcare Technology, there are vast changes in patient records. In the 1960s, the first use of EHRs (Electronic Health Records) was implemented in the Mayo Clinic of Rochester, Minnesota. (Earl) However, EHRs continue to enhance at a rapid rate and are becoming one of the fastest growing industries worldwide. The problem that arises with keeping confidential patient information on the cloud or servers is the access to hackers looking to steal information for misuse and causing detrimental harm to patients’ privacy. Thus, HIMSS (Healthcare Information and Management Systems Society) has continued to put rules and regulations into effect across the board of EHR systems. The issue is that these security measures do not fall on to the EHR system software creators but the medical practices themselves. (Health IT) But who in these practices or hospitals are going to regulate these significant measures? Many do not know that there is a software on the market today what will handle these tedious adjustments for the safety of the businesses and patients. Software companies like HIPAA One will do just that. (HIPAA One) These small companies will work with your current EHRs in compliance with the federally regulated HIPAA laws to ensure practices and hospitals alike are providing safety of patient information by using security risk assessment tools. However, numerous users of electronic health records do not use these critical tools because there are not well known. I have observed many EHR systems, leading me to believe the importance of an EHR software that will integrate HIPAA compliant technology without a middle man such as HIPAA One; putting this responsibility on software designers instead of practices. 1. Earl, Elizabeth. Health IT & CIO Review. 16 Februrary 2015. 01 March 2016. . 2. Health IT. n.d. https://www.healthit.gov/providers-professionals/security-risk-assessment-tool. 01 March 2016. 3. HIPAA One. n.d. 05 March 2016.
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    Resources at Risk: The Coordinated Management of Meaning and Study Abroad
    (2012-03-16) Noblet, Nicholas Patrick; Parrish-Sprowl, John; Sandwina, Ronald M.; Goering, Elizabeth M.
    This study seeks to elucidate the concept of resources at risk as detailed in the Coordinated Management of Meaning (CMM) theoretical framework. Risk is the possibility that a communicator’s resources are in jeopardy of change, and this study seeks to explicate how a communicator places his or her resources at risk. An undergraduate spring break study abroad program was selected as the context for this examination, with six students participating in before and after interviews. Results showed that three types of resources at risk were identified, with a fourth type unable to be identified through transcript analysis. This study demonstrates theoretical and practical implications that further the understanding of CMM and its execution. In addition, limitations and areas for future research are discussed.