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Recent Research Publications and Funding
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October 28, 2013 4:00AM
Background: Preeclampsia contributes significantly to pregnancy-associated morbidity and mortality as well as future risk of cardiovascular disease in mother and offspring, and preeclampsia in offspring. The lack of reliable methods for early detection limits the opportunities for prevention, diagnosis, and timely treatment.Purpose: The purpose of this study was to explore distinct DNA methylation patterns associated with preeclampsia in both maternal cells and fetal-derived tissue that represent potential biomarkers to predict future preeclampsia and inheritance in children.Method: A convenience sample of nulliparous women (N = 55) in the first trimester of pregnancy was recruited for this prospective study. Genome-wide DNA methylation was quantified in first-trimester maternal peripheral white blood cells and placental chorionic tissue from normotensive women and those with preeclampsia (n = 6/group).Results: Late-onset preeclampsia developed in 12.7% of women. Significant differences in DNA methylation were identified in 207 individual linked cytosine and guanine (CpG) sites in maternal white blood cells collected in the first trimester (132 sites with gain and 75 sites with loss of methylation), which were common to approximately 75% of the differentially methylated CpG sites identified in chorionic tissue of fetal origin.Conclusion: This study is the first to identify maternal epigenetic targets and common targets in fetal-derived tissue that represent putative biomarkers for early detection and heritable risk of preeclampsia. Findings may pave the way for diagnosis of preeclampsia prior to its clinical presentation and acute damaging effects, and the potential for prevention of the detrimental long-term sequelae.
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October 11, 2013 4:00AM
Immune dysregulation influences outcome following acute ischemic stroke (AIS). Admission white blood cell (WBC) counts are routinely obtained, making the neutrophil–lymphocyte ratio (NLR) a readily available biomarker of the immune response to stroke. This study sought to identify the relationship between NLR and 90 day AIS outcome. This study shows that the NLR, a readily available biomarker, may be a clinically useful tool for risk stratification when evaluating AIS patients as candidates for endovascular therapies.
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October 10, 2013 4:00AM
The Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals’ financial incentives with payers’ and patients’ quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses’ efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients.
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October 7, 2013 4:00AM
OBJECTIVE: Stressful life events experienced during childhood and as an adult negatively impact mental and physical health over the life span. This study examined polymorphisms from 2 hypothalamic-pituitary-adrenal axis-related genes previously associated with posttraumatic stress disorder-FKBP5 and CRHR1-as moderators of the impact of child abuse and adult stress on physical health.
METHOD: A national, community-based subsample of non-Hispanic European American respondents (n = 527) from a prospective longitudinal 3-year study of stress and coping (N = 2,729) provided saliva for genotyping.
RESULTS: FKBP5 (rs1360780) and CRHR1 (rs12944712) polymorphisms significantly interacted with child abuse and adult stress to predict increases in physical health ailments over 3 years. Child abuse and adult stress were strongly related to physician-diagnosed physical ailments among individuals with the risk alleles of both single nucleotide polymorphisms. Individuals carrying the low-risk homozygotic genotypes were protected from the long-term negative health implications of experiencing both child abuse and adult stress.
CONCLUSION: Consistent with theories linking the hypothalamic-pituitary-adrenal axis with stress-related disease, hypothalamic-pituitary-adrenal axis polymorphism genotypes moderated the association between exposure to child abuse/adult stress and long-term physical health outcomes in a national sample.
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Loneliness and Quality of Life in Chronically Ill Rural Older Adults| October 1, 2013 4:00AM
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October 1, 2013 4:00AM
Sexual activity and alcohol use continue to have negative effects on the well-being of today’s adolescents. This study used multiple regression analysis to examine relationships among personal factors, family factors, and adolescent sexual activity and alcohol use over three time points. Significant protective factors, which were inversely related to risky behavior, included general adolescent–mother communication, father and family connectedness, and disapproving parental attitudes towards sex. Permissive parenting was associated with self-efficacy for safe sex, early sexual initiation, and increased alcohol use. Health care providers should work to promote positive parent–child relationships and familial protective effects.
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September 23, 2013 4:00AM
The National Quality Forum (2011) recommends the use of alcohol based skin preparation agents prior to surgery to help prevent infections. This multi-hospital study (n=3,794) evaluates its use in a general surgery patient population prior to the NQF recommendation. Forty-seven percent of cases received an alcohol based skin preparation agent.
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September 10, 2013 4:00AM
Oncology nurses have a great opportunity to prevent cancer—not just treat it! Media outlets recently reported Michael Douglas’ diagnosis of throat cancer and his statement that human papillomavirus virus (HPV) infection caused his cancer. Oncology nurses can lead the way in efforts to protect the next generation from this type of cancer if they know the facts about HPV vaccination for both girls and boys.
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September 9, 2013 4:00AM
The Baltimore-based CAPABLE program combines the talents of occupational therapists, registered nurses, and handymen to address clients’ self-identified problems in home safety, fall prevention, and basic and instrumental activities of daily living
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September 6, 2013 4:00AM
A pilot study was conducted to learn more about the prevalence of loneliness in rural older adults with chronic illness and how it affects their quality of life. The purposes of the data analysis reported here were twofold: to describe loneliness, chronic illness diagnoses, chronic illness control measures, prescription medication use, and quality of life in a sample of rural older adults; and to examine the relationships among these elements.