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Search Results: 1 - 10 of 6413 matches for " Michelle Davis "
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Diagnosing Patients with Age-Related Hearing Loss and Tinnitus: Supporting GP Clinical Engagement through Innovation and Pathway Redesign in Audiology Services
Adrian Davis,Pauline A. Smith,Michelle Booth,Margaret Martin
International Journal of Otolaryngology , 2012, DOI: 10.1155/2012/290291
Abstract: The public health challenge of hearing impairment is growing, as age is the major determinant of hearing loss. Almost one in four (22.6%) over 75-year olds reports moderate or severe worry because of hearing problems. There is a 40% comorbidity of tinnitus and balance disorders. Good outcomes depend on early presentation and appropriate referral. This paper describes how the NHS Improvement Programme in England used service improvement methodologies to identify referral pathways and tools which were most likely to make significant improvements in diagnosing hearing loss, effective referrals and better patient outcomes. An audiometric screening device was used in GP surgeries to enable thresholds for effective referrals to be measured in the surgery. Revised referral criteria, the use of this device, new “assess and fit” technology in the audiology clinic, and direct access pathways can transform audiology service delivery so that patient outcomes are measurably better. This, in turn, changes the experience of GPs, so they are more likely to refer patients who can benefit from treatment. At the end of 2011, 51 GP practices in one of the audiology pilot areas had bought HearCheck screeners, a substantial development from the 4 practices who first engaged with the pilot.
Diagnosing Patients with Age-Related Hearing Loss and Tinnitus: Supporting GP Clinical Engagement through Innovation and Pathway Redesign in Audiology Services
Adrian Davis,Pauline A. Smith,Michelle Booth,Margaret Martin
International Journal of Otolaryngology , 2012, DOI: 10.1155/2012/290291
Abstract: The public health challenge of hearing impairment is growing, as age is the major determinant of hearing loss. Almost one in four (22.6%) over 75-year olds reports moderate or severe worry because of hearing problems. There is a 40% comorbidity of tinnitus and balance disorders. Good outcomes depend on early presentation and appropriate referral. This paper describes how the NHS Improvement Programme in England used service improvement methodologies to identify referral pathways and tools which were most likely to make significant improvements in diagnosing hearing loss, effective referrals and better patient outcomes. An audiometric screening device was used in GP surgeries to enable thresholds for effective referrals to be measured in the surgery. Revised referral criteria, the use of this device, new “assess and fit” technology in the audiology clinic, and direct access pathways can transform audiology service delivery so that patient outcomes are measurably better. This, in turn, changes the experience of GPs, so they are more likely to refer patients who can benefit from treatment. At the end of 2011, 51?GP practices in one of the audiology pilot areas had bought HearCheck screeners, a substantial development from the 4 practices who first engaged with the pilot. 1. Introduction In the UK, NHS Audiology services are complex health systems in complex environments. They provide “end-to-end” care with newborn screening, diagnostic assessment of patients, dispensing of hearing aids, and appropriate follow-up to ensure good outcomes are obtained. Historically, audiology services were commonly commissioned from the acute sector and have had a low priority because of the silent and insidious nature of the disability. In addition, the general public do not see hearing impairment as a dramatic health problem requiring urgent intervention. First presentation in the UK is usually to the General Practitioner (GP). Although the majority (80%) of UK patients access their hearing care through the NHS [1], there is also an option to use the independent sector without a GP referral. There are recent initiatives involving screening, for example, by telephone or internet [2], which may in future lead to self-referral without the need for GP involvement. The public health challenge of hearing impairment is growing due to the demographics of the population, as age is the major determinant of hearing loss. Hearing impairment in the UK affects one in ten adults aged 55–74 years. Over the next 15 years hearing impairment will be an increasing population problem, because
Macronutrient Intake Influences the Effect of 25-Hydroxy-Vitamin D Status on Metabolic Syndrome Outcomes in African American Girls
Anna L. Newton,Lynae J. Hanks,Ambika P. Ashraf,Elizabeth Williams,Michelle Davis,Krista Casazza
Cholesterol , 2012, DOI: 10.1155/2012/581432
Abstract: The objectives were to determine the effect of macronutrient modification on vitamin D status and if change in 25-hydroxy-vitamin D concentration influences components of metabolic syndrome in obese African American girls. Methods. Five-week intervention using reduced CHO (43% carbohydrate; 27% fat: SPEC) versus standard CHO (55% carbohydrate; 40% fat: STAN) eucaloric diet. Subjects were 28 obese African American females, aged 9–14 years. Dual energy X-ray absorptiometry and meal test were performed at baseline and five weeks. Results. Approximately 30% of girls had metabolic syndrome. Serum 25OHD increased in both groups at five weeks [STAN: 20.3 ± 1.1 to 22.4 ± 1.1 (<0.05) versus SPEC: 16.1±1.0 to 16.8±1.0 (=0.05)]. The STAN group, increased 25OHD concentration over five weeks (<0.05), which was positively related to triglycerides (<0.001) and inversely associated with total cholesterol (<0.001) and LDL (<0.001). The SPEC group, had increase in 25OHD (=0.05), which was positively related to fasting insulin (<0.001) and insulin sensitivity while inversely associated with fasting glucose (<0.05). The contribution of vitamin D status to metabolic syndrome parameters differs according to macronutrient intake. Improvement in 25OHD may improve fasting glucose, insulin sensitivity, and LDL; however, macronutrient intake warrants consideration.
Nicotine Promotes Tumor Growth and Metastasis in Mouse Models of Lung Cancer
Rebecca Davis,Wasia Rizwani,Sarmistha Banerjee,Michelle Kovacs,Eric Haura,Domenico Coppola,Srikumar Chellappan
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0007524
Abstract: Nicotine is the major addictive component of tobacco smoke. Although nicotine is generally thought to have limited ability to initiate cancer, it can induce cell proliferation and angiogenesis in a variety of systems. These properties might enable nicotine to facilitate the growth of tumors already initiated. Here we show that nicotine significantly promotes the progression and metastasis of tumors in mouse models of lung cancer. This effect was observed when nicotine was administered through intraperitoneal injections, or through over-the-counter transdermal patches.
Does Skipping a Meal Matter to a Butterfly's Appearance? Effects of Larval Food Stress on Wing Morphology and Color in Monarch Butterflies
Haley Johnson, Michelle J. Solensky, Dara A. Satterfield, Andrew K. Davis
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0093492
Abstract: In animals with complex life cycles, all resources needed to form adult tissues are procured at the larval stage. For butterflies, the proper development of wings involves synthesizing tissue during metamorphosis based on the raw materials obtained by larvae. Similarly, manufacture of pigment for wing scales also requires resources acquired by larvae. We conducted an experiment to test the effects of food deprivation in the larval stage on multiple measures of adult wing morphology and coloration of monarch butterflies (Danaus plexippus), a species in which long-distance migration makes flight efficiency critical. In a captive setting, we restricted food (milkweed) from late-stage larvae for either 24 hrs or 48 hrs, then after metamorphosis we used image analysis methods to measure forewing surface area and elongation (length/width), which are both important for migration. We also measured the brightness of orange pigment and the intensity of black on the wing. There were correlations between several wing features, including an unexpected association between wing elongation and melanism, which will require further study to fully understand. The clearest effect of food restriction was a reduction in adult wing size in the high stress group (by approximately 2%). Patterns observed for other wing traits were ambiguous: monarchs in the low stress group (but not the high) had less elongated and paler orange pigmentation. There was no effect on wing melanism. Although some patterns obtained in this study were unclear, our results concerning wing size have direct bearing on the monarch migration. We show that if milkweed is limited for monarch larvae, their wings become stunted, which could ultimately result in lower migration success.
Prevalence and Risk Factors for Oral HPV Infection in Young Australians
Annika Antonsson, Michelle Cornford, Susan Perry, Marcia Davis, Michael P. Dunne, David C. Whiteman
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0091761
Abstract: The prevalence of human papillomavirus (HPV)–associated head and neck cancers is increasing, but the prevalence of oral HPV infection in the wider community remains unknown. We sought to determine the prevalence of, and identify risk factors for, oral HPV infection in a sample of young, healthy Australians. For this study, we recruited 307 Australian university students (18–35 years). Participants reported anonymously about basic characteristics, sexual behaviour, and alcohol, tobacco and illicit drugs use. We collected oral rinse samples from all participants for HPV testing and typing. Seven of 307 (2.3%) students tested positive for oral HPV infection (3 HPV-18, one each of HPV-16, -67, -69, -90), and six of them were males (p = 0.008). Compared to HPV negative students, those with oral HPV infection were more likely to have received oral sex from more partners in their lifetime (p = 0.0004) and in the last year (p = 0.008). We found no statistically significant associations with alcohol consumption, smoking or numbers of partners for passionate kissing or sexual intercourse. In conclusion, oral HPV infection was associated with male gender and receiving oral sex in our sample of young Australians.
Macronutrient Intake Influences the Effect of 25-Hydroxy-Vitamin D Status on Metabolic Syndrome Outcomes in African American Girls
Anna L. Newton,Lynae J. Hanks,Ambika P. Ashraf,Elizabeth Williams,Michelle Davis,Krista Casazza
Cholesterol , 2012, DOI: 10.1155/2012/581432
Abstract: The objectives were to determine the effect of macronutrient modification on vitamin D status and if change in 25-hydroxy-vitamin D concentration influences components of metabolic syndrome in obese African American girls. Methods. Five-week intervention using reduced CHO (43% carbohydrate; 27% fat: SPEC) versus standard CHO (55% carbohydrate; 40% fat: STAN) eucaloric diet. Subjects were 28 obese African American females, aged 9–14 years. Dual energy X-ray absorptiometry and meal test were performed at baseline and five weeks. Results. Approximately 30% of girls had metabolic syndrome. Serum 25OHD increased in both groups at five weeks [STAN: 20.3 ± 1.1 to 22.4 ± 1.1 ( ) versus SPEC: to ( )]. The STAN group, increased 25OHD concentration over five weeks ( ), which was positively related to triglycerides ( ) and inversely associated with total cholesterol ( ) and LDL ( ). The SPEC group, had increase in 25OHD ( ), which was positively related to fasting insulin ( ) and insulin sensitivity while inversely associated with fasting glucose ( ). The contribution of vitamin D status to metabolic syndrome parameters differs according to macronutrient intake. Improvement in 25OHD may improve fasting glucose, insulin sensitivity, and LDL; however, macronutrient intake warrants consideration. 1. Introduction The steady rise in prevalence of pediatric obesity over the past three decades has been accompanied by accumulation of risk factors for metabolic syndrome (MetSyn) in childhood and adolescence. The occurrence of hypovitaminosis D (expressed as levels <20?ng/mL of circulating 25-hydroxy vitamin D (25OHD)) has been increasingly documented in the same population [1, 2]. Moreover, children/adolescents with hypovitaminosis D have been reported to experience greater instances of hypertension, hypertriglyceridemia, hyperglycemia, and low high-density lipoprotein cholesterol (HDL) [1, 3, 4]. Further, it has been proposed that elevated parathyroid hormone (PTH), consequential to chronic low vitamin D level, is mechanistically involved in the adverse perturbations of risk factors underlying MetSyn [5]. Given the emerging identification of vitamin D as an integral player in numerous metabolic pathways, it stands to reason that vitamin D status in the pediatric populace may play a role in the prevalence of metabolic disease risk factors [6, 7]. The relationship between 25OHD status and metabolic health is not equally distributed across groups. In particular, the relationship is more apparent among African American (AA) females, particularly those who are overweight/obese
Health Promotion in Cardiac Rehabilitation Patients through the Use of a High-Intensity Interval Training Protocol  [PDF]
Michelle Tinkham
World Journal of Cardiovascular Diseases (WJCD) , 2014, DOI: 10.4236/wjcd.2014.410059
Abstract: According to the American Heart Association’s (AHA) recent statistical update, over 2150 Americans die each day from cardiovascular disease (CVD), which equals approximately 1 death every 40 seconds; many of which were under the age of 65 years old [1]. In 2009, 386,324 people, 1 in 6 Americans, died as a result of coronary artery disease (CAD) alone [1]. They also estimate 150,000 people have “silent” heart attacks each year [1]. Even though the number of cardiovascular disease deaths has declined in the last 10 years, they still accounted for 32.3% of American deaths [1]. As a result, the AHA updated their 2020 goals to improve the nation’s cardiovascular health by 20% [1]. One of these methods is through the use of cardiac rehabilitation. Cardiac rehabilitation (CR) is a health promotion strategy to help return cardiac patients to their previous level of functioning, increase health, decrease comorbidities and promote education and lifestyle change. For select patients, another alternative exercise plan may exist to gain even better results. High intensity interval training (HIIT) has shown positive training results for athletes and many studies show that it may also be an effective exercise modality for many cardiac patients instead of the traditional circuit training method. This article will review current literature on the effects of HIIT on CR patients as well as a sample HIIT protocol for instituting this treatment with appropriate patients.
Emotionally Competent Behaviors and Nurse Bullying: Is There a Direct Link?  [PDF]
Michelle Doas
Open Journal of Psychiatry (OJPsych) , 2015, DOI: 10.4236/ojpsych.2015.51008
Abstract: An abundance of literature spanning many years depicts the devastating effects of nurse bullying within the profession. The evidence suggests that bullying in general is a deliberate act aimed at another person. Conceptualizing nurse bullying appears to be a key ingredient in creating both awareness and preventative strategies. Emotional competence includes a set of behaviors which are unique to each individual. These behaviors according to Goldman (1995) include, but are not limited to emotional self-assessment, accurate self-assurance, self-confidence, emotional self-control, and empathy. The majority of researchers agree that emotionally competent behaviors are impacted by both positive and negative interactions and experiences. Thus, it is hypothesized that emotionally competent behaviors are continually cultivated throughout one’s life based upon lived experiences. This article assesses direct relationships between implementation of emotionally competent behaviors as a means of combatting nurse bullying within the profession. Creating awareness of these two areas can be initial steps in cultivating the needed tools and supportive interventions to assist nurses from novice to expert to professionally mentor and role model for generations to come.
Are We Losing the Art of Actively Listening to Our Patients? Connecting the Art of Active Listening with Emotionally Competent Behaviors  [PDF]
Michelle Doas
Open Journal of Nursing (OJN) , 2015, DOI: 10.4236/ojn.2015.56060
Abstract: Active listening is an essential communication technique that requires the listener to focus and provide feedback on what is heard. The ability to listen actively demonstrates sincerity, and assumes that nothing is being shrugged or taken for granted. As a result, active listeners strive to improve professional and personal relationships, decrease misinterpretation of information, strengthen compliance, and foster understanding. Likewise, active listening can foster trust, mutual respect, and patient compliance. This paper will explore vital connections between active listening and displaying emotionally competent behaviors. Additionally, analysis of a case study as a means of strengthening these connections while improving patient outcomes will be assessed.
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