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Search Results: 1 - 10 of 194182 matches for " Nicole D. Gillespie "
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Implementation of a Tool to Modify Behavior in a Chronic Disease Management Program
Nicole D. Gillespie,Thomas L. Lenz
Advances in Preventive Medicine , 2011, DOI: 10.4061/2011/215842
Abstract: Chronic diseases like diabetes, hypertension, and dyslipidemia continue to be a significant burden on the US health care system. As a result, many healthcare providers are implementing strategies to prevent the incidence of heart disease and other chronic conditions. Among these strategies are proper drug therapy and lifestyle modifications. Behavior change is often the rate-limiting step in the prevention and maintenance of lifestyle modifications. The purpose of this paper is to describe a tool used to guide the progression and assess the effectiveness of a cardiovascular risk reduction program. The tool uses the Transtheoretical Model of Behavior Change to determine the readiness and confidence to change specific lifestyle behaviors pertinent to cardiovascular health. The tool aids the practitioner in developing a patient-centered plan to implement and maintain lifestyle changes and can be tailored to use in any situation requiring a behavior change on the part of the patient. 1. Introduction Health behavior change is a key component in the prevention of disease. Studies have shown that 90% of type 2 diabetes, 80% of coronary artery disease, and 70% of all strokes are potentially preventable by a combination of nonsmoking, maintenance of a healthy bodyweight, regular physical activity, healthy eating habits, and moderate alcohol consumption [1]. Unfortunately, behavior change is often the rate-limiting step in the implementation and maintenance of these preventive lifestyle behaviors. The Transtheoretical Model of Behavior Change was developed to understand how individuals progress towards establishing and maintaining health behavior change for optimal health [2]. The model consists of six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. The key to using this theory in practice is to assess the patient’s stage and then educate and persuade the patient to move toward the action, maintenance, and termination stages [2]. The model is widely used by practitioners in the realm of substance abuse [3], as well as independently increasing physical activity [4] and proper nutrition [5]. However, there is little literature describing its practical use in a behavior change program that implements more than one behavior change. In 2008, a comprehensive cardiovascular risk reduction program (CVRRP) was developed at a private Midwestern university to curb the progression of cardiovascular disease in its employees [6]. The program offers the participants an individualized lifestyle medication program that targets
Development and Implementation of a Novel Lifestyle Medicine Advanced Pharmacy Practice Experience Elective
Nicole D. Gillespie, PharmD,Thomas L. Lenz, PharmD, MS, PAPHS, FACLM
INNOVATIONS in Pharmacy , 2012,
Abstract: Objective: To develop and implement an Advanced Pharmacy Practice Experience (APPE) to increase student’s awareness and use of lifestyle modifications in chronic disease prevention and management. Design: A five-week APPE was developed that utilized a wide variety of activities, including direct patient care, patient education, case studies, journal clubs and reflective assessment and writing to explore various lifestyle modifications and their relation to chronic disease prevention and management. Conclusion: The novel lifestyle medicine APPE provides students a unique opportunity to advance their knowledge in therapeutic lifestyle changes and expand their understanding of the pharmacist’s role in chronic disease prevention and management.
Health-Related Quality of Life Impact in Employees Participating in a Pharmacist-Run Risk Reduction Program
Thomas L. Lenz, PharmD,Nicole D. Gillespie, PharmD,Maryann Z. Skrabal, PharmD,Michele A. Faulkner, PharmD
INNOVATIONS in Pharmacy , 2012,
Abstract: Health related quality of life (HRQOL) and self-perceived well-being have been shown to be associated with lower healthcare utilization and costs in people with chronic diseases. A pharmacist-run employee health program started in 2008 sought to improve HRQOL through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participant’s self-reported general health rating significantly improved compared with their baseline rating (p < 0.001). Participants also reported a significantly lower number of days within a month when they did not feel physically and/or mentally well at baseline vs. one-year, respectively (10.3 days vs. 6.0 days, p < 0.01). Pharmacists can positively impact self-reported HRQOL when working in an employee health setting.
Lifestyle Medicine-Related Cardiovascular Risk Factor Changes in Employees Participating in a Pharmacist-Run Risk Reduction Program
Thomas L. Lenz, PharmD,Nicole D. Gillespie, PharmD,Michele A. Faulkner, PharmD,Maryann Z. Skrabal, PharmD
INNOVATIONS in Pharmacy , 2012,
Abstract: Cardiovascular disease (CVD) remains the leading cause of death among American adults accounting for approximately one-third of all deaths. It has been shown, however, that the actual causes of death are related to lifestyle behaviors such as tobacco use, poor diet and physical activity and alcohol consumption. A pharmacist-run employee health program, started in 2008, sought to lower CVD risk through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participants were shown to significantly increase exercise quantity (p < 0.001), fruit and vegetable consumption (p < 0.001), and decrease self-reported stress level (p = 0.006). The percentage of program participants simultaneously adherent to the recommended levels of exercise, combined fruit and vegetable intake and tobacco abstinence at one-year was 34.5% vs. 5.5% at baseline. This compares with only 5.1% of the U.S. population adherent to the same three behaviors. Pharmacists can positively impact healthy lifestyle behaviors when working in an employee health setting.
Medication Adherence Improvements in Employees Participating in a Pharmacist-Run Risk Reduction Program
Mallory C. McKenzie, PharmD,Thomas L. Lenz, PharmD,Nicole D. Gillespie, PharmD,Jessica J. Skradski, PharmD
INNOVATIONS in Pharmacy , 2012,
Abstract: Objective: To evaluate the medication adherence of individuals participating in a pharmacist-run employee health Cardiovascular and Diabetes Risk Reduction Program. Design: Retrospective analysis of medication adherence using pharmacy refill data. Setting: A medium sized university located in the Midwest United States and the organization’s outpatient pharmacy. Participants: 38 participants ≥ 18 years of age, employed and receiving their health insurance through the organization, and have a diagnosis of hypertension, hyperlipidemia, diabetes mellitus, or a combination thereof. Intervention: Participation in the risk reduction program that emphasizes medication therapy management (MTM), lifestyle medicine and care coordination. Main Outcome Measures: The Proportion of Days Covered (PDC) and the Medication Possession Ratio (MPR). Results: PDC and MPR analysis showed a statistically significant improvement in medication adherence for 180 days and 360 days post enrollment versus the 180 days prior to enrollment (P<0.01). The PDC analysis demonstrated a statistically significant improvement in the number of medications that achieved a PDC ≥ 80% (high adherence) for the 180 days post enrollment versus the 180 days prior to enrollment (+30%, P<0.01). The MPR analysis showed a non-statistically significant improvement in the number of medications that achieved an MPR ≥ 80% (high adherence) pre enrollment versus post enrollment (+10%, P=0.086). The percentage of participants in the program that reached a PDC and MPR adherence rate ≥ 80% at 180 days post enrollment was 78.9% and 94.4%, respectively which exceeds that of a matched cohort that reached a PDC and MPR adherence rate ≥ 80% of 66.4% and 82.8%, respectively. Conclusion: Pharmacists can improve medication adherence as measured by PDC and MPR when working with employees enrolled in a novel pharmacist-run employee health risk reduction program. Medication adherence was shown to be sustainable for at least one year and was shown to be better when compared to a matched cohort of similar age, condition and region.
Development of a Composite Lifestyle Index and Its Relationship to Quality of Life Improvement: The CLI Pilot Study
Thomas L. Lenz,Nicole D. Gillespie,Jessica J. Skradski,Laura K. Viereck,Kathleen A. Packard,Michael S. Monaghan
ISRN Preventive Medicine , 2013, DOI: 10.5402/2013/481030
Abstract: An important component to optimal health is quality of life (QOL). Several healthy lifestyle behaviors have independently shown to improve QOL. The simultaneous implementation of multiple lifestyle behaviors is thought to be difficult, and the current literature lacks the assessment of multiple lifestyle behaviors simultaneously with respect to the effect on QOL. This current pilot study sought to develop a method to quantify multiple lifestyle behaviors into a single index value. This value was then measured with QOL for a possible correlation. The results showed that it is possible to convert multiple raw healthy lifestyle data points into a composite value and that an improvement in this value correlates to an improved QOL. After 12 months of participation in a cardiovascular risk reduction program, study participants ( ) demonstrated a 37.4% ( ) improvement in the composite lifestyle index (CLI). The improved CLI demonstrated a correlation with a statistically significant improvement in how participants rated their overall health in 12 months ( , ) as well as the number of self-reported unhealthy days per month in 12 months ( , ). 1. Introduction Since 1948, the World Health Organization has defined health not only by the absence of disease or infirmity, but also as a state of complete physical, mental, and social well-being [1]. This definition implies that research outcomes should not only measure disease outcomes, but also quality of life outcomes. Measuring health-related quality of life provides a means of identifying and monitoring the impact of interventions on the physical and mental health of individuals as they themselves perceive this impact [2]. Quality of life may be measured objectively based on functioning or health status and subjectively based on one’s own perception of health [3]. A number of lifestyle modifications including adequate nutrition, increased physical activity, adequate sleep, proper stress management, limited alcohol consumption, and tobacco cessation have been independently shown to have a positive effect on an individual’s quality of life [2–13]. It is often assumed that initiating multiple behavior changes at the same time can become overwhelming for individuals and lead to decreased adherence. However, a recent study has shown that patients are able to effectively incorporate and maintain a number of lifestyle modifications initiated concomitantly [11]. The PREMIER clinical trial showed that participants could effectively incorporate and sustain multiple lifestyle changes to lower blood pressure risk and decrease
Surface Proteome Analysis and Characterization of Surface Cell Antigen (Sca) or Autotransporter Family of Rickettsia typhi
Khandra T. Sears ,Shane M. Ceraul,Joseph J. Gillespie,Edwin D. Allen Jr.,Vsevolod L. Popov,Nicole C. Ammerman,M. Sayeedur Rahman,Abdu F. Azad
PLOS Pathogens , 2012, DOI: 10.1371/journal.ppat.1002856
Abstract: Surface proteins of the obligate intracellular bacterium Rickettsia typhi, the agent of murine or endemic typhus fever, comprise an important interface for host-pathogen interactions including adherence, invasion and survival in the host cytoplasm. In this report, we present analyses of the surface exposed proteins of R. typhi based on a suite of predictive algorithms complemented by experimental surface-labeling with thiol-cleavable sulfo-NHS-SS-biotin and identification of labeled peptides by LC MS/MS. Further, we focus on proteins belonging to the surface cell antigen (Sca) autotransporter (AT) family which are known to be involved in rickettsial infection of mammalian cells. Each species of Rickettsia has a different complement of sca genes in various states; R. typhi, has genes sca1 thru sca5. In silico analyses indicate divergence of the Sca paralogs across the four Rickettsia groups and concur with previous evidence of positive selection. Transcripts for each sca were detected during infection of L929 cells and four of the five Sca proteins were detected in the surface proteome analysis. We observed that each R. typhi Sca protein is expressed during in vitro infections and selected Sca proteins were expressed during in vivo infections. Using biotin-affinity pull down assays, negative staining electron microscopy, and flow cytometry, we demonstrate that the Sca proteins in R. typhi are localized to the surface of the bacteria. All Scas were detected during infection of L929 cells by immunogold electron microscopy. Immunofluorescence assays demonstrate that Scas 1–3 and 5 are expressed in the spleens of infected Sprague-Dawley rats and Scas 3, 4 and 5 are expressed in cat fleas (Ctenocephalides felis). Sca proteins may be crucial in the recognition and invasion of different host cell types. In short, continuous expression of all Scas may ensure that rickettsiae are primed i) to infect mammalian cells should the flea bite a host, ii) to remain infectious when extracellular and iii) to infect the flea midgut when ingested with a blood meal. Each Sca protein may be important for survival of R. typhi and the lack of host restricted expression may indicate a strategy of preparedness for infection of a new host.
中国生物工程杂志 , 1983,
Abstract: 溶于nai的信使rna(mrna)将吸附在硝酸纤维素膜上。在低温下,核糖rna、天然dna和变性dna的结合是很少的。固定的mrna使用于分子杂交,并可被翻译成蛋白质,或反转录成dna。
The Effect of Pharmacist Intervention on Diabetes Screening Promotion and Education in a Geriatric Population
Alicia Pol, PharmD,Nicole Gillespie, PharmD,Emily Knezevich, PharmD,Ann Ryan-Haddad, PharmD
INNOVATIONS in Pharmacy , 2012,
The PI3K pathway regulates endochondral bone growth through control of hypertrophic chondrocyte differentiation
Veronica Ulici, Katie D Hoenselaar, J Ryan Gillespie, Frank Beier
BMC Developmental Biology , 2008, DOI: 10.1186/1471-213x-8-40
Abstract: Employing an organ culture system of embryonic mouse tibiae and LY294002, a pharmacological inhibitor of PI3K, we show that inhibition of the pathway results in significant growth reduction, demonstrating that PI3K is required for normal endochondral bone growth in vitro. PI3K inhibition reduces the length of the proliferating and particularly of the hypertrophic zone. Studies with organ cultures and primary chondrocytes in micromass culture show delayed hypertrophic differentiation of chondrocytes and increased apoptosis in the presence of LY294002. Surprisingly, PI3K inhibition had no strong effect on IGF1-induced bone growth, but partially blocked the anabolic effects of C-type natriuretic peptide.Our data demonstrate an essential role of PI3K signaling in chondrocyte differentiation and as a consequence of this, in the endochondral bone growth process.Bone formation occurs through two different mechanisms: endochondral and intramembranous ossification. Longitudinal growth of the axial and appendicular skeleton is a result of endochondral ossification (EO) that is controlled by the cartilage growth plate [1]. EO involves the aggregation of mesenchymal cells to form cartilaginous nodules [2]. A subset of the cells in these nodules matures further into growth plate chondrocytes.During endochondral bone development in the limb, growth plate chondrocytes undergo well-ordered and controlled phases of cell proliferation, maturation, and apoptosis [3]. The growth plate can be divided into three main chondrocyte subpopulations: the resting, proliferating and hypertrophic chondrocytes. These populations are arranged in distinct zones that are distinguishable by morphological criteria, but are also characterized by specific molecular markers. The proliferation and/or differentiation of these subpopulations are controlled by a complex network of regulatory molecules [4]. Proliferative chondrocytes synthesize type II collagen and form characteristic columns; they then exit t
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