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Search Results: 1 - 10 of 297814 matches for " Tiffany J. Braley "
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Fatigue, Tiredness, Lack of Energy, and Sleepiness in Multiple Sclerosis Patients Referred for Clinical Polysomnography
Tiffany J. Braley,Ronald D. Chervin,Benjamin M. Segal
Multiple Sclerosis International , 2012, DOI: 10.1155/2012/673936
Fatigue, Tiredness, Lack of Energy, and Sleepiness in Multiple Sclerosis Patients Referred for Clinical Polysomnography
Tiffany J. Braley,Ronald D. Chervin,Benjamin M. Segal
Multiple Sclerosis International , 2012, DOI: 10.1155/2012/673936
Abstract: Objectives. To assess the relationship between nocturnal polysomnographic (PSG) findings and a group of key self-reported symptoms—fatigue, tiredness, lack of energy, and sleepiness—among sleep-laboratory referred patients with and without multiple sclerosis (MS). Methods. PSG and questionnaire data from MS patients and matched controls were analyzed retrospectively. Associations between symptoms of fatigue, tiredness, lack of energy, sleepiness, and PSG variables of interest were examined among MS patients and controls. Results. More MS patients than controls reported fatigue, tiredness, and lack of energy to occur often or almost always (Chi-square for each), but sleepiness was reported similarly by both groups ( ). Among MS patients, tiredness correlated with sleepiness (Spearman correlation ), and a trend emerged toward correlation between fatigue and sleepiness (Spearman correlation ). Decreased sleep efficiency on PSGs correlated with fatigue, tiredness, and lack of energy in MS patients (Spearman correlation , 0.029, and 0.048, resp.), but not sleepiness or any symptom among controls. Conclusion. In comparison to controls, MS patients report more fatigue, tiredness, and lack energy, but not sleepiness. Fatigue and related symptoms may arise from MS itself or in relation to reduced sleep efficiency. 1. Introduction Multiple sclerosis (MS) is an autoimmune disease of the central nervous system that causes myelin destruction and axonal damage in the brain and spinal cord. It is the leading cause of nontraumatic neurological disability among young adults and is associated with a variety of debilitating symptoms, including fatigue. Fatigue is the most common symptom experienced by persons with MS, affecting up to 90% of patients at some point in their disease course [1–3]. Fatigue imposes significant socioeconomic consequences, including loss of work hours and employment [4], and is a prominent cause of diminished quality of life among individuals with MS [3]. Despite its prevalence in MS as well as other medical conditions, there is no unified definition for fatigue. Consequently, there is potential for considerable overlap between fatigue and other subjective terms commonly used by MS patients to describe lack of energy or alertness, including sleepiness. Sleep disorders are traditionally recognized for their contributions to excessive daytime sleepiness. However, many subjects in the general population who have sleep disorders such as obstructive sleep apnea report that problems with fatigue, tiredness, or lack of energy supersede problems with
Tensión superficial de la lágrima Surface tension in tears
J.M. Tiffany
Archivos de la Sociedad Espa?ola de Oftalmología , 2006,
La ciencia en el amanecer del milenio
Ayala, Francisco J.,Ayers, Tiffany
Arbor : Ciencia, Pensamiento y Cultura , 2000,
Abstract: No disponible
Romantic Breakups, Heartbreak and Bereavement—Romantic Breakups  [PDF]
Tiffany Field
Psychology (PSYCH) , 2011, DOI: 10.4236/psych.2011.24060
Abstract: This literature review suggests that romantic breakups may lead to bereavement symptoms including intrusive thoughts and attempts to suppress them and insomnia as well as morbidity factors including broken heart syndrome and immune dysfunction. Although the broken heart syndrome has mimicked real heart attacks, angiograms revealed no clogged arteries or permanent heart damage. Compromised immune function may result from reduced vagal activity and increased cortisol and catecholamines leading to increased inflammatory cytokines and decreased natural killer cell activity. The model proposed here is that romantic breakups result in the loss of a person as a regulator of stimulation and arousal modulation that can then lead to these physiological and biochemical effects. These data highlight the complexity of romantic breakups, heartbreak and bereavement and the need for multi-variable research on these systems both before and after the breakups occur.
Relationships as Regulators  [PDF]
Tiffany Field
Psychology (PSYCH) , 2012, DOI: 10.4236/psych.2012.36066
Abstract: This paper reviews the Hofer (1984, 1996) and Field (1985, 1994) models on relationships as regulators, suggesting that relationships regulate optimal stimulation and thereby modulate arousal levels and attenuate stress. In these models, the behavioral, physiological and biochemical rhythms of individuals become synchronized within close relationships like mother-infant and peer relationships both in human and animal species, and they become more coordinated over time, with some potentially remaining stable, much like zeitgebers. Hofer supports his model by data on infant rat separation stress and Field describes “psychobiological attunement” between human infants and their mothers and between young peers. This review revisits the “relationships as regulators” model, summarizing studies on relationships between non-depressed versus depressed mothers and their infants, between infant, preschool and preadolescent friends versus acquaintances and between happily versus unhappily married couples. Although some behavioral and physiological data support Hofer’s and Field’s “relationships as regulators” model, many studies on relationships have focused instead on the effects of separation or loss. Both Hofer and Field suggest that the real question is “what was there about the relationship that was then missing after the loss?” Future research could address the question of potential mediators and underlying mechanisms for relationships becoming regulators. Potential mediators are explored here including mirror neurons, affective priming, imitation and empathy. The individuals’ rhythms and the attraction to others’ rhythms as regulators may be an epigenetic programming phenomenon, suggesting both genetic and early experience effects that endure across development.
Opportunities for nurses in the era of electronic health records  [PDF]
Tiffany Kelley
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.41003

Nursing leaders are currently faced with opportunities to advance nursing’s role in the use of electronic health records (EHRs). Nurse leaders can advance the design of EHRs with nurse informaticists to improve health outcomes of individual and populations of patients.

The role of B-type natriuretic peptide in the evaluation of congestive heart failure patients in emergency department  [PDF]
Hao Wang, Tiffany Littleton, Sonya J. Wilson, Ferran Ros, Richard D. Robinson, Kathleen A. Delaney
Open Journal of Clinical Diagnostics (OJCD) , 2012, DOI: 10.4236/ojcd.2012.22003
Abstract: Aim: Congestive heart failure (CHF) is a severe cardiovascular disorder seen in the Emergency Department (ED). B-type Natriuretic Peptide (BNP) is usually ordered to evaluate the CHF severity. However, it is difficult to interpret serum BNP level when different clinical entities existed. The aim of this study is to illustrate the correlation between serum BNP level and relevant clinical variables and further determine the role of serum BNP in different CHF patients. Methods: Univariate comparisons between 26 clinical variables and serum BNP level were analyzed. In order to avoid confounding factors, potential independent clinical variables were analyzed together using multivariate regression. Results: 529 CHF patients were reviewed and divided into different groups by 26 clinical variables. Serum BNP levels were found statistically significant different by univariate compareson between groups divided by 8 clinical variables that included obesity, diastolic/systolic heart failure (HF), serum blood urea nitrogen (BUN) level, serum creatinine (Cr) level, serum sodium (Na) level, patients taking loop diuretics, history of cerebrovascular accident (CVA), and history of dementia. Among all 8 clinical variables, obesity, serum BUN, Cr level, and diastolic/systolic HF had weak-to-moderate correlation effects with serum BNP level by correlation coefficient analysis. However, only obesity and dia- stolic/systolic HF were two moderately stronger clini- cal variables that can affect the serum BNP levels by multivariate regression. Analyzing CHF patients separately by obesity and diastolic/systolic HF subsets showed longer hospitalization in diastolic HF patients with relatively higher serum Cr level. In addition, poor correlation was found between serum BNP level and length of hospitalization (LOH) as well. Conclusion: High variability of serum BNP levels exists in CHF patients with weak-to-moderate correlation effects particularly on obesity and diastolic/systolic HF.It is recommended that physicians should be cautious on interpreting BNP in different CHF populations.
Premature Senescence and Increased TGFβ Signaling in the Absence of Tgif1
Brad J. Zerlanko, Laurent Bartholin, Tiffany A. Melhuish, David Wotton
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0035460
Abstract: Transforming growth factor β (TGFβ) signaling regulates cell cycle progression in several cell types, primarily by inducing a G1 cell cycle arrest. Tgif1 is a transcriptional corepressor that limits TGFβ responsive gene expression. Here we demonstrate that primary mouse embryo fibroblasts (MEFs) lacking Tgif1 proliferate slowly, accumulate increased levels of DNA damage, and senesce prematurely. We also provide evidence that the effects of loss of Tgif1 on proliferation and senescence are not limited to primary cells. The increased DNA damage in Tgif1 null MEFs can be partially reversed by culturing cells at physiological oxygen levels, and growth in normoxic conditions also partially rescues the proliferation defect, suggesting that in the absence of Tgif1 primary MEFs are less able to cope with elevated levels of oxidative stress. Additionally, we show that Tgif1 null MEFs are more sensitive to TGFβ-mediated growth inhibition, and that treatment with a TGFβ receptor kinase inhibitor increases proliferation of Tgif1 null MEFs. Conversely, persistent treatment of wild type cells with low levels of TGFβ slows proliferation and induces senescence, suggesting that TGFβ signaling also contributes to cellular senescence. We suggest that in the absence of Tgif1, a persistent increase in TGFβ responsive transcription and a reduced ability to deal with hyperoxic stress result in premature senescence in primary MEFs.
Long-term impact of four different strategies for delivering an on-line curriculum about herbs and other dietary supplements
Tiffany Beal, Kathi J Kemper, Paula Gardiner, Charles Woods
BMC Medical Education , 2006, DOI: 10.1186/1472-6920-6-39
Abstract: As previously described, we conducted a randomized control trial comparing four different strategies for delivering an e-curriculum about herbs and other dietary supplements (HDS) to clinicians. The four strategies were delivering the curriculum by: a) email over 10 weeks; b) email within one week; c) web-site over 10 weeks; d) web-site within one week. Participants were surveyed at baseline, immediately after the course and 6–10 months after completing the course (long-term). Long-term outcomes focused on clinicians' knowledge, confidence and communication practices.Of the 780 clinicians who completed the course, 385 (49%) completed the long-term survey. Completers and non-completers of the long-term survey had similar demographics and professional characteristics at baseline. There were statistically significant improvements from baseline to long-term follow-up in knowledge, confidence and communication practices; these improvements did not differ by curriculum delivery strategy. Knowledge scores improved from 67.7 ± 10.3 at baseline to 78.8 ± 12.3 at long-term follow-up (P < 0.001). Confidence scores improved from 53.7 ± 17.8 at baseline to 66.9 ± 12.0 at long term follow-up (P < 0.001); communication scores improved from 2.6 ± 1.9 at baseline to 3.6 ± 2.1 (P < 0.001) at long-term follow-up.This e- curriculum led to significant and sustained improvements in clinicians' expertise about HDS regardless of the delivery strategy. Future studies should compare the impact of required vs. elective courses and self-reported vs. objective measures of behavior change.Herbs and dietary supplements (HDS) are the most commonly used complementary medical therapies purchased in the United States [1], leading to concerns about HDS safety and efficacy[2]. Health care professionals have expressed a strong interest in HDS training courses[3-5]. However, face-to-face Continuing Medical Education (CME) courses often fail to result in sustained changes in physician behaviors [6,7]. On
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