Biomedical subjects

Jennifer Hoffman

Publications and source records attributed to Jennifer Hoffman.

6 recordsLinked to original sources

PubMed2006

Non-viral delivery of nuclear factor-kappaB decoy ameliorates murine inflammatory bowel disease and restores tissue homeostasis.

BACKGROUND: Nuclear factor-kappaB (NF-kappaB) is a key transcriptional regulator of inflammatory bowel disease (IBD). AIM: To investigate the therapeutic potential of a locally administered "non-viral" nuclear factor-kappaB decoy (NFkappaBD) in multiple experimental models of IBD. METHODS: A fully phosphorothioated decoy oligonucleotide with improved stability that specifically binds NF-kappaB and blocks inflammatory mediators regulated by this transcription factor without the help of viral envelope-assisted delivery was developed. The therapeutic effects of NFkappaBD were studied in the trinitrobenzene sulphonic acid, oxazolone and dextran sodium sulphate induced colitis models. RESULTS: Intracolonic administration of NFkappaBD results in the delivery of NFkappaBD to inflammatory cells and a reduction of NF-kappaB heterodimers. In the T helper cell 1-driven trinitrobenzene sulphonic acid-induced colitis model, mice receiving NFkappaBD treatment exhibit a dose-dependent reduction in disease severity and a more rapid recovery to normal body weight, similar to a clinically relevant dose of budesonide. Clinical efficacy was corroborated by considerable reductions in colitis pathology and tissue levels of several pro-inflammatory markers, including tumour necrosis factor alpha, interleukin 6, interleukin 1beta and monocyte chemotactic protein 1. NFkappaBD also mitigates disease activity in the T helper cell 2-like oxazolone colitis and epithelial injury-related acute dextran sodium sulphate colitis models. Interestingly, restoration of tissue homeostasis is observed in NFkappaBD-treated animals with the rapid re-emergence of functional goblet cells and a return to normal patterns of cell proliferation in the mucosal epithelium and smooth muscle cell layers. CONCLUSIONS: These data support the potential use of "naked" NFkappaBD as a cross-functional therapeutic in IBD, and show for the first time that it can facilitate the restoration of colon homeostasis and function.

Animals↗

PubMed2006

Senior friendly health services.

As our population continues to age and to put increasing pressures on the health care system, we need to evolve the system to be sensitive to the unique needs of seniors. There are many examples of innovative, evidence-based strategies that have been shown to improve outcomes for elderly individuals utilizing health services. The association between the physical environment and its negative impact on outcomes for hospitalized geriatric patients is well recognized. The use of strategies such as an audit tool to guide modifications of the physical environment or formal programs such as HELP, are good examples of practical approaches that can be implemented. The challenge today is for leaders in the healthcare system to champion and develop principles and a vision of care that supports implementation of these elder-friendly approaches.

Aged↗

PubMed2005

Construct validity of the auditory continuous performance test for preschoolers.

Development of diagnostic instruments directed toward neuropsychological assessment of preschoolers lags significantly behind those available for school-age children (DeWolfe, Byrne, & Bawden, 2000). This is particularly true for measures of executive function (EF). The Auditory Continuous Performance Test for Preschoolers (ACPT-P; Mahone, Pillion, & Hiemenz, 2001) is a computerized, Go-No-go test developed to measure selected EF skills in preschoolers. First, to determine whether performance on the ACPT-P is associated with hearing impairment, we compared performance of children with mild hearing loss (MHL) to controls on the ACPT-P, and measures of spatial working memory (SWM) and motor persistence (MP). There were no differences between performance of the MHL group and controls on any of these measures. Second, to examine the construct validity of the ACPT-P, we compared performance of 40 preschoolers with ADHD to 40 age- and sex-matched controls, using the ACPT-P to measure response preparation, sustained attention, and inhibitory control. We also compared these groups on measures of SWM and MP. The group with attention deficit hyperactivity disorder (ADHD) performed significantly worse than controls on the ACPT-P (omissions, mean response time, variability) and MP. The ACPT-P was correlated with the MP, but not with the SWM measure. Both the ACPT-P and the MP measures showed low to moderate correlations with parent ratings of behavior associated with ADHD. These findings support the use of performance-based assessment of executive control skills in preschoolers suspected of having ADHD. In this age group, the ACPT-P may be particularly useful in assessing sustained attention and response preparation and may complement behavior rating scales.

Acoustic Stimulation↗

PubMed2003

Critical gaps in the world's largest electronic medical record: Ad Hoc nursing narratives and invisible adverse drug events.

The Veterans Health Administration (VHA), of the U.S. Department of Veteran Affairs, operates one of the largest healthcare networks in the world. Its electronic medical record (EMR) is fully integrated into clinical practice, having evolved over several decades of design, testing, trial, and error. It is unarguably the world's largest EMR, and as such it makes an important case study for a host of timely informatics issues. The VHA consistently has been at the vanguard of patient safety, especially in its provider-oriented EMR. We describe here a study of a large set of adverse drug events (ADEs) that eluded a rigorous ADE survey based on prospective EMR chart review. These numerous ADEs were undetected (and hence invisible) in the EMR, missed by an otherwise sophisticated ADE detection scheme. We speculate how these invisible nursing ADE narratives persist and what they portend for safety re-engineering.

Adverse Drug Reaction Reporting Systems↗

PubMed2002

Pedobarographic and musculoskeletal examination of collegiate dancers in relevé.

Twenty-one collegiate ballet pupils were evaluated via history/questionnaire, musculoskeletal assessment, and pedobarographs, focusing on factors (e.g., alignment of hip, knee, and foot) thought to affect the important and common second-position relevé in dance. In a blinded manner, three observers classified the pedobarographs (obtained by an independent examiner) according to force distribution through the foot. Most dancers bore weight through the toes and transmitted force on both the medial and central metatarsal heads, and some transmitted force through only one of these rays, but none transmitted force through the lateral ray alone. This analysis provides a baseline for future assessment of normal or abnormal dance maneuvers.

Adolescent↗

PubMedDate not supplied

Nurse's role in tracking adverse drug events: the impact of provider order entry.

Adverse drug events (ADE), or injuries caused by drug therapy, are a frequent and serious problem in hospitalized patients. Monitoring, preventing, and treating ADEs is an important patient safety function. Nurses play a significant role in this function, because their data is a unique and important indicator of ADEs and because they are the final point of medication administration. New provider order entry systems with electronic medical records have been viewed as an effective innovation and solution to high rates of ADEs. These systems increase legibility of drug orders, provide decision support, and increase access to the medical record. However, they may not interface with nursing processes effectively. This study reports the experience of a team conducting an ADE surveillance study in a Veterans Health Administration setting where extensive computerized innovations are in place. Lessons learned regarding the integration of nursing work processes with the computerized setting are described. Three areas of concern are highlighted: decreased access to nursing narratives, lack of decision support for medication administration, and failure to code nursing data. Each of these is discussed in terms of relevance to patient safety and the design of information systems.

Female↗