The Saint Louis University Mental Status (SLUMS) Examination is a relatively new brief cognitive screening measure developed for use with veterans. To date, there has been a paucity of research on its psychometric properties. Using a sample of 148 male veterans referred to a VA Mild Cognitive Impairment (MCI) Clinic for evaluation, the SLUMS’ ability to discriminate between MCI versus other diagnoses or no diagnosis was compared to results from a more comprehensive neuropsychological battery. Approximately 51% of the sample was diagnosed with MCI, 16% with Major Depressive Disorder (MDD), 17% did not meet criteria for a diagnosis, and 16% were given some other DSM-IV-TR diagnosis. The SLUMS demonstrated poor internal consistency (Cronbach’s alpha = .57), but scores were significantly correlated with scores on every neuropsychological measure, except for Trails B. Diagnostic discriminability was comparable to that of the more time intensive neuropsychological battery for discriminating between MCI and no diagnosis, and MCI and MDD. In the current sample, a cutoff score of 25 was optimal for discriminating between MCI and no diagnosis, whereas a slightly lower cutoff score of 24 is recommended for discriminating between MCI and those with MDD. Diagnostic indicators were poor for the SLUMS and the battery when discriminating between MCI and a heterogeneous group of other disorders. Possible reasons for low reliability in such a screening measure in the context of convergent validity are discussed. It is concluded that the SLUMS may be a viable brief cognitive screening measure in such veteran populations, particularly when discriminating between MCI and MDD; however, additional studies should be completed to evaluate other forms of consistency, such as test-retest reliability.

Background: Becoming a parent can elicit many emotions. For some parents, it can be a time of anxiety and depression. Fathers are not exempt from this type of depression. Paternal depression (PD) is a serious health issue with long lasting consequences for both the father and child. Unfortunately, little research has been done on PD. The research that has been done recommends routine PD screening. Methods: A cross-sectional descriptive study design was used to determine the current PD screening practices and screening tools of providers in the Tucson area. The study sample consisted of randomly selected healthcare providers. The total number of possible participants was eighty two. Participants were provided a 20 question survey to assess screening practices as well as the beliefs, attitudes, norms, and confidence of providers regarding PD screening. Results: The study found many providers routinely screen for maternal depression but few screen for PD. While providers did recognize the impact PD has on children, this belief was not enough to implement screening. Most providers were unsure if PD was serious or if PD screening and therapy were effective. Few providers had any training or education regarding PD and few were confident in their ability to screen for PD. Providers who felt confident in their ability to screen, acknowledge the USPTF recommendation for screening all adults for depression, and had positive beliefs/attitudes regarding PD screening were more likely to have incorporated screening into practice. Of those who do screen, the majority do not use a validated screening. Conclusions: Although research recommends PD screening, it has not been implemented into practice. Training and education regarding PD is also lacking. The next step in research is to implement interventions that improve screening practices among providers, increase provider confidence in screening, and increase provider's awareness about PD.

The American Academy of Pediatrics (AAP) released a statement recommending that primary care providers perform developmental screening with a standardized instrument for all 9-, 18-, 24-, or 30-month well-child visits. Despite evidence-based recommendations by the AAP, numerous pediatric practices do not currently use a standardized instrument for well-child visits. This quality improvement project aimed to determine the feasibility of implementing the Ages and Stages Questionnaire (ASQ), a validated developmental screening tool, at a pediatric primary care practice. In order to accurately assess implementation barriers and benefits, this feasibility study would have determined if the ASQ was the right fit for this pediatric practice. The first phase of implementation would have begun with the 9-month well-child visits and using the same process, later expanded to include the 18- and 24-month visits. The Plan-Do-Study-Act (PDSA) method would have provided the implementation framework for this project and the project would have been written utilizing the SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines. However, due to unforeseen complications, this project was unable to be completed as planned. Instead, this project discusses outcomes of the DNP project without data, and provides guidance and points of consideration for future implementation in pediatric primary care settings.

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No description available.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Purpose: compare the Southwestern Indigenous Cognitive Assessment (SWICA), a novel tool for screening AI older adults in Arizona, with The Montreal Cognitive Assessment (MoCA), a commonly used memory screening tool, for comparison of cultural bias. Methods: Cultural bias was assessed by retrospectively comparing coded participant responses to 16 questions about their cultural context. Intrasample variation on MoCA and SWICA tests was controlled by using the participants as their own controls. Data were analyzed using a multiple regression general linear model on SPSS software. Results: Scores on the SWICA test were independently associated with English use in the home (Beta = .396, p = .026), years of education (Beta = 335, p = .027), and ease of learning (Beta = .361, p = .029), but not age (Beta = .366, p = .054). Scores on the MoCA test were independently associated with age (Beta = ‐.491, p = .001), English use in the home (Beta = ‐.320, p = .039) , and years of education (Beta = ‐.284. p = .030), but not ease of learning (Beta = ‐.267, p = .067). Conclusions: Scores were similar on both tests (t=3.934, p=.001), and were independently associated with English use in the home and years of education. SWICA was uniquely associated with ease of learning and MoCA was uniquely associated with age. This preliminary comparison demonstrates the usefulness of SWICA, and validation of this tool is recommended.

As a barrier to metastases, cells normally undergo apoptosis after they lose contact with their extra cellular matrix or their neighbouring cells. This cell death process has been termed “anoikis”. Tumour cells that acquire malignant potential have developed mechanisms to resist anoikis and thereby survive after detachment from their primary site and while travelling through the lymphatic and circulatory systems. The understanding of the molecular regulators of anoikis resistance will allow for a better understanding of the metastatic process and the development of novel anti-metastatic therapeutics. To better determine the molecular underpinnings of anoikis resistance, we have used both chemical biology and genetic approaches. Using chemical biological approaches such as small molecule screens, we determined that both FLIP and Na+/K+ ATPase could modulate a cell’s response to anoikis. Through the use of a shRNA genome wide lentiviral screen we determined that ABHD4 was able to inhibit a cell’s response to anoikis. We also showed the importance of anoikis resistance in the ability of malignant cancer cells to survive in circulation. By decreasing a cell’s ability to resist anoikis, one is able to decrease the ability of a cancer cell to survive in circulation and form tumours in distant organs. Taken together, we have identified novel regulators of anoikis resistance and demonstrated the importance of anoikis in metastatic progression, which may lead to the development of novel treatments for metastatic cancers.

Human assessors are currently the best instruments for evaluating the sensory properties of both food and non-food consumer products. In the early stages of descriptive sensory panel training, a lexicon is still undergoing refinement and assessors are only beginning to understand the identities of sensory attributes and how to use the scale to communicate the intensity of sensations. To expedite training, the panel leader provides structure and feedback. Several statistical approaches have been proposed that indicate training status. In this thesis several approaches are reviewed, and a multistage process that involves scrubbing data, estimating parameters, reviewing fit, and exploring multivariate relationships is developed. The process reveals attribute misunderstandings, considers candidate training targets for subsequent training sessions, and explores data to better understand product properties.

This research is part of an ongoing program, Nutrition Screening Tool for Every Preschooler (NutriSTEP®). NutriSTEP® is a valid and reliable 17-item, parent-administered, questionnaire for nutritional risk in preschoolers (3-5 years of age). Due to an expressed need across Canada, the specific objective of this research was to create a draft toddler (18-35 month) NutriSTEP®. Based on results from a comprehensive literature review, focus groups (n=6) with 48 parents of toddlers, and input from 13 pediatric nutrition experts, many questions from the original preschooler NutriSTEP® questionnaire were refined or removed, and novel questions were added. Basic changes included combining separate fruit and vegetable intake questions, and adding breast milk and formula as examples of dairy products. In conclusion, a 19 item Toddler NutriSTEP® was created to reflect the differences in nutritional risk between preschoolers and toddlers. Next steps in the development process include refinement, test-retest reliability and criterion validation. / Canadian Institutes of Health Research

Syfte: Syftet med studien var att undersöka i vilken utsträckning legitimerade sjuksköterskor på vårdavdelningar frågar patienter om våld i nära relationer i samband med anamnesupptagning vid inläggning på vårdavdelningen, samt hur de följer den lokala handlingsplanen för våldsutsatta patienter.   Metod: Kvantitativ tvärsnittstudie. I enkätstudien deltog 50 legitimerade sjuksköterskor från fyra olika vårdavdelningar på ett sjukhus i Mellansverige. Data analyserades med hjälp av deskriptiv och icke-parametrisk statistik. Resultat: Majoriteten (76%) av sjuksköterskorna frågade ”Aldrig” eller ”Sällan” om våld i nära relationer vid anamnesupptagningen. Handlingsplanen för omhändertagande av våldsutsatta hade majoriteten varken diskuterat eller läst och mindre än hälften visste var den hittades. Orsakerna till att inte fråga om våld vid anamnesupptagningen presenterades i fyra kategorier: ”Brist på rutiner”, ”Tidsbrist”, ”Okunskap” samt ”Ej passande eller relevant att fråga”. Att det är sjuksköterskan ansvar att fråga om våld tyckte majoriteten, tre kategorier presenteras om ansvarsfördelningen: ”Sjuksköterskans ansvar”, ”Läkarens ansvar” samt ”Allas ansvar”.      Slutsats: Sjuksköterskor frågar i liten utsträckning patienter om de utsatts för våld i nära relationer vid anamnesupptagningen. Sjuksköterskorna använder även i liten utsträckning den lokala handlingsplanen som kan fungera som en riktlinje. Därmed går de troligtvis miste om tillfällen att identifiera och hjälpa patienter som utsatts för våld i nära relationer.