Use of the DACUM process in the identification and verification of competencies for the medical administrative assistant

Medicine has changed in recent years. Medicare will all of its rules and regulations, worker's compensation laws, managed care and the trend toward more and larger group practices all contributed to the creation of an extremely structured regulatory environment which in turn demanded highly trained medical administrative assistants.^ The researcher noted three primary problems in the identification of competencies for the medical administrative assistant position: A lack of curricula, diverse roles, and a complex environment which has undergone radical change in recent years and will continue to evolve. Therefore, the purposes of the study were to use the DACUM process to develop a relevant list of competencies required by the medical administrative assistant practicing in physicians' offices in South Florida; determine the rank order of importance of each competency using a scale of one to five; cross-validate the DACUM group scores with a second population who did not participate in the DACUM process; and establish a basis for a curriculum framework for an occupational program.^ The DACUM process of curriculum development was selected because it seemed best suited to the need to develop a list of competencies for an occupation for which no programs existed. A panel of expert medical office administrative staff was selected to attend a 2-day workshop to describe their jobs in great detail. The panel, led by a trained facilitator, listed major duties and the respective tasks of their job. Brainstorming techniques were used to develop a consensus.^ Based upon the DACUM workshop, a survey was developed listing the 8 major duties and 71 tasks identified by the panel. The survey was mailed to the DACUM group and a second, larger population who did not participate in the DACUM. The survey results from the two groups were then compared. The non-DACUM group validated all but 3 of the 71 tasks listed by the DACUM panel. Because the three tasks were rated by the second group as at least "somewhat important" and rated "very important" by the DACUM group, the researcher recommended the inclusion of all 71 tasks in program development for this occupation. ^

Social determinants of fruit and vegetable intake and validation of Pro-Children Eating Habits Questionnaire for 3rd and 5th grade children

BACKGROUND: The Pro Children Eating Habits Questionnaire has been evaluated as a valid and reliable tool in Europe to measure determinants of fruit and vegetable intake for children; however, it has not been validation for United States populations. The purpose of this study was to (1) assess the reliability and discrimination validity of fruit and vegetable correlates for the Pro Children Eating Habits Questionnaire; (2) investigate the predictive validity of determinants of fruit and vegetable consumption for multi-ethnic elementary school children; and, (3) to assess the association of social determinants with fruit and vegetable consumption. METHODS: One hundred and thirty elementary school students from the 3rd and 5th grades completed this cross-sectional study. RESULTS: Fruit and vegetable determinants, had satisfactory internal consistencies. No differences were found between the test and the retest for the individual questions with the exception of the question for mean perceived vegetable intake. The discriminatory validity indicated the questionnaire could show differences across grade and gender levels for barriers of fruit and vegetables but not for other factors. Grade together with gender explained barriers to eating fruit and vegetables. Greater availability of fruit in the home and school was associated with higher frequency of consumption. CONCLUSIONS: The results of this study indicate the Pro-Children Eating Habits Questionnaire may be a reliable and valid tool for assessing fruit and vegetable consumption of children in the United States.

The refinement and validation of the critical decision making and problem solving scale moral dilema (CDP-MD)

This thesis extended previous research on critical decision making and problem solving by refining and validating a measure designed to assess the use of critical thinking and critical discussion in sociomoral dilemmas. The purpose of this thesis was twofold: 1) to refine the administration of the Critical Thinking Subscale of the CDP to elicit more adequate responses and for purposes of refining the coding and scoring procedures for the total measure, and 2) to collect preliminary data on the initial reliabilities of the measure. Subjects consisted of 40 undergraduate students at Florida International University. Results indicate that the use of longer probes on the Critical Thinking Subscale was more effective in eliciting adequate responses necessary for coding and evaluating the subjects performance. Analyses on the psychometric properties of the measure consisted of test-retest reliability and inter-rater reliability.

Data Based Identification and Prediction of Nonlinear and Complex Dynamical Systems

We thank Dr. R. Yang (formerly at ASU), Dr. R.-Q. Su (formerly at ASU), and Mr. Zhesi Shen for their contributions to a number of original papers on which this Review is partly based. This work was supported by ARO under Grant No. W911NF-14-1-0504. W.-X. Wang was also supported by NSFC under Grants No. 61573064 and No. 61074116, as well as by the Fundamental Research Funds for the Central Universities, Beijing Nova Programme.

Development and validation of an attitudinal-profiling tool for patients with asthma

Peer reviewed

Identification and classification of geometrical parameeters related to foot pathologies

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Rapid quantification and validation of lipid concentrations within liposomes

Quantification of the lipid content in liposomal adjuvants for subunit vaccine formulation is of extreme importance, since this concentration impacts both efficacy and stability. In this paper, we outline a high performance liquid chromatography-evaporative light scattering detector (HPLC-ELSD) method that allows for the rapid and simultaneous quantification of lipid concentrations within liposomal systems prepared by three liposomal manufacturing techniques (lipid film hydration, high shear mixing, and microfluidics). The ELSD system was used to quantify four lipids: 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC), cholesterol, dimethyldioctadecylammonium (DDA) bromide, and D-(+)-trehalose 6,6′-dibehenate (TDB). The developed method offers rapidity, high sensitivity, direct linearity, and a good consistency on the responses (R2 > 0.993 for the four lipids tested). The corresponding limit of detection (LOD) and limit of quantification (LOQ) were 0.11 and 0.36 mg/mL (DMPC), 0.02 and 0.80 mg/mL (cholesterol), 0.06 and 0.20 mg/mL (DDA), and 0.05 and 0.16 mg/mL (TDB), respectively. HPLC-ELSD was shown to be a rapid and effective method for the quantification of lipids within liposome formulations without the need for lipid extraction processes.

Development and validation of a rapid, aldehyde dehydrogenase bright-based cord blood potency assay.

Banked, unrelated umbilical cord blood provides access to hematopoietic stem cell transplantation for patients lacking matched bone marrow donors, yet 10% to 15% of patients experience graft failure or delayed engraftment. This may be due, at least in part, to inadequate potency of the selected cord blood unit (CBU). CBU potency is typically assessed before cryopreservation, neglecting changes in potency occurring during freezing and thawing. Colony-forming units (CFUs) have been previously shown to predict CBU potency, defined as the ability to engraft in patients by day 42 posttransplant. However, the CFU assay is difficult to standardize and requires 2 weeks to perform. Consequently, we developed a rapid multiparameter flow cytometric CBU potency assay that enumerates cells expressing high levels of the enzyme aldehyde dehydrogenase (ALDH bright [ALDH(br)]), along with viable CD45(+) or CD34(+) cell content. These measurements are made on a segment that was attached to a cryopreserved CBU. We validated the assay with prespecified criteria testing accuracy, specificity, repeatability, intermediate precision, and linearity. We then prospectively examined the correlations among ALDH(br), CD34(+), and CFU content of 3908 segments over a 5-year period. ALDH(br) (r = 0.78; 95% confidence interval [CI], 0.76-0.79), but not CD34(+) (r = 0.25; 95% CI, 0.22-0.28), was strongly correlated with CFU content as well as ALDH(br) content of the CBU. These results suggest that the ALDH(br) segment assay (based on unit characteristics measured before release) is a reliable assessment of potency that allows rapid selection and release of CBUs from the cord blood bank to the transplant center for transplantation.

Identification and characterization of a glycosulfatase-encoding gene cluster in Bifidobacterium breve UCC2003

Bifidobacteria constitute a specific group of commensal bacteria, typically found in the gastrointestinal tract (GIT) of humans and other mammals. Bifidobacterium breve strains are numerically prevalent among the gut microbiota of many healthy breast-fed infants. In the current study, we investigated glycosulfatase activity in a bacterial nursling stool isolate, B. breve UCC2003. Two putative sulfatases were identified on the genome of B. breve UCC2003. The sulfated monosaccharide N-acetylglucosamine-6-sulfate (GlcNAc-6-S) was shown to support growth of B. breve UCC2003, while, N-acetylglucosamine-3-sulfate, N-acetylgalactosamine-3-sulfate and N-acetylgalactosamine-6-sulfate, did not support appreciable growth. Using a combination of transcriptomic and functional genomic approaches, a gene cluster, designated ats2, was shown to be specifically required for GlcNAc-6-S metabolism. Transcription of the ats2 cluster is regulated by a ROK-family transcriptional repressor. This study represents the first description of glycosulfatase activity within the Bifidobacterium genus. Bifidobacteria are saccharolytic organisms naturally found in the digestive tract of mammals and insects. Bifidobacterium breve strains utilize a variety of plant and host-derived carbohydrates which allow them to be present as prominent members of the infant gut microbiota as well as being present in the gastrointestinal tract of adults. In this study, we introduce a previously unexplored area of carbohydrate metabolism in bifidobacteria, namely the metabolism of sulfated carbohydrates. B. breve UCC2003 was shown to metabolize N-acetylglucosamine-6-sulfate (GlcNAc-6-S) through one of two sulfatase-encoding gene clusters identified on its genome. GlcNAc-6-S can be found in terminal or branched positions of mucin oligosaccharides, the glycoprotein component of the mucous layer that covers the digestive tract. The results of this study provide further evidence of this species' ability to utilize mucin-derived sugars, a trait which may provide a competitive advantage in both the infant and adult gut.

Identification and classification of geometrical parameeters related to foot pathologies

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Isolation and Validation of Anti-B7-H4 scFvs from an Ovarian Cancer scFv Yeast-Display Library.

B7-H4 (VTCN1, B7x, B7s) is an inhibitory modulator of T-cell response implicated in antigen tolerization. As such, B7-H4 is an immune checkpoint of potential therapeutic interest. To generate anti-B7-H4 targeting reagents, we isolated antibodies by differential cell screening of a yeast-display library of recombinant antibodies (scFvs) derived from ovarian cancer patients and we screened for functional scFvs capable to interfere with B7-H4-mediated inhibition of antitumor responses. We found one antibody binding to B7-H4 that could restore antitumor T cell responses. This chapter gives an overview of the methods we developed to isolate a functional anti-B7-H4 antibody fragment.

Magnetic properties contribution to the identification and provenance of marine sediments: distal IRD in the Galicia Interior Basin (NW Spain)

This paper discusses the advantages of using a combined environmagnetic and geochemical approach to the provenance and characterization of distal IRDs occurring during the Last Glacial Period in core CI12PC3 from the Galicia Interior Basin (GIB). Six Heinrich layers (HL1-6) have been identified in the area in base to the detection of distinct populations of exotic magnetic mineral assemblages alien to the local/regional sedimentation environment. Their extension has been determined by Ca/Sr and Si/Sr ratios and their provenance by 143Nd/144Nd and 87Sr/86Sr isotopic ratios and FORCs. The sedimentary expression of HL is characterized by the presence of distal Ice Rafted Detritus (IRD). Distal IRD magnetic signatures in the GIB consist of (i) an increase of one order of magnitude in the peak amplitude of magnetic susceptibility from background values, (ii) a general coarsening of the magnetic grain size in a mineral assemblage dominated by titano-magnetites, (iii) FORC distributions pushing towards the coarse MD or PSD component, and (iv) thermomagnetic curves depicting the occurrence of several magnetite phases. These four features are very different from the fine-grained biogenic magnetic assemblages characterized by the combination of lower MS and higher coercivity values that dominate the predominant mixtures of the non-interacting SSD and PSD components in the non-IRD influenced background sedimentation. Our results show that the last 70.000 yr of sedimentation in the GIB were controlled by the relative contribution of local detrital material derived from the Iberian Variscan Chain and IRD alien material from the iceberg melting during the Heinrich Events. They also show two main IRD provenance fields: Europe and Canada. And that the later is more important for for HL1, HL2, HL4 and HL5. FORCs analysis complemented the isotopic information and provided a very unique information, indicating that glacial flour may not always have the same provenance as IRD and that ice-melted derived suspended sediment has its own dynamics and may reach further and/or persists longer than IRD.

Identification and Characterization of New Small Molecule Inhibitors of Picornavirus Replication

The Picornaviridae family consists of positive-strand RNA viruses that are the causative agents of a variety of diseases in humans and animals. Few drugs targeting picornaviruses are available, making the discovery of new antivirals a high priority. Here, we identified and characterized three compounds from a library of kinase inhibitors that block replication of poliovirus, coxsackievirus B3, and encephalomyocarditis virus. The antiviral effect of these compounds is not likely related to their known cellular targets because other inhibitors targeting the same pathways did not inhibit viral replication. Using an in vitro translation-replication system, we showed that these drugs inhibit different stages of the poliovirus life cycle. A4(1) inhibited the formation of a functional replication complex, while E5(1) and E7(2) affected replication after the replication complex had formed. A4(1) demonstrated partial protection from paralysis in a murine model of poliomyelitis. Poliovirus resistant to E7(2) had a single mutation in the 3A protein. This mutation was previously found to confer resistance to enviroxime-like compounds, which target either PI4KIIIβ (major enviroxime-like compounds) or OSBP (minor enviroxime-like compounds), cellular factors involved in lipid metabolism and shown to be important for replication of diverse positive-strand RNA viruses. We classified E7(2) as a minor enviroxime-like compound, because the localization of OSBP changed in the presence of this inhibitor. Interestingly, both E7(2) and major enviroxime-like compound GW5074 interfered with the viral polyprotein processing. Multiple attempts to isolate resistant mutants in the presence of A4(1) or E5(1) were unsuccessful, showing that effective broad-spectrum antivirals could be developed on the basis of these compounds. Studies with these compounds shed light on pathways shared by diverse picornaviruses that could be potential targets for the development of broad-spectrum antiviral drugs.

Identification and characterisation of telomere regulatory and signalling pathways after induction of telomere dysfunction

Telomeres are DNA-protein complexes which cap the ends of eukaryotic linear chromosomes. In normal somatic cells telomeres shorten and become dysfunctional during ageing due to the DNA end replication problem. This leads to activation of signalling pathways that lead to cellular senescence and apoptosis. However, cancer cells typically bypass this barrier to immortalisation in order to proliferate indefinitely. Therefore enhancing our understanding of telomere dysfunction and pathways involved in regulation of the process is essential. However, the pathways involved are highly complex and involve interaction between a wide range of biological processes. Therefore understanding how telomerase dysfunction is regulated is a challenging task and requires a systems biology approach. In this study I have developed a novel methodology for visualisation and analysis of gene lists focusing on the network level rather than individual or small lists of genes. Application of this methodology to an expression data set and a gene methylation data set allowed me to enhance my understanding of the biology underlying a senescence inducing drug and the process of immortalisation respectively. I then used the methodology to compare the effect of genetic background on induction of telomere uncapping. Telomere uncapping was induced in HCT116 WT, p21-/- and p53-/- cells using a viral vector expressing a mutant variant of hTR, the telomerase RNA template. p21-/- cells showed enhanced sensitivity to telomere uncapping. Analysis of a candidate pathway, Mismatch Repair, revealed a role for the process in response to telomere uncapping and that induction of the pathway was p21 dependent. The methodology was then applied to analysis of the telomerase inhibitor GRN163L and synergistic effects of hypoglycaemia with this drug. HCT116 cells were resistant to GRN163L treatment. However, under hypoglycaemic conditions the dose required for ablation of telomerase activity was reduced significantly and telomere shortening was enhanced. Overall this new methodology has allowed our group and collaborators to identify new biology and improve our understanding of processes regulating telomere dysfunction.