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Title: IDENTIFYING POPULATIONS AT RISK FOR INFECTION AFTER KNEE ARTHROPLASTY: AN INTEGRATED LITERATURE REVIEW.
Creator: Coker, Christian, Bushy, Angeline, University of Central Florida
Abstract / Description: The purpose of this integrated review of the literature was to explore the postsurgical infection complications commonly occurring in individuals undergoing total knee replacement surgery, and the relationship of co-morbidities, lifestyle choices, and genetics on the risk for complication. A comprehensive search of the literature focusing on the patient surgical site infection and total knee replacement surgery using the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and...
Show moreThe purpose of this integrated review of the literature was to explore the postsurgical infection complications commonly occurring in individuals undergoing total knee replacement surgery, and the relationship of co-morbidities, lifestyle choices, and genetics on the risk for complication. A comprehensive search of the literature focusing on the patient surgical site infection and total knee replacement surgery using the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medical Literature On-line (MEDLINE). Initial searches revealed 80 results. Upon closer scrutiny, duplicates were removed, as well as those not relevant to infection in total knee arthroplasty. This resulted in a review of 6 articles that fit the inclusion criteria. Inclusion criteria were articles written in the English language and published in scholarly, peer-reviewed, journals from 2009 to present. In addition to published articles, pertinent material from current nursing textbooks was evaluated and chosen to further substantiate the literature results. In cases of knee arthroplasty, diagnoses of obesity and diabetes were discovered to be risk factors for postsurgical infection. The findings of this thesis offer interpretation for nursing practice, research, education, and policy. Implications for nursing research, policy, education and practice are highlighted along with limitations of this integrative review.
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Date Issued: 2014
Identifier: CFH0004668, ucf:45302
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004668

Title: ETHANOL LOCK THERAPY IN THE TREATMENT AND PREVENTION OF CATHETER-RELATED BLOODSTREAM INFECTIONS.
Creator: Anderson, Breanna, Heglund, Stephen, University of Central Florida
Abstract / Description: Ethanol lock therapy is a novel technique that is being studied for its efficacy in eradicating catheter related bloodstream infections. A systematic review of interdisciplinary studies from CINAHL, Medline, Academic Search Premier, Biological Abstracts, and Web of Knowledge databases was performed. This meta-analysis examined the findings of thirty-five studies on ethanol lock therapy. Twenty-six of these studies compared ethanol to a placebo and nine studies performed a direct comparison of...
Show moreEthanol lock therapy is a novel technique that is being studied for its efficacy in eradicating catheter related bloodstream infections. A systematic review of interdisciplinary studies from CINAHL, Medline, Academic Search Premier, Biological Abstracts, and Web of Knowledge databases was performed. This meta-analysis examined the findings of thirty-five studies on ethanol lock therapy. Twenty-six of these studies compared ethanol to a placebo and nine studies performed a direct comparison of ethanol to other agents frequently used in antimicrobial lock technique. Ethanol lock therapy was shown to be effective as both a prophylactic therapy and as an active treatment in eradicating biofilms of organisms that frequently cause catheter-related blood stream infections, including Staphylococcus epidermis, Staphylococcus aureus, Klebsiella pneumonia, Pseudomonas aeruginosa, E. coli, and Candida albicans. Ethanol has been shown to have a synergistic effect with several other antimicrobial agents. The majority of studies examined in this thesis have found that ethanol has equal or greater efficacy to several antibiotic and antimicrobial agents used in practice and should therefore be considered for the treatment of catheter-related blood stream infections.
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Date Issued: 2012
Identifier: CFH0004183, ucf:44845
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004183

Title: Infection Control and Health Care Associated Infection (HCAI) in the Nursing Home: A Study to Determine the Impact of an Educational Video and Pamphlet About Infection Control on Knowledge and Perception of Hand Hygiene in Certified Nurse Assistants.
Creator: Hypes, Kathe, Blackwell, Christopher, Covelli, Maureen, Winton, Mark, University of Central Florida
Abstract / Description: The impact of an education program on perception, knowledge, and infection rate was evaluated in this study. The educational intervention consisted of a video on infection control and a World Health Organization (WHO) pamphlet for hand hygiene. The study was conducted in one nursing home in the Southeastern United States. The survey sample consisted of 66 certified nurse assistants (CNAs). A pre- and post-intervention design was employed using the WHO's Hand Hygiene Knowledge Questionnaire...
Show moreThe impact of an education program on perception, knowledge, and infection rate was evaluated in this study. The educational intervention consisted of a video on infection control and a World Health Organization (WHO) pamphlet for hand hygiene. The study was conducted in one nursing home in the Southeastern United States. The survey sample consisted of 66 certified nurse assistants (CNAs). A pre- and post-intervention design was employed using the WHO's Hand Hygiene Knowledge Questionnaire and the WHO Perception Survey. Friedman's test and central tendencies showed no statistical relationship between the educational intervention and the overall knowledge scores of the sample. There also were no statistical differences in perception of hand hygiene in the CNA sample. Infection frequency was reduced with a percent change of -42%. While results of knowledge and perception surveys were not statistically significant, multiple conclusions were derived to suggest that educational opportunities may impact hand hygiene practice in CNAs and lead to a decrease in infection.
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Date Issued: 2012
Identifier: CFE0004551, ucf:49239
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004551

Title: PROTOCOL BASED SCREENING TOOLS TO IDENTIFY SEPSIS PATIENTS TRANSPORTED BY EMERGENCY MEDICAL SERVICES.
Creator: Moser, Isaiah, Talbert, Steven, University of Central Florida
Abstract / Description: Sepsis is a complicated disorder in which an infection has reached the bloodstream and caused a cascade of events that in time will lead to death. Interventions aimed at identifying sepsis early in its progression are imperative to stopping the process. The purpose of this study is to examine the current state of the literature regarding sepsis screening tools utilized by emergency medical services. A literature review exploring the various tools in place was conducted to see their value in...
Show moreSepsis is a complicated disorder in which an infection has reached the bloodstream and caused a cascade of events that in time will lead to death. Interventions aimed at identifying sepsis early in its progression are imperative to stopping the process. The purpose of this study is to examine the current state of the literature regarding sepsis screening tools utilized by emergency medical services. A literature review exploring the various tools in place was conducted to see their value in predicting sepsis and secondary what the initiation of a sepsis alert has on the patients' outcome. Results found included that sepsis screening tools when in place decrease time to identification, decrease time to antibiotics, increase amount of fluid administration, and overall reduce hospital stay and mortality rate. With these findings educational training for EMS providers and the introduction of generalized protocols are of the upmost importance. Further research is needed to be done to create a consistent tool to be used by all EMS agencies that has a validated predictive value of sepsis.
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Date Issued: 2017
Identifier: CFH2000155, ucf:46061
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000155

Title: AEROMONAS HYDROPHILA IN AMPHIBIANS: HARMLESS BYSTANDER OR OPPORTUNISTIC PATHOGEN.
Creator: Rivas, Zachary P, Savage, Anna Evangeline, University of Central Florida
Abstract / Description: For several decades amphibian populations have been declining. Historically, the bacterium A. hydrophila (Ah) was hypothesized to be the causal factor in amphibian disease and population declines. However, with the discovery of a chytrid fungus, Batrachochytrium dendrobatidis (Bd) in 1998, which was identified on the skin of amphibians during documented mortality events, Ah research became of minor interest as focus shifted to Bd. Recent studies into the immunocompromising abilities of Bd,...
Show moreFor several decades amphibian populations have been declining. Historically, the bacterium A. hydrophila (Ah) was hypothesized to be the causal factor in amphibian disease and population declines. However, with the discovery of a chytrid fungus, Batrachochytrium dendrobatidis (Bd) in 1998, which was identified on the skin of amphibians during documented mortality events, Ah research became of minor interest as focus shifted to Bd. Recent studies into the immunocompromising abilities of Bd, however, have opened new questions about its relationship with Ah and their combined effects on a host. In this study, I explore the relationship between infection with these two pathogens, Bd and Ah, in two amphibian species from distinct regions of the United States. I developed a novel qPCR assay to measure the microbial load of Ah on the skin of two anuran species, Lithobates yavapaiensis (N=232) and Pseudacris ornata (N=169), which have confirmed Bd infections. I use a logistic regression model to identify whether significant relationships exist between these two pathogens, disease, and death. I find that even amongst the most severely infected frogs, Ah is not detectable on the skin and only appears post-mortem. I therefore conclude that Ah is an opportunistic bacterial pathogen, scavenging on anurans only after mortality events. This research is the first known study to quantitatively assess Ah in amphibians in conjunction with Bd. While there is no causal relationship between these pathogens, future work will examine potential Ah infections in other organs to more fully understand the relationship between Bd and Ah.
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Date Issued: 2016
Identifier: CFH2000013, ucf:45589
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000013

Title: CHARACTERIZATION OF HEMERYTHRIN-LIKE PROTEIN RV2633C.
Creator: Cherne, Michelle D, Self, William, University of Central Florida
Abstract / Description: Hemerythrin-like protein Rv2633c is a small 18 kDa protein that is expressed in Mycobacterium tuberculosis (Mtb). Sequence analysis of Rv2633c predicts the presence of a hemerythrin-like domain, which binds dioxygen using a �-oxo-bridge (Fe-O-Fe), rather than a heme group. Though it is noticeably upregulated during macrophage infection and during in vitro acidification, the role of Rv2633c in Mtb survival has yet to be elucidated. This project aims to characterize the function of Rv2633c by...
Show moreHemerythrin-like protein Rv2633c is a small 18 kDa protein that is expressed in Mycobacterium tuberculosis (Mtb). Sequence analysis of Rv2633c predicts the presence of a hemerythrin-like domain, which binds dioxygen using a �-oxo-bridge (Fe-O-Fe), rather than a heme group. Though it is noticeably upregulated during macrophage infection and during in vitro acidification, the role of Rv2633c in Mtb survival has yet to be elucidated. This project aims to characterize the function of Rv2633c by studying the in vitro response of the recombinant protein to conditions present in the macrophage lysosome, such as reduced oxygen levels or the presence of reactive oxygen species. UV-visible spectroscopy is used to observe these changes, as the spectrum shows a characteristic peak at 330 nm that likely corresponds to the diiron cofactor in its native state. Our results show this spectrum shifts in response to hydrogen peroxide addition, showing the proposed environmental conditions can affect the active site. Bioinformatics techniques, such as the 3D modeling program SWISS-MODEL, have been used to hypothesize possible structure and function. Determining the function of Rv2633c may help explain how Mtb so readily evades the human immune system to reside in the macrophage.
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Date Issued: 2016
Identifier: CFH2000011, ucf:45581
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000011

Title: Stable expression of tuberculosis vaccine antigen in lettuce chloroplasts.
Creator: Saikumar Lakshmi, Priya, Daniell, Henry, Khaled, Annette, Naser, Saleh, University of Central Florida
Abstract / Description: Tuberculosis (TB) is caused by Mycobacterium tuberculosis and is one of the leading reasons of death by an infectious bacterial pathogen. The development of TB vaccines has been recognized as a major public health priority by the World Health Organization. In this study, a potential candidate antigen, ESAT-6 (6 kDa early secretory antigenic target) was fused with cholera toxin B subunit (CTB). Transplastomic lettuce plants were generated expressing these fusion proteins. Site-specific...
Show moreTuberculosis (TB) is caused by Mycobacterium tuberculosis and is one of the leading reasons of death by an infectious bacterial pathogen. The development of TB vaccines has been recognized as a major public health priority by the World Health Organization. In this study, a potential candidate antigen, ESAT-6 (6 kDa early secretory antigenic target) was fused with cholera toxin B subunit (CTB). Transplastomic lettuce plants were generated expressing these fusion proteins. Site-specific transgene integration into the chloroplast genome was confirmed by polymerase chain reaction and Southern blot analysis. In transplastomic leaves, expression levels of fusion protein (CTB-ESAT6) varied depending upon the developmental stage and time of leaf harvest with highest-level of accumulation in mature leaves harvested at 6PM. Transplastomic CTB-ESAT6 lettuce plants accumulated up to 0.75% of total leaf protein. Lyophilization increased CTB-ESAT6 protein content per gram of leaf material by 22 fold. Western blot analysis of lyophilized lettuce leaves showed that the CTB-ESAT6 fusion protein was stable and can be stored for prolonged period at RT. Hemolysis assay with purified CTB-ESAT6 protein showed partial hemolysis of red blood cells and confirmed functionality of ESAT-6 antigen. GM-1 binding assay demonstrated that the CTB-ESAT6 fusion protein formed pentamers to interact with GM1 ganglioside receptor. The expression of functional Mycobacterium tuberculosis antigens fused to CTB in transplastomic plants should facilitate development of a cost-effective and orally deliverable TB vaccine with potential for long term storage at room temperature.
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Date Issued: 2011
Identifier: CFE0004487, ucf:49303
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004487

Title: Modeling Risk for Sexually Transmitted Infections in Women in a Court-Ordered Substance Treatment Program.
Creator: Deavers, Frances, Cassisi, Jeffrey, Bowers, Clint, Eldridge, Gloria, University of Central Florida
Abstract / Description: Developing a comprehensive model of Sexually Transmitted Infection (STI) risk factors and their inter-relationships is vital to improving methods of risk identification and treatment delivery. The CDC posed three general categories that may serve as a framework for such a model: sexual network, individual behavior, and social/ structural risk. None of the extant risk models incorporate measures from all three categories. Additionally, none of these models, generally focused on individual...
Show moreDeveloping a comprehensive model of Sexually Transmitted Infection (STI) risk factors and their inter-relationships is vital to improving methods of risk identification and treatment delivery. The CDC posed three general categories that may serve as a framework for such a model: sexual network, individual behavior, and social/ structural risk. None of the extant risk models incorporate measures from all three categories. Additionally, none of these models, generally focused on individual behavior, use medical data on infection as their outcome variable. This is problematic because the ultimate outcome of infection is also influenced by sexual network and social/ structural variables, in addition to individual behaviors. Therefore the current study aimed to develop a comprehensive model of risk incorporating sexual network, individual behavior, and social/ structural risk variables, using medical data on infection status as the outcome variable. The sample consisted of 506 women in a court-ordered substance treatment program. An Exploratory Factor Analysis provided preliminary evidence for a three factor model corresponding to the CDC framework. However, a Confirmatory Factor Analysis failed to confirm this model. Additionally, a logistic regression suggested that this model has limited clinical utility for this sample. Future studies may more conclusively determine the importance of various STI risk variables, the relationships between them, and whether they mirror the CDC theoretical framework. With rates of infection still high in the United States, and even increasing among women for certain STIs, this is a critical public health issue that should continue to be examined.
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Date Issued: 2014
Identifier: CFE0005323, ucf:50502
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005323

Title: EPIDEMIOLOGICAL MODELS FOR MUTATING PATHOGENS WITH TEMPORARY IMMUNITY.
Creator: Singh, Neeta, Rollins, David, University of Central Florida
Abstract / Description: Significant progress has been made in understanding different scenarios for disease transmissions and behavior of epidemics in recent years. A considerable amount of work has been done in modeling the dynamics of diseases by systems of ordinary differential equations. But there are very few mathematical models that deal with the genetic mutations of a pathogen. In-fact, not much has been done to model the dynamics of mutations of pathogen explaining its effort to escape the host's immune...
Show moreSignificant progress has been made in understanding different scenarios for disease transmissions and behavior of epidemics in recent years. A considerable amount of work has been done in modeling the dynamics of diseases by systems of ordinary differential equations. But there are very few mathematical models that deal with the genetic mutations of a pathogen. In-fact, not much has been done to model the dynamics of mutations of pathogen explaining its effort to escape the host's immune defense system after it has infected the host. In this dissertation we develop an SIR model with variable infection age for the transmission of a pathogen that can mutate in the host to produce a second infectious mutant strain. We assume that there is a period of temporary immunity in the model. A temporary immunity period along with variable infection age leads to an integro-differential-difference model. Previous efforts on incorporating delays in epidemic models have mainly concentrated on inclusion of latency periods (this assumes that the force of infection at a present time is determined by the number of infectives in the past). We begin with reviewing some basic models. These basic models are the building blocks for the later, more detailed models. Next we consider the model for mutation of pathogen and discuss its implications. Finally, we improve this model for mutation of pathogen by incorporating delay induced by temporary immunity. We examine the influence of delay as we establish the existence, and derive the explicit forms of disease-free, boundary and endemic equilibriums. We will also investigate the local stability of each of these equilibriums. The possibility of Hopf bifurcation using delay as the bifurcation parameter is studied using both analytical and numerical solutions.
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Date Issued: 2006
Identifier: CFE0001043, ucf:46801
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0001043

Title: SYSTEMATIC REVIEW AND META-ANALYSIS: TUBERCULOSIS, TNFΑ INHIBITORS, AND CROHN'S DISEASE.
Creator: Cao, Brent L, Naser, Saleh A., University of Central Florida
Abstract / Description: Inflammation is often a protective reaction against harmful foreign agents. However, in many disease conditions, the mechanisms behind the inflammatory response are poorly understood. Often times, the inflammation causes adverse effects, such as joint pain, abdominal pain, fever, fatigue, and loss of appetite. Thus, many treatments aim to inhibit the inflammatory response in order to control adverse symptoms. Such treatments include TNFα inhibitors. However, a major risk associated with drugs...
Show moreInflammation is often a protective reaction against harmful foreign agents. However, in many disease conditions, the mechanisms behind the inflammatory response are poorly understood. Often times, the inflammation causes adverse effects, such as joint pain, abdominal pain, fever, fatigue, and loss of appetite. Thus, many treatments aim to inhibit the inflammatory response in order to control adverse symptoms. Such treatments include TNFα inhibitors. However, a major risk associated with drugs inhibiting tumor necrosis factor alpha (TNFα) is serious infection, including tuberculosis (TB). Anti-TNFα therapy is used to treat patients with Crohn's disease, for which the risk of tuberculosis may be even more concerning. Recent literature suggests Crohn's might involve Mycobacterium avium subspecies paratuberculosis (MAP), an intracellular TB-like bacterium. This study seeks to investigate the risk of developing TB in patients with Crohn's disease treated with TNFα inhibitors. A meta-analysis synthesized existing evidence. Evidence came from published randomized, double-masked, placebo-controlled trials of TNFα inhibitors for treatment of adult Crohn's disease. Twenty-three trials were identified, including 5,669 patients. The risk of tuberculosis was significantly increased in anti-TNFα treated patients, with a risk difference of 0.028 (95% confidence interval [CI], 0.0011-0.055). The odds ratio was 4.85 (95% CI, 1.02-22.99) when all studies were included and 5.85 (95% CI, 1.13-30.38) when studies reporting zero tuberculosis cases were excluded. The risk of tuberculosis is increased in patients with Crohn's disease treated with TNFα inhibitors. The medical community should be alerted about this risk and the potential for TNFα inhibitor usage favoring granulomatous infections and worsening the patient condition.
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Date Issued: 2018
Identifier: CFH2000360, ucf:45909
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000360

Title: SEX EDUCATION POLICY IN FLORIDA: STRATEGIES FOR CHANGE.
Creator: Cawley, Jenna, Fine, Terri Susan, University of Central Florida
Abstract / Description: Sex education policies and programs in Florida are largely dominated by the abstinence-only approach. This paper makes the case that abstinence-only education is a failing policy in Florida, and evaluates strategies advocates may use in order to accomplish reform. Three different strategies are evaluated: countywide school district reform, statewide rejection of federal abstinence-only funding, and statewide standardization of sex education via legislation. Contrasts are drawn between all...
Show moreSex education policies and programs in Florida are largely dominated by the abstinence-only approach. This paper makes the case that abstinence-only education is a failing policy in Florida, and evaluates strategies advocates may use in order to accomplish reform. Three different strategies are evaluated: countywide school district reform, statewide rejection of federal abstinence-only funding, and statewide standardization of sex education via legislation. Contrasts are drawn between all three strategies with regard to their potential impact on sex education policy in Florida, viability, and the challenges they present to advocates. This paper concludes that statewide standardization of sex education in Florida represents the best way to remedy the problem of insufficient sex education, but is unlikely to occur without increased bipartisan support in the Florida legislature. Statewide rejection of Title V federal abstinence-only funds remains an important policy goal for the purpose of accomplishing an end to federal abstinence grants but would likely achieve very little for Florida's students. Countywide sex education changes are thus far the only substantive victory for sex education advocates in Florida and should be instituted across the state with advocates taking special care to engage teachers, medical professionals, parents and local community leaders.
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Date Issued: 2008
Identifier: CFE0002259, ucf:47829
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002259

Title: Genetic and biochemical characterization of the roles of two putative purine transporters in the infectious cycle of Borrelia burgdorferi.
Creator: Jain, Sunny, Jewett, Mollie, Naser, Saleh, Self, William, Vonkalm, Laurence, University of Central Florida
Abstract / Description: Lyme disease, the most common tick borne disease in United States, is caused by the bacterial pathogen Borrelia burgdorferi. In nature, B. burgdorferi exists in an enzootic infectious cycle between an arthropod vector and mammalian hosts. Identification and characterization of the genes essential for B. burgdorferi survival throughout its infectious cycle is an important step toward understanding the molecular mechanisms involved in B. burgdorferi pathogenesis. B. burgdorferi contains a small...
Show moreLyme disease, the most common tick borne disease in United States, is caused by the bacterial pathogen Borrelia burgdorferi. In nature, B. burgdorferi exists in an enzootic infectious cycle between an arthropod vector and mammalian hosts. Identification and characterization of the genes essential for B. burgdorferi survival throughout its infectious cycle is an important step toward understanding the molecular mechanisms involved in B. burgdorferi pathogenesis. B. burgdorferi contains a small genome, which lacks the genes encoding for the enzymes required for de novo synthesis of amino acids, fatty acids and nucleic acid precursors. Therefore, the spirochete is dependent upon the host environment for the uptake of these essential nutrients. Purines are required for the synthesis of nucleotides for the biosynthesis of DNA and RNA. Due to the lack of de novo purine synthesis, the ability of B. burgdorferi to salvage purines from its host environments is essential to its survival. While the enzymes critical for the B. burgdorferi purine salvage pathway are known, the transporters involved in the uptake of purines from the host environments are not. The work in this thesis is focused on identification of the genes encoding purine permeases in B. burgdorferi and genetic and biochemical characterization of their functions in the infectious cycle of B. burgdorferi. Here, we demonstrate that homologous genes bbb22 and bbb23 present on circular plasmid 26 encode for purine permeases, which are important for transport of hypoxanthine, adenine and guanine. Furthermore, genes bbb22-23 together were essential for B. burgdorferi infection in mice. BBB22 and BBB23 share 78% amino acid identify. And although, individually both BBB22 and BBB23 were found to be capable of purine transport, BBB22 has higher affinity for hypoxanthine and adenine compared to BBB23. Moreover, the bbb22 gene alone was sufficient to restore mouse infectivity to spirochetes lacking both bbb22 and bbb23, whereas, bbb23 was not. Nonetheless, the spirochete loads in the tissues of mice infected with B. burgdorferi carrying bbb22 alone were significantly reduced compared to B. burgdorferi carrying both bbb22 and bbb23, demonstrating the importance of the two genes together for the spirochetes to achieve wild type levels of infection. In ticks, genes bbb22 and bbb23 were dispensable for spirochete survival but contributed to spirochete replication in fed larvae. The replication of spirochetes lacking bbb22-23 in larval ticks was restored to wild type levels by the reintroduction of the low affinity purine transporter encoded by bbb23 alone. Overall, we have identified a purine transport system in B. burgdorferi, which is essential for spirochete survival in the mammalian host and contributes to spirochete replication in the tick vector. As B. burgdorferi lacks typical virulence factors and toxins, these studies highlight the critical role of physiological functions in the virulence of this pathogen. Moreover, the BBB22-23 in vivo essential transport system may represent a novel therapeutic target to deliver antimicrobial drugs to treat Lyme disease.
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Date Issued: 2014
Identifier: CFE0005511, ucf:50303
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005511

Title: THE INCIDENCE AND EPIDEMIOLOGIC FACTORS OF COMMUNITY-ACQUIRED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS SKIN AND SOFT TISSUE INFECTIONS IN A SUBURBAN FAMILY PRACTICE IN FLORIDA.
Creator: Johnson, Ivonne, Rash, Elizabeth, University of Central Florida
Abstract / Description: Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem nationwide, threatening to develop into an epidemic. Many of these patients are presenting to their primary care clinics with skin and soft tissue infections (SSTIs). The CDC has reported that in 2005, MRSA was responsible for an estimated 94,000 life-threatening infections and 16,650 deaths. The purpose of this study is to estimate the incidence of CA-MRSA within a specific family practice in Florida and to...
Show moreMethicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem nationwide, threatening to develop into an epidemic. Many of these patients are presenting to their primary care clinics with skin and soft tissue infections (SSTIs). The CDC has reported that in 2005, MRSA was responsible for an estimated 94,000 life-threatening infections and 16,650 deaths. The purpose of this study is to estimate the incidence of CA-MRSA within a specific family practice in Florida and to identify epidemiologic factors, classify antibiotic susceptibility patterns, and evaluate patient education in regard to disease management and prevention. This study was a descriptive, epidemiologic, three-year retrospective medical record review of all wound cultured skin and soft tissue infections that presented to a family practice between January 2007 and December 2009. Sixty-two medical records met the inclusion and exclusion criteria for the study. Of these 62 SSTIs, 44 cultures grew one or more bacterial organisms. The incidence of CA-MRSA was 66% (n=29). The mean age of those with CA-MRSA was 40 years old, with a range from 7 to 90 years old. Sixty-two percent (n=18) were male and 38% (n=11) were female; additionally 69% (n=20) lived within a 10 mile radius from the family practice, while 31% (n=9) lived in a surrounding suburb. The most frequent race was Caucasian 83% (n=24), with African American at 10% (n=3) and Hispanics 7% (n=2). Risk factors associated with CA-MRSA was obesity 41% (n=10), diabetes mellitus 24% (n=7), and a previous history of MRSA infection 24% (n=7). Skin and soft tissue infections were diagnosed as either an abscess 62% (n=18), boil 24% (n=7), pustule 10% (n=3), or cellulitis 4% (n=1). CA-MRSA isolates were susceptible to trimethoprim-sulfamethoxazole 100% (n=29), doxycycline 93% (n=27), and rifampin 100% (n=14). Clindamycin susceptibility was 65% (n=15) with resistance at 30% (n=7) and 5% (n=1) intermediate. Both cephalexin and erythromycin were 100% resistant. Documentation in the medical record on wound care was found in 45% (n=13) of the records. The incidence of CA-MRSA SSTI was 66%, which identifies this suburban community at high risk for this bacterial infection. Risk factors associated with CA-MRSA included obesity (BMI >30), history of previous MRSA infection, and diabetes mellitus. There were no clinical characteristics that helped distinguish MRSA infection from other bacterial SSTIs. Most SSTI were treated with incision and drainage and a susceptible antibiotic. Judicious use of antibiotics not only provides appropriate treatment, but is also critical in prevention of antibiotic resistance. Lastly, patient education in adequate hygiene is essential in preventing the spread of CA-MRSA
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Date Issued: 2010
Identifier: CFE0003309, ucf:48495
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003309

Title: Ventilator-Associated Complications in the Mechanically Ventilated Veteran.
Creator: Grano, Joan, Sole, Mary, Covelli, Maureen, Talbert, Steven, McGuirt, Aron, University of Central Florida
Abstract / Description: Surveillance of ventilator-associated pneumonia (VAP) has been the common outcome measurement used for internal and external benchmarking for mechanically ventilated patients; and although not a clinical definition, it is commonly used as an outcome measurement for research studies. Criteria in the VAP definition include both subjective and objective components, leading to questions of validity. In addition, recent legislation has mandated the public reporting of healthcare-associated...
Show moreSurveillance of ventilator-associated pneumonia (VAP) has been the common outcome measurement used for internal and external benchmarking for mechanically ventilated patients; and although not a clinical definition, it is commonly used as an outcome measurement for research studies. Criteria in the VAP definition include both subjective and objective components, leading to questions of validity. In addition, recent legislation has mandated the public reporting of healthcare-associated infections, including VAP, in many states. Infectious disease experts have recently recommended monitoring a new outcome, ventilator-associated events (VAE), that contain specific objective criteria. The Centers for Disease Prevention and Control (CDC) have refined this definition and released a new VAE protocol and algorithm, replacing the VAP surveillance definition, as a result. The VAE protocol assesses for ventilator-associated conditions (VAC). The primary aims of this study were to determine the incidence of VAC; and to assess four predictors for VAC, including two VAP prevention strategies (use of the subglottic secretion drainage endotracheal-tube [SSD-ETT]), and daily sedation vacation); and two patient-related factors (alcohol withdrawal during mechanical ventilation, and history of COPD). In addition, the incidence for VAE, using a new national algorithm was determined. Using a retrospective study design, electronic medical records of 280 veterans were reviewed to identify cases of VAC using the VAE algorithm. The setting was two intensive care units (ICU) at a large Veterans Administration Healthcare System (VAHCS) from October 2009 to September 2011. In addition to demographic information, variables were collected to determine if cases met event criteria (VAC, infection-related ventilator-associated complication [IVAC], and possible or probable VAP). Incidence rates were calculated for VAC and IVAC. Comparative data between those with and without VAC were assessed with independent sample T-test or non-parametric equivalents. The study sample was predominantly male (97.1%), Caucasian (92.1%), non-Hispanic (90.7%); with a mean (SD) age of 67.2 (10.4) years. Twenty patients met the VAC definition resulting in a VAC incidence of 7.38 per 1000 ventilator days. There were no statistically significant differences in demographics or disease characteristics found between the two groups (patients with VAC and patients without VAC). Using logistic regression, the impact of the four predictors for VAC was assessed. None of the four explanatory variables were predictive of the occurrence of VAC. Secondary outcomes (e.g. mechanical ventilation days, ICU days, hospital days, and mortality) of veterans with VAC were compared to veterans without VAC. Results indicated that the VAC group was associated with a significantly longer duration of ICU stay, longer mechanical ventilation period, more likely to have a tracheostomy, and had a higher mortality during hospitalization. Expanding mechanical ventilation quality performance measures to include VAE/VAC provides a better representation of infectious and non-infectious ventilator-associated problems, and provides more accurate morbidity and mortality in this high-risk ICU population. Further research is necessary to explore patient characteristics and prevention strategies that impact the development of all VAC.
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Date Issued: 2013
Identifier: CFE0004853, ucf:49706
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004853

Title: THE EFFECTIVENESS OF INTERVENTIONS AND BUNDLES FOR CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS IN THE NEONATAL INTENSIVE CARE UNIT.
Creator: Alhamwi, Mohamad, Ramirez, Bernardo, Sole, Mary Lou, University of Central Florida
Abstract / Description: Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing...
Show moreIntroduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing CLABSI in NICUs. Methods: A systematic literature search was conducted using CINAHL Plus with Text, Cochrane Database of Systematic Reviews and MEDLINE from January 2008 up to 2018. There were multiple search terms used and these included "neonate OR newborn OR infant", "CLABSI OR central line-associated bloodstream infection", "intervention OR prevention" and "bundle". The search solely focused on the outcome of infant patients. Therefore studies were excluded for the following criteria: being non-peer reviewed, being published before 2008, and being a case in which CLABSI was assessed in patients outside the NICU. See Table 4 and 5 for further information. Results: Eight articles were eligible for inclusion all of which CDC's guidelines were implemented in their strategy of intervention. The systematic review showed that adherence to care bundles decreases infection rates drastically. All eight articles reported a significant decrease in CLABSI rates following the implementation of the bundle set by CDC with two studies achieving a CLABSI rate of zero. Author's Conclusion: Implementation of care bundles showed a success in reducing CLABSI rates in the NICUs; however none of the studies endorsed a specific bundle application utilized to achieve its intended goal. Some practices adopted CDC's guidelines more than others and those showed a greater decrease in infection rate. In addition, it is evident that nurses deliver the best care when preventing an infection. Further research is needed to assess the effectiveness of a specific bundle element.
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Date Issued: 2018
Identifier: CFH2000407, ucf:45736
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000407

Title: Light Scattering Property of Gold Nanoparticles with Applications to Biomolecule Detection and Analysis.
Creator: Zheng, Tianyu, Huo, Qun, Zou, Shengli, Gesquiere, Andre, Kang, Hyeran, Zhai, Lei, University of Central Florida
Abstract / Description: Gold nanoparticles (AuNPs) have unique optical and chemical properties. Dynamic light scattering (DLS) is an analytical tool used routinely for nanoparticle size measurement. The combined use of AuNPs and DLS has led to a novel analytical assay technology called D2Dx (from diameter to diagnostics). Herein, my dissertation highlights the extended use of D2Dx for biomolecule detection and analysis. Under this general theme, Chapter 1 provides some background information of AuNPs, DLS, the...
Show moreGold nanoparticles (AuNPs) have unique optical and chemical properties. Dynamic light scattering (DLS) is an analytical tool used routinely for nanoparticle size measurement. The combined use of AuNPs and DLS has led to a novel analytical assay technology called D2Dx (from diameter to diagnostics). Herein, my dissertation highlights the extended use of D2Dx for biomolecule detection and analysis. Under this general theme, Chapter 1 provides some background information of AuNPs, DLS, the principle of D2Dx technique and its potential applications. Chapter 2 summarizes a study on the effect of AuNP concentrations and laser power on the hydrodynamic size measurement of AuNPs by DLS. This study demonstrated the multiple scattering effect on DLS analysis, and how to use the exceptionally high sensitivity of DLS in AuNP aggregate detection for bioassay design and development. Chapter 3 explores a cooperative interaction between AuNP and certain proteins in blood serum that are key to the immune system, leading to a novel diagnostic tool that can conveniently monitor the humoral immunity development from neonates to adults and detect active infections in animals. Chapter 4 reports an application of D2Dx technique for acute viral infection detection based on the active immune responses elicited from mouse models infected with influenza virus. Chapter 5 describes another application of D2Dx for prostate cancer detection. The D2Dx assay identifies prostate cancer patients from non-cancer controls with improved specificity and sensitivity than PSA test. Chapter 6 demonstrates the use of AuNPs and DLS for hydrodynamic size measurement of protein disulfide isomerase with two different conformations. Chapter 7 investigates the concentration-dependent self-assembling behavior of ribostamycin through its interaction with AuNPs in aqueous solution. Overall, this dissertation established several lines of applications of using AuNPs and DLS for biomolecular research and in vitro diagnostics.
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Date Issued: 2018
Identifier: CFE0007385, ucf:52056
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007385

infection (4)	+ -
Bacterial infection (1)	+ -
Borrelia burgdorferi (1)	+ -
CA-MRSA (1)	+ -
CABSI Bundle (1)	+ -

CLABSI (1)	+ -
CLABSI Bundle (1)	+ -
CLABSI Prevention (1)	+ -
Central line-associated bloodstream infection (1)	+ -
Community-acquired MRSA (1)	+ -
Crohn's disease (1)	+ -
Edible vaccine (1)	+ -
Gold nanoparticle (1)	+ -
Health care associated infections (1)	+ -
Hemerythrin (1)	+ -
Hemerythrin-like (1)	+ -
Hopf bifurcation (1)	+ -
Ixodes scapularis (1)	+ -
Lyme disease (1)	+ -
Lyophilized leaves (1)	+ -
MRSA (1)	+ -
Methicillin-resistant Staphylococcus aureus (1)	+ -
Mycobacterium tuberculosis (1)	+ -
NICU (1)	+ -
Neonatal CLABSI (1)	+ -
Neonatal CLABSI prevention (1)	+ -
Oral delivery (1)	+ -
STI (1)	+ -
Skin and soft tissue infections (1)	+ -
Systematic review (1)	+ -

ETD Collection (9)	+ -
Honors Collection (7)	+ -

University of Central Florida (16)	+ -
Covelli, Maureen (2)	+ -
Naser, Saleh (2)	+ -
Self, William (2)	+ -
Talbert, Steven (2)	+ -

Alhamwi, Mohamad (1)	+ -
Anderson, Breanna (1)	+ -
Blackwell, Christopher (1)	+ -
Bowers, Clint (1)	+ -
Bushy, Angeline (1)	+ -
Cao, Brent L (1)	+ -
Cassisi, Jeffrey (1)	+ -
Cawley, Jenna (1)	+ -
Cherne, Michelle D (1)	+ -
Coker, Christian (1)	+ -
Daniell, Henry (1)	+ -
Deavers, Frances (1)	+ -
Eldridge, Gloria (1)	+ -
Fine, Terri Susan (1)	+ -
Gesquiere, Andre (1)	+ -
Grano, Joan (1)	+ -
Heglund, Stephen (1)	+ -
Huo, Qun (1)	+ -
Hypes, Kathe (1)	+ -
Jain, Sunny (1)	+ -
Jewett, Mollie (1)	+ -
Johnson, Ivonne (1)	+ -
Kang, Hyeran (1)	+ -
Khaled, Annette (1)	+ -
McGuirt, Aron (1)	+ -

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