I am an associate professor of Curriculum and Instruction at Northern Illinois University. My teaching and scholarship centers on the intersection of race, Whiteness, media and popular culture, and curriculum. I am also president elect of the American Association for Teaching and Curriculum. Address: Dekalb, Illinois, United States
This article examines urban school–university partnership research after No Child Left Behind. Ce... more This article examines urban school–university partnership research after No Child Left Behind. Central to the review is an analysis in the trend of research methods utilized across studies. It was found that many studies are single-case studies or anecdotal. There are few quantitative, sustained qualitative, or mixed-methods studies represented in the literature sampled. We suggest that significant hurdles make more reliable studies difficult to mount. In light of that, we offer suggestions about issues and factors for consideration when such partnerships are created.
Data Revues 00223476 V145i3 S0022347604002859, Aug 25, 2011
Evaluation of the efficacy and safety of amlodipine in hypertensive children. A randomized, doubl... more Evaluation of the efficacy and safety of amlodipine in hypertensive children. A randomized, double blinded, placebo-controlled, parallel-group, dose-ranging study was conducted at 49 centers in North and South America. The primary end point was the effect of amlodipine on systolic blood pressure (BP); secondary end points included the effect of amlodipine on diastolic BP, the effect of amlodipine as a function of dose and body size, and evaluation of safety. We enrolled 268 hypertensive children (mean age, 12.1 +/- 3.3 years); 84 (31.3%) had primary hypertension, and 177 (66%) were boys. Amlodipine produced significantly greater reductions in systolic BP than placebo; these were -6.9 mm Hg for 2.5 mg daily (P=.045 vs placebo) and -8.7 mm Hg for 5 mg daily (P=.005 vs placebo). The underlying cause of hypertension had no effect on the response to amlodipine. There was a significant dose-response effect of amlodipine on both systolic and diastolic BP beginning at doses > or =0.06 mg/kg per day. Systolic BP < or =95(th) percentile was achieved in 34.6% of subjects with systolic hypertension. Amlodipine was well tolerated, with just 6 children withdrawn from treatment because of drug-related adverse events. Amlodipine effectively lowers systolic BP in a dose-dependent manner in hypertensive children who require drug treatment.
American Journal of Physiology Heart and Circulatory Physiology, Nov 1, 1992
This study demonstrates that bacterial lipopolysaccharide and lipid A exert a significant effect ... more This study demonstrates that bacterial lipopolysaccharide and lipid A exert a significant effect on eicosanoid formation by primary cultures of microvascular endothelial cells (MECs). Qualitative studies using [14C]-arachidonic acid demonstrated that prostaglandin E2 was the primary eicosanoid formed by MECs after 20 h of treatment with either vehicle or lipopolysaccharide. Significant, dose-dependent productions of PGE2 and prostacyclin, beginning at an endotoxin dose of 0.01 ng/ml, were quantified by radioimmunoassay in supernatants of cells treated for 20 h with lipopolysaccharide or lipid A. This eicosanoid production was inhibited by meclofenamate and cycloheximide and occurred without cellular injury. The time course and kinetics of eicosanoid production in response to endotoxin demonstrate a significant, time-related enhancement. Endotoxin-treated MECs responded to exogenous substrate with augmented PGE2 production, suggesting enhanced prostaglandin endoperoxide synthase activity. These results demonstrate a significant interaction of endotoxin with endothelial cells of microvascular origin that results in an enhanced potential for eicosanoid metabolism. This effect may be mediated in part through induction of prostaglandin endoperoxide synthase.
Nephrology Nursing Journal Journal of the American Nephrology Nurses Association, 2010
Catheter infections are a significant problem in pediatric hemodialysis. To reduce infection rate... more Catheter infections are a significant problem in pediatric hemodialysis. To reduce infection rates, the use of closed luer-lock access connectors, which create a mechanically and microbiogically closed system while allowing unobstructed blood flow, was implemented Infection rates fell from 7.8 infections per 1000 patient days to 3.65 infections per 1000 patient days after the switch to the closed connector (t = 0.04). The adoption of a closed connector system appeared to produce a significant reduction in bloodstream infections.
Hypertension (HTN) in children and adolescents has become increasingly common. We sought to ident... more Hypertension (HTN) in children and adolescents has become increasingly common. We sought to identify variability in the approach to HTN among general pediatricians as well as obstacles to care of hypertensive youth by surveying pediatricians referring to an urban children's hospital. Although most pediatricians begin blood pressure measurement at 3 years, there was substantial variability in the initial diagnostic evaluation of hypertensive patients. Just 7% of pediatricians routinely start antihypertensive drug treatment for HTN, whereas 82% refer their hypertensive patients to a specialist; 40% of pediatricians felt uncomfortable evaluating and treating HTN. Pediatricians unfamiliar with The Fourth Report were more likely to be uncomfortable with the care of hypertensive patients than those familiar with it (54% vs 33%, P < .05). Current practice does not appear to follow recent consensus recommendations. Interventions designed to address the issues identified in this survey may lead to improved care for pediatric patients with HTN.
Severe acute hypertension in pediatric patients requires prompt and controlled blood pressure (BP... more Severe acute hypertension in pediatric patients requires prompt and controlled blood pressure (BP) reduction to prevent end-organ damage. The authors aimed to examine the efficacy and safety of isradipine, an orally administered second-generation dihydropyridine calcium channel blocker, for treatment of acute hypertension in hospitalized pediatric patients. A retrospective analysis of 391 doses of isradipine administered to 282 patients (58% boys) with acute hypertension and median age of 12.8 years (range, 0.1-21.9) was performed. Primary diagnoses included renal disease (n=154), malignancy (45), nonrenal transplant (37), neurologic disease (21), and other (25). The decrease in systolic BP was 16.3%±11.6% (mean ± SD) and diastolic BP was 24.2%±17.2%. BPs were significantly lower in all age groups and in all diagnosis categories following isradipine administration. The decrease in BP was the highest in children younger than 2 years. The mean increase in pulse after a dose was 7±17 beats per minute. Forty adverse events were reported in 33 patients, with emesis and nausea being the most common; 5 of these events were hypotension. The authors conclude that isradipine effectively reduces BP in a wide variety of hospitalized children and adolescents with acute hypertension. A lower initial dose of 0.05 mg/kg may be appropriate in children younger than 2 years.
Research activities in the field of pediatric hypertension have been increasing in recent years, ... more Research activities in the field of pediatric hypertension have been increasing in recent years, leading to important new findings in the epidemiology, diagnosis, and treatment of hypertension in children. This review summarizes recent work in these areas, focusing on the epidemic of obesity-related hypertension in children, advances in the drug therapy of childhood hypertension, and the increasing use of ambulatory blood pressure monitoring in evaluation of hypertensive children. Each of these three areas will no doubt develop further over the years ahead, resulting in further advances in the field of childhood hypertension.
To assess depression in children with chronic kidney disease and to determine associations with p... more To assess depression in children with chronic kidney disease and to determine associations with patient characteristics, intellectual and educational levels, and health-related quality of life (HRQoL). Subjects aged 6-17 years from the Chronic Kidney Disease in Children cohort study completed the Children's Depression Inventory (CDI), Wechsler Abbreviated Scales of Intelligence, Wechsler Individual Achievement Test-II-Abbreviated, and the Pediatric Inventory of Quality of Life Core Scales 4.0. Regression analyses determined associations of CDI score and depression status with subject characteristics, intellectual and educational levels, and HRQoL. A joint linear mixed model and Weibull model were used to determine the effects of CDI score on longitudinal changes in glomerular filtration rate and time to renal replacement therapy. A total of 344 subjects completed the CDI. Eighteen (5%) had elevated depressive symptoms, and another 7 (2%) were being treated for depression. In adj...
Pediatric nephrology (Berlin, Germany), Jan 28, 2015
Studies in children with chronic kidney disease indicate a high prevalence of masked hypertension... more Studies in children with chronic kidney disease indicate a high prevalence of masked hypertension detected by ambulatory blood pressure monitoring (ABPM). However, it is not well known if the frequency of masked hypertension is related to the level of normal casual blood pressure (BP). We hypothesized that lower levels of normal casual BP are associated with a lower prevalence of masked hypertension. Data from the chronic kidney disease (CKiD) cohort were analyzed cross-sectionally across multiple visits. The majority of children with normal casual BP also had normal wake and sleep ABP (60 %), even at the highest percentiles of casual BP. The frequency of masked hypertension was lower in children with casual BP ≤25th percentile versus those with casual BP in 26-50th percentile and casual BP in 51-90th percentile during both wake and sleep periods. In children with the lowest normal casual BP levels (≤25th percentile), the frequency of abnormal mean wake or sleep ABP was 2-7 %, and o...
Obesity has been linked with abnormal nocturnal dipping of blood pressure (BP) in adults, which i... more Obesity has been linked with abnormal nocturnal dipping of blood pressure (BP) in adults, which in turn is associated with poor cardiovascular outcomes. There are few data regarding abnormal dipping status in the obese pediatric population. The goal of this study was to further describe the relationship between obesity and non-dipping status on ambulatory blood pressure monitor (ABPM) in children. We conducted a cross-sectional study using a database of patients aged 5-21 years who had undergone 24-hour ABPM at Seattle Children's Hospital from January 2008 through May 2014. Subjects were grouped by body mass index (BMI) into lean (BMI 15th-85th percentile) and obese (BMI >95th percentile) groups. Compared to lean subjects (n = 161), obese subjects (n = 247) had a prevalence ratio (PR) for non-dipping of 2.15, adjusted for race (95% confidence interval (CI) = 1.25-3.42). Increasing severity of obesity was not further associated with nocturnal non-dipping. Nocturnal non-dipping...
This article examines urban school–university partnership research after No Child Left Behind. Ce... more This article examines urban school–university partnership research after No Child Left Behind. Central to the review is an analysis in the trend of research methods utilized across studies. It was found that many studies are single-case studies or anecdotal. There are few quantitative, sustained qualitative, or mixed-methods studies represented in the literature sampled. We suggest that significant hurdles make more reliable studies difficult to mount. In light of that, we offer suggestions about issues and factors for consideration when such partnerships are created.
Data Revues 00223476 V145i3 S0022347604002859, Aug 25, 2011
Evaluation of the efficacy and safety of amlodipine in hypertensive children. A randomized, doubl... more Evaluation of the efficacy and safety of amlodipine in hypertensive children. A randomized, double blinded, placebo-controlled, parallel-group, dose-ranging study was conducted at 49 centers in North and South America. The primary end point was the effect of amlodipine on systolic blood pressure (BP); secondary end points included the effect of amlodipine on diastolic BP, the effect of amlodipine as a function of dose and body size, and evaluation of safety. We enrolled 268 hypertensive children (mean age, 12.1 +/- 3.3 years); 84 (31.3%) had primary hypertension, and 177 (66%) were boys. Amlodipine produced significantly greater reductions in systolic BP than placebo; these were -6.9 mm Hg for 2.5 mg daily (P=.045 vs placebo) and -8.7 mm Hg for 5 mg daily (P=.005 vs placebo). The underlying cause of hypertension had no effect on the response to amlodipine. There was a significant dose-response effect of amlodipine on both systolic and diastolic BP beginning at doses > or =0.06 mg/kg per day. Systolic BP < or =95(th) percentile was achieved in 34.6% of subjects with systolic hypertension. Amlodipine was well tolerated, with just 6 children withdrawn from treatment because of drug-related adverse events. Amlodipine effectively lowers systolic BP in a dose-dependent manner in hypertensive children who require drug treatment.
American Journal of Physiology Heart and Circulatory Physiology, Nov 1, 1992
This study demonstrates that bacterial lipopolysaccharide and lipid A exert a significant effect ... more This study demonstrates that bacterial lipopolysaccharide and lipid A exert a significant effect on eicosanoid formation by primary cultures of microvascular endothelial cells (MECs). Qualitative studies using [14C]-arachidonic acid demonstrated that prostaglandin E2 was the primary eicosanoid formed by MECs after 20 h of treatment with either vehicle or lipopolysaccharide. Significant, dose-dependent productions of PGE2 and prostacyclin, beginning at an endotoxin dose of 0.01 ng/ml, were quantified by radioimmunoassay in supernatants of cells treated for 20 h with lipopolysaccharide or lipid A. This eicosanoid production was inhibited by meclofenamate and cycloheximide and occurred without cellular injury. The time course and kinetics of eicosanoid production in response to endotoxin demonstrate a significant, time-related enhancement. Endotoxin-treated MECs responded to exogenous substrate with augmented PGE2 production, suggesting enhanced prostaglandin endoperoxide synthase activity. These results demonstrate a significant interaction of endotoxin with endothelial cells of microvascular origin that results in an enhanced potential for eicosanoid metabolism. This effect may be mediated in part through induction of prostaglandin endoperoxide synthase.
Nephrology Nursing Journal Journal of the American Nephrology Nurses Association, 2010
Catheter infections are a significant problem in pediatric hemodialysis. To reduce infection rate... more Catheter infections are a significant problem in pediatric hemodialysis. To reduce infection rates, the use of closed luer-lock access connectors, which create a mechanically and microbiogically closed system while allowing unobstructed blood flow, was implemented Infection rates fell from 7.8 infections per 1000 patient days to 3.65 infections per 1000 patient days after the switch to the closed connector (t = 0.04). The adoption of a closed connector system appeared to produce a significant reduction in bloodstream infections.
Hypertension (HTN) in children and adolescents has become increasingly common. We sought to ident... more Hypertension (HTN) in children and adolescents has become increasingly common. We sought to identify variability in the approach to HTN among general pediatricians as well as obstacles to care of hypertensive youth by surveying pediatricians referring to an urban children's hospital. Although most pediatricians begin blood pressure measurement at 3 years, there was substantial variability in the initial diagnostic evaluation of hypertensive patients. Just 7% of pediatricians routinely start antihypertensive drug treatment for HTN, whereas 82% refer their hypertensive patients to a specialist; 40% of pediatricians felt uncomfortable evaluating and treating HTN. Pediatricians unfamiliar with The Fourth Report were more likely to be uncomfortable with the care of hypertensive patients than those familiar with it (54% vs 33%, P < .05). Current practice does not appear to follow recent consensus recommendations. Interventions designed to address the issues identified in this survey may lead to improved care for pediatric patients with HTN.
Severe acute hypertension in pediatric patients requires prompt and controlled blood pressure (BP... more Severe acute hypertension in pediatric patients requires prompt and controlled blood pressure (BP) reduction to prevent end-organ damage. The authors aimed to examine the efficacy and safety of isradipine, an orally administered second-generation dihydropyridine calcium channel blocker, for treatment of acute hypertension in hospitalized pediatric patients. A retrospective analysis of 391 doses of isradipine administered to 282 patients (58% boys) with acute hypertension and median age of 12.8 years (range, 0.1-21.9) was performed. Primary diagnoses included renal disease (n=154), malignancy (45), nonrenal transplant (37), neurologic disease (21), and other (25). The decrease in systolic BP was 16.3%±11.6% (mean ± SD) and diastolic BP was 24.2%±17.2%. BPs were significantly lower in all age groups and in all diagnosis categories following isradipine administration. The decrease in BP was the highest in children younger than 2 years. The mean increase in pulse after a dose was 7±17 beats per minute. Forty adverse events were reported in 33 patients, with emesis and nausea being the most common; 5 of these events were hypotension. The authors conclude that isradipine effectively reduces BP in a wide variety of hospitalized children and adolescents with acute hypertension. A lower initial dose of 0.05 mg/kg may be appropriate in children younger than 2 years.
Research activities in the field of pediatric hypertension have been increasing in recent years, ... more Research activities in the field of pediatric hypertension have been increasing in recent years, leading to important new findings in the epidemiology, diagnosis, and treatment of hypertension in children. This review summarizes recent work in these areas, focusing on the epidemic of obesity-related hypertension in children, advances in the drug therapy of childhood hypertension, and the increasing use of ambulatory blood pressure monitoring in evaluation of hypertensive children. Each of these three areas will no doubt develop further over the years ahead, resulting in further advances in the field of childhood hypertension.
To assess depression in children with chronic kidney disease and to determine associations with p... more To assess depression in children with chronic kidney disease and to determine associations with patient characteristics, intellectual and educational levels, and health-related quality of life (HRQoL). Subjects aged 6-17 years from the Chronic Kidney Disease in Children cohort study completed the Children's Depression Inventory (CDI), Wechsler Abbreviated Scales of Intelligence, Wechsler Individual Achievement Test-II-Abbreviated, and the Pediatric Inventory of Quality of Life Core Scales 4.0. Regression analyses determined associations of CDI score and depression status with subject characteristics, intellectual and educational levels, and HRQoL. A joint linear mixed model and Weibull model were used to determine the effects of CDI score on longitudinal changes in glomerular filtration rate and time to renal replacement therapy. A total of 344 subjects completed the CDI. Eighteen (5%) had elevated depressive symptoms, and another 7 (2%) were being treated for depression. In adj...
Pediatric nephrology (Berlin, Germany), Jan 28, 2015
Studies in children with chronic kidney disease indicate a high prevalence of masked hypertension... more Studies in children with chronic kidney disease indicate a high prevalence of masked hypertension detected by ambulatory blood pressure monitoring (ABPM). However, it is not well known if the frequency of masked hypertension is related to the level of normal casual blood pressure (BP). We hypothesized that lower levels of normal casual BP are associated with a lower prevalence of masked hypertension. Data from the chronic kidney disease (CKiD) cohort were analyzed cross-sectionally across multiple visits. The majority of children with normal casual BP also had normal wake and sleep ABP (60 %), even at the highest percentiles of casual BP. The frequency of masked hypertension was lower in children with casual BP ≤25th percentile versus those with casual BP in 26-50th percentile and casual BP in 51-90th percentile during both wake and sleep periods. In children with the lowest normal casual BP levels (≤25th percentile), the frequency of abnormal mean wake or sleep ABP was 2-7 %, and o...
Obesity has been linked with abnormal nocturnal dipping of blood pressure (BP) in adults, which i... more Obesity has been linked with abnormal nocturnal dipping of blood pressure (BP) in adults, which in turn is associated with poor cardiovascular outcomes. There are few data regarding abnormal dipping status in the obese pediatric population. The goal of this study was to further describe the relationship between obesity and non-dipping status on ambulatory blood pressure monitor (ABPM) in children. We conducted a cross-sectional study using a database of patients aged 5-21 years who had undergone 24-hour ABPM at Seattle Children's Hospital from January 2008 through May 2014. Subjects were grouped by body mass index (BMI) into lean (BMI 15th-85th percentile) and obese (BMI >95th percentile) groups. Compared to lean subjects (n = 161), obese subjects (n = 247) had a prevalence ratio (PR) for non-dipping of 2.15, adjusted for race (95% confidence interval (CI) = 1.25-3.42). Increasing severity of obesity was not further associated with nocturnal non-dipping. Nocturnal non-dipping...
Uploads
Papers by Joseph Flynn