Browsing by Author "Penny, Caitlin"

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    Polymorphic variants of Fc receptors and antibodies derived from humans and rhesus macaques exhibit differential binding
    (2017-05-12) Penny, Caitlin
    Immune effector functions often depend on the fragment crystallizable (Fc) region of antibodies binding with Fc receptors (FcRs) on immune cells to trigger various responses. Polymorphisms in both Fc and FcR genes in humans and rhesus macaques have been demonstrated to alter the strength of this binding and consequently the immune response that is elicited. Rhesus macaques are often studied as an animal model for AIDS-like diseases, although he diversity of their FcRs has not yet been well characterized. Rhesus have more variation in their FcR genes, but less variation among IgG subclasses compared to humans. I hypothesize that the strength of signaling and subsequent immune responses caused by FcR-bearing cells will be regulated by the strength of Fc binding and the expression levels of FcRs on effector cells. To test this hypothesis, a more accurate genome map of human and rhesus macaques must be compiled, and methods developed to characterize interactions between polymorphic variants of FcRs and antibodies. I devised an ELISA protocol to test the hypothesis that known human and rhesus macaque FcR polymorphisms have differing binding affinities to antibody variants. My results suggest that ELISA assays can measure the strength of binding between variants of FcRs and antibodies to characterize interactions between these molecules. Future work should use similar ELISA techniques as well as immune complexes suspended in solution to distinguish the differing responses among a wider variety of both human and macaque polymorphisms within both FcR and antibody genes.
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    The Psychological Safety Scale of the Safety, Communication, Operational, Reliability, and Engagement (SCORE) Survey: A Brief, Diagnostic, and Actionable Metric for the Ability to Speak Up in Healthcare Settings.
    (Journal of patient safety, 2022-09) Adair, Kathryn C; Heath, Annemarie; Frye, Maureen A; Frankel, Allan; Proulx, Joshua; Rehder, Kyle J; Eckert, Erin; Penny, Caitlin; Belz, Franz; Sexton, J Bryan

    Objectives

    The current study aimed to guide the assessment and improvement of psychological safety (PS) by (1) examining the psychometric properties of a brief novel PS scale, (2) assessing relationships between PS and other safety culture domains, (3) exploring whether PS differs by healthcare worker demographic factors, and (4) exploring whether PS differs by participation in 2 institutional programs, which encourage PS and speaking-up with patient safety concerns (i.e., Safety WalkRounds and Positive Leadership WalkRounds).

    Methods

    Of 13,040 eligible healthcare workers across a large academic health system, 10,627 (response rate, 81%) completed the 6-item PS scale, demographics, safety culture scales, and questions on exposure to institutional initiatives. Psychometric analyses, correlations, analyses of variance, and t tests were used to test the properties of the PS scale and how it differs by demographic factors and exposure to PS-enhancing initiatives.

    Results

    The PS scale exhibited strong psychometric properties, and a 1-factor model fit the data well (Cronbach α = 0.80; root mean square error approximation = 0.08; Confirmatory Fit Index = 0.97; Tucker-Lewis Fit Index = 0.95). Psychological Safety scores differed significantly by role, shift, shift length, and years in specialty. The PS scale correlated significantly and in expected directions with safety culture scales. The PS score was significantly higher in work settings with higher rates of exposure to Safety WalkRounds or Positive Leadership WalkRounds.

    Conclusions

    The PS scale is brief, diagnostic, and actionable. It exhibits strong psychometric properties; is associated with better safety, teamwork climate, and well-being; differs by demographic factors; and is significantly higher for those who have been exposed to PS-enhancing initiatives.