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Enhancing Patient’S Perceptions Of Cesarean Indications Through Teach-Back Methods, Naveena R. Daram, Malika L. Day, Rose A. Maxwell, Keith Reisinger-Kindle

Obstetrics and Gynecology Faculty Publications

Introduction

Cesarean section (C-section) deliveries are on the rise, with an increase from 23.5% in the 1990s to 32.2% in 2022. Research has shown that poor communication by health care providers can lead to negative outcomes. Patients’ understanding of their C-section indications has significant implications for their future obstetric health. Therefore, interventions are needed to ensure optimal communication between providers and patients to improve outcomes.

Materials and Methods

Sixty-eight participants were enrolled and randomized into traditional counseling or teach-back intervention groups. Phone interviews were used to capture data at 2 weeks and 6 months postoperatively. Chi square and Fisher’s Exact …

A Study On The 2016 And 2022 Ms And Oh Populations: How Obesity Is Related To The Co-Mingling Of Median Household Income, Limited Access To Healthy Foods And Limited Access To Exercise Opportunities, Ben Schlessel, Justice Williams

Scholarship in Medicine - All Papers

Background: Obesity has plagued the United States for decades, and while the implications of obesity have drastically changed over time (from a sign of wealth to a possible implication of mal/low nutrition), its impacts on the country’s population are abrasive and costly. Objective: The aim is to address and investigate how factors such as Median Household Income (MHI), Limited Access to Healthy Food and Limited Access to Exercise interplay with and correlate to obesity. Methods: Data acquired from the County Health Rankings was analyzed using several analysis strategies (paired and unpaired T-tests, and regression plots, etc.). Only Mississippi and Ohio …

Assessing Socioeconomic Patterns Of Excessive Alcohol Consumption In Ohio: A County-Level Analysis, Tate Barney, Dev Patel

Scholarship in Medicine - All Papers

Background: Excessive alcohol consumption poses significant public health challenges, with complex socioeconomic factors influencing drinking behaviors. Understanding the relationship between socioeconomic determinants and excessive drinking patterns at the state and county levels is crucial for informing targeted interventions. Objective: To investigate the associations between excessive drinking (binge or heavy drinking) and socioeconomic factors, including median household income, mental health provider availability, health insurance coverage, educational attainment, and unemployment rates across counties in Ohio. Methods: We analyzed data from the 2023 County Health Rankings for 88 counties in Ohio. Spearman correlations were used to assess associations between excessive drinking and socioeconomic …

Insufficient Sleep In Ohio And Its Complication In Risky Behaviors, James Dai, Jackson Mitchell

Scholarship in Medicine - All Papers

Background Insufficient sleep is a major public health concern in the United States. Lack of sufficient sleep causes impaired decision making that can increase the chance of participating in risky behavior. Methods County Health Rankings data from Ohio in 2016 and 2022 were reviewed for percentage of insufficient sleep and risky behaviors. We identified excessive alcohol use, driving deaths due to alcohol, drug overdose mortality, and percentage of smokers as risky behaviors. Urban and rural counties were identified via HRSA. Results: There was a significant increase in insufficient sleep from 2016 to 2022 in Ohio. Smoking and drug overdose mortality …

The Shortage Of Primary Care Physicians In The United States, Its Impact On Health Outcomes, And Rationale For Potential Solutions, Jacob Mardovin, Graham Kessler

Scholarship in Medicine - All Papers

Purpose: In the United States there is a growing shortage of primary care physicians that has the potential to negatively impact health outcomes of the general population. In this study, we aim to explore this potential impact by investigating the relationship between the primary care physician to patient ratio, a representation of the shortage, and various health outcomes. Methods: The data for this study was collected from County Health Rankings and the variables included were the primary care physician to patient ratio, several health outcome variables looking at both length and quality of life, and the other primary care provider …

The Relationship Between Being Uninsured And Having Poor Health Outcomes And Experiences In Eastern Kentucky, Danielle Adams, Amber Todd

Scholarship in Medicine - All Papers

Objective: To examine health insurance and health outcome disparities in Eastern Kentucky since Kentucky’s implementation of the Affordable Care Act. Methods: Using data from County Health Rankings and Roadmap, rates of uninsurance will be compared before and a decade after implementation of the ACA in Kentucky (2013 and 2023). In addition, prevalence of certain health outcomes in Eastern Kentucky will be compared from 2013 and 2023 and correlation established between uninsured rates and particular health outcomes for 2023. Results: Since 2013, the percentage of those uninsured in Eastern Kentucky has seen a significant decline. While there is no correlation between …

Obstetrics Emergency Labor And Delivery Case Simulations With Normal Vaginal Delivery Demonstration: A Hands-On Simulation For Clerkship Students, Emily A. Young, William A. Winter, Robyn N. D'Agostino, Rose A. Maxwell, Sheela Barhan, Marilyn Kindig

Obstetrics and Gynecology Faculty Publications

Introduction: Simulation is rarely used for medical student education in the field of obstetrics. This method is an effective model of learning for topics that are encountered in clinical situations and for topics that pose significant risk to patients when an untrained individual is involved. Methods: A 2-hour obstetric delivery simulation session was developed and incorporated into the third-year obstetrics and gynecology clerkship rotation at Wright State University Boonshoft School of Medicine. Medical students completed self-guided content reviews with resources provided prior to the session. During the session, each medical student conducted a normal vaginal delivery and one of the …

Postpartum Abdominal Binder Use For Pain Management After Vaginal Delivery – A Randomized Controlled Trial, Laura A. Bute, Elena Fuell-Wysong, Vijay K. Rings, Samantha M. Younglove, Rose A. Maxwell, Sheela Barhan

Obstetrics and Gynecology Faculty Publications

Objective: To investigate the impact of abdominal binder plus usual care versus usual care alone 26 after spontaneous vaginal delivery on pain severity scores. 27 28 Methods: A prospective randomized study was performed, recruiting patients on a Labor and 29 Delivery unit who were anticipating spontaneous vaginal delivery from 2019 to 2022. Patients 30 were randomly assigned to receive an abdominal binder plus usual care or usual care alone 31 within two hours postpartum. Primary outcomes were patient-reported immediate postpartum 32 pain score and average daily pain scores on days 0 and 1 postpartum (using a scale from 0 to …

A Randomized Trial Of Vaginal Antiseptic Preparation Solutions To Reduce Bacteria Colony Counts In Patients Undergoing Vaginal Surgery, James R. Saelens, Adam J. Langer, Andrew N. Boeckley, Natalie M. Castillo, Julie A. Desouza, Jennifer L. Drerup, Kelly M. Muterspaw, Hannah M. Stump, Rose A. Maxwell, Geoffrey Towers

Obstetrics and Gynecology Faculty Publications

Antiseptic preparation of surgical sites is known to reduce the rate of infective complications. However, surgical site infections (SSI) remain a leading cause of post-operative hospitalizations, increasing patient stress and cost for the healthcare system.1-7 In gynecologic surgery, preparation of the vagina is performed to reduce bacterial load prior to surgery, though it is known to remain contaminated.3 In the US, only solutions containing povidone-iodine (PI) are FDA approved for vaginal preparation; though, a 2018 ACOG Practice Bulletin lists chlorhexidine gluconate (CHG) with low (<4%) alcohol concentrations as a reasonable option for off-label use.3 Other preparations for vaginal surgery have been reported including baby shampoo (BS) and a commercially available preparation, containing PCMX (para-chloro-meta-xylenol, Techni-care®, chloroxylenol), that is marketed specifically for use with mucous membranes.8-12 There is a growing need to establish evidence-based alternatives to iodine for vaginal preparation for patients with allergies or sensitivity to iodine-containing products while minimizing postoperative irritation. One retrospective study comparing BS to PI in gynecologic surgeries showed a non-significant lower rate of surgical site infection with BS.9 One major challenge for determining effectiveness of surgical scrubs for reducing SSI is the relatively rare occurrence of postoperative infection. As an alternative proxy for infection colony counts of bacteria/fungi, before and after preparation, have been used.12,13 BS has been shown to reduce bacterial loads in non-gynecologic surgery, but there is limited data regarding its use in vaginal surgery, even though surgeons have been using BS in cases of iodine allergy or intolerance to other antiseptics.9-12CHG use in vaginal surgery has been debated due to concerns about vaginal irritation, however studies have demonstrated that alteration of the solution to 2-4% chlorhexidine with low (4%) alcohol concentration was associated with mild to no vaginal irritation. CHG showed similar reduction in post-incision bacterial counts and wound infections in cesarean delivery, and reduced colony counts during hysterectomy (when compared to PI).14-20 PCMX and CHG were shown to significantly reduce bacterial colonization of extracted root canals, and PCMX has been marketed specifically for vaginal antiseptic preparation.21 While some information on the effectiveness of these four antiseptic preparations has been documented in the literature, at this time there are no randomized controlled trials comparing these solutions in the context of vaginal surgery. Further evaluation and research of antiseptic solutions is warranted to provide evidence for best practices in minimizing infection and irritation. The purpose of this study was to compare the effectiveness of three antiseptic solutions with the standard, PI, for reducing bacterial colonies as a proxy for SSI, and to assess postoperative irritation and infection symptoms.

Concealed Carry Legislation And Firearm-Related Deaths In The United States: Possible Causes And Ramifications, Amelia Liu, Kyle Willette

Scholarship in Medicine - All Papers

Background: Previous research has shown that there is not an association between the legislation of constitutional carry and firearm deaths, but rather it is predominantly associated with socioeconomic status and location. On the national scale, the factors that most significantly affected firearm related deaths, firearm homicides, and firearm suicides were partisan lean, urbanization, and poverty rate over these three categories. Concealed carry legislation was not significantly associated with deaths. Objective: We are looking at whether the passage of constitutional carry laws have impacts on the rates of firearm-related deaths or violent crime across states. Important variables we are considering include …

Weight Health In The Modern Lens: Investigating The Intersectionality Of Obesity, William Bohne, Anthony Onochie

Scholarship in Medicine - All Papers

Purpose The purpose of this study is to investigate the relationship between these social determinants of health and obesity to provide a better understanding of geographical differences in obesity rates. Methods All data was collected using countyhealthrankings.org. The variables that were studied included access to exercise, food insecurity, and life expectancy due to previous literature demonstrating probable association between these variables and the prevalence of obesity. Results Statistically significant increase in number of adults with obesity from 2016 to 2022 (32% to 37%). Statistically significant weak, negative correlation between access to exercise and obesity (r=-.306). Statistically significant weak, negative correlation …

The Impact Of Permit Concealed Carry And Social Factors On Firearm Fatalities, Witty Kwok, Jacob Weaver

Scholarship in Medicine - All Papers

A tragic amount of gun fatalities occur in today's world. These fatalities can be from acts of aggression, negligence, or accidental, but nonetheless are taking lives at an alarming rate. There has been a call to action to make changes and begin combating these issues, with the most commonly proposed solution being firearm regulation. This study aimed to assess the effectiveness of firearm legislation, specifically of concealed carry regulations, on controlling firearm fatalities while also attempting to identify underlying causes or predictors of firearm fatalities. In an attempt to simplify the many regulations implemented differently between states, this study looked …

The Impact Of Mental Healthcare Access On Community Safety, David Buchinsky, Caroline Watts

Scholarship in Medicine - All Papers

Mental health illness is a pressing American public health concern. Approximately one in five Americans is diagnosed with a mental health condition.1 While cost, location, and physician shortage play a role in one’s access to mental healthcare, research is still determining the effects of mental healthcare access on community safety. Using County Health Rankings (CHR), we analyze the changes in mental health providers between 2016 and 2022 in Alabama and Massachusetts, two states with differing rankings in access to mental healthcare and firearm legislation. We then investigate how access to mental health providers affects community safety (firearm fatalities, suicide rates, …

Investigating Factors In Firearm Fatalities In Pediatric Populations, Parth Patel, Domenick Bartoletti

Scholarship in Medicine - All Papers

Despite advancements in public health initiatives, preventable firearm injuries among children persist in the United States. This study investigates correlations between household income, single parent households, severe housing problems, and firearm fatalities among pediatric populations in Ohio counties. Utilizing data from the County Health Rankings and the National Center for Health Statistics–Mortality Files, our analysis reveals a negative correlation between household income and firearm fatalities, emphasizing the role of socioeconomic factors in firearm safety. Additionally, we found a positive correlation between single parent households and firearm fatalities. Furthermore, a weak positive correlation suggests a potential link between severe housing problems …

Positive Correlation Of Smoking Percentage And Mentally Unhealthy Days In Ohio 2016-2022, Kevin Williams, Matt Crudele

Scholarship in Medicine - All Papers

There is substantial research regarding the negative physical side effects of smoking, such as increased risk of developing hypertension or chronic obstructive pulmonary disease. Smoking rates are substantially higher among those with a pre-existing mental illness (such as schizophrenia or generalized anxiety disorder)1. Additionally, second-hand smoke exposure among non-smokers has been attributed to an increased risk of developing symptoms of poor mental health (such as anxiety or depression)2,3. It has also been shown that smoking cessation leads to improved mental health4. However, there is limited research regarding the negative effects of smoking on mental health, especially in the state of …

A Study Into Exercise And Obesity On Diabetes In Ohio, Colorado, And Mississippi, Grace Li, Wafiq Choudhury

Scholarship in Medicine - All Papers

Type 2 diabetes has become an epidemic in the US adult population, with its prevalence increasing every year. The disease is associated with physical inactivity and obesity. Like other lifestyle diseases, type 2 diabetes is preventable and manageable. Previous studies have shown that exercise plays an important role in diabetes treatment. In this study, we aimed to investigate relationships among obesity rate, access to exercise opportunities, and diabetes prevalence in Ohio, Colorado, and Mississippi by analyzing County Health Rankings data of the three states from 2016 and 2022. Our results showed associations among obesity rate, access to exercise opportunities, and …

Associations Between The Lived Environment And Health Markers In Ohio Counties, Jake Trzybinski, Darbi Griffith, Brian Johns

Scholarship in Medicine - All Papers

Environmental exposures have known to be associated with poor health outcomes in adults, however there is scarce literature on which exposures that are county-specific influence health outcomes in the state of Ohio. There are known longitudinal effects of the environment on a person’s physical and mental health and demonstrated correlations could have the potential to improve health outcomes of those living in communities disproportionately impacted by environmental stressors. Through a retrospective review using County Health Rankings and the defined parameters of rurality, we looked at various measures of environmental exposures and living conditions and their effect on diabetes rates, chlamydia …

Factors Affecting Health Outcomes In Ohio’S Most Populated Rural And Urban Counties, Isaac Stokes, Omar Sarhan

Scholarship in Medicine - All Papers

Background: Citizens of Ohio live in a diverse range of settings, such as urban, metropolitan, and rural counties. Populations living in urban settings may live longer and have more access to healthcare providers (Primary Care and Mental Health). Due to the improved access of care, populations in the urban settings may have less hospital visits and overall, better health compared to rural counties within Ohio. Objective: The objective of this investigation was to examine the urban and rural counties in the state for differences in years of potential life lost, primary care physician ratio, preventable hospitalization stays, and mental health …

The Impact Of Mental Health On Academic Performance In Ohio In 2022, Lily Chen, Samantha Gilbert

Scholarship in Medicine - All Papers

Background: Previous research has shown a significant link between mental health issues and low academic performance. Our study explores the delicate connection between mental health issues and academic performance in Ohio school children, in particular, how the dynamic may differ between rural and non-rural communities. Methods: We utilized County Health Rankings data from the years 2016 and 2022 from all 88 counties in Ohio, which we further substratified as 44 rural and 44 non-rural counties. From CHR, we chose data categories to represent measures of academic performance, internalizing mental health problems, and access to mental health services, and utilized SPSS …

Analyzing The Correlation Between Water Violations And Hospitalization Rates, Rebekah Dalton, Jed Speers

Scholarship in Medicine - All Papers

Unsafe water due to violations in water safety can result in illness and ultimately hospitalization. However, there is little data that analyzes regional rates of water violations and their correlation to hospitalization rates. This research aims to analyze the correlation between water violations and hospitalization rates between the Midwest, East and West Coasts, and between Ohio counties that use the Lake Erie water basin and those that use the Ohio River water basin. Methods include the use of data from County Health Rankings and the following statistical tests: paired and unpaired T-tests, ANOVA, and Pearson Correlation test. Results showed that …

Regional Disparities In Hispanic/Latino Health Outcomes: A Comparative Analysis Of The Midwest And Top Hispanic Population States, Julian Aviles, Marcelo Hyczy Dacosta Neto

Scholarship in Medicine - All Papers

Background: Hispanic/Latino communities in the United States face significant health disparities and poorer health outcomes compared to non-Hispanic whites. While previous research has documented these inequalities at the national level, it is unclear whether certain regions exhibit more substantial disparities than others. Hypothesis/Research Question: This study aims to investigate whether counties in Midwest states with higher rates of health inequalities and unfavorable outcomes have compared to counties in the top 3 states by Hispanic/Latino population percentage. Methods: Using County Health Rankings, we examined counties in Midwest states (Ohio, South Dakota, and North Dakota) and counties within high Latino population states …

‘Things That You Can’T Really Suppress’: Adverse Childhood Experiences In The Narratives Of People With Opioid Use Disorder, Sydney Silverstein, Josef Rivera, Danielle Gainer, Raminta Daniulaityte

Psychiatry Faculty Publications

While numerous studies have established relationships between Adverse Childhood Experiences (ACEs) and adult substance use, few qualitative studies have explored the differing ways in which experiences of childhood adversity are emplotted into narratives of drug use and recovery. This paper analyzes qualitative data collected as part of a mixed-methods longitudinal study of people with opioid use disorder. Narratives of adverse childhood experiences emerged unprompted. After coding qualitative data for mention of ACEs, we thematically analyzed coded data using a framework of critical phenomenology and constructed a four-part typology to differentiate the ways that ACEs were emplotted into narratives. Our …

Incidental Recognition Of Umbilical-Portal-Systemic Venous Shunt Diagnosed During Bpp For Decreased Fetal Movement, Kathleen Lundeberg, Adam Hiett

Obstetrics and Gynecology Faculty Publications

Background: The prevalence of prenatally diagnosed umbilical-portal systemic venous shunts (UPSVS) is reportedly rare, ranging from 0.003-0.209% [1]. Disruption in the normal development of the fetal venous system can be caused by primary failure of a system or by secondary occlusion of an already transformed system [2]. While UPSVS’s are rare, the downstream effects are potentially fatal, including intrauterine growth restriction, high output cardiac failure, associated neonatal morbidity and mortality, and thus necessitate early detection with appropriate monitoring.

Introduction: The patient was a 21-year-old G2P1001 who presented to the Maternal Fetal Medicine Ultrasound Genetics (MFMUG) clinic at 36w2d for a …

The Persistence Of Blue Ash In The Aftermath Of Emerald Ash Borer May Be Due To Adult Oviposition Preferences And Reduced Larval Performance, Don Cipollini, Emily Morton

Biological Sciences Faculty Publications

1. We examined the health of mature blue ash, Fraxinus quadrangulata, in two forests in southwestern Ohio in relation to that of mature white ash, F. americana, and examined the potential importance of oviposition preferences and larval resistance in the persistence of blue ash.
2. Both blue ash and white ash were largely unaffected by emerald ash borer in 2012. By 2018, nearly 90% of the blue ash trees observed in these forests had full or nearly full canopies, as opposed to less than 20% of the white ash encountered in our studies. In 2021, blue ash maintained a …

Integrating An Evidence Based Medicine Module Presentation Into The Ob-Gyn Clerkship, Judith Mathess, Betsy Gauthier, Zenab Saeed, Ngozi Anachebe, Rose A. Maxwell, Jason C. Massengill, Marilyn Kindig

Obstetrics and Gynecology Faculty Publications

Introduction: During the preclinical curriculum, students are introduced to EBM principles, however structured application to clinical medicine varies throughout clinical experiences. Application of EBM in a clinical educational environment affords students opportunities to practice required skills.

Methods: Students selected a patient case and formulated a question related to diagnosis ortreatment using the PICO framework. Students selected research publications related to the patient case, critically appraised their validity and generalization, and developed a comprehensive presentation involving a case summary and related EBM topics, which were evaluated by a faculty member using a rubric developed for the project. To assess the effectiveness …

Homeostatic Synaptic Plasticity Of Miniature Excitatory Postsynaptic Currents In Mouse Cortical Cultures Requires Neuronal Rab3a, Andrew G. Koesters, Mark M. Rich, Kathrin L. Engisch

Biological Sciences Faculty Publications

Following prolonged activity blockade, amplitudes of miniature excitatory postsynaptic currents (mEPSCs) increase, a form of homeostatic plasticity termed “synaptic scaling.” We previously showed that a presynaptic protein, the small GTPase Rab3A, is required for full expression of the increase in miniature endplate current amplitudes following prolonged blockade of action potential activity at the mouse neuromuscular junction in vivo (Wang et al., 2011), but it is unknown whether this form of Rab3A-dependent homeostatic plasticity shares any characteristics with central synapses. We show here that synaptic scaling of mEPSCs is impaired in mouse cortical neuron cultures prepared from Rab3A-/- and Rab3A Earlybird …

Case Study: The Elusive Vaginal Leiomyoma, Fiona Hodges, Roziya Tursunova, Kelly Nagy, Halei Wong, Wright State University Boonshoft Som Department Of Obstetrics And Gynecology, Wright Patterson Air Force Base Department Of Obstetrics And Gynecology

Obstetrics and Gynecology Faculty Publications

This poster was presented at the September 2023 Armed Forces District Meeting.

Radiographic Measurements Correlate To Isolated Posterolateral Corner (Plc) Injury In A Novel Cadaveric Model, Joseph D. Henningsen, Scott Huff, Andrew Reichard, Andrew W. Froehle, Anil Krishnamurthy

School of Health and Exercise Sciences Faculty Publications

Introduction: Injury to the posterolateral corner (PLC) of the knee often requires surgical reconstruction. There remains no consensus on treatment for PLC injury, and, therefore, it is imperative to have a reproducible injury model to improve the general knowledge of PLC injuries. A novel cadaveric model of isolated PLC injury is proposed and evaluated using radiographic parameters as well as gross dissection.

Material and methods: All protocols were reviewed by the Human Investigation and Research Committee of the home institution and were approved. Translational force in a defined posterior and lateral direction was applied to cadaveric native knees to induce …

Novel Enhanced Recovery After Surgery Pathway Reduces Length Of Stay And Postoperative Opioid Usage In Adolescent Idiopathic Scoliosis Patients Undergoing Posterior Spinal Fusion, Kristen Spisak, Matthew Thomas, Zachary J. Sirois, Alvin Jones, Lucinda M. Brown, Andrew W. Froehle, Michael Albert

School of Health and Exercise Sciences Faculty Publications

Purpose: The goal of this study was to compare our institution’s recently implemented enhanced recovery after surgery (ERAS) protocol to previous post-operative management for adolescent idiopathic scoliosis patients undergoing posterior spinal fusion, specifically assessing length of stay, opioid consumption, and pain scores.

Methods: This is a retrospective analysis that compares the length of stay, opioid consumption, and pain scores of patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis. Patients were analyzed prior to the implementation of our ERAS protocol, deemed the traditional pain pathway (TPP), to those who underwent the ERAS pathway. All patients undergoing posterior spinal fusion for …

A Cohort Study Assessing The Impact Of Anki As A Spaced Repetition Tool On Academic Performance In Medical School, Michael M. Gilbert, Timothy C. Frommeyer, Garrett V. Brittain, Nickolas A. Stewart, Todd M. Turner, Adrienne Stolfi, Dean Parmelee

Pediatrics Faculty Publications

Introduction

Anki is an application that capitalizes upon the techniques of spaced repetition and is increasingly utilized by medical students for examination preparation. This study examines the impact of Anki usage in a medical school curriculum on academic performance. Secondary objectives analyzed individual Anki utilization and a qualitative assessment of Anki use.

Methods

A cohort-control study was conducted at Boonshoft School of Medicine. One hundred thirty first-year medical students were enrolled in an Anki utilization training program from July 2021 to September 2021. Training included educational Anki courses and subsequent survey data collection over Anki usage. Data variables included all …