Medicine and Health Sciences Commons^™

Compassionate Curiosity: Mitigating The Effects Of Biasthrough Motivational Interviewing, Paul J. Hershberger, Dean A. Bricker, Angie Castle, Timothy N. Crawford, Stacy R. Flowers, Alexandria L. Goff, Katharine Conway

Family Medicine Faculty Publications

There is strong evidence that the implicit biases of health care professionals affect the treatment of patients, and that minority and other marginalized patients are disproportionately harmed. Assumptions made about patient knowledge or lack thereof function as judgments that are prone to bias, which then affect the education and advice imposed upon patients. We review how the motivational interviewing (MI) approach to patient engagement includes components of evidence-based bias-mitigating strategies, such as understanding circumstances from the patient’s point of view, and therefore we propose that the MI approach can reduce the impact of bias in patient care.

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 …

Nursing The Wright Way: A History Of Nursing At Wright State University, 1973-2023, Donna Miles Curry

Books Authored by Wright State Faculty/Staff

This book explores the history of an innovative nursing education program in Dayton, Ohio from its creation in the 1970s until 2023. On the cutting edge with a theory driven curriculum this program went from BSN, adding the master's degree with advanced practice options and also a DNP.

Third Annual Research Symposium Program With Abstracts, Office Of Research Affairs, Boonshoft School Of Medicine

Boonshoft School of Medicine Research Symposium

The program booklet is a compilation of abstracts from oral and poster presentations at Wright State University's First Annual Boonshoft School of Medicine Medical Research Symposium held on April 4, 2024.

Objective Assessment Of Rupture Parameters In Intact And Acute Post-Cystorrhaphy Cadaveric Bladders, Geoffrey D. Towers, Dani G. Zoorob, Rose A. Maxwell, Ashley N. Reid, Jerome L. Yaklic, Jason C. Massengill

Obstetrics and Gynecology Faculty Publications

Background: Certain procedures, particularly those used to treat symptoms of bladder pain syndrome/interstitial cystitis (BPS/IC), involve filling the bladder to or over its capacity for visualization and/or relief of symptoms. Rarely, if excessive pressure or volume is used, bladders may rupture causing significant harm to the patient. The purpose of this study was to identify baseline data for pressure and volume when hydrodistention is attempted in explanted cadaveric bladders, as well as determine bladder rupture pressure changes in the acute post-cystorrhaphy state. Methods: Eight explanted cadaveric bladders were filled using a systematic digital pump system. Intravesical pressure and volume were …

A Physiological Approach To Renal Clearance: From Premature Neonates To Adults, Nick Holford, Conor J. O'Hanlon, Karel Allegaert, Brian Anderson, Amilcar Falcão, Nicolas Simon, Yoke Lin Lo, Alison H. Thomson, Catherine M.T. Sherwin, Evelyne Jacqz-Aigrain, Carolina Llanos-Paez, Stefanie Hennig, Linas Mockus, Carl Kirkpatrick

Pediatrics Faculty Publications

Aims: We propose using glomerular filtration rate (GFR) as the physiological basis for distinguishing components of renal clearance. Methods: Gentamicin, amikacin and vancomycin are thought to be predominantly excreted by the kidneys. A mixed-effects joint model of the pharmacokinetics of these drugs was developed, with a wide dispersion of weight, age and serum creatinine. A dataset created from 18 sources resulted in 27,338 drug concentrations from 9,901 patients. Body size and composition, maturation and renal function were used to describe differences in drug clearance and volume of distribution. Results: This study demonstrates that GFR is a predictor of two distinct …

Moral Distress And Moral Injury In Military Healthcare Clinicians: A Scoping Review, Melissa A. Wilson, Amy Shay, J. Irene Harris, Nicole Faller, Timothy J. Usset, Angela Simmons

Nursing Faculty Publications

Introduction: Healthcare clinicians are often at risk of psychological distress due to the nature of their occupation. Military healthcare providers are at risk for additional psychological suffering related to unique moral and ethical situations encountered in military service. This scoping review identifies key characteristics of moral distress and moral injury and how these concepts relate to the military healthcare clinician who is both a care provider and service member.

Methods: A scoping review of moral distress and moral injury literature as relates to the military healthcare clinician was conducted on the basis of the Joanna Briggs Institute scoping review framework. …

The Impact Of The Gut-Brain Axis On Alzheimer’S Disease, Elissa Wakim

Best Integrated Writing

Elissa’s review for the Graduate Biomedical Review focuses on the links between the gastrointestinal tract and the brain; the gut-brain axis and the development of Alzheimer’s disease. As a student in the Microbiology and Immunology Masters Program Elissa was particularly interested in the gut microbiota and their connection to neurodegenerative disease. She tidily reviewed the literature and wrote a fascinating and compelling piece of work.

Characterizing The Polyamorous Experience Through Research, Kacey O'Harra

Best Integrated Writing

Scientific study of polyamory and the individuals who practice it has seen a sharp increase in the last decade, revealing data and subjective experiences that support their capacity to be closely intimate and fulfilling, to bolster personal development, to provide a positive and stable family environment, and to mutually strengthen the bonds of each relationship involved. Understanding the unique experiences and challenges faced by polyamorous lovers is essential for cultural competence in relational research, clinical practice, institutional regulations, and moving toward greater social acceptance. Examined here are the associated stigmas and their impacts on polyamorous individuals, the motivations people have …

Balancing The Mind: The Role Of Selective Serotonin Reuptake Inhibitors In Managing Anxiety, Olivia Mace

Best Integrated Writing

Olivia’s senior capstone review article focuses on the role of the selective serotonin reuptake inhibitor (SSRI) escitalopram in the management of anxiety. SSRIs have been successfully used to treat depression for decades, with fluoxetine (Prozac) being introduced to the US market in 1987. Recently it has been found that the SSRI escitalopram has efficacy in treating anxiety as well as depression. Olivia’s review is detailed and timely. Unmanaged anxiety and depression are common among students and this review will be of interest to students, parents and the university population in general.

Exploring The Systems-Related Factors Influencing Depression And Anxiety In The Private Healthcare System: A Nursing Student’S Perspective, Andrea Cessna

Best Integrated Writing

This paper presents a student’s critical synthesis of the literature and excellent grasp of the application of the World Health Organization Health Systems Building Blocks Framework to identify strengths, and improvement opportunities for nursing interventions in mental health care. The student’s writing demonstrates an awareness of factors that impact complex health systems in nursing practice which is an important competency in system-based practice.

The Potential Role Of Txa In Treating Brain Hemorrhage, Elijah Byrd

Best Integrated Writing

Elijah Bird’s essay provides an excellent review of the existing research and explores the promising possibilities of TXA in the treatment of brain hemorrhages.

Best Integrated Writing Spring 2024 - Complete Edition, Wright State University School Of Humanities And Cultural Studies, Kristie Mckiernan, Tracy Smith

Best Integrated Writing

Best Integrated Writing includes excellent student writing from Integrated Writing courses taught at Wright State University. This is the first issue after a 5 year hiatus.

When Will The Glomerular Filtration Rate In Former Preterm Neonates Catch Up With Their Term Peers?, Yunjiao Wu, Karel Allegaert, Robert B. Flint, Sebastiaan C. Goulooze, Pyry A.J. Välitalo, Matthijs De Hoog, Hussain Mulla, Catherine M.T. Sherwin, Sinno H.P. Simons, Elke H.J. Krekels, Catherijne A.J. Knibbe, Swantje Völler

Pediatrics Faculty Publications

Aims: Whether and when glomerular filtration rate (GFR) in preterms catches up with term peers is unknown. This study aims to develop a GFR maturation model for (pre)term-born individuals from birth to 18 years of age. Secondarily, the function is applied to data of different renally excreted drugs. Methods: We combined published inulin clearance values and serum creatinine (Scr) concentrations in (pre)term born individuals throughout childhood. Inulin clearance was assumed to be equal to GFR, and Scr to reflect creatinine synthesis rate/GFR. We developed a GFR function consisting of GFRbirth (GFR at birth), and an Emax model dependent on PNA …

Motivational Interviewing Skills Practice Enhanced With Artificial Intelligence, Paul J. Hershberger, Yong Pei, Dean A. Bricker, Timothy N. Crawford, Ashutosh Shivakumar, Angie Castle, Katharine Conway, Raveendra Medaramitta, Maria Rechtin, Josephine F. Wilson

Family Medicine Faculty Publications

Background: Finding time in the medical curriculum to focus on motivational interviewing (MI) training is a challenge in many medical schools. We developed a software-based training tool, “Real-time Assessment of Dialogue in Motivational Interviewing” (ReadMI), that aims to advance the skill acquisition of medical students as they learn the MI approach. This human-artificial intelligence teaming may help reduce the cognitive load on a training facilitator. Methods: During their Family Medicine clerkship, 125 third-year medical students were scheduled in pairs to participate in a 90-minute MI training session, with each student doing two role-plays as the physician. Intervention group students received …

Sarin-Induced Neuroinflammation In Mouse Brain Is Attenuated By The Caspase Inhibitor Q-Vd-Oph, Ekta J. Shah, William C. Grunwald Jr., Teresa L. Garrett, Thomas L. Brown, David R. Cool

Neuroscience, Cell Biology & Physiology Faculty Publications

Organophosphates cause hyperstimulation of the central nervous system, leading to extended seizures, convulsions, and brain damage. Sarin is a highly toxic organophosphate nerve agent that has been employed in several terrorist attacks. The prolonged toxicity of sarin may be enhanced by the neuroinflammatory response initiated by the inflammasome, caspase involvement, and generation/release of proinflammatory cytokines. Since neurodegeneration and neuroinflammation are prevalent in sarin-exposed animals, we were interested in evaluating the capacity of quinolyl-valyl-O-methylaspartyl-[-2,6-difluorophenoxy]-methyl ketone (Q-VD-OPh), a pan caspase inhibitor to attenuate neuroinflammation following sarin exposure. To test this hypothesis, sarin-exposed C57BL/6 mice were treated with Q-VD-OPh or negative control quinolyl-valyl-O-methylglutamyl-[-2,6-difluorophenoxy]-methyl …

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 …

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 …

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 …

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 …

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.

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 …

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 …

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 …

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 …

Mechanosensory Encoding In Ex Vivo Muscle–Nerve Preparations, Stephen N. Housley, Evelyn A. Gardolinski, Paul Nardelli, J'Ana Reed, Mark M. Rich, Timothy C. Cope

Neuroscience, Cell Biology & Physiology Faculty Publications

Our objective was to evaluate an ex vivo muscle-nerve preparation used to study mechanosensory signalling by low threshold mechanosensory receptors (LTMRs). Specifically, we aimed to assess how well the ex vivo preparation represents in vivo firing behaviours of the three major LTMR subtypes of muscle primary sensory afferents, namely type Ia and II muscle spindle (MS) afferents and type Ib tendon organ afferents. Using published procedures for ex vivo study of LTMRs in mouse hindlimb muscles, we replicated earlier reports on afferent firing in response to conventional stretch paradigms applied to non-contracting, that is passive, muscle. Relative to in vivo …

Evaluating Functional Inhibitors Of Acid Sphingomyelinase As Potential Negative Modulators Of Microvesicle Particle Release In Response To Skin Stressors, Taskin Sabit

Browse all Theses and Dissertations

Many diseases including lupus erythematosus, atopic eczema, and rosacea can be associated with photosensitivity, which is an abnormal response to sunlight. Recent studies by our group have implicated microvesicle particles (MVP) as playing an important role in causing inflammation and systemic immunosuppression. Previous studies show that functional inhibitors of acid sphingomyelinase (FIASMA) can block MVP release in response to ultraviolet B (UVB) radiation or Platelet-activating Factor (PAF) agonist, which are skin stressors. However, more research needs to be conducted to evaluate the role of PAF, UVB and FIASMA in MVP generation and to formulate a therapeutic medication to be potentially …

Evaluating The Deductive Competence Of Large Language Models, Spencer M. Seals, Valerie L. Shalin

Psychology Faculty Publications

The development of highly fluent large language models (LLMs) has prompted increased interest in assessing their reasoning and problem-solving capabilities. We investigate whether several LLMs can solve a classic type of deductive reasoning problem from the cognitive science literature. The tested LLMs have limited abilities to solve these problems in their conventional form. We performed follow up experiments to investigate if changes to the presentation format and content improve model performance. We do find performance differences between conditions; however, they do not improve overall performance. Moreover, we find that performance interacts with presentation format and content in unexpected ways that …