Medicine and Health Sciences Commons^™

The Association Between Autism Spectrum Disorders And Secondhand Tobacco Exposure, Bhupinder Kaur

Master of Public Health Program Student Publications

Second hand tobacco smoke exposure has been associated with neurobehavioral disorders among children. The objective of this study was to evaluate the relationship between second hand smoking and autism spectrum disorders (ASD) in children in the United States. Parent-reported postnatal tobacco exposure inside and outside the house and ASD diagnosis was examined in children younger than 12 years using the 2011-2012 National Survey on Children's Health. The physician diagnosis of current ASD as reported by the parents was used as the outcome variable. Univariate and multivariate logistic regression models adjusted for potential confounders were used to assess the associations. Of …

Neighborhood-Level Influences On Delays In Diagnostic Follow-Up From Mammography Screening In African-American Women: A Systematic Review, Barbara A. Fowler

Nursing Faculty Publications

Although there has been a steady decrease in breast cancer deaths among all women (pooled data) age 40 to 65 years during the past two decades in the United States, breast cancer deaths remain substantially higher among African-American women than White women (32.4% vs. 23.9%), resulting in an overall lower five-year survival rate (78.4% vs. 91.2%). These differences are primarily due to delays in diagnostic follow-up from mammography screening (MS) (ACS, 2012]. Following the secondary research data methods by analyzing the popular medical databases and articles published in the peer-reviewed medical journals in US during 2004-2014 the author would like …

No Shows: Effectiveness Of Termination Policy And Review Of Best Practices, Maalinii Vijayan

Master of Public Health Program Student Publications

The primary objective of the study was to identify whether the implementation of Patient No Show and Termination policy at Five Rivers Health Centers (FRHC) is associated with a significant reduction of its no show rate. The secondary objective was to perform the best practices review on other strategies to reduce no shows. The data for this study was obtained retrospectively from the electronic medical records of the seven clinical centers of FRHC. Individual clinic's no show rates and cumulative no show rates for pre-implementation and post-implementation period were calculated. Chi-squared test were used to detect statistical significance between pre- …

Smarter Lunchrooms - Ohio: Using Production And Sales Records To Measure Change In Food Selection, Roopsi J. Narayan

Master of Public Health Program Student Publications

Background: The 2010 Healthy, Hunger-Free Kids Act (HHFKA) updated the national school meals standards from the 1995 to the 2010 Dietary Guidelines for Americans. The HHFKA are the most comprehensive changes to the national school meal standards in 15 years. Measurement of food selection is essential to determine the impact of the new rules. This study develops an indicator, using production records, to track food selection in school cafeterias. Methods: Participating Ohio school districts applied interventions from The Smarter Lunchrooms Movement to cafeterias. Using MyPlate as a model and production records from two school districts, a coding system was developed …

Fruit And Vegetable Consumption Patterns Among Children During School Lunch, Haley R. Riegel

Master of Public Health Program Student Publications

Background: As the United States suffers from a childhood obesity epidemic, more attention has been given to school lunch nutrition. Federal requirements on school lunch are evolving to include a variety of fruits and vegetables, whereas other programs study ways to increase healthy food consumption during school lunch. This project categorizes fruits and vegetables by the United States Department of Agriculture (USDA) and Cornell University’s Smarter Lunchrooms school lunch categories in order to gain a better understanding of fruit and vegetable waste during school lunch.

Methods: Visual estimations of tray waste were collected across four school districts. Averages of fruit …

The Impact Of Implementation Of An Evidence-Based Practice Model In A Long Term Acute Care Hospital, Michele L. Marshall

Doctor of Nursing Practice Program Projects

Inadequate and delayed implementation of current evidence into practice has contributed to medical errors, safety issues and patient deaths. The Institute of Medicine (IOM) has challenged the healthcare profession to achieve 90% of integration of current evidence into practice by 2020. The purpose of this doctoral project was to implement an evidence-based practice (EBP) model in a long-term acute care hospital as they began their journey in pursuit of Magnet recognition. Implementation of an EBP model, the Advancing Research and Clinical practice through close Collaboration (ARCC) model, involved conducting an initial organizational assessment of staff to understand the staff’s beliefs, …

Implementation Of A Total Knee Arthroplasty Evidence Based Practice Guideline Quality Improvement Project In A Va Orthopedic Surgical Setting To Reduce Surgical Infections, Paula A. Kimpton

Doctor of Nursing Practice Program Projects

The prevention of surgical site infections, specifically orthopedic surgery cases, has been cited as the most preventable source for morbidity and mortality for patients undergoing total knee arthroplasties (TKA). In the most recent Veteran Affairs (VA) National Surgery Office Quarterly Report (July 1, 2012 through June 30, 2013), a problem with surgical site infections was identified in patients with TKA surgery at Dayton Veterans Affairs Medical Center (VAMC). The Dayton VAMC had a 5.3% TKA surgical infection rate versus 1.3% nationally.

The purpose of this quality improvement project was to decrease post-operative TKA infection rates with utilization of evidence based …

Impact Of Poor Retention In Hiv Medical Care On Time To Viral Load Suppression, Timothy N. Crawford, Wayne T. Sanderson, Alice Thornton

Family Medicine Faculty Publications

Objective: The purpose of this study was to evaluate how poor retention in HIV care impacts time to viral suppression after initiating highly active antiretroviral therapy. Methods: A retrospective cohort study design, employing a medical chart review, was conducted at an academic infectious disease clinic at the University of Kentucky. Patients seeking care between 2003 and 2011 were included in the study. A log-normal model was employed to determine the factors associated with time to viral suppression. Results: Of the 532 patients in the study, 426 (80.1%) patients were virally suppressed. Controlling for insurance status, race, baseline CD4 counts, and …

Flipping The Global Health Challenge To The Classroom, Cristina Redko

Population and Public Health Sciences Faculty Publications

Much of the debate concerning global health education remains focused on building effective training programs. This paper emphasizes the development of teaching strategies specific to global health education. Inspired by the active learning process of “flipped classrooms” where critical thinking happens in the classroom and fact finding happens outside, this paper describes the experience of bringing the real global health challenge of high maternal mortality in Somaliland directly into the North American classroom in a public health graduate program.

The Likelihood Of Khat Chewing Serving As A Neglected And Reverse ‘Gateway’ To Tobacco Use Among Uk Adult Male Khat Chewers: A Cross Sectional Study, Saba Kassim, Nikki Lynn Rogers, Kelly Leach

Population and Public Health Sciences Faculty Publications

Background

Chewing khat leaves is often accompanied by tobacco use. We assessed aspects of tobacco use and explored factors associated with tobacco use patterns (frequency of use per week) among khat chewers who used tobacco only when chewing khat (“simultaneous tobacco and khat users”, STKU).

Methods

A sample of 204 male khat chewers was recruited during random visits to khat outlets. Data collected included socio-demographic items, tobacco use and khat chewing behaviours. Both psychological and physical dependence on khat were assessed using the Severity of Psychological Dependence on Khat (SDS-Khat) Scale, the Diagnostic Statistical Manual IV (DSM-IV) and adapted items …

The Role Of The Nurse In Family Coping After Miscarriage, Wesley Hannebaum

Celebration of Undergraduate & Graduate Research, Scholarship, and Creative Activities Materials

When a miscarriage occurs, it affects the entire family unit, making coping an important part of healing during this time. After miscarriage, women are at increased risk for developing mental disorders such as anxiety and depression. Miscarriage is seldom seen as a concern for the father of the lost child, and thus their feelings are often ignored. It is important for the nurse to know how to best help these men, women, and the rest of the involved family cope after miscarriage so they can move on in a healthy way. The following is a review of the literature to …

Best Practices: A Network Approach Of The Mandatory Influenza Vaccination Among Healthcare Workers, Greg Attenweiler, Angie Thomure

Master of Public Health Program Student Publications

A network simulation was applied to hospital social networks improve the influenza vaccination rate of healthcare workers in a healthcare system. Social network methods can be used to develop an understanding of structures of social relations. Over 200,000 U.S. patients are hospitalized annually for influenza, which attributes to 36,000 deaths and is the sixth leading cause of death in adults. The best way to prevent influenza each year is by receiving the influenza vaccination. The typical influenza vaccination rate among healthcare workers is 40- 50%. A Healthy People 2020 objective is to increase the percentage of healthcare workers who are …

Key Influences Of Patient Satisfaction Measurement As A Quality Indicator In Inpatient Facilities, Mitila Arasu

Master of Public Health Program Student Publications

Patient Satisfaction remains a focal point in overall healthcare experience. Satisfaction of patients has become a priority for hospital administrators because of the ties to improve organization performance, increase reimbursement schedules, prevent claims, and gain return to provider reputation. This study examines the key influences of patient satisfaction and how it is measured in an inpatient facility. A literature search was done through PubMed and Google Scholar to determine specific areas needing improvement. Out of 30 articles that met all search criteria (published in the year 2000 or later, survey administered in United States, published in English, administered in an …

Integration Of Early Clinical Experience And Population Health In Undergraduate Medical Education, Thang N. Vu, Josephine Mensah-Dapaah

Master of Public Health Program Student Publications

Objective: In order to better prepare physicians to face the challenges in health care delivery today, educators have pushed for the integration of core population health competencies into undergraduate medical education. The goal is to equip future physicians with the necessary skills to not only improve the health of an individual, but also be able to advocate for a community and meet the health needs of a population. The purpose of this research study is to propose a plan to evaluate the pilot program Early Meaningful Clinical Experience (EMCE) at the Boonshoft School of Medicine at Wright State University.

Methods: …

A Description Of Snack Foods In Select Ohio Schools: A Baseline Prior To Usda New Competitive Food Guidelines, Chukwudubem C. Obianagha

Master of Public Health Program Student Publications

Background: The proliferation of snack foods in school lunch programs has necessitated the USDA to regulate its consumption by implementing policies regarding its use. The competitive food guidelines were enacted in June 2013 through the Healthy, Hunger-Free Kids Act. This required development of federal nutritional guidelines snack foods had to meet in order to be considered a competitive food and thus sold in school lunchrooms.

Objectives: The purpose of this study is to describe the current snack food offerings in select Ohio high schools, and to determine how these snack foods affect the consumption of healthier free and reduced meal …

Piwi Homologs Mediate Histone H4 Mrna Localization To Planarian Chromatoid Bodies, Labib Rouhana, Jennifer A. Weiss, Ryan S. King, Phillip A. Newmark

Biological Sciences Faculty Publications

The well-known regenerative abilities of planarian flatworms are attributed to a population of adult stem cells called neoblasts that proliferate and differentiate to produce all cell types. A characteristic feature of neoblasts is the presence of large cytoplasmic ribonucleoprotein granules named chromatoid bodies, the function of which has remained largely elusive. This study shows that histone mRNAs are a common component of chromatoid bodies. Our experiments also demonstrate that accumulation of histone mRNAs, which is typically restricted to the S phase of eukaryotic cells, is extended during the cell cycle of neoblasts. The planarian PIWI homologs SMEDWI-1 and SMEDWI-3 are …

Middle Years And Elder Years Team-Based Learning Exercise, Brenda J. Roman, Sabrina M. Neeley, Dean Parmelee, Lindsey Allison

Medical Education Faculty Publications

Introduction: This exercise is used in a first-year medical curriculum Human Development course. It was developed in 2012, and has been used twice. This team-based learning (TBL) session utilizes a Readiness Assessment Test (RAT), with questions regarding development during the middle and elder years, and an application exercise consisting of two case vignettes. One case involves two siblings, both in their middle years of life, who struggle with what to do with their ailing father, from whom they had previously had minimal contact with for a number of years. The second case involves physician who receives a diagnosis of cancer. …

Anti-Cancer Effects Of Glypican-3 On Huh-7 Hepatocellular Carcinoma Cells, Jiyu Wen, Xiaojun Wen, Jinju Wang, Yang Shu, Zhidong Qiu, Zhongkao Liu, Ran Li, Guofang Zeng, Shiting Bao, Huilai Miao, Yanfang Chen, Mingyi Li

Pharmacology and Toxicology Faculty Publications

Aim: Previous studies have suggested Glypican-3 (GPC3) could be a valuable diagnostic marker for hepatocellular carcinoma. This study examined the effects of overexpression of GPC3 on Huh-7 hepatoma cells.

Methods: We constructed a recombinant plasmid vector pcDNA3.1 (+)-GPC3 for GPC3 overexpression studies in Huh-7 cells. RT-PCR and Western blotting were used to confirm GPC3 gene expression. Cell proliferation was evaluated by 5-ethynyl-2-deoxyuridine (EdU) incorporation assay. Cell cycle progression and apoptosis were determined by flow cytometry using propidium iodide (PI) and Annexin V-FITC/PI staining, respectively. Cell migration and invasion were examined by Boyden Transewll and Matrigel assays.

Results: GPC3 overexpression effectively …

Fish Odor Syndrome: A Case Report Of Trimethylaminuria, Catherine A. Ulman, Julian J. Trevino, Marvin E. Miller, Rishi K. Gandhi

Pediatrics Faculty Publications

Trimethylaminuria is a rare, autosomal recessive, metabolic disorder that results in accumulation of trimethylamine (TMA), which smells like rotten fish. The chemical is excreted in sweat and urine owing to a deficiency in the enzyme flavin monooxygenase 3 (FMO3). We report a case of trimethylaminuria in a 12-year-old girl. The patient failed treatment with diet and hygiene modification, but achieved symptomatic improvement after a four-month course of metronidazole.

Challenges And Considerations In Optimizing Ovarian Stimulation Protocols In Oncofertility Patients, Kathryn Coyne, Makenzie Purdy, Kathleen O'Leary, Jerome L. Yaklic, Steven R. Lindheim, Leslie A. Appiah

Obstetrics and Gynecology Faculty Publications

The scope of cancer treatment in women of childbearing age has changed in the last decade. Fertility preservation is no longer an afterthought but central to multi-disciplinary cancer treatment planning and should be addressed due to the cytotoxic effects of cancer therapy. However, oncology patients present as a unique treatment challenge as the physician must balance the urgency of fertility preservation with the risks of delaying cancer therapy. Controlled ovarian stimulation (COS) is routinely applied in assisted reproductive technology but can be contraindicated in women with estrogen-receptor-positive tumors. This paper reviews some of the challenges to consider when using COS …

An Evaluation Of The Chronic Disease Self-Management Program, Joan Sevy Majers

Doctor of Nursing Practice Program Projects

The prevalence and costs of chronic disease continue to escalate with the aging of the population and continued advancements in medical care. Self-management of chronic disease may be an alternative approach to care that could assist in moving away from a disease-oriented model to health-oriented one. Outcomes from chronic disease self-management programs are promising but inconsistent across disease entities and populations. Among the Veteran population, chronic disease self-management programs have been implemented in a number of Veteran Affairs facilities. The purpose of this project was to evaluate specific outcomes from the chronic disease self-management program conducted in the five medical …

Nurses Perceptions Of Shared Governance Two Years Post Implementation Of A Councilor Shared Governance Model, Kathleen L. Wilson

Doctor of Nursing Practice Program Projects

Participation in shared governance councils can provide nurses with an opportunity for input into organizational policies that influence quality health care outcomes. Nurse leaders are diligently seeking a practice model that has a foundation of engagement of staff in decision making, quality outcomes, competency, evidence-based practice, shared power and job satisfaction. With the Patient Protection and Affordable Care Act (PPACA) of 2010, health care systems can expect an influx of some 30 million more patients (Pfeifer, 2013). In addition, mandated purchase of health care insurance will replace the fee for service model with one that ties payment to outcomes and …

Factors For Recurrent Injuries In Victims Of Suspected Non-Accidental Trauma: A Retrospective Cohort Study, Katherine Deans, Jonathan D. Thackeray, Johnathan I. Groner, Jennifer N. Cooper, Peter Minneci

Pediatrics Faculty Publications

Background

Many children who are victims of non-accidental trauma (NAT) may be repeatedly evaluated for injuries related to maltreatment. The purpose of this study was to identify risk factors for repeated injuries in children with suspected NAT.

Methods

We conducted a retrospective cohort study using claims data from a pediatric Medicaid accountable care organization. Children with birth claims and at least one non-birth related claim indicating a diagnosis of NAT or skeletal survey in 2007–2011 were included. Recurrent events were defined as independent episodes of care involving an urgent/emergent care setting that included a diagnosis code specific for child abuse, …

Department Of Surgery Update, January 2014, Wright State University Department Of Surgery

Department of Surgery Updates

A three page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, recruitment for various depositions, a list of important dates, committee meetings and more.

Complexity Of Breastfeeding Health Policy In Tanzania, Africa, Theresa Thompson

Master of Public Health Program Student Publications

Background: The purpose of this study was to investigate Tanzanian health policy regarding the protection and promotion of breastfeeding.

Country Profile: Tanzania is a United Republic composed of the mainland and also the islands of Zanzibar. Tanzania is located in east Africa with a population of approximately 46 million. About 1.6 million babies are born each year in Tanzania, however only approximately 140,000 are registered annually. Tanzania’s infant mortality rate is 68 infant deaths per 1000 live births. Tanzania makes up for approximately 0.5% of the world population but 2% of the global infant death.

Approaches: In this study, the …

Diabetes And The Uninsured In Montgomery County, Ohio: Effects Of A County-Funded Health Services Program On Hemoglobin A1c Values, Mark Feighery

Master of Public Health Program Student Publications

Montgomery County Care (MCC) was a county-funded, limited benefit health services program launched in 2010 as a bridge to expanded Medicaid and the health insurance marketplaces for the uninsured of Montgomery County, Ohio. A principal goal was to help manage chronic disease, particularly diabetes. Approximately 20% of the MCC members assigned to a community health center were diagnosed with diabetes. Paired sample t-tests of Hemoglobin A1c values were compared for diabetic members enrolled in the program for a minimum of one year. Among 188 members for whom initial and subsequent values were recorded, HA1c values declined (showed an improvement) from …

Association Of Demographic Characteristics With Gestational Diabetes Mellitus And Gestational Hypertension In Ohio During 2012, Jared D. Klein

Master of Public Health Program Student Publications

Background: Gestational Diabetes Mellitus (GDM) and Gestational Hypertension (GHTN) are serious conditions that can arise during pregnancy. Both of these disorders can cause detrimental health effects to both mother and newborn. Methods: Ohio vital statistics birth data was obtained from Public Health- Dayton and Montgomery County. The data set included 137,268 women who gave birth during 2012 in Ohio and had a known GDM and/or GHTN status. IBM Statistical Package for Social Sciences for Mac Version 20 (SPSS, IBM, 2011) was used to analyze the data. Descriptive statistics, odds ratios, chi-square analyses, and multivariate logistic forward stepwise regressions were calculated …

Obtaining Efficiencies In Food-Borne Illness Protection For Residential, Health Department-Licensed, And Non-Licensed Entities, Ted W. Talley

Master of Public Health Program Student Publications

Severe storms, natural disasters, and other emergencies resulting in extended periods of power loss can negatively impact public health as the likelihood of food-borne illnesses resulting from the consumption of food products held in refrigerators and freezers at improper temperatures is greatly increased. Additionally, food products used or served during emergency responses present additional challenges as many of the products may have other risk factors often associated with food-borne illness outbreaks. These include food from unsafe sources (food prepared in a facility not subject to regulation or inspection), improper cooking temperatures, preparation on contaminated food contact surfaces, and poor hygienic …

Pain Scores Among Ed Patients: Correlation With Desire For Pain Medication, Catherine A. Marco, Megan Mcgervey, Joan Gekonde, Caitlin Martin

Emergency Medicine Faculty Publications

Introduction: Pain has been identified as the most common reason for Emergency Department (ED) visits. The verbal numeric rating pain scale (VNRS) is commonly used to assess pain in the ED. This study was undertaken to determine whether VNRS pain scores correlate with desire for pain medication among ED patients.

Methods: In this prospective survey study, eligible patients included Emergency Department patients over 18 with painful conditions. The primary outcome measures included self-reported VNRS, ED diagnosis, number of ED visits and number of ED admissions within the past year, and the self-reported desire for pain medication.

Results: Among 482 participants …

Effects Of Delayed Pharmacological Treatment And Limb Rehabilitation On Infarct Size And Functional Recovery After Stroke, Maria Helen Harley Balch

Browse all Theses and Dissertations

Previous studies show a fluoxetine/simvastatin drug combination successfully reduced infarct size and increased functional recovery when administered 20-26 hours post stroke. This project tested the hypothesis that earlier drug delivery at 6-12 hours post stroke will improve functional recovery and decrease infarct size, and that limb rehabilitation will improve functional recovery.

Pre-stroke function was determined in rats, a stroke was induced, and daily treatment began 6-12 hours post stroke. Baseline functional deficit was established, and additional testing over 90 days monitored functional recovery. Limb rehabilitation was provided for designated animals, and brain analysis measured infarct size.

In animals with no …