Medicine and Health Sciences Commons^™

Protocol For Serious Fall Injury Adjudication In The Strategies To Reduce Injuries And Develop Confidence In Elders (Stride) Study, David A. Ganz, Albert L. Siu, Jay Magaziner, Nancy K. Latham, Thomas G. Travison, Nancy P. Lorenze, Charles Lu, Rixin Wang, Erich J. Greene, Cynthia L. Stowe, Lea N. Harvin, Katy L.B. Araujo, Jerry H. Gurwitz, Yuri Agrawal, Rosaly Correa-De-Araujo, Peter Peduzzi, Thomas M. Gill, Shalender Bhasin, Thomas M. Gill, David B. Reuben, Siobhan Mcmahon, Nancy K. Latham, Shehzad Basaria, Brooke Brawley, Richard Eder, Amy Larson, Lori Goehring, Molly Lukas, Scott Margolis, Thomas W. Storer, Martha B. Carnie, Priscilla Gazarian

Orthopaedic Surgery Faculty Publications

Background: This paper describes a protocol for determining the incidence of serious fall injuries for Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE), a large, multicenter pragmatic clinical trial with limited resources for event adjudication. We describe how administrative data (from participating health systems and Medicare claims) can be used to confirm participant-reported events, with more time- and resource-intensive full-text medical record data used only on an "as-needed" basis. Methods: STRIDE is a pragmatic cluster-randomized controlled trial involving 5451 participants age ≥ 70 and at increased risk for falls, served by 86 primary care practices in 10 US …

Theorizing The Social Determinants Of Breast Cancer In Sub-Saharan Africa: A Family Health Nursing Perspective, Rosemary W. Eustace, Tumaini Nyamhanga, Eunice Lee

Seminars in Local and Global Regional Economies

The aim of this presentation is to discuss the theorizing process of a Family Health Strength-Based Socio-Ecological Model of Breast Cancer in Sub-Saharan Africa and the model’s meaning to family nursing practice. The major purpose of theorizing this model is to explore the social determinants of breast cancer within and external to the family system. The model is developed based on key realities inductively generated from integrated and empirical evidence on breast cancer in the region. Understanding the social contexts of health from this multilevel holistic systems approach offers nurses opportunities to prioritize research and interventions in disease prevention and …

Proceedings - Wright State University Boonshoft School Of Medicine Eleventh Annual Medical Student Research Symposium, Office Of Research Affairs, Boonshoft School Of Medicine

Medical Student Research Symposium Proceedings

The student abstract booklet is a compilation of abstracts from students' oral and poster presentations at Wright State University's Eleventh Annual Boonshoft School of Medicine Medical Student Research Symposium held on April 1, 2019.

A Value Analysis Of Microsurgical Lower Extremity Reconstruction Vs. Acellular Urinary Bladder Matrix (Ubm) For Radiation Wounds Of The Lower Extremity, Christopher J. Micallef, Jamie N. Johnson, R. Michael Johnson

Orthopaedic Surgery Faculty Publications

In the USA, external beam radiation is offered to patients as an alternative to surgery for non-melanoma skin cancers. While this technique may be useful in highly specific patient populations, recalcitrant chronic radiation wounds can result. These complex wounds ultimately may require major reconstructive surgery to achieve closure. Porcine urinary bladder matrix (UBM) may be effective in the treatment of radiation wounds and eliminating the need for vascularized tissue transfers. A case report of an elderly male with bilateral radiation wounds of the lower extremity, one extremity treated with free flap reconstruction and the other with porcine urinary bladder matrix, …

Initial Characterization Of The Indole-3-Carboxamide Bic-154 As A Fast Onset And Reversible Orai Channel Blocker, Tetyana Zhelay, Kalina Szteyn, Elisa Liardo, Jae Eun Cheong, Steffi Koerner, Anil Ekkati, Lijun Sun, J. Ashot Kozak

Neuroscience, Cell Biology & Physiology Faculty Publications

Calcium ion elevations are required for human T-lymphocyte proliferation in response to antigen recognition by a T-cell receptor. Calcium influx through the plasma membrane is necessary for efficient T-cell proliferation and effector function. The calcium channels responsible for Ca2+ influx in lymphocytes have been identified and Orai interacting with ER Ca2+ sensor STIM were shown to be crucial for persistent calcium mobilization. Loss-of-function mutations in Orai1 or STIM1 result in severe combined immunodeficiency (SCID) with muscle hypotonia. Suppression of calcium influx through Orai/STIM channels gives rise to various lymphoproliferative defects. Thus, deletion of Orai or STIM in mice results in …

Decreasing Door-To-Door Times For Infliximab Infusions In A Children's Hospital Observation Unit, Kelly C. Sandberg, Janet N. Lucien, Denise Stoll, Erica Yanney, Adam Mezoff

Pediatrics Faculty Publications

Introduction:

Children with inflammatory bowel disease (IBD) often require infliximab infusions to manage their disease. Infusions administered in the hospital setting require the patient and their families to devote many hours away from home. Changing to a rapid infusion protocol has been shown in the literature to be safe and has the potential to decrease time spent in the hospital receiving infusions.

Methods:

We describe stepwise changes made over a 4-month period to improve infliximab infusion efficiency and lessen the time spent in the hospital by IBD patients and their families. These changes included the implementation of a standardized order …

Evaluation Of Safe Sleep Practices Of Cribs For Kids Class Attendees, Halimat Adeshola Olaoluwa

Master of Public Health Program Student Publications

Sudden Infant Death Syndrome (SIDS) is a major cause of infant mortality, and sleep-related causes of SIDS are a focus of many strategies to combat infant mortality because they are largely preventable. One intervention that combines the distribution of a portable crib and safe sleep education to families that indicate a financial need is the Cribs for Kids program. The purpose of this study was to assess any changes in recommended safe sleep practices by Cribs for Kids attendees before and after the receipt of a portable crib and safe sleep education. Families who met eligibility criteria were enrolled in …

The Relationship Between Generalized Anxiety Disorder And Patient Age Among Emergency Department Patients, Mitchell Mcmurray

Scholarship in Medicine - All Papers

The objective of this study was to determine the relationship between Generalized Anxiety Disorder (GAD) and patient age in emergency department patients. The GAD-7 screening tool was used in an urban ED setting to survey patients about their anxiety, with a score of 8 or higher suggesting a diagnosis of GAD. Eligible participants included ED patients over the age of 18 with a painful condition ranging from 1-10 on the verbal numeric rating pain scale (VNRS). Participants were excluded if they were in distress and/or did not speak English. Of the 320 patients surveyed, the mean patient age was determined …

Automobile Restraint Use Among Patients In Motor Vehicle Crashes: Factors Associated With Noncompliance, Ashley A. Brent

Scholarship in Medicine - All Papers

Despite the 1968 U.S. law requiring that all vehicles have seat belts in every seat, many drivers and passengers choose not to use them. This is an important healthcare issue when the there is an estimated $917 billion spent annually on hospital services due to noncompliance with seat belt use.1 Previous literature has demonstrated that patients who are noncompliant with seatbelts are not only “more likely to use more hospital resources because they are more severely injured”, but also less likely to have health insurance, thus incurring more debt for the hospitals serving them¹. Conversely, restraint compliance has …

Cross-Cultural Adaptation Of An Instrument To Address The Mental Health Needs In Nepal, Dene S. Berman

Master of Public Health Program Student Publications

Nepal has had devastating earthquakes compounded by economic struggles, social and political crises. There is evidence of significant psychological distress but few mental health resources. The current project’s aim is to provide the people of Nepal who are experiencing emotional distress with information about improving their lives in a way that otherwise would not be available in rural health centers. For this purpose, a culturally sensitive and valid adaptation of Healthy Habits for Emotional Well-being into Nepali was created following World Health Organization guidelines. Implications for its use were discussed, along with possible future directions for continued outreach efforts.

Perfluoroalkyl Substances Exposure And Cancer In Nhanes 2011-2016 U.S. Population, Michael Crowder

Master of Public Health Program Student Publications

Background: Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are persistent synthetic compounds that may have associated health risks.

Purpose: To explore the association between four common detectable serum PFASs perfluorooctanoic acid (PFOA), perfluorooctyl sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) and cancer risk in United States (U.S.) adults.

Methods: Data from 4,497 participants from the 2011–2016 National Health and Nutrition Examination Survey (NHANES) were analyzed. Gender stratified adjusted logistic regression analysis was conducted to determine association between serum PFASs tertiles and risk of cancer.

Results: Median (IQR) PFASs were significantly higher in men compared to women, and among individual with …

Dichlorophenol Exposure And Chronic Kidney Disease, Karla James

Master of Public Health Program Student Publications

Purpose: To explore the relationship between the common pesticides, 2,4-dichlorophenol (2,4-DCP) and 2,5-dichlorophenol (2,5-DCP) with serum creatinine as a biomarker of kidney function. Methods: National Health and Nutrition Examination Survey (NHANES) 2013 to 2014 data (N = 2,063, 47% male and 53% female) was used to statistically analyze the relationship between either of two common pesticides 2,4-DCP or 2,5-DCP and serum creatinine levels. Gender stratified analysis was completed using multivariate adjusted linear regression. Variables adjusted were age, ethnicity and annual household income. Results: In both males and females exposure to 2,4-DCP did not elevate serum creatinine and regression results …

Evaluating An Evidence-Based Suicide Risk Assessment Intervention For An Inpatient Mental Health Hospital Unit, Tyler D. Green

Doctor of Nursing Practice Program Projects

Suicide is a worldwide problem that claims over 800,000 lives annually (NIMH, 2017; WHO, 2017). Almost one third of mental health professionals feel they have received inadequate training on suicide prevention (Jahn, Quinnett, & Ries, 2016). Asking mental health clients to agree to a no-suicide contract is a widely-used practice in the inpatient mental health care setting but lacks efficacy and can have ethical implications (Bryan et al., 2017). The NGASR was selected from a variety of suicide risk assessment tools for incorporation into a public inpatient mental health hospital unit in the Midwestern U.S.A. The NGASR is unique in …

The Perspectives Of African American Women: Their Pregnancy Experience And Their Babies’ Birth Outcomes, Kayla M. Hairston

Master of Public Health Program Student Publications

The health disparity surrounding infant mortality has been a challenge for public health professionals for the past two decades. Today African American babies continue to die at a rate two times higher than the nation’s average rate. The purpose of this study was to explore African American mothers’ perspectives on their pregnancy experience and their babies’ birth outcomes, as a way to provide suggestions for current efforts and interventions being used to lower the rate of infant mortality in the African American population. This study examined fifteen peer reviewed articles that shared the perspectives of African American women who were …

Assessing The Social Determinants Of Health Needs Of Older Lgbt People In The Greater Miami Valley Of Ohio, Jessica L. Sokol

Master of Public Health Program Student Publications

Background: While the older LGBT population continues to grow, they remain an underserved, invisible, and under-researched segment of the population. They experience many of the same risk and protective factors of all older adults, but discrimination is one social determinant of health that is quite prevalent among this community, causing lasting impacts on health.

Objective: The purpose of this study was to assess the social determinants of health issues and needs of the aging LGBT population in Dayton, Ohio, in order to direct advocacy strategies and better targeting of local support efforts.

Methods: Data were collected through a cross-sectional survey …

Topical Photodynamic Therapy Induces Immunosuppression: Potential Role Of Lipid Mediator Platelet-Activating Factor, Christina E. Borchers, Christine M. Rapp, Elizabeth Cates, Amy Williams, Jeffery B. Travers

Dermatology Faculty Publications

opical photodynamic therapy (PDT), or blue light therapy, isa procedure using a photosensitizing agent, or precursoragent 5-aminolevulinic acid (5-ALA), and is commonly usedto treat precancerous actinic keratosis. The 5-ALA is takenup by skin lesions through targeting cells with high turnoverthat are metabolically active (malignant proliferation) andconverted to the photoactive drug protoporphyrin IX.Following exposure to blue light, significant cell destructionoccurs which has been linked to the generation of reactiveoxygen species (1). Though PDT is effective, several studieshave suggested that this procedure results inimmunosuppression, which might limit the effectiveness ofthis therapy. Our group has demonstrated previously thatexperimental PDT of keratinocyte cell lines …

Sex Differences In The Outcomes Of Mild Traumatic Brain Injury In Children Presenting To The Emergency Department, Taylor M. Yeates

Master of Public Health Program Student Publications

Mild traumatic brain injuries (mTBI) put children and adolescents at risk for short and long-term health risks. The purpose of this study was to evaluate sex differences in post-acute outcomes among children and adolescents presenting to the Emergency Department (ED) for mTBI. The study is a secondary analysis of a de-identified dataset which was drawn from a concurrent cohort, prospective, and longitudinal study design that included 8 to 16 year-old children with mTBI and a comparison group of children with mild orthopedic injuries (OI) not involving the head. Participants were recruited and completed an initial assessment during their initial visit …

The Relationship Between Advanced Degrees And Performance On Usmle Step 1, Martha E. Orozco Cortes

Scholarship in Medicine - All Papers

While previous studies have analyzed the relationship of pre-admission factors on USMLE Step 1 scores few studies have looked at the effects obtaining a graduate degree prior to medical school matriculation. Therefore, this study sought to determine if there was an advantage between obtaining a graduate degree before medical school when it came to step 1 board scores. This retrospective study analyzed step 1 scores and medical school application data from 718 students who matriculated at a public midwestern medical school between 2014 and 2016. A combination of analyzes of variance, chi-square tests, and multiple regression analyses were used. When …

What Does Anxiety Look Like? Prevalence Among Ed Patients, Justin B. Anderson

Scholarship in Medicine - All Papers

The prevalence of mental illness in the US population is common, with an estimated value of 8%. The emergency department patient population is especially vulnerable to mental illness. Previous studies from 2012 and 2017 estimated the rate of undiagnosed mental illness in the Emergency Department (ED) at 41-42%.1,2 According to the studies, only a minority of these were identified by the physician.

DSM-5 defines the criteria for generalized anxiety disorder (GAD) as “excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school …

Academic Success In Medical School For Prematriculation Program Students—A Retrospective Analysis Of Year 1 Course Exams At Boonshoft School Of Medicine At Wright State University, James E. Elliott

Scholarship in Medicine - All Papers

As medical schools are striving to enroll the most diverse candidates to their schools, the medical schools have developed enriching prematriculation programs to their diverse candidates to ensure that all students are prepared for the first year of medical school. The prematriculation programs attempt to build in academic content with study techniques to help students become confident in their learning in the first weeks of school but also in the last months of their first year when they can still employ various study tools learned in the summer from the prematriculation program. However, with the implementation of these programs, there …

The Relationship Between Generalized Anxiety Disorder And Self-Reported Pain Scores Among Emergency Department Patients, Nicholas Seitz

Scholarship in Medicine - All Papers

Anxiety is common among Emergency Department (ED) patients. Self-reported pain scores have been associated with a variety of physical and psychological factors. However, the relationship between pain and anxiety in ED patients has not been previously reported. This study aims to identify a relationship between self-reported pain scores and the diagnosis of generalized anxiety disorder among ED patients.

This prospective patient survey study was conducted at Miami Valley Hospital, an urban ED in Dayton, Ohio. Eligible participants included ED patients age 18 or over, with a self-reported pain score ranging from 1-10 on the verbal numeric rating pain scale (VNRS). …

The Association Of Perfluoroalkyl Substance Exposure And Lung Function In The U.S. Population, Brenna C. Heinle

Master of Public Health Program Student Publications

Background/Aim: Perfluoroalkyl substances (PFASs) are chemical compounds used in consumer products and are linked with increase in cholesterol, thyroid disease, and pregnancy-induced hypertension. However, their association with lung function is not completely understood.

Methods: Cross sectional 2011-12 U.S. population data from the National Health and Nutrition Examination Survey (NHANES) was used (N=1,450, aged 12 to 79 years, 52% men). Serum concentration of four PFASs, perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorohexane sulfonic acid (PFHxS) were assessed using mass spectrometry and were categorized into tertiles. Lung function was measured by spirometry as forced vital capacity (FVC), …

Cannabis Use And Association With Pain, Anxiety, And Depression Among Emergency Department Patients, John Detherage

Scholarship in Medicine - All Papers

Introduction:

Cannabis use is increasing nationwide. Many states have legalized medical and recreational use of cannabis. This study was undertaken to identify any association between cannabis use and chronic pain among ED patients.

Methods:

This was a prospective survey study of Emergency Department (ED) patients at Miami Valley Hospital, a level 1 trauma center in Dayton, Ohio conducted during June – August 2018. The survey included data regarding the frequency of cannabis use, chronic pain, and current mental illness.

Results:

Three hundred and sixty patients participated in this study. The majority of respondents were white (55%) or African American (42%). …

Lead Exposure And Metabolic Syndrome In U.S. Population, Nhanes 2013-2014, Khadra Gukadowr

Master of Public Health Program Student Publications

Background: Lead is a known endocrine disruptor and can impair regulation of blood glucose, blood pressure, abdominal adiposity, blood lipid levels which are risk factors for metabolic syndrome (MetS).

Objective: To study the association of lead exposure and MetS in United States (U.S.) adults.

Methods: Data from 523 male and 528 female participants aged 20 years and older from the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) were analyzed. Based on blood lead distribution in males and females, participants were categorized into low and high blood lead groups in both genders. Adjusted logistic regression analysis was used …

Who Is Testing? Demographic And Sexual Risk Factors Associated With Hiv Testing Among African American College Students, Elizabeth Gonder-Strutz

Master of Public Health Program Student Publications

Despite significant progress made in reducing HIV diagnoses, many populations are still disproportionately affected. Although African American college students tend to engage in safer sex practices than their peers, they are still at an elevated risk for contracting HIV. Therefore, it is important that HIV prevention programs understand the unique needs and risk factors among African American college students. HIV testing is an essential component of HIV prevention. This study examined the relationship between HIV testing and demographic and behavioral factors among African American college students from two universities. The study found that older students (upperclassmen) are significantly more likely …

Vital Signs, Winter 2019, Boonshoft School Of Medicine

Vital Signs

A thirty-two page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Systemic Sclerosis Presenting With Bilateral Retinal Cotton Wool Spots, Christina E. Borchers, Ronald E. Warwar

Dermatology Faculty Publications

Systemic sclerosis is a systemic inflammatory diseasecharacterized by a triad of autoimmune reactions,vasculopathy, and fibrosis due to collagen deposition. Thediffuse sclerosis type includes vascular abnormalities in theskin (puffy, taut, thickened skin, pitting of fingertips), soft tissues(arthralgias, myalgias), lungs (pulmonary hypertension,interstitial fibrosis), gastrointestinal tract (esophagealdysmotility, GERD), kidneys (scleroderma renal crisis), andheart (arrhythmias, heart failure).Rarely, systemic sclerosis can present with signs of retinalvascular occlusion and cotton wool spots in the eyes. Thefollowing case report describes a patient presenting with cottonwool spots as an early manifestation of systemic sclerosis.

Kiaa1549-Braf Expression Establishes A Permissive Tumor Microenvironment Through Nfκb-Mediated Ccl2 Production, Ran Chen, Chanel Keoni, Christopher A. Waker, Robert M. Lober, Robert M. Lober, Yihsien Chen, David H. Gutmann

Pediatrics Faculty Publications

KIAA1549-BRAF is the most frequently identified genetic mutation in sporadic pilocytic astrocytoma (PA), creating a fusion BRAF (f-BRAF) protein with increased BRAF activity. Fusion-BRAF-expressing neural stem cells (NSCs) exhibit increased cell growth and can generate glioma-like lesions following injection into the cerebella of naïve mice. Increased Iba1+ monocyte (microglia) infiltration is associated with murine f-BRAF-expressing NSC-induced glioma-like lesion formation, suggesting that f-BRAF-expressing NSCs attract microglia to establish a microenvironment supportive of tumorigenesis. Herein, we identify Ccl2 as the chemokine produced by f-BRAF-expressing NSCs, which is critical for creating a permissive stroma for gliomagenesis. In addition, f-BRAF regulation of Ccl2 production …

Differences In Access To Care Of Children With Intellectual Disability Versus Children With Autism Spectrum Disorder, Kelly J. Haller

Scholarship in Medicine - All Papers

Objective: With the increase in ASD awareness and diagnosis, concerns are raised as to whether children with ID have more unmet health care needs than children with ASD. The purpose of this study was to assess the unmet health care needs of children with ID compared to children with ASD and whether inconsistent health insurance coverage is associated with any differences. Methods: The 2016-2017 NSCH identified children with diagnoses of ID and ASD (with or without ID). Caregivers were asked if the child had an unmet need for health care during the past 12 months, and the type of care …

Success Of Non-Traditional Students In Medical School, Rebecca A. Nowak

Scholarship in Medicine - All Papers

The demographics of United States medical schools are changing to include an increasing number of older students, men and women who have switched careers into medicine, those with post-graduate degrees before starting medical school, and other diverse backgrounds. These “non-traditional” students today are still a minority (an annual questionnaire sent out to matriculating medical students by the Association of American Medical Colleges last year showed as many as 90% of students knew they wanted to study medicine by the end of undergraduate¹) but make up a growing slice of the demographics of current U.S. medical students. Much research …