Medicine and Health Sciences Commons^™

Exploring Graduate Student Mental Health And Service Utilization By Gender, Race, And Year In School, Mikhila N. Wildey, Meghan E. Fox, Kelly A. Machnik, Deborah Ronk

Peer Reviewed Articles

Objective: The current study explored differences in mental health problems, services utilization, and support of graduate students by gender, race/ethnicity, and year in school.

Participants: Participants consisted of 734 graduate students from a large, Midwestern university.

Methods: Graduate students answered a series of questionnaires in fall 2021 assessing their mental health, services utilization, and perception of services.

Results: Women (vs men) and participants in their second year and beyond (vs first year) reported greater mental health problems, negative impact of the pandemic, and more services utilization. White (vs non-White) participants reported greater negative impact of the pandemic, greater services utilization, …

Engaging Caregivers To Use An Evidence‑Based Intervention For Medicaid Benefciaries With Alzheimer’S Disease: A Pilot Study, Sandra Lee Spoelstra, Alla Sikorskii, Monica Schueller, Viktoria Basso, Autumn Baldwin

Peer Reviewed Articles

Background This pilot study aimed to adapt an intervention, engaging informal caregivers to help clinicians with providing care to improve (or maintain) physical function of individuals with Alzheimer’s Disease or other dementias. To the best of our knowledge, for the frst time, we report on use of the intervention in those with Alzheimer’s Disease or other dementias.

Methods This was a 5-month mixed methods cohort study in a convenience sample of clinicians, caregivers, and benefciaries at 3-Medicaid Home and Community-based Service sites in Michigan. Two content experts and 5 caregivers modifed the intervention. We trained 116 clinicians to engage caregivers …

Results Of A Multi-Site Pragmatic Hybrid Type 3 Cluster Randomized Trial Comparing Level Of Facilitation While Implementing An Intervention In Community-Dwelling Disabled And Older Adults In A Medicaid Waiver, Sandra Spoelstra, Monica Schueller, Viktoria Basso, Alla Sikorskii

Peer Reviewed Articles

Background: Evidence-based interventions that optimize physical function for disabled and older adults living in the community who have difficulty with daily living tasks are available. However, uptake has been limited, particularly in resource-constrained (Medicaid) settings. Facilitation may be an effective implementation strategy. This study’s aim was to compare internal facilitation (IF) versus IF and external facilitation (EF) on adoption and sustainability of an intervention in a Medicaid home and community-based waiver.

Methods: In a hybrid type 3 trial, waiver sites (N = 18) were randomly assigned to implement the intervention using a bundle of strategies with either IF or IF …

Interrupted Time Series Analysis To Evaluate The Performance Of Drug Overdose Morbidity Indicators Shows Discontinuities Across The Icd-9-Cm To Icd-10-Cm Transition, Hannah Yang, Emilia Pasalic, Peter Rock, James W. Davis, Sarah Nechuta, Ying Zhang

Peer Reviewed Articles

Introduction: On 1 October 2015, the USA transitioned from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) to the International Classification of Diseases, 10th Revision (ICD-10-CM). Considering the major changes to drug overdose coding, we examined how using different approaches to define all-drug overdose and opioid overdose morbidity indicators in ICD-9-CM impacts longitudinal analyses that span the transition, using emergency department (ED) and hospitalisation data from six states’ hospital discharge data systems.

Methods: We calculated monthly all-drug and opioid overdose ED visit rates and hospitalisation rates (per 100 000 population) by state, starting in January 2010. We applied …

Impact Of Benzodiazepines And Polysubstance Status On Repeat Non-Fatal Drug Overdoses, Sarah Mayberry, Sarah Nechuta, Shanthi Krishnaswami

Peer Reviewed Articles

Research has shown that benzodiazepines and mental health disorders can increase the likelihood of repeat overdose, but researcher have not explored this association in Tennessee (TN). We examined benzodiazepines, polysubstance overdose status with/without benzodiazepines, and mental health comorbidities with repeat overdose using statewide data in TN. This study analyzed TN hospital discharge data on nonfatal overdoses for patients ages 18–64 from 2012 to 2016 for 21,066 patients with an initial inpatient visit and 36,244 patients with an initial outpatient visit. The study assessed each patient at one year after initial overdose to determine likelihood of repeat overdose. We used a …

Descriptive Exploration Of Overdose Codes In Hospital And Emergency Department Discharge Data To Inform Development Of Drug Overdose Morbidity Surveillance Indicator Definitions In Icd-10-Cm, Leigh M. Tyndall Snow, Katelyn E. Hall, Cody Curtis, Allison L. Rosenthal, Emilia Pasalic, Sarah Nechuta, James W. Davis, Bretta Jane Jacquemin, Sherani R. Jagroep, Peter Rock, Elyse Contreras, Barbara A. Gabella, Katherine A. James

Peer Reviewed Articles

Background: In October 2015, discharge data coding in the USA shifted to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), necessitating new indicator definitions for drug overdose morbidity. Amid the drug overdose crisis, characterising discharge records that have ICD-10-CM drug overdose codes can inform the development of standardised drug overdose morbidity indicator definitions for epidemiological surveillance.

Methods: Eight states submitted aggregated data involving hospital and emergency department (ED) discharge records with ICD-10-CM codes starting with T36-T50, for visits occurring from October 2015 to December 2016. Frequencies were calculated for (1) the position within the diagnosis billing fields where …

Enhancement Of Fast Scan Cyclic Voltammetry Detection Of Dopamine With Tryptophanmodified Electrodes, Sarah E. Davis, Andrew L. Korich, Eric S. Ramsson

Peer Reviewed Articles

Fast scan cyclic voltammetry (FSCV) allows for real -time analysis of phasic neurotransmitter levels. Tryptophan (TRP) is an aromatic amino acid responsible for facilitating electron transfer kinetics in oxidoreductase enzymes. Previous work with TRP-modified electrodes showed increased sensitivity for cyclic voltammetry detection of dopamine (DA) when used with slower scan rates (0.05 V/s). Here, we outline an in vitro proof of concept for TRP-modified electrodes in FSCV detection of DA, and decreased sensitivity for ascorbic acid (AA). TRP-modified electrodes had a limit of detection (LOD) for DA of 2.480 ± 0.343 nM compared to 8.348 ± 0.405 nM for an …

S100a12 In Digestive Diseases And Health: A Scoping Review, Alexandre Carvalho, Jacky Lu, Jamisha D. Francis, Rebecca E. Moore, Kathryn P. Haley, Ryan S. Doster, Steven D. Townsend, Jeremiah G. Johnson, Steven M. Damo, Jennifer A. Gaddy

Peer Reviewed Articles

Calgranulin proteins are an important class of molecules involved in innate immunity. These members of the S100 class of the EF-hand family of calcium-binding proteins have numerous cellular and antimicrobial functions. One protein in particular, S100A12 (also called EN-RAGE or calgranulin C), is highly abundant in neutrophils during acute inflammation and has been implicated in immune regulation. Structure-function analyses reveal that S100A12 has the capacity to bind calcium, zinc, and copper, processes that contribute to nutritional immunity against invading microbial pathogens. S100A12 is a ligand for the receptor for advanced glycation end products (RAGE), toll-like receptor 4 (TLR4), and CD36, …

Teaching Health Education Through The Development Of Student Centered Video Assignment, Heather M. Wallace, Julia Vandermolen

Peer Reviewed Articles

The purpose of this study was to explore the ways in which a student centered video assignment enhanced student learning about developing and teaching a health education plan designed to address a complex public health problem. The objectives of the assignment included (1) to explore a complex public health problem, (2) practice developing a corresponding health education plan, and (3) develop and fully execute a multimedia video to deliver high impact health education and or promotion to a diverse audience. The assignment referred to as the student centered video assignment was developed and piloted at Grand Valley State University and …

"Farewell" To Prognosis In Shared Decision-Making, Robert F. Johnson

Peer Reviewed Articles

Whether because of a cultural pattern or personal preference, palliative care clinicians encounter persons approaching the end of life who wish to limit or forego prognostic information relating to their situation. This scenario has received attention in a recent motion picture as well as a newly available advance directive modification—the Prognosis Declaration form. The ordinary expectation for end-of-life shared decision-making with a capable person is clinician disclosure of the best effort at prognostic assessment. The optimal match between the expressed values, goals, and preferences of the person with available clinician expertise is hopefully achieved. For the clinician, a person’s choice …

Cold Exposure Induces Dynamic, Heterogeneous Alterations In Human Brown Adipose Tissue Lipid Content, Crystal L. Coolbaugh, Bruce M. Damon, Emily C. Bush, E Brian Welch, Theodore F. Towse

Peer Reviewed Articles

Brown adipose tissue undergoes a dynamic, heterogeneous response to cold exposure that can include the simultaneous synthesis, uptake, and oxidation of fatty acids. The purpose of this work was to quantify these changes in brown adipose tissue lipid content (fat-signal fraction (FSF)) using fat-water magnetic resonance imaging during individualized cooling to 3 °C above a participant’s shiver threshold. Eight healthy men completed familiarization, perception-based cooling, and MRI-cooling visits. FSF maps of the supraclavicular region were acquired in thermoneutrality and during cooling (59.5 ± 6.5 min). Brown adipose tissue regions of interest were defined, and voxels were grouped into FSF decades …

Prevalence And Risk Factors Associated With Long-Term Opioid Use After Injury Among Previously Opioid-Free Workers, Zoe Durand, Sarah Nechuta, Shanthi Kreishnaswami, Eric L. Hurwitz, Melissa Mcpheeters

Peer Reviewed Articles

Importance Using opioids for acute pain can lead to long-term use and associated morbidity and mortality. Injury has been documented as a gateway to long-term opioid use in some populations, but data are limited for injured workers.

Objective To evaluate the prevalence and risk factors of long-term opioid use after injury among workers in Tennessee who were opioid free at the time of injury.

Design, Setting, and Participants This cohort study identified injured workers aged 15 to 99 years who reported only 1 injury to the Tennessee Bureau of Workers’ Compensation from March 2013 to December 2015 and had no …

Improving Undergraduate Student Engagement In A Hybrid Research Course, Genevieve B. Elrod

Peer Reviewed Articles

Undergraduate nursing students have traditionally struggled to appreciate and understand research. Traditional teaching and learning methods in the research classroom are not meeting the needs of current students (McCurry & Martins, 2010), and innovations must be sought to overcome students' resistance to research. Efforts to improve the early research utilization skills and attitudes of students is critical if we are to hope for the grounding of their future practice in evidence.

To engage students in one hybrid research course, the faculty member created an innovative “March Madness” assignment that assists students in applying their learning. This article details …

Nonalcoholic Fatty Liver Disease And The Pnpla3 Gene, Lori Houghton-Rahrig, Debra Schutte, Jenifer I. Fenton, Jennifer Awad

Peer Reviewed Articles

Nonalcoholic fatty liver disease (NAFLD) is a rapidly emerging worldwide public health concern strongly associated with obesity, insulin resistance/diabetes type 2, and the metabolic syndrome (Younossi et al., 2011). It is the most common cause of liver disease in the world (World Gastro - enterology Organisation [WGO], 2012). Defined as a total liver weight comprised of more than 5% fat, NAFLD can progress from simple fatty liver disease to nonalcoholic steatohepatitis with or without fibrosis, liver cirrhosis, liver cancer, or liver failure resulting in premature death (Levene & Goldin, 2012). The development and progression of NAFLD is influenced by genetic …

Differential Localizations Of Protein Phosphatase 1 Isoforms Determine Their Physiological Function In The Heart, Ruijie Liu, Christian Miller, Christiana D'Annibale, Kimberly Vo, Ashley Jacobs

Peer Reviewed Articles

Protein phosphatase 1 isoforms α, β, and γ (PP1α, PP1β, and PP1γ) are highly homologous in the catalytic domains but have distinct subcellular localizations. In this study, we utilized both primary cell culture and knockout mice to investigate the isoform-specific roles of PP1s in the heart. In both neonatal and adult cardiac myocytes, PP1β was mainly localized in the nucleus, compared to the predominant presence of PP1α and PP1γ in the cytoplasm. Adenovirus-mediated overexpression of PP1α led to decreased phosphorylation of phospholamban, which was not influenced by overexpression of either PP1β or PP1γ. Interestingly, only cardiac-specific knockout of PP1β resulted …

Hiv Diagnosis Disclosure To Infected Children And Adolescents; Challenges Of Family Caregivers In The Central Region Of Ghana, Anna Hayfron-Benjamin, Dorcas Obiri-Yeboah, Stephen Ayisi-Addo, Peter Mate Siakwa, Sylvia Mupepi

Peer Reviewed Articles

Background

Disclosure of Human Immunodeficiency Virus (HIV) to infected older children and adolescents is essential for both personal health maintenance and HIV prevention within the larger population. Non-disclosure of HIV status has been identified as one of the potential barriers to optimum adherence especially in children and adolescents. Like many other countries in the SSA region, Ghana has significant number of children and adolescents infected by HIV, who have increased survival times, due to increased access to ART. However, both family caregivers and healthcare workers face an array of challenges with the disclosure process, including the timing, what information about …

The Death Debate: Penumbra Conundrum, Robert F. Johnson

Peer Reviewed Articles

Determination and declaration of death by neurologic criteria, brain death, is an established and legally accepted clinical practice with profound implications. Concerns regarding the accuracy of this diagnosis raise important clinical, ethical, and legal issues. A recent magazine article highlights these concerns by describing a poignant example of a patient meeting accepted clinical and ancillary testing criteria for brain death in the setting of post cardiac arrest hypoxic ischemic encephalopathy (CA-HIE). With continuation of ventilatory and nutritional support, this patient not only survived but over time demonstrated findings that were no longer consistent with brain death. Offered here is a …

It’S Not About You—It’S About Me, Robert F. Johnson

Peer Reviewed Articles

Hold Me, a film written and directed by Teace Snyder (2016) was distributed by email to palliative care clinicians and educators. The viewpoint presented here is not a review of this movie as a drama for entertainment. Rather it reviews the film to address the suggestion by its producers that it could serve as an adjunct to palliative care professional education.

Going Beyond ‘Do No Harm’: A Critical Annotation, Robert F. Johnson

Peer Reviewed Articles

The Op-Ed article in the New York Times (November 4th, 2016), “On Assisted Suicide, Going Beyond Do No Harm” by Haider Javed Warraich provided an articulate and timely plea for more widespread availability and application of physician-assisted dying, or “suicide”, as part of end-of-life medical care. While this profound intervention should be considered by physicians and others as an option for those able to express their wishes at the end-of-life, it must be considered in the context of the ethical principles appropriate for all health care interventions and recognized for its limited role in the overall approach to compassionate care …

Acculturation, Stress And Birth Outcomes In Mexican And Mexican American Women, Paulette A. Chaponniere

Peer Reviewed Articles

Purpose: This study examined the relationships between stress, stress buffers, acculturation and birth outcomes of infants born to 81 Mexican and Mexican American women living in West Michigan.

Method: An interrupted times series design was used to collect data prior to labor and delivery. Neuman’s Systems Model was used as the theoretical framework as it illustrates how stress impacts health outcomes. Women were recruited from local health and community agencies. Interviews were conducted in English or Spanish as desired by the subject using standardized questionnaires.

Results: Acculturation was negatively correlated with age (r = -.378, p < 0.001) and social support (r = -.258, p = .02). Bicultural women had the highest mean birth weight, and very Mexican–oriented women had the longest gestation. The third trimester of pregnancy was significantly different from the second trimester for stress, coping and social support. The women least integrated in either culture, e.g. marginalized (ARSMA-II), had the most stress. Spiritual coping predicted weight (β = .278) while pregnancy distress (β = -.237) and sense of belonging (β = -.258) predicted length of gestation.

Conclusion: Pregnancy-related distress was …

Why It’S Not Ok For Doctors To Participate In Executions, Robert F. Johnson

Peer Reviewed Articles

A plea for direct physician participation in executions was presented by Sandeep Jauhar in a New York Times Op-Ed (“Why It’s OK for Doctors to Participate in Executions”—April 21, 2017). Jauhar’s article is not a discussion of the ethics of capital punishment. He describes his own opposition “as a matter of principle, as a doctor.” However, since capital punishment is legal in 31 states, with required physician participation in several, he acquiesces to a utilitarian stance rather than the principled approach he acknowledges is expected of a physician in this circumstance.

Loss Of Displaced Starburst Amacrine Cells In A Rat Glaucoma Model, C A. Cooley-Themm, Q Ameel, David M. Linn, Cindy L. Linn

Peer Reviewed Articles

Acetylcholine (ACh) release by starburst amacrine cells (SACs) has been implicated in the production of retinal waves during early retinal development. Inhibitory gamma-aminobutyric acid (GABA) release by SACs is known to be involved in directional selectivity in the mature retina. However, the role of SAC release of ACh in the adult developed mammalian retina is not entirely understood. Some evidence suggests a neuroprotective effect on retinal ganglion cells (RGCs) acting through alpha7 nicotinic acetylcholine receptors (nAChRs) present in RGCs. If ACh released by SACs is neuroprotective to RGCs, it would follow that this cholinergic transmission might be compromised in glaucoma …

Neonatal Shoulder Width Suggests A Semirotational, Oblique Birth Mechanism In Australopithecus Afarensis, Jeremy M. Desilva, Natalie M. Laudicina, Karen R. Rosenberg, Wenda R. Trevathan

Peer Reviewed Articles

Birth mechanics in early hominins are often reconstructed based on cephalopelvic proportions, with little attention paid to neonatal shoulders. Here, we find that neonatal biacromial breadth can be estimated from adult clavicular length (R² = 0.80) in primates. Using this relationship and clavicular length from adult Australopithecus afarensis, we estimate biacromial breadth in neonatal australopiths. Combined with neonatal head dimensions, we reconstruct birth in A. afarensis (A.L. 288-1 or Lucy) and find that the most likely mechanism of birth in this early hominin was a semi-rotational oblique birth in which the head engaged and passed through the inlet …

Replicable Interprofessional Competency Outcomes From High-Volume, Inter-Institutional, Interprofessional Simulation, Deborah Bambini, Matthew Emery, Margaret De Voest, Lisa Meny, Michael J. Shoemaker

Peer Reviewed Articles

There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students’ perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students …

Proof Of Concept Of A Mobile Health Short Message Service Text Message Intervention That Promotes Adherence To Oral Anticancer Agent Medications: A Randomized Controlled Trial, Sandra L. Spoelstra, Charles W. Given, Alla Sikorskii, Constantinos K. Coursaris, Atreyee Majumder, Tracy Dekoekkoek, Monica Schueller, Barbara A. Given

Peer Reviewed Articles

Introduction: This multisite, randomized controlled trial assigned 75 adult cancer patients prescribed an oral anticancer agent to either an experimental group that received daily text messages for adherence for 21 days plus usual care or a control group that received usual care.

Materials and Methods: Measures were administered at baseline, weekly (Weeks 1–8), and at exit (Week 9). A satisfaction survey was conducted following the intervention. Acceptability, feasibility, and satisfaction were examined. Primary outcomes were adherence and symptoms. Secondary outcomes were depressive symptoms, self-efficacy, cognition, physical function, and social support. Mixed or general linear models were used for the analyses …

Prevention Of Glaucoma-Induced Retinal Ganglion Cell Loss Using Alpha7 Nachr Agonists, P J. Birkholz, C A. Gossman, M K. Webster, David M. Linn, Cindy L. Linn

Peer Reviewed Articles

In this study, the neuroprotective effect of various nicotinic alpha7 acetylcholine receptor agonists in an in-vivo model of glaucoma using adult Long Evans rats was analyzed. Glaucoma-like conditions were induced in the eyes of Long Evans rats after injection of hypertonic saline into episcleral veins to create scar tissue and increase the animal’s intraocular pressure. This procedure produced significant loss of retinal ganglion cells within one month and was associated with an increase of intraocular pressure. Using this model system, various alpha7 nicotinic acetylcholine receptor (a7 nAChR) agonists were applied at different doses as eye drops to the right eye …

A Trial Examining An Advanced Practice Nurse Intervention To Promote Medication Adherence And Symptom Management In Adult Cancer Patients Prescribed Oral Anti-Cancer Agents: Study Protocol, Sandra L. Spoelstra, Peggy S. Burhenn, Tracy Dekoekkoek, Monica Schueller

Peer Reviewed Articles

Aim: To report a study protocol that refines then examines feasibility, preliminary efficacy, and satisfaction of ADHERE, an intervention using motivational interviewing and brief cognitive behavioral therapy as a mechanism for goal-oriented systematic patient education to promote symptom management and adherence among cancer patients prescribed oral anti-cancer agents.

Background: Cancer treatment with oral anti-cancer agents shifts responsibility for managing treatment from clinicians in supervised cancer centers to patients and their caregivers. Thus, a need exists to standardize start-of-care for support patient self-management of care at home.

Design: A two-phase quasi-experimental sequential design with repeated measures.

Methods: Sixty five adult patients …

Driving In Early-Stage Alzheimer’S Disease: An Integrative Review Of The Literature, Rebecca L. Davis, Jennifer M. Ohman

Peer Reviewed Articles

One of the most difficult decisions for individuals with Alzheimer’s disease (AD) is when to stop driving. Because driving is a fundamental activity linked to socialization, independent functioning, and wellbeing, making the decision to stop driving is not easy. Cognitive decline in older adults can lead to getting lost while driving, difficulty detecting and avoiding hazards, as well as increased errors while driving due to compromised judgment and difficulty in making decisions. The purpose of the current literature review was to synthesize evidence regarding how individuals with early-stage AD, their families, and providers make determinations about driving safety, interventions to …

Aldh1a1 Mrna Expression In Association With Prognosis Of Triple-Negative Breast Cancer, Yan Liu, Michelle Baglia, Ying Zheng, William Blot, Ping-Ping Bao, Hui Cai, Sarah Nechuta, Wei Zheng, Qiuyin Cai, Xiao Ou Shu

Peer Reviewed Articles

ALDH1 is a crucial element in the retinoic acid signaling pathway regulating the self-renewal and differentiation of normal stem cells, and may play an important role in cancer progression. However, research on ALDH1 gene expression and breast cancer prognosis has yielded conflicting results. We evaluated the association between tumor tissue ALDH1A1/ALDH1A3 mRNA expression and triple-negative breast cancer (TNBC) prognosis in the Shanghai Breast Cancer Survival Study (SBCSS, N=463), Nashville Breast Health Study (NBHS, N=86), and Southern Community Cohort Study (SCCS, N=47). Gene expression was measured in RNA isolated from breast cancer tissues. In the SBCSS, higher ALDH1A1 mRNA level was …

Adolescent Exercise In Association With Mortality From All Causes, Cardiovascular Disease, And Cancer Among Middle-Aged And Older Chinese Women, Sarah J. Nechuta, Xiao Ou Shu, Gong Yang, Hui Cai, Yu-Tang Gao, Hong-Lan Li, Yong-Bing Xiang, Wei Zheng

Peer Reviewed Articles

Background: Little is known regarding the role of early-life exercise, a potentially modifiable factor, in long-term adult morbidity and mortality. We utilized the Shanghai Women's Health Study (SWHS) to investigate adolescent exercise in association with cancer, cardiovascular disease (CVD), and all-cause mortality among middle-aged and older women.

Methods: The SWHS is a prospective cohort of 74,941 Chinese women ages 40 to 70 years recruited from 1996 to 2000. In-person interviews at enrollment assessed adolescent and adult exercise history, medical and reproductive history, and other lifestyle and socioeconomic (SES) factors. Mortality follow-up occurs via annual linkage to the Shanghai Vital Statistics …