Medicine and Health Sciences Commons^™

The Use Of Low-Calorie Sweeteners By Children: Implications For Weight Management, John Foreyt, Ronald Kleinman, Rebecca Brown, Rachel Lindstrom

United States Public Health Resources

The rise in pediatric obesity since the 1970s has been well established in the United States and is becoming a major concern worldwide. As a potential means to help slow the obesity epidemic, low-calorie sweeteners (LCS) have gained attention as dietary tools to assist in adherence to weight loss plans or prevention of excess weight gain. Observational studies tend to show positive correlations between LCS consumption and weight gain in children and adolescents. Although the data are intriguing, these epidemiologic studies do not establish that LCS cause weight gain, because there are likely many lifestyle and genetic differences between children …

Salmonella Enterica Serotype Enteritidis: Increasing Incidence Of Domestically Acquired Infections, Shua J. Chai, Patricia L. White, Sarah L. Lathrop, Suzanne M. Solghan, Carlota Medus, Beth Mcglinchey, Melissa Tobin-D'Angelo, Ruthanne Marcus, Barbara Mahon

United States Public Health Resources

Background. Salmonella enterica causes an estimated 1 million cases of domestically acquired foodborne illness in humans annually in the United States; Enteritidis (SE) is the most common serotype. Public health authorities, regulatory agencies, food producers, and food processors need accurate information about rates and changes in SE infection to implement and evaluate evidence-based control policies and practices.

Methods. We analyzed the incidence of human SE infection during 1996–2009 in the Foodborne Diseases Active Surveillance Network (FoodNet), an active, population-based surveillance system for laboratory-confirmed infections. We compared FoodNet incidence with passively collected data from complementary surveillance systems and with …

The Structure Of Posttraumatic Psychopathology In Veterans Attending Primary Care, David Forbes, Jon D. Elhai, Emma Lockwood, Mark Creamer, B. Christopher Frueh, Kathryn M. Magruder

United States Public Health Resources

This study attempted to extend research indicating that posttraumatic stress disorder (PTSD) factors of Re-experiencing, Avoidance and Hyperarousal are more related to Fear/phobic disorders, while PTSD Dysphoria is more related to Anxious-Misery disorders. Trauma exposure, PTSD and comorbidity data for 668 veteran patients were analysed using confirmatory factor analyses and relative strengths of the relationships between PTSD factors and the Fear and Anxious-Misery factors were assessed. Combining Simms, Watson, and Doebbeling’s (2002) model of PTSD symptoms and Krueger’s (1999) Fear/Anxious Misery model of mood and anxiety disorders fit the data well. Contrary to previous research, PTSD Reexperiencing, Avoidance and Hyperarousal …

Trends In Total Laryngectomy In The Era Of Organ Preservation: A Population- Based Study, Patrick Tate Maddox, Louise Davies

United States Public Health Resources

Objective. To describe time trends in total laryngectomy health services utilization across the United States, such as rates of surgery, cost, length of stay, and insurance payer, and to compare this to important milestones in recommendations for laryngeal cancer treatment.

Study Design. Population-based cohort study

Setting. Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) 1997-2008: stratified sample of all US hospital discharges.

Subjects and Methods. All patients with the principal procedure of complete laryngectomy. The unit of analysis was the discharge.

Results. Between 1997 and 2008, the number of laryngectomies done in the United States …

Women At War: Understanding How Women Veterans Cope With Combat And Military Sexual Trauma, Kristin M. Mattocks, Sally G. Haskell, Erin E. Krebs, Amy C. Justice, Elizabeth M. Yano, Cynthia Brandt

United States Public Health Resources

The wars in Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF) have engendered a growing population of US female veterans, with women now comprising 15% of active US duty military personnel. Women serving in the military come under direct fire and experience combatrelated injuries and trauma, and are also often subject to in-service sexual assaults and sexual harassment. However, little is known regarding howwomen veterans cope with these combat and military sexual trauma experiences once they return from deployment. To better understand their experiences, we conducted semi-structured interviews with nineteen OEF/OIF women veterans between JanuaryeNovember 2009. Women …

Factors Associated With Screening Or Treatment Initiation Among Male United States Veterans At Risk For Osteoporosis Fracture, Richard E. Nelson, Jonathan R. Nebeker, Brian C. Sauer, Joanne Lafleur

United States Public Health Resources

Male osteoporosis continues to be under-recognized and undertreated in men. An understanding of which factors cue clinicians about osteoporosis risk in men, and which do not, is needed to identify areas for improvement. This study sought to measure the association of a provider's recognition of osteoporosis with patient information constructs that are available at the time of each encounter. Using clinical and administrative data from the Veterans Health Administration system, we used a stepwise procedure to construct prognostic models for a combined outcome of osteoporosis diagnosis, treatment, or a bone mineral density (BMD) test order using time-varying covariates and Cox …

Β2 Adrenergic Receptor Agonists And Steroids Inhibit Cafo Dust-Mediated Bronchial Epithelial Inflammation In Vitro, D. J. Romberger, K. Palm, A. J. Heires, T. M. Nordgren, M. L. Toews, T. A. Wyatt

United States Public Health Resources

Rationale: Agricultural workers employed in concentrated animal feeding operations (CAFOs) are repeatedly exposed to aerosolized dust, and are susceptible to inflammatory lung diseases including COPD. Aqueous extracts of agricultural dust collected from swine CAFOs (HDE) have been shown to be potent inflammatory stimulators in human cells and in vivo mouse models. HDE exposure augments proinflammatory cytokine release, ICAM-1 expression, PKC activation, and lymphocyte and neutrophil adhesion to airway epithelial cells. Because ₂ adrenergic receptor agonists (β-agonists) alone, and in combination with corticosteroids, have been used to treat COPD, we examined the ability of these agents to diminish the inflammatory …

Cytokine Responses In Whole Blood Assay In Veterans With Agriculture Work Exposures, J. D. J. Romberger, J. L. Meza, E.C. Chickris, A. J. Heires, R. M. Zotti-Pierce, T. D. Levan

United States Public Health Resources

RATIONALE: Agriculture exposures are associated with increased risk of chronic obstructive pulmonary disease (COPD). Endotoxin exposure in agricultural environments is associated with lung disease. Our objective was to evaluate responsiveness to endotoxin stimulation in an in vitro whole blood assay and its association with COPD in an agriculturally exposed cohort.

METHODS: Veterans with ≥ two years agricultural work exposure participated in this case-control study. Cases are veterans with COPD defined as FEV1/FVC ratio < 70% on spirometry post-bronchodilator. Controls did not have COPD as assessed by spirometry nor other significant lung conditions. Whole blood assay (WBA) was done with 2 ml heparinized blood mixed with 2 ml of media and stimulated with increasing doses of LPS (0 – 1 ng/ml). Samples were incubated at 37°C for 24 hours, centrifuged, supernatants harvested and frozen until assayed for cytokines by ELISA. Cytokine values were log transformed. Repeated measures ANOVA was used to examine the association between LPS dose and group (case or control) and the interaction of dose with group. All p values were adjusted for age.

RESULTS: There were 272 participants, 110 cases with COPD and 158 controls. Baseline demographics (gender, age, race) were similar between cases and controls. LPS-stimulated …

Scavenger Receptor A Activation Enhances Peptidoglycan-Stimulated Interleukin-8 Release In Bronchial Epithelium, J. P. Berger, K. L. Bailey, J. M. Devasure, D. J. Romberger, T. A. Wyatt

United States Public Health Resources

INTRODUCTION: The immune response to certain pathogens or cellular stressors is initiated and regulated by pattern recognition receptors of the innate immune system. Pattern recognition receptors are effective by utilizing either endocytic (Scavenger Receptors) or signaling receptors (Toll-like Receptors). It has been previously demonstrated that mouse dendritic cells deficient in scavenger receptor A (SRA) negatively regulated the immune response produced by Toll-like receptors when exposed to modified lipid proteins. Previously, we have shown that peptidoglycan contained in organic dust from swine barns stimulates pro-inflammatory cytokine release in bronchial epithelium. We hypothesized bronchial epithelial SRA would also have a regulatory …

Fish Oil And Indomethacin In Combination Potently Reduce Dyslipidemia And Hepatic Steatosis In Ldlr-/- Mice, Ganesan Murali, Ginger L. Milne, Corey Webb, Ann B. Stewart, Ryan P. Mcmillan, Brandon C. Lyle, Matthew W. Hulver, Viswanathan Saraswathi

United States Public Health Resources

Fish oil (FO) is a potent anti-inflammatory and lipid-lowering agent. Because inflammation can modulate lipid metabolism and vice versa, we hypothesized that combining FO with cyclooxygenase inhibitors (COXIBs), well-known anti-inflammatory drugs, can enhance the anti-inflammatory and lipid-lowering effect of FO. LDLR-/- mice were fed a high fat diet supplemented with 6% olive oil or FO for 12 wk in the presence or absence of indomethacin (Indo, 6mg/liter drinking water). FO reduced plasma total cholesterol by 30% but in combination with Indo, exerted a greater decrease (44%). The reduction of liver cholesterol ester (CE) and triglycerides (TG) by FO (63% …

Annual Report To The Nation On The Status Of Cancer, 1975-2008, Featuring Cancers Associated With Excess Weight And Lack Of Sufficient Physical Activity, Christie Eheman, S. Jane Henley, Rachel Ballard-Barbash, Eric J. Jacobs, Maria J. Schymura, Anne-Michelle Noone, Liping Pan, Robert N. Anderson, Janet E. Fulton, Betsy A. Kohler, Ahmedin Jemal, Elizabeth Ward, Marcus Plescia, Lynn A. G. Ries, Brenda K. Edwards

United States Public Health Resources

BACKGROUND: Annual updates on cancer occurrence and trends in the United States are provided through collaboration between the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This year’s report highlights the increased cancer risk associated with excess weight (overweight or obesity) and lack of sufficient physical activity (<150 minutes of physical activity per week).

METHODS: Data on cancer incidence were obtained from the CDC, NCI, and NAACCR; data on cancer deaths were obtained from the CDC’s National Center for Health Statistics. Annual percent changes in …

The Association Between Depression And Anxiety And Use Of Oral Health Services And Tooth Loss, Catherine A. Okoro, Tara W. Strine, Paul I. Eke, Satvinder S. Dhingra, Lina S. Balluz

United States Public Health Resources

Objective: The purpose of this study is to examine the associations among depression, anxiety, use of oral health services, and tooth loss.

Methods: Data were analysed for 80 486 noninstitutionalized adults in 16 states who participated in the 2008 Behavioral Risk Factor Surveillance System. Binomial and multinomial logistic regression analyses were used to estimate predicted marginals, adjusted prevalence ratios, adjusted odds ratios (AOR) and their 95% confidence intervals (CI).

Results: The unadjusted prevalence for use of oral health services in the past year was 73.1% [standard error (SE), 0.3%]. The unadjusted prevalence by level of tooth loss …

Business And Wealth Transfer In Nonmetropolitan Nebraska 2012 Nebraska Rural Poll Results, Rebecca J. Vogt, Cheryl A. Burkhart-Kriesel, Randolph L. Cantrell, Bradley Lubben, Odee Ingersoll, Shawn Kaskie

Rural Futures Institute: Publications

Includes

Executive Summary

Introduction

Businesses in the Community

Expected Number of Businesses in Local Community Five Years from Now by Community Size

Most Likely Outcome when Business Owner Leaves or Retires in Community

Business Exits and Transitions

Concern with Business Exits

Concern that Business Closings will Affect Ability to Get Needed Things by Occupation

Views of Community Strategies for Business Exits

Community Well-Being In Nonmetropolitan Nebraska 2012 Nebraska Rural Poll Results, Rebecca J. Vogt, Cheryl A. Burkhart-Kriesel, Randolph L. Cantrell, Bradley Lubben

Rural Futures Institute: Publications

Includes

Executive Summary

Trends in Community Ratings, 1996-2012

Community Change, 1996-2012

Expected Destination of Those Planning to Move: 1998-2012

Proportions of Respondents Very or Somewhat Satisfied with Each Service, 1997-2012

The Community and Its Attributes in 2012

Perceptions of Community Change by Community Size

Expected Community Change in Ten Years by Community Size

Satisfaction with Cellular Phone Service by Community Size

Difficulty or Ease of Leaving Community

Ease or Difficulty of Leaving Community by Length of Residence in Community

Feelings of Community Powerlessness by Community Size

Local Community Involvement Activities, 2002 and 2012

Distance from Goods and Services

Distance from …

Measuring Discrimination In South Korea: Underestimating The Prevalence Of Discriminatory Experiences Among Female And Less Educated Workers?., Seung-Sup Kim, Yeonseung Chung, David R. Williams

Environmental and Occupational Health Faculty Publications

Objectives

To investigate the possibility that Koreans show different patterns in reporting discriminatory experiences based on their gender and education level, we analyzed the participants who answered “Not Applicable” for the questions of discriminatory experiences that they were eligible to answer.

Methods

Discriminatory experiences in eight social situations were assessed using the 7th wave of Korean Labor and Income Panel Study. After restricting the study population to waged workers, a logistic regression model was constructed to predict the probability that an individual has experienced discrimination based on the observed covariates for each of eight situations, using the data of participants …

Hemicrania Continua Headache In A Veteran With Post Traumatic Stress Disorder And Major Depressive Disorder Without Traumatic Brain Injury, Brandon A. Kohrt, Erica Duncan

Psychiatry and Behavioral Sciences Faculty Publications

Hemicrania continua is a headache characterized by chronic unremitting unilateral pain associated with ipsilateral autonomic findings. This type of headache responds to high-flow oxygen and indomethacin. This case report describes a male veteran with posttraumatic stress disorder (PTSD) and major depressive disorder who suffers from comorbid hemicrania continua. The psychiatric symptoms were recalcitrant to psychopharmacological intervention. However, when the patient's hemicrania continua was treated appropriately, the patient's psychiatric symptoms also abated. This case demonstrates the need to address physical comorbidities that may exacerbate psychiatric disorders, such as PTSD.

Vascular Inflammatory Cells In Hypertension., David G Harrison, Paul J. Marvar, Jens M Titze

Pharmacology and Physiology Faculty Publications

Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients, and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. …

Physician Wages In States With Expanded Aprn Scope Of Practice, Patricia Pittman, Benjamin Williams

Health Policy and Management Faculty Publications

In recent years, states have looked to reforms in advanced practice nursing scope of practice (SOP) barriers as a potential means to increase access to primary care while reducing costs. Currently, 16 states and the District of Columbia permit advanced practice registered nurses to practice independently of physicians, allowing them to perform functions such as diagnosing and prescribing under their own authority within the primary care setting. Given the resistance of many physician associations to these reforms, we asked whether the economic interests of primary care physicians might be affected by reforms. Using the Bureau of Labor Statistics data on …

Enhancing Cultural Awareness: Building Relationships Between Non Native American Nurses And Native American Lakota Patients, Sharon Mercill

Theses and Graduate Projects

Enhancing Cultural Awareness: Building Relationships Between Non Native American Nurses and Native American Lakota PatientsCulture impacts the perceptions and responses to health and wellness and acceptance of nursing care. Learning how to build strong relationship bridges with the Native American Lakota patient is important so that a professional nurse can respond appropriately and sufficiently while delivering holistic nursing care. Patients will experience better health if a successful nurse-client relationship is built between them that will allow for all the patient"s needs to be fully considered promoting a true partnership. Jean Watson's caring science nursing framework of caring and healing relationships …

Partnering Associate Degree Nursing Students And Community Health Worker Students In A Collaborative, Culturally Focused, Interprofessional Learning Experience, Jane E. Johnson

Theses and Graduate Projects

The purpose of this project is to provide nursing students in the final semester of their associate degree nursing program and community health worker students with a culturally focused, interactive, collaborative, interprofessional learning experience. Health care reform addresses health disparities in an increasingly diverse population with complex chronic health needs. The needs of this diverse population require health professionals to function as members of interprofessional teams providing culturally competent care. Published professional literature supports interprofessional education for students entering the health care field to prepare them to practice as members of interprofessional teams. Government studies and professional accrediting bodies overseeing …

Bridging The Gap: Nurse Mentorship Program, Jacqueline J. Johnson

Theses and Graduate Projects

High-quality, effective mentorship can be a crucial and valuable tool in recruiting, retaining, and supporting nurses' success, especially novice registered nurses. In the current healthcare environment, growth and development of nursing staff is essential to maintain quality outcomes. Mentorship programs can create a unique environment that facilitates educational opportunities for both the novice and expert registered nurse. Nursing leaders and organizations can make lasting impacts through mentoring relationships. Through effective mentorship, nurses can positively impact healthcare organization, improve job satisfaction, promote professional development, and empower themselves. Even more important is that mentoring can result in improved nursing care, high-quality healthcare, …

Creating A Culture Of Caring In The Perianesthesia Practice, Tammy S. Bergan

Theses and Graduate Projects

Caring has been described as the essence of nursing. What nurses do as they care for patients and others is multi-dimensional, complex, and essential. Nursing's ability to clearly define and articulate what caring is guides the ethics, values, decisions, and foundations of nursing practice. Caring evokes a range of perceptions, feelings, and experiences for the patient and nurse in the perianesthesia specialty setting. Caring as a pillar of the nursing profession is explored on several levels for the perianesthesia setting. Aspects of caring include perceptions of caring, what denotes a caring environment, the role of nursing leadership in a caring …

Developing A Nursing Based Support Group For Incarcerated Women Survivors Of Childhood Sexual Assault: Pathways For Healing, Paula Johns

Theses and Graduate Projects

Every year large numbers of women are incarcerated in jail, prisons or other correctional jurisdictions in America. Research has shown that more than half of these women report a history of sexual abuse as a child, many who have rarely told their story. Typical coping mechanisms for those who have been traumatized sexually are attempts to commit suicide, the use and abuse of drugs and alcohol, running away, disassociation, becoming promiscuous, or eating disorders, etc. These early adaptations at a young age can influence nearly every parameter of their lives, contributing to numerous other negative consequences, such as increased physical …

The Patient Protection And Affordable Care Act And Medicaid Expansion: Leadership Strategies For Effective Change Management In Managed Care Organizations, Emily Aurand

Theses and Graduate Projects

As a result of tlie 2010 Patient Protection and Affordable Care Act (ACA), eligibility requirements for the Medicaid program were revised resulting in a greater number of people eligible to enroll in tlie government healthcare program. These circumstances require numerous organizational changes for Medicaid managed care organizations (MCOs) that administer the Medicaid program in order to accommodate the healthcare needs of the growing Medicaid population and comply with applicable regulatory requirements. This case study sought to identify effective leadership strategies employed by Minnesota Medicaid MCO change leaders guiding organizational change processes and seeking quality change outcomes, resulting from the externally …

Type 2 Diabetes And Insomnia: Impact On Metabolic Control, Cheryl Lee Tannas

Wayne State University Dissertations

Diabetes is one of the most serious health challenges in the United States, affecting nearly 21 million Americans. The goal of diabetes management is to maintain the blood glucose close to normal to prevent diabetic complications and therefore extending life expectancy and improving quality of life. Research now indicates a relationship of the quantity and quality of sleep to glycemic control in type 2 diabetics. No research on the impact of insomnia on diabetes prevention and/or management was found in the literature. The purpose of this 11 week intervention study was to examine the effects of participation in Cognitive Behavioral …

Managing Soft Tissue Sarcomas In A Developing Country: Are Prognostic Factors Similar To Those Of Developed World?, Irfan Qadir, Masood Umer, Hafiz Muhammad Umer, Nasir Uddin, Farrok Karson, Muhammad Sharoz Rabbani

Section of Orthopaedic Surgery

Background: Managing soft tissue sarcomas (STS) in a developing country with limited financial resources and a poor health referral system is a challenge. Presenting late, these extremity STS are prone to recurrence despite apparently complete resection. This study aimed to explore and compare the impact of clinico-pathological factors on recurrence and survival in Pakistan with the corresponding figures quoted from the developed world.
Methods: An institutional review was performed on all patients with primary STS of the extremities operated on between 1994 and 2008. The prognostic influence of clinical, pathologic, and treatment variables on local recurrence free survival (LRFS), metastasis …

Skeletal Manifestations Of Scurvy: A Case Report From Dubai, Shahryar Noordin, Naveed Baloch, Muhammad Sohail Salat, Abdul Rashid Memon, Tashfeen Ahmad

Section of Orthopaedic Surgery

Introduction: Nutritional deficiencies are rarely reported in developed countries. We report a child of Pakistani origin brought up in Dubai who developed skeletal manifestations of scurvy due to peculiar dietary habits.
Case Presentation: A 4.5 year old boy presented with pain and swelling of multiple joints for three months and inability to walk for two months. Dietary history was significant for exclusive meat intake for the preceding two years. On examination the child's height and weight were below the 5th percentile for his age. He was pale and tachycardic. There was significant swelling and tenderness over the wrist, knee and …

Duhamel's Procedure For Adult Hirschsprung's Disease, Mehreen Adhi, Salma Khan, Hasnain Zafar, Muhammad Arshad

Section of General Surgery

An adult presented with chronic constipation and abdominal mass. Clinical features, abdominal radiographs and barium enema revealed features consistent with Hirschsprung's disease. Full-thickness rectal biopsy was planned, but patient was lost to follow-up and presented 3 years later with intestinal obstruction. Exploratory laparotomy with resection of affected sigmoid colon and end colostomy were performed. Sequential rectal biopsies were obtained during the procedure to confirm the diagnosis. Later, Duhamel's procedure with a diverting loop ileostomy was successfully performed. Ileostomy reversal was done thereafter. There was complete resolution of symptoms and dramatic improvement in bowel function.

Rapidly Progressive Periodontal Disease Associated With Human Immunodeficiency Virus, Khalid Al Hezaimi, Fawad Javed, Tazeen S. Ali, Mansour Al Askar, Abdulaziz Al Rasheed

School of Nursing & Midwifery

Severe periodontal inflammation with generalized dental plaque accumulation, spontaneous and severe gingival bleeding, fungal infection, and interdental papillae necrosis are presented in a patient infected with human immunodeficiency virus (HIV). Bite-wing radiographs revealed a generalized horizontal alveolar bone loss of 7-8 millimetres in both arches. Erythematous patches were noted on the gingival mucosa in both jaws. DNA testing was performed to indentify the periodontopathogens. The patient had no signs or symptoms of acquired immunodeficiency syndrome. This case-report presents the massive periodontal destruction that occurred in a patient infected with HIV. Therefore, it is highly recommended that patients infected with HIV …

Domestic Violence Against Infertile Women In Karachi, Pakistan, Neelofar Sami, Tazeen S. Ali

School of Nursing & Midwifery

This study investigates the prevalence of physical and psychological violence against infertile women in Karachi, Pakistan. A total of 400 infertile women attending the selected infertility clinics in Karachi, Pakistan were interviewed using the to investigate their experiences of physical and psychological violence. Out of 400 infertile women, 278 (64%) reported to be the victims of violence during the last 12 months before they were interviewed. Nearly one quarter (23.1%) reported facing physical violence. All women reported their husbands and their family members to be the perpetrators. It is concluded that Clinicians should identify the abused women and provide them …