Medicine and Health Sciences Commons^™

One-Year Evaluation Of The Impact Of An Emergency Obstetric And Neonatal Care Training Program In Western Kenya, Rachel F. Spitzer, Sarah Jane Steele, David Caloia, Julie Thorne, Alan D. Bocking, Astrid Christoffersen-Deb, Aaron Yarmoshuk, Loise Maina, Johanna Sitters, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Objective: To determine the impact of introducing an emergency obstetric and neonatal care training program on maternal and perinatal morbidity and mortality at Moi Teaching and Referral Hospital, Eldoret, Kenya.

Methods: A prospective chart review was conducted of all deliveries during the 3-month period (November 2009 to January 2010) before the introduction of the Advances in Labor and Risk Management International Program (AIP), and in the 3-month period (August–November 2011) 1 year after the introduction of the AIP. All women who were admitted and delivered after 28 weeks of pregnancy were included. The primary outcome was the direct obstetric case …

Ido2 In Immunomodulation And Autoimmune Disease., George C Prendergast, Richard Metz, Alexander J Muller, Lauren M F Merlo, Laura Mandik-Nayak

Department of Microbiology and Immunology Faculty Papers

IDO2 is a relative of IDO1 implicated in tryptophan catabolism and immune modulation but its specific contributions to normal physiology and pathophysiology are not known. Evolutionary genetic studies suggest that IDO2 has a unique function ancestral to IDO1. In mice, IDO2 gene deletion does not appreciably affect embryonic development or hematopoiesis, but it leads to defects in allergic or autoimmune responses and in the ability of IDO1 to influence the generation of T regulatory cells. Gene expression studies indicate that IDO2 is a basally and more narrowly expressed gene than IDO1 and that IDO2 is uniquely regulated by AhR, which …

Use Of Social Media In Dental Schools: Pluses, Perils, And Pitfalls From A Legal Perspective, Joseph W. Parkinson, Sharon P. Turner

Oral Health Practice Faculty Publications

One of the ways dental education is changing the way it is preparing the next generation of learners is through efficient utilization of interactive social media. Social media, which facilitates interaction and sharing of new ideas, is being utilized to educate students, residents, and faculty. Unfortunately, as with most improvements in technology, there are growing pains. Faculty, student, and patient interaction on social media platforms, such as Facebook and Twitter, can lead to inappropriate or embarrassing situations. Striking the appropriate balance between free speech rights of students and faculty and the need for colleges and universities to have efficient operations …

Parental Factors That Influence Swimming In Children And Adolescents, Jennifer Pharr, Carol C. Irwin, Richard L. Irwin

Environmental & Global Health Faculty Research

Swimming can be an important source of physical activity across the life-span. Researchers have found that parents influence physical activity behaviors of their children. The purpose of this study was to determine what parental factors influenced the number of days that children swam. Survey respondents (n = 1,909) from six cities across the United States were surveyed at local YMCAs. Children were found to swim significantly more if their parents encouraged them to swim, members of the family knew how to swim and swam with them, or their parents were not afraid of the children drowning or afraid of …

Oncolog, Volume 59, Number 11-12, November-December 2014, Bryan Tutt, Sunita Patterson, S. Moreau

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Striving to Improve Treatments for Uveal Melanoma: Although primary uveal melanoma can be effectively treated with radiation or surgery, patients with metastatic disease-or those at high risk for metastases-have few proven options. But specialists in medical oncology, radiation oncology, ophthalmology, surgery, and traditional research are working to improve those options
• Beyond Diabetes: Metformin May Have Broad Utility in Cancer: Metformin, an inexpensive drug that has been prescribed for diabetes for decades, may also be useful in preventing or treating several types of cancer
• HOUSE CALL: Smoking Cessation-Medications help smokers quit
• INBRIEF: Vaccine Explored to Reduce Risk of HER2-Positive Breast Cancer …

Interventions Combining Motivational Interviewing And Cognitive Behavior To Promote Medication Adherence: A Literature Review, Sandra L. Spoelstra, Monica Schueller, Melissa Hilton, Kimberly Ridenour

Peer Reviewed Articles

Aims and objectives: The World Health Organization has indicated medication adherence is a global problem. Both motivational interviewing (MI) and cognitive behavioral therapy (CBT) interventions alone have been found to be effective at improving medication adherence. This article summarizes research that has combined motivational interviewing and cognitive behavioral therapy to improve medication adherence.

Background: Projections indicate that by 2015, 33% of cancer treatment will be in pill form, shifting responsibility for managing medication adherence to patients. These regimens are often complex, with multiple doses, drugs, or cycling, and patients often experience side effects from symptoms, making adherence difficult. Patients taking …

Hypoxic Stress Induces, But Cannot Sustain Trophoblast Stem Cell Differentiation To Labyrinthine Placenta Due To Mitochondrial Insufficiency, Yufen Xie, Sichang Zhou, Zhongliang Jiang, Jing Dai, Elizabeth E. Puscheck, Icksoo Lee, Graham Parker, Maik Hüttemann, Daniel A. Rappolee

Department of Obstetrics and Gynecology Research Publications

Dysfunctional stem cell differentiation into placental lineages is associated with gestational diseases. Of the differentiated lineages available to trophoblast stem cells (TSC), elevated O2 and mitochondrial function are necessary to placental lineages at the maternal–placental surface and important in the etiology of preeclampsia. TSC lineage imbalance leads to embryonic failure during uterine implantation. Stress at implantation exacerbates stem cell depletion by decreasing proliferation and increasing differentiation. In an implantation site O2 is normally ~ 2%. In culture, exposure to 2% O2 and fibroblast growth factor 4 (FGF4) enabled the highest mouse TSC multipotency and proliferation. In contrast, hypoxic stress (0.5% …

Quality Of Cancer Registry Data, Alicia Noel Richardson

Applied Research Projects

Cancer registry is a growing field and with data being collected year round the data needs to be of good quality standing. Quality of cancer care is measurable per standards when met within the time frame allotted per care regimen. Cancer programs are evaluating and implementing new process to make their data valid and complete through information technology and connection among hospital-based and community-based practices. The aim of this study is to review the available validity, barriers and utilization related to quality of cancer care data. The studies were consistent among each other in that a concurrent review of data, …

Department Of Surgery Update, November/December 2014, Wright State University Department Of Surgery

Department of Surgery Updates

A four page newsletter created by the Department of Surgery documenting changes to the department. This issue for November and December of 2014 contains a message from the chair, pictures from the ACS Alumni Reception, a list of important dates, committee meetings, a list of presentations and more.

Effect Of Silver-Alloy Urinary Catheters In Reducing The Rate Of Cauti’S In Patients Requiring Short-Term Catheterization: A Review Of The Literature, Courtney Mckee, Devon Williams

Nursing Student Work

No abstract provided.

Standardized Report Format: A Review Of The Literature, Madeline Kutzy, Kathleen Fitzgerald

Nursing Student Work

No abstract provided.

Prevention Of Central Venous Catheter-Associated Blood Stream Infections In Pediatric Patients: A Review Of The Literature, Shanna Giedl, Brittany Cain

Nursing Student Work

No abstract provided.

Effect Of Incentive Spirometry On Preventing Atelectasis: A Review Of The Literature, Caitlin Powers, Caine Teal

Nursing Student Work

No abstract provided.

Respecting Our Elders: Say No To Restraints!, Charity G. Schenk, Stephanie J. Williams

Nursing Student Work

No abstract provided.

When Should Nurses Use Restraints Versus Alternatives To Restraints?, Rosa Garza Moore, Motunrayo Ogunkua

Nursing Student Work

No abstract provided.

Flushing Out The Competition: Normal Saline Vs Heparin Flushes In Peripheral Iv Catheters, Sarah Albrecht, Sarah Williams

Nursing Student Work

No abstract provided.

"It's Just A Way Of Fitting In:" Tobacco Use And The Lived Experience Of Lesbian, Gay, And Bisexual Appalachians, Keisa Bennett, Janelle M. Ricks, Britteny M. Howell

Family and Community Medicine Faculty Publications

Lesbian, gay, and bisexual (LGB) people are affected by multiple health disparities and risk factors, including tobacco use. Few studies to date have examined tobacco use specifically in rural LGB populations, and none has investigated the intersections of identity, rural LGB culture, and tobacco. The purpose of this study was to explore the perspective of Appalachian LGB people regarding tobacco use.

METHODS: Nineteen LGB-identified Appalachian residents participated in audiotaped, semi-structured interviews. Two authors analyzed and coded transcripts through constant comparison, and determined themes through consensus.

RESULTS: Five themes emerged: the convergence of Appalachian and LGB identities, tacit awareness …

The Mini-Mental State Examination As A Diagnostic And Screening Test For Delirium: Systematic Review And Meta-Analysis, Alex J. Mitchell, Deepak Shukla, Hafsa A. Ajumal, Brendon Stubbs, Tayyeb Tahir

Brain and Mind Institute

Objective

To analyse the evidence concerning the accuracy of the Mini-Mental State Examination (MMSE) as a diagnostic and screening test for the presence of delirium in adults.

Method

Two authors searched MEDLINE, PsychINFO and EMBASE from inception till March 2014. Articles were included that investigated the diagnostic validity of the MMSE to detect delirium against standardised criteria. A diagnostic validity meta-analysis was conducted.

Results

Thirteen studies were included representing 2017 patients in medical settings of whom 29.4% had delirium. The meta-analysis revealed the MMSE had an overall sensitivity and specificity estimate of 84.1% and 73.0%, but this was 81.1% and …

Timing Of Goals Scored In Selected European And South American Football Leagues, Fifa And Uefa Tournaments And The Critical Phases Of A Match, Wycliffe W. Njororai Simiyu

Health & Kinesiology Faculty Publications and Presentations

The purpose of this study was to analyze the timing of goals scored in various soccer leagues around Europe and South America, as well as Federation of International Football Associations’ (FIFA) World Cup, Confederation Cup, Union of European Football Associations’ (UEFA) Champions League and EURO 2012 matches to derive the latest trends with the hope of improving team preparation for matches and game management by coaches. The study derived data from http://www.soccerstats.com and www.fifa.com data bases. The analysis centered on the big five European leagues including England’s Barclays Premier League, Spain’s la liga, Germany’s Bundesliga, Italy’s Serie A, France’s lique …

Low Vision Depression Prevention Trial In Age-Related Macular Degeneration: A Randomized Clinical Trial., Barry W. Rovner, Robin J Casten, Mark T Hegel, Robert W Massof, Benjamin E Leiby, Allen C Ho, William S Tasman

Department of Psychiatry and Human Behavior Faculty Papers

PURPOSE: To compare the efficacy of behavior activation (BA) + low vision rehabilitation (LVR) with supportive therapy (ST) + LVR to prevent depressive disorders in patients with age-related macular degeneration (AMD).

DESIGN: Single-masked, attention-controlled, randomized, clinical trial with outcome assessment at 4 months.

PARTICIPANTS: Patients with AMD and subsyndromal depressive symptoms attending retina practices (n = 188).

INTERVENTIONS: Before randomization, all subjects had 2 outpatient LVR visits, and were then randomized to in-home BA+LVR or ST+LVR. Behavior activation is a structured behavioral treatment that aims to increase adaptive behaviors and achieve valued goals. Supportive therapy is a nondirective, psychological treatment …

Symptom Burden And Healthcare Utilization In Pulmonary Arterial Hypertension, Catherina Anne Madani Phd

Dissertations

Background: Pulmonary arterial hypertension (PAH) is a rapidly progressive disease. There is currently no cure; thus treatment is aimed at prolonging survival, improving functional status (FS), and symptom mitigation. Symptom burden (SB) can impact quality of life (QOL), and lead to increased healthcare utilization. Palliative care (PC) has been associated with higher QOL, decreased depression, aggressive care, and mortality. The Institute of Medicine's (IOM) recent report supports earlier integration of PC for people living with serious illness. Detection of patients at high risk for heavy SB may help to identify patients who could benefit from earlier integration of PC into …

Patients With Advanced Lung Cancer: Quality Of Life And Perception Of Dyspnea, Barbara A. Roces Phd, Msn, Np, Rn

Dissertations

Background: Dyspnea perception can be defined as a multidimensional experience of breathing discomfort, influenced by physiological, psychological, social, and environmental factors, that includes secondary psychological and behavioral responses and cannot be defined only by physical objective abnormalities (Mularski et al., 2010). Dyspnea is the most common and distressing symptom in patients with advanced lung cancer and decreases one's quality of life (QOL) (Smith et al., 2001). Furthermore, dyspnea has been found to interfere with physical activities such as walking, work, and psychological activities such as disposition, taking pleasure in life, relationship with others, and sleep (Tanaka, Akechi, Okuyama, Nishiwaki, & …

Patient Care Technology And The Nurse-Patient Relationship, Belinda M. Toole Phd, Msn, Rn

Dissertations

Background: Technological devices are increasingly used in healthcare and their proliferation has providers questioning the impact on the patient-provider relationship. Technological device integration has been studied in the primary care setting, less extensively in the acute care setting. The impact of device use on the nurse-patient relationship in acute care setting required further study, particularly with nursing's history of holistic practice incorporating caring and presence. Objectives: The study purpose was to explore the patient's perceptions of nurse caring and presence when technological devices were used in care delivery in the acute care setting. Specific aims were: 1) to describe the …

Setting Thresholds To Varying Blood Pressure Monitoring Intervals Differentially Affects Risk Estimates Associated With White-Coat And Masked Hypertension In The Population, Kei Asayama, Yan Li, Yu-Mei Gu, Azusa Hara, Yan-Ping Liu, Zhenyu Zhang, Fang-Fei Wei, Inés Lujambio, Luis J. Mena, Gladys E. Maestre

School of Medicine Publications

Outcome-driven recommendations about time intervals during which ambulatory blood pressure should be measured to diagnose white-coat or masked hypertension are lacking. We cross-classified 8237 untreated participants (mean age, 50.7 years; 48.4% women) enrolled in 12 population studies, using ≥140/≥90, ≥130/≥80, ≥135/≥85, and ≥120/≥70 mm Hg as hypertension thresholds for conventional, 24-hour, daytime, and nighttime blood pressure. White-coat hypertension was hypertension on conventional measurement with ambulatory normotension, the opposite condition being masked hypertension. Intervals used for classification of participants were daytime, nighttime, and 24 hours, first considered separately, and next combined as 24 hours plus daytime or plus nighttime, or plus …

Oligonucleotide Ligation Assay Detects Hiv Drug Resistance Associated With Virologic Failure Among Antiretroviral-Naive Adults In Kenya, Michael Chung, Ingrid A. Beck, Sandra Dross, Kenneth Tapia, James N. Kiarie, Barbra A. Richardson, Julie Overbaugh, Samah R. Sakr, Grace C. John-Stewart, Lisa M. Frenkel

Internal Medicine, East Africa

Background: Transmitted drug resistance (TDR) is increasing in some areas of Africa. Detection of TDR may predict virologic failure of first-line non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART). We evaluated the utility of a relatively inexpensive oligonucleotide ligation assay (OLA) to detect clinically relevant TDR at time of ART initiation.

Methods: Pre-ART plasmas from ART-naive Kenyans initiating an NNRTI-based fixed-dose combination ART in a randomized adherence trial conducted in 2006 were retrospectively analyzed by OLA for mutations conferring resistance to NNRTI (K103N, Y181C, and G190A) and lamivudine (M184V). Post-ART plasmas were analyzed for virologic failure (≥1,000 copies/mL) at 6 month …

The Significance Of Functional Renal Obstruction In Predicting Pathologic Stage Of Upper Tract Urothelial Carcinoma., Michael J. Amirian, Kushan Radadia, Hadley Narins, Kelly A. Healy, Scott G. Hubosky, Demetrius H. Bagley, Edouard J. Trabulsi, Costas D. Lallas

Department of Urology Faculty Papers

BACKGROUND AND PURPOSE: Assessing the severity of upper tract urothelial carcinoma (UTUC) has been difficult because of inadequate biopsy specimens. Additional predictive parameters of disease stage would be useful when deciding a treatment plan; it has been suggested that preoperative hydronephrosis can be a surrogate. We examined the relationship between preoperative ipsilateral renal obstruction identified by imaging with final pathologic stage after nephroureterectomy (NU) for UTUC. We then analyzed those patients with ipsilateral renal obstruction and examined if tumor location is associated with an advanced pathologic stage.

METHODS: Patients who underwent NU for UTUC between the years 2001 to 2013 …

Adult Neurogenesis In The Four-Striped Mice (Rhabdomys Pumilio), Olatunbosun O. Olaleye, Amadi O. Ihunwo

Brain and Mind Institute

In this study, we investigated non-captive four-striped mice (Rhabdomys pumilio) for evidence that adult neurogenesis occurs in the adult brain of animal models in natural environment. Ki-67 (a marker for cell proliferation) and doublecortin (a marker for immature neurons) immunostaining confirmed that adult neurogenesis occurs in the active sites of subventricular zone of the lateral ventricle with the migratory stream to the olfactory bulb, and the subgranular zone of the dentate gyrus of the hippocampus. No Ki-67 proliferating cells were observed in the striatum substantia nigra, amygdala, cerebral cortex or dorsal vagal complex. Doublecortin-immunoreactive cells were observed in …

Genome-Wide Association Study Of Saturated, Mono- And Polyunsaturated Red Blood Cell Fatty Acids In The Framingham Heart Offspring Study, Nathan L. Tintle, James V. Pottala, Sean Lacey, Vasan Ramachandran, Jason Westra, Ally Rogers, Jake Clark, Ben Olthoff, Martin Larson, William Harris, Gregory C. Shearer

Faculty Work Comprehensive List

Most genome-wide association studies have explored relationships between genetic variants and plasma phospholipid fatty acid proportions, but few have examined apparent genetic influences on the membrane fatty acid profile of red blood cells (RBC). Using RBC fatty acid data from the Framingham Offspring Study, we analyzed over 2.5 million single nucleotide polymorphisms (SNPs) for association with 14 RBC fatty acids identifying 191 different SNPs associated with at least 1 fatty acid. Significant associations (p<1×10⁻⁸) were located within five distinct 1 MB regions. Of particular interest were novel associations between (1) arachidonic acid and PCOLCE2 (regulates apoA-I maturation …

The Incentive Amplifying Effects Of Nicotine Are Reduced By Selective And Non-Selective Dopamine Antagonists In Rats, Matthew I. Palmatier, Marissa R. Kellicut, A. Brianna Sheppard, Russell W. Brown, Donita L. Robinson

ETSU Faculty Works

Nicotine is a psychomotor stimulant with ‘reinforcement enhancing’ effects — the actions of nicotine in the brain increase responding for non-nicotine rewards. We hypothesized that this latter effect of nicotine depends on increased incentive properties of anticipatory cues; consistent with this hypothesis, multiple laboratories have reported that nicotine increases sign tracking, i.e. approach to a conditioned stimulus (CS), in Pavlovian conditioned-approach tasks. Incentive motivation and sign tracking are mediated by mesolimbic dopamine (DA) transmission and nicotine facilitates mesolimbic DA release. Therefore, we hypothesized that the incentive-promoting effects of nicotine would be impaired by DA antagonists. To test this hypothesis, separate …

Provider Cost Analysis Supports Results-Based Contracting Out Of Maternal And Newborn Health Services: An Evidence-Based Policy Perspective, Peter Hatcher, Shiraz Shaikh, Hassan Fazli, Shehla Zaidi, Atif Riaz

Community Health Sciences

Background

There is dearth of evidence on provider cost of contracted out services particularly for Maternal and Newborn Health (MNH). The evidence base is weak for policy makers to estimate resources required for scaling up contracting. This paper ascertains provider unit costs and expenditure distribution at contracted out government primary health centers to inform the development of optimal resource envelopes for contracting out MNH services.

Methods

This is a case study of provider costs of MNH services at two government Rural Health Centers (RHCs) contracted out to a non-governmental organization in Pakistan. It reports on four selected Basic Emergency Obstetrical …