Medicine and Health Sciences Commons^™

Revealing The Phytochemical Profile And Antioxidant Potential Of A Medicinal Folklore: Bombax Ceiba L., Syeda Saniya Zahra Miss., Hafiz Tahsin Ullah Jan, Adila Nazli, Syeda Tayyaba Batool Kazmi, Humaira Fatima Miss.

Journal of Bioresource Management

Current study intends to investigate the extraction yield, phytochemical analysis and antioxidant potential of selected plant by executing a wide range of in vitro assays. This was done to suggest the most proficient solvent system and plant part for isolation and purification of probable bioactive leads. The colorimetric estimation of total phenolic, flavonoid contents, total antioxidant capacity, total reducing power and free radical scavenging activity was done. The specific polyphenols were quantified by RP-HPLC analysis. The present findings proved acetone and methanol (AC:M) extract of root bark part as an enriched source of antioxidant phytochemicals. The highest amount of rutin …

Typical Graves' Ophthalmopathy In Primary Hypothyroidism, Zareen Kiran, Owais Rashid, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Graves ophthalmopathy (GO) usually occurs in a close temporal relationship with hyperthyroidism. It is rare in patients with normal thyroid function (euthyroid GO) and in patients with hypothyroid forms of thyroid autoimmune diseases (hypothyroid GO). We report a 52-years old man presenting in our endocrine clinic with diagnosed primary hypothyroidism 3 months back during evaluation for glaucoma. He was later referred by an ophthalmologist to exclude Grave's eye disease, where he had presented with chief complaints of bilateral prominent eyes. On examination there was only bilateral exophthalmos with marked chemosis. Magnetic resonance imaging (MRI) of the orbits showed typical findings …

Mental Illness Stigma, Socially Acceptable Treatment, And Barriers To Health, Frances Renee Gellert

Independent Study Project (ISP) Collection

This paper discusses the topic of mental illness stigma and treatment in Uganda as explored through internship in the Social Work Department at Butabika National Referral Mental Hospital. The objectives of this project were to complete a meaningful internship while exploring causes of mental illness in Uganda, contradictions between traditional and modern approaches to treatment, and the affect of stigma on mental well-being. The internship included a total of 120 hours at Butabika Hospital. Individual research using documentary and literature review methods accompanied the internship. Butabika Hospital did not consent to the completion of formal research at, so any conclusions …

Adjuvant Radiation Therapy, Androgen Deprivation, And Docetaxel For High-Risk Prostate Cancer Postprostatectomy: Results Of Nrg Oncology/Rtog Study 0621., Mark D. Hurwitz, Jonathan Harris, Oliver Sartor, Ying Xiao, Bobby Shayegan, Paul W. Sperduto, Kasra R. Badiozamani, Colleen A.F. Lawton, Eric M. Horwitz, Jeff M. Michalski, Kevin Roof, David C. Beyer, Qiang Zhang, Howard M. Sandler

Department of Radiation Oncology Faculty Papers

BACKGROUND: Phase 3 trials have demonstrated a benefit from adjuvant radiation therapy (ART) for men who have adverse factors at radical prostatectomy (RP). However, some patients have a high risk of progression despite ART. The role of systemic therapy with ART in this high-risk group remains to be defined.

METHODS: Patients who had either a post-RP prostate-specific antigen (PSA) nadir > 0.2 ng/mL and a Gleason score ≥7 or a PSA nadir ≤0.2 ng/mL, a Gleason score ≥8, and a pathologic tumor (pT) classification ≥ pT3 received 6 months of androgen-deprivation therapy (ADT) plus radiotherapy and 6 cycles of docetaxel. The …

Initial Construct Validity Evidence Of A Virtual Human Application For Competency Assessment In Breaking Bad News To A Cancer Patient, Timothy C. Guettermann, Frederick W. Kron, Toby C. Campbell, Mark W. Scerbo, Amy B. Zelenski, James F. Cleary, Michael D. Fetters

Psychology Faculty Publications

Background: Despite interest in using virtual humans (VHs) for assessing health care communication, evidence of validity is limited. We evaluated the validity of a VH application, MPathic-VR, for assessing performance-based competence in breaking bad news (BBN) to a VH patient.

Methods: We used a two-group quasi-experimental design, with residents participating in a 3-hour seminar on BBN. Group A (n=15) completed the VH simulation before and after the seminar, and Group B (n=12) completed the VH simulation only after the BBN seminar to avoid the possibility that testing alone affected performance. Pre-and postseminar differences for Group A were analyzed with a …

Term Neonate With Atypical Hypoxic-Ischemic Encephalopathy Presentation: A Case Report., Nick Townley, Emily Mcnellis, Venkatesh Sampath

Manuscripts, Articles, Book Chapters and Other Papers

We describe a case of atypical hypoxic-ischemic encephalopathy (HIE) in a neonate following a normal pregnancy and delivery who was found to have an umbilical vein thrombosis. The infant arrived to our center with continuous bicycling movement of her lower extremities. She had a continuous electroencephalogram that showed burst suppression and magnetic resonance imaging of the brain showed diffusely abnormal cerebral cortical/subcortical diffusion restriction which may be secondary hypoxic-ischemic injury. Interestingly, a pathology report noted a focal umbilical vein thrombosis appearing to have compressed an umbilical artery with associated arterial dissection and hematoma. Our case illustrates how umbilical venous or …

Functional Selectivity Of Gpcr-Directed Drug Action Through Location Bias., Roshanak Irannejad, Veronica Pessino, Delphine Mika, Bo Huang, Philip B. Wedegaertner, Marco Conti, Mark Von Zastrow

Department of Biochemistry and Molecular Biology Faculty Papers

G-protein-coupled receptors (GPCRs) are increasingly recognized to operate from intracellular membranes as well as the plasma membrane. The β 2 -adrenergic GPCR can activate G s -linked cyclic AMP (G s -cAMP) signaling from endosomes. We show here that the homologous human β 1 -adrenergic receptor initiates an internal G s -cAMP signal from the Golgi apparatus. By developing a chemical method to acutely squelch G-protein coupling at defined membrane locations, we demonstrate that Golgi activation contributes significantly to the overall cellular cAMP response. Golgi signaling utilizes a preexisting receptor pool rather than receptors delivered from the cell surface, requiring …

Optimizing Critical Illness Outcomes Through The Family Experience-A Theoretical Review, Kirby P. Mayer, Samantha A. Mancuso, Dana M. Howell

EKU Faculty and Staff Scholarship

An estimated six to eight million patients are admitted to the intensive care unit (ICU) in the United States every year [1, 2]. It is possible that new and innovative medical therapies have provided patients with treatment options that enhance survival of a critical illness and allow them go home with more medical support than previously available in earlier years. This may explain why there are now millions of ICU survivors are a result of declining mortality rates (8-19%) even though there are increased ICU admissions [3, 4]. This also indicates a change in direction of the attitudes and beliefs …

Physician Attitudes Toward The Ethics Of Pre-Exposure Prophylaxis (Prep): Cost, Safety, And Resource Allocation, Jessica Grippo, Stacy W. Smallwood, Katherine Pincura, Tamara Wright, William A. Mase

Journal of the Georgia Public Health Association

Background: In the United States, human immunodeficiency virus (HIV) remains a substantial public health issue. There is evidence that the use of antiretroviral medications such as pre-exposure prophylaxis (PrEP) can be a safe and effective primary prevention strategy to reduce new cases of HIV infection. Provider practice behavior as it relates to prescribing PrEP and the potential impact on specific vulnerable populations needs increased attention. Few studies have evaluated the attitudes of physicians towards ethical issues related to prescribing PrEP.

Methods: The purpose of the present literature review was to evaluate provider attitudes toward the ethics of prescribing PrEP for …

Application Of A Fath-Based Integration Tool To Assess Mental And Physical Health Interventions, Donna M. Saunders, Jean Leak, Monique E. Carver, Selina A. Smith

Journal of the Georgia Public Health Association

Background: To build on current research involving faith-based interventions (FBIs) for addressing mental and physical health, this study a) reviewed the extent to which relevant publications integrate faith concepts with health and b) initiated analysis of the degree of FBI integration with intervention outcomes.

Methods: Derived from a systematic search of articles published between 2007 and 2017, 36 studies were assessed with a FaithBased Integration Assessment Tool (FIAT) to quantify faith-health integration. Basic statistical procedures were employed to determine the association of faith-based integration with intervention outcomes.

Results: The assessed studies possessed (on average) moderate, inconsistent integration because of poor …

Operational And Financial Performance Of Georgia's Critical Access Hospitals, Linda G. Kimsey, Bettye A. Apenteng, William Mase, Samuel T. Opoku, Mark Hanna, Kwabena G. Boakye, Lisa Carhuff, Charles F. Owens, Angela Peden, Stuart H. Tedders, Patricia Whaley

Journal of the Georgia Public Health Association

Background: Georgia’s Critical Access Hospitals (CAHs) face increasingly complex threats to financial sustainability, as demonstrated by the disproportionally high number of closures in comparison to other states in the nation.

Methods: Financial performance measures (including profitability, revenue, liquidity, debt, utilization, and productivity), site visits, key personnel interviews, and a revenue cycle management assessment were used to assess the strategic landscape of CAHs in Georgia, analyze financial and operational performance, and provide recommendations.

Results: For CAHs in Georgia, financial and operating performance indicators, interviews, and assessments depict a challenging operating environment, but opportunities for improvement exist through implementation of a Lean …

Analysis Of Hypertension Control Rates Among Participants In The Georgia Hypertension Management And Outreach Program, Sara Byers, Jean O'Connor, Kia Powell-Threets, Brittany Taylor, Kia Padgett, Melissa K. Hallow

Journal of the Georgia Public Health Association

Background: This study utilized health department electronic medical records retrospectively to evaluate hypertension control rates achieved by the Georgia Hypertension Management and Outreach Program (HMOP), an education, screening, and treatment control program that provides services, including blood pressure screening and assessment, referral to physicians, counseling, educational material, disease case management, and treatment.

Methods: Hypertension control rates after at least 6 months of study participation were determined for patients participating in the program for at least 6 months between 2010 and 2014, and for African American and uninsured subgroups.

Results: The overall hypertension control rate was 61.1%, above the 2012 national …

Implementation Of The Safecare Model In Georgia For Preventing Child Maltreatment, Dan Whitaker, Theresa L. Glasheen

Journal of the Georgia Public Health Association

Background: The SafeCare model is a behaviorally-based parenting model used in the prevention of child maltreatment. SafeCare targets three proximal risk factors for child neglect and abuse: parent-child interactions, home safety, and child health. SafeCare is one of only a few evidence-based practices for preventing child neglect, the dominant problem in child welfare, accounting for over 75% of child maltreatment cases. SafeCare has been broadly implemented in several states in the US, including Georgia, and is disseminated by the National SafeCare Training and Research Center (NSTRC) at Georgia State University. The presentation will (1) describe SafeCare and associated data, (2) …

Mock Me! A Guide To Developing A First Rate Training Tool On A Second Rate Budget, Galen Baxter

Journal of the Georgia Public Health Association

Background: Working closely with county Environmental Health Specialists through the Standardization Process, a critical need was identified. Assistance was needed in prioritizing inspections based on risk levels identified in restaurant kitchens during inspections. Additionally, more training was needed to help them identify other areas in food service establishments that require further assessment.

Methods: Tight budget constraints prevented the purchase of expensive training equipment; however, with a little creativity and team work, a mock kitchen made entirely out of cardboard, tape and a couple of aluminum pans was created as a portable, handson training tool that could be easily transported around …

Georgia's Critical Access Hospitals: Financial Performance And Process Improvement, William A. Mase, Bettye A. Apenteng, Lisa Carhuff, Mark Hanna, Kwabena G. Boakye, Linda G. Kimsey, Samuel T. Opoku, Charles F. Owens, Stuart H. Tedders, Patricia Whaley

Journal of the Georgia Public Health Association

Background: Georgia’s Critical Access Hospitals (CAH) are in crisis. Within the last 2 years, four CAHs have closed their doors due to failed financial and operational performance. Evidence points to the risk that several more are on the brink of closure. CAH closures have far-reaching impact on residents. Negative impacts include the extra distance that patients must travel to seek care, the displacement of health professionals and the unravelling of the entire fabric of the communities these hospitals serve. We hope to help participants understand the financial and operational challenges of CAHs, and to identify realistic strategies to enhance the …

Enhancing The Future Public Health Workforce Through Competency-Based Student Field Placements, Michelle L. Carvalho, Laura M. Lloyd, Melissa Alperin, Lisa Mccormick, Kathleen R. Miner

Journal of the Georgia Public Health Association

Background: The Public Health Workforce Interest and Needs (PHWINS) 2014 survey from ASTHO (Association of State and Territorial Health Officials) demonstrated a dramatic need for succession planning and retention of the future public health workforce. To address this need, the Region IV Public Health Training Center’s (R-IV PHTC) Pathways to Practice Scholars Program places students from accredited schools and programs of public health into practical field placement positions across eight states. Skill- and competency-based student field placements reinforce the value of working with medically underserved areas/populations (MUA/Ps) through public health agencies. Field placements use adult learning theory through experiential learning …

Trends In Hiv Testing Among Adults In Georgia: Analysis Of The 2011-2015 Brfss Data, Benjamin Ansa

Journal of the Georgia Public Health Association

Background: Georgia is ranked fifth highest among states for rates of HIV diagnosis. About 4% of persons living with HIV infection in the United States reside in Georgia, and almost 19% of these people do not know their HIV status. The present study examined the trends and associated factors of HIV testing among adults in Georgia between 2011 and 2015.

Methods: The 2011-2015 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed.

Results: A total of 31,094 persons aged ≥18 years were identified who responded to the question “Have you ever been tested for HIV?” Overall, there were 11,286 (44.2%) …

Associations Between Multi-Level Contextual Factors And Mental Health Service Utilization In Adolescents With Comorbid Depression And Substance-Use: Moderating Role Of School Connectedness On Racial/Ethnic Disparities In Service Utilization, Kate Thornton

Journal of the Georgia Public Health Association

Background: Comorbid depression and substance use has been a prevalent issue in adolescent health. Although rates have remained relatively stable, their level is still alarming and efforts to see a decrease have led leaders and organizations to call for research to better understand factors related to both depression and substance use as well as how these factors may change when these disorders occur together.

Methods: Data from the National Survey on Drug Use and Health (NSDUH) were utilized to pursue the research objectives for this study. The NSDUH is an ongoing cross-sectional survey of the civilian and non-institutionalized population of …

Solo Practice Physicians In Georgia, Fedelis Mutiso, Emmanuel Akowuah, Samuel T. Opoku, Bettye A. Apenteng

Journal of the Georgia Public Health Association

Background: Office-based physicians can practice in a solo or group setting. Solo physician practices are staffed by a single physician who is responsible for all the care of the patients. Physicians in solo practices are also responsible for the infrastructure, personnel and investment cost of their practices. Further, evidence suggests that physicians in solo practices are more likely to be dissatisfied with their medical career compared to those in group practices. Given these challenges, current trend suggests a shift away from solo physician practices. However, there are still physicians in solo practices in Georgia but little is known about them. …

Hepatitis C And Hiv Screening, Merry L. Perry

Journal of the Georgia Public Health Association

Background: Chronic hepatitis C virus (HCV) affects more than 3 million people in the United States. Current HCV treatment offers a shorter treatment interval with fewer adverse reactions as well as improved cure rates of 96%. The increasing rates of hepatitis C infections in adults have been accompanied by multifaceted adverse health outcomes. The purpose of this screening program is to identify HCV-infected individuals, which will lead to clinical interventions and treatment that will improve health outcomes compared to no screening.

Methods: The Centers for Disease Control and Prevention guidelines recommend that anyone with risk factors should be screened for …

Determinants Of Knowledge Of Critical Danger Signs, Safe Childbirth And Immediate Newborn Care Practices Among Auxiliary Midwives: A Cross Sectional Survey In Myanmar, Kyu Kyu Than, Alison Morgan, Minh Duc Pham, James G. Beeson, Stanley Luchters

Population Health, East Africa

Objectives The re-emergence of community-based health workers such as the auxiliary midwives (AMWs) in Myanmar, who are local female volunteers, has been an important strategy to address global health workforce shortages. The Myanmar government recommends one AMW for every village. The aim of this study is to investigate the current knowledge of critical danger signs and practices for safe childbirth and immediate newborn care of AMWs to inform potential task shifting of additional healthcare responsibilities.

Methods A cross-sectional survey was conducted from July 2015 to June 2016 in three hard-to-reach areas in Myanmar. Face-to-face interviews were conducted using a pretested …

Metabolic Syndrome And Its Predictors In An Urban Population In Kenya: A Cross Sectional Study, Geoffrey Omuse, Daniel Maina, Mariza Hoffman, Jane Mwangi, Caroline Wambua, Elizabeth Kagotho, Angela Amayo, Peter Ojwang, Zul Premji, Kiyoshi Ichihara, Rajiv Erasmus

Pathology, East Africa

Background: The metabolic syndrome (MetS) is a clustering of interrelated risk factors which doubles the risk of cardio-vascular disease (CVD) in 5–10 years and increases the risk of type 2 diabetes 5 fold. The identification of modifiable CVD risk factors and predictors of MetS in an otherwise healthy population is necessary in order to identify individuals who may benefit from early interventions. We sought to determine the prevalence of MetS as defined by the harmonized criteria and its predictors in subjectively healthy black Africans from various urban centres in Kenya.

Method: We used data collected from healthy black Africans in …

Neonatal Graves' Disease With Maternal Hypothyroidism., Gangaram Akangire, Alain Cuna, Charisse I. Lachica, Ryan T. Fischer, Sripriya Raman, Venkatesh Sampath

Manuscripts, Articles, Book Chapters and Other Papers

Neonatal Graves' disease presenting as conjugated hyperbilirubinemia is a diagnostic challenge because the differential includes a gamut of liver and systemic diseases. We present a unique case of neonatal Graves' disease in a premature infant with conjugated hyperbilirubinemia born to a mother with hypothyroidism during pregnancy and remote history of Graves' disease. Infant was treated with a combination of methimazole, propranolol, and potassium iodide for 4 weeks. Thyroid function improved after 8 weeks of treatment with full recovery of thyroid function, disappearance of thyroid-stimulating antibodies, and resolution of failure to thrive and conjugated hyperbilirubinemia. This case provides several clinical vignettes …

Aging, Executive Function, Fronto-Parietal Network Cortical Thickness: Insights From Cognitive Reserve, Katherine Reiter

Dissertations (1934 -)

Cognitive reserve (CR) indexes the nonlinear relationship between neurological insult and behavioral change. CR is manifested in both static factors (e.g., childhood environment, education) and modifiable lifestyle factors, (e.g., leisure activities). Detailed investigation of the influence of CR on cortical thickness, which indexes neuropathology, and cognitive functioning could be particularly important in understanding the heterogeneity of Alzheimer’s disease (AD). While memory decline is the hallmark of AD, executive functioning (EF) decline often predates memory changes, making EF an important target for investigating CR influences. The current study examines the relationship of CR and genetic risk for AD (ε4) on EF …

Anthropometric Indices For Non-Pregnant Women Of Childbearing Age Differ Widely Among Four Low-Middle Income Populations, K Michael Hambidge, Nancy F. Krebs, Ana Garcés, Jamie E. Westcott, Lester Figueroa, Shivaprasad S. Goudar, Sangappa Dhaded, Omrana Pasha, Sumera Aziz Ali, Antoinette Tshefu

Community Health Sciences

Background: Maternal stature and body mass indices (BMI) of non-pregnant women (NPW) of child bearing age are relevant to maternal and offspring health. The objective was to compare anthropometric indices of NPW in four rural communities in low- to low-middle income countries (LMIC).
Methods: Anthropometry and maternal characteristics/household wealth questionnaires were obtained for NPW enrolled in the Women First Preconception Maternal Nutrition Trial. Body mass index (BMI, kg/m²) was calculated. Z-scores were determined using WHO reference data.
Results: A total of 7268 NPW participated in Equateur, DRC (n = 1741); Chimaltenango, Guatemala (n = 1695); North …

A Prospective Investigation To Develop Data-Driven Interventions And Improve Process Efficiency At A Level Ii Trauma Center, Tracy L. Litzinger

Doctoral Dissertations and Master's Theses

The purpose of this investigation was to better understand process inefficiencies in a Level II trauma center through the identification and classification of flow disruptions. Data-driven interventions were systematically developed and introduced in an effort to reduce disruptions threatening the optimal delivery of trauma care.

Medical human factors researchers observed disruptions during resuscitation and imaging in 117 trauma cases. Data was classified using the human factors taxonomy Realizing Improved Patient Care through Human-centered Operating Room Design for Threat Window Analysis (RIPCHORD-TWA). Interdisciplinary subject matter experts (SMEs) utilized a human factors intervention matrix (HFIX) to generate targeted interventions designed to address …

Putative Adult Neurogenesis In Two Domestic Pigeon Breeds (Columba Livia Domestica): Racing Homer Versus Utility Carneau Pigeons, Pedzisai Mazengenya, Adhil Bhagwandin, Pilani Nkomozepi, Paul R. Manger, Amadi O. Ihunwo

Brain and Mind Institute

Generation of neurons in the brains of adult birds has been studied extensively in the telencephalon of song birds and few studies are reported on the distribution of PCNA and DCX in the telencephalon of adult non-song learning birds. We report here on adult neurogenesis throughout the brains of two breeds of adult domestic pigeons (Columba livia domestica), the racing homer and utility carneau using endogenous immunohistochemical markers proliferating cell nuclear antigen (PCNA) for proliferating cells and doublecortin (DCX) for immature and migrating neurons. The distribution of PCNA and DCX immunoreactivity was very similar in both pigeon breeds with only …

Alcohol And Substance Use Knowledge, Attitudes, Subjective Norms, Self-Efficacy, Perceived Behavioral Control, And Behavioral Intentions Among Omani College Students, Muna S. Bait Ajzoon

Health Services Research Dissertations

Alcohol and/or substance use among college students is a serious public health issue. In Oman, studies addressing college student’s alcohol and/or substance use are limited. The purpose of this study was to identify knowledge, attitudes, subjective norms, self-efficacy, and perceived behavioral control associated with alcohol and/or substance usage patterns among Omani college students (OCSs); identify behavioral intentions for alcohol and/or substance use among OCSs; and facilitate the development of culturally relevant evidenced-based interventions for Omani young people by communicating study findings to policymakers and healthcare program leaders.

A cross-sectional design used an online survey completed by college students from Oman …

A Low-Frequency Inactivating Akt2 Variant Enriched In The Finnish Population Is Associated With Fasting Insulin Levels And Type 2 Diabetes Risk, Alisa Manning, Heather M. Highland, Jessica Gasser, Xueling Sim, Taru Tukiainen, Pierre Fontanillas, Niels Grarup, Manuel A. Rivas, Anubha Mahajan, John Blangero

School of Medicine Publications

To identify novel coding association signals and facilitate characterization of mechanisms influencing glycemic traits and type 2 diabetes risk, we analyzed 109,215 variants derived from exome array genotyping together with an additional 390,225 variants from exome sequence in up to 39,339 normoglycemic individuals from five ancestry groups. We identified a novel association between the coding variant (p.Pro50Thr) in AKT2 and fasting plasma insulin (FI), a gene in which rare fully penetrant mutations are causal for monogenic glycemic disorders. The low-frequency allele is associated with a 12% increase in FI levels. This variant is present at 1.1% frequency in Finns but …

Tailored, Theory-Based Strategies For Engaging Low-Income Populations With A Personal Health Record, Tammy Toscos Phd, Maria Wright Rn, Bsn, Mindy Flanagan Phd, Kislaya Kunjan Ms, Mba, Amy Olson-Miller Ms, Bradley N. Doebbeling Md, Ms

Health Services and Informatics Research

There remain significant barriers to the use of personal health records (PHRs), which limit potential benefits in underserved patient populations. Novel strategies must be developed to achieve the desired impact of PHRs on patient engagement and health outcomes. This paper describes the health information needs and technology preferences of adults seeking care in Community Health Centers (CHCs), which provide care to low-income, uninsured and underinsured patients. We offer design suggestions emerging from interviews with 43 CHC patients and 49 CHC staff members that explored many themes including: patient barriers to accessing health care, health information needs of patients between clinic …