Medicine and Health Sciences Commons^™

Ureterovaginal Fistula Secondary To Retained Vaginal Foreign Body In A Young Girl, Anjum Bandarkar, Adebunmi O. Adeyiga, Eglal Shalaby-Rana

Radiology Faculty Publications

We present the case of a 13-year-old girl with a recurrent urinary tract infection, malodorous vaginal discharge, and urinary incontinence caused by a retained vaginal foreign body. The foreign body, an aerosol cap retained for over 2 years, resulted in the formation of a ureterovaginal fistula, an extremely rare complication. The critical value of ultrasound and magnetic resonance urography in delineating the foreign body, the fistulous tract, and the intraperitoneal urine leak is described. Through this unique diagnostic dilemma, we wish to highlight that the evaluation of persistent unusual urinary symptoms and vaginal discharge in a young girl must include …

Implementation Science To Accelerate Clean Cooking For Public Health., Joshua Rosenthal, Kalpana Balakrishnan, Nigel Bruce, David Chambers, Jay Graham, Darby Jack, Lydia Kline, Omar Masera, Sumi Mehta, Ilse Ruiz Mercado, Gila Neta, Subhrendu Pattanayak, Elisa Puzzolo, Helen Petach, Antonello Punturieri, Adolfo Rubinstein, Michael Sage, Rachel Sturke, Anita Shankar, Kenny Sherr, Kirk Smith, Gautam Yadama

Environmental and Occupational Health Faculty Publications

Clean cooking has emerged as a major concern for global health and development because of the enormous burden of disease caused by traditional cookstoves and fires. The World Health Organization has developed new indoor air quality guidelines that few homes will be able to achieve without replacing traditional methods with modern clean cooking technologies, including fuels and stoves. However, decades of experience with improved stove programs indicate that the challenge of modernizing cooking in impoverished communities includes a complex, multi-sectoral set of problems that require implementation research. The National Institutes of Health, in partnership with several government agencies and the …

Clarithromycin Attenuates Il-13–Induced Periostin Production In Human Lung Fibroblasts, Kosaku Komiya, Shoichiro Ohta, Kazuhiko Arima, Masahiro Ogawa, Shoichi Suzuki, Yasutaka Mitamura, Satoshi Nunomura, Yasuhiro Nanri, Tomohito Yoshihara, Atsushi Kawaguchi, Jun-Ichi Kadota, Bruce K. Rubin, Kenji Izuhara

Biochemistry and Molecular Biology Publications

Background

Periostin is a biomarker indicating the presence of type 2 inflammation and submucosal fibrosis; serum periostin levels have been associated with asthma severity. Macrolides have immunomodulatory effects and are considered a potential therapy for patients with severe asthma. Therefore, we investigated whether macrolides can also modulate pulmonary periostin production.

Methods

Using quantitative PCR and ELISA, we measured periostin production in human lung fibroblasts stimulated by interleukin-13 (IL-13) in the presence of two 14-member–ring macrolides—clarithromycin or erythromycin—or a 16-member–ring macrolide, josamycin. Phosphorylation of signal transducers and activators of transcription 6 (STAT6), downstream of IL-13 signaling, was evaluated by Western blotting. …

Neutralization Of Diverse Human Cytomegalovirus Strains Conferred By Antibodies Targeting Viral Gh/Gl/Pul128-131 Pentameric Complex, Sha Ha, Fengsheng Li, Matthew C. Troutman, Daniel C. Freed, Aimin Tang, John W. Loughney, Dai Wang, I-Ming Wang, Josef Vlasak, David C. Nickle, Richard R. Rustandi, Melissa Hamm, Pete A. Dephillips, Ningyan Zhang, Jason S. Mclellan, Hua Zhu, Stuart P. Adler, Michael A. Mcvoy, Zhiqiang An, Tong-Ming Fu

Biochemistry and Molecular Biology Publications

Human cytomegalovirus (HCMV) is the leading cause of congenital viral infection, and developing a prophylactic vaccine is of high priority to public health. We recently reported a replication-defective human cytomegalovirus with restored pentameric complex glycoprotein H (gH)/gL/pUL128-131 for prevention of congenital HCMV infection. While the quantity of vaccine-induced antibody responses can be measured in a viral neutralization assay, assessing the quality of such responses, including the ability of vaccine-induced antibodies to cross-neutralize the field strains of HCMV, remains a challenge. In this study, with a panel of neutralizing antibodies from three healthy human donors with natural HCMV infection or a …

Uncovering Precision Phenotype-Biomarker Associations In Traumatic Brain Injury Using Topological Data Analysis, Jessica L. Nielson, Shelly R. Cooper, John K. Yue, Marco D. Sorani, Tomoo Inoue, Esther L. Yuh, Pratik Mukherjee, Tanya C. Petrossian, Jesse Paquette, Pek Y. Lum, Gunnar E. Carlsson, Mary J. Vassar, Hester F. Lingsma, Wayne A. Gordon, Alex B. Valadka, David O. Okonkwo, Geoffrey T. Manley, Adam R. Ferguson, Track-Tbi Investigators

Neurosurgery Publications

Background

Traumatic brain injury (TBI) is a complex disorder that is traditionally stratified based on clinical signs and symptoms. Recent imaging and molecular biomarker innovations provide unprecedented opportunities for improved TBI precision medicine, incorporating patho-anatomical and molecular mechanisms. Complete integration of these diverse data for TBI diagnosis and patient stratification remains an unmet challenge.

Methods and findings

The Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot multicenter study enrolled 586 acute TBI patients and collected diverse common data elements (TBI-CDEs) across the study population, including imaging, genetics, and clinical outcomes. We then applied topology-based data-driven discovery to …

Natural History Of Acute Subdural Hematoma, Rafael A. Vega, Alex B. Valadka

Neurosurgery Publications

• Although guidelines for surgical decision-making in patients with acute subdural hematomas (ASDHs) are widely available, the evidence supporting these guidelines is weak, and management of these patients must often be individualized.
• Smaller ASDHs in patients in good neurologic condition usually can be successfully managed without surgery.
• Large ASDHs with minimal mass effect in patients with minimal symptoms also may be considered for nonoperative management.
• The literature is divided about the effects of anticoagulant and antiplatelet medications on rapid growth of ASDHs and on their likelihood of progression to large chronic subdural hematomas, but it is reasonable to reverse the effects …

Monthly Food Insecurity Assessment In Rural Mkushi District, Zambia: A Longitudinal Analysis, Muzi Na, Bess Caswell, Sameera A Talegawkar, Amanda C Palmer

Global Health Faculty Publications

Background

Perception-based scales are widely used for household food insecurity (HFI) assessment but were only recently added in national surveys. The frequency of assessments needed to characterize dynamics in HFI over time is largely unknown. The study aims to examine longitudinal changes in monthly reported HFI at both population- and household-level.

Methods

A total of 157 households in rural Mkushi District whose children were enrolled in the non-intervened arm of an efficacy trial of biofortified maize were included in the analysis. HFI was assessed by a validated 8-item perception-based Likert scale on a monthly basis from October 2012 to March …

The Vasodilatory Effects Of Anti-Inflammatory Herb Medications: A Comparison Study Of Four Botanical Extracts., Hong Ping Zhang, Dan-Dan Zhang, Yan Ke, Ka Bian

Biochemistry and Molecular Medicine Faculty Publications

Inflammation plays a pivotal role in the development and progression of cardiovascular diseases, in which, the endothelium dysfunction has been a key element. The current study was designed to explore the vasodilatory effect of anti-inflammatory herbs which have been traditionally used in different clinical applications. The total saponins from Actinidia arguta radix (SAA), total flavonoids from Glycyrrhizae radix et rhizoma (FGR), total coumarins from Peucedani radix (CPR), and total flavonoids from Spatholobi caulis (FSC) were extracted. The isometric measurement of vasoactivity was used to observe the effects of herbal elements on the isolated aortic rings with or without endothelium. To …

The Role Of Osteopontin And Its Gene On Glucocorticoid Response In Myasthenia Gravis., Yanchen Xie, Hai-Feng Li, Liang Sun, Linda L Kusner, Shuhui Wang, Yunxiao Meng, Xu Zhang, Yu Hong, Xiang Gao, Yao Li, Henry J Kaminski

Neurology Faculty Publications

Biomarkers that assess treatment response for patients with the autoimmune disorder, myasthenia gravis (MG), have not been evaluated to a significant extent. We hypothesized the pro-inflammatory cytokine, osteopontin (OPN), may be associated with variability of response to glucocorticoids (GCs) in patients with MG. A cohort of 250 MG patients treated with standardized protocol of GCs was recruited, and plasma OPN and polymorphisms of its gene, secreted phosphoprotein 1 (SPP1), were evaluated. Mean OPN levels were higher in patients compared to healthy controls. Carriers of rs11728697*T allele (allele definition: one of two or more alternative forms of a gene) were more …

Using Diagnostic Tests To Inform Better Care, Save Lives And Fight Antibiotic Resistance: A Factsheet For Healthcare Professionals, Antibiotic Resistance Action Center (Arac)

Antibiotic Resistance Action Center (ARAC)

No abstract provided.

Unleashing The Power Of Diagnostic Tests In The Fight Against Antibiotic Resistance, Antibiotic Resistance Action Center (Arac)

Antibiotic Resistance Action Center (ARAC)

No abstract provided.

Febrile Rhinovirus Illness During Pregnancy Is Associated With Low Birth Weight In Nepal., Erin K Philpott, Janet A Englund, Joanne Katz, James Tielsch, Subarna Khatry, Stephen C Leclerq, Laxman Shrestha, Jane Kuypers, Amalia S Magaret, Mark C Steinhoff, Helen Y Chu

Global Health Faculty Publications

BACKGROUND: Adverse birth outcomes, including low birth weight (LBW), defined as <2500 >grams, small-for-gestational-age (SGA), and prematurity, contribute to 60%-80% of infant mortality worldwide and may be related to infections during pregnancy. The aim of this study was to assess whether febrile human rhinovirus (HRV) illness is associated with adverse birth outcomes.

METHODS: Active household-based weekly surveillance was performed for respiratory illness episodes in pregnant women as part of a community-based, prospective, randomized trial of maternal influenza immunization in rural Nepal. Rhinovirus (HRV) febrile illness episodes were defined as fever plus cough, sore throat, runny nose, and/or myalgia with HRV detected …

Using Xbox Kinect Motion Capture Technology To Improve Clinical Rehabilitation Outcomes For Balance And Cardiovascular Health In An Individual With Chronic Tbi, Shane Chanpimol, Bryant A. Seamon, Haniel J. Hernandez, Michael O. Harris-Love, Marc R. Blackman

Exercise and Nutrition Sciences Faculty Publications

Background

Motion capture virtual reality-based rehabilitation has become more common. However, therapists face challenges to the implementation of virtual reality (VR) in clinical settings. Use of motion capture technology such as the Xbox Kinect may provide a useful rehabilitation tool for the treatment of postural instability and cardiovascular deconditioning in individuals with chronic severe traumatic brain injury (TBI). The primary purpose of this study was to evaluate the effects of a Kinect-based VR intervention using commercially available motion capture games on balance outcomes for an individual with chronic TBI. The secondary purpose was to assess the feasibility of this intervention …

Examining The Literature On Fluoxetine Treatment For Selective Mutism In Children, Kelsey West

Psychology: Student Scholarship & Creative Works

Published literature on the research on using Fluoxetine, a specific type of SSRI, for children who have selective mutism was reviewed and then critiqued to determine conclusions on this type of treatment.

Mealtime Insights: A Photovoice Project With African American Mothers And Their Young Children, Paula Ann Rabaey

Occupational Therapy Program Student Theses, Dissertations and Capstones

Mothering is a complex and multifaceted occupation that encompasses the nurturing work that women engage in. It addition, it has been established that ethnicity, class, and gender have effects on motherhood that need to be taken into account when looking at the occupations of motherhood across cultures. One important task that occurs within a mothers’ daily routine is that of making meals for their children. This dissertation sought to gain a rich, in-depth description of the phenomenon of the mealtime experience for African American mothers of low socioeconomic status and young children living in an inner-city environment in the Midwest. …

Leadership Within Occupational Therapy : A Mixed Methods Study, Scott Truskowski

Occupational Therapy Program Student Theses, Dissertations and Capstones

PURPOSE: This sequential embedded mixed methods study first identified the ways in which occupational therapy leaders experience leadership, then explored the ways in which those same leaders utilized their professional training as occupational therapists within their practice of leadership. METHODS: The twelve participants held formal leadership positions in either academia, clinical practice, or professional associations. The ecology of human performance model of practice was utilized to frame the research study. Data was collected through an initial interview with all 12 participants and through leadership artifacts and a second interview with six participants. RESULTS: Three themes resulted from thematic analysis of …

Prevalence Of Vitreomacular Traction In Patients 40 Years Of Age And Older, Julie Rodman

Student Theses, Dissertations and Capstones

Vitreomacular traction (VMT) is a condition characterized by an incomplete posterior vitreous detachment resulting in traction on the macula and decreased visual acuity. The process of vitreomacular traction can lead to a number of maculopathies including cystoid macular edema, epiretinal membranes, and macular holes. VMT is more common in patients over 40 years of age; however no population-based studies documenting the prevalence of VMT in this age group has been published. Purpose: The current study was undertaken to evaluate the prevalence of vitreomacular traction syndrome in the population aged above 40. Clinical examination does not adequately illustrate the extent of …

Ocular Sensory Dominance And Viewing Distance, Karen Squier

Student Theses, Dissertations and Capstones

Abstract Purpose: It is not clear as to whether sensory dominance is affected by test distance. Jiang et al previously reported that that the sensory dominant eyes may be affected by refractive error; however this study was done at a near distance only (60 cm). In this study, we investigated the effect of two different test distances (near, 60 cm vs distance, 6 meters) on the laterality of ocular dominance. Methods: Ocular sensory dominance was quantified in 60 subjects with a technique that involves the dichoptic presentation of a Mondrian noise and a Gabor patch. The threshold to detect the …

Comparison Of Three Clinical Tests Of Accommodation To Hofstetter's Norms To Guide Diagnosis And Treatment, Marc Brian Taub

Student Theses, Dissertations and Capstones

Purpose. It has been documented previously that the push up (PU) and pull away (PA) methods overestimate accommodative amplitude (AA), while the minus lens-to-blur (MLB) method underestimates it. It also has been shown that the PU and PA methods produce similar results. We sought to compare data obtained from these three clinically used methods to determine AA in children and young adults with base-line normative data predicted by Hofstetter.

Methods. Ninety healthy subjects (mean 11.7 years, range: 6-36 and 50F/40M), split into two groups, children (mean 9.8 years, range: 6-13 and 38F/22M) and young adults (mean 25.5 years, range: 21-36 …

Lived Experience Of The Advanced Practice Provider On The Burn Surgery Service, Susan Lee Smith

Health Sciences Program Student Theses, Dissertations and Capstones

The purpose of this qualitative dissertation study was to examine the lived experience and meaning making of challenges, benefits, satisfaction, and professional sustainability for the advanced practice provider in the burn surgery specialty service. The problem addressed was the knowledge gap resulting from a lack of literature describing aspects of the advanced practice provider role in the burn specialty. An interpretive phenomenological analysis, informed by the philosophy of Dr. Martin Heidegger, was undertaken. Participants were solicited from the American Burn Association Advanced Practice Provider (APP) special interest group site. The results provided a thick description of the lived experience of …

Faculty And Staff Perceptions Of Interprofessional Education: A Comparative Survey Of Dental And Health Science/Nursing Faculty And Staff, Tabitha Nicole Fair

Health Sciences Program Student Theses, Dissertations and Capstones

Research has shown a strong correlation between oral and systemic disease; therefore, there is an increased need for collaboration between dental and medical professionals. The purpose of this study was to examine the current opportunities that exist for interprofessional education (IPE) at Nova Southeastern University (NSU), the perceived need for IPE for dental and health science/nursing students, the perceived advantages of an IPE program, the features that should be included in an IPE program, and the perceived administrative and financial barriers to increased interprofessional activities. This study surveyed graduate faculty and staff from NSU’s College of Health Care Sciences, College …

Death Related To Fistulas Involving The Gastrointestinal And Cardiovascular Systems, Allan Joseph Medwick Edd, Joseph Prahlow

Research Day

BACKGROUND/INTRODUCTION: Gastrointestinal tract fistulas are relatively uncommon and can be congenital or acquired. Fistulas may communicate with a variety of anatomic locations, including body cavities, the skin, and other organ systems. Acquired fistulas which communicate with the cardiovascular system are of particular concern, as they may be associated with significant morbidity and mortality. This study reports on three cases of acquired, post-surgical fistula formation involving the gastrointestinal and cardiovascular systems. CASE REPORTS: Case 1 - A 57-year-old man experienced sudden cardiac death shortly after having a permanent pacemaker placed for atrial fibrillation. Approximately two years earlier, he underwent surgical resection …

The Impact Of Wmed Family Medicine Obesity Clinic On Weight Loss And Patient's Overall Health In The Family Health Center, Kalamazoo, Mi, Latifa Pacheco Do, Abigail Annan Md

Research Day

No abstract provided.

The Lived Experience In Relation To The Educational Needs Of Nurses Caring For Induced Hypothermia Patients, Marie Regina Hankinson

Student Theses, Dissertations and Capstones

Background: Ongoing educational development is essential to ensure the effectiveness of professional nurses’ learning experiences. Understanding the ways in which workplace learning occurs is fundamental to enabling nurse educators to deliver that knowledge. Induced hypothermia was introduced as a new treatment modality in 2005 and education surrounding the care of the hypothermia patient is lacking in the literature. Purpose: The purpose of this study is to illuminate how nurses learn new knowledge in the clinical setting. Theoretical Framework: The learning theory chosen for this study is the three dimensions of learning by Illeris (2004). Methods: Semistructured interviews were conducted with …

Transition To Practice Experience: The Impact On Newly Licensed Rn Performance, Patricia P. Lawson

Student Theses, Dissertations and Capstones

This quantitative non-experimental descriptive correlational design sought to answer the question if there was a difference in newly licensed RN (NLRN) performance at one-year post hire after participation in a nurse residency program that offers a formalized curriculum that extends throughout the entire year, one that offers a formalized curriculum that does not extend throughout the entire year, or one that does not provide a formalized curriculum. The study utilized the Six Dimension Scale of Nursing Performance (SDNP) and evaluated NLRN performance on six subscales: leadership, critical care, teaching/collaboration, planning/evaluation, interpersonal relations/communication, and professional development at one-year post hire. Benner’s …

Professional Nursing Value Development In Nursing Students Who Participate In International Service Learning, Heather Ferrillo-Diiulio

Student Theses, Dissertations and Capstones

Background: International Service Learning (ISL) is becoming widely used in nursing education as a means to provide global learning opportunities. Concrete outcomes for these experiences have not been clearly supported in previous research. Determining if ISL experience facilitate the development of Professional Nursing Values (PNV) can support the use of ISL as a viable pedagogy. Purpose: The purpose of the study was to determine if there were a difference in PNV development in students who participate in ISL as part of their clinical experiences compared to those who do not. The hypothesis was that there was a difference in the …

Factors That Predit Levels Of Sleepiness Of Advanced Practice Nursing Students, Deana Shevit Goldin

Student Theses, Dissertations and Capstones

Background: Due to arduous demands of graduate education, advanced practice nursing (APN) students who are classified as adult learners are at risk for suffering sleep deprivation. Factors contributing to sleep deprivation include stress, expected academic challenges, and everyday life stressors. Purpose: This study investigated if APN students’ grade-point average (GPA), gender, and employment status predicted levels of daytime sleepiness. Theoretical Framework. The psychological well-being model selected for this study was consistent with the theory that sleep is a resource essential to well-being; adequate sleep is the resource needed to optimally manage stressful life demands. Methods. Bivariate and multiple regression were …

Cancer-Related Fatigue Clinical Guideline And Protocol For Hospitalized Oncology Patients: A Quality Improvement Project, Sulotte Valcin Amilcar

Student Theses, Dissertations and Capstones

Background: Cancer-related fatigue is one of the most common symptom experienced by cancer patients throughout their cancer trajectory. However, very little effort has been made within many oncology practices to assess this clinical problem and to provide timely nursing interventions to reduce its impact. While there have been tremendous advancements in the treatments of the disease aspects of cancer in term of medicine and advanced technology, basic assessment of related physiological concerns, such as fatigue, have not seen the same progress. Purpose: The purpose of this quality improvement project was to develop an evidence-based cancer-related fatigue assessment guideline and a …

Chemotherapy Side Effects At Home: A Nursing Impact, Gwendolyn E. Saint-Clarke

Student Theses, Dissertations and Capstones

Background: Approximately 32% of all lymphoma patients experience immunocompromised severe avoidable side effects of nadir at home after discharge postchemotherapy. The certified oncology nurses employed at a large metropolitan hospital in Atlanta, Georgia, lack standardized discharge guidelines that include regulatory organizations’ recommendations to assist patients/families with at-home self-management of the avoidable side effects. Purpose: The purpose of this quality improvement project was to utilize the institution’s existing postchemotherapy discharge protocol to assess certified oncology nurses’ knowledge of severe avoidable side effects of nadir; modify the existing healthcare institution’s postchemotherapy discharge protocol to reflect standardized practice for promoting clinical practice continuity …

Evidence-Based Diabetic Discharge Guideline: A Standardized Initiative To Promote Nurses' Adherence, Marjorie V. Scarlett

Student Theses, Dissertations and Capstones

Background: Diabetes mellitus (DM) affects more than 29.1 million Americans. Standardized clinical practice guidelines recommended by regulatory healthcare agencies are the standard of care for diabetic patients and must be adhered to by healthcare professionals providing care. Purpose: The purpose of this quality improvement project was to identify Centers for Medicare and Medicaid Services’, Joint Commission on Accreditation of Healthcare Organization’s, and other professional healthcare organizations’ guidelines for nurses’ knowledge of evidence-based discharge practices; determine level of nurses’ knowledge on evidence-based discharge practice process; develop a quality improvement plan, including development of an evidence-based guideline for diabetic discharge instructions; present …