Preventive Medicine Commons^™

An Interdisciplinary Process Change: Conversion Of Picc Line Capping Solution From Heparin To Normal Saline, Angela Colella, Brandon Bodager, Frank Spexarth, Natalie Mcdonough, Deb Kastenholz, Paul Grebe

Journal of Patient-Centered Research and Reviews

Background: Heparin-induced thrombocytopenia (HIT) and HIT with thrombosis syndrome (HITTS) are serious conditions. Patients are at increased risk for developing HIT/HITTS with any exposure to heparin, even intravenous line flushes. Patients may be exposed to heparin multiple times each day when they have a peripherally inserted central catheter (PICC) that is flushed and capped with heparin. At Aurora Health Care, heparin is the standard capping solution for PICCs, but with a recent switch to positive pressurized caps, normal saline may be a capping option that reduces patient exposure to heparin.

Purpose: To reduce heparin exposure at a single hospital by …

Defining And Targeting Health Disparities In Chronic Obstructive Pulmonary Disease, Roy A. Pleasants, Isaretta L. Riley, David M. Mannino

Preventive Medicine and Environmental Health Faculty Publications

The global burden of chronic obstructive pulmonary disease (COPD) continues to grow in part due to better outcomes in other major diseases and in part because a substantial portion of the worldwide population continues to be exposed to inhalant toxins. However, a disproportionate burden of COPD occurs in people of low socioeconomic status (SES) due to differences in health behaviors, sociopolitical factors, and social and structural environmental exposures. Tobacco use, occupations with exposure to inhalant toxins, and indoor biomass fuel (BF) exposure are more common in low SES populations. Not only does SES affect the risk of developing COPD and …

The Postfinasteride Syndrome; An Overview, David L. Rowland, Ion G. Motofei, Florian Popa, Vlad D. Constantin, Adriana Vasilache, Ioana Păunică, Cristian Bălălău, Georgeta P. Păunică, Petrisor Banu, Stana Păunică

Journal of Mind and Medical Sciences

As a 5-α reductase inhibitor, Finasteride has proven effective in ameliorating two conditions documented to be androgen dependent, namely male androgenic alopecia and benign prostatic hyperplasia. Therapeutic results are maintained as long as the drug is administered, with treatment cessation generally leading to the return of symptomatology for each condition. In addition, during the therapeutic phase, several adverse effects have been reported, some of which persist long or indefinitely after treatment cessation, known as “post-finasteride syndrome.”

Herein we present and discuss the most common finasteride side effects, along with a psycho-neuroendocrine rationale that could explain the persistence of many adverse …

Opportunities And Challenges In Incorporating Ancillary Studies Into A Cancer Prevention Randomized Clinical Trial, Phyllis J. Goodman, Catherine M. Tangen, Amy K. Darke, Kathryn B. Arnold, Joann Hartline, Monica Yee, Karen Anderson, Allison Caban-Holt, William G. Christen, Patricia A Cassano, Peter Lance, Eric A. Klein, John J. Crowley, Lori M. Minasian, Frank L. Meyskens

Sanders-Brown Center on Aging Faculty Publications

Background: The Selenium and Vitamin E Cancer Prevention Trial (SELECT) was a randomized, double-blind, placebo-controlled, prostate cancer prevention study funded by the National Cancer Institute and conducted by SWOG (Southwest Oncology Group). A total of 35,533 men were assigned randomly to one of four treatment groups (vitamin E + placebo, selenium + placebo, vitamin E + selenium, placebo + placebo). At the time of the trial’s development, NIH had invested substantial resources in evaluating the potential benefits of these antioxidants. To capitalize on the knowledge gained from following a large cohort of healthy, aging males on the effects of selenium …

Surveillance, Epidemiological, And Virological Detection Of Highly Pathogenic H5n1 Avian Influenza Viruses In Duck And Poultry From Bangladesh, Wahedul Karim Ansari, Md Safiullah Parvej, Mohamed E. El Zowalaty, Sally Jackson, Stephen A. Bustin, Adel K. Ibrahim, Md Tanvir Rahman, Han Zhang, Mohammad Ferdousur Rahman Khan, Md Mostakin Ahamd, Md. Fasiur Rahman, Marzia Rahman, Khm Nazmul H. Nazir, Sultan Ahmed, Md Liakot Hossenn, Md Abdul Kafi, Mat Yamage, Nitish C. Debnath, Graba Ahmed, Hossam Ashour, Md Masoud, Ayman Noreddin, Md B. Rahman

Pharmacy Faculty Articles and Research

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. …

Investigation Of Cnt-Induced Escherichia Coli Lysis And Protein Release, Abdollah Mosleh

Graduate Theses and Dissertations

This research investigated the use of carbon nanotubes (CNTs) as a treatment to increase the permeability of a bacterial cell wall. Recombinant Escherichia coli BL21 (DE3) containing a plasmid that expressed Green Fluorescent Protein (GFP) and -lactamase were exposed to CNTs under various levels of agitation for different times. Fluorescence assay for GFP, optical absorbance for -lactamase activity, and Transmission Electron Microscopy (TEM) were used to determine the amount of released protein, and visually examine the permeability enhancement of the cells, respectively. It was found that more -lactamase was present in the culture fluid after treatment with CNTs in a …

Multipurpose Tenofovir Disoproxil Fumarate Electrospun Fibers For The Prevention Of Hiv-1 And Hsv-2 Infections., Kevin Tyo

Electronic Theses and Dissertations

Sexually transmitted infections affect hundreds of millions of worldwide. Both human immunodeficiency virus (HIV-1 and -2) and herpes simplex virus-2 (HSV-2) remain incurable, urging the development of new prevention strategies. While current prophylactic technologies are dependent on strict user adherence to achieve efficacy, there is a dearth of delivery vehicles that provide discreet and convenient administration, combined with prolonged-delivery of active agents. To address these needs, we created electrospun fibers (EFs) comprised of FDA-approved polymers, poly(lactic-co-glycolic acid) (PLGA) and poly(DL-lactide-co-ε-caprolactone) (PLCL), to provide sustained-release and in vitro protection against HIV-1 and HSV-2. PLGA and PLCL EFs, incorporating the antiretroviral, tenofovir …

A Comparison Of Cervical And Trunk Musculoskeletal Characteristics Between Female And Male Army Helicopter Pilots, Takashi Nagai, Karen A. Keenan, John P. Abt, Timothy C. Sell, Brian W. Smalley, Michael D. Wirt, Scott M. Lephart

International Journal of Aviation, Aeronautics, and Aerospace

Introduction: Neck pain (NP) and low back pain (LBP) are prevalent among military helicopter pilots. Although there have been few studies on sex differences in the NP/LBP prevalence in this population, females are shown to be at a greater risk of NP/LBP in civilian studies. This disparity may be due to musculoskeletal characteristics differences that predispose females for NP/LBP. The purpose of this study was to compare cervical and trunk musculoskeletal characteristics between male and female pilots. Methods: A total of 8 female pilots (Age: 27.6 ± 4.2yrs, HT: 166.1 ± 7.7cm, WT: 67.9 ± 10.6kg) were tested, and they …

Development Of The Chronic Obstructive Pulmonary Disease Morning Symptom Diary (Copd-Msd), Gary Globe, Brooke Currie, Nancy Kline Leidy, Paul Jones, David M. Mannino, Fernando Martinez, Paul Klekotka, Sean O'Quinn, Niklas Karlsson, Ingela Wiklund

Preventive Medicine and Environmental Health Faculty Publications

Background: The morning tends to be the most difficult time of day for many patients with chronic obstructive pulmonary disease (COPD) when symptoms can limit one’s ability to perform even simple activities. Morning symptoms have been linked to higher levels of work absenteeism, thereby increasing the already substantial economic burden associated with COPD. A validated patient-reported outcome (PRO) instrument designed to capture morning symptoms will allow for a more comprehensive approach to the evaluation of treatment benefit in COPD clinical trials.

Methods: A qualitative interview study was conducted among a sample of symptomatic adults with COPD. Concept elicitation interviews ( …

A Structured Telephonic Transition Program For Heart Failure Patients, Julia E. Robinson

Doctor of Nursing Practice Final Manuscripts

HF is a fatal condition affecting more than 5 million Americans leading to frequent hospitalizations, poor quality of life and death. The annual cost to the healthcare system is approximately $38 billion, ranking HF as one of the costliest conditions to manage. Significant evidence exists that HF self-care management programs improve patient self-care and decrease HF-related readmissions. Current guidelines recommend health professionals provide comprehensive HF education focused on knowledge, skills of management, and self-care behaviors.

The Iowa Model of Evidence Based Practice provided the foundation for the practice change. Structured telephonic support (STS) was based on Bandura’s Self- Efficacy behavior …

Inter-Rater Agreement Of The Visually Rated Single-Leg Squat Assessment, Christopher Ballance, Daniel Clifton, Eric Schussler, Angie Beisner, Jimmy Onate

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

No abstract provided.

Routine Screening For Abdominal Aortic Aneurysm: Is It For Everyone?, Catherine E. Nowak

Physician Assistant Capstones, 2016 to 2019

Objective: Determine whether routine abdominal ultrasound screening in all men ages 65 and over, not just those who are symptomatic or at risk, would be beneficial in reducing the mortality rate from abdominal aortic aneurysms (AAA). Design: Systematic literature review. Methods: The clinical question investigated is whether routine ultrasound screening of AAA for men over age 65 reduces AAA-related mortality as compared to not routinely screening. Searches were done through PubMed using the keywords: screening, abdominal aortic aneurysm, reduce, and mortality. Citations used by the USPSTF AAA screening guidelines were also added to the literature search. In PubMed, further limitations …

Want To Lose Weight? Commercial Weight Loss Programs Vs. Primary Care, Jessica Jacobson, Katherine Chui

Physician Assistant Capstones, 2016 to 2019

Context Overweight and obesity rates are on a continuous incline in the United States leading to increased rates of diabetes, cardiovascular disease and death. Much of the healthcare costs are going into treating this disease; therefore, it is vital to find effective weight loss treatments in both the primary care and community settings to reduce the prevalence of overweight and obesity and subsequent healthcare costs.

Objective To assess whether primary care-based therapy or commercial weight loss programs help overweight and obese patients lose 5% of their weight from baseline.

Design, Setting and Participants A systematic review of four randomized control …

The Effect Of Sleep Quality And High Intensity Physical Activity On Inflammation And Cardiovascular Disease Risk Factors In College Students, Catherine Abraham

Honors Scholar Theses

Background: Inflammation is the common denominator in chronic conditions such as obesity, diabetes, and depression. While adequate physical activity and optimal sleep quality may help maintain normal inflammation levels, evidence is somewhat conflicting. Aim: This cross-sectional observational study aimed to assess how sleep quality and high intensity physical activity associated with cardiovascular disease (CVD) risk factors and inflammatory biomarkers in a sample of young adults (n=106, ages 18-25 years). Methods: Laboratory-based assessments included lifestyle behaviors (sleep quality, Pittsburgh Sleep Quality Index; self-reported frequency/intensity of physical activity; Healthy Behavior Index derived from reported preference for diet and physical activity), CVD risk …

Redesigning Gfp Reporter System For Utilization In Clostridium Difficile, Laura E. Fitzgerald

Biological Sciences Undergraduate Honors Theses

Clostridium difficile (C. difficile) is a gram-positive bacterium that comprises part of the healthy human gut microbiome. When it gains sufficient access to peptides, C. difficile flourishes and releases tissue-damaging toxins, which cause inflammation of the colon that can develop into a Clostridium difficile Infection (CDI).¹⁰ The Ivey Laboratory believes that the best tactic in preventing CDIs is stopping peptide ingestion, which theoretically could be accomplished by manipulating the oligopeptide permease (App) system.⁷ In order to verify that altering the App system would successfully impede peptide uptake, first the expression of the app Promoter Region ( …

The Effects Of Iron Deficiency Anemia And Iron Supplementation In Pregnancy, Anna J. Cox

Senior Honors Theses

Iron deficiency anemia (IDA) is a condition that occurs in both underdeveloped and developed countries worldwide. This disorder is diagnosed in an individual who presents the common signs and symptoms of anemia along with consistently low clinical markers of stored iron. Iron deficiency (ID) usually precedes a diagnosis of IDA as the insufficient amount of iron often goes undetected until one’s quality of life is diminished. Certain populations, such as women who are pregnant or of reproductive age, are particularly at risk for ID and the development of IDA. During pregnancy, the recommended dietary allowance (RDA) for iron is greater …

Aberrant Dna Methylation: Implications In Racial Health Disparity, Xuefeng Wang, Ping Ji, Yuanhao Zhang, Joseph F. Lacomb, Xinyu Tian, Ellen Li, Jennie L. Williams

Department of Biomedical Engineering Faculty Publications

Background Incidence and mortality rates of colorectal carcinoma (CRC) are higher in African Americans (AAs) than in Caucasian Americans (CAs). Deficient micronutrient intake due to dietary restrictions in racial/ethnic populations can alter genetic and molecular profiles leading to dysregulated methylation patterns and the inheritance of somatic to germline mutations. Materials and Methods Total DNA and RNA samples of paired tumor and adjacent normal colon tissues were prepared from AA and CA CRC specimens. Reduced Representation Bisulfite Sequencing (RRBS) and RNA sequencing were employed to evaluate total genome methylation of 5’-regulatory regions and dysregulation of gene expression, respectively. Robust analysis was …

Affecting Tdap Vaccination Rates Among Women: A Multifaceted Intervention, Soneka Wynter

Evidence-Based Practice Project Reports

Despite the availability of a preventive vaccine, the incidence of pertussis in the United States has continued to increase over the past two decades and it is now considered the most common preventable infectious illness. Highly contagious in nature, it is estimated that about 50 million people are infected each year, and approximately 300,000 deaths occur worldwide (Centers for Disease Control and Prevention [CDC], 2012). In 2013, Indiana reported 616 cases (Indiana State Department of Health [ISDH], 2014). In spite of CDC recommendations on strategies that can improve vaccine delivery, rates of immunization remain low nationwide (CDC, 2014). The purpose …

Targeting Interventions To Reduce Chlamydia-Related Disparities In Kalamazoo County Using Gis And Statistical Analysis, Claudio Owusu

Masters Theses

The annual incident rates of chlamydia continue to rise within Kalamazoo County despite an increase in public health campaign, particularly for persons between the ages of 15-24. This trend in incidence rates of chlamydia by age also shows strong disparities in race/ethnicity and gender at state and county levels. With the increasing burden on the cost of treatment of chlamydia, which is one of the many sexually transmitted infections, targeting high risk populations offers a means of reducing the cost and the spread of the infection. This has shaped attention of researchers and policy makers to the complexity of the …

Treatment And Prevention Of Human Rotavirus (Hrv) In Developing Countries: The Potential Of Avian Immunoglobulin Y, Christa Brown

Senior Honors Theses

Rotavirus gastroenteritis is a leading cause of childhood mortality, killing ~1400 children younger than five daily, primarily through severe diarrheal dehydration. Eighty-five percent of this mortality occurs in developing countries where rotavirus vaccines are not widely implemented and are only partially effective. In those countries, it has proven difficult to implement the recommended supportive therapies like oral rehydration therapy (ORT) on a wide scale due to lack of both medical infrastructure and private economic investment combined with cultural bias against ORT. IgY targeting human rotavirus (anti-HRV IgY) shows potential as a passive immunotherapy that reduces rotavirus-associated morbidity and mortality, augments …