School of Medicine

Wayne State University School of Medicine
Dr. Mateika awarded Research Career Scientist status for another five years
In Headlines on August 26, 2015
Jason Mateika Ph.D.

Jason Mateika Ph.D.

Jason Mateika Ph.D., professor of Physiology for the Wayne State University School of Medicine and research career scientist for the John D. Dingell Veterans Affairs Medical Center in Detroit, has recently been recognized for a number of awards and national appointments.

Dr. Mateika’s VA Research Career Scientist Award was renewed for five years. The award recognizes established, independent investigators who have distinguished themselves through scientific achievement, and contribution to training and mentoring of junior scientists, in addition to serving on local and national grant review committees.

He also was recently recognized as a Star Reviewer for the Journal of Applied Physiology. This program is designed by the American Physiological Society to recognize the top three reviewers of each APS journal who consistently go above and beyond the call of duty to provide an extraordinary number of reviews and/or who have provided particularly timely reviews.

Also, Dr. Mateika was nominated as a member of a National VA Medical/Surgical Clinical Science Research and Developmental Centralized Data Monitoring Committee. The nomination is in addition to his membership on the Department of Veterans Affairs Joint Biomedical Laboratory Research and Clinical Science Research and Development Scientific Merit Review Board.

National association adopts three environmental health policies written by WSU grad student
In Headlines on August 25, 2015
Samantha Iovan

Samantha Iovan

The National Association of County and City Health Officials adopted three public health policies developed by Samantha Iovan, a graduate student in the Wayne State University School of Medicine’s Master’s of Public Health program.

(Read the policies: Recreational Water Safety; Sustainable Water Use; Water Quality)

“I have always been interested in environmental health, specifically water quality. I am passionate about ensuring that everyone has access to clean, safe water, and working on these policy statements allowed me to have a significant impact on how water is monitored and protected by local health departments,” she said.

The policies were drafted while Iovan participated in the first class of NACCHO’s Policy and Practice Scholars program, a competitive academic, practice-based opportunity for graduate-level students to impact public health locally. She worked in the area of Environmental Health Practice, specifically on water issues, including drafting and refining policy statements on water and conducting key informant interviews with health departments in making the connection between environmental health and public health accreditation.

NACCHO’s members are the 2,800 local health departments across the United States.

“Samantha has been especially successful in the M.P.H. program because she systematically strove to build her command of public health science and then leveraged that science to the greatest community benefit,” said Kimberly Campbell Voytal, Ph.D., R.N., the school’s M.P.H. program director and an assistant professor of Family Medicine and Public Health Sciences. “These policies guide water safety practices in county health departments across the United States. Sam was engaged in active learning and public health practice at its best. We are proud of her accomplishments.”

After the adoption of a recreational water safety policy in March 2015, Iovan decided to stay with NACCHO past her 100-hour requirement to continue working on the additional statements on sustainable water use and water quality.

“I’m thrilled to have all three of the policies I worked on during my internship at NACCHO officially adopted. It is a huge accomplishment to know that my hard work will help guide health departments and make an impact on public health across the country,” Iovan said.

Iovan has presented her final degree project, titled “Environmental Health Policy Statement Use by Local Health Departments,” and will graduate this month.

“It was great to be able to incorporate my work with NACCHO into my final M.P.H. project. I am now looking for a full-time job, where I can hopefully continue to work with public health policy or environmental health,” she said.

Study finds little difference in post-discharge problems between rural and urban populations, but reports alarming increase in such events
In Headlines on August 24, 2015
Dennis Tsilimingras, M.D., M.P.H.

Dennis Tsilimingras, M.D., M.P.H.

A study that set out to examine the difference in the rate of post-hospital discharge adverse events between rural and urban patients reported little difference between the two populations, but did find that the number of such incidents has greatly increased.

The study, “Post-Discharge Adverse Events Among Urban and Rural Patients of an Urban Community Hospital: A Prospective Cohort Study,” published in the August 2015 edition of the Journal of General Internal Medicine, is the largest to date to examine post-discharge adverse events in urban and rural patients, said principal investigator Dennis Tsilimingras, M.D., M.P.H., assistant professor and director of patient safety in the Wayne State University School of Medicine’s Department of Family Medicine and Public Health Sciences.

More than 28 percent of the study participants experienced an adverse event after discharge from the hospital, more than two-thirds of which were preventable or ameliorable, the study found.

While the study found little difference between the number of post-discharge adverse events between the urban and rural patients, Dr. Tsilimingras found the rate of such events “alarmingly high.” The first post-discharge adverse event study, published in 2003, reported a rate of 19 percent in urban patients. His study found that rate jumped to 28 percent in urban and rural populations.

“This may indicate that a decade later we have made little progress in preventing post-discharge adverse events and we must do more to identify effective interventions for patients who are adopted by hospitals around the country, during this critical post-hospital discharge period when patients transition from the hospital to home,” he said.

The study followed 684 patients who were under the care of hospitalist physicians and who were being discharged home, spoke English and could be contacted after discharge. The patients were identified as urban or rural based on the ZIP code in which they lived. While there was no difference in the rate of incidents between the two groups, post-discharge adverse events associated with hypertension and diabetes were found only in urban patients.

While Dr. Tsilimingras had hypothesized that rural patients might be at higher risk for post-discharge adverse events than urban patients, the results indicated that was not the case. In fact, the study found nearly identical rates of adverse events between rural and urban patients. However, further research may be needed to change the overall perception of the risks between the groups, he said.

“It may be that the reasons for post-discharge adverse events are different in the two populations,” Dr. Tsilimingras said. “For example, rural patients may be at higher risk because of lack of access to health care, but that may be counter-balanced by urban patients actually being sicker. The study raises a number of hypotheses that we can test. The goal is to identify the risks inherent in different populations so that we can better target effective interventions for each group.”

The study indicated a trend toward more management and therapeutic errors among urban patients, a factor that suggests these patients may be more medically complex, he said. Several “non-significant findings” provide hints at access-to-care issues among rural patients who had a trend toward adverse events of a longer duration and more adverse drug events due to anticoagulation, which required regular monitoring to prevent.

The findings, Dr. Tsilimingras said, may suggest potential customization of interventions to improve transitions of care based on residential status. They also justify the need for the effective implementation of interventions to improve patient safety upon discharge from a hospital.

Kresge resident takes Mich. Society of Eye Physicians and Surgeons' top research prize
In Headlines on August 21, 2015
Jia Yin, M.D., Ph.D.

Jia Yin, M.D., Ph.D.

Wayne State University School of Medicine 2015 residency graduate Jia Yin, M.D., Ph.D., won the Michigan Society of Eye Physicians and Surgeons’ Resident Research Competition at the organization’s annual meeting, held Aug. 6-8 on Mackinac Island.

She qualified by taking the top spot in her department’s annual clinical conference last year. Yin’s project focused on the interaction between sensory nerves and dendritic cells in diabetic corneas. Her research interest is to understand the cellular and molecular mechanisms of corneal physiology and pathology, including wound healing and infection. Her project mentor was Kresge Eye Institute Director of Research Fu-Shin Yu, Ph.D. a professor of Ophthalmology and of Anatomy and Cell Biology.

“I feel honored and proud. This is a Michigan statewide competition among the top resident research projects from the University of Michigan, Henry Ford, Beaumont and WSU ophthalmology programs,” Yin said. “My project was a basic science project that required lengthy planning and experimenting. Dr. Mark Juzych (chair of the WSU Department of Ophthalmology and of KEI) and the Kresge Eye Institute residency program granted me protected academic time. Our cornea attending physicians, Dr. Mark McDermott and Dr. Frank Hwang, also provided strong support throughout the project, in addition to Dr. Yu’s scientific guidance. This win truly is a group effort, and showcased Kresge’s high quality of resident research and serious commitment to resident academic activities.”

She completed her Ophthalmology residency in June and starts a cornea fellowship at the Harvard Medical School-affiliated Mass Eye and Ear Infirmary in Boston this month. In 2008, she completed a doctorate from the WSU School of Medicine in Anatomy and Cell Biology with a concentration in Vision Science, under the mentorship of Dr. Yu. She worked as a postdoctoral fellow and research scientist in the Department of Ophthalmology before beginning her medical residency in 2011. She received her medical degree from Capital Medical University in Beijing, China, in 2003.

Prostate cancer symposium set for Sept. 19
In Headlines on August 21, 2015
Elisabeth Heath, M.D.

Elisabeth Heath, M.D.

Brian Rivers, Ph.D., M.P.H.

Brian Rivers, Ph.D., M.P.H.

The Barbara Ann Karmanos Cancer Institute, in collaboration with the Wayne State University School of Medicine, will present the fifth annual Prostate Cancer Symposium, “Latest Treatment Advancements: What You Learn Here Could Save Your Life,” on Sept. 19 at the Charles H. Wright Museum of African American History in Detroit. The symposium is free but registration is required before Sept. 19.

The symposium, which runs from 8 a.m. to 2:30 p.m., will focus on the latest research and treatment advancements for surviving prostate cancer, Gleason scores and what they mean, active surveillance versus treatment and additional heath awareness information. Attendees will hear updates from several experts and have an opportunity to ask questions regarding treatment therapies and access to new therapies, participating in clinical trials, research progress and more.

Elisabeth Heath, M.D., F.A.C.P., the Patricia C. and E. Jan Hartmann endowed chair in Prostate Cancer Research at Karmanos Cancer Institute and professor of Oncology and Medicine for the WSU School of Medicine is the symposium leader. She will be joined by several other experts, including keynote speaker Brian Rivers, Ph.D., M.P.H., associate member in the Department of Health Outcomes & Behavior at Moffitt Cancer Center in Florida. Dr. Rivers’ expertise related to prostate cancer, especially within minority populations, has been recognized by the state of Florida and has aided the development of cancer-related legislation. He is a member of the National Institute of Heath’s National Institute of Minority Health and Health Disparities National Advisory Council on Minority Health and Health Disparities. In addition, Dr. Rivers was elected to serve on the American Association for Cancer Research Minorities in Cancer Research Council.

Registration begins at 8 a.m. and sessions begin at 8:30 a.m. Free valet or self-parking will be available. Breakfast and lunch will be provided.

 

To register and to view the full agenda, visit www.karmanos.org/2015ProstateCancer.

For more information, call 1-800- 527-6266.
Health declines the longer refugees stay in U.S., Family Medicine and Public Health Sciences research team reveals
In Headlines on August 20, 2015
Bengt Arnetz, M.D., Ph.D., M.P.H., is the study's principal investigator.

Bengt Arnetz, M.D., Ph.D., M.P.H., is the study's principal investigator.

Hikmet Jamil, M.D., Ph.D., discusses study results.

Hikmet Jamil, M.D., Ph.D., discusses study results.

Wendy Acho of the Chaldean Community Foundation speaks at the meeting.

Wendy Acho of the Chaldean Community Foundation speaks at the meeting.

The mental health of refugees with a history of high trauma exposure fleeing war-torn Iraq for the United States declines the longer they live in the U.S., because post-displacement factors such as alcohol and tobacco use, unemployment and increase in body mass index can quickly and significantly exacerbate any pre-displacement mental health problems. Chronic diseases such as diabetes, hypertension and high cholesterol also increase over time.

Those are some of the key findings unveiled by Wayne State University School of Medicine researchers Aug. 14 at a workshop held with Michigan nonprofit and government-based policy makers to discuss the findings and implications of a multi-year study that looked at the stress and needs of newly-arrived refugees from the Middle East, particularly Iraqi refugees.

“What happens when they arrive in the U.S. is just as important as what happened to them before,” said A. Michelle Wright, Ph.D., the study’s research assistant who presented the results.

The workshop was attended by representatives from the Michigan Department of Health and Human Services, Gov. Rick Snyder’s Middle East Commission, the Chaldean Community Foundation, the Iraqi Consulate, the Iraqi Christians Advocacy and Empowerment Institute and more.

“Now that we are disseminating this information to the community, we are planning to take these outcomes and write a proposal on how we can go forward, submitting first to all these grassroots organizations, then to the government,” said project coordinator Hikmet Jamil, M.D., Ph.D., a WSU professor of Family Medicine and Public Health Sciences and Iraq native who came to the U.S. and WSU in 1997. “We want to use the research to help people and to reduce the cost of our health care system in the U.S.”

The researchers found that employment is particularly protective against additional trauma exposure, worsening mental health, increased need for resources, boredom or loss of purpose and social isolation (including acculturation and lack of English language skills). Refugees were more than twice as likely as immigrants to use provided health care, but only until Medicaid assistance ran out eight months after arrival.

“Providing a little money for preventative services is much better in the long run than providing a lot of money for these huge chronic diseases and other unemployment issues. People really need access to prevention,” Wright said.

The results are the outcome of a National Institutes of Health-funded study led by Bengt Arnetz, M.D., Ph.D., M.P.H., professor of Family Medicine and Public Health Sciences and director of the Division of Occupational and Environmental Health. The team, in collaboration with community organizations, followed the health trajectory and health care utilization among newly arrived refugees exposed to trauma in their homelands as they attempt to adapt to new lives in Michigan.

“This is the end of the beginning so to speak. We really want to develop programs together,” Dr. Arnetz said.

Metropolitan Detroit has long been home to one of the world’s largest populations of Arabic peoples outside of the Middle East. Increasingly, more are fleeing the region to escape the horrors of war and ethnic and religious conflict.

“They think the U.S. will offer them everything they need. When you come, you think everything is covered, everything is easy,” added Haidar Farah, who emigrated to the U.S. four years ago. In Jordan, he was a practicing family medicine physician. Here, he is a health educator with the Arab American and Chaldean Council.

“They used to live in a big house. They were seeing people killed in front of their eyes daily,” he said.

The researchers worked with community partners such as the Arab Community Center for Economic and Social Services, the Chaldean Federation of America, Kurdish Human Rights Watch and Lutheran Social Services of Michigan to recruit 298 Iraqi refugees and 314 immigrants older than 18 between October 2010 and August 2011. The study participants were interviewed three times. Refugees had been in the country about one month at the time of their first interview. The study aimed to measure the subjects’ mental health upon arrival and the effect of trauma exposure, evaluate the risk factors for worsening mental health and evaluate protective factors for improving mental health.

Partnering organizations provide a variety of services, including employment services, youth programs, educational and cultural programs, English language courses and mental health programs.

According to the U.S. Census Bureau, nearly 35 percent of U.S. residents who were born in Iraq now live in Michigan. This number includes about 12,000 Muslims and 90,000 Chaldeans or Christian Iraqis. Much of the Chaldean population has settled in Oakland and Macomb counties.

While the study focused on refugees from Iraq, the results yielded valuable information that can be applied to refugees from other countries.

“To what extent can we use this information to help other refugees we may come in contact with?” asked Sheryl Weir, who manages the Michigan’s Department of Health and Human Services section on health disparities reduction and minority health. “How can it inform other, some broader policy? That’s what I was looking for.”
Many refugees bring with them advanced education in medicine, engineering and other high-paying fields. A substantial number who carry the nightmares associated with the horrors they saw and experienced in their native homeland often can only get jobs in discount “dollar” stores once they arrive in America, and live with several others in 500-square-foot apartments, said Wendy Acho, the Chaldean Community Foundation’s director of Strategic Initiatives.

“We visit our embassy folks in the refugee camps in Jordan, Syria, Lebanon and Turkey. We found that the fear starts once they become stateless… . I think if before their exit visas are issued, maybe (it would help) if we thought differently and if we thought more innovatively and said, ‘Let’s begin mental health care in the refugee camps,’” she said.

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