Digital Commons Network^™

A Mini-Review Of What Matters In The Management Of Nas, Is Esc The Best Care?, Enrique Gomez Pomar

Pediatrics Faculty Publications

As the use of opioids and polysubstance by pregnant women has increased over the years, there has also been a sharp increase in cases of neonatal abstinence syndrome (NAS). Classically, infants affected by NAS have been cared for in neonatal intensive care units resulting in an increase of healthcare expenditure and resource utilization as well as separation from the families. Consequently, the Eat, Sleep, and Console (ESC) tool was developed and promoted as a novel method that focuses on maternal/infant dyad during hospital stay while decreasing the use of pharmacological interventions and therefore decreasing the length of stay and healthcare …

Negative Outcomes Of Teen Sexual Activity: Is There A Regional Effect?, Hannah Latta, Said Shahtahmasebi, Hatim A. Omar

Pediatrics Faculty Publications

A recent victory with respect to teen sexual behavior is the reduction of the national teen birth rate. In 1991, there were 61.8 births per 1000 females aged 15-19. By 2014, this rate plummeted to 24.2 births per 1000 adolescent females. Averages, however, do not reflect state-level variation. For example, in 2014, Kentucky reported 35.3 births per 1000 adolescent females, while New York reported a teen birth rates of 16.1 births per 1000 adolescent females. This report asks: are these discrepancies due to regional factors, and are these differences statistically significant? To examine rural and urban differences in outcomes of …

Simplification Of The Finnegan Neonatal Abstinence Scoring System: Retrospective Study Of Two Institutions In The Usa, Enrique Gomez Pomar, Loretta P. Finnegan, Lori Delvin, Henrietta S. Bada, Vanessa A. Concina, Katrina T. Ibonia, Philip M. Westgate

Pediatrics Faculty Publications

Objective To develop a simplified Finnegan Neonatal Abstinence Scoring System (sFNAS) that will highly correlate with scores ≥ 8 and ≥12 in infants being assessed with the FNAS.

Design, setting and participants This is a retrospective analysis involving 367 patients admitted to two level IV neonatal intensive care units with a total of 40 294 observations. Inclusion criteria included neonates with gestational age ≥ 37 0/7 weeks, who are being assessed for neonatal abstinence syndrome (NAS) using the FNAS. Infants with a gestational age < 37 weeks were excluded.

Methods A linear regression model based on the original FNAS data from one institution was developed …

The Impact Of Youth Alert! Intervention In Reducing Violence In Schools, Douglas Wain, Hatim A. Omar, Said Shahtahmasebi

Pediatrics Faculty Publications

Youth violence has long-term adverse effects on both victims and their communities. Most interventional strategies have little or no impact on reducing violence because they target supporting the victims whilst ignoring a social environment that continually facilitates exposure to violence through social and entertainment media. This paper provides some supporting evidence that interventional strategies that target changing attitudes and behaviour at a very young age through education are likely to positively change behaviour.

The Role Of Stress In Assessing Life Satisfaction And Self-Efficacy Among Prison Officers, Kamilla Bargiel-Matusiewicz, Paulina Stelmachowska, Hatim A. Omar

Pediatrics Faculty Publications

Stress is a major public health concern. It can be observed in all aspects of life, in everyday family life and work life. The focus of this article is work-related stress. Work stress can be observed in any work environment and in all professions. As a complex condition it affects different people in different ways. The study presented in this article was done on a sample of 59 prison officers who volunteered to participate. Among those 59 participants 34 were males and 25 were females aged between 25 to 52. Each participant received a survey to collect general information about …

Improving Human Papillomavirus Immunization Rates In Kentucky, Nneka S. Udechukwu, Paul Duffin, Alissa Briggs, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Effect Of Metformin On Body Mass Index In Adolescent Females With Polycystic Ovary Syndrome, Alissa Briggs, Mandakini Sadhir, Maya Todd, Hatim A. Omar

Pediatrics Faculty Publications

Polycystic ovary syndrome (PCOS) is often associated with obesity, insulin resistance, irregular menstrual periods and pelvic pain. Treatment involves hormonal methods for regulation of menstrual cycle, lifestyle changes and metformin for improving insulin resistance and weight. The aim of our study was to compare changes in body mass index (BMI) of adolescent female with PCOS treated with metformin as compared to lifestyle modification only. Participants: Adolescent and young adult females aged I0-25 years diagnosed with PCOS seen for at least two visits for at least one year on the same treatment. Based on treatment plan, participants were categorized as metformin …

Chinese Adolescent In Hong Kong, Mandakini Sadhir

Pediatrics Faculty Publications

No abstract provided.

Prevention: Sexual Violence Against Adolescent And Young Adult Women, Kimberly K. Mcclanahan, Marlene B. Huff, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

Disability And Women's Health, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

Children, adolescents, and women with disabilities experience the same sexual development, pubertal changes, concerns, and desire to reproduce as their typically developing counterparts. However, society has tended to stigmatize women with disabilities as "asexual" and ignore this aspect of their health care. These women are less likely to receive gynecological exams, contraception, and evaluation of sexual dysfunction. Unfortunately, having a disability places women at risk for sexual exploitation and abuse as well as sexually transmitted infections. Therefore, reproductive health care for these women is imperative. A number of barriers to receiving reproductive care exist. However, with proper education and knowledge …

Academic Predictors And Characteristics Of Self-Reported Juvenile Firesetting, Carrie Howell Bowling, Hatim A. Omar

Pediatrics Faculty Publications

The main purpose of this study was to address gaps in existing research by examining the relationship between academic performance and attention problems with juvenile firesetting. Two datasets from the Achenbach System for Empirically Based Assessment (ASEBA) were used. The Factor Analysis Dataset (N = 975) was utilized and results indicated that adolescents who report lower academic performance are more likely to set fires. Additionally, adolescents who report a poor attitude toward school are even more likely to set fires. Logistic regressions were run to determine if attention problems predicted firesetting and the findings indicated that attention problems are predictive …

Adolescence And Sexuality, Joav Merrick, Ariel Tenenbaum, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Adolescent Violence Prevention, Hatim A. Omar

Pediatrics Faculty Publications

Violence in adolescence has seen an increase since the 1990s with dramatic statistics on violent death and risk behaviors. School violence has been focused upon by a huge media coverage of especially violent cases that could have had some endemic consequences worldwide. We present a case of a 14 year old white male with change in school behavior, strategies for the case investigation, its results and long term prevention. Other research has shown that preventive measures during pregnancy, infancy and childhood can prevent adolescent and adult delinquency.

The Impact Of The Internet On The Sexual Health Of Adolescents: A Brief Review, Julia Springate, Hatim A. Omar

Pediatrics Faculty Publications

The object of this review is to summarize the impact of the Internet on the sexual health of adolescents. This article examines the use of websites, blogs and chat rooms as sources for sexual health information for adolescents. The influence of Internet pornography on sexual behaviors and attitudes is addressed. The use of the Internet as a place to find sexual partners is also assessed. During a time of great physical, emotional and sexual change, the Internet is playing a huge role in the decisions adolescents are making, both positive and negative.

College Drinking: A Call To Physicians, Shawn Sorrel, Hatim A. Omar

Pediatrics Faculty Publications

The aim of this paper was to review literature related to prevalence of drinking on college campuses and current prevention practices targeting this population. This paper focuses on current data surrounding alcohol use and misuse. It further discusses strategies which have been successful to prevent alcohol abuse. Finally, it discusses the need for further research to determine the role of the physician in alcohol prevention at university student health services.

Educating Adolescents About Puberty: Are We Missing Something?, Hatim A. Omar

Pediatrics Faculty Publications

Adolescents undergo significant physical and cognitive changes during their pubertal development. These changes contribute to and impact their future development. Educating adolescents at an early age about their expected development decreases the possible anxiety associated with this period of life and also helps adolescents make better choices in regards to their sexuality. In order to assess the degree of education regarding pubertal development and sexuality, we conducted a survey of late adolescents (median age 19 years) and parents of adolescents. A total of 409 adolescents (237 females, 172 males) and 124 parents completed the survey. 14.4% of teens (36.6% of …

Hyperandrogenism And Obesity, Amit M. Deokar, Shawn J. Smith, Amanda J. Goodwin, Hatim A. Omar

Pediatrics Faculty Publications

This chapter has a two-fold objective. One, ti addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this chapter will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, …

A Policy And Intervention For Overweight Children And Adolescents, Kimberly K. Mcclanahan, Marlene B. Huff, Hatim A. Omar

Pediatrics Faculty Publications

The global epidemic of childhood and adolescent overweight has become a major public health concern. Not only are these youth more likely to become obese adults, and thus more prone to obesity-related diseases than their non overweight peers, they are also likely to suffer emotional and social effects associated with overweight. Overweight in youth has been linked to depression, low self-esteem, eating disorders, negative body image, and stigma. It appears to be bi-directional in nature, with overweight sometimes predicting certain psychological effects and psychosocial issues sometimes predicting overweight. Effective assessment and treatment of psychological and mental health issues in overweight …

Bridging The Gaps: Biomedicine, Complementary And Alternative Medicine In A Holistic Approach, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

The 4^th international conference on holistic health and medicine was held during September 24-26, 2008 in Lexington, Kentucky in the United States of America. This conference brought many participants from 23 countries, both mainstream health care providers as well as holistic health practitioners to address the latest in knowledge and research, and in turn to find ways to collaborate and work together to provide the best possible care for their patients and clients. These conferences are held to build bridges between the various fractions of medicine and health care providers. The scientific program included plenary sessions, keynotes, workshops and …

Concepts Of Contraception For Adolescents With Obesity: Pathways Of Judicial Moderation, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika

Pediatrics Faculty Publications

All sexually active youth, whether obese or normal weight, should be offered counseling regarding contraception and appropriate contraceptive methods. However, obese youth who are sexually active may be less likely than their normal weight peers to use contraceptives correctly. Methods of contraception for obese adolescents are reviewed in this discussion. Combined oral contraceptives (COCs) and the contraceptive patch have higher failure rates in obese versus normal weight females, though failure rates are lower than noted with barrier contraceptives. The risk for venous thrombosis is higher in obese youth on COCs. Progestin-only pills and the levonorgestrel intrauterine system appear to be …

Hyperandrogenism And Obesity: Ominous Co-Morbidities, Amit M. Deokar, Shawn J. Smith, Amanda J. Goodwin, Hatim A. Omar

Pediatrics Faculty Publications

This review has a two-fold objective. One, it addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this article will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, …

Obesity And Contraception, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika

Pediatrics Faculty Publications

All sexually active youth, whether obese or normal weight, should be offered counseling regarding contraception and appropriate contraceptive methods. However, obese youth who are sexually active may be less likely than their normal weight peers to use contraceptives correctly. Methods of contraception for obese adolescents are reviewed in this discussion. Combined oral contraceptives (COCs) and the contraceptive patch have higher failure rates in obese versus normal weight females, though failure rates are lower than noted with barrier contraceptives. The risk for venous thrombosis is higher in obese youth on COCs. Progestin-only pills and the levonorgestrel intrauterine system appear to be …

Obesity And Hyperandrogenism, Amit M. Deokar, Shawn J. Smith, Amanda J. Goodwin, Hatim A. Omar

Pediatrics Faculty Publications

This chapter has a two-fold objective. One, it addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this article will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, …

Obesity And Lack Of Physical Activity, Hatim A. Omar, Efrat Merrick-Kenig, Joav Merrick

Pediatrics Faculty Publications

Lack of physical activity and overweight status continues to be a significant health problem in the United States. To assess the actual prevalence of these problems, we reviewed data from the School-based Health Promotion Centers in one middle school, and one high school in central Kentucky. A total of 232 6th graders and 607 9th graders were included. A total of 92% of 6th graders and 45% of 9th graders reported complete lack of regular exercise. 37% of 9th graders and 59% of 6th graders had inappropriate nutrition, 47% of 9th graders and 33% of 6th graders had Body Mass …

Prevalence Of Obesity And Lack Of Physical Activity Among Kentucky Adolescents, Hatim A. Omar, Kristin Rager

Pediatrics Faculty Publications

Lack of physical activity and overweight status continues to be a significant health problem in the United States. To assess the actual prevalence of these problems, we reviewed data from the School-based Health Promotion Centers in one middle school, and one High school in central Kentucky. A total of 232 6th graders and 607 9th graders were included. A total of 92% of 6th graders and 45% of 9th graders reported complete lack of regular exercise. 37% of 9th graders and 59% of 6th graders had inappropriate nutrition, 47% of 9th graders and 33% of 6th graders had Body Mass …