Medicine and Health Sciences Commons^™

Physical Activity Interventions In Children With Juvenile Idiopathic Arthritis: A Systematic Review Of Randomized Controlled Trials, Maura D. Iversen, Marie Andre, Johan Von Heideken

Physical Therapy Faculty Publications

Introduction: Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA.

Materials and methods: A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and …

Health Technology In School-Based Health Centers: Supporting Continuous Care During Covid-19, Erin Sullivan, Anna Goddard, Paula Fields, Suzanne Mackey

Nursing Faculty Publications

Background: Children and adolescents in the United States face disparities by race, ethnicity, and socioeconomic status, including unequal access to consistent and high-quality healthcare. School-based health centers (SBHCs) promote health equity by delivering primary, mental, and other health services directly to students in their schools. The COVID-19 outbreak in the United States resulted in schools and SBHCs closing their physical sites and pivoting to virtual service delivery. Methods: In the months immediately following school closures, school-based health center practitioners and sponsors participated in an online listening series to share how they used technology to creatively advertise services, engage with students, …

Implementation And Sustainment Strategies For Open Visitation In The Intensive Care Unit: A Multicentre Qualitative Study, Kerry A. Milner, Suzanne Marmo, Susan A. Goncalves

Nursing Faculty Publications

Objective

Open visitation in adult intensive care units has been associated with improved family and patient outcomes. However, worldwide adoption of this practice has been slow and reasons for this are unclear. This study documents barriers and strategies for implementing and sustaining open visitation in adult intensive care units in the United States experienced by nursing leadership.

Research design

Qualitative approach using grounded theory.

Participants

Nurse leaders in adult intensive care units with open visitation.

Setting

Magnet® or Pathway to Excellence® designated hospitals in the United States.

Methods

Semi structured interviews were conducted with 19 nurse leaders from 15 geographically …

Efficacy And Safety Of Once-Daily Vibegron For Treatment Of Overactive Bladder In Patients Aged ≥65 And ≥75 Years: Subpopulation Analysis From The Empowur Randomized, International, Phase Iii Study, Susann Varano, David Staskin, Jeffrey Frankel, Denise Shortino, Rachel Jankowich, Paul N. Mudd

Physician Assistant Studies Faculty Publications

Background

Overactive bladder (OAB) is common among older adults. The efficacy and safety of vibegron for the treatment of OAB were demonstrated in the international, phase III EMPOWUR trial. This subpopulation analysis from EMPOWUR assessed the efficacy and safety of vibegron in patients aged ≥ 65 and ≥ 75 years.

Methods

In EMPOWUR, patients with OAB were randomly assigned 5:5:4 to receive once-daily vibegron 75 mg, placebo, or tolterodine 4 mg extended release, respectively, once daily for 12 weeks. Coprimary efficacy endpoints were change from baseline at week 12 in average daily number of micturitions and urge urinary incontinence (UUI) …

The Quality Of Intervention Reporting In Trials Of Therapeutic Exercise For Hip Osteoarthritis: A Secondary Analysis Of A Systematic Review, Louise C. Burgess, Thomas C. Wainwright, Khara A. James, Johan Von Heideken, Maura D. Iversen

Physical Therapy Faculty Publications

Background: Therapeutic exercise is recommended as a core treatment for hip osteoarthritis (HOA). Whilst it is widely accepted that exercise can improve pain and disability, optimal type and dose of exercise are yet to be agreed upon. This may, in part, be attributed to the wide variation and inadequate reporting of interventions within the literature. This study evaluates the quality of intervention reporting among trials of therapeutic exercise in HOA.

Methods: Randomised controlled trials (RCTs) were sourced in a systematic review, completed in August 2020. Two raters independently used the Template for Intervention Description and Replication (TIDieR) and Consensus on …

Measures Of Pediatric Function And Physical Activity In Arthritis, Anna E. Greer, Maura D. Iversen

Exercise Science Faculty Publications

Physical function can be assessed through physical examination with the use of performance-based measures and patient-reported outcome measures (PROMs). Each form of assessment provides a unique contribution to the understanding of the impact of rheumatologic conditions on the patient. PROMs of physical function (PF) are an important component of the assessment of children with arthritis and have been included in the recommended core set of measures for childhood arthritis and musculoskeletal conditions. These measures provide the child’s or parent’s perspective of function within the context of daily living. Measures of PF include both generic measures, which are designed for use …

Atrial Fibrillation And Exercise: Exercise Recommendations, Paul Sorace, Peter Ronai, Robert Berry

Exercise Science Faculty Publications

Atrial fibrillation (AF), characterized by a rapid pulse rate and an irregular heart rhythm. It is a more common cardiac arrhythmia. AF may lack symptoms, although fatigue and an impaired exercise ability are common symptoms. This column will discuss exercise testing and training recommendations as well as special considerations.

Elderly Bleeding Risk Of Direct Oral Anticoagulants In Nonvalvular Atrial Fibrillation: A Systematic Review And Meta-Analysis Of Cohort Studies, Jessika Lobraico-Fernandez, Salma Baksh, Eric C. Nemec

Physician Assistant Studies Faculty Publications

Introduction The 2014 American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Rhythm Society (HRS) guidelines recommend anticoagulation to reduce clot formation and the risk of thromboembolic events in patients with atrial fibrillation but does not specify guidelines for the elderly population. Direct oral anticoagulants (DOACs) are newer US FDA-approved alternatives to warfarin and include dabigatran, rivaroxaban, apixaban and edoxaban. The efficacy of DOACs is heavily researched, but few studies have evaluated their bleeding risk. Objectives This systematic review and meta-analysis investigates which DOAC has the lowest bleeding risk in elderly patients with nonvalvular atrial fibrillation (NVAF). Methods CINAHL and MEDLINE …

Delirium Prevention, Identification And Management In The Oncology Setting: A Unique Partnership With Patients And Their Family Caregivers, Mary Kate Eannielo, Christine M. Waszynski, Kerry A. Milner

Nursing Faculty Publications

Significance & Background: Delirium affects a significant number of hospitalized adults each year resulting in negative patient outcomes and family caregiver distress. Clinical identification of delirium by nurses and use of family caregivers as part of a multicomponent delirium prevention strategy are not consistently implemented in the practice setting despite being best practice.Purpose: An interdisciplinary team in this 800 bed level one trauma center has been created to create and implement this best practice delirium protocol. The purpose of this initiative was to incorporate the family caregiver into this existing multicomponent delirium prevention, detection and management protocol. Interventions: Consistent implementation …

Using A Multifaceted Approach To Working With Children Who Have Differences In Sensory Processing And Integration, Stacey Reynolds, Tara J. Glennon, Karla Ausderau, Roxanna M. Bendixen, Heather Miller-Kuhaneck, Beth Pfeiffer, Renee Watling, Kimberly Wilkinson, Stefanie C. Bodison

Occupational Therapy Faculty Publications

Pediatric occupational therapy practitioners frequently provide interventions for children with differences in sensory processing and integration. Confusion exists regarding how best to intervene with these children and about how to describe and document methods. Some practitioners hold the misconception that Ayres Sensory Integration intervention is the only approach that can and should be used with this population. The issue is that occupational therapy practitioners must treat the whole client in varied environments; to do so effectively, multiple approaches to intervention often are required. This article presents a framework for conceptualizing interventions for children with differences in sensory processing and integration …

Determining Risk Of Falls In Community-Dwelling Older Adults: A Systematic Review And Meta-Analysis Using Posttest Probability, Michelle M. Lusardi, Stacy Fritz, Addie Middletown, Leslie Allison, Mariana Wingood, Emma Phillips, Michelle Criss, Sangita Verma, Jackie Osborne, Kevin Chui

All PTHMS Faculty Publications

BACKGROUND:

Falls and their consequences are significant concerns for older adults, caregivers, and health care providers. Identification of fall risk is crucial for appropriate referral to preventive interventions. Falls are multifactorial; no single measure is an accurate diagnostic tool. There is limited information on which history question, self-report measure, or performance-based measure, or combination of measures, best predicts future falls.

PURPOSE:

First, to evaluate the predictive ability of history questions, self-report measures, and performance-based measures for assessing fall risk of community-dwelling older adults by calculating and comparing posttest probability (PoTP) values for individual test/measures. Second, to evaluate usefulness of cumulative …

Gender Differences In Concussion Reporting Among High School Athletes, Theresa Miyashita, Eleni Diakogeorgiou, Christina Vandervegt

All PTHMS Faculty Publications

Background: An athlete’s lack of concussion knowledge could lead to significant underreporting and injury mismanagement. To provide more effective management strategies of concussions in adolescent athletes, further examination of reporting behaviors is of critical importance. Hypothesis: The hypotheses for this study were as follows: (1) Girls are more likely to report concussion, (2) girls are more likely to report future concussions after an educational intervention, and (3) a difference in rationale for not reporting concussion will be found between sexes. Study Design: Cross-sectional, cohort design. Level of Evidence: Level 3. Methods: Survey answers were collected on 454 high school athletes …

Health-Related Fitness For Children And Adults With Cerebral Palsy, Yvette Blanchard, Mary E. Gannotti, Wendy Romney

All PTHMS Faculty Publications

Position Statement of ACSM Sports Medicine Basics 2016: Health-related physical fitness for persons with Cerebral Palsy should be developed in the same model as fitness for all of us: start early, be easily available and continue throughout the life span.

Predictors Of Orthopaedic Surgery In Ncaa Athletes, Dean Wang, Caitlin M. Rugg, Erik Mayer, Pamela Sulzicki, Jeremy Vail, Sharon L. Hame

Athletic Training Faculty Publications

Objectives: Orthopaedic injury and surgery is relatively common in National Collegiate Athletic Association (NCAA) athletes and can have devastating career consequences. However, there is a paucity of data regarding predictors of orthopaedic surgery in collegiate athletes. The purpose of this study was to analyze player-related predictors of orthopaedic surgery, including that of the shoulder, hip, and knee, in NCAA athletes. Methods: All NCAA Division I collegiate athletes at a single institution who began participation from the 2003-2004 through 2008-2009 seasons were retrospectively identified. Player-related factors, including gender, sport, and any pre-college upper or lower extremity orthopaedic surgery, were elicited through …

Epidermal Growth Factor Mediated Healing In Stem Cell-Derived Vocal Fold Mucosa, Liliana Palencia, Amritava Das, Sean P. Palecek, Susan L. Thibeault, Ciara Leydon

Communication Disorders Faculty Publications

Background: The goal of vocal fold wound healing is the reconstitution of functional tissue, including a structurally and functionally intact epithelium. Mechanisms underlying reepithelialization in vocal folds are not known, although it is suspected that healing involves the interplay between several growth factors. We used a three-dimensional human embryonic stem cell-derived model of vocal fold mucosa to examine the effects of one growth factor, exogenous epidermal growth factor (EGF), on wound healing. Materials and methods: A scratch wound was created in the in vitro model. Rate of wound healing, epidermal growth factor receptor (EGFR) activation, and cell proliferation after injury …

Epithelial Cells Are Active Participants In Vocal Fold Wound Healing: An In Vivo Animal Model Of Injury, Ciara Leydon, Mitsuyoshi Imaizumi, Rebecca S. Bartlett, Sarah F. Wang, Susan L. Thibeault

Communication Disorders Faculty Publications

Vocal fold epithelial cells likely play an important, yet currently poorly defined, role in healing following injury, irritation and inflammation. In the present study, we sought to identify a possible role for growth factors, epidermal growth factor (EGF) and transforming growth factor-beta 1 (TGFβ1), in epithelial regeneration during wound healing as a necessary first step for uncovering potential signaling mechanisms of vocal fold wound repair and remodeling. Using a rat model, we created unilateral vocal fold injuries and examined the timeline for epithelial healing and regeneration during early and late stages of wound healing using immunohistochemistry (IHC). We observed time-dependent …

Cardiac Rehabilitation Programmes For Low-Risk Patients And Leisure Athletes: A Potential Paradox, Wendy Bjerke, Stu Steinman, Vincent Cotto

All PTHMS Faculty Publications

Background: Athletes are enrolled in cardiac rehabilitation (CR) programmes in small numbers and require unique diagnostic testing and training considerations. Additionally, many physiotherapists, exercise physiologists, athletic trainers and physicians lack experience treating athletes in CR due to their limited exposure to these types of patients. Content: This analysis distinguishes athletes from typical CR patients within the context of diagnostic testing, assessment, exercise prescription, and management. Several case studies present unique challenges and approaches to the rehabilitation of athletes in a CR setting. Conclusions: Athletes enrolled in CR should be treated and trained according to their abilities and goals. Combining traditional …

Analysis Of Vitamin D Status At Two Academic Medical Centers And A National Reference Laboratory: Result Patterns Vary By Age, Gender, Season, And Patient Location, Jonathan R. Genzen, Jennifer T. Gosselin, Thomas C. Wilson, Emilian Racila, Matthew D. Krasowski

Psychology Faculty Publications

Background: Testing for 25-hydroxyvitamin D [25(OH)D] has increased dramatically in recent years. The present report compares overall utilization and results for 25(OH)D orders at two academic medical centers - one in New York and one in Iowa – in order to characterize the vitamin D status of our inpatient and outpatient populations. Results are also compared to those from a national reference laboratory to determine whether patterns at these two institutions reflect those observed nationally.

Methods: Retrospective data queries of 25(OH)D orders and results were conducted using the laboratory information systems at Weill Cornell Medical College / New York Presbyterian …

Blended Learning In Anesthesia Education: Current State And Future Model, Jaya Kannan, Viji Kurup

Jandrisevits Faculty Publications

Purpose of review: Educators in anesthesia residency programs across the country are facing a number of challenges as they attempt to integrate blended learning techniques in their curriculum. Compared with the rest of higher education, which has made advances to varying degrees in the adoption of online learning anesthesiology education has been sporadic in the active integration of blended learning. The purpose of this review is to discuss the challenges in anesthesiology education and relevance of the Universal Design for Learning framework in addressing them.

Recent findings: There is a wide chasm between student demand for online education and the …

The Special Care Nursery, Linda Kahn-D’Angelo, Yvette Blanchard, Beth Mcmanus

Physical Therapy Faculty Publications

Providing services to high-risk infants and their families in the neonatal intensive care unit is a complex subspecialty of pediatric physical therapy requiring knowledge and skills beyond the competencies for entry into practice. The newborns in the neonatal intensive care unit (NICU) are among the most fragile patients that physical therapists will treat, and detrimental effects can occur as the result of routine caregiving procedures. Pediatric physical therapists (PTs) need advanced education in areas such as early fetal and infant development; infant neurobehavior; family responses to having a sick newborn; the environment of the NICU, physiologic assessment and monitoring; newborn …

Use Of The Term "Elderly", Dale Avers, Marybeth Brown, Kevin Chui, Rita A. Wong, Michelle M. Lusardi

All PTHMS Faculty Publications

Using the term elderly for a person who is robust and independent as well as for a person who is frail and dependent says little about the individual.

Identifying And Co-Managing The Hiv-Infected Adult: A Guidebook For Primary Care Clinicians, Jason Leider, Susan F. Lelacheur, Julie G. Stewart Dnp, Mph

Nursing Faculty Publications

This guidebook was designed to help primary care clinicians improve their performance in terms of HIV identification and co-management. Surmounting barriers to opt-out screening, making an HIV diagnosis, and preventing transmission and opportunistic infections will be discussed, as will selection of initial therapy and considerations for patients receiving antiretroviral therapy (ART).

Are Scores On The Ppt Useful In Determination Of Risk Of Future Falls In Individuals With Dementia?, Mary K. Farrell, Richard A. Rutt, Michelle M. Lusardi, Ann K. Williams

All PTHMS Faculty Publications

Individuals with dementia or Alzheimer’s disease (AD), exhibit both a progressive decline in cognitive function and accumulating difficulty with physical function.¹ As cognitive impairment begins, individuals will initially demonstrate difficulties with short-term memory and with instrumental activities of daily living. As the dementia progresses, individuals will increasingly demonstrate difficulties with long-term memory, communication, and basic activities of daily living.

The Neural Underpinnings Of Prosody In Autism, Inge-Marie Eigsti, Jillian Schuh, Einar Mencl, Robert T. Schultz, Rhea Paul

Communication Disorders Faculty Publications

This study examines the processing of prosodic cues to linguistic structure and to affect, drawing on fMRI and behavioral data from 16 high-functioning adolescents with autism spectrum disorders (ASD) and 11 typically developing controls. Stimuli were carefully matched on pitch, intensity, and duration, while varying systematically in conditions of affective prosody (angry versus neutral speech) and grammatical prosody (questions versus statement). To avoid conscious attention to prosody, which normalizes responses in young people with ASD, the implicit comprehension task directed attention to semantic aspects of the stimuli. Results showed that when perceiving prosodic cues, both affective and grammatical, activation of …

Addressing The Fertility Needs Of Hiv-Seropositive Males, Brian A. Levine, Sahadat K. Nurudeen, Jennifer T. Gosselin, Mark V. Sauer

Psychology Faculty Publications

An increasing number of serodiscordant couples are utilizing advanced reproductive technologies to address their reproductive needs. Recent literature has demonstrated that it is not only technically possible but also safe to utilize sperm-washing techniques to allow for the creation of embryos, thereby preventing both horizontal and vertical transmission of HIV. This article addresses the strengths and weakness of various reproductive techniques and discusses our experience at Columbia University (NY, USA), the location of the largest HIV-focused fertility program in the USA.

Getting To Know You: Key Clinical Concepts In Relationship-Based Interventions And Neurobehavioral Observations With Young Infants, Yvette Blanchard

All PTHMS Faculty Publications

The newborn infant is a social organism, pre-disposed to interact with his caregiver and able to elicit the kind of caregiving necessary for successful adaptation. The earliest developmental task of the newborn is to organize behavior to be able to play an active role in influencing the caregiving environment and eliciting the kind of support needed for development. This task is accomplished through the attainment of self-regulation or balanced neurobehavioral functioning of the infant's autonomic, motor, state, and responsivity behavioral dimensions as described by Als.

Physical Activity And Cognitive-Health Content In Top-Circulating Magazines, 2006–2008, Anna E. Greer, Sara J. Corwin, Daniela B. Friedman

All PTHMS Faculty Publications

Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90–300 min of …

Parents Ask: Am I Risking Autism If I Vaccinate My Children?, Rhea Paul

Communication Disorders Faculty Publications

There is no evidence that autism is caused by any vaccine or any additive or preservative ever used in one. There have been large, well-controlled studies done all over the Western world that have confirmed this finding over and over again. There is no reason for any parent to deny a child the crucial protection today’s vaccines offer out of misguided fear that doing so would increase the risk for autism.

White Paper: Walking Speed: The Sixth Vital Sign, Stacy Fritz, Michelle M. Lusardi

All PTHMS Faculty Publications

Walking speed is "almost the perfect measure." This review summarizes the strong psychometric properties of walking speed and robust evidence for using this clinical measurement. Walking speed is easily measurable, clinically interpretable, and a potentially modifiable risk factor. For these reasons, using WS as the sixth vital sign is both pragmatic and essential.

Associations Between Performance On The Rey-Osterrieth Complex Figure And Regional Brain Volumes In Children With And Without Velocardiofacial Syndrome, Kevin M. Antshel, Jena Peebles, Nuria Abdulsabur, Anne Marie Higgins, Nancy Roizen, Robert J. Shprintzen, Wanda Fremont, Robert Natasi, Wendy R. Kates

Communication Disorders Faculty Publications

Ninety-two children with velocardiofacial syndrome (VCFS), a genetic disorder caused by a microdeletion of chromosome 22q11.2 and an age, race, and gender-ratio comparable sample of 59 control participants were included in the project. Participants received an MRI as well as a comprehensive neuropsychological battery; the primary outcome measure in the current report is the Rey-Osterrieth Complex Figure (ROCF). Children with VCFS performed less well on the ROCF and have lower whole brain volume compared to controls. After controlling for whole brain volume differences, children with VCFS have bilaterally less parietal lobe gray and white matter yet more frontal lobe white …