Medicine and Health Sciences Commons^™

Inhibitory Control Training Improves Cold But Not Warm Cognition In Typically Developing Preschoolers., Vahid Nejati, Ladan Ghotbi, Sarah Raskin

Faculty Scholarship

Inhibitory control, as a fundamental executive function, has been found to be associated with a range of cognitive processes. In this study, our objective was to enhance inhibitory control through a targeted training program and assess its impact on delay discounting and risky decision making. Thirty-two typically-developing children (age mean 6.89±0.32 years) were recruited in a random clinical trial design in two equal intervention and active control groups. Go/No-Go, Flanker, continuous performance, delay discounting, and balloon analogue risk tasks were used for assessment in three baseline, post- intervention, and 3-months follow-up sessions. The intervention group received the program for attentive …

Improved Motor Skills In Autistic Children After Three Weeks Of Neurologic Music Therapy Via Telehealth: A Pilot Study, Nicole M. Richard Williams, Corene Hurt-Thaut, Jessica Brian, Luc Tremblay, Marija Pranjic, Jessica Teich, Melissa Tan, Julia Kowaleski, Michael Thaut

Faculty Scholarship

Background: Many autistic children experience motor skill deficits which can impact other areas of functioning, and research on therapeutic interventions for motor skills in autism is in a preliminary stage. Music-based therapies have been used extensively to address motor skills in non-autistic populations. Though a handful of studies exist on the effects of music-based therapies for movement in autistic children, none have investigated the possibility of administering sessions via telehealth. This mixed-methods pilot study investigated whether nine Neurologic Music Therapy (NMT)^® sessions via telehealth would improve motor and attention skills in autistic children.

Methods: Five autistic children between five …

Patterns Of Prospective Memory Errors Differ In Persons With Multiple Sclerosis., Caitlyn A Nguyen, Sarah A Raskin, Aaron P Turner, Zaenab Dhari, Lindsay O Neto, Elizabeth S Gromisch

Faculty Scholarship

INTRODUCTION: Prospective memory (PM) deficits have been documented in multiple sclerosis (MS). This study aimed to explore the specific types of errors made by persons with MS (PwMS), including differences between PwMS and healthy controls (HC) and PwMS who do and do not have impairments in processing speed and/or verbal learning and memory.

METHOD: PwMS (

RESULTS: Nearly 93% of PwMS made at least one PM error, compared to 76% of HC (

CONCLUSIONS: PM errors are common in PwMS, particularly when there are longer delays and time-based cues. Not only do PwMS make more errors than demographically similar HC, …

The Efficacy Of High-Fidelity Simulation On Knowledge And Performance In Undergraduate Nursing Students: An Umbrella Review Of Systematic Reviews And Meta-Analysis, Celeste Marie Alfes

Faculty Scholarship

Objectives: This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students. Design: Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results. Data sources: Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies. Review methods: The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). …

Auditory Feedback Decreases Timing Variability For Discontinuous And Continuous Motor Tasks In Autistic Adults, Nicole M. Richard Williams, Luc Tremblay, Corene Hurt-Thaut, Jessica Brian, Julia Kowaleski, Kathrin Mertel, Sebastian Schlüter, Michael Thaut

Faculty Scholarship

Introduction: Autistic individuals demonstrate greater variability and timing error in their motor performance than neurotypical individuals, likely due at least in part to atypical cerebellar characteristics and connectivity. These motor difficulties may differentially affect discrete as opposed to continuous movements in autistic individuals. Augmented auditory feedback has the potential to aid motor timing and variability due to intact auditory-motor pathways in autism and high sensitivity in autistic individuals to auditory stimuli. Methods: This experiment investigated whether there were differences in timing accuracy and variability in autistic adults as a function of task (discontinuous vs. continuous movements) and condition (augmented auditory …

Factors Influencing Music Therapists’ Retention Of Clinical Hours With Autistic Clients Over Telehealth During The Covid-19 Pandemic, Nicole M. Richard Williams

Faculty Scholarship

The COVID-19 pandemic influenced music therapists to migrate services to online platforms, though some lost clinical hours during the pandemic when telehealth was not a viable option. This survey study aimed to ascertain factors that helped music-based therapists to continue serving autistic clients over telehealth during the pandemic. We surveyed 193 accredited music therapists located mainly in Canada and the United States. In addition to gathering data on general perceptions of telehealth music therapy and Neurologic Music Therapy® (NMT), one-way ANOVAs were applied to determine differences in percent-change loss of clinical hours for music therapists: 1) working in different employment …

A Conceptual Analysis Of Sbirt Implementation Alongside The Continuum Of Prep Awareness: Domains Of Fit And Feasibility., Lesley M. Harris, Kerr C. Jelani, Blake D. Skidmore, Smita Ghare, Andrea Reyes-Vega, Vania Remenik-Zarauz, Harideep Samanapally, Rana U. Anwar, Rishikesh Rijal, Kendall Bryant, Martin T. Hall, Shirish Barve

Faculty Scholarship

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a supplementary intervention that can be incorporated into the Pre-Exposure Prophylaxis (PrEP) Care Continuum, complementing initiatives and endeavors focused on Human Immunodeficiency Virus (HIV) prevention in clinical care and community-based work. Referencing the Transtheoretical Model of Change and the PrEP Awareness Continuum, this conceptual analysis highlights how SBIRT amplifies ongoing HIV prevention initiatives and presents a distinct chance to address identified gaps. SBIRT's mechanisms show promise of fit and feasibility through (a) implementing universal Screening (S), (b) administering a Brief Intervention (BI) grounded in motivational interviewing aimed at assisting individuals in …

Lived Experiences: Growing Up With A Seriously Mentally Ill Parent, Deborah Lindell, Elliane Irani

Faculty Scholarship

Introduction: Individuals with serious mental illness often have persistent and disruptive symptoms. These can profoundly affect their children's lives, exposing them to adverse social and psychological conditions. Such conditions can result in traumatic lived experiences during childhood, which can carry over into adulthood, influencing their self-perceptions and shaping their attitudes toward themselves and society. To gain insights into this phenomenon, this study explored the lived experiences of adults who grew up with a parent with serious mental illness and their perceptions of their lives in adulthood. Design: This study used an interpretive phenomenological design. Methods: Participants were invited to voluntarily …

Predictive Power Of Wastewater For Nowcasting Infectious Disease Transmission: A Retrospective Case Study Of Five Sewershed Areas In Louisville, Kentucky, Fayette Klaassen, Rochelle H. Holm, Ted Smith, Ted Cohen, Aruni Bhatnagar, Nicolas A. Menzies

Faculty Scholarship

Background: Epidemiological nowcasting traditionally relies on count surveillance data. The availability and quality of such count data may vary over time, limiting representation of true infections. Wastewater data correlates with traditional surveillance data and may provide additional value for nowcasting disease trends. Methods: We obtained SARS-CoV-2 case, death, wastewater, and serosurvey data for Jefferson County, Kentucky (USA), between August 2020 and March 2021, and parameterized an existing nowcasting model using combinations of these data. We assessed the predictive performance and variability at the sewershed level and compared the effects of adding or replacing wastewater data to case and death reports. …

Patient Access To Health Device Data: Toward A Legal Framework, Charles Duan, Christopher J. Morten

Faculty Scholarship

New health care devices, including at-home diagnostic devices, are generating and aggregating data on patients’ health at a staggering pace. Yet much of that data is inaccessible because it is held in data siloes, most often cloud services controlled by device manufacturers. This proprietary siloing of patient data is problematic from ethical, economic, scientific, and broad public policy perspectives. This chapter frames these concerns and begins to sketch a regulatory framework for patient access to health care device data. As with other consumer data, breaking down siloes and securing patients’ access to their device data safeguards patients’ ownership interests, promotes …

Intentional Parenthood, Contingent Fetal Personhood, And The Right To Reproductive Self-Determination, Laura D. Hermer

Faculty Scholarship

This Article argues that intent should govern legal parenthood, regardless of the method of conception, the person’s biological or genetic relationship to the resulting embryo/fetus, or the person’s gender. This proposition is not new. This Article adds to scholarly discourse by extending the concept: Intent should not just determine parenthood, but also fetal rights. When a pregnant person establishes their procreational intent (or lack thereof) prior to birth, then both the existence (or lack thereof) of legal protections for the embryo/fetus and the gestator’s rights and duties (or lack thereof) should flow from this intent. Non-gestating gamete contributors would do …

Introducing Biosimilar Competition For Cell And Gene Therapy Products, Brian Canter, Sabine Sussman, Stephen Colvill, Nitzan Arad, Elizabeth Staton, Arti Rai

Faculty Scholarship

This article provides an early analysis of the potential for creating future biosimilar competition for cell and gene therapies (CGTs) to lower prices and improve patient access, building on a unique set of interviews with relevant experts. Our discussion addressed regulatory, manufacturing, intellectual property, and market size challenges. Due to CGTs’ complexity, meeting the regulatory requirement of ‘high similarity with no clinically meaningful differences’ will be difficult. Gene therapies are likely better candidates for biosimilar development than cell therapies. Biosimilarity should be met when gene therapy biosimilars contain the same genetic sequence as a reference product, and the variability in …

Historic Redlining And Health Outcomes: A Systematic Review, Noa T. Kraus, Sarah Connor, Krista Shoda, Scott Emory Moore, Elliane Irani

Faculty Scholarship

Objective: The purpose of this systematic review was to synthesize the existing literature on the associations between historic redlining and modern-day health outcomes across the lifespan. Method: This review searched PubMed and CINAHL for peer-reviewed, data-based articles examining the relationship between historic redlining and any health outcome. Articles were appraised using the JBI critical appraisal checklist. The results were synthesized using a narrative summary approach. Results: Thirty-six articles were included and focused on various health outcomes, including cardiovascular outcomes, breast cancer incidence and mortality, firearm injury or death, birth-related outcomes, and asthma outcomes. Most of the included articles (n = …

Assessment Of Deficits In Specific Cognitive Domains In Older Adults Living With Hiv., Andrea Reyes-Vega, Harideep Samanapally, Rishikesh Rijal, Stephen P. Furmanek, Christopher B. Shields, Brandon C. Dennis, Smita Ghare, Shirish Barve

Faculty Scholarship

A significant proportion of people living with HIV (PLWH) have cognitive impairment. Moreover, approximately 70% of PLWH in the United States will be ≥50 years old by 2030, raising concerns of a higher incidence of dementia as they age. Accordingly, there is a clinical need to monitor their cognitive status. The aim of this study was to delineate specific cognition areas impacted in OALWH with a clinical diagnosis of neurocognitive impairment. We used a comprehensive set of tests (paper and NIH Toolbox Cognition Battery), to assess different cognitive domains in a total of 25 OALWH ≥ 50 years. 64% were …

Swimming Together Upstream: How To Align Mlp Services With U.S. Healthcare Delivery, William M. Sage, Keegan D. Warren

Faculty Scholarship

Medical-legal partnership (MLP) embeds attorneys and paralegals into care delivery to help clinicians address root causes of health inequities. Notwithstanding decades of favorable outcomes, MLP is not as well-known as might be expected. In this essay, the authors explore ways in which strategic alignment of legal services with healthcare services in terms of professionalism, information collection and sharing, and financing might help the MLP movement become a more widespread, sustainable model for holistic care delivery.

Social Activity Restriction And Psychological Health Among Caregivers Of Older Adults With And Without Dementia, Elliane Irani, Kylie Meyer, Scott Emory Moore, Kedong Ding

Faculty Scholarship

Objectives: We examined associations between social activity restriction and psychological distress and well-being for caregivers of older adults with and without dementia, and if the identified associations are different for the two groups. Methods: Using data from the 2017 National Study of Caregiving, we identified caregivers of older adults with (N = 541) and without (N = 1701) dementia. Linear regression models were estimated, adjusting for caregivers’ age, gender, race, education, relationship to care recipient, and self-rated health. Results: Restriction in visiting friends and family and attending religious services were associated with higher distress in dementia caregivers. Restriction in visiting …

Maternal Exposure To Ssris Or Snris And The Risk Of Congenital Abnormalities In Offspring: A Systematic Review And Meta-Analysis, Weiyi Huang, Robin Page, Theresa Morris, Susan Ayres, Alva Ferdinand, Samiran Sinha

Faculty Scholarship

Background

The association of maternal exposure to selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) with the risk of system-specific congenital malformations in offspring remains unclear. We conducted a meta-analysis to examine this association and the risk difference between these two types of inhibitors.

Methods

A literature search was performed from January 2000 to May 2023 using PubMed and Web of Science databases. Cohort and case-control studies that assess the association of maternal exposure to SSRIs or SNRIs with the risk of congenital abnormalities were eligible for the study.

Results

Twenty-one cohort studies and seven case-control …

Healthaichain: Improving Security And Safety Using Blockchain Technology Applications In Ai-Based Healthcare Systems, Naresh Kshetri, James Hutson, Revathy G

Faculty Scholarship

Blockchain as a digital ledger for keeping records of digital transactions and other information, it is secure and decentralized technology. The globally growing number of digital population every day possesses a significant threat to online data including the medical and patients’ data. After bitcoin, blockchain technology has emerged into a general-purpose technology with applications in medical industries and healthcare. Blockchain can promote highly configurable openness while retaining the highest security standards for critical data of medical patients. Referred to as distributed record keeping for healthcare systems which makes digital assets unalterable and transparent via a cryptographic hash and decentralized network. …

Apheresis Collection Of Mononuclear Cells For Chimeric-Antigen Receptor Therapies, Robert W. Maitta

Faculty Scholarship

Collections of lymphocytes to be genetically modified to treat hematologic malignancies have seen a dramatic increase over the last few years as commercial products have been approved. Reports of new products in development that can possibly treat solid organ malignancies represent a massive change in the field. Apheresis is at the center of the collection of cells for the manufacture of these chimeric-antigen receptor therapy products. The expansion of these collections represents one of the areas of apheresis procedures growth. This review will summarize concepts important to this type of collection and variables that need to be optimized to obtain …

The Effect Of Mandatory Triage Questions On Triage Processes: A Qualitative Exploratory Study, Paul Clark Rn, Phd, Ma, Faen

Faculty Scholarship

Objective: The study purpose was to obtain an understanding of both the types of questions mandated for the triage encounter in emergency departments across the US, and how emergency nurses (EN) perceive the relevance of these questions to the triage process. Methods: a qualitative descriptive exploratory study using focus group data was used. Data were collected at an in-person emergency nursing conference held in September 2022. Data were analyzed using Mayring’s 8-step process. Results: Participants (n=35) voiced concerns about a lack of expertise at all points in the triage process. The overarching problem is reported as data required by regulatory …

Use Of Electronic Ecological Momentary Assessment Methodologies In Physical Activity, Sedentary Behavior, And Sleep Research In Young Adults: Systematic Review, Kimberly R. Hartson, Luz Huntington-Moskos, Clara G. Sears, Gina Genova, Cara Mathis, Wessly Ford, Ryan E. Rhodes

Faculty Scholarship

Background: Recent technological advances allow for the repeated sampling of real-time data in natural settings using electronic ecological momentary assessment (eEMA). These advances are particularly meaningful for investigating physical activity, sedentary behavior, and sleep in young adults who are in a critical life stage for the development of healthy lifestyle behaviors.

Objective: This study aims to describe the use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults.

Methods: The PubMed, CINAHL, PsycINFO, Embase, and Web of Science electronic databases were searched through August 2022. Inclusion criteria were use of eEMA; sample of young adults …

Editorial: Developments In Sickle Cell Disease Therapy And Potentials For Gene Therapy, Robert W. Maitta, Hollie M. Reeves

Faculty Scholarship

No abstract provided.

Incorporating Sexual And Gender Minority Patient Care Competencies: A Case Based Curriculum For Caring For Gender Diverse Youth, Eileen Cichoskikelly, Suzanne Kingery, Susan Sawning

Faculty Scholarship

There is a gap in medical education training content specifically focused on the care of Sexual and Gender Minority (SGM) people and people with Differences in Sex Development (DSD). Inadequate training contributes to suboptimal health care access, utilization, and experiences among SGM-DSD people. Improving medical education training can be challenging as many clinician educators received sparse instruction themselves in these areas and there are limited teaching resources that expand beyond didactic instruction. In 2014 the Association of American Medical Colleges (AAMC) Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development published a landmark document identifying 30 specifiers of competence …

Traumatic Brain Injury Screening And Neuropsychological Functioning In Women Who Experience Intimate Partner Violence, Sarah Raskin, Olivia Dejoie, Carolyn Edwards, Chloe Ouchida, Jocelyn Moran, Olivia White, Michelle Mordasiewicz, Dorothy Anika, Blessing Njoku

Faculty Scholarship

Objective: The potential for traumatic brain injury (TBI) to occur as the result of intimate partner violence (IPV) has received increased interest in recent years. This study sought to investigate the possible occurrence of TBI in a group of women who survived IPV and to measure the specific profile of cognitive deficits using standardized neuropsychological measures. Method: A comprehensive questionnaire about abuse history; neuropsychological measures of attention, memory and executive functioning; and measures of depression, anxiety and post-traumatic stress disorder were given to women who were IPV survivors, women who were sexual assault (SA) survivors, and a comparison group of …

Online Dashboards For Sars-Cov-2 Wastewater Data Need Standard Best Practices: An Environmental Health Communication Agenda, Colleen C. Naughton, Rochelle H. Holm, Nancy J. Lin, Brooklyn P. James, Ted Smith

Faculty Scholarship

The COVID-19 pandemic has highlighted the benefits of wastewater surveillance to supplement clinical data. Numerous online information dashboards have been rapidly, and typically independently, developed to communicate environmental surveillance data to public health officials and the public. In this study, we review dashboards presenting SARS-CoV-2 wastewater data and propose a path toward harmonization and improved risk communication. A list of 127 dashboards representing 27 countries was compiled. The variability was high and encompassed aspects including the graphics used for data presentation (e.g., line/bar graphs, maps, and tables), log versus linear scale, and 96 separate ways of labeling SARS-CoV-2 wastewater concentrations. …

Measurement Of Prospective Memory In Spanish Speakers, Laura Cadavid, Alicia Camuy, Valerie Velez, Sarah Raskin

Faculty Scholarship

Introduction: This study aimed to provide preliminary evidence on the psychometric properties of a measure of prospective memory in Spanish speakers, the Memory for Intentions Test (MIST) Spanish translation.

Methods: In addition, this study investigated whether acculturation influenced performance on the MIST. Finally, we measured other cognitive factors that might be impacting the relationship between culture and prospective memory performance. These factors were working memory, autobiographical memory, and episodic future thought.

Results: Overall, the psychometric properties of the Spanish MIST appear to be similar to the English language MIST, but our sample size was too small to allow for the …

Reflections On The Use Of Patient Records: Privacy, Ethics, And Reparations In The History Of Psychiatry, Jonathan Sadowsky

Faculty Scholarship

One of the most common questions we get asked as historians of psychiatry is “do you have access to patient records?” Why are people so fascinated with the psychiatric patient record? Do people assume they are or should be available? Does access to the patient record actually tell us anything new about the history of psychiatry? And if we did have them, what can, or should we do with them? In the push to both decolonize and personalize the history of psychiatry, as well as make some kind of account or reparation for past mistakes, how can we proceed in …

Central Pattern Generator And Control Of Breathing (Ośrodkowy Generator Wzorca I Kontrola Oddychania), Jaroslaw Richard Romaniuk

Faculty Scholarship

Fifty years ago, Clark and Euler published a model of the neural control of respiration that stimulated modern studies on the central generator of the rate and depth of breathing. These studies led to new discoveries concerning both anatomical localization and functional characteristics of respiratory central pattern generator (CPG), and as a result our knowledge has greatly changed. This article describes the history of respiratory CPG research and, more specifically, explains how studies concerning the regulation of breathing parameters affect the creation of new hypotheses and theoretical models of the neural control of respiration. Comparing studies on the generators of …

Resilience As A Moderator Of Role Overload And Sleep Disturbance Among Caregivers Of Persons With Dementia, Elliane Irani, Fei Wang, Stephanie Griggs, Ronald L. Hickman

Faculty Scholarship

The purpose of this study was to examine if resilience moderates the association between role overload and sleep disturbance among caregivers of persons with dementia. This was a secondary analysis of data on 437 informal caregivers (mean age=61.77 years, SD=13.69) of persons with dementia in the United States. Data from the 2017 wave of the National Study of Caregiving were analyzed using multiple regression with interaction terms to evaluate the moderation effect of resilience, while controlling for caregivers’ age, race, gender, education, self-rated health, caregiving hours, and primary caregiving status. Higher role overload was associated with greater sleep disturbance and …

Small Molecule Inhibitors Of 15-Pgdh Exploit A Physiologic Induced-Fit Closing System, Wei Huang, Hongyun Li, Janna G. Kiselar, Stephen P. Fink, Sagar Regmi, Alexander Day, Yiyuan Yuan, Mark R. Chance, Sanford D. Markowitz, Derek J. Taylor

Faculty Scholarship

15-prostaglandin dehydrogenase (15-PGDH) is a negative regulator of tissue stem cells that acts via enzymatic activity of oxidizing and degrading PGE2, and related eicosanoids, that support stem cells during tissue repair. Indeed, inhibiting 15-PGDH markedly accelerates tissue repair in multiple organs. Here we have used cryo-electron microscopy to solve the solution structure of native 15-PGDH and of 15-PGDH individually complexed with two distinct chemical inhibitors. These structures identify key 15-PGDH residues that mediate binding to both classes of inhibitors. Moreover, we identify a dynamic 15-PGDH lid domain that closes around the inhibitors, and that is likely fundamental to the physiologic …