Digital Commons Network^™

Unmet Needs Of Unaccompanied Minors From Central America: Perceptions Of Professionals From Multiple Sectors, Sheyla P. Medina, Carol Lewis, Roberta Goldman

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: In recent years, there has been a significant influx of Central American youth who cross the U.S.-Mexico border without a parent or legal guardian. While federal procedures are established to oversee the treatment and placement of unaccompanied minors, less is known about the needs of unaccompanied minors and available services afterthey are placed in appropriate custody.

Methods: Purposive and strategic sampling of professionals from medical, social work, education and legal fields was conducted. Fourteen informants were recruited across the U.S. for confidential semi-structured interviews, which were audio recorded and transcribed in 2016 to 2017. Standard anthropological …

Discrimination Against Mixed-Status Families And Its Health Impact On Latino Children, Margaret A. Singer Ba, Manuela Gutierrez Velez Bs, Scott D. Rhodes Phd, Mph, Julie M. Linton M.D.

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background and Objective: Restrictive immigration policies and discrimination are associated with negative health outcomes for immigrant and Latino families. Mixed-status families represent a unique subpopulation of Latinos affected by restrictive immigration policies. This qualitative study explored discrimination against mixed-status families and its potential health impact on Latino children from the perspective of Latina mothers.

Methods: In 2017, twenty in-depth interviews with Latina mothers of mixed-status families living in northwestern North Carolina were conducted, transcribed, and analyzed. Constant comparison, an approach to grounded theory development, was used.

Results: Nine themes emerged that reflected experiences with discrimination and its …

Implications For Immigrant Child Health: Creating Evidence-Based Practice In A Changing Environment, Robert Sanborn Edd, Christopher Greeley

Journal of Applied Research on Children: Informing Policy for Children at Risk

Executive Editors, Dr. Robert Sanborn and Dr. Christopher Greeley, discuss the implications of research presented in the Journal of Applied Research on Children 10 (1) regarding the well being of immigrant children.

Screening For Undiagnosed Bleeding Disorders In Post-Tonsillectomy Bleed Patients: Retrospective Review And Systematic Review Of The Literature, Sarah A Gitomer, Grace Shebha Anand, Hallie E Bradley, Manish Kumar, Lara Ouellette, Mary F Musso

Library Staff Publications

OBJECTIVES: There is currently no standard for screening children with post-tonsillectomy bleeds (PTB) for coagulopathy disorders. This study aims to identify children with occult coagulopathy diagnosed at PTB and to identify factors associated with diagnosis. A systematic review of the literature further identified trends in this topic.

METHODS: A retrospective chart review of patients returning to the operating room for PTB at a tertiary children's hospital was undertaken from 2012 to 2016. A systematic review using Medline OVID was subsequently performed.

RESULTS: Of 12,503 tonsillectomies, 311 children (52% male, mean age 8 years) required surgery for PTB (2.5% rate). Twenty-one …

Surviving Hurricane Michael - Helping Individuals With Serious And Persistent Mental Illness, Foster Families And Child Welfare Involved Families Prepare And Recover, Lawrence Allen, David Daniels, Angela Lee, Taryn Tasker, Carla Gayle Woffard

Journal of Family Strengths

During a natural disaster the preparation and recovery can be challenging, and is further complicated when working with individuals and families with histories of trauma, serious mental illness, and involvement in child welfare. In natural disaster the social service professionals and their families may also be impacted. This requires agencies and service professionals to provide support for those served while dealing with personal loss and helping their families adapt and recover. This is a perspectives from the field article describing the challenges of preparing for and recovering from Hurricane Michael, which struck the Florida panhandle on October 10, 2018. These …

Improving The Youth Hiv Prevention And Care Cascades: Innovative Designs In The Adolescent Trials Network For Hiv/Aids Interventions, Sylvie Naar, Michael G Hudgens, Ron Brookmeyer, April Idalski Carcone, Jason Chapman, Shrabanti Chowdhury, Andrea Ciaranello, W Scott Comulada, Samiran Ghosh, Keith J Horvath, Ladrea Ingram, Sara Legrand, Cathy J Reback, Kit Simpson, Bonita Stanton, Tyrel Starks, Dallas Swendeman

Faculty, Staff and Student Publications

Dramatic decreases in HIV transmission are achievable with currently available biomedical and behavioral interventions, including antiretroviral therapy and pre-exposure prophylaxis. However, such decreases have not yet been realized among adolescents and young adults. The Adolescent Medicine Trials Network (ATN) for HIV/AIDS interventions is dedicated to research addressing the needs of youth at high risk for HIV acquisition as well as youth living with HIV. This article provides an overview of an array of efficient and effective designs across the translational spectrum that are utilized within the ATN. These designs maximize methodological rigor and real-world applicability of findings while minimizing resource …

Unraveling The Functional Role Of The Orphan Solute Carrier, Slc22a24 In The Transport Of Steroid Conjugates Through Metabolomic And Genome-Wide Association Studies, Sook Wah Yee, Adrian Stecula, Huan-Chieh Chien, Ling Zou, Elena V Feofanova, Marjolein Van Borselen, Kit Wun Kathy Cheung, Noha A Yousri, Karsten Suhre, Jason M Kinchen, Eric Boerwinkle, Roshanak Irannejad, Bing Yu, Kathleen M Giacomini

Faculty, Staff and Student Publications

Variation in steroid hormone levels has wide implications for health and disease. The genes encoding the proteins involved in steroid disposition represent key determinants of interindividual variation in steroid levels and ultimately, their effects. Beginning with metabolomic data from genome-wide association studies (GWAS), we observed that genetic variants in the orphan transporter, SLC22A24 were significantly associated with levels of androsterone glucuronide and etiocholanolone glucuronide (sentinel SNPs p-value

Pm25 Metal Constituent Exposure And Stillbirth Risk In Harris County, Texas, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Elaine Symanski

Faculty, Staff and Student Publications

There is limited evidence on the role of exposure to chemical constituents of fine particulate matter (PM

Low-Cost, High-Resolution Imaging For Detecting Cervical Precancer In Medically-Underserved Areas Of Texas, Sonia G Parra, Ana M Rodriguez, Katelin D Cherry, Richard A Schwarz, Rose M Gowen, Laura B Guerra, Andrea M Milbourne, Paul A Toscano, Susan P Fisher-Hoch, Kathleen M Schmeler, Rebecca R Richards-Kortum

Faculty, Staff and Student Publications

OBJECTIVE: Cervical cancer rates in the United States have declined since the 1940's, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center.

METHODS: HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers …

Drunk Without Drinking: A Case Of Auto-Brewery Syndrome, Bobak J Akhavan, Luis Ostrosky-Zeichner, Eric J Thomas

Faculty, Staff and Student Publications

Information on auto-brewery syndrome is limited in the medical literature. This rare syndrome occurs when yeast overgrowth leads to ethanol fermentation in the gut. We present a patient presenting with symptoms of alcohol intoxication with objective laboratory data of elevated blood ethanol levels without a history of alcohol consumption. We reviewed the literature and have discussed the current diagnostic and therapeutic options.

Nuclear Receptor Subfamily 4 Group A Member 2 Inhibits Activation Of Erk Signaling And Cell Growth In Response To Β-Adrenergic Stimulation In Adult Rat Cardiomyocytes, Sadia Ashraf, Yassmin K Hegazy, Romain Harmancey

Faculty, Staff and Student Publications

Sustained elevation of sympathetic activity is an important contributor to pathological cardiac hypertrophy, ventricular arrhythmias, and left ventricular contractile dysfunction in chronic heart failure. The orphan nuclear receptor NR4A2 is an immediate early-response gene activated in the heart under β-adrenergic stimulation. The goal of this study was to identify the transcriptional remodeling events induced by increased NR4A2 expression in cardiomyocytes and their impact on the physiological response of those cells to sustained β-adrenergic stimulation. Treatment of adult rat ventricular myocytes with isoproterenol induced a rapid (<4 >h) increase in NR4A2 levels that was accompanied by a transient (<24 >h) increase …

Infant With Protein C Deficiency And Stroke In The Setting Of Iron Deficiency Anemia, Tahseen Jalal Karim, Dustin J Paul, Regina M Troxell, Rajan Patel, Ian J Butler

Faculty, Staff and Student Publications

We report an 18-month-old infant with ischemic stroke, neurocognitive impairment, and psychomotor retardation in the setting of severe iron deficiency anemia. Although an uncommon outcome in anemic children, stroke is important to consider as a cause for developmental delay in children with iron deficiency anemia.

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Silvia Chiang, Carmen Contreras, Ganmaa Davaasambuu, Wafaie W Fawzi, Molly F Franke, Jerome T Galea, Daniel Garcia-Ferrer, Maria Gil-Fortuño, Barbará Gomila-Sard, Amita Gupta, Nikhil Gupte, Rabia Hussain, Jesus Iborra-Millet, Najeeha T Iqbal, Jose Vicente Juan-Cerdán, Aarti Kinikar, Leonid Lecca, Vidya Mave, Noemi Meseguer-Ferrer, Grace Montepiedra, Ferdinand M Mugusi, Olumuyiwa A Owolabi, Julie Parsonnet, Freddy Roach-Poblete, Maria Angeles Romeu-García, Stephen A Spector, Christopher R Sudfeld, Mark W Tenforde, Toyin O Togun, Rosa Yataco, Zibiao Zhang, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.

METHODS AND FINDINGS: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …

Epstein-Barr Virus-Positive Large Cell Neuroendocrine Carcinoma Of The Nasopharynx: Report Of One Case And Review Of The Literature, Zhenjian Cai, Mei Lin, Angel I Blanco, Jing Liu, Hui Zhu

Faculty, Staff and Student Publications

Epstein-Barr Virus (EBV)-positive neuroendocrine carcinoma (NEC) of the nasopharynx is exceedingly rare, only two cases have been reported in the literature. While EBV infection is strongly associated with nasopharyngeal carcinoma, which is carcinoma with squamous differentiation, the link between EBV and NEC is not well known, and can be diagnostically challenging. In this study, we report the third case of EBV-positive large cell NEC of nasopharynx with neck lymph node metastasis. The patient was treated with combined radiation and chemotherapy and showed complete clinical and radiological response. Similar treatment response has been reported in another patient with high stage EBV-positive …

Nuclear Receptor Subfamily 4 Group A Member 2 Inhibits Activation Of Erk Signaling And Cell Growth In Response To Β-Adrenergic Stimulation In Adult Rat Cardiomyocytes, Sadia Ashraf, Yassmin K Hegazy, Romain Harmancey

Faculty, Staff and Student Publications

Sustained elevation of sympathetic activity is an important contributor to pathological cardiac hypertrophy, ventricular arrhythmias, and left ventricular contractile dysfunction in chronic heart failure. The orphan nuclear receptor NR4A2 is an immediate early-response gene activated in the heart under β-adrenergic stimulation. The goal of this study was to identify the transcriptional remodeling events induced by increased NR4A2 expression in cardiomyocytes and their impact on the physiological response of those cells to sustained β-adrenergic stimulation. Treatment of adult rat ventricular myocytes with isoproterenol induced a rapid (<4 >h) increase in NR4A2 levels that was accompanied by a transient (<24 >h) increase …

Indications For Lung Transplant Referral And Listing, Omar Shweish, Goutham Dronavalli

Faculty, Staff and Student Publications

Lung transplantation is a valuable therapeutic option for many patients with severe lung disease who have exhausted other medical or surgical therapies. However, since lungs are not a manufacturable organ like artificial heart valves or left ventricular assist devices, and since they are a limited resource compared to number of patients requiring the organs, the Department of Health and Human Services set the Final Rule of organ allocation in 1998. This led to development and implementation of Lung Allocation Score (LAS) in 2005. The score broadly divides lung diseases into 4 diagnostic criteria with a coefficient factor given to each …

Low-Cost, High-Resolution Imaging For Detecting Cervical Precancer In Medically-Underserved Areas Of Texas, Sonia G Parra, Ana M Rodriguez, Katelin D Cherry, Richard A Schwarz, Rose M Gowen, Laura B Guerra, Andrea M Milbourne, Paul A Toscano, Susan P Fisher-Hoch, Kathleen M Schmeler, Rebecca R Richards-Kortum

Faculty, Staff and Student Publications

OBJECTIVE: Cervical cancer rates in the United States have declined since the 1940's, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center.

METHODS: HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers …

Ms 151 Guide To The Robert G. Mccorkle Family Papers, (1920-1973), Robert G. Mccorkle (1923-1979)

Manuscript Finding Aids

The McCorkle Family collection includes framed artwork and awards; medical instruments including bronchial and esophageal specular, and laryngoscopes; and a leather doctor’s bag. See more at MS 151.

Blood Leukocyte Dna Methylation Predicts Risk Of Future Myocardial Infarction And Coronary Heart Disease, Golareh Agha, Michael M Mendelson, Cavin K Ward-Caviness, Roby Joehanes, Tianxiao Huan, Rahul Gondalia, Elias Salfati, Jennifer A Brody, Giovanni Fiorito, Jan Bressler, Brian H Chen, Symen Ligthart, Simonetta Guarrera, Elena Colicino, Allan C Just, Simone Wahl, Christian Gieger, Amy R Vandiver, Toshiko Tanaka, Dena G Hernandez, Luke C Pilling, Andrew B Singleton, Carlotta Sacerdote, Vittorio Krogh, Salvatore Panico, Rosario Tumino, Yun Li, Guosheng Zhang, James D Stewart, James S Floyd, Kerri L Wiggins, Jerome I Rotter, Michael Multhaup, Kelly Bakulski, Steven Horvath, Philip S Tsao, Devin M Absher, Pantel Vokonas, Joel Hirschhorn, M Daniele Fallin, Chunyu Liu, Stefania Bandinelli, Eric Boerwinkle, Abbas Dehghan, Joel D Schwartz, Bruce M Psaty, Andrew P Feinberg, Lifang Hou, Luigi Ferrucci, Nona Sotoodehnia, Giuseppe Matullo, Annette Peters, Myriam Fornage, Themistocles L Assimes, Eric A Whitsel, Daniel Levy, Andrea A Baccarelli

Faculty, Staff and Student Publications

BACKGROUND: DNA methylation is implicated in coronary heart disease (CHD), but current evidence is based on small, cross-sectional studies. We examined blood DNA methylation in relation to incident CHD across multiple prospective cohorts.

METHODS: Nine population-based cohorts from the United States and Europe profiled epigenome-wide blood leukocyte DNA methylation using the Illumina Infinium 450k microarray, and prospectively ascertained CHD events including coronary insufficiency/unstable angina, recognized myocardial infarction, coronary revascularization, and coronary death. Cohorts conducted race-specific analyses adjusted for age, sex, smoking, education, body mass index, blood cell type proportions, and technical variables. We conducted fixed-effect meta-analyses across cohorts.

RESULTS: Among …

Utilizing Temporal Information In The Ehr For Developing A Novel Continuous Prediction Model, Kang Lin Hsieh

Dissertations and Theses (Open Access)

Type 2 diabetes mellitus (T2DM) is a nation-wide prevalent chronic condition, which includes direct and indirect healthcare costs. T2DM, however, is a preventable chronic condition based on previous clinical research. Many prediction models were based on the risk factors identified by clinical trials. One of the major tasks of the T2DM prediction models is to estimate the risks for further testing by HbA1c or fasting plasma glucose to determine whether the patient has or does not have T2DM because nation-wide screening is not cost-effective.

Those models had substantial limitations on data quality, such as missing values. In this dissertation, I …

Design And Architecture Of An Ontology-Driven Dialogue System For Hpv Vaccine Counseling, Amith Faheem Muhammad

Dissertations and Theses (Open Access)

Speech and conversational technologies are increasingly being used by consumers, with the inevitability that one day they will be integrated in health care. Where this technology could be of service is in patient-provider communication, specifically for communicating the risks and benefits of vaccines. Human papillomavirus (HPV) vaccine, in particular, is a vaccine that inoculates individuals from certain HPV viruses responsible for adulthood cancers - cervical, head and neck cancers, etc. My research focuses on the architecture and development of speech-enabled conversational agent that relies on series of consumer-centric health ontologies and the technology that utilizes these ontologies. Ontologies are computable …

Your Patient And My Client: Perspectives From Legal Work With Unaccompanied Children, Wendy Wylegala, Esq.

Journal of Applied Research on Children: Informing Policy for Children at Risk

Drawing from a dozen years’ experience in providing legal services to unaccompanied immigrant children, the author describes the legal landscape navigated by immigrant children, and some of the challenges they face. The article suggests approaches to improved communication when serving a child who is an immigrant to the U.S., calls for an increase in cross-disciplinary collaboration, and concludes with a suggested reading and resource list.

The Ripple Effects Of Us Immigration Policy On Refugee Children: A Canadian Perspective, Shazeen Suleman M.D., Mph, Ripudaman Minhas M.D., Mph, Tony Barozzino M.D.

Journal of Applied Research on Children: Informing Policy for Children at Risk

Since 2016, an estimated 40,000 individuals have crossed the Canadian/U.S. border, seeking asylum, impacted by changing U.S policies on immigration.3 Some come from countries affected by the U.S. immigration ban, while others come as the result of failed refugee claims, worsening discrimination and immigration enforcement. In this perspective piece, we outline how domestic U.S policy can have rippling effects internationally, focusing on Canada. From direct health impacts from mental health and trauma, to limited access to health care, the impact on housing and employment, and finally the subtle but poignant shift in Canadian values, we argue that the impacts of …

The Biology Of Hope, Fernando Stein M.D.

Journal of Applied Research on Children: Informing Policy for Children at Risk

Children do not immigrate; they flee. I have used this simple phrase during the recent years that I have been thrust into the debate related to the migration of children alone or with families across the southern border of the United States.

Children As Pawns Of Us Immigration Policy, Sarah Polk M.D., Scm, Mhs, Shamelle Richards, Mary Ann Hernando, Margaret Moon M.D., Joshua Sharfstein M.D.

Journal of Applied Research on Children: Informing Policy for Children at Risk

The highly publicized imposition and retraction of the “family separation” border policy by the current U.S. Administration was not an anomaly in U.S. history. In this manuscript, we place these troubling recent events in the context of decades of U.S. immigration policies and politics. We then describe the consequences of family separation and other current immigration policies on child health. We end with a call to action: Pediatricians and other advocates for child health should demand a new direction in immigration policy that stops the use of children as pawns. Instead, the United States should adopt as a fundamental guiding …

Stay Or Go! Challenges For Hispanic Families Preceding Hurricanes: Lessons Learned, Melinda L. Lewis Phd, Paula T. Rappe Msw, Lcsw, Linda K. Tierney Msw, Janet D. Albury Msw

Journal of Family Strengths

The complexities of critical decision making processes for Hispanic/Latino immigrant families concerning whether to shelter in place or evacuate preceding hurricanes along the southern coastal region of the continental United States are explored. Hispanic/Latino immigrant families in the U.S., particularly migrant workers, may experience obstacles of language, social vulnerabilities, information dissemination, distrust of authorities, and contextual barriers. Historical perspectives and lessons learned from previous disaster preparation efforts suggest a more inclusive infrastructure at the local, community, regional, state and national levels through coordinated efforts to enhance existing meso and macro-level practice and procedures supporting health and safety of Hispanic/Latino families …

The Impact Of Hurricanes On Children And Families And Interconnected Systems, Alison Salloum, Tara Powell

Journal of Family Strengths

No abstract provided.

Resilience And Coping For The Healthcare Community: A Post-Disaster Group Work Intervention For Healthcare And Social Service Providers, Paula Yuma, Tara Powell, Jennifer Scott, Mara Vinton

Journal of Family Strengths

Healthcare and social service providers play a critical role in supporting children, families and communities immediately after a disaster and throughout the recovery process. These providers, who may have also experienced the disaster and related losses, are among the least likely to receive mental health or psychological support which can result in burnout, secondary traumatic stress, depression and anxiety. Accessible psychosocial interventions designed for healthcare and social service providers in the aftermath of a disaster are therefore critical to recovery and to ensure providers are available to support families after future disasters. The purpose of this article is to describe …

Bridging Social Capital Through The Techno-Subsystem: A Qualitative Analysis Of Gofundme Requests For Hurricane Relief, Monica Bixby Radu, Lisa Mcmanus

Journal of Family Strengths

Disaster planning and risk communication are not always effective in preparation for devastating storms, and families are left to pick up the pieces as they rebuild their lives. Social capital theory poses that social connectedness and bonds between family members and friends are especially important in times of need. Recently, requesting financial assistance via crowdfunding has emerged as an alternative method for seeking assistance after a hurricane. Drawing from social capital and ecological systems theories, we qualitatively explore how requests for hurricane relief are framed via the crowdfunding website, GoFundMe.com. Among our sample (N = 26), we find that …

Hurricanes And Indigenous Families: Understanding Connections With Discrimination, Social Support, And Violence On Ptsd, Catherine E. Mckinley, Jenn Miller Scarnato, Jessica Liddell, Hannah Knipp, Shanondora Billiot

Journal of Family Strengths

This article uses the culturally grounded Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to examine the experiences and impacts of hurricanes on indigenous (i.e., Native American) family members in the Gulf Coast and to identify how experiencing hurricanes and natural disasters, family and community support, adverse childhood experiences (ACE), discrimination, and intimate partner violence (IPV) may be related to post-traumatic stress disorder (PTSD) among two Southeastern tribes. Results were drawn from a convergent mixed-methodology design, which incorporates ethnographic qualitative data and a culturally grounded quantitative follow-up survey. Thematic analysis of qualitative data with 208 participants from a coastal indigenous …