Medicine and Health Sciences Commons^™

Transition Readiness Tools To Improve Health Care Transitions Among Adolescents With Inflammatory Bowel Disease, Meagan Moffett

Doctor of Nursing Practice (DNP) Projects

Inflammatory bowel disease is associated with severe disease in pediatric patients often requires treatment through adulthood. Collaborative efforts of patients, families, and health providers are needed to foster a smooth transition of care from pediatric to adult health care.

The purpose of this quality improvement project was to establish a baseline understanding of transition readiness among adolescents at one gastroenterology clinic to improve transition to adult care. A cross-sectional design was used to assess adolescents’ readiness for transition of care over a three-month period. Transitioning Readiness Assessment Questionnaire (TRAQ) was administered followed by individualized education on topics covered in the …

The Dangers Of Aces, Olivia Carey, Thea Forrest, Adna Abdi

Maine Medical Center

ACEs stands for Adverse Childhood Experiences, included (but not limited to) physical, emotional, and sexual abuse, substance abuse, neglect, dysfunctional families, and mental illness'. ACEs impacts childhood development and increases chances of future health implications.

Qualitative Study Exploring The Feasibility, Usability And Acceptability Of Neonatal Continuous Monitoring Technologies At A Public Tertiary Hospital In Nairobi, Keny, Mai-Lei Woo Kinshella, Violet Naanyu, Dorothy Chomba, Mary Waiyego, Jessica Rigg, Jesse Coleman, Bella Hwang, J. Mark Ansermino, William Macharia, Amy Sarah Ginsburg

Paediatrics and Child Health, East Africa

Objective: To assess the feasibility, usability and acceptability of two non-invasive, multiparameter, continuous physiological monitoring (MCPM) technologies for use in neonates within a resource-constrained healthcare setting in sub-Saharan Africa.

Design: A qualitative study using in-depth interviews and direct observations to describe healthcare professional and caregiver perspectives and experiences with investigational MCPM technologies from EarlySense and Sibel compared with selected reference technologies.

Setting: Pumwani Maternity Hospital is a public, high-volume, tertiary hospital in Nairobi, Kenya.

Participants: In-depth interviews were conducted with five healthcare administrators, 12 healthcare providers and 10 caregivers. Direct observations were made of healthcare providers using the technologies on …

Can Implicit Measures Augment Suicide Detection In Youth? The Feasibility And Acceptability Of The Death Implicit Association Test Among Pediatric Medical Impatients, Annabelle M. Mournet, Daniel S. Powell, Elizabeth C. Lanzillo, Sandra Mcbee-Strayer, Emory Bergdoll, Catherine R. Glenn, Alexander Millner, Maryland Pao, Matthew K. Nock, Lisa M. Horowitz, Jeffrey A. Bridge

Psychology Faculty Publications

Background: Medically ill youth are at increased suicide risk, necessitating early detection. This study aimed to assess the feasibility of administering the Death Implicit Association Test (Death IAT) to pediatric medical inpatients. Methods: Participants completed measures including the Ask Suicide-Screening Questions (ASQ) and the Death IAT. Results: Over 90% of participants found the Death IAT to be acceptable and more than 75% of participants were comfortable completing the task. There was a small, but statistically significant, improvement from pre-survey to post-survey reports of mood (t(174) = 3.02, p = 0.003, d = 0.15). Participants who endorsed a past suicide attempt …

Imaging For Diagnosis And Assessment Of Necrotizing Enterocolitis., Vinayak Mishra, Alain Cuna, Rachana Singh, Daniel M. Schwartz, Sherwin S. Chan, Akhil Maheshwari

Manuscripts, Articles, Book Chapters and Other Papers

Necrotizing enterocolitis (NEC) is inflammatory bowel necrosis of preterm and critically ill infants. The disease is seen in 6-10% of preterm infants who weigh less than 1500 g at birth and carries considerable morbidity, mortality, and healthcare cost burden. Efforts focused on timely mitigation remain restricted due to challenges in early diagnosis as clinical features, and available laboratory tests remain nonspecific until late in the disease. There is renewed interest in the radiological and sonographic assessment of intestinal diseases due to technological advances making them safe, cost-efficient, and supporting Web-based transmission of images, thereby reducing time to diagnosis by disease …

Variability Of Respiratory Rate Measurements In Neonates- Every Minute Counts, Catherine Muthoni, J. Mark Ansermino, William Macharia, Dustin T. Dunsmuir

Paediatrics and Child Health, East Africa

Background: Respiratory rate is difficult to measure, especially in neonates who have an irregular breathing pattern. The World Health Organisation recommends a one-minute count, but there is limited data to support this length of observation. We sought to evaluate agreement between the respiratory rate (RR) derived from capnography in neonates, over 15 s, 30 s, 120 s and 300 s, against the recommended 60 s.

Methods: Neonates at two hospitals in Nairobi were recruited and had capnograph waveforms recorded using the Masimo Rad 97. A single high quality 5 min epoch was randomly chosen from each subject. For each selected …

Implementing Nih Behavior Change Consortium Treatment Fidelity Recommendations In A Multi-Site Randomized Controlled Trial Of An Active Music Engagement Intervention For Young Children With Cancer And Parents., Jessica A. Maclean, Kristin Stegenga, Amanda K. Henley, Sheri L. Robb

Manuscripts, Articles, Book Chapters and Other Papers

Treatment fidelity is the use of methodological strategies to monitor and enhance reliability and validity of behavioral intervention trials. Despite availability of guidelines and checklists, treatment fidelity remains underreported, hindering evaluation, interpretation, and cross-study comparisons. Treatment fidelity is particularly important for music interventions given the inherent complexity of musical stimuli and flexibility required for tailored delivery. The purpose of this paper is to define and describe treatment fidelity strategies for our trial of a music-based play intervention for young children with cancer and parents grounded in the NIH Behavior Change Consortium Treatment Fidelity Recommendations. We report strategies for all 5 …

Additive And Interactive Associations Of Environmental And Sociodemographic Factors With The Genotypes Of Three Glutathione S-Transferase Genes In Relation To The Blood Arsenic Concentrations Of Children In Jamaica, Mohammad H Rahbar, Maureen Samms-Vaughan, Yuansong Zhao, Sepideh Saroukhani, Sheikh F Zaman, Jan Bressler, Manouchehr Hessabi, Megan L Grove, Sydonnie Shakspeare-Pellington, Katherine A Loveland

Journal Articles

Arsenic (As) is a metalloid that has been classified as a xenobiotic with toxic effects on human beings, especially on children. Since the soil in Jamaica contains As, dietary intake is considered the main source of As exposure in Jamaicans. In addition, glutathione S-transferase (GST) genes, including

Associations Between Eight Earth Observation-Derived Climate Variables And Enteropathogen Infection: An Independent Participant Data Meta-Analysis Of Surveillance Studies With Broad Spectrum Nucleic Acid Diagnostics, Josh M. Colston, Benjamin F. Zaithcik, Hamada S. Badr, Eleanor Burnett, Syed Asad Ali, Ajit Rayamajhi, Syed M. Satter, Daniel Eibach, Ralf Krumkamp, M Imran Nisar, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Diarrheal disease, still a major cause of childhood illness, is caused by numerous, diverse infectious microorganisms, which are differentially sensitive to environmental conditions. Enteropathogen‐specific impacts of climate remain underexplored. Results from 15 studies that diagnosed enteropathogens in 64,788 stool samples from 20,760 children in 19 countries were combined. Infection status for 10 common enteropathogens—adenovirus, astrovirus, norovirus, rotavirus, sapovirus, Campylobacter, ETEC, Shigella, Cryptosporidium and Giardia—was matched by date with hydrometeorological variables from a global Earth observation dataset—precipitation and runoff volume, humidity, soil moisture, solar radiation, air pressure, temperature, and wind speed. Models were fitted for each pathogen, accounting …

Severity Of Child Autistic Symptoms And Parenting Stress In Mothers Of Children With Autism Spectrum Disorder In Japan And Usa: Cross-Cultural Differences, Noriko Porter, Katherine A Loveland, Sepideh Saroukhani, Yana Posey, Kana Morimoto, Mohammad H Rahbar

Journal Articles

The purpose of this study was to compare the relationship between parenting stress and autistic symptom severity in the U.S. and Japan. Fifty-two U.S. and 51 Japanese mothers of children aged 2-12 with autism completed measures of parenting stress and child characteristics, including the parenting stress index (PSI), the social communication questionnaire (SCQ), and social responsiveness scale-2 (SRS-2). There was a nonlinear relationship between the child's autistic symptom severity and parenting stress in both countries. We also found some cultural differences: in the parent domain, the relationships between children's SCQ scores and PSI scores differed significantly between the U.S. and …

Meeting The 24-H Movement Guidelines And Health-Related Outcomes Among Youth With Autism Spectrum Disorder: A Seven-Country Observational Study, Chunxiao Li, Justin A. Haegele, Fenghua Sun, Maria Luiza Tanure Alves, Stefanie Hwee Chee Ang, Jihyun Lee, Kwok Ng, Isabella Dos Santos Alves, Sean Healy, Wendy Yajun Huang, Pauli Rintala, Jernice Sing Yee Tan, Yandan Wu, Hannah Yang, Eija Kärnä, Hyokju Maeng, André Lisandro Schliemann

Human Movement Sciences & Special Education Faculty Publications

Background: Meeting daily guidelines for physical activity, screen time, and sleep duration is associated with a host of health indicators for youth. In this cross-sectional observational study, we investigated the associations between adherence to the movement guidelines and health-related outcomes among youth with autism spectrum disorder (ASD).

Methods: Parents of youth with ASD (10-17 years) from seven countries and regions were invited to provide online proxy-reports for child's movement behaviors (i.e., physical activity, sleep and screen time), and health-related outcomes (i.e., body mass index [BMI], general health, and quality of life). A series of multiple linear regression analyses were used …

Longitudinal Changes Of Cardiorespiratory Fitness Performance In High School: Association With Individual And School-Based Variables, Xihe Zhu, Justin A. Haegele, Jinting Shao, Summer Davis

Human Movement Sciences & Special Education Faculty Publications

This study aimed to model adolescents’ cardiorespiratory fitness performance change trajectories longitudinally across high school years and its relation to school- and individual/student-level factors. We employed hierarchical linear modeling to examine longitudinal cardiorespiratory fitness performance changes, as measured by the progressive aerobic capacity endurance run (PACER), over the years, between sexes, and in association with the school-level variables. Participants were 76,227 adolescents from 80 high schools in the mid-Atlantic region of the United States. School-level academic performance (SAP), the percent of students eligible for free and reduced-price meals (FARM), and physical education student-faculty ratio were obtained with permission from the …

Prenatal And Pediatric Oral Health Education Among Dental Hygiene Programs In The United States, Denise M. Claiborne, Shillpa Naavaal

Dental Hygiene Faculty Publications

Purpose: Health care and dental providers must be prepared to address the oral health needs of mothers and children in order to reduce the burden of dental disease in these populations. The purpose of this study was to describe the curriculum and clinical experiences related to prenatal and pediatric oral health in the university and community college dental hygiene programs in the United States (US).

Methods: Dental hygiene program directors (PDs) from across the US were invited to participate in a cross-sectional electronic survey regarding the prenatal and pediatric oral health curriculum at their institution. In addition to program characteristics, …

Vitamin D Level In Relation To Depression Symptoms During Adolescence, Reem Al-Sabah, Abdullah Al-Taiar, Lemia Shaban, Ahmed N. Albatineh, Reem Sharaf Alddin, Praveen K. Durgampudi

Community & Environmental Health Faculty Publications

BACKGROUND: This study aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D) and depression symptoms among adolescents in Kuwait, a country with a high prevalence of vitamin D deficiency.

METHODS: A school based cross-sectional study was conducted on randomly selected 704 adolescents in middle schools. Data on depression symptoms were collected using the Children's Depression Inventory (CDI). Data on covariates were collected from the parents by self-administered questionnaire and from adolescents by face-to-face interview. Blood samples were analyzed in an accredited laboratory; and 25(OH)D was measured using liquid chromatography-tandem mass spectrometry.

RESULTS: Of 704 adolescents, 94 (13.35%; 95%CI:10.35-17.06%) had depression …

Preventive Training Program Feedback Complexity, Movement Control, And Performance In Youth Athletes, Hayley J. Root, Eleanor M. Beltz, Julie P. Burland, Jessica C. Martinez, R. Curt Bay, Lindsay J. Distefano

Rehabilitation Sciences Faculty Publications

Context: Preventive training programs (PTPs) reduce injury risk by improving movement control. Corrective feedback is important; however, many cues at once may be too complicated for athletes.

Objective: To compare movement control and long-jump (LJ) changes in youth athletes participating in a season-long PTP, with simplified feedback, traditional feedback, or a warmup of the coaches' choosing.

Design: Cluster-randomized controlled trial.

Setting: Soccer fields.

Patients or Other Participants: A total of 420 athletes (simplified feedback = 173, traditional feedback = 118, and control = 129; age = 11 ± 3 years).

Intervention(s): Teams were randomized into the simplified PTP, traditional PTP, …

Effectiveness Of Wechat-Group-Based Parental Health Education In Preventing Unintentional Injuries Among Children Aged 0-3: Randomized Controlled Trial In Shanghai, Yuheng Feng, Xueqi Ma, Qi Zhang, Ruo Jiang, Jun Lu, Kaiyue Chen, Huiping Wang, Qinghua Xia, Jicui Zheng, Jingwei Xia, Xiaohong Li

Community & Environmental Health Faculty Publications

BACKGROUND: Unintentional injuries to children are a major public health problem. The online social media is a potential way to implement health education for caregivers in online communities. Using WeChat, a free and popular social media service in China, this study evaluated the effectiveness of social online community-based parental health education in preventing unintentional injuries in children aged 0-3.

METHODS: We recruited 365 parents from two community health centers in Shanghai and allocated them into intervention and control groups randomly. Follow-up lasted for one year. The intervention group received and followed their WeChat group and a WeChat official account for …

Next-Generation Sequencing Of Minimal Residual Disease For Predicting Relapse After Tisagenlecleucel In Children And Young Adults With Acute Lymphoblastic Leukemia., Michael A. Pulsipher, Xia Han, Shannon L. Maude, Theodore W. Laetsch, Muna Qayed, Susana Rives, Michael W. Boyer, Hidefumi Hiramatsu, Gregory A. Yanik, Tim Driscoll, Douglas Myers, Peter Bader, Andre Baruchel, Jochen Buechner, Heather E. Stefanski, Creton Kalfoglou, Kevin Nguyen, Edward R. Waldron, Karen Thudium Mueller, Harald J. Maier, Gabor Kari, Stephan A. Grupp

Manuscripts, Articles, Book Chapters and Other Papers

We assessed minimal residual disease (MRD) detection and B-cell aplasia after tisagenlecleucel therapy for acute lymphoblastic leukemia (ALL) to define biomarkers predictive of relapse (N = 143). Next-generation sequencing (NGS) MRD detection >0 in bone marrow (BM) was highly associated with relapse. B-cell recovery [signifying loss of functional chimeric antigen receptor (CAR) T cells] within the first year of treatment was associated with a hazard ratio (HR) for relapse of 4.5 [95% confidence interval (CI), 2.03-9.97; P < 0.001]. Multivariate analysis at day 28 showed independent associations of BMNGS-MRD >0 (HR = 4.87; 95% CI, 2.18-10.8; P < 0.001) and B-cell recovery (HR = 3.33; 95% CI, 1.44-7.69; P = 0.005) with relapse. By 3 months, the BMNGS-MRD HR increased to 12 …

Trends In Stunting, Underweight And Overweight Among Children Aged < 5 Years In Kuwait: Findings From Kuwait Nutritional Surveillance System (2007-2019), Nawal Alqaoud, Abdullah Al-Taiar

Community & Environmental Health Faculty Publications

Background: There is a paucity of data on the secular trends of stunting and overweight among children aged < 5 years in oil-rich countries in the Middle East.

Aims: To examine the secular trends of stunting, underweight and overweight in children aged < 5 years in Kuwait between 2007 and 2019.

Methods: We used large individual data records (n=48 108) from the Kuwait Nutritional Surveillance System (KNSS) to calculate height/length-for-age z score (HAZ), weight-for-age z score and body mass index (BMI)-for-age z score using World Health Organization growth references. Stunting and underweight were defined as less than -2 standard deviation (SD) and overweight (including obesity) as ≥ 2 SD. Trends of stunting, underweight and overweight were …

Still Birth Classification: Application Of Relevant Condition At Death (Recode) Classification System In A Tertiary Care Hospital Of Pakistan, Urooj Kashif, Shelina Bhamani, Asma Patel, Zaheena Shamsul Islam

Department of Obstetrics & Gynaecology

Objectives: To determine the cause of stillbirth after application of relevant condition at death (ReCoDe) classification system.
Methods: This was a retrospective cross sectional study of 207 women diagnosed with stillbirth after 24 completed weeks of pregnancy at the Aga Khan University Hospital (AKUH), Karachi between 1st January 2015 and 31st December 2019. The primary objective was to find the cause of stillbirth according to the new classification of relevant condition at death (ReCoDe).
Results: There were a total of 32413 live births and 207 stillbirths during the study period thus stillbirth rate of 6 per 1000 live births. In …

Incidence, Etiology, Sociodemographic And Clinical Characterization Of Acute Respiratory Failure In Pediatric Patients At A High-Altitude City: A Multicenter Cohort Study, Sarha M Vargas Muñoz, Sara De Vivero Haddad, Aldo M Beltran, Carolina Bonilla Gonzalez, Melisa Naranjo Vanegas, Sergio Moreno-Lopez, Paola Rueda-Guevara, Pedro Barrera, Juan Gabriel Piñeros, Luz Marina Mejía, María Lucia Mesa, Sonia Restrepo-Gualteros, Olga Lucía Baquero Castañeda, Andrea Ramírez Varela

Journal Articles

BACKGROUND: Acute respiratory failure is a life-threatening medical condition, associated with a variety of conditions and risk factors, including acute respiratory diseases which are a frequent cause of pediatric morbidity and mortality worldwide. In Colombia, the literature related to ARF is scarce.

OBJECTIVE: To determine the incidence, causes, and sociodemographic and clinical characteristics of ARF in three hospitals in Bogota, a high-altitude city located in Colombia, during the COVID-19 pandemic.

METHODS: A multicenter prospective cohort study called the FARA cohort was developed between April 2020 - December 2021. Patients older than one month and younger than 18 years with respiratory …

Covid-19 In Children And The Influence On The Employment Activity Of Their Female Caregivers: A Cross Sectional Gender Perspective Study, Catalina Jaime Trujillo, Natalia Herrera Olano, Kevin Rico Gutiérrez, Daniela Medellín, Paola Sánchez, María Lucía Mesa-Rubio, Melisa Sofía Naranjo, Sergio Mauricio Moreno, Carolina Bonilla, Pedro Barrera, Sonia M Restrepo-Gualteros, Luz Marina Mejia, Olga Lucía Baquero, Juan Gabriel Piñeros, Andrea Ramírez Varela

Journal Articles

INTRODUCTION: During the COVID-19 pandemic, women disproportionately assume more unpaid activities, affecting their employment.

OBJECTIVE: Describe the influence of COVID-19 on the employment of caregivers of children and adolescents from a gender perspective.

METHODS: Cross-sectional study in three high-complexity hospitals in Bogotá, Colombia from April 2020 to June 2021. A subsample of the FARA cohort was taken, including those patients with a positive test for SARS-COV2. We took as our analysis category children older than 8 years and younger than 18 years who had a positive SARS-COV2 test, as well as, caregivers of all children with a positive SARS-COV2 test. …

Coping With Adverse Childhood Experiences During The Covid-19 Pandemic: Perceptions Of Mental Health Service Providers, Sumaita Choudhury, Paul G Yeh, Christine M Markham

Journal Articles

BACKGROUND: Adverse Childhood Experiences (ACEs) have been associated with long-term physical and mental health conditions, toxic stress levels, developing unstable interpersonal relationships, and substance use disorders due to unresolved childhood adversities.

AIMS: This study assessed the perspectives of mental health providers (MHPs) regarding their adult patients' coping with ACEs during COVID-19 in Houston, Texas. Specifically, we explored how individuals with ACEs are coping with the increased stresses of the pandemic, how MHPs may provide therapeutic support for individuals with ACEs during this pandemic, pandemic-related challenges of accessing and utilizing mental health services for individuals with ACEs, and the awareness and …

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 …

Challenges In Evaluating Pediatric Fever And Rash In The Era Of Covid-19 And Multisystem Inflammatory Syndrome In Children (Mis-C)., Taylor Jarvill, Priyanka Lauber Do, Samuel Umaru Md, Tibisay Villalobos Md, Susan K. Yaeger Md

Department of Emergency Medicine

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has challenged the medical community to characterize and treat a new illness. Now almost two years after the initial confirmed cases of COVID-19, medical teams are faced with another unique disease process temporally related to the pandemic-multisystem inflammatory syndrome in children (MIS-C). The comparison of these patients’ presentations illustrates the new challenges of evaluating a pediatric rash and fever in the era of MIS-C. Case Reports: This report presents three cases with features of MIS-C, positivity for SARS-CoV-2, rashes, fevers, gastrointestinal involvement, and elevated inflammatory markers. The first case poses a diagnostic …