Medical Specialties Commons^™

Mechanisms, Diagnosis, Prevention And Management Of Perioperative Opioid-Induced Hyperalgesia, Sylvia H Wilson, Kevin M Hellman, Dominika James, Adam C Adler, Arvind Chandrakantan

Faculty, Staff and Students Publications

Opioid-induced hyperalgesia (OIH) occurs when opioids paradoxically enhance the pain they are prescribed to ameliorate. To address a lack of perioperative awareness, we present an educational review of clinically relevant aspects of the disorder. Although the mechanisms of OIH are thought to primarily involve medullary descending pathways, it is likely multifactorial with several relevant therapeutic targets. We provide a suggested clinical definition and directions for clinical differentiation of OIH from other diagnoses, as this may be confusing but is germane to appropriate management. Finally, we discuss prevention including patient education and analgesic management choices. As prevention may serve as the …

Social Isolation: Impact On Physical And Mental Health, Alexa Waters, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Review the impact of social isolation and loneliness on important aspects of health and well-being, with a focus on older adults
• Review risk and protective factors for social isolation and loneliness
• Discuss how the health care system and primary care physicians can better identify and address social isolation
• Briefly highlight interventions to enhance social connectedness and reduce loneliness

Outline

• Background
• Impacts of social isolation and loneliness on health and well-being
• Risk and protective factors for social isolation and loneliness
• Role of the health system and primary care in addressing social isolation and loneliness
• Cases throughout

Mental Health Of Children And Adolescents Amidst Covid-19 And Past Pandemics: A Rapid Systematic Review, Salima Meherali, Neelam Punjani, Samantha Louie-Poon, Komal Abdul Rahim, Jai K. Das, Rehana A. Salam, Zohra S. Lassi

School of Nursing & Midwifery

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children's and adolescent's mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children's and adolescents' mental health.
Methodology: We conducted …

James's Choice: Treating An Infant With Craniosacral Therapy (Cst), Veronica Quarry

Journal of Transformative Touch

No abstract provided.

Cooper Neurological Institute, Kayla Cupano

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Alcohol Use In Tanzanians With Chronic Psychotic Disorders And Poor Medication Adherence, Emily Simon, Jennifer B. Levin, Carol Blixen, Michelle Aebi, Kristin Cassidy, Martha Sajatovic

Faculty Scholarship

Background: The burden of chronic psychotic disorders (CPDs) in sub-Saharan Africa (SSA) is significant. Poorly medically adherent patients are more likely to have worse outcomes and require more resources. However, factors impacting effective treatment of CPD in this population are unclear. Aim: Examine the relationship between alcohol use and disease management and compare alcohol risk stratification between the Alcohol Use Disorders Identification Test (AUDIT) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in poorly medication adherent Tanzanians with CPD. Setting: Muhimbili National Hospital and ambulatory clinics in Dar es Salaam, Tanzania. Methods: 100 Tanzanians with CPDs and suboptimal medication …

Examination Of Anger Prevalence In Ncaa Division I Student-Athletes, Robert Madden, Zachary K. Winkelmann, Samantha R. Weber, Erin M. Moore, Toni M. Torres-Mcgehee

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: Anger associated with sports participation may affect inability to acutely process anger, may decrease performance and increase the likelihood of risk-taking behavior in collegiate athletes. Therefore, the purpose was to examine the prevalence of anger in collegiate student-athletes across sex, academic status, and sport type. Methods: A cross sectional study over a three-year period examined 759 NCAA Division I student-athletes at one institution (age=20±1 years; males: n=259; females: n=500) completed an optional pre-participation behavioral health screening questionnaire, personal demographic information and the Anger Index Self-Test. Results: Overall, 37.2% (n=282/759; males=127/259, 49.0%; females=155/500, 31.0%) of participants were at …

Surrogacy Among Filipinos Who Have Struggled With Infertility: A Discourse Analysis, Gabrielle Marie A. Liamzon, Andrea Mari P. Santos, Marie Ashley G. Tamayo, Ma. Elizabeth J. Macapagal

Psychology Department Faculty Publications

Surrogacy continues to be practiced to address infertility in the Philippines; however, discussions on the method are sparse, given its limited accessibility and morally questionable procedures that may concern potential parents in a developing country. Using discourse analysis, the researchers interviewed ten (10) Filipino Roman Catholics who were struggling with infertility, to uncover how they construct the idea of surrogacy. The study shows the discourses on surrogacy are often approached in a detached manner, where potential parents describe the method as a last choice or one that is never considered. They articulate this position by highlighting the emotional factors surrogacy …

Pornography: Social, Emotional And Mental Implications Among Adolescents, William Kelly Canady

National Youth Advocacy & Resilience Conference

This presentation will explain the historical development of pornography. It will highlight four segments: 1- Porn’s impact on brain development of reward pathways, ultimately increasing the appetite for more porn. 2- Porn can be a false substitute for real intimacy, resulting in decreased sexual satisfaction with a real person and increased verbal and physical aggression. 3- Porn promotes sex trafficking, promotes multiple sex partners and reduced STD prevention. 4- A review of interventions available to assist clients in navigating a lifestyle away from pornography.

The Complicated Path To Wellness, Jennifer Reese, Martin Huecker

Journal of Wellness

No abstract provided.

The Psychometric Properties Of The Bergen–Yale Sex Addiction Scale For The Iranian Population, Samaneh Youseflu, Shane W. Kraus, Majid Yousefi Afrashteh, Soudabeh Niroomand, Fatemeh Razavinia

Psychology Faculty Research

Background: The assessment of sex addiction among different populations requires a valid and reliable tool. Since the Bergen–Yale Sex Addiction Scale (BYSAS) was not available in Iran, this study aimed to evaluate the validity and reliability of the Persian version of the BYSAS. Methods: After translation/back-translation procedure, a total of 756 Iranian men and women completed the BYSAS. The structural validity of this tool was evaluated by exploratory and confirmatory factor analyses. An expert panel review also examined content validity of the items. Psychometric properties of the scale including validity, reliability (internal consistency [Cronbach’s alpha]) and test-retest) and factor structure …

Evaluating Opioid Dispensing Rates Among Pediatrics And Young Adults Based On Cures Data Reporting In California From 2015–2019, Michael T. Phan, Courtney Wong, Daniel M. Tomaszewski, Zeev N. Kain, Brooke Jenkins, Candice D. Donaldson, Michelle Fortier, Sun Yang

Pharmacy Faculty Articles and Research

Background

Receipt of opioid prescriptions in pediatric and young adult patients may be a risk factor for future opioid misuse. Data from prescription drug monitoring programs provide insight on outpatient opioid use. In our study, we analyzed the opioid dispensing rates for pediatrics and young adults in California. Methods

A secondary analysis was performed from 2015–2019 using Controlled Utilization Review and Evaluation System data. This database provides dispensing data of controlled substances in California. Patients younger than 25 years who were prescribed opiates were analyzed by county. We further divided them into two groups (children: ≤14 years; adolescents and young …

Deconstructing Patriarchy In The Healing Arts, Rebekah Harbour

Journal of Transformative Touch

Sometimes we perpetuate the very systems we want to change because it's the only way we know. Making a change in the outer world can require a shift in our inner perspective.

A Biallelic Pathogenic Variant In The Ogdh Gene Results In A Neurological Disorder With Features Of A Mitochondrial Disease, Zheng Yie Yap, Klaudia Strucinska, Satoshi Matsuzaki, Sukyeong Lee, Yue Si, Kenneth Humphries, Mark A Tarnopolsky, Wan Hee Yoon

Faculty, Staff and Students Publications

2-Oxoglutarate dehydrogenase (OGDH) is a rate-limiting enzyme in the mitochondrial TCA cycle, encoded by the OGDH gene. α-Ketoglutarate dehydrogenase (OGDH) deficiency was previously reported in association with developmental delay, hypotonia, and movement disorders and metabolic decompensation, with no genetic data provided. Using whole exome sequencing, we identified two individuals carrying a homozygous missense variant c.959A>G (p.N320S) in the OGDH gene. These individuals presented with global developmental delay, elevated lactate, ataxia and seizure. Fibroblast analysis and modeling of the mutation in Drosophila were used to evaluate pathogenicity of the variant. Skin fibroblasts from subject # 2 showed a decrease in …

Suicide Prevention And Mood Disorders: Self-Exclusion Agreements For Firearms As A Suicide Prevention Strategy, Melvin G. Mcinnis, Stephen B. Thompson, Sofia D. Merajver, Carl E. Schneider

Articles

Suicide involves a complex set of behaviors and emotions that lead up to actions that may be based on planning and forethought or the result of impulse. While there are a host of antecedent circumstances the presence of a mood disorder, primarily depression, is the most common factor in suicide. While management of depression is recognized as important prevention strategy in depression, the means by which suicide occurs must be a critical element of prevention. Policies that lower access to the means for suicide will decrease the fatality. Guns are associated with half of suicides and the case fatality rate …

Mental Health Disorders Among Patients With Acute Myocardial Infarction In The United States, Jayakumar Sreenivasan, Muhammad Shahzeb Khan, Safi U Khan, Urvashi Hooda, Wilbert S Aronow, Julio A Panza, Glenn N Levine, Yvonne Commodore-Mensah, Roger S Blumenthal, Erin D Michos

Faculty, Staff and Students Publications

OBJECTIVE: To assess the prevalence, temporal trends and sex- and racial/ethnic differences in the burden of mental health disorders (MHD) and outcomes among patients with myocardial infarction (MI) in the United States.

METHODS: Using the National Inpatient Sample Database, we evaluated a contemporary cohort of patients hospitalized for acute MI in the United States over 10 years period from 2008 to 2017. We used multivariable logistic regression analysis for in-hospital outcomes, yearly trends and estimated annual percent change (APC) in odds of MHD among MI patients.

RESULTS: We included a total sample of 6,117,804 hospitalizations for MI (ST elevation MI …

Dnp Final Report: Breaking The Cycle: Care Coordination Interventions And Sickle Cell Readmissions, Naphtali Edge

DNP Final Reports

Background

Approximately 100,000 people in the United States are affected by Sickle Cell Disease (SCD). Sickle Cell Disease represents the second highest readmitting diagnosis at Houston Methodist Hospital. The purpose of this study is to determine the impact of implementing care coordination interventions to reduce hospital readmissions of patients with SCD.

PICOT

In adult patients with SCD in the acute care hospital setting, how does care coordination intervention compared to no care coordination intervention affect the readmission rate for patients with SCD over a 3 – 6-month period?

Body of Evidence

Eleven studies were critical appraised and included in the …

Methamphetamine Associated Cardiomyopathy In Pregnancy: The Distinctions And The Implications, Ashan Hatharasinghe, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction

Methamphetamine associated cardiomyopathy (MAC) and peripartum cardiomyopathy (PPCM) are both rare obstetric conditions. Literature regarding methamphetamine associated cardiomyopathy in the obstetric population is limited, and it can be difficult to make the distinction between the two given the similarities in clinical presentation. However similar, there are significant distinctions in the pathophysiology of these two that can help clinicians with the management process.

Clinical Findings and Outcomes

This case involves a 35-year-old Hispanic G6P5005 at 37 weeks gestation presenting with acute respiratory failure secondary to acute decompensated heart failure with reduced ejection fraction and superimposed preeclampsia leading to urgent cesarean …

Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen

Nursing DNP Projects

Purpose and Rationale

The aim of the evidence-based practice (EBP) project is to improve psychological outcomes for socially isolated older adults enrolled in a Homebound Program (HP) through the implementation of an EBP intervention. Social isolation has a multitude of negative consequences, including impacting the psychological health (e.g. depression, loneliness, anxiety) of the older adult population.

Synthesis of Evidence

Meta-analyses, systematic reviews, and randomized controlled trials addressing the clinical problem of social isolation were identified. Through critical appraisal of the evidence, physical activity, psychotherapy, and socialization interventions have shown to decrease depression and loneliness in older adults. There were mixed …

Hello Darkness My Old Friend: An Experience Of A Transformative Session With Zero Balancing, James Mccormick

Journal of Transformative Touch

An Experience of a Transformative Session with Zero Balancing showing the effects of client experiencing an expanded state of consciousness furring a Zero Balancing session.

Anxiety And Mood Disorders Impacting Physician Opioid Prescribing In The Pediatric Hospital Setting, Candice D. Donaldson, Zeev N. Kain, Louis Ehwerhemuepha, Michelle A. Fortier, Michael T. Phan, Daniel M. Tomaszewski, Sun Yang, William Feaster, Brooke N. Jenkins

Psychology Faculty Articles and Research

This research examined whether pediatric inpatients without an anxiety/mood disorder are more likely to receive opioids in response to pain compared to patients diagnosed with a mental health condition. Research questions were tested using cross-sectional inpatient electronic medical record data. Propensity score matching was used to match patients with a disorder with patients without the disorder (anxiety analyses: N = 2892; mood analyses: N = 1042). Although patients with anxiety and mood disorders experienced greater pain, physicians were less likely to order opioids for these patients. Analyses also disclosed an interaction of anxiety with pain—the pain-opioid relation was stronger for …

Misty Rhoads Ijzbtt Editorial Welcome, Misty Rhoads

Journal of Transformative Touch

Editorial Welcome to the IJZBTT from the Executive Editor -Dr. Misty Rhoads-

Same Day Transportation For Opioid Use Disorder: Impact Of The Crisis Addiction Recovery Transportation (Cart) Program, Katherine Palmer Loveluck, Andrew King

Medical Student Research Symposium

Patients with opioid use disorder (OUD) frequently present to the emergency department (ED). Delays or barriers in referral to recovery programs from the ED may decrease successful linkage to ongoing care. Immediately following discharge is a particularly high-risk time for OUD patients as studies have shown that immediately following a non-fatal overdose there is an increase in death rates¹. To attempt to combat this gap in care The Detroit Medical Center (DMC) partnered with a community program, Team Wellness (TW), to offer direct transportation 18 hours per day to the TW facility. This crisis addiction recovery transportation (CART) …

Assessment Of Stakeholder Engagement In A Down Syndrome Research Study, Jeanhee Chung, Ashwini Sarathy, Yichuan Grace Hsieh, Greg Estey, Amy Torres, Vasiliki Patsiogiannis, Karen Donelan, Brian G. Skotko

Journal of Patient-Centered Research and Reviews

There is growing recognition of the importance of engaging patients early in the design of research studies. For studies involving patients with intellectual and cognitive disabilities, researchers may consider engaging with family caregivers, health professionals, community advocates, and/or subject matter experts to provide a more multifaceted, surrogate perspective. Evaluating the engagement of these stakeholder groups in research is nascent, and tools are limited. Research studies involving these individuals provide the opportunity to test new methods of measurement of stakeholder engagement in research. We conducted a 3-year research study implementing and evaluating Down Syndrome Clinic to You, an online platform for …

The Silence Of Food Insecurity: Disconnections Between Primary Care And Community Organizations, Nicole K. Runkle, David A. Nelson

Journal of Patient-Centered Research and Reviews

Purpose: Food insecurity is a prominent issue in the United States, and it is well established that food insecurity is linked to health and chronic illnesses. Studies show that screening for food insecurity is not yet part of standardized practice among all primary care physicians, nor are care providers comfortable with how to proceed with a patient who presents with this issue. Food insecurity is often handled by community-based organizations (CBOs) such as food pantries. Family medicine and pediatric clinics (FMPC) and CBOs hold unique relationships with their clients and can benefit from partnerships with each other to improve health …

Relationship Between Physician Burnout And Patient’S Perception Of Bedside Time Spent By Physicians, Shannon Leung, Mukta Panda, Georgia Mcintosh, Nargiza Kurbanova, Anna-Carson Rimer Uhelski, Muhammad Mubbashir Sheikh, Rehan Qayyum

Journal of Patient-Centered Research and Reviews

Although the adverse effect of burnout on physicians has been widely documented, studies have shown an inconsistent relationship between burnout and the quality of patient care. We hypothesized that physician burnout will have an inverse relationship with the time spent at the bedside by physicians. In a cross-sectional study, we surveyed patients on their perception of the time spent by their physician on the day of the survey (4 categories: 0–5, 6–10, 11–15, > 15 minutes). Oldenburg Burnout Inventory was used to assess physician burnout; burnout was defined as high levels of both exhaustion (≥ 2.25) and disengagement (≥ 2.10). Among …

Agrp Neurons Trigger Long-Term Potentiation And Facilitate Food Seeking, Chunmei Wang, Wenjun Zhou, Yang He, Tiffany Yang, Pingwen Xu, Yongjie Yang, Xing Cai, Julia Wang, Hesong Liu, Meng Yu, Chen Liang, Tingting Yang, Hailan Liu, Makoto Fukuda, Qingchun Tong, Qi Wu, Zheng Sun, Yanlin He, Yong Xu

Children’s Nutrition Research Center Staff Publications

Sufficient feeding is essential for animals' survival, which requires a cognitive capability to facilitate food seeking, but the neurobiological processes regulating food seeking are not fully understood. Here we show that stimulation of agouti-related peptide-expressing (AgRP) neurons triggers a long-term depression (LTD) of spontaneous excitatory post-synaptic current (sEPSC) in adjacent pro-opiomelanocortin (POMC) neurons and in most of their distant synaptic targets, including neurons in the paraventricular nucleus of the thalamus (PVT). The AgRP-induced sEPCS LTD can be enhanced by fasting but blunted by satiety signals, e.g. leptin and insulin. Mice subjected to food-seeking tasks develop similar neural plasticity in AgRP-innervated …

Effectiveness Of Two Frequently Used Screening Tools In Identifying Depression And Anxiety In Collegiate Athletes, Adriana C. Isacke Do, Amy Haskins Phd, Christina Holt Md, Msc, Williams Dexter Md, Facsm

Journal of Maine Medical Center

Introduction: To determine whether the Electronic Pre-participation Physical Examination (EPPE), a proprietary and frequently used tool, is an effective method for depression and anxiety screening in the collegiate athlete population as compared to the Patient Health Questionnaire-4 (PHQ-4).

Methods: College athletes at a Division III university completed PHQ-4 questionnaires and a proprietary EPPE. Positive reponse rates to depression and/or anxiety for both questionnaires were collected and analyzed with a kappa (κ) statistic.

Results: Among 420 students, we found that 9 (2%) reported depression and/or anxiety via the EPPE. Of the 26 students (6%) who answered positively on the PHQ-4, we …

Microbiome For Mars: Surveying Microbiome Connections To Healthcare With Implications For Long-Duration Human Spaceflight, Virtual Workshop, July 13, 2020, Michael Lapelusa, Dorit Donoviel, Sergio E Branzini, Paul E Carlson, Stephanie Culler, Amrita K Cheema, Rima Kaddurah-Daouk, Denise Kelly, Isabelle De Cremoux, Rob Knight, Rosa Krajmalnik-Brown, Stephen L Mayo, Sarkis K Mazmanian, Emeran A Mayer, Joseph F Petrosino, Keith Garrison

Faculty, Staff and Students Publications

The inaugural "Microbiome for Mars" virtual workshop took place on July 13, 2020. This event assembled leaders in microbiome research and development to discuss their work and how it may relate to long-duration human space travel. The conference focused on surveying current microbiome research, future endeavors, and how this growing field could broadly impact human health and space exploration. This report summarizes each speaker's presentation in the order presented at the workshop.

Spreading Encouragement To Seniors In A Pandemic, Bonnie L. Rogulj, Lashia Hicks

Physical Therapy Collection

This brief note describes a "virtual calendar" project created by students of the University of St. Augustine for Health Sciences. The calendar of images and poetry was shared with older adult community members to reduce loneliness and increase mental health and wellness in this population during the COVID-19 pandemic.