Medical Specialties Commons^™

A Pathway For Inclusive Innovation In Pediatric Mental Health: Prevention And Intervention Using Technology, Kate Corinne Bennett

DSW Capstone Projects

It is no secret that access to quality healthcare is difficult for citizens to achieve in the United States. Racism, discrimination, and oppression further exist at the root of compounding social problems, including limits in minority access to mental health services. The COVID-19 pandemic has also exacerbated mental health problems for young children, especially those who are already underserved and at risk. For these reasons, it is imperative that the social work profession emphasizes innovative approaches to equitable treatment access, including a focus on early intervention and the use of technology. Product one of this capstone engages a systematic review …

The Lived Experiences Of Sports Retirement Among Elite, Action Sports Athletes, Gracie Struthers

Antioch University Dissertations & Theses

This study explored the lived experiences of sports retirement among elite, action sport athletes. This study examined participants’ retirement experiences, their well-being post-retirement, and recommendations participants had for current athletes about retirement. Interviews were conducted remotely with four participants. Participants identified as Caucasian, in the 25–38 age range, had been involved with their sport competitively for 17.75 years, and had been retired for 3.37 years. Data was collected and analyzed utilizing Interpretive Phenomenological Analysis (IPA). Participants’ experiences during retirement illustrated a significant disruption in their lives and the way they lived. This disruption was characterized by significant grief and distress, …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

A Literature Resource For Those Supporting Patients With Autism Spectrum Disorder And Cancer, Kaylee James

Psychology Doctoral Specialization Projects

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that impacts both social interaction and patterns of behavior. ASD is rooted in genetic, biological, and environmental causes. Cancer begins when cells grow out of control and there is also a genetic and biological cause of cancer. There is an overlap between the genetic and biological causes of ASD and cancer. As a result, evidence supports an increased risk of developing some types of cancer as well as protective factors for some times of cancer for individuals with ASD. Therefore, individuals with ASD may be at a heightened risk to develop cancer, …

Perceived Instability, Pain, And Psychological Factors Predict Function And Disability In Individuals With Chronic Ankle Instability, Ashley M.B. Suttmiller, Julie M. Cavallario, Shelby E. Baez, Jessica C. Martinez, Ryan S. Mccann

Rehabilitation Sciences Faculty Publications

Context:

Chronic ankle instability (CAI) is associated with residual instability, pain, decreased function, and increased disablement. Injury-related fear has been associated with CAI, although its relationship to other impairments is unclear. The Fear-Avoidance Model is a theoretical framework hypothesizing a relationship between injury-related fear, chronic pain, pain catastrophizing, and disability. It has been useful in understanding fear's influence in other musculoskeletal conditions but has yet to be studied in those with CAI.

Objective:

To explore relationships between instability, pain catastrophizing, injury-related fear, pain, ankle function, and global disability in individuals with CAI.

Design:

Cross-Sectional Study

Setting:

Anonymous online survey

Patients …

Profiles And Correlates Of Language And Social Communication Differences Among Young Autistic Children, Rachel Reetzke, Vini Singh, Ji Su Hong, Calliope B. Holingue, Luther G. Kalb, Natasha N. Ludwig, Deepa Menon, Danika L. Pfeiffer, Rebecca J. Landa

Communication Disorders & Special Education Faculty Publications

Delays in early language development are characteristic of young autistic children, and one of the most recognizable first concerns that motivate parents to seek a diagnostic evaluation for their child. Although early language abilities are one of the strongest predictors of long-term outcomes, there is still much to be understood about the role of language impairment in the heterogeneous phenotypic presentation of autism. Using a personcentered, Latent Profile Analysis, we first aimed to identify distinct patterns of language and social communication ability in a clinic-based sample of 498 autistic children, ranging in age from 18 to 60 months (M = …

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …

Racial And Socioeconomic Disparities In Patients With Meningioma: A Retrospective Cohort Study, Hudin N Jackson, Caroline C Hadley, A Basit Khan, Ron Gadot, James C Bayley, Arya Shetty, Jacob Mandel, Ali Jalali, K Kelly Gallagher, Alex D Sweeney, Arif O Harmanci, Akdes S Harmanci, Tiemo Klisch, Shankar P Gopinath, Ganesh Rao, Daniel Yoshor, Akash J Patel

Faculty, Staff and Student Publications

BACKGROUND: Meningiomas are the most common intracranial neoplasms. Although genomic analysis has helped elucidate differences in survival, there is evidence that racial disparities may influence outcomes. African Americans have a higher incidence of meningiomas and poorer survival outcomes. The etiology of these disparities remains unclear, but may include a combination of pathophysiology and other factors.

OBJECTIVE: To determine factors that contribute to different clinical outcomes in racial populations.

METHODS: We retrospectively reviewed 305 patients who underwent resection for meningiomas at a single tertiary care facility. We used descriptive statistics and univariate, multivariable, and Kaplan-Meier analyses to study clinical, radiographical, and …

Health Disparities And Psychosocial And Behavioral Interventions For Type 2 Diabetes Within Latinx Communities: A Systematic Review, Elisa Hernandez-Guerrero Smith

Theses and Dissertations

As Hispanic adults are 70% more likely than non-Hispanic White adults to be diagnosed with diabetes (Centers for Disease Control and Prevention, 2022), there is an urgent need to provide culturally appropriate care to the people with diabetes of Latinx heritage. The purpose of this systematic review is to better understand the availability and effectiveness of psychosocial and behavioral interventions for T2DM within the Latinx population. Additional focus was given to the impact of health disparities and complexities within the Latinx population that have been diagnosed with, or are at risk of, T2DM. With a greater understanding of health disparities …

Icu-Related Medical Trauma: A Socioecological Exploration Of Contributing Factors And Experiences Of Traumatic Stress In Adult Icu Survivors, Jacqueline Hanson

Theses and Dissertations

Advances in biomedical technologies and critical care are leading to increased survivorship rates of ICU patients. During critical care, patients confront a variety of stressors that may contribute to adverse psychological outcomes, including posttraumatic stress. The nature of posttraumatic stress in this population differs from that associated with traditional trauma. The phenomenon of medical trauma in ICU survivors is complex: it is highly subjective, exists on a continuum, is cumulative in nature and carries cumulative effects, involves a combination of endogenous and exogenous, physical and emotional stressors that vary in intensity and duration, occurs in an interpersonal context that involves …

Cross-Mentorship: A Unique Lens Into The Realities And Challenges Of Diversity In Surgery., Marina Affi Koprowski, Karen J Dickinson, Crystal N Johnson-Mann, Martha Godfrey, Emilia J Diego, Marie Crandall, Kevin Y. Pei Md, Mhsed

Other Specialties

Mentorship in surgery is a perennial topic of interest, as successful mentoring relationships are associated with improved career satisfaction, academic promotion, research productivity, and overall well-being. While it is true that certain minority groups in surgery find great personal and professional benefit in receiving and providing mentorship among “their own” (ie, a female academic surgeon mentoring a female resident), it is important to recognize that many mentoring relationships, whether intentionally or otherwise, extend across gender, sexuality, generations, race, ethnicity, and other differences. Lived examples of these include an Asian man hailing from the Northeast with no children mentoring a White …

Social And Biological Determinants Of Pregnancy-Related Mortality And Morbidity In A Rural, Underserved Population, Anna Hansen

Theses and Dissertations--Sociology

Cases of severe maternal morbidity (SMM) and pregnancy-related mortality (PRM) are increasing in the US. Research concerning SMM and PRM has neglected women in Central Appalachia; a largely rural, health-disparate population. The aims of this study are two-fold: (1) Examine patient-level and place-based predictors of SMM/PRM via hierarchical logistic regression modeling, and (2) Elucidate Appalachian healthcare patients’ and providers’ experiences with SMM/PRM, perceptions of contributing factors, and insights on points of intervention.

This study uses a mixed methods approach guided by the WHO’s conceptual framework for action on social determinants of health to identify determinants of SMM and PRM among …

Unpacking The Influence Of Islamic Religious Culture And Individual Religious Affiliation On Testing Hiv-Positive, Brittany Hayes, Amy Adamczyk

Publications and Research

The distribution of HIV cases varies cross-nationally. We separate the influences of Islam at the macro-and micro-levels to understand the role of religion in shaping the spread of HIV. Drawing on biomarker data from the Demographic and Health Surveys, we construct a multilevel database (Individual N= 568,476; Country N= 30). We examine a series of national-and individual-level predictors that may mediate the relationship between Islam and testing HIV-positive. Individual religious affiliation and proportion Muslim retained their risk-reducing effects even when accounting for a range of mediators and suppressors. Islam has a sui generis effect on testing HIV-positive.

Factors Associated With Mask Use In New York City Neighborhood Parks During The Covid-19 Pandemic: A Field Audit Study, Lisa Hitch, Marie A. Sillice, Hanish Kodali, Katarzyna E. Wyka, Javier Otero Peña, Terry Tk Huang

Publications and Research

Background: Mask use is a cost-effective measure to decrease COVID-19 transmission. Mask mandates intend to increase mask compliance but are often ambiguous when it comes to public outdoor spaces.

Methods: We used a field audit study to examine mask use in New York City neighborhood parks during COVID-19. 1453 park visitors were observed in 13 parks during July–August 2020 using a modified and validated park use audit tool (System for Observing Play and Recreation in Communities) that included items on general and proper mask use (i.e., mask covering both nose and mouth). Generalized estimating equation regression was used to determine …

Non-Physician’S Challenges In Sexual And Reproductive Health Care Provision For Women Of Reproductive Age With Cancer: A Scoping Review Of Barriers And Facilitators, Qi Chen, Emma Carpenter, Kari White

Publications and Research

Purpose: The American Society of Clinical Oncology Clinical Practice guidelines recommend that non-physicians such as nurses, social workers, psychologists should be prepared to discuss fertility and sexual concerns with patients. However, literature showed that the utilization rate of sexual and reproductive care for women with cancer remained low. We conducted a scoping review to describe non-physicians’ roles, barriers and facilitators providing sexual and reproductive health (SRH) care to women of reproductive age with cancer.

Methods: We searched six databases for articles that met the following criteria: 1) English-language; 2) original research; 3) non-physician providers; 4) women with cancer under …

The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett

DNP Projects

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …

Promotion Of Early Recognition Of Depression To Improve Health Related Quality Of Life In Pediatric Oncology Patients, Jennifer Blankenship

DNP Projects

Background: Depression and anxiety are serious complications of cancer and deemed a challenging diagnosis due to the symptoms of depression mimicking common side effects of chemotherapy and radiation. Signs/symptoms frequently are underrecognized thus appropriate treatment is delayed, compromising the health-related quality of life (HRQOL) for pediatric oncology patients.

Purpose: Analyze existing physician and Advanced Practice Provider (APP) clinical practice regarding depression, via a pre- and post-survey and educational PowerPoint on the use of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to promote early recognition of depression.

Methods: A prospective, single-arm, study was completed in the Kentucky Children’s …

Psychosocial Factors Of Covid-19 Impact Oral Health, Neeru Ramaswami Bds, Ms, Mph

The Journal of the Michigan Dental Association

The impact of psychosocial factors on oral health during the COVID-19 pandemic necessitates an interdisciplinary approach to patient care. This article, part of National Children’s Dental Health Month, focuses on adolescent oral health and eating disorders, authored by experts from the University of Michigan. With a dramatic increase in eating disorders among Michigan adolescents during the pandemic, especially affecting transgender and diverse youth, identifying such issues is crucial. General dentists, in an ideal position for interaction, can play a vital role in addressing these challenges, emphasizing the need for continued education and collaboration.

J Mich Dent Assoc January 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists! In this January 2022 issue, the reader will find the following original content:

• A cover feature, “Eating Disorders in Adolescents: Facts and Recommendations for the Oral Health Team”
• An introduction to the Pediatric Health Series, “Psychosocial Factors of COVID-19 Impact Oral Health”
• A DEI Feature, “Inclusion of the Mobility Impaired in Our Community”
• A 10-Minute EBD, “Factors Impacting Gingival Margin Position Following Esthetic Crown Lengthening”
• News you need, an …

Identification Of Adhd And Comorbid Disorders In Children: The Potential Role Of Minority Group Membership, Rachel H. Tayler

Dissertations and Theses

Identification of ADHD and Comorbid Disorders in Children: The potential role of minority group membership

by

Rachel Tayler, MSc, MA

Advisor: Sarah O’Neill, PhD

Attention-Deficit/Hyperactivity Disorder (ADHD) affects six million US children. Females, Latinx, and possibly Black children have lower rates of diagnosis than their Male and White non-Latinx peers. ADHD is behaviorally defined, and as such, clinicians' perceptions of symptoms and determination of diagnoses may be influenced by demographic factors such as race, ethnicity and sex.

This vignette study examined whether clinicians' implicit ethnic, racial, and sex biases affect diagnosis of ADHD and comorbid conditions. Psychiatry trainees and pediatricians …

Maternal Feeding Styles And Child Appetitive Traits: Direction Of Effects In Hispanic Families With Low Incomes, Maria A Papaioannou, Nilda Micheli, Thomas G Power, Teresia M O'Connor, Jennifer Orlet Fisher, Sheryl O Hughes

Children’s Nutrition Research Center Staff Publications

Feeding styles of parents have been associated with dietary quality/intake and weight outcomes; however, much of the research to date has been cross sectional and the direction of influence unclear. This prospective longitudinal study evaluated the direction of effects between feeding styles and child appetitive traits over time in a sample of 129 Hispanic parent/child dyads that participated in a larger study. Data analyzed for the current study were collected when the children were 4-5 years old and again at ages 7-9 years. Parents (all mothers) reported on their feeding styles and children's appetitive traits using well-established questionnaires. Cross-lagged panel …

Factors Associated With Intention To Disclose Concussive Symptoms In Active Duty Soldiers, Carly Beck

College of Graduate Studies: Theses & Dissertations

Background: Concussion disclosure is a heavily researched topic, and while previous literature has explored predictors of concussion disclosure in numerous populations, research within the active duty Soldier population is limited. This study further explored predictors of concussion disclosure to a medical professional or leadership in the active duty Solider population through the lens of the Theory of Planned Behavior. Methods: A cross-sectional electronic survey was distributed to 181 active duty Soldiers. Descriptive statistics were used to report frequency of high intention to disclose concussive symptoms among demographics, and a multivariate regression model was used to assess significant predictors of intention …

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

Graduate Theses/Dissertations

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …

Utilizing Virtual Reality Goggles During Pediatric Laceration Repairs To Reduce Perceived Pain In Pediatric Patients, Emily C. Bozzer

Graduate Theses/Dissertations

In pediatric emergency departments, several providers assess pediatric patients in need a laceration repair, require procedural sedation in order to ensure compliance and complete the laceration repair. This study explored one safe alternative to procedural sedation during pediatric laceration repairs by assessing what pain scores pediatric patients report when undergoing a laceration repair utilizing virtual reality goggles. Pediatric patients ages 6-17 years old perceived pain scores utilizing FACES pain scale was documented. This study found a majority of patients reported lower pain scores during the laceration repair in comparison to their baseline pain score.

The Neighborhood Environment And Hispanic/Latino Health, Natalia I Heredia, Tianlin Xu, Minjae Lee, Lorna H Mcneill, Belinda M Reininger

Faculty, Staff and Student Publications

PURPOSE: Hispanic/Latino adults on the Texas-Mexico border have high rates of chronic disease. Neighborhoods can influence health, though there is a limited research on neighborhood environment and health in Hispanics/Latinos. The purpose of this study was to assess the relation of neighborhood environment with health variables in Hispanic/Latino adults, including physical activity [PA], depression, anxiety, and lab-assessed conditions (type 2 diabetes, metabolic syndrome, and chronic inflammation).

METHODS: Participants were randomly-selected from a Hispanic/Latino cohort on the Texas-Mexico border. Neighborhood environment, self-reported PA, anxiety, and depression were assessed through questionnaires. Laboratory values determined Type 2 diabetes, metabolic syndrome, and C-reactive protein …

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

Faculty, Staff and Student Publications

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. …

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

Faculty, Staff and Student Publications

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 …

Treating Gut Feelings: A Systematic Review Of Psychological Treatments For Pediatric Inflammatory Bowel Disease, Venus Mirbod

Theses and Dissertations

Psychological comorbidities and psychosocial challenges are prevalent among children and adolescents with Inflammatory Bowel Disease (IBD). However, a comprehensive review of the availability and effectiveness of psychological treatments for pediatric IBD patients is lacking. This systematic review aimed to determine the availability and efficacy of psychological interventions for children and adolescents with IBD. The systematic review was conducted in accordance with PRISMA guidelines and performed using two electronic databases, PsycINFO and PubMed, from inception until March 2022. Databases were searched for English-language, controlled trials of psychological interventions for children and adolescents with IBD. Outcomes of interest included: depression, anxiety, health-related …

Associations Between Physical Activity And Alcohol Consumption In Rural Cancer Survivors, Scherezade K Mama, Natalia I Heredia, Hannah Johnston, David E Conroy

Faculty, Staff and Student Publications

PURPOSE: Rural adults and cancer survivors are more likely to be physically inactive and exceed recommendations for alcohol use. Physical activity and alcohol use are positively associated in adults and cancer survivors but associations between physical activity and alcohol use in rural cancer survivors is unknown. This cross-sectional study explored associations between physical activity, sitting time, and alcohol use in rural cancer survivors.

METHODS: Cancer survivors residing in central Pennsylvania were recruited to the Partnering to Prevent and Control Cancer (PPCC) study and completed mailed questionnaires assessing physical activity (low, moderate, high), sitting time (≥6 hours/day), and alcohol use (0 …

Blood Metabolites Predicting Mild Cognitive Impairment In The Study Of Latinos-Investigation Of Neurocognitive Aging (Hchs/So), Shan He, Einat Granot-Hershkovitz, Ying Zhang, Jan Bressler, Wassim Tarraf, Bing Yu, Tianyi Huang, Donglin Zeng, Sylvia Wassertheil-Smoller, Melissa Lamar, Martha Daviglus, Maria J Marquine, Jianwen Cai, Thomas Mosley, Robert Kaplan, Eric Boerwinkle, Myriam Fornage, Charles Decarli, Bruce Kristal, Hector M Gonzalez, Tamar Sofer

Faculty, Staff and Student Publications

INTRODUCTION: Blood metabolomics-based biomarkers may be useful to predict measures of neurocognitive aging.

METHODS: We tested the association between 707 blood metabolites measured in 1451 participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), with mild cognitive impairment (MCI) and global cognitive change assessed 7 years later. We further used Lasso penalized regression to construct a metabolomics risk score (MRS) that predicts MCI, potentially identifying a different set of metabolites than those discovered in individual-metabolite analysis.

RESULTS: We identified 20 metabolites predicting prevalent MCI and/or global cognitive change. Six of them were novel and 14 were previously reported as …