Medical Specialties Commons^™

Houston Hurricane Harvey Health (Houston-3h) Study: Assessment Of Allergic Symptoms And Stress After Hurricane Harvey Flooding, Abiodun O Oluyomi, Kristen Panthagani, Jesus Sotelo, Xiangjun Gu, Georgina Armstrong, Dan Na Luo, Kristi L Hoffman, Diana Rohlman, Lane Tidwell, Winifred J Hamilton, Elaine Symanski, Kimberly Anderson, Joseph F Petrosino, Cheryl Lyn Walker, Melissa Bondy

Faculty, Staff and Students Publications

BACKGROUND: In August 2017, Hurricane Harvey caused unprecedented flooding across the greater Houston area. Given the potential for widespread flood-related exposures, including mold and sewage, and the emotional and mental toll caused by the flooding, we sought to evaluate the short- and long-term impact of flood-related exposures on the health of Houstonians. Our objectives were to assess the association of flood-related exposures with allergic symptoms and stress among Houston-area residents at two time points: within approximately 30 days (T1) and 12 months (T2) after Hurricane Harvey's landfall.

METHODS: The Houston Hurricane Harvey Health (Houston-3H) Study enrolled a total of 347 …

Central Nervous System Intravascular Lymphoma Leading To Rapidly Progressive Dementia, Christie G Turin, Kevin Ting, Anthony Bradshaw, S Richard Dunham, Karen Nunez-Wallace, Shital M Patel, Priti Dangayach, Stephanie Holdener, Weei-Chin Lin

Faculty, Staff and Students Publications

Intravascular lymphoma is an uncommon subtype of B-cell lymphoma with neoplastic cells limited to the lumen of small blood vessels. We report a case of a 52-year-old man who presented with constitutional symptoms and rapidly progressive dementia. He was found to have diffuse leptomeningeal and faint parenchymal enhancement on magnetic resonance imaging and was subsequently diagnosed with intravascular lymphoma following a brain biopsy. He responded remarkably well to systemic and intrathecal chemotherapy. The diagnosis and treatment of intravascular lymphoma have been guided by a few case reports and are largely based on expert opinion.

Disparities In Cardiovascular Disease Outcomes Among Pregnant And Post-Partum Women, Mohamed M Gad, Islam Y Elgendy, Ahmed N Mahmoud, Anas M Saad, Toshiaki Isogai, Isadora Sande Mathias, Rabel Misbah Rameez, Johnny Chahine, Hani Jneid, Samir R Kapadia

Faculty, Staff and Students Publications

Background

The incidence of cardiovascular disease among pregnant women is rising in the United States. Data on racial disparities for the major cardiovascular events during pregnancy are limited.

Methods and Results

Pregnant and post‐partum women hospitalized from January 2007 to December 2017 were identified from the Nationwide Inpatient Sample. The outcomes of interest included: in‐hospital mortality, myocardial infarction, stroke, pulmonary embolism, and peripartum cardiomyopathy. Multivariate regression analysis was used to assess the independent association between race and in‐hospital outcomes. Among 46 700 637 pregnancy‐related hospitalizations, 21 663 575 (46.4%) were White, 6 302 089 (13.5%) were Black, and 8 914 …

Connected: Using A Novel In-House Communication System To Efficiently Deliver Imaging Results, Daniel Greentree, Brendan R. Calhoun, Steven Farraher

Journal of Maine Medical Center

Introduction: The primary objective was to investigate the effectiveness of a fully staffed electronic communication system (1Connect) in delivering timely critical imaging results and incidental findings. The secondary objective was to evaluate the financial impact of this system on a radiology practice.

Methods: From January 2014 through June 2016, the 1Connect database was retrospectively reviewed and sorted by category of submission type: Critical (1-hour communication time), STAT (2 hours), or Unexpected finding (3 business days). The percent of successful communications completed within the appropriate time frame was calculated for each priority category and used as a measure of the system’s …

Maternal Hpa Axis Function During Parenting Is Associated With Reduced Brain Activation To Infant Cry And More Intrusive Parenting Behavior, Andrew Erhart

Electronic Theses and Dissertations

Previous research indicated that maternal cortisol function and maternal brain response to infant stimuli are separately related to differences in parenting behavior. Evidence from animal models have demonstrated that chronically high cortisol concentration alters brain structure and function, suggesting that studying these two mechanisms together may further improve understanding of parental behavior in human mothers. First time mothers of infants aged 1-7 months old (M age = 3 months) were recruited to participate. Mother’s cortisol concentration was measured during a naturalistic interaction with their infant and their behavior was coded for maternal sensitivity and nonintrusiveness. In a separate session using …

Mechanisms Of Sensory Adaptation In The Primate Visual System, Boris Isaac Peñaloza Rojas

Electronic Theses and Dissertations

Under ecological conditions, the luminance impinging on the retina varies within a dynamic range of 220 dB. Stimulus contrast can also vary drastically within a scene, and eye movements leave little time for sampling luminance. In addition, the amount of information reaching our visual system far exceeds the brain’s information processing capacity. Given the limited dynamic range of its neurons and its limited capacity in processing visual information in real-time, the brain deploys both structural and functional solutions that work in tandem to adapt to the surroundings. In this work, employing visual psychophysics and computational neuroscience, we study the mechanisms …

Voices From The Field: A Qualitative Study Of The Challenges And Promising Practices Of Rural Public Health In Addressing Hiv And Hepatitis C, Martha Elbaum Williamson Mpa, Karen B. Pearson Mlis, Ms, Amanda R. Burgess Mppm, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd

Population Health

Rural areas of the United States may be vulnerable to an HIV or hepatitis C (HCV) outbreak among persons who inject drugs. Researchers at the University of Southern Maine’s Rural Health Research Center examined the capacity of rural public health systems to prepare for, identify, control, and respond to an HIV or HCV outbreak. Through semi-structured interviews with 36 state and local public health professionals from six rural states, we sought to understand the challenges related to HIV, HCV, and serving rural persons who inject drugs and to identify strategies to address those challenges. Challenges limiting the public health capacity …

Transitioning From Foster Care To Adulthood: Supporting Adolescents And Young Adults, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Children involved in foster care have significant trauma histories and have often experienced substantial neglect and/or abuse. Such adverse childhood experiences can lead to cumulative toxic stress, which if not buffered by support and a consistent adult caregiver, can negatively impact physical, mental and socio-emotional development. Such experiences can also result in a lack of trust in adults and systems of care, which can further reduce sources of support for children in foster care.

For questions about this publication or others, please email [email protected]

childrens.com/fostercare

A Systematic Review Of Center Of Mass As A Measure Of Dynamic Postural Control Following Concussion, Sarah Patejak, Joshua Forrest, Emily Harting, Mable Sisk, Eric Schussler

Rehabilitation Sciences Faculty Publications

BACKGROUND: The incidence of sports-related concussion in the US is between 1.6-3.8 million annually. Identification of ongoing impairment post-concussion continues to be challenging, as research indicates many patients are cleared for return to activity while still suffering subclinical impairment of function. Purpose: To identify and review the current literature on the use of center of mass (COM) during gait as a potential indicator variable after concussive injury. Study Design: Systematic Review.

METHODS: A Pubmed search was undertaken utilizing search terms involving gait performance and concussion. Study inclusion criteria included: (1) COM used as a variable in data analysis, (2) study …

Development Of An Integrated Medical And Behavioral Health Care Model For Children In Foster Care: The Rees-Jones Center For Foster Care Excellence, Kimberly Stone, Sara Moore, Sara Pollard

Integrated, Trauma-Informed Care

Children in foster care are classified as a population with special health care needs. They face multiple adverse childhood experiences and disrupted relationships, yet face barriers accessing consistent, high-quality health care. The American Academy of Pediatrics recommends integrated physical and behavioral health care for children in foster care, but little is known about the implementation of integrated care for this population. As a pediatrician, doctor of nursing practice, and psychologist in an academic medical setting, we describe the development and implementation of the Rees-Jones Center for Foster Care Excellence, emphasizing the role of medical and behavioral health providers in promoting …

Empowerment Pathways: A Mitigation Approach To Adolescent And Youth Racial Stress In Marginalized Populations, Lauren B. Robins, Megan Cannedy, Rachel Kerrigan, Brittany G. Suggs

Counseling & Human Services Faculty Publications

Racial unrest recently has been incessant. In response, this conceptual contribution explores a prevention-based program for African American adolescents and youth to aid in their navigation through ubiquitous racial unrest and persistent mental health adversities. This article provides a comprehensive literature review on racial injustice and presents information regarding race-based traumatic stressors and adverse mental health outcomes. The prevention-based program that was created in response to the apparent racial unrest among African American youth and adolescents is presented and explored. The goal of this conceptual article is to raise awareness of this issue, provide practical steps to combat racial injustice, …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Experiences Of Women With Ovarian Cancer During The Covid-19 Pandemic: Examining Intolerance Of Uncertainty And Fear Of Covid-19 In Relation To Psychological Distress, Erin M. Hill, Andriana Frost, Jamie D. Martin

Psychology Faculty Publications

Purpose: Our research aimed to examine the role of intolerance of uncertainty (IU) in psychological distress (PD) among women with ovarian cancer. Fear of COVID-19 (FCOV) was examined as a mediator, and participant health status and the reopening status of their geographic region were examined as moderators. Design: A cross-sectional quantitative design was employed. Participants: Participants (n ¼ 100) were recruited through various online sources and completed the study via Qualtrics. Methods: Moderated mediation models and post-hoc linear regression analyses were used to determine the role of predictor variables in PD. Results: No significant moderators or mediators were found. Despite …

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

Opioid Use Disorder: The Timeline For Medication Assisted Therapy, Alexander Cristofori

Capstone Showcase

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached …

Psychosocial Preoperative Preparation In A Non-Children's Hospital Without Child Life Supports, Haley M. Fricke

EWU Masters Thesis Collection

On average, 6 million children undergo general anesthesia for surgery annually in the United States (Shah et al., 2021).Anesthesia can be one of the most stress provoking experiences, with 40% to 60% of children displaying emotional and behavior stress before surgery (Boles, 2016). Psychosocial preoperative preparation in pediatrics has been seen to lower children’s stress levels, enhance understanding, increase compliance, decrease length of time in recovery, and decrease analgesic use (Aranha et al., 2017; Al-Yateem et al., 2016; Dolidze et al., 2013; Tunney & Boore 2013; Wenstrom et al., 2011). The purpose of this exploratory case study was to better …

Burnout With Caregiving Of Autism And The Covid19 Pandemic, Erin Babcock, Leah Recker

Williams Honors College, Honors Research Projects

I am working with Leah Recker and we are doing research on parent/caregiver burnout of those with children that have autism, especially during COVID. We are creating a survey on Qualtrics, using stem questions followed by Likert scale items, which we will then send to the Director of Programs, Lisa Thompson, at Autism Society of Greater Akron. She will then pass it along to the parents and caregivers within their community, via Facebook or their weekly newsletter. Parents/caregivers will have the opportunity to complete the survey and we will receive the results when done so. We will then analyze the …

Evaluating Racial And Ethnic Disparities In Access To Primary Care Among Gay And Bisexual Men In The Us, A Population At High-Risk Of Hiv Infection, Jessica S. Kiernan, April D. Kimmel

Graduate Research Posters

BACKGROUND: 69% of new HIV diagnoses in the US are among gay and bisexual men, with disparities by race and ethnicity. Primary care providers increasingly provide HIV prevention. Racial and ethnic disparities in primary care access are well-documented, but their persistence among gay and bisexual men is unknown. We examined racial and ethnic disparities in access to primary care among this population.

METHODS: We used nationally representative person-level sociodemographic, health status and utilization data, and data on organizational- and socially determinant barriers to care, from the National Health Interview Survey, 2013-2018. Outcomes were: 1) general physician visit

RESULTS: The sample …

Comics For Pediatric Oncology Patients And Families: Education And Empowerment, Natalie Johns

Calvert Undergraduate Research Awards

The major objective is to develop the first book of a boxed set series of comic vignettes that will serve as a clinical educational tool for pediatric patients with a recent cancer diagnosis and their caregivers. These comics are hypothesized to improve patient and family understanding of the disease, its treatment, side effects, and outcomes in an engaging and aesthetically pleasing way. The overall goals of this project are to reduce anxiety and increase health literacy in patients and their families while assisting the oncology team in providing optimal medical care, thus improving the overall quality of treatment. Comics aimed …

Perceptions Of Integrated Mental And Behavioral Health In Pediatric Specialty Care Settings: A Mixed-Methods Study, Desireé Nicole Williford

Graduate Theses, Dissertations, and Problem Reports (ETD)

Pediatric patients are at an increased risk of experiencing mental and behavioral health concerns, which have direct associations with HRQOL, physiological health, and likelihood that youth will engage in health promoting behavior. Researchers and practitioners have increased their awareness of these concerns and identified strategies for improving the mental and behavioral health of these youth, specifically via implementing organizational efforts (i.e., task forces) and guidelines around integrating psychosocial screening and other services into routine practice. Despite this, there are several identified barriers to families receiving mental/behavioral health care in these settings. These barriers exist at all levels, including at the …

Hospice Response To Covid-19: Promoting Sustainable Inclusion Strategies For Racial And Ethnic Minorities, M. Courtney Hughes, Erin Vernon

Faculty Articles, Papers, and Other Scholarship

There is a disproportionate burden of illness and death among racial/ethnic minorities related to COVID-19. The importance of reaching groups suffering the most with resources such as advance directive guidance, telehealth, and culturally sensitive education materials is vital to providing quality, inclusive care. A crisis presents an opportunity to unite and problem-solve to help avoid the dire consequences facing inaction. In this way, inclusive responses by hospices, social workers, other community partners during the COVID-19 pandemic can help reach and alleviate the pain of those groups most afflicted. We offer hospice inclusion strategies that align with general pandemic response trends …

Cannabis Treatment Of Autism In Children: A Literature Review, Mai Xiong

All Graduate Theses, Dissertations, and Other Capstone Projects

Objectives: This literature review aims to summarize the effects of medical cannabis use in children on Autism Spectrum Disorder (ASD) symptoms, side effects and provide recommendations for practice, education, and research. Background: ASD is characterized by core behaviors of significant impairment in social communication and interaction and restricted and repetitive patterns of behavior, interests, or activities (APA, 2013). In addition to these core behaviors, individuals with ASD often have noncore behavioral disorders and several medical comorbidities. Treatment for ASD symptoms includes Cognitive Behavioral Therapy (CBT), aripiprazole (Abilify) and/or risperidone (Risperdal). As of this review, 14 states have added ASD …

Chronic Pain, Malingering, And The Word Memory Test, Dawn Marie Emmett Bishop

Walden Dissertations and Doctoral Studies

AbstractThe importance of using scientifically grounded strategies to detect malingering has been established in the literature and past research. Many reliable tools have been established for the detection of malingered neurocognition; however, research on how pain may affect these tools is sparse. The purpose of this study was to investigate the effect of pain on cognitive symptom validity testing and to establish the validity of the Word Memory Test (WMT), a cognitive symptom validity test with good sensitivity and specificity, when the test taker is feigning pain (simulating) or remembering pain. The biopsychosocial model and the gate theory of pain …

Athletics As A Life Curriculum: Lessons Learned Through Different Aspects Of Athletics, Thomas J. Davis

College of Graduate Studies: Theses & Dissertations

For my dissertation, I decided to write a memoir to have the opportunity to go through the self-reflection process and learn more about my inner self. I wanted to learn how the life experiences I write about have affected me as a student-athlete, coach, teacher, parent, and how they have shaped me into who I am today. I took instances from my life in athletics that I believe are significant in the development of my overall being. Educational scholars such as William Pinar (1995, 2004), John Dewey (1916/2019, 1933), Frederic Gros (2011), Immanuel Kant (1908/2015), Nel Noddings (2005), and Paulo …

Does Team Leader Gender Matter? A Bayesian Reconciliation Of Leadership And Patient Care During Trauma Resuscitations, Elizabeth D. Rosenman, Anthony Misisco, Jeffrey Olenick, Sarah M. Brolliar, Anne K. Chipman, Marie C. Vrablik, Georgia T. Chao, Steve W.J. Kozlowski, James A. Grand, Rosemarie Fernandez

Psychology Faculty Publications

OBJECTIVE: Team leadership facilitates teamwork and is important to patient care. It is unknown whether physician gender-based differences in team leadership exist. The objective of this study was to assess and compare team leadership and patient care in trauma resuscitations led by male and female physicians.

METHODS: We performed a secondary analysis of data from a larger randomized controlled trial using video recordings of emergency department trauma resuscitations at a Level 1 trauma center from April 2016 to December 2017. Subjects included emergency medicine and surgery residents functioning as trauma team leaders. Eligible resuscitations included adult patients meeting institutional trauma …

Nonsuicidal Self-Injury, Suicide Planning, And Suicide Attempt Among High-Risk Adolescents Prior To Psychiatric Hospitalization, Christina M. Sellers, Antonia Díaz-Valdés, Andrew C. Porter, Catherine R. Glenn, Adam Bryant Miller, Adeline Wyman Battalen, Kimberly H. Mcmanama O'Brien

Psychology Faculty Publications

The purpose of this study was to understand the trajectories of nonsuicidal self-injury (NSSI) and suicide plans (SP) in the 90 days prior to inpatient hospitalization, understand the role of NSSI and SP in predicting suicide attempts (SA) on a given day, and to test the interaction between NSSI and SP in predicting same-day SA. Participants included 69 adolescents (77% female, 65% white, 77% Non-Hispanic/Latinx, Mage = 15.77 SDage = 1.00) from an inpatient psychiatric unit. Past 90 day NSSI, SP, and SA were measured using the Columbia Suicide Severity Rating Scale and Timeline Follow Back. First, mixed effect models …

How Duty Rosters And Stress Relate To Sleep Problems And Fatigue Of International Pilots, Marion Venus, Martin Grosse Holtforth

International Journal of Aviation, Aeronautics, and Aerospace

While previous research focused on pilots’ fatigue, rosters, potential performance-impairment and aviation-safety, this research investigates, how pilots’ work-related and psychosocial stress and rosters can affect their sleep and fatigue. A cross-sectional online survey was completed by 192 pilots flying for European operators, 180 Australian pilots and 34 pilots from UAE, Turkey and Asia Pacific. Pilots reported their actual duty- and flight-hours, flown sectors, standby, rest, vacation days, number of early starts, night-flights and sports-hours for the last two months. Schedule-related data, way to work, age, flight-hours on the present type of aircraft, subjective job-security and psychosocial stress were used as …

Market Structure And Quality Of Service: Investigating Oligopolies And The Quality Of Nursing Home Care In California During The Covid-19 Pandemic, Tessa Ireton

Senior Independent Study Theses

Quality-of-service outcomes in nursing homes are of great social and human importance. However, especially during the COVID-19 pandemic, consistently maintaining markets with high quality care has been a pervading issue in the American nursing home industry. Furthermore, the industry is strongly characterized by oligopolies, a market structure that literature indicates may be less compatible with quality service than competitive markets. With this paper, I aim to investigate the possible intersection of oligopolist market structures and the quality of nursing home care during the COVID-19 pandemic. I start by describing quality of care in nursing homes, particularly during the COVID-19 pandemic, …

Prevalence And Correlates Of Sex Selling And Sex Purchasing Among Adults Seeking Treatment For Cocaine Use Disorder, Emma C Lathan, Judy H Hong, Angela M Heads, Nicholas C Borgogna, Joy M Schmitz

Faculty, Staff and Student Publications

Exchange sex places individuals with cocaine use disorder (CUD) at particularly high risk for deleterious safety and health outcomes. A substance use treatment provider who is aware of a patient's exchange sex behavior is better able to provide appropriate screening, care, and/or referral to risk reduction services. However, little is known about exchange sex, especially purchasing, among treatment-seeking adults with CUD. The current study examined the prevalence and correlates of sex selling and sex purchasing among treatment-seeking men and women with CUD (

Customizing Early Intervention Treatment For Psychosis In The Uthealth - Harris County Psychiatric Center, Alia R Warner, Gordon C Shen, Jane E Hamilton, Luca Lavagnino, Scott D Lane

Faculty, Staff and Student Publications

High-need, high-cost patients include those with diagnosed serious mental illnesses (e.g., schizophrenia; SMI). They often delay or fail to seek treatment. If they receive treatment, care is often sought from generalist settings (e.g., primary care or emergency medicine) or is suboptimal due to the provision of limited, non-evidence-based intervention and lack of communication, integration, and coordination among providers. This results in high aggregate costs and poor outcomes. Value-based health care requires care coordination to address the medical and social needs of this population. We describe a unique early intervention program for SMI that emanates from an inpatient setting: The Early …