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Bounds DT, Rodrigues SM, Balsam D, Lennan N, Rodriguez KR, Milburn NG. Creating Space for Adolescents and Families With Lived Experience of Homelessness to Build Familial Empathy, Communication, and Emotional Regulation: A Qualitative Study of Facilitators of Implementation. J Psychosoc Nurs Ment Health Serv 2024; 62:27-35. [PMID: 37379121 DOI: 10.3928/02793695-20230622-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Youth experiencing homelessness are vulnerable to commercial sexual exploitation (CSE). Structural racism disproportionately entraps marginalized youth into CSE while simultaneously obscuring their identification as victims. Adaptation and tailoring of effective interventions to mitigate associated sequelae and inequities is warranted. Support To Reunite, Involve, and Value Each Other (STRIVE) is a strengths-based dyadic intervention with demonstrated efficacy in reducing delinquency, substance use, and high-risk sexual behaviors among marginalized adolescents experiencing homelessness. The adapted STRIVE+ was piloted to explore potential for reducing youth risk factors for CSE. The current article reports findings from interviews exploring participants' experiences with STRIVE+. Youth and caregivers reported increased empathy, communication, and emotional regulation post-STRIVE+ and found relevance and meaning through participating in the adapted intervention. Feasibility of recruitment, engagement, and retention of minoritized adolescents and their caregivers were also demonstrated. Findings warrant larger scale implementation trials of STRIVE+ among minoritized youth at highest risk for CSE. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 27-35.].
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Balsam D, Bounds DT, Rahmani AM, Nyamathi A. Evaluating the Impact of an App-Delivered Mindfulness Meditation Program to Reduce Stress and Anxiety During Pregnancy: Pilot Longitudinal Study. JMIR Pediatr Parent 2023; 6:e53933. [PMID: 38145479 PMCID: PMC10775027 DOI: 10.2196/53933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Stress and anxiety during pregnancy are extremely prevalent and are associated with numerous poor outcomes, among the most serious of which are increased rates of preterm birth and low birth weight infants. Research supports that while in-person mindfulness training is effective in reducing pregnancy stress and anxiety, there are barriers limiting accessibility. OBJECTIVE The aim of this paper is to determine if mindfulness meditation training with the Headspace app is effective for stress and anxiety reduction during pregnancy. METHODS A longitudinal, single-arm trial was implemented with 20 pregnant women who were instructed to practice meditation via the Headspace app twice per day during the month-long trial. Validated scales were used to measure participant's levels of stress and anxiety pre- and postintervention. Physiological measures reflective of stress (heart rate variability and sleep) were collected via the Oura Ring. RESULTS Statistically significant reductions were found in self-reported levels of stress (P=.005), anxiety (P=.01), and pregnancy anxiety (P<.0001). Hierarchical linear modeling revealed a statistically significant reduction in the physiological data reflective of stress in 1 of 6 heart rate variability metrics, the low-frequency power band, which decreased by 13% (P=.006). A total of 65% of study participants (n=13) reported their sleep improved during the trial, and 95% (n=19) stated that learning mindfulness helped with other aspects of their lives. Participant retention was 100%, with 65% of participants (n=13) completing about two-thirds of the intervention, and 50% of participants (n=10) completing ≥95%. CONCLUSIONS This study found evidence to support the Headspace app as an effective intervention to aid in stress and anxiety reduction during pregnancy.
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Affiliation(s)
- Donna Balsam
- School of Nursing, San Diego State University, San Diego, CA, United States
| | - Dawn T Bounds
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Amir M Rahmani
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Adeline Nyamathi
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
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Karber BCF, Nielsen JC, Balsam D, Messina C, Davidson D. Optimal radiologic position of an umbilical venous catheter tip as determined by echocardiography in very low birth weight newborns. J Neonatal Perinatal Med 2017; 10:55-61. [PMID: 28304320 DOI: 10.3233/npm-1642] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To compare chest X-ray with echocardiogram (ECHO) in the localization of an umbilical venous catheter (UVC) tip in very low birth weight infants (VLBW). Secondary objectives determined the association between techniques for tip placement by the vertebral body level on X-ray, as well as the length of the thoracic inferior vena cava-right atrial (TIVC-RA) junction by ECHO. STUDY DESIGN Prospective, sequentially enrolled, masked, single regional perinatal center study. Shortly after birth, one or more anterior-posterior X-rays were ordered by the clinical team to verify that the UVC tip was fixed in the central right atrium (cRA) or at the TIVC-RA junction. An echocardiogram was performed as soon as possible after the last X-ray and UVC tip location was interpreted by a pediatric cardiologist. The pediatric radiologist and cardiologist were masked with regard to each other's reading. RESULTS The newborns (n = 51) were 27 (±3) weeks by gestational age with birth weights of 1029 (±288) grams (mean±SD). The radiologist read 50 UVC tips (98%) in the cRA or TIVC-RA junction and 1 (2%) in the LA. The cardiologist read 22 (43%) in the cRA or TIVC-RA, 21 (41%) in the LA and 8 (16%) tips could not be located in the heart. When the UVC tip was interpreted by X-ray as located in the TIVC-RA junction 8/29 (28%) were in the LA by echocardiogram. There was no agreement between vertebral level and tip position in the TIVC-RA junction, RA or LA. The TIVC-RA junction measured 6±1 mm and correlated with birth weight r = 0.54 (p < 0.001). CONCLUSION In VLBW newborns, placement of the UVC tip into the cRA or TIVC-RA junction by X-ray does not avoid misplacement in the left atrium as demonstrated by echocardiography. For VLBW infants, it is suggested that echocardiography may be helpful in verifying that the original placement or migration of the UVC tip into the LA has not occurred.
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Affiliation(s)
- B C F Karber
- Department of Pediatrics, Stony Brook University Hospital, Stony Brook, NY, USA
| | - J C Nielsen
- Department of Pediatrics, Stony Brook University Hospital, Stony Brook, NY, USA
| | - D Balsam
- Department of Radiology Stony Brook University Hospital, Stony Brook, NY, USA
| | - C Messina
- Department of Preventive Medicine Stony Brook University Hospital, Stony Brook, NY, USA
| | - D Davidson
- Department of Pediatrics, Stony Brook University Hospital, Stony Brook, NY, USA
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Balsam D. Malpractice: avoiding alliteration. AJR Am J Roentgenol 2000; 175:1191. [PMID: 11000196 DOI: 10.2214/ajr.175.4.1751191b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
A number of diverse head and neck manifestations of HIV infection have been described, including adenoidal hypertrophy. We report a series of HIV-infected children in which 9 of 18 had abnormally small or radiographically absent adenoidal tissue. This finding did not, however, seem to correlate with several parameters for the severity or stage of illness.
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Affiliation(s)
- D Balsam
- Nassau County Medical Center, East Meadow, NY 11554, USA
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Schweitzer ME, Balsam D, Weiss R. Spina bifida occulta. Incidence in parents of offspring with spina bifida cystica. Spine (Phila Pa 1976) 1993; 18:785-6. [PMID: 8516715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M E Schweitzer
- Department of Radiology, Nassau County Medical Center/SUNY StonyBrook, East Meadow, New York
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Abstract
A case of hypertrophic osteoarthropathy (HOA) is presented in a 14-month-old girl with adult respiratory distress syndrome (ARDS) secondary to severe burn injury. The child developed clubbing during a lengthy and tumultuous hospitalization for her underlying lung disease, and hypertrophic osteoarthropathy was demonstrated radiologically.
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Affiliation(s)
- N Wadhwa
- Department of Radiology, Nassau County Medical Center, East Meadow, New York 11554
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Abstract
Tumors of smooth muscle origin are rare in childhood. We report a case of multiple bronchial leiomyomata in a seven year old girl with clinical HIV infection who presented with new onset of wheezing. Clinical details of this case have been published elsewhere, but without imaging studies [1].
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Affiliation(s)
- D Balsam
- Department of Radiology, Nassau County Medical Center, East Meadow, NY 11554
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Abstract
Invasive laryngeal candidiasis is an uncommon cause of epiglottitis, seen most often in immunocompromised or antibiotic-treated patients. We present the clinical and radiographic findings in an HIV-infected infant who developed significant stridor due to candidal epiglottitis. Stridor or hoarseness of unknown cause in an immunocompromised patient should lead to prompt evaluation for opportunistic laryngeal infection.
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Affiliation(s)
- D Balsam
- Nassau County Medical Center, East Meadow, New York
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Balsam D, Lodespoto M. Normal location of conus medullaris in childhood. AJR Am J Roentgenol 1989; 153:888-9. [PMID: 2773753 DOI: 10.2214/ajr.153.4.888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Canas JA, Balsam D, Leggiadro RJ. Adenovirus pericarditis. N Y State J Med 1986; 86:269-70. [PMID: 3012429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Bass IS, Haller JO, Friedman AP, Twersky J, Balsam D, Gottesman R. The sonographic appearance of the hemorrhagic ovarian cyst in adolescents. J Ultrasound Med 1984; 3:509-513. [PMID: 6392579 DOI: 10.7863/jum.1984.3.11.509] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Pelvic sonography was performed on ten teenaged girls who were proven by surgery to have hemorrhagic ovarian cysts. Pathologically, four were follicular ovarian cysts, while three were corpus luteal cysts, and the exact nature of three was undetermined. At sonography, these masses had variable appearances, ranging from anechoic to moderately echoic with septa and thick walls. All these features are nonspecific and can be encountered in other adnexal masses. The changing sonographic appearance of the hemorrhagic ovarian cyst due to clot lysis is helpful in establishing the diagnosis, and was demonstrated in two cases. These ten cases are discussed, the varied sonographic appearances are described and a review of pertinent literature is included.
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Abstract
Ventriculoperitoneal diversion of cerebrospinal fluid in infants and children with hydrocephalus has become the procedure of choice over the last 15 years. It has replaced ventriculoatrial shunts, resulting in a marked decrease in the complication rate after such procedures. Four cases of migration of the shunt tip through patent processus vaginalis resulting in scrotal hydrocele are presented.
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Annunziato D, Kaplan MH, Hall WW, Ichinose H, Lin JH, Balsam D, Paladino VS. Atypical measles syndrome: pathologic and serologic findings. Pediatrics 1982; 70:203-9. [PMID: 7099785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The clinical course of measles occurring in 17 adolescents who had previously received killed measles vaccine is described. All adolescents had a peripheral dermatitis. Fifteen had characteristic pulmonary infiltrates. Serologic study in six adolescents using immunoprecipitation of 35S-methionine-labeled measles virus antigens revealed that 5/6 acute sera lacked antibody to the hemolysin antigen whereas 5/6 sera contained antibody to hemagglutinin antigen. Skin biopsies, obtained from three patients, demonstrate a combination of an Arthus reaction and delayed hypersensitivity. The typical measles histologic complex was absent. Measles virions were seen in the deep dermal blood vessels. The serologic and histopathologic presentation of this disease indicates that killed vaccine does not adequately induce antibody to the hemolysin (F) which is necessary to prevent cell-to-cell spread of paramyxoviruses. Killed vaccine does, however, produce hemagglutinin antibody and simultaneously incites later hypersensitivity to wild virus infection, producing the unusual dermatopathologic reaction seen.
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Abstract
The increasing use of prenatal diagnostic methods, including sonography and amniotic fluid analysis, has made it possible to suspect certain fetal defects at an early gestational age. In selected cases, accurate diagnosis of the specific malformation may have an effect on fetal and neonatal prognosis, and on prenatal counseling of the parents. As part of a large regional screening program for neural tube defects, we performed 28 midtrimester amniograms. We found 14 neural tube defects (nine spina bifida, four anencephaly, one Meckel syndrome), four abdominal wall defects, two tumors, and eight normal examinations. Radiographic examples of these malformations are presented, including previously undescribed findings in meningomyeloceles. The place of amniography in prenatal diagnosis is discussed.
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Leggiadro RJ, Balsam D. Haemophilus influenzae sepsis leading to pericarditis despite antimicrobial therapy. Johns Hopkins Med J 1980; 146:133-6. [PMID: 6966005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Acute purulent pericarditis is a well-recognized, though infrequently seen, manifestation of systemic Haemophilus influenzae type b disease. We recently studied two pediatric patients who developed signs of this septic complication during appropriate antibiotic treatment for bacteremia. These case reports should alert physicians to the possibility that pericarditis may become clinically evident in patients with systemic H. influenzae infections many days after initiation of appropriate therapy. The pathophysiology, diagnostic modalities and therapy are briefly reviewed.
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Balsam D, Goldfarb CR, Stringer B, Farruggia S. Bone scintigraphy for neonatal osteomyelitis: simulation by extravasation of intravenous calcium. Radiology 1980; 135:185-6. [PMID: 7360958 DOI: 10.1148/radiology.135.1.7360958] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Intravenously administered calcium gluconate has become increasingly popular in the treatment of neonatal tetany. Occasionally, extravasation results in cellulitis, leading to a clinical diagnosis of superimposed osteomyelitis. Osseous scintigraphy, as the accepted modality in the early detection of osteomyelitis, would tend to be used in this circumstance. This case illustrates a false-positive result, probably due to soft-tissue calcification.
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Verma U, Weiss RR, Almonte R, Macri JN, Tejani N, Balsam D, Tuck S. Early prenatal diagnosis of soft-tissue malformations. Obstet Gynecol 1979; 53:660-3. [PMID: 440682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study presents 3 cases of severe soft-tissue malformations of the fetus. Prenatal diagnosis was established early in the second trimester, and the accuracy of the diagnosis was confirmed by pathological examination in each instance. A clinically oriented work-up plan for early prenatal diagnosis is proposed.
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Weiss RR, Balsam D, Macri JN. Neural tube defects. Obstet Gynecol 1978; 52:510-1. [PMID: 82236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Abstract
Amniography for the visualization and confirmation of suspected neural tube defect was performed in 9 midtrimester gravidas. In all cases, amniotic fluid alpha-feto protein (AFP) was abnormally elevated. Four cases of anencephaly and one of spina bifida were demonstrated by amniography. These pregnancies were terminated and the defects were confirmed by gross pathologic examination. In 4 remaining cases, amniography was normal. Three of these pregnancies proceeded to term, culminating in the birth of a normal child. The fourth patient had spontaneous abortion of a normal fetus at 23 weeks of gestation. The experience reported here suggests that amniography is an important adjunctive diagnostic technique in the prenatal diagnosis of neural tube defect, and if used correctly, may significantly reduce the chance of false-positive diagnosis.
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Abstract
This rare syndrome is characterized by short stature, sparse, fine scalp hair, a pear-shaped nose, long philtrum, normal intelligence, and cone-shaped epiphyses of the phalanges with deformities of the fingers.
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Kassner EG, Baumstark A, Balsam D, Haller JO. Passage of feeding catheters into the pleural space: a radiographic sign of trauma to the pharynx and esophagus in the newborn. AJR Am J Roentgenol 1977; 128:19-22. [PMID: 401580 DOI: 10.2214/ajr.128.1.19] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Although rarely recognized, traumatic pharyngeal and cervical esophageal pseudodiverticula are probably not infrequent in newborns who have undergone vigorous oropharyngeal suctioning and endotracheal intubation. This report describes four premature infants with clinically unsuspected retroesophageal false passages incidentally discovered on chest radiographs. Differentiation of pseudodiverticula from spontaneous rupture of the middle or distal esophagus can be achieved by careful inspection of the course of the feeding catheter in frontal and lateral projections and by partial withdrawal of the catheter to permit injection of the retroesophageal false passage with a small volume of water-soluble contrast material.
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Macri JN, Weiss RR, Tillitt R, Balsam D, Elligers KW. Prenatal diagnosis of neural tube defects. JAMA 1976; 236:1251-4. [PMID: 60498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A prospective program for the prenatal detection of neural tube defects in a high-risk pregnancy group has been under way for one year. Twenty high-risk mothers have undergone a complete prenatal work-up, including sonography, amniocentesis, and amniotic fluid and maternal serum alpha-fetoprotein quantitation. Within this group, two cases were prospectively diagnosed and were later confirmed.
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