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Bernstein GA, Khan MH, Freese RL, Manko C, Silverman M, Ahmed S, Farhadian B, Ma M, Thienemann M, Murphy TK, Frankovich J. Psychometric Properties of the PANS 31-Item Symptom Rating Scale. J Child Adolesc Psychopharmacol 2024; 34:157-162. [PMID: 38536004 DOI: 10.1089/cap.2023.0088] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Objectives: Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by sudden onset of obsessive-compulsive disorder and/or eating restriction with associated neuropsychiatric symptoms from at least two of seven categories. The PANS 31-Item Symptom Rating Scale (PANS Rating Scale) was developed to identify and measure the severity of PANS symptoms. The objective of this study was to define the psychometric properties of the PANS Rating Scale. Methods: Children with PANS (N = 135) and their parents participated. Parents completed the PANS Rating Scale and other scales on Research Electronic Data Capture. The PANS Rating Scale includes 31 items that are rated on a Likert scale from 0 = none to 4 = extreme. Pearson's correlations were run between the PANS Total score and scores on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), Yale Global Tic Severity Scale (YGTSS), Modified Overt Aggression Scale (MOAS), Columbia Impairment Scale (CIS), PANS Global Impairment Score (GIS), and Children's Global Assessment Scale (CGAS). Results: Convergent validity was supported by significant correlations between the PANS Total and scores on the CY-BOCS, YGTSS, MOAS, CIS, GIS, and CGAS. The largest correlations were with measures of functional impairment: PANS Total and CIS (r = 0.81) and PANS Total and GIS (r = 0.74). Cronbach's alpha was 0.89 which demonstrates strong internal consistency of the 31 items. PANS Total score was significantly higher in children in a flare of their neuropsychiatric symptoms compared to children who were not in a flare. Conclusions: This study provides preliminary support for the PANS Rating Scale as a valid research instrument with good internal consistency. The PANS Rating Scale appears to be a useful measure for assessing children with PANS.
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Affiliation(s)
- Gail A Bernstein
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Masonic Institute for the Developing Brain, Minneapolis, Minnesota, USA
| | - Maroof H Khan
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Rebecca L Freese
- Clinical and Translational Science Institute, Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cindy Manko
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Melissa Silverman
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Sana Ahmed
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Bahare Farhadian
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Meiqian Ma
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Margo Thienemann
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Tanya K Murphy
- Department of Pediatrics, University of South Florida, St Petersburg, Florida, USA
| | - Jennifer Frankovich
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
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So M, Freese RL, Barnes AJ. Pushed Out and Drawn In: Exclusionary Discipline, Mental Health, and Protective Factors Among Youth in Public Schools. J Sch Health 2024; 94:128-137. [PMID: 37867252 PMCID: PMC10843458 DOI: 10.1111/josh.13405] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Exclusionary discipline (ED) has long been an educational equity concern, but its relationship with student health and protective factors is less understood. METHODS Using population-based public school student data (N = 82,216), we examined associations between past-month ED and positive depression and anxiety screening instrument results. We also assessed whether each of 9 potential protective factors moderated the ED-mental health relationship by testing interaction effects. RESULTS Over 1 in 10 youth experienced past-month ED, with variation by sex, gender identity, special education status, poverty, region, race/ethnicity, and adverse childhood experiences. Net of sociodemographic factors, youth who experienced ED had higher likelihood for current depression (adjusted odds ratio [AOR]: 1.64, 95% confidence interval [CI]: 1.55, 1.73) and anxiety (AOR: 1.49, 95% CI: 1.41, 1.58) symptoms. Significant associations were robust across 5 racial/ethnic groups, except for anxiety among American Indian/Alaska Native youth. Individual, interpersonal, and school-level protective factors appeared to mitigate depression and anxiety regardless of disciplinary experience. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Our findings document ED disproportionality and possible ramifications for emotional well-being. CONCLUSIONS In concert with structural efforts to reduce reliance on ED, strategies that bolster protective factors may support youth already impacted by ED and/or mental health problems.
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Affiliation(s)
- Marvin So
- LifeLong Medical Care, William Jenkins Health Center, Richmond, CA
- University of Minnesota Medical School, Department of Pediatrics, Minneapolis, MN
| | - Rebecca L. Freese
- University of Minnesota, Clinical and Translational Science Institute, Minneapolis, MN
| | - Andrew J. Barnes
- University of Minnesota Medical School, Department of Pediatrics, Minneapolis, MN
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3
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Arora P, Freese RL, Bigliardi PL. The Diagnostic Value of Delayed-Type Reactions to Perennial Aeroallergens for Atopic Disease. Dermatitis 2024; 35:S91-S97. [PMID: 37134216 PMCID: PMC10913491 DOI: 10.1089/derm.2022.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Background: Delayed-type reactions to aeroallergens have been observed, however, their clinical significance continues to be debated. Objective: We assessed the prevalence and significance of delayed-type reactions to aeroallergens in atopic patients. Methods: Retrospective study including 266 patients with history or evidence of atopic disease (atopic dermatitis [AD], allergic rhinitis, and/or allergic asthma) and tested via either the intradermal skin test (IDT) or atopy patch test for common aeroallergens, specifically house dust mites (Dermatophagoides farinae, Dermatophagoides pteronyssinus) and perennial molds (Aspergillus fumigatus, Penicillium notatum). All patients were tested via IDT with both immediate (15 minute) and delayed (2 and 4 days) readings. Delayed reading was considered positive if the IDT injection site demonstrated at least 5 mm induration 48 hours after inoculation. Results: In total, 195 (73.3%) patients demonstrated an immediate-type reaction, whereas 118 (44.4%) had a delayed-type reaction. In total, 75 (28.2%) patients experienced both immediate- and delayed-type reactions, 43 (16.2%) reacted delayed-type only, and 85.3% of delayed-type reactions to individual aeroallergens were associated with eczematous lesions predominantly in air-exposed areas. Conclusion: Delayed-type reactions to aeroallergens are prevalent and clinically significant as a component of extrinsic AD and atopic diseases. The data support delayed reading of the IDT to guide diagnosis and management in these patients.
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Affiliation(s)
- Puneet Arora
- From the Department of Dermatology; University of Minnesota, Minneapolis, Minnesota, USA
| | - Rebecca L. Freese
- From the Department of Dermatology; University of Minnesota, Minneapolis, Minnesota, USA
| | - Paul L. Bigliardi
- From the Department of Dermatology; University of Minnesota, Minneapolis, Minnesota, USA
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4
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Robiner WN, Barnes RD, Freese RL, Palmer B, Kim MH. Homicides of psychologists, physicians, nurses, pharmacists, social workers, and other health professionals: National Violent Death Reporting System data 2003-2020. J Clin Psychol 2023; 79:2932-2946. [PMID: 37639225 DOI: 10.1002/jclp.23589] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/17/2023] [Accepted: 08/12/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE Homicide is the extreme endpoint along the continuum of interpersonal violence. Violence in healthcare settings and directed toward healthcare workers has been a growing concern. Analysis of health professionals' homicides is needed to inform prevention interventions. METHODS Decedent numbers, age, and sex in the National Violent Death Reporting System are reported for 10 types of health professionals: advance practice registered nurses, dentists, nurses, pharmacists, physicians, physician assistants, psychiatrists, psychologists, social workers, and veterinarians. RESULTS Between 2003 and 2020, 944 homicides of these professionals were reported to the NVDRS. Nearly 80% of victims were women; 53% of homicides involved guns. Nurses, social workers, physicians, and pharmacists comprised the most victims. In 2020, nurses, social workers, pharmacists, and psychologists had the highest homicide rates relative to their workforce size. Few of these homicides were related to professionals' work. The number of homicides within these professions correlated highly with the size of professions' workforces. CONCLUSIONS Health professionals' homicides constitute a small proportion of US homicides generally at lower rates than seen in the general population. Age is likely one of the protective factors. Future, more comprehensive data will provide greater insights into emerging trends to inform strategies to mitigate homicide risk in health professionals. Prevention needs to go beyond healthcare settings and address societal roots of violence.
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Affiliation(s)
- William N Robiner
- Department of Medicine, Division of Geriatric, Palliative, and Primary Care, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Rachel D Barnes
- Department of Medicine, Division of Geriatric, Palliative, and Primary Care, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Rebecca L Freese
- Clinical and Translational Science Institute, Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Brooke Palmer
- Department of Medicine, Division of Geriatric, Palliative, and Primary Care, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Michael H Kim
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Department of Medicine, Division of Hospital Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Jacobsen A, Kabbur G, Freese RL, Rypka KJ, Goldfarb N. Socioeconomic factors and financial burdens of research "gap years" for dermatology residency applicants. Int J Womens Dermatol 2023; 9:e099. [PMID: 37547567 PMCID: PMC10403007 DOI: 10.1097/jw9.0000000000000099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/16/2023] [Indexed: 08/08/2023] Open
Affiliation(s)
- Audrey Jacobsen
- Department of Dermatology, Veterans Affairs Medical Center, Minneapolis, Minnesota
- Department of Dermatology, Hennepin County Medical Center, Minneapolis, Minnesota
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Gowri Kabbur
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Rebecca L. Freese
- Clinical and Translational Science Institute, Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, Minnesota
| | - Katelyn J. Rypka
- Department of Dermatology, Veterans Affairs Medical Center, Minneapolis, Minnesota
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Noah Goldfarb
- Department of Dermatology, Veterans Affairs Medical Center, Minneapolis, Minnesota
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
- Department of Internal Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota
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6
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Bellefeuille G, Paiewonsky B, Khalid B, Freese RL, Lowes M, Kirby JS, Alavi A, Goldfarb N. Worst area local Hidradenitis suppurativa Activity and Severity Index-Revised (W-HASI-R): a study evaluating construct validity. Br J Dermatol 2023; 189:338-354. [PMID: 37143371 PMCID: PMC10449531 DOI: 10.1093/bjd/ljad138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 04/13/2023] [Accepted: 05/20/2023] [Indexed: 05/06/2023]
Abstract
Current validated hidradenitis suppurativa (HS) severity assessment tools are time-consuming and impractical in fast-paced, ambulatory clinic settings. This study evaluated the construct validity of the most severe or ‘worst’ area local Hidradenitis suppurativa Activity and Severity Index-Revised (W-HASI-R) as a novel target area assessment tool for clinical setting use. W-HASI-R had strong association with the International Hidradenitis Suppurativa Severity Score System and abscess and nodule count, moderate association with Hurley stage and HS physician global assessment and weak, negative association with reverse-scored Dermatology Quality Life Index. The resulting data suggest that W-HASI-R may be an option as an efficient target area assessment tool for fast-paced, ambulatory settings.
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Affiliation(s)
| | - Briana Paiewonsky
- Departments of Dermatology and
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | | | - Rebecca L Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | | | - Joslyn S Kirby
- Department of Dermatology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Noah Goldfarb
- Departments of Dermatology and
- Medicine, University of Minnesota Academic Health Center, Minneapolis, MN, USA
- Departments of Medicine and Dermatology, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
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Horning ML, Friend S, Freese RL, Barr-Anderson DJ, Linde JA, Sidebottom A, Sommerness SA, Fulkerson JA. Parent Weight, Diet, Active Living, and Food-Related Outcomes of the Family-Focused:NU-HOME Randomized Controlled Trial: NU-HOME Randomized Controlled Trial. J Acad Nutr Diet 2023; 123:751-760.e1. [PMID: 36244610 PMCID: PMC10097834 DOI: 10.1016/j.jand.2022.10.009] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/12/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about parent outcomes of rural, family-focused childhood obesity prevention trials. OBJECTIVE Our aim was to evaluate parent outcomes of the rural, family-focused NU-HOME (New Ulm at HOME [Healthy Offerings via the Mealtime Environment]) randomized controlled trial designed to prevent obesity in children aged 7 through 10 years. DESIGN Families were randomized to the intervention or wait-list control group after baseline data collection. Staff measured parent height, weight, and percent body fat. Surveys measured parent cognitive and behavioral outcomes (eg, portion-size confidence, dietary intake, total and moderate-to-vigorous physical activity, and screen time). Post-intervention data were collected 8 to 10 months after baseline. PARTICIPANTS/SETTING The randomized controlled trial took place in rural, south central Minnesota, and enrolled parent and child dyads (N = 114; 2017-2018); 98 parents provided data at post intervention (2018-2019) and comprise the analytic sample. Parent inclusion criteria were being the primary meal preparer, living with the child most of the time, and being willing to attend intervention sessions. Exclusion criteria were planning to move or having a medical condition that would contraindicate participation. INTERVENTION The theory-guided intervention (7 sessions and 4 goal-setting calls) focused on family eating and active living behaviors. MAIN OUTCOME MEASURES Height, weight, and percent body fat were measured and the survey assessed diet, active living, and food-related outcomes. STATISTICAL ANALYSES PERFORMED Multiple linear regression models tested change in parent outcomes from baseline to post intervention by treatment group adjusted for demographic characteristics and baseline values. RESULTS In the intervention group vs control group, parent total weekly hours of physical activity was 1.73 hours higher (95% CI 0.11 to 3.35 hours) and portion-size confidence was 1.49 points higher (95% CI 0.78 to 2.19). No other statistically significant changes were observed by treatment group. CONCLUSIONS Findings indicate that parent cognitive and behavioral outcomes are amenable to change in family-focused childhood obesity prevention programs. Parent increases in portion-size confidence and total physical activity hours may support long-term parent health and provide positive context for child health.
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Affiliation(s)
| | - Sarah Friend
- School of Nursing, University of Minnesota, Minneapolis, Minnesota
| | - Rebecca L Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota
| | | | - Jennifer A Linde
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | - Jayne A Fulkerson
- Center for Child & Family Health Promotion Research, Clinical and Translational Science Institute Translational Research and Career Training TL1 Program and Translational Research Development Program, School of Nursing, University of Minnesota, Minneapolis
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8
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Anugwom C, Thomson M, Freese RL, Lake JR, Lim N. Lower survival and higher rates of cirrhosis in patients with ROUX-EN-Y gastric bypass hospitalised with alcohol-associated hepatitis. BMJ Open Gastroenterol 2023; 10:bmjgast-2022-001083. [PMID: 36808070 PMCID: PMC9943920 DOI: 10.1136/bmjgast-2022-001083] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE The incidence of alcohol-associated liver disease (ALD) is increasing, and weight loss surgery is more common due to the obesity epidemic. Roux-en-Y gastric bypass (RYGB) is associated with alcohol use disorder and ALD; however, its impact on outcomes in patients hospitalised for alcohol-associated hepatitis (AH) is unclear. DESIGN We performed a single-centre, retrospective study of patients with AH from June 2011 to December 2019. Primary exposure was the presence of RYGB. The primary outcome was inpatient mortality. Secondary outcomes included overall mortality, readmissions and cirrhosis progression. RESULTS 2634 patients with AH met the inclusion criteria; 153 patients had RYGB. Median age of the entire cohort was 47.3 years; median Model for End Stage Liver Disease - Sodium (MELD-Na) was 15.1 in the study group versus 10.9 in the control group. There was no difference in inpatient mortality between the two groups. On logistic regression, increased age, elevated body mass index, MELD-Na >20 and haemodialysis were all associated with higher inpatient mortality. RYGB status was associated with increased 30-day readmission (20.3% vs 11.7%, p<0.01), development of cirrhosis (37.5% vs 20.9%, p<0.01) and overall mortality (31.4% vs 24%, p=0.03). CONCLUSIONS Patients with RYGB have higher rates of readmissions, cirrhosis and overall mortality after discharge from hospital for AH. Allocation of additional resources on discharge may improve clinical outcomes and reduce healthcare expenditure in this unique patient population.
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Affiliation(s)
- Chimaobi Anugwom
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA .,Digestive Care, HealthPartners, Bloomington, Minnesota, USA
| | - Mary Thomson
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Rebecca L Freese
- Clinical and Translational Science Institute, Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - John R Lake
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Nicholas Lim
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
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9
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Henkle BE, Freese RL, Dahlheimer M, Kane C, Hoth KF, Kunisaki KM. Cognitive function and inhaler technique following recovery from exacerbations of COPD. ERJ Open Res 2023; 9:00627-2022. [PMID: 37143839 PMCID: PMC10152261 DOI: 10.1183/23120541.00627-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/04/2023] [Indexed: 02/18/2023] Open
Abstract
Cognitive impairment is highly prevalent in COPD outpatients during the post-exacerbation recovery period and is associated with poor inhaler technique https://bit.ly/3XkCvCv.
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10
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Bellefeuille G, Paiewonsky B, Khalid B, Freese RL, Lowes MA, Kirby JS, Alavi A, Goldfarb N. Inflammatory induration in hidradenitis suppurativa and application to severity assessment. Br J Dermatol 2023; 188:309-310. [PMID: 36634097 DOI: 10.1093/bjd/ljac076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/06/2022] [Accepted: 10/24/2022] [Indexed: 01/13/2023]
Abstract
Skin thickness, as known as inflammatory induration, is a component in several HS grading instruments including the HASI and HASI-R. This study sought to evaluate how thickest lesion measurement (mm) corresponds to HS severity. This study demonstrates that inflammatory induration has moderate association with HS severity, thickest lesion measurement (mm) demonstrates known-validity across Hurley stages, and cut-offs for thickest lesion measurement (mm) were determined for inflammatory induration grading for the purpose of HASI-R training.
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Affiliation(s)
| | - Briana Paiewonsky
- Department of Dermatology.,Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL, USA
| | | | - Rebecca L Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | | | - Joslyn S Kirby
- Department of Dermatology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Noah Goldfarb
- Department of Dermatology.,Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Departments of Medicine and Dermatology, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.,Department of Medicine, University of Minnesota Academic Health Center, Minneapolis, MN, USA
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11
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Ravipati P, Freese RL, Royal V, Bu L, Canetta P, Gipson D, Kallash M, Kiryluk K, Nast C, Reich HN, Rheault MN, Saha M, Nachman PH. Clinicopathologic Significance of Predominant Lambda Light Chain Deposition in IgA Nephropathy. Kidney Int Rep 2022; 7:2462-2473. [PMID: 36531879 PMCID: PMC9751582 DOI: 10.1016/j.ekir.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction IgA nephropathy (IgAN) differs from other glomerular diseases by the frequently predominant lambda over kappa light chain deposition. Using the Cure Glomerulonephropathy (CureGN) IgAN cohort, we aimed to determine whether predominant lambda chain deposition is associated with worse clinical outcomes or histopathologic markers of more active disease. Methods Patients were categorized based on the intensity of light chain staining. The lambda dominant (LD) group was defined by a difference in intensity score of lambda minus kappa ≥ 1+ and the kappa-lambda codominant (KL) group by a difference < 1+. We compared the clinical course of patients in each category from the time of kidney biopsy and time of enrollment into CureGN to the time of remission (proteinuria < 0.3 g/g), 50% reduction in estimated glomerular filtration rate (eGFR), or progression to end-stage kidney disease (ESKD). We also analyzed differences in histopathologic characteristics between the 2 groups. Results Among 440 patients, we found no significant differences between groups in baseline clinical characteristics nor in rates of remission, 50% reduction in eGFR, or progression to ESKD. Patients in the LD group had a modestly greater frequency of IgG staining ≥ 1+. The biopsy results of 234 patients reviewed by CureGN pathologists revealed a greater frequency of endocapillary hypercellularity (51.1% vs. 36.3%, P = 0.04) in the LD group, but no other significant difference in histopathologic features. Conclusion In IgAN, we found an association between lambda predominance and increased endocapillary hypercellularity, but no association with clinical outcomes.
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Affiliation(s)
- Prasanth Ravipati
- Division of Nephrology and Hypertension, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
- Division of Nephrology, Department of Medicine, University of Nebraska, Omaha, Nebraska, USA
| | - Rebecca L. Freese
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, USA
| | - Virginie Royal
- Department of Pathology, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Lihong Bu
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Pietro Canetta
- Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Debbie Gipson
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Mahmood Kallash
- Section of Pediatric Nephrology, The Ohio State University College of Medicine, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Krzysztof Kiryluk
- Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Cynthia Nast
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Heather N. Reich
- Division of Nephrology, University Health Network, Toronto, Ontario, Canada
| | - Michelle N. Rheault
- Division of Pediatric Nephrology, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota, USA
| | - Manish Saha
- Division of Nephrology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Patrick H. Nachman
- Division of Nephrology and Hypertension, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
- Correspondence: Patrick H. Nachman, Division of Nephrology and Hypertension, University of Minnesota, 717 Delaware Street Southeast, Minneapolis, Minnesota 55414, USA.
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12
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Allen KA, Freese RL, Pitt MB. Rejection Resilience-Quantifying Faculty Experience With Submitting Papers Multiple Times After a Rejection. Acad Pediatr 2022; 22:876-878. [PMID: 34999008 PMCID: PMC9256847 DOI: 10.1016/j.acap.2021.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/25/2021] [Accepted: 12/30/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Katherine A. Allen
- University of Minnesota, Masonic Children’s Hospital, Pediatric Hospital Medicine, Academic Office Building, 2450 Riverside Ave S AO-301, Minneapolis, MN 55454
| | - Rebecca L. Freese
- University of Minnesota, Clinical and Translational Science Institute, Biostatistical Design and Analysis Center, 717 Delaware St SE, Minneapolis, MN 55414
| | - Michael B. Pitt
- University of Minnesota School of Medicine & Masonic Children’s Hospital, Pediatric Hospital Medicine, Academic Office Building, 2450 Riverside Ave S AO-114, Minneapolis, MN 55454
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Fulkerson JA, Horning M, Barr-Anderson DJ, Sidebottom A, Linde JA, Lindberg R, Friend S, Beaudette J, Flattum C, Freese RL. Weight outcomes of NU-HOME: a randomized controlled trial to prevent obesity among rural children. Int J Behav Nutr Phys Act 2022; 19:29. [PMID: 35305674 PMCID: PMC8934465 DOI: 10.1186/s12966-022-01260-w] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Rural children are at greater obesity risk than their urban peers. The NU-HOME study is an innovative collaborative effort to prevent childhood obesity in rural communities. Weight outcomes of the NU-HOME study, a family-meal focused randomized controlled trial (RCT) are described. We hypothesized that compared to control group children, intervention group children would have significantly lower weight-related post-intervention (PI) outcomes. METHODS Participants were 114 dyads (7-10 year-old rural children and a parent). In 2017-2018 and 2018-2019, research staff measured height, weight and body fat at baseline (BL) and PI. Families were randomized to intervention (n = 58) or control (n = 56) groups without blinding. Designed with Social Cognitive Theory and community engagement, the NU-HOME program included seven monthly sessions delivered in community settings and four goal-setting calls. The program engaged entire families to improve healthy eating, physical activity, family meals and the home food environment. Multiple linear and logistic regression models tested PI outcomes of child BMIz-score, percent body fat, percent over 50th percentile BMI, and overweight/obesity status by treatment group, adjusted for BL values and demographics (n = 102). RESULTS No statistically significant intervention effects were seen for child BMIz or overweight/obesity status. However, a promising reduction in boys' percent body fat (- 2.1, 95% CI [- 4.84, 0.63]) was associated with the intervention. CONCLUSIONS Although our findings were in the hypothesized direction, making significant impacts on weight-related outcomes remains challenging in community trials. Comprehensive family-focused programming may require intensive multi-pronged interventions to mitigate complex factors associated with excess weight gain. CLINICAL TRIAL REGISTRATION This study is registered with NIH ClinicalTrials.gov: NCT02973815 .
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Affiliation(s)
- Jayne A Fulkerson
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN, 55455, USA.
| | - Melissa Horning
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN, 55455, USA
| | | | | | - Jennifer A Linde
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Sarah Friend
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN, 55455, USA
| | | | - Colleen Flattum
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca L Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
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14
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Robiner WN, Petrik ML, Flaherty N, Fossum TA, Freese RL, Nevins TE. Depression, Quantified Medication Adherence, and Quality of Life in Renal Transplant Candidates and Recipients. J Clin Psychol Med Settings 2022; 29:168-184. [PMID: 34089133 PMCID: PMC8642472 DOI: 10.1007/s10880-021-09792-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 11/26/2022]
Abstract
Like patients with many chronic illnesses, ESRD patients experience psychological challenges with greater incidence of depression and reduced quality of life (QoL). A series of 139 transplant candidates' depression and QoL, and a subset of 82 candidates' medication adherence were monitored, revealing heterogenous patterns of depression and adherence and reduced QoL. Twenty-eight patients who received kidney transplants were re-evaluated 6 months post-transplant revealing mixed patterns. Mean depression and quantitated adherence decreased and QoL increased. Some patients improved whereas others declined in depression and adherence. Pre-transplant depression was negatively correlated with post-transplant adherence but positively correlated with post-transplant depression. Nevertheless, the ability to predict individuals' post-transplant adherence and depression, principal objectives of pre-transplant psychological evaluations, is limited. Consequently, it is important to provide periodic screening of ESRD patients for depression and adherence pre- and post-transplant as they reflect changing states, rather than static traits, with variable patterns across patients.
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Affiliation(s)
- William N Robiner
- Health Psychology, Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, MMC 741, 420 Delaware Street, S.E, Minneapolis, MN, 55455, USA.
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Megan L Petrik
- Health Psychology, Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, MMC 741, 420 Delaware Street, S.E, Minneapolis, MN, 55455, USA
| | - Nancy Flaherty
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Thyra A Fossum
- Health Psychology, Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, MMC 741, 420 Delaware Street, S.E, Minneapolis, MN, 55455, USA
| | - Rebecca L Freese
- Biostatistical Design and Analysis Center (BDAC), Clinical and Translational Science Institute (CTSI), University of Minnesota, Minneapolis, MN, USA
| | - Thomas E Nevins
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
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15
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Ingraham NE, Vakayil V, Pendleton KM, Robbins AJ, Freese RL, Palzer EF, Charles A, Dudley RA, Tignanelli CJ. Recent Trends in Admission Diagnosis and Related Mortality in the Medically Critically Ill. J Intensive Care Med 2022; 37:185-194. [PMID: 33353475 DOI: 10.1177/0885066620982905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/16/2022]
Abstract
PURPOSE With decades of declining ICU mortality, we hypothesized that the outcomes and distribution of diseases cared for in the ICU have changed and we aimed to further characterize them. STUDY DESIGN AND METHODS A retrospective cohort analysis of 287,154 nonsurgical-critically ill adults, from 237 U.S. ICUs, using the manually abstracted Cerner APACHE Outcomes database from 2008 to 2016 was performed. Surgical patients, rare admission diagnoses (<100 occurrences), and low volume hospitals (<100 total admissions) were excluded. Diagnoses were distributed into mutually exclusive organ system/disease-based categories based on admission diagnosis. Multi-level mixed-effects negative binomial regression was used to assess temporal trends in admission, in-hospital mortality, and length of stay (LOS). RESULTS The number of ICU admissions remained unchanged (IRR 0.99, 0.98-1.003) while certain organ system/disease groups increased (toxicology [25%], hematologic/oncologic [55%] while others decreased (gastrointestinal [31%], pulmonary [24%]). Overall risk-adjusted in-hospital mortality was unchanged (IRR 0.98, 0.96-1.0004). Risk-adjusted ICU LOS (Estimate -0.06 days/year, -0.07 to -0.04) decreased. Risk-adjusted mortality varied significantly by disease. CONCLUSION Risk-adjusted ICU mortality rate did not change over the study period, but there was evidence of shifting disease burden across the critical care population. Our data provides useful information regarding future ICU personnel and resource needs.
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Affiliation(s)
- Nicholas E Ingraham
- Department of Medicine, 311816University of Minnesota Medical School, Minneapolis, MN, USA
- School of Public Health, 311816University of Minnesota, Minneapolis, MN, USA
| | - Victor Vakayil
- School of Public Health, 311816University of Minnesota, Minneapolis, MN, USA
- Department of Surgery, 311816University of Minnesota Medical School, Minneapolis, MN, USA
| | - Kathryn M Pendleton
- Department of Medicine, 311816University of Minnesota Medical School, Minneapolis, MN, USA
| | - Alexandria J Robbins
- Department of Surgery, 311816University of Minnesota Medical School, Minneapolis, MN, USA
| | - Rebecca L Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, 311816University of Minnesota, Minneapolis, MN, USA
| | - Elise F Palzer
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, 311816University of Minnesota, Minneapolis, MN, USA
| | - Anthony Charles
- Department of Surgery, 2331University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Gillings School of Global Public Health, 2331University of North Carolina, Chapel Hill, NC, USA
| | - R Adams Dudley
- Department of Medicine, 311816University of Minnesota Medical School, Minneapolis, MN, USA
- School of Public Health, 311816University of Minnesota, Minneapolis, MN, USA
- Institute for Health Informatics, 311816University of Minnesota Academic Health Center, Minneapolis, MN, USA
| | - Christopher J Tignanelli
- Department of Surgery, 311816University of Minnesota Medical School, Minneapolis, MN, USA
- Institute for Health Informatics, 311816University of Minnesota Academic Health Center, Minneapolis, MN, USA
- Department of Surgery, North Memorial Health Hospital, Robbinsdale, MN, USA
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16
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Li T, Petrik ML, Freese RL, Robiner WN. Suicides of psychologists and other health professionals: National Violent Death Reporting System data, 2003-2018. Am Psychol 2022; 77:551-564. [PMID: 35389672 PMCID: PMC9440758 DOI: 10.1037/amp0001000] [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] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Suicide is a prevalent problem among health professionals, with suicide rates often described as exceeding that of the general population. The literature addressing suicide of psychologists is limited, including its epidemiological estimates. This study explored suicide rates in psychologists by examining the National Violent Death Reporting System (NVDRS), the Centers for Disease Control and Prevention's data set of U.S. violent deaths. Data were examined from participating states from 2003 to 2018. Trends in suicide deaths longitudinally were examined. Suicide decedents were characterized by examining demographics, region of residence, method of suicide, mental health, suicidal ideation, and suicidal behavior histories. Psychologists' suicide rates are compared to those of other health professionals. Since its inception, the NVDRS identified 159 cases of psychologist suicide. Males comprised 64% of decedents. Average age was 56.3 years. Factors, circumstances, and trends related to psychologist suicides are presented. In 2018, psychologist suicide deaths were estimated to account for 4.9% of suicides among 10 selected health professions. As the NVDRS expands to include data from all 50 states, it will become increasingly valuable in delineating the epidemiology of suicide for psychologists and other health professionals and designing prevention strategies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Tiffany Li
- University of Minnesota, Department of Psychology
| | - Megan L. Petrik
- University of Minnesota Medical School, Department of Medicine
| | - Rebecca L. Freese
- University of Minnesota, Clinical and Translational Science Institute, Biostatistical Design and Analysis Center
| | - William N. Robiner
- University of Minnesota Medical School, Departments of Medicine and Pediatrics
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17
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Doche I, Romiti R, Rivitti-Machado MC, Gorbatenko-Roth K, Freese RL, Hordinsky MK. Quality-of-life impairment is not related to disease activity in lichen planopilaris and frontal fibrosing alopecia. Results of a preliminary cross-sectional study. J Eur Acad Dermatol Venereol 2021; 36:e288-e290. [PMID: 34753220 DOI: 10.1111/jdv.17798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/03/2021] [Indexed: 11/29/2022]
Affiliation(s)
- I Doche
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
| | - R Romiti
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
| | - M C Rivitti-Machado
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
| | - K Gorbatenko-Roth
- Department of Psychology, University of Wisconsin-Stout, Menomonie, WI, USA
| | - R L Freese
- Clinical and Translational Science Institute, Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, MN, USA
| | - M K Hordinsky
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, MN, USA
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18
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Bensignor MO, Freese RL, Sherwood NE, Berge JM, Kunin-Batson A, Veblen-Mortenson S, French SA. The Relationship between Household SNAP Participation, Parent Feeding Styles, and Child Eating Behaviors. J Hunger Environ Nutr 2021; 19:23-37. [PMID: 38174344 PMCID: PMC10760976 DOI: 10.1080/19320248.2021.1994506] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This cross-sectional analysis of the Minnesota Now Everybody Together for Amazing Healthful Kids (NET-Works) study evaluated whether SNAP participation was associated with specific parental feeding styles and child eating behaviors. Associations between parent-reported feeding styles and child eating behaviors and SNAP participation were examined using multiple linear regression analyses and responses from 534 parent/child dyads (49.1% female children, 91.7% female parents). SNAP participation was not associated with specific feeding styles or child eating behaviors when adjusting for food insecurity, timing in SNAP cycle, and other covariates in this large, ethnically and racially diverse sample of predominantly mothers and preschool-aged children. Other factors, such as food insecurity, not SNAP participation, may influence parental feeding and child eating behaviors, and screening by health care providers is recommended.
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Affiliation(s)
- Megan O Bensignor
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN
- Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN
- Healthy Weight Research Center, University of Minnesota, Minneapolis, MN
| | - Rebecca L Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN
| | - Nancy E Sherwood
- Healthy Weight Research Center, University of Minnesota, Minneapolis, MN
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Jerica M Berge
- Healthy Weight Research Center, University of Minnesota, Minneapolis, MN
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Alicia Kunin-Batson
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN
- Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN
- Healthy Weight Research Center, University of Minnesota, Minneapolis, MN
| | - Sara Veblen-Mortenson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Simone A French
- Healthy Weight Research Center, University of Minnesota, Minneapolis, MN
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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19
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Sarvas EW, Eckerle JK, Gustafson KL, Freese RL, Shlafer RJ. Oral health needs among youth with a history of foster care: A population-based study. J Am Dent Assoc 2021; 152:589-595. [PMID: 34090662 DOI: 10.1016/j.adaj.2021.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/04/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Children and youth in foster care are considered to have special health care needs, including oral health care needs. This study compares the self-identified oral health care needs and access to oral health care among youth who have and have not experienced foster care. METHODS Data were drawn from the 2019 Minnesota Student Survey, a statewide survey of public school students in the 5th, 8th, 9th, and 11th grades (N = 169,484). Youth with a history of foster care (3%) were compared with youth with no history of foster care for 7 oral health indicators. RESULTS Youth with a history of foster care reported more oral health problems and less access to oral health care than their peers with no history of foster care. Using logistic regression to control for key covariates, the odds of an oral health problem for youth with a history of foster care were 1.54 higher (95% confidence interval, 1.44 to 1.65) than for their peers. CONCLUSIONS Youth with a history of foster care report more oral health problems than their peers. Dentists should recognize the oral health concerns of these youth in the context of their special health care needs and be prepared to render appropriate care. Future studies should explore barriers to oral health care among this vulnerable population. PRACTICAL IMPLICATIONS Youth in foster care have self-identified oral health care needs that should be assessed by dental professionals.
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20
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Lund TC, Doherty TM, Eisengart JB, Freese RL, Rudser KD, Fung EB, Miller BS, White KK, Orchard PJ, Whitley CB, Polgreen LE. Biomarkers for prediction of skeletal disease progression in mucopolysaccharidosis type I. JIMD Rep 2021; 58:89-99. [PMID: 33728251 PMCID: PMC7932872 DOI: 10.1002/jmd2.12190] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Orthopedic disease progresses in mucopolysaccharidosis type I (MPS I), even with approved therapies and remains a major factor in persistent suffering and disability. Novel therapies and accurate predictors of response are needed. The primary objective of this study was to identify surrogate biomarkers of future change in orthopedic disease. METHODS As part of a 9-year observational study of MPS I, range-of-motion (ROM), height, pelvic radiographs were measured annually. Biomarkers in year 1 were compared to healthy controls. Linear regression tested for associations of change in biomarkers over the first year with change in long-term outcomes. RESULTS MPS I participants (N = 19) were age 5 to 16 years and on average 6.9 ± 2.9 years post treatment initiation. Healthy controls (N = 51) were age 9 to 17 years. Plasma IL-1β, TNF-α, osteocalcin, pyridinolines, and deoxypyridinolines were higher in MPS than controls. Within MPS, progression of hip dysplasia was present in 46% to 77%. A 1 pg/mL increase in IL-6 was associated with -22°/year change in ROM (-28 to -15; P < .001), a 20 nmol/mmol creatinine/year increase in urine PYD was associated with a -0.024 Z-score/year change in height Z-score (-0.043 to -0.005; P = .016), and a 20 nmol/mmol creatinine/year increase in urine PYD was associated with a -2.0%/year change in hip dysplasia measured by Reimers migration index (-3.8 to -0.1; P = .037). CONCLUSIONS Inflammatory cytokines are high in MPS I. IL-6 and PYD were associated with progression in joint contracture, short stature, and hip dysplasia over time. Once validated, these biomarkers may prove useful for predicting response to treatment of skeletal disease in MPS I.
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Affiliation(s)
- Troy C. Lund
- Department of PediatricsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Terence M. Doherty
- Department of PediatricsThe Lundquist Institute at Harbor‐UCLA Medical CenterTorranceCaliforniaUSA
| | | | - Rebecca L. Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science InstituteUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Kyle D. Rudser
- School of Public Health, Division of BiostatisticsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Ellen B. Fung
- Department of HematologyUniversity of California, San Francisco Benioff Children's HospitalOaklandCaliforniaUSA
| | - Bradley S. Miller
- Department of PediatricsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Klane K. White
- Department of Orthopaedics and Sports MedicineSeattle Children's HospitalSeattleWashingtonUSA
| | - Paul J. Orchard
- Department of PediatricsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | | | - Lynda E. Polgreen
- Department of PediatricsThe Lundquist Institute at Harbor‐UCLA Medical CenterTorranceCaliforniaUSA
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21
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Fulkerson JA, Horning ML, Barr-Anderson DJ, Linde JA, Sidebottom AC, Lindberg R, Friend S, Flattum C, Freese RL. Universal childhood obesity prevention in a rural community: Study design, methods and baseline participant characteristics of the NU-HOME randomized controlled trial. Contemp Clin Trials 2021; 100:106160. [PMID: 33002598 PMCID: PMC8011038 DOI: 10.1016/j.cct.2020.106160] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 01/19/2023]
Abstract
Childhood obesity is a major health concern in the United States (US) and those living in rural communities are at higher risk than their urban counterparts. Few prevention trials have engaged whole families of school-age children in community settings, and none to date have promoted family meals, family activity and healthful home environments in rural settings through a rigorous, randomized controlled trial (RCT). The New Ulm at HOME (NU-HOME) study recruited 114 parent/child dyads in a two-arm (intervention versus wait-list control) RCT to test the efficacy of a family meals-focused program aimed to prevent excess weight gain among 7-10 year-old children in rural Minnesota. The NU-HOME program was adapted from a previously tested program for urban families through a unique community collaboration. The program included 7 monthly in-person sessions for all family members. Parents also participated in 4 motivational goal-setting phone calls. The primary outcome measures were age- and sex-adjusted child body mass index (BMI) z-score, percent body fat, and incidence of overweight and obesity post-intervention. Secondary outcomes included quality of food and beverage availability in the home; family meals and snacks; children's dietary intake quality (e.g., Healthy Eating Index (HEI)-2015, fruits and vegetables, sugar-sweetened beverages, snacks); and children's screen time and weekly minutes of moderate-to-vigorous physical activity, total physical activity, and sedentary behavior. The NU-HOME RCT was a collaborative effort of academic and health system researchers, interventionists and community leaders that aimed to prevent childhood obesity in rural communities through engagement of the whole family in an interactive intervention.
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Affiliation(s)
- Jayne A Fulkerson
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
| | - Melissa L Horning
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
| | - Daheia J Barr-Anderson
- School of Kinesiology, University of Minnesota, 1900 University Ave SE, Cooke Hall 209, Minneapolis, MN 55455, USA.
| | - Jennifer A Linde
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2(nd) St., Suite 300, Minneapolis, MN 55454, USA.
| | - Abbey C Sidebottom
- Care Delivery Research, Allina Health, 710 East 24(th) Street, MR 43402, Minneapolis, MN 55404, USA.
| | - Rebecca Lindberg
- Minneapolis Heart Institute Foundation, 920 East 28(th) Street, Suite 100, Minneapolis, MN 55407, USA
| | - Sarah Friend
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
| | - Colleen Flattum
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2(nd) St., Suite 300, Minneapolis, MN 55454, USA.
| | - Rebecca L Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, 717 Delaware Street, SE, Minneapolis, MN 55414, USA.
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22
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Peltier SJ, Mazepa MA, Freese RL, Nelson SF, Kearney SL, Reding MT. Opioid exposure in haemophilia patients is common and underreported. Haemophilia 2020; 26:251-256. [DOI: 10.1111/hae.13950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/23/2019] [Accepted: 02/10/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Skye J. Peltier
- Center for Bleeding and Clotting Disorders University of Minnesota Medical Center Minneapolis Minnesota United States
| | - Marshall A. Mazepa
- Center for Bleeding and Clotting Disorders University of Minnesota Medical Center Minneapolis Minnesota United States
| | - Rebecca L. Freese
- Biostatistical Design and Analysis Center University of Minnesota Minneapolis Minnesota United States
| | - Shannon F. Nelson
- Center for Bleeding and Clotting Disorders University of Minnesota Medical Center Minneapolis Minnesota United States
| | - Susan L. Kearney
- Center for Bleeding and Clotting Disorders Children's Hospitals and Clinics of Minnesota Minneapolis Minnesota United States
| | - Mark T. Reding
- Center for Bleeding and Clotting Disorders University of Minnesota Medical Center Minneapolis Minnesota United States
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