Philadelphia College of Osteopathic Medicine
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Exploring Screen Time Trends among Children with Autism Spectum Disorder: A Quantitative Survey Analysis
Full text linkResearch exploring the trends, motivations, and parental influences of screen use among children with autism spectrum disorder (ASD) is limited. The purpose of this study was to address these gaps by examining screen time habits among children with ASD. Specifically, it explored the duration of screen time, screen-based activities, device ownership, parental mediation strategies, functional uses of screens, and caregiver perceptions of children’s screen time. Besides entertainment, children with ASD also use screens for emotional regulation, sensory seeking, accessing restricted interests, and communication, including Augmentative and Alternative Communication (AAC) devices. The data for this study were collected using a quantitative survey of parents of children under nine years old with ASD. The results were analyzed with descriptive statistics, and findings indicated that most children with ASD exceed the American Academy of Pediatrics (AAP) recommendation of no more than two hours of non-educational screen time daily (Council on Communications and Media, 2016). Results from this study suggest that excessive screen time among children with ASD is more closely related to their unique developmental and emotional needs than to any shortcomings in parental awareness or mediation efforts. These findings underscore the need for ASD-specific screen time guidelines and interventions that provide appropriate alternatives while still supporting the unique needs of this population
The Comparison Between Conventional Photodynamic Therapy and Painless Photodynamic Therapy in the Treatment of Actinic Keratosis: A Mini Review
No full textActinic keratosis is a prevalent skin condition associated with prolonged exposure to ultraviolet radiation and serves as a precursor to squamous cell carcinoma. This condition arises from DNA mutations and abnormal cell growth triggered by ultraviolet rays. While uncertainties persist regarding the progression rate of actinic keratosis (AK) to squamous cell carcinoma, the significance of nonmelanoma skin cancers underscores the need for safe, efficient, cost-effective, and accessible treatment options. Factors such as number of lesions, skin type, and sun exposure increase the risk of progression into squamous cell carcinoma. Available therapeutics include cryosurgery, topical medications, laser ablation, field ablative treatments, and photodynamic therapy (PDT). PDT has emerged as a frontline choice for addressing widespread damage, demonstrating its effectiveness in impeding the carcinogenic progression of actinic keratosis. PDT utilizes topical photosensitizers such as 5-aminolevulinic acid or methyl aminolevulinate, followed by an incubation period and subsequent exposure to either red or blue light. Both light sources exhibit similar efficacy in treating actinic keratosis and are likely to possess distinct advantages and disadvantages. Conventional PDT presents the challenge of causing significant pain and inflammation. In contrast, \u27painless\u27 PDT minimizes incubation time and extends light exposure, showing similar efficacy and improved patient comfort. Insights into pain management during photodynamic therapy reveal a correlation to protoporphyrin IX tissue accumulation. Limiting the incubation time has demonstrated a decrease in protoporphyrin IX accumulation, thus reducing pain. Further research through larger trials is imperative to establish standardized protocols and validate the potential of \u27painless\u27 PDT in reducing patient discomfort during AK treatment while preserving effectiveness.Citation: Yousefian F, Ismaili A, Sachdeva S, et al. The comparison between conventional photodynamic therapy and ‘painless’ photodynamic therapy in the treatment of actinic keratosis: a mini review. J Drugs Dermatol. 2025;24(5):502-506. doi:10.36849/JDD.8638
The impact of smoking on ocular health and its link to lung cancer
Full text linkIntroduction
Smoking is a well-established risk factor for both ocular diseases and lung cancer, yet its impact on eye health remains underrecognized. Tobacco exposure contributes to oxidative stress, inflammation, and vascular damage, accelerating the progression of cataracts, age-related macular degeneration (AMD), diabetic retinopathy, and glaucoma. Emerging evidence suggests that ocular manifestations in chronic smokers may serve as early indicators of systemic diseases, including lung cancer. This study explores the interconnection between smoking-related ocular pathology and lung cancer, highlighting the potential role of ophthalmic evaluation in early disease detection.
Methods
A systematic literature review was conducted using PubMed, MEDLINE, and Google Scholar. Keywords included smoking and ocular health, lung cancer and vision loss, cataracts and smoking, and age-related macular degeneration and tobacco use. Studies published within the last 15 years, including epidemiological analyses and clinical trials, were reviewed to assess the association between smoking-related ocular diseases and lung cancer incidence.
Results
Data analysis revealed a strong correlation between smoking and increased risk of ocular diseases. Smokers exhibited a two- to threefold higher likelihood of developing AMD and cataracts. Additionally, smoking exacerbated diabetic retinopathy and increased intraocular pressure, accelerating glaucoma progression. Notably, individuals diagnosed with smoking-related ocular conditions demonstrated a higher incidence of lung cancer, suggesting a shared pathogenic pathway. These findings emphasize the need for an integrated screening approach that leverages ophthalmic assessments for early detection of systemic diseases.
Discussion
The intersection of ocular and pulmonary pathology in smokers underscores the importance of interdisciplinary collaboration in preventive healthcare. Given the accessibility of routine eye exams, ophthalmologists may play a critical role in identifying high-risk individuals for lung cancer screening. Public health initiatives should prioritize smoking cessation strategies not only to reduce lung cancer incidence but also to prevent irreversible vision loss. Future research should explore ophthalmic biomarkers as predictive tools for systemic disease progression, particularly in populations with high smoking prevalence.
Conclusion
Smoking has a profound impact on ocular and systemic health, reinforcing the need for integrated screening and early intervention. Recognizing ophthalmic manifestations as potential indicators of smoking-related diseases may enhance lung cancer screening efforts and improve patient outcomes. This study advocates for a multidisciplinary approach to disease prevention, leveraging ocular health assessments as a gateway for broader systemic health monitoring
Evaluating the Predictive Values of Attachment Security and Perfectionism on Psychological Well-being
Full text linkAttachment security impacts social competence and the development of one’s sense of self. It has also been implicated in the development of psychological conditions, including depression, personality disorders, and post-traumatic stress disorder (PTSD). Perfectionism has distinct characteristics that also influence how people relate to others and understand themselves. Research suggests that perfectionism negatively affects a person’s psychological well-being, often leading to mental health concerns such as anxiety and obsessive-compulsive disorder (OCD). Despite the introduction of the perfectionism social disconnection model (PSDM), few studies have attempted to understand the direct relationship between attachment security, perfectionism, and psychological well-being. It was hypothesized that attachment security and perfectionism would be correlated. It was also hypothesized that the linear combination of attachment security and perfectionism would predict psychological well-being. The hypotheses were partially supported; self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) were correlated with attachment security, and only the combination of SPP and attachment security predicted psychological well-being. The results of this study may provide further insight into how the perceived societal expectation of perfection and one’s sense of social connection may impact one’s mental health
Validation of a 5-item tool to measure parent assessment of clinician compassion during pediatric visits.
Full text linkOur objective was to validate a 5-item compassion measurement tool as a reliable measure of patient assessments of clinician compassion in the pediatric outpatient setting. We completed a cross-sectional study in a U.S. academic healthcare system consisting of six pediatric clinics between February and September 2023. We adapted the original 5-item tool to elicit responses regarding the pediatric patient. The measure was disseminated with the Clinician and Group Consumer Assessment of Healthcare Providers and System (CG-CAHPS) survey. We included patients aged \u3c 18 years old who had an outpatient clinic visit and had a parent complete the CG-CAHPS survey. Validity testing of the 5-item tool was performed using confirmatory factor analysis. Internal reliability was tested using Cronbach\u27s α, and convergent validity with overall provider rating questions from the CG-CAHPS survey was evaluated using Spearman correlation. We analyzed 640 responses. The median (interquartile range) patient age was 8 (3-13) years, and 47% of patients were female. Sixty-one percent of patients were White/Caucasian and 25% were Black/African American. Confirmatory factor analyses found a good fit. The compassion measure demonstrated good internal consistency (α = 0.97) and convergent validity with overall provider rating (rs = 0.63 (95% confidence interval 0.56-0.70)) but reflected a patient experience domain distinctly different from what is currently captured in CG-CAHPS surveys. Our results suggest that the 5-item compassion measure is a valid tool that can reliably and distinctly measure patient assessments of clinician compassion in the pediatric outpatient setting
Impact of PCOS Knowledge and Treatment Recommendations on Women’s Quality of Life
Full text linkPolycystic ovary syndrome (PCOS) is a chronic endocrine disorder affecting 15–20% of women of reproductive age (Krug et al., 2019). Characterized by hyperandrogenism, irregular menstrual cycles, and ovarian cysts, PCOS is associated with obesity, insulin resistance, and infertility (Correa et al., 2015). These complications can significantly diminish women’s quality of life. This study investigated the relationship between women’s knowledge of PCOS health outcomes, providers’ use of lifestyle management interventions, and quality of life. A cross-sectional survey design was used, and participants completed the PCOS Quality of Life Scale (Williams et al., 2018). It was hypothesized that greater knowledge of PCOS outcomes would be associated with higher quality of life, and that women whose providers emphasized lifestyle management would report better quality of life compared to those who did not receive such guidance. In addition, age was hypothesized to correlate positively with the subscales of Hirsutism and Mood, and negatively with Impact of PCOS and Infertility. Results revealed no association between knowledge and quality of life, and no differences in quality of life between women who received lifestyle management and those who did not. However, age was significantly related to mood, infertility, and the impact of PCOS. These findings suggest that concerns shift across the lifespan, highlighting the need for age-sensitive approaches to clinical care. The results provide practical implications for healthcare professionals and psychologists seeking to improve psychoeducation, collaborative intervention, and ultimately the well-being of women living with PCOS
Pheochromocytoma
No full textPheochromocytoma is a rare tumor that has debilitating effects. These tumors originate from chromaffin cells and are located in the adrenal medulla. Tumors located outside of the adrenal medulla are known as paragangliomas. Patients usually suffer from episodes of hypertension, headaches, sweating, etc. This is due to excess circulating catecholamines. An adrenalectomy is the mainstay of treatment. However, appropriate management of hemodynamics in the perioperative period is key to a successful outcome
Impact of a clinician-directed educational program on communicating with patients regarding gun violence at two community urban healthcare centers.
Full text linkCONTEXT: Gun violence negatively impacts not only victims but also their families and surrounding communities. Resources and counseling services may be available to support families affected by gun violence, but the families and their clinicians may not know about these resources or how to access them.
OBJECTIVES: The objective of this study was to investigate the impact of a clinician-directed educational program on patient reports of their discussions with their physician regarding gun violence, prevention, and available resources for support and treatment.
METHODS: This quasi-experimental, cross-sectional, survey-based, quality-improvement study included pre-, mid-, and posttraining surveys administered to patients and clinicians participating in an educational program at two urban healthcare centers in Philadelphia. The educational program included office enhancements (handouts and posters) and lunchtime presentations for clinicians regarding gun violence prevalence, prevention strategies, local support resources, and impacts on mental health for patients and their families. The anonymous patient survey was offered to all patients seen at two urban healthcare centers in Philadelphia during three nonconsecutive weeks over 3 months.
RESULTS: Among 542 patients seen over the 3 weeks of survey collection, 428 completed the survey (response rate of 79 %). Sixty-four percent acknowledged being impacted by gun violence including the death of a loved one, witnessing a shooting, or being shot themselves. Over the course of the educational program, patients reported significant increases in (1) awareness of materials related to gun violence in the waiting areas, by 17.2 %, (2) discussions of gun violence with their clinician, by 12.1 %, and (3) discussions of methods to prevent gun injury, by 9.7 %. At the end of the study, 19.3 % of patients reported having discussions with their clinician about gun violence, and 14.3 % discussed strategies to prevent gun injury. Participating clinicians reported high levels of satisfaction and increased confidence when talking to patients about gun violence at the end of the program.
CONCLUSIONS: Providing clinician-directed education and printed materials increased the frequency with which clinicians discussed gun violence, prevention, and available resources with their patients. Increases were modest, with opportunities for improvement. A holistic and multifaceted approach is required to support families affected by gun violence, including education for clinicians and dissemination of information for families
Time to Measure: A Proposed Theoretical Model for Head and Neck Cancer Intervals of Care
No full textHead and neck cancer care delays are challenging, given the complexity of cancer care pathways, which leads to delays throughout the patient journey, from the symptom onset to treatment completion. Current models and literature addressing cancer care are limited by heterogeneous definitions of care intervals, a focus on specific aspects of the patient journey instead of the whole care continuum, and limited use of implementation science to target gaps in implementing evidence-based interventions. Here, we propose the Head and Neck Cancer TImely aCess TO Care Model as an approach to conceptualize, measure, and address delays in diverse health systems
Compounded incretins in clinical practice: An opinion of the endocrine and metabolism practice and research network of the American College of Clinical Pharmacy.
No full textAIMS: This article aims to summarize the role of compounded incretin mimetics in clinical practice and in the context of drug shortages.
METHODS: The Endocrine and Metabolism Practice and Research Network, a focused group of the American College of Clinical Pharmacy members, convened an independent committee to evaluate the role of compounded incretin mimetics.
RESULTS: There is limited data demonstrating positive clinical outcomes in small cohorts of patients receiving compounded semaglutide and tirzepatide. However, there remain significant legal and safety concerns since compounded incretins do not undergo approval by the Food and Drug Administration.
CONCLUSION: Whenever possible, healthcare providers should make every effort to assist patients with obtaining approved medications. If patients choose to obtain compounded incretins, providers can encourage safety by ensuring use of reputable compounding pharmacies and routinely monitoring patients for safety and efficacy of the compounded product