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Longitudinal idiographic assessment of adolescent-dog relationships and adaptive coping for youth with social anxiety: The Teen & Dog Study protocol
No full textThe Teen & Dog Study is a longitudinal research project aimed at understanding the impact of youth-dog relationships on youth coping with social anxiety. The study will follow 514 United States adolescents (ages 13-17) with high social anxiety who live with dogs and their families, collecting longitudinal assessments of their physiological, emotional, and social well-being. With a focus on identifying the mechanisms by which youth-dog interactions may support adaptive coping, the study has three primary aims: (1) assess how the youth-dog relationship contributes to coping with social anxiety over time, factoring in individual, family, and peer influences; (2) investigate family-level processes that enhance youth-dog relationships and identify barriers to optimization; and (3) examine how dog interactions influence adolescents\u27 physiological responses, particularly in relation to anxiety. The study integrates quantitative and qualitative data, including surveys, interviews, ecological momentary activity, and continuous physiological monitoring, to assess strategies for optimizing youth-dog interactions in the context of social anxiety. This paper outlines the study protocol and presents characteristics of the study sample at baseline. Ultimately, the Teen & Dog Study seeks to inform interventions that harness the benefits of youth-dog relationships to improve mental health outcomes
Emergency Care Team Comfort and Experience with Harm Reduction for Opioid Use Disorder
No full textIntroduction: Harm reduction strategies are effective in mitigating risks associated with substance use. However, their implementation in emergency department (ED) settings has been limited. This study explored ED care team members’ experiences and comfort with harm reduction provision.
Methods: We conducted a cross-sectional study to assess ED care team members’ experiences and comfort levels (0–10 scale) with providing harm reduction resources to patients. An electronic survey was distributed to 446 care team members at a Level 1 tertiary care ED. Domains included prior harm reduction practice, comfort levels, perceived barriers to harm reduction provision, and perceived importance of various factors in harm reduction provision.
Results: Of 92 care team members (21.1% response rate), 52 (58%) reported having provided naloxone (mean comfort 8.06). Fifty (56%) had provided wound care supplies (mean comfort 8.32), whereas only 11 (13%) reported providing safer use supplies. Comfort varied for individual supplies, with the lowest for glass pipes (mean 4.9) and the highest for alcohol swabs (mean 8.33). Barriers to providing harm reduction resources and role-based differences were identified, highlighting the need for patients and clinician education.
Discussion: Despite relatively high comfort levels, ED care teams face barriers to harm reduction provision, including insufficient knowledge, limited access to resources, and time constraints, particularly among nurses. These barriers hinder the widespread adoption of harm reduction practices in the ED.
Conclusion: Although ED care team members were generally comfortable with harm reduction strategies, practices were inconsistently translated into patient care. Addressing knowledge gaps, resource access, and time limitations is crucial to improving harm reduction resource provision in EDs
ASO Visual Abstract: Clinicopathologic and Molecular Characteristics of High-Grade Appendiceal Mucinous Neoplasms
No full textNoninvasive Oxygenation Strategies in Critical Care: Applications and Challenges
No full textNoninvasive oxygen delivery methods, including high-flow nasal cannula therapy and noninvasive positive pressure ventilation, are essential tools in managing acute respiratory failure. These strategies offer effective oxygenation and ventilatory support while avoiding complications associated with invasive mechanical ventilation. This review explores the physiological principles, clinical indications, weaning, and comparative effectiveness of high-flow nasal cannula therapy and noninvasive positive pressure ventilation in patients with hypoxemic or hypercapnic respiratory failure. The article explores patient self-inflicted lung injury, which is associated with excessive respiratory muscle effort during noninvasive respiratory support. Early recognition, appropriate modality selection, and continuous monitoring are needed to prevent patient self-inflicted lung injury and improve patient outcomes. The use of predictive tools such as the respiratory oxygen index for evaluating high-flow nasal cannula therapy success is discussed. Through case-based analysis and evidence-based insights, the article highlights the importance of interdisciplinary collaboration and individualized care in optimizing noninvasive oxygen therapy
Fshr gene depletion prevents recognition memory loss, fat accrual and bone loss in Alzheimer\u27s mice
No full textEpidemiologic evidence links follicle-stimulating hormone (FSH), a pituitary glycoprotein that rises during menopause, to memory loss, fat accumulation, and bone loss. We and others have shown that the attenuation of FSH signaling, either genetically or pharmacologically, prevents memory loss, fat accrual, and bone loss in multiple mouse models. Here, we investigated whether the genetic depletion of the FSH receptor (Fshr) affects recognition memory, body composition, and bone mineral density (BMD) in two AD mouse models. We generated male and female 3xTg and APP-KI mice carrying the Fshr, Fshr, and Fshr genotypes. Recognition memory was evaluated using the Novel Object Recognition (NOR) test. Body composition (fat, lean, and total mass) and site-specific bone mineral density (femur, tibia, L3-L5 spine) measurements were made using quantitative nuclear magnetic resonance (qNMR) and dual-energy X-ray absorptiometry (DXA), respectively, at two time points. Given that female Fshr genotypes are otherwise hypogonadal, they were implanted with 17β-estradiol pellets at 8-12 weeks of age to normalize serum estrogen. At the early time point, the deficit in recognition memory was rescued in female 3xTg;Fshr and APP-KI;Fshr mice, but not in male mice. Likewise, female, but not male 3xTg;Fshr mice showed reduced fat mass at both the early and later time points, but without changes in total body mass. In contrast, in the APP-KI cohort, both female and male Fshr mice showed reduced fat mass at the early, but not the late time point. DXA revealed that female, but not male APP-KI;Fshr mice showed progressive increases with time in BMDs in tibiae, femora, and vertebrae, which were either statistically significant or approached significance. This phenotype was not observed on the 3xTg background. These studies constitute the first report for time- and strain-dependent effects of global Fshr depletion in the same mouse, setting the stage for the simultaneous prevention, using a single therapeutic, of three disorders of public health magnitude-Alzheimer\u27s disease, obesity and osteoporosis
New Patient Onboarding
Get PDFCurrently there are barriers to establish a new patient with a primary care. The workflow for patients who self-refer currently requires 10 steps and is performed by 7 care team members. 4 PSR at the front desk complete paper intake forms that are then manually entered into a spreadsheet by 3 other care team members.
The step in the workflow, to obtain the release of information for patient records to be requested and submit the form, is inconsistently followed internally and externally and results in very long process time of 40+ days. This step is frequently overlooked due to the overall process time and manual nature, leading to failure of the workflow.
Phase II
Additionally, once patient records are received, either electronically or by mail, there are few dedicated/trained resources to abstract them into the EMR, which leads to events when the new patient visit is happening, and the chart is not ready for the PCP
The emerging role of metabolomics analysis in genetic and genomic testing: A points to consider statement of the American College of Medical Genetics and Genomics (ACMG)
No full text
Pediatric Hot Topic: Lessons We Learn From Measles... or What I Need to Know I Learned in Kindergarten! (Really- It was the pre-vaccine era)
No full textCME available for 1 year after presentation
CME Text Code: 97007
In order to claim CME credit, please complete an evaluation in CloudCME for each presentation.https://knowledgeconnection.mainehealth.org/pediatrics_gr/1069/thumbnail.jp
The Impact of Social Media Use on the Development of Eating Disorders
No full textPediatric providers are caring for youth who are digital natives and will spend their lives as online media consumers. Awareness of the risks and benefits, as well as ways to mitigate harm are essential to effectively care for children and adolescents, as well as educate their families. Social media is widely used by youth, with widespread effects, including the potential to influence the development of disordered eating. Higher risk youth can be vulnerable to advertising, body image comparisons, and predatory online eating disorder communities