Objective: Standing desks present a novel approach to reduce sedentary time in the classroom and address cardiovascular risk factors at an early age. In the context of designing a standing desk study, parents and children were surveyed regarding their perceptions and current use of standing desks and other flexible seating.
Methods: Survey administered from January 31st to February 26th, 2024 to a convenience cohort of 50 parent-child pairs presenting for well or acute care at a pediatrics clinic affiliated with an academic institution (Hershey, Pennsylvania, United States).
Introduction: Patients with Ehlers-Danlos syndromes (EDS) and hypermobility spectrum disorders (HSD) have significant health challenges that are well-documented, however their impact in terms of cost is not known. Our research objective was to examine the cost burden of EDS and HSD in the United States. We focused this analysis on those with commercial insurance plans.
View Article and Find Full Text PDFBackground: Disease-modifying anti-inflammatory bowel disease drugs (DMAIDs) revolutionized the management of ulcerative colitis (UC). This study assessed the relationship between the number and timing of drugs used to treat UC and the risk of colectomy and postoperative complications.
Methods: This was a retrospective review of adult patients with UC treated with disease-modifying drugs between 2005 and 2020 in the MarketScan database.
Introduction: Human papillomavirus (HPV) vaccination rates are lower than other recommended adolescent vaccines. Cancer survivor narratives are used to promote cancer prevention and control, but little is known about their impact on adolescent HPV vaccination.
Objective: This pilot study explored the feasibility and effects of a video education intervention using a cancer survivor narrative to improve parents' attitudes toward and intentions to get the HPV vaccine.
Introduction: Food insecurity is a common problem with many associated negative downstream health impacts. Despite government sponsored and private supports, many individuals struggle with making healthy, nutritious meals. Penn State's Cooking with the Community program was constructed with the objective of providing cooking equipment and instructions to increase knowledge of healthy cooking techniques and consumption of under-utilized food pantry ingredients.
View Article and Find Full Text PDFIntroduction: Pennsylvania's Student Assistance Program (SAP) began in the mid-1980s to address student barriers to academic success. SAP teams, groups of trained school and community professionals, review referrals, and connect students to services. State leadership conducts an annual SAP team survey, but capacity to evaluate data and affect change is limited.
View Article and Find Full Text PDFUnlabelled: To reduce gastroesophageal reflux, infants are commonly placed in an inclined position. We sought to observe the extent to which infants exhibit (1) oxygen desaturation and bradycardia in supine and inclined positions and (2) signs and symptoms of post-feed regurgitation in these positions.
Study Design: Healthy infants aged 1-5 months with gastroesophageal reflux disease (GERD) (N = 25) and controls (N = 10) were enrolled into one post-feed observation.
Front Glob Womens Health
February 2023
Objective: To compare the proportion of female and male fetuses classified as microcephalic (head circumference [HC] < 3rd percentile) and macrocephalic (>97th percentile) by commonly used sex-neutral growth curves.
Methods: For fetuses evaluated at a single center, we retrospectively determined the percentile of the first fetal HC measurement between 16 and 0/7 and 21-6/7 weeks using the Hadlock, Intergrowth-21st, and NICHD growth curves. The association between sex and the likelihood of being classified as microcephalic or macrocephalic was evaluated with logistic regression.
Limited data exist regarding the relationship between socioeconomic risk factors and failure to thrive (FTT). Using data from the National Health and Nutrition Examination Survey (NHANES) from years 1999 to 2014, we sought to determine whether there was a higher prevalence of underweight (<5th percentile weight-for-age [WFA], weight-for-length [WFL], or body mass index-for-age [BFA]), and, therefore, likely a higher risk of FTT, in US children <3 years with low household income or food insecurity compared with children without these factors. Among 7356 evaluated children, there were no significant differences in the prevalence of underweight by adjusted household income quintile, food security, household Women, Infants, and Children (WIC) status, or federal poverty income ratio.
View Article and Find Full Text PDFThe COVID-19 pandemic forced United States school closures in March 2020. Students moved to online learning, fostering a sedentary lifestyle. As the pandemic heightened population disparities, the impact on weight gain may also be unequally distributed.
View Article and Find Full Text PDFBackground: The Student Assistance Program (SAP) is mandated kindergarten to 12th grade in Pennsylvania schools to address barriers to student academic success. Following student referral, SAP teams use a systematic process to inform recommendations for school or community-based services. To evaluate program outcomes, a review of student SAP referral trends over a 5-year period was undertaken.
View Article and Find Full Text PDFIntroduction: The routine use of chest x-ray (CXR) to evaluate the pleural space after chest tube removal is a common practice driven primarily by surgeon preference and institutional protocol. The results of these postpull CXRs frequently lead to additional interventions that serve only to increase health care costs and resource utilization. We investigated the utility of these postpull CXRs in thoracic surgery patients and assessed their effectiveness in predicting the need for tube replacement.
View Article and Find Full Text PDFClin Genitourin Cancer
June 2022
Introduction: In colorectal, cervical, and breast cancers, oncologic follow-up can exacerbate or alleviate patient stress about disease recurrence. Such patient experiences are less well defined for urologic malignancies. We developed a cross-sectional prospective survey study to assess kidney (Kid), prostate (Pros), and bladder (Bld) cancer patient perceptions of oncologic follow-up following surgical treatment.
View Article and Find Full Text PDFBackground: The Model for End Stage Liver Disease (MELD) predicts mortality for liver disease patients. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) estimates mortality risk for surgical patients; however, NSQIP does not collect data regarding liver disease. This study's aim was to examine the accuracy of NSQIP mortality estimates for patients with elevated MELD scores.
View Article and Find Full Text PDFOur study extends a cross-sectional dataset on the Ehlers-Danlos syndromes (EDS) assembled by the National Institute on Aging (NIA), under a protocol entitled Clinical and Molecular Manifestations of Heritable Disorders of Connective Tissue. We were successful in contacting 171 of the original 252 participants with EDS. Our study cohort included 91 participants who completed at least one of the following surveys: Brief Pain Inventory (BPI), Pittsburgh Sleep Quality Index (PSQI), Multidimensional Fatigue Inventory (MFI-20), and Short Form (SF-36) Health Survey, at both baseline and follow-up.
View Article and Find Full Text PDFImportance: Adolescent major depressive disorder (MDD) prevalence has nearly doubled in the past decade. The US Preventive Services Task Force endorses universal adolescent MDD screening in primary care; however, most adolescents lack preventive health care, resulting in worsening disparities in MDD screening and treatment.
Objective: To evaluate the effectiveness of universal adolescent MDD screening in the school setting in an effort to reduce disparities and improve MDD identification and treatment initiation.
Objective: This study aimed to evaluate if early (within the first 3 hours after birth) transient neonatal hypoglycemia (TNH) is associated with poor academic performance in infants at-risk for hypoglycemia.
Study Design: This was a retrospective cohort study of at risk-infants (late preterm infants, small and large for gestational age infants, and infants of diabetic mothers [IDMs]) who were born in 1998 and 1999 at the University of Arkansas for Medical Sciences and had ≥1 recorded glucose concentration. The outcome measure was proficiency on 4th grade literacy and mathematics achievement tests.
The rise of vaccine-preventable disease outbreaks calls for a deeper understanding of the impact of policy on school-entry vaccine compliance. Provisional attendance policies vary by state but permit under-vaccinated students a limited period to attend school while receiving their immunizations. The primary objective of this study was to clarify the relationship between annual immunization coverage and state provisional policies for a single-dose of school-entry-required adolescent vaccinations: tetanus, diphtheria, pertussis (Tdap), meningococcal conjugate (MCV4), and human papillomavirus (HPV).
View Article and Find Full Text PDFPurpose: With the introduction of the Oncology Care Model and plans for the transition to Oncology Care First, alternative payment models (APMs) are an increasingly important piece of the oncology care landscape. Evidence is mixed on the Oncology Care Model's impact on utilization and costs, but as policymakers consider expansion of similar models, it is critical to understand the characteristics of hospitals that may be differentially affected.
Methods: We used 2007-2016 SEER-Medicare data to identify patients with breast and prostate cancer receiving chemotherapy, endocrine therapy (breast), or androgen deprivation therapy (prostate).
Background: This investigation sought to determine whether early season rates of pediatric influenza vaccination changed in a season when there was a concurrent COVID-19 pandemic.
Methods: This study used cohort and cross sectional data from an academic primary care division in Southcentral Pennsylvania that serves approximately 17,500 patients across 4 practice sites. Early season (prior to November 1) vaccination rates in 2018, 2019 and 2020 were recorded for children, age 6 months to 17 years.
Objective: To increase blood lead level screening rates in children at 12- and 24-month well visits through provider education and the implementation of a point-of-care (POC) lead screening program in 4 primary care practice offices located in and neighbored by counties with ≥5% prevalence of blood lead levels ≥5 μg/dL.
Study Design: Baseline data were collected July 2017 to June 2018. All providers received education on screening recommendations and local prevalence of elevated blood lead levels in July 2018.
Background: During spring 2020, COVID-19 forced widespread United States school building closures in an unprecedented disruption for K-12 students and staff. Partnering with the American School Health Association (ASHA), we sought to identify areas of concern among school staff planning for school reopening with the goal of addressing gaps in resources and education.
Methods: This 16-item web-based survey was distributed via email to 7467 ASHA members from May to June 2020.