Background And Objectives: Peer observation and feedback (POF) enables clinicians to observe one another and learn concrete strategies for improvement. In a 2019 national study, pediatric hospitalists endorsed a desire for POF. We describe a national POF faculty development program designed to formalize, standardize, and normalize POF in pediatric hospital medicine (PHM), along with lessons learned.
View Article and Find Full Text PDFThis study extends a behavioral-ecological framework for healthcare access and utilization to explore patterns of healthcare and veterinary care access within pet-owning households in the United States. Using Latent Class Analysis, a person-centered analytic approach, we identified five subgroups of pet owners in a diverse national sample ( = 750), each characterized by unique patterns of perceived access and actual usage of both human and veterinary healthcare. The first subgroup, "Good access/unfair system" (27%) and the second subgroup, "Good access/fair system" (30%) reported high probabilities of good healthcare and veterinary care access and limited financial burden but differed in their perceptions of healthcare fairness.
View Article and Find Full Text PDFObjective: The objective of this work was to evaluate if task-specific training (TST) preceded by bilateral upper limb motor priming (BUMP) reduces upper limb impairment more than TST preceded by control priming ([CP], sham electrical stimulation) in people with chronic stroke.
Methods: In this single-blind, randomized controlled trial, 76 adults with moderate to severe upper limb hemiparesis ≥6 months post-stroke were stratified by baseline impairment and randomized to receive either BUMP or CP prior to receiving the same TST protocol. Participants completed 30 h of treatment in 15 days over 6 weeks.
: Stress and repetitive exposures to potentially traumatizing events are inherent to first-responder professions. Firefighters and other crisis responders are often exposed to incidents in their work environments and are at risk of developing acute or posttraumatic symptomatology, depression, and anxiety, as well as harmful patterns of alcohol consumption. Most prior research and theory suggests that many firefighters use alcohol to cope with past and current stressors, and that increased drinking accompanies ongoing exposures to stressful occupational hazards.
View Article and Find Full Text PDFPet acquisition purportedly increased during the COVID-19 pandemic with individuals acquiring pets during periods of social isolation. Families with children experienced unique challenges during the COVID-19 pandemic, balancing childcare, remote schooling, and other needs and therefore patterns of pet acquisition and loss may differ from the broader population. The goal of this study was to understand patterns of pet ownership within families with adolescents during the pandemic to help identify areas for improved support and programmatic recommendations.
View Article and Find Full Text PDFFirefighters are trained to respond to a wide range of emergencies, and over the course of responding to emergencies, are exposed to a variety of potentially traumatic events. Repeated exposure to traumatic events may adversely impact firefighters' mental health. Combined with stigma surrounding help-seeking, lack of systematic resources and referral programs, and other barriers to care, firefighters do not routinely receive a continuum of trauma informed, assessment and treatment services from trained professionals.
View Article and Find Full Text PDFPeer victimization can negatively impact emotion regulation in youth and is associated with harmful mental health outcomes. One protective factor against the impacts of peer victimization is a strong attachment to family and positive peer relationships. Given that pets are commonly seen as family members and that youth report turning to their pet for emotional comfort, companion animals could provide an avenue of support for youth experiencing victimization.
View Article and Find Full Text PDFStroke is a leading cause of disability worldwide and upper limb hemiparesis is the most common post-stroke disability. Recent studies suggest that clinically significant motor recovery is possible in chronic stroke survivors with severe impairment of the upper limb. Three promising strategies that have been investigated are (1) high dose rehabilitation therapy (2) bilateral motor priming and (3) vagus nerve stimulation.
View Article and Find Full Text PDFIntroduction: Relationships with companion animals have been associated with higher levels of prosocial behavior and lower levels of socioemotional difficulties for children and adolescents. Companion animals may be supportive of developing prosocial behavior in youth through practice with positive social interactions and the development of empathy and reciprocity skills. The goal of this study was to use a person-centered approach to investigate if living with a pet (including pet species) is associated with profiles of adolescent peer social behaviors (i.
View Article and Find Full Text PDFAdolescence is a key developmental period for the onset of social anxiety, as it is a time of social transitions and stressors. Therefore, it is important to identify protective factors within the environment that can prevent and/or reduce the effects of social anxiety in addition to existing evidence-based treatments. The presence of a supportive pet dog may be one way of reducing the effects of acute social stressors for youth, but these effects have not been tested robustly in real-world settings.
View Article and Find Full Text PDFThe COVID-19 pandemic has resulted in significant social disruptions for youth caused by lockdowns, school closures, and a lack of in-person social interactions. Companion animals are prevalent in US households and may provide a source of emotional support and motivation for youth to engage in adaptive coping behaviors during social challenges. The goals of this study were to assess if dog owners, non-dog pet owners, and non-pet owners differed in stress levels, positive affect, and use of adaptive coping strategies such as increased time outdoors, regular walking, and healthy behaviors.
View Article and Find Full Text PDFObjectives: To describe demographics, presentation, resource use, and outcomes of patients diagnosed with omphalitis.
Methods: This was a retrospective descriptive study of infants with omphalitis at a children's hospital system between January 2006 and December 2020. Presentation, resource use, and outcomes (omphalitis complications [eg, necrotizing fasciitis], 30-day related cause revisit, and death) were described.
Learning to sequence movements is necessary for skillful interaction with the environment. Neuroplasticity, particularly long-term potentiation (LTP), within sensorimotor networks underlies the acquisition of motor skill. Short-term immobilization of the arm, even less than 12 hours, can reduce corticospinal excitability and increase the capacity for LTP-like plasticity within the contralateral primary motor cortex.
View Article and Find Full Text PDFObjective: To assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic, to explore the impact of the pandemic on marginalized communities, and to understand perceptions regarding barriers and incentives of telehealth appointments as a method to increase care access.
Sample: 205 active Community Veterinary Medicine Clinic clients at Tufts at Tech Community Veterinary Clinic in Worcester, MA.
Procedures: This cross-sectional study used a survey-based method to assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic.
Previous research has suggested that short-term immobilization of the arm may be a low-cost, non-invasive strategy to enhance the capacity for long-term potentiation (LTP)-like plasticity in primary motor cortex (M1). Short-term immobilization reduces corticospinal excitability (CSE) in the contralateral M1, and interhemispheric inhibition (IHI) from ipsi- onto contralateral M1 is increased. However, it is unclear whether reduced CSE and increased IHI are associated with changes in intracortical inhibition, which has been shown to be important for regulating neuroplasticity in M1.
View Article and Find Full Text PDFBackground: Various priming techniques to enhance neuroplasticity have been examined in stroke rehabilitation research. Most priming techniques are costly and approved only for research. Here, we describe a priming technique that is cost-effective and has potential to significantly change clinical practice.
View Article and Find Full Text PDFWomens Health Rep (New Rochelle)
May 2022
Background: There is limited documentation about pain and side effects associated with dilation and evacuation (D&E) abortion, yet, pain and side effects are important factors that can affect a client's abortion experience. In 2016, Hope Clinic for Women, an independent abortion clinic in Illinois, altered its cervical preparation protocols before D&E to reduce the total time of the abortion process and improve the client experience. This analysis addresses the gap in data on client experience of abortion in the later second trimester by evaluating pain, side effects, and acceptability by gestational age.
View Article and Find Full Text PDFObjective: Access to veterinary care is critical for pet, human, and community health. However, inequities in how easily pet owners can access veterinary care may exacerbate health disparities in vulnerable populations. This research analyzed pet owners' perceptions of access to veterinary care in order to understand how demographic characteristics and financial fragility predict perceived access to veterinary services.
View Article and Find Full Text PDFJ Healthy Eat Act Living
March 2022
Rural regions in the United States are home to approximately 15-20% of the country's population. These regions are often characterized by low access to medical care and high rates of disease and death. The literature has detailed the heterogeneous nature of rural health disparities, calling for research detailing regional factors that influence individual-level risk factors such as diet and physical activity.
View Article and Find Full Text PDFBackground: The principle of equity is fundamental to many current debates about social issues and plays an important role in community and individual health. Traditional research has focused on singular dimensions of equity (e.g.
View Article and Find Full Text PDFBackground: High-intensity occupational therapy can improve arm function after stroke, but many people lack access to such therapy. Home-based therapies could address this need, but they don't typically address abnormal muscle co-activation, an important aspect of arm impairment. An earlier study using lab-based, myoelectric computer interface game training enabled chronic stroke survivors to reduce abnormal co-activation and improve arm function.
View Article and Find Full Text PDFObjective: Companion animals are an important feature of the family system, and human-animal interaction is increasingly being recognized as an important social determinant of health. However, there is a need for more nuanced assessment of not only who owns pets, but how pet ownership is related to various health outcomes, and which sociodemographic and contextual factors moderate these associations.
Design: Secondary analysis of cross-sectional data collected from an online, probability-based panel to generate a nationally representative sample of adults in the United States ( = 1267).
Understanding reasons for COVID-19 vaccine hesitancy is necessary to ensure maximum uptake, needed for herd immunity. We conducted a cross-sectional online survey between May 29-June 20, 2020 among a national sample of U.S.
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