Publications by authors named "Loftus C"
Background And Aims: Abdominal bloating is a difficult symptom to treat. Hypnotherapy and diaphragmatic intervention have separately shown benefit on bloating in prior work but have not been united into a single intervention. We aimed to obtain data on the potential therapeutic impact of a novel audio-recorded bloating treatment for bloating integrating hypnosis and diaphragmatic breathing, with proposed synergistic effect.
View Article and Find Full Text PDFBackground: Patient-provider communication through the patient portal has markedly increased in recent years. Some health care facilities implemented programs to enable providers to bill for responding to patient-initiated messages that require substantive medical decision making through an e-visit.
Objective: To evaluate the effect of billing eligible patient-initiated portal messages as e-visits using a mixed-methods approach.
Purpose: The Environmental influences on Child Health Outcomes (ECHO) Cohort has enrolled over 60,000 children to examine how early environmental factors (broadly defined) are associated with key child health outcomes. The ECHO Cohort may be well-positioned to contribute to our understanding of rural environments and contexts, which has implications for rural health disparities research. The present study examined the outcome of child obesity to not only illustrate the suitability of ECHO Cohort data for these purposes but also determine how various definitions of rural and urban populations impact the presentation of findings and their interpretation.
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- Prenatal exposure to ozone (O) might influence child lung function, particularly through oxidative stress, and diet may play a role in modifying these effects.
- In a study of 661 women in the CANDLE cohort, no significant associations were found between prenatal O exposure and lung function; however, there were hints of adverse effects during specific fetal development periods.
- Interactions between maternal diet (OBS) and race did not consistently modify the effects of O, although some associations were noted among specific racial groups under certain dietary conditions.
Background: PAH exposure is associated with adverse health outcomes, but exposure sources in pregnancy are not well-understood.
Objectives: We examined associations between urinary OH-PAHs during pregnancy and environmental tobacco smoke (ETS) and short-term ambient air pollution exposure. Participants included 1603 pregnant non-smokers in three cohorts from 7 sites across the USA.
Article Synopsis
- Background research highlights that prenatal exposure to ambient fine particulate matter (PM) may negatively affect child lung health, yet studies specifically investigating the timing of exposure during critical lung development phases are limited.
- The study involved 675 children, tracking prenatal PM exposure and assessing lung function at ages 8-9 through spirometry while controlling for various factors like maternal and child characteristics.
- Results showed weak associations between PM exposure during specific fetal development phases and lung function measures (FEV1 and FVC), with no significant effect from factors like child sex or allergic sensitization.
Given the longevity of the COVID-19 pandemic, it is important to address the perceptions and experiences associated with the progression of the pandemic. This narrative can inform future strategies aimed at mitigating moral distress, injury, and chronic stress that restores resilience and well-being of HCWs. In this context, a longitudinal survey design was undertaken to explore how health care workers are experiencing the COVID-19 pandemic over time.
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- There is a lack of thorough longitudinal studies on how the COVID-19 pandemic has impacted children's mental health over time, particularly regarding variations among different subgroups.
- The study aims to assess changes in youth mental health from before the pandemic to the middle of it, using data from the Environmental influences on Child Health Outcomes (ECHO) Program.
- Results showed that of 1,229 participants, there were minor decreases in levels of externalizing behaviors, indicating subtle shifts in mental health throughout the pandemic while accounting for various sociodemographic factors.
Objective: Prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) is associated with adverse birth and developmental outcomes in children. We aimed to describe prenatal PAH exposures in a large, multisite U.S.
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- Executive functions, crucial for problem-solving and planning, develop rapidly in childhood, but prenatal exposure to environmental toxicants like polycyclic aromatic hydrocarbons (PAHs) may hinder this development.
- The study analyzed 814 children from non-smoking mothers, measuring urine levels of PAH metabolites during pregnancy and evaluating their executive functions at age 8-9, focusing on cognitive flexibility, working memory, and inhibitory control.
- Results showed mostly null associations between PAH exposure and executive functions, although some interactions between specific PAH metabolites and working memory were observed, highlighting the need for further research in this area.
Article Synopsis
- The study investigates the impact of early childhood air pollution on executive function in school-aged children, using data from 1235 participants across three US pregnancy cohorts.
- It examines the effects of pollutants like PM 2.5, nitrogen dioxide (NO2), and ozone (O3) during the ages of 0-4, assessing various cognitive abilities such as working memory and cognitive flexibility.
- Results suggest that air pollution exposure, particularly NO2, negatively affects executive function, with stronger effects observed in areas with higher educational opportunities; further research is needed to deepen understanding of these environmental influences on child development.
Background: Internal hemorrhoids (IH) is a common medical condition that can result in morbidity secondary to bleeding and discomfort. Treatment for IH has traditionally consisted of dietary and conservative medical management, focal treatments including banding and sclerotherapy or hemorrhoidectomy. Recently, rectal artery embolization (RAE) has been studied as a potential treatment for bleeding predominant IH.
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- *The study analyzed data from 1012 mother-child pairs in Shelby County, Tennessee, using techniques like weighted quantile sum regression to assess how neighborhood factors impacted greenspace, measured by NDVI, tree canopy, and park proximity.
- *Findings reveal that aspects like homeownership, nearby educational resources, and racial composition significantly contribute to greenspace quality, while adding individual-level data did not enhance prediction accuracy, emphasizing the need for targeted policies to promote equitable greenspace access.
We examined associations between prenatal fine particulate matter (PM), nitrogen dioxide (NO), and ozone (O) exposures and child respiratory outcomes through age 8-9 years in 1279 ECHO-PATHWAYS Consortium mother-child dyads. We averaged spatiotemporally modeled air pollutant exposures during four fetal lung development phases: pseudoglandular (5-16 weeks), canalicular (16-24 weeks), saccular (24-36 weeks), and alveolar (36+ weeks). We estimated adjusted relative risks (RR) for current asthma at age 8-9 and asthma with recent exacerbation or atopic disease, and odds ratios (OR) for wheezing trajectories using modified Poisson and multinomial logistic regression, respectively.
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- This study examined the effects of prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) on asthma and wheezing in children aged 8-9, using data from a diverse sample of 1,081 parent-child pairs across five U.S. cities.! -
- Researchers measured levels of PAH metabolites in mothers during mid-pregnancy and assessed asthma and wheezing symptoms in children, adjusting for various factors like smoke exposure and demographics.! -
- The findings revealed limited evidence linking prenatal PAH exposure to asthma or wheezing trajectories, with some associations noted for specific compounds in boys and girls, but no strong overall connections were established.
Article Synopsis
- The study aimed to identify the relationship between cleaning anesthesia machines and the prevalence of bacterial pathogens, suggesting that keeping CFU (colony-forming units) below 100 can reduce infections.
- Samples collected from various sources in nine hospitals showed that only 3% of samples with <100 CFU returned positive for pathogens compared to 23% of those with ≥100 CFU.
- The results support the hypothesis that better cleaning of anesthesia machines might lower the risk of surgical site infections by reducing pathogen presence significantly.
Objective: To evaluate urinary outcomes following cystoscopic external urinary sphincter onabotulinumtoxinA (BTX) injections in patients with cerebral palsy (CP). Adults with CP can suffer from bladder outlet obstruction and urinary retention due to a spastic external urethral sphincter ("pseudodysynergia"). We have used BTX injections into the sphincter to relieve the obstruction and allow patients to maintain spontaneous voiding rather than intermittent catheterization.
View Article and Find Full Text PDFPlacental corticotropin-releasing hormone (pCRH) is a neuroactive peptide produced in high concentrations in mid-late pregnancy, during key periods of fetal brain development. Some evidence suggests that higher pCRH exposure during gestation is associated with adverse neurodevelopment, particularly in female offspring. In 858 mother-child dyads from the sociodemographically diverse CANDLE cohort (Memphis, TN), we examined: (1) the slope of pCRH rise in mid-late pregnancy and (2) estimated pCRH at delivery as a measure of cumulative prenatal exposure.
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- A study aimed to identify clusters of chronic obesity-related, neurodevelopmental, and respiratory issues in children, examining how these clusters relate to chemical exposure.
- Researchers analyzed data from 1092 children collected between 2011 and 2022 across three pregnancy cohorts and identified three distinct health outcome clusters based on k-means clustering.
- A significant association was found between exposure to certain phthalates and membership in a cluster with high rates of asthma and other respiratory problems, suggesting shared underlying causes for these health outcomes.
Background: Green space exposures may promote child mental health and well-being across multiple domains and stages of development. The aim of this study was to investigate associations between residential green space exposures and child mental and behavioral health at age 4-6 years.
Methods: Children's internalizing and externalizing behaviors in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort in Shelby County, Tennessee, were parent-reported on the Child Behavior Checklist (CBCL).
Article Synopsis
- Prenatal exposure to chemicals like phthalates and psychosocial stressors may affect the developing brain, but their combined effects are not well studied.
- Researchers analyzed data from three pregnancy cohorts, measuring phthalates in urine and mothers' reported stressful life events during pregnancy, to see how these factors impacted children's problem behaviors at ages 4-6.
- The study found some weak links between phthalate exposure and behavior issues, with unexpected results showing that higher stress levels during pregnancy might lessen the impact of certain phthalates on child behaviors, especially in boys, indicating a need for further investigation.