- Chicago, United States
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Research Interests: Pain, Quality Improvement, Treatment Outcome, Medicine, Pain Management, and 15 moreProspective studies, Humans, Female, Male, Clinical Sciences, Longitudinal Studies, Adult, Analysis of Variance, Illinois, Analgesic, Pain Measurement, Emergency Department, Analgesics, Acute Disease, and Interviews as topic
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Transcriptomics, regional cerebral blood flow (rCBF), and a virtual reality-based spatial motor task were integrated using mediation analysis in a novel demonstration of “imaging omics.” Data collected in National Collegiate Athletic... more
Transcriptomics, regional cerebral blood flow (rCBF), and a virtual reality-based spatial motor task were integrated using mediation analysis in a novel demonstration of “imaging omics.” Data collected in National Collegiate Athletic Association (NCAA) Division I football athletes cleared for play before in-season training showed significant relationships in 1) elevated levels of miR-30d and miR-92a to elevated putamen rCBF, 2) elevated putamen rCBF to compromised Balance scores, and 3) compromised Balance scores to elevated microRNA (miRNA) levels. rCBF acted as a consistent mediator variable (Sobel’s test P < 0.05) between abnormal miRNA levels and compromised Balance scores. Given the involvement of these miRNAs in inflammation and immune function and that vascular perfusion is a component of the inflammatory response, these findings support a chronic inflammatory model in these athletes with 11 years of average football exposure. rCBF, a systems biology measure, was necessary...
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Summary Research suggests contact sports affect neurological health. This study used permutation-based mediation statistics to integrate measures of metabolomics, neuroinflammatory miRNAs, and virtual reality (VR)-based motor control to... more
Summary Research suggests contact sports affect neurological health. This study used permutation-based mediation statistics to integrate measures of metabolomics, neuroinflammatory miRNAs, and virtual reality (VR)-based motor control to investigate multi-scale relationships across a season of collegiate American football. Fourteen significant mediations (six pre-season, eight across-season) were observed where metabolites always mediated the statistical relationship between miRNAs and VR-based motor control (pSobelperm≤ 0.05; total effect > 50%), suggesting a hypothesis that metabolites sit in the statistical pathway between transcriptome and behavior. Three results further supported a model of chronic neuroinflammation, consistent with mitochondrial dysfunction: (1) Mediating metabolites were consistently medium-to-long chain fatty acids, (2) tricarboxylic acid cycle metabolites decreased across-season, and (3) accumulated head acceleration events statistically moderated pre-season metabolite levels to directionally model post-season metabolite levels. These preliminary findings implicate potential mitochondrial dysfunction and highlight probable peripheral blood biomarkers underlying repetitive head impacts in otherwise healthy collegiate football athletes.
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Research Interests: Neuropsychology, Traumatic Brain Injury, Medicine, Humans, Female, and 15 moreMale, Differential Diagnosis, Brain injury, Concussion, Head injury, Adult, Poison Control, Unconsciousness, Logistic Models, Brain injuries, Trauma Severity Indices, Neuropsychological Tests, Acute Disease, Psychology and Cognitive Sciences, and Medical and Health Sciences
<sec> <title>BACKGROUND</title> <p>Beginning in March 2020, state-of-emergency policy changes at the state and federal level greatly expanded accessibility to telehealth, allowing patients to receive ongoing care... more
<sec> <title>BACKGROUND</title> <p>Beginning in March 2020, state-of-emergency policy changes at the state and federal level greatly expanded accessibility to telehealth, allowing patients to receive ongoing care while limiting in-person interactions to mitigate transmission of COVID-19.</p> </sec> <sec> <title>OBJECTIVE</title> <p>The purpose of this study was to broadly understand patients' satisfaction with and attitudes towards receiving telemental health care 10 months into the COVID-19 pandemic.</p> </sec> <sec> <title>METHODS</title> <p>A questionnaire was designed and administered to elicit comprehensive feedback about telehealth care, and to gauge participants' desire to use it in the future. Survey questions were rated on 5-point Likert scale. Participants were asked about their desire to continue telemental health care post-pandemic.</p> </sec> <sec> <title>RESULTS</title> <p>Most of the 602 participants reported favorable experiences with telemental health care. 505 (84.4%) were satisfied or extremely satisfied, and 527 (88.6%) rated the use of telehealth extremely easy or easy, 531(89.1 %) rated overall comfort with telehealth as very comfortable or comfortable. A majority felt at ease using a private 491(82.5%) and quiet space 509(86.0%) to communicate using telehealth. Perceived benefits of telemental health care were varied and included improved ability to manage work and family obligations. Quality of care was comparable to in-person visits. A majority 523(86.88%) of participants would like to have telemental health offered as an option in the future, even after the pandemic resolves.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>Nearly a year into the COVID-19 pandemic, patients rated telemental health care highly across measures of satisfaction, comfort, ease of use, and quality of care. Participants reported tangible benefits of telemental health care such as time and money savings, and also intangible benefits, like increased flexibility and decreased stress. Participants expressed their desire that telemental health care be a readily available option in the post-pandemic future. Maintaining accessibility to telehealth care for psychiatric patients in the future should be a priority.</p> </sec> <sec> <title>CLINICALTRIAL</title> <p>ClinicalTrials.gov NCT04693052; https://clinicaltrials.gov/ct2/show/NCT04693052</p> </sec>
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Abstract Background: Little is known about which therapeutic treatment models are being used most commonly at community-based mental health settings to treat young children exposed to violence. Objective: We aimed to (1) explore the use... more
Abstract Background: Little is known about which therapeutic treatment models are being used most commonly at community-based mental health settings to treat young children exposed to violence. Objective: We aimed to (1) explore the use of commonly applied treatment models for young children exposed to violence across community-based clinical sites and (2) examine the associations of the use of these models with child demographics and type(s) of violence to which the child was exposed. The models examined included Cognitive Behavioral Therapy (CBT), Attention, Regulation, and Competency (ARC), Child-Parent Psychotherapy (CPP), and Child-Centered Play Therapy (CCPT). Participants and setting: Participants were 500 children aged 0-6 years, who were exposed to violence and received treatment at 1 of the 12 community-based sites. The mean age was 48.1 months (SD = 13.9 months). Methods: Descriptive analyses were conducted on child demographics, type of violence, and treatment model(s) employed. Binary logistic regressions were conducted to examine the associations of treatment model(s) used with child demographics and type of violence. Results: 76.2% of the sample received CCPT or an integrative approach, rather than evidence-based treatments (e.g., CBT, CPP). Black children were more likely to receive CCPT (OR = 6.490; 95% CI = 1.262, 33.375). Hispanic children were less likely to receive ARC (OR = 0.234; 95% CI = 0.074, 0.738). Associations between type of violence exposure and treatment model utilization were also found. Conclusions: Our results underscore a need to disseminate EBTs, as well as to assure that treatment needs of individual children are met.
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ABSTRACT This study explored whether youth protective factors become more or less developed overtime for 4811 youth involved in child welfare using the Child and Adolescent Need and Strengths (CANS) Assessment. Using child welfare... more
ABSTRACT This study explored whether youth protective factors become more or less developed overtime for 4811 youth involved in child welfare using the Child and Adolescent Need and Strengths (CANS) Assessment. Using child welfare administrative data, analyses investigated if the improvement of youth protective factors while in the child welfare system was associated with reducing the risk of justice system involvement. Study findings demonstrated that youth with improved community life strengths, talents/interests, educational strengths, and spiritual/religious strengths were at a significantly lower risk of becoming justice involved while in child welfare. This speaks to the protective effect that positive self-concept in the form of individual talents or creativity, community resources, educational supports, and spiritual/religious encouragement have on youth development and functioning while in the child welfare system, in addition to the potential role of the child welfare system in helping to develop these specific protective factors.
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This paper examines the response of former SSI DA&A beneficiaries to the loss of benefits across multiple areas of functioning and across time. The main purposes of the study were to determine how termination of the DA&A program affected... more
This paper examines the response of former SSI DA&A beneficiaries to the loss of benefits across multiple areas of functioning and across time. The main purposes of the study were to determine how termination of the DA&A program affected individuals generally, to understand the degree of variation in response to lost benefits, and to determine the individual and social correlates of improvement and decline given expected individual variations in adaptability. Self-report data collected at six-month intervals over two years at nine study sites from 1,640 former SSI DA&A recipients were analyzed to assess the overall degree of change across seven areas of functioning. Contrary to expectations, we found that the majority of subjects had maintained a constant level of functioning or were slightly improved. However, those who were among the heaviest alcohol and drug users at baseline and who were not able to substantially replace their lost disability income were the most likely to show ...
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This study examined the criminogenic effects of terminating the Supplemental Security Income program for drug addiction and alcoholism. Hierarchical linear modeling was used to analyze self-reported crime, economic, and drug-use data... more
This study examined the criminogenic effects of terminating the Supplemental Security Income program for drug addiction and alcoholism. Hierarchical linear modeling was used to analyze self-reported crime, economic, and drug-use data collected as part of a two-year multisite study with five interview waves from 1,640 former DA&As. The primary independent variables examined included subjects’ replacement of lost SSI benefits legally or through re qualification under another disability category and their weekly use of heroin and/or cocaine. The study found that failure to replace lost cash benefits resulted in a moderate increase in crime, particularly drug and property crime, that peaked two years after loss of benefits. Heroin and cocaine use were also related to criminality, though the magnitude of this effect was greatest at six months after loss of benefits. The study also found a relationship between drug use and loss of benefits, suggesting that the federal legislation has crea...
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Research Interests: Psychology, Perception, Research Methodology, Mental Health, Depression, and 15 moreBehavior, Social Interaction, Health, Ethnicity, Population, African American, Social Environment, Ethnic Groups, Developed Countries, Risk Factor, Ethnic Group, Parenting Style, Depressive Symptoms, Ethnic Difference, and Cultural Background
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Research Interests: Psychology, Psychological Assessment, Decision Making, Psychotherapy, Treatment Outcome, and 15 moreMedicine, Clinical Decision Making, Clinical Practice, Humans, Business and Management, Female, Cognitive Therapy, Male, Cognitive Behavioral Treatment Method, Empirical Research, Mood Disorders, Adult, Prognosis, Clinical Competence, and Treatment Response
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Research Interests: Psychology, Psychotherapy, Psychometrics, Personality Assessment, Consulting, and 14 moreMedicine, Humans, Female, Male, Regression Analysis, American Psychological Association, Adult, Regression Model, Statistical models, Treatment planning, Treatment Response, Random Coefficients, Growth Model, and Ambulatory Care
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Research Interests: Pain, Nonparametric Statistics, Sickle Cell Anemia, Adolescent, Medicine, and 15 moreHumans, Female, Male, Regression Analysis, Clinical Sciences, Aged, Middle Aged, Adult, Public health systems and services research, Retrospective Studies, Academic, Pain Measurement, Emergency Department, Analgesics, and Acute Disease
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Research Interests: Dementia, Medicine, Humans, Major Depressive Disorder, Female, and 15 moreMale, American, Caregivers, Clinical Sciences, Aged, Middle Aged, Adult, Public health systems and services research, Cost of Illness, Pilot Projects, Internet, Community Based Mental Health Services, Severity of Illness Index, Neuropsychological Tests, and Community health services
This pilot study explored the acceptability and feasibility of and estimated the effectiveness of a weight loss/breast health intervention designed to reduce breast cancer risk in African-American women ages 35-65. The study had a... more
This pilot study explored the acceptability and feasibility of and estimated the effectiveness of a weight loss/breast health intervention designed to reduce breast cancer risk in African-American women ages 35-65. The study had a one-group repeated-measures design and took place in a community setting. Forty-four African-American women were recruited, 35 completed the program, and 30 returned for the one-year follow-up. The pilot intervention was three weeks in duration and included twice-weekly exercise classes and weekly active learning seminars that addressed weight loss, breast health, healthy eating, and leading an active life. Measures included those of behavior related to diet, physical activity, and breast health. Satisfaction questionnaires and focus groups were also used to assess acceptability and cultural competency. Statistical analyses included Paired t-tests and Wilcoxon signed ranks tests. Significant results postintervention showed improved physical activity, dieta...
Research Interests: Health Promotion, Health Behavior, Focus Groups, Life Style, Medicine, and 15 moreChicago, Humans, Female, Patient Satisfaction, Risk factors, African Americans, Intervention Studies, Middle Aged, Adult, Analysis of Variance, Risk Factors, Pilot Projects, Breast Neoplasms, mass Screening, and Medical and Health Sciences
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... Database: PsycINFO. [Comment/Reply]. Misrepresentation in Wampold and Bolt's critique of Elkin, Falconnier, Martinovich, and Mahoney's study of therapist effects. Elkin, Irene; Falconnier,Lydia; Martinovich, Zoran.... more
... Database: PsycINFO. [Comment/Reply]. Misrepresentation in Wampold and Bolt's critique of Elkin, Falconnier, Martinovich, and Mahoney's study of therapist effects. Elkin, Irene; Falconnier,Lydia; Martinovich, Zoran. Psychotherapy Research, Vol 17(2), Mar 2007, 253-256. ...
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BACKGROUND Workplace bullying in health care settings, including emergency departments (EDs), is a significant and negative factor in the dynamics of patient care, nursing work culture, and nurse retention. Specifically, workplace... more
BACKGROUND Workplace bullying in health care settings, including emergency departments (EDs), is a significant and negative factor in the dynamics of patient care, nursing work culture, and nurse retention. Specifically, workplace bullying has a significant and negative effect on patient care, with both direct (errors and substandard care) and indirect sequelae (high turnover and inexperienced nursing staff hired to replace those nurses who have left to escape bullying behavior). The purpose of this study was to determine the theoretical coherence of the ENA model of nurse bullying in emergency department and its impact on emergency nurses' intent to leave their job. METHODS Correlational study using the Practice Environment Scale of the Nursing Work Index (PES-NWI), the Secondary Traumatic Stress Scale (STSS), and the Short Negative Acts Questionnaire (SNAQ) in a cross-sectional sample of emergency nurses working in the United States. RESULTS Extremely high intent to leave the current ED (PD1) rates were associated with nurses' reported exposure to daily bullying (PD1 rate = 67.6%, zero-order OR = 4.77, Nr2 = 3.2%, p < .001) and bullying multiple times per week (49.1%, zero-order OR = 2.31, Nr2 = 2.6%, p < .001). Nurses who reported no exposure to bullying at work had a distinctly below average PD1 rate (22.9%, OR = 0.47, Nr2 = 3.9%, p < .001). CONCLUSIONS The relationships between the tested elements of the model (specifically, the influence of bullying on nurse intent to leave) as constructed appear to adequately reflect the phenomenon of workplace bullying and its effects on nurse retention in emergency care settings.
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... Crosby. Rüdiger Nübling. Sandra Sassaroli. Scott Leon. Shabad-Ratan Klaksa. Shari Geller. Silja Vocks. Stulz Niklaus. Steffen Walter. Tanja Hechler. Thane Erickson. Tilman Grande. Tim Martin. Timothy Anderson. Timulak Ladislav. ...
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Abstract This study sought to distinguish youth in the child welfare system who became involved with the justice system from youth who did not become involved with the justice system based on the youth's protective factors and their... more
Abstract This study sought to distinguish youth in the child welfare system who became involved with the justice system from youth who did not become involved with the justice system based on the youth's protective factors and their caregivers' parenting skills. This was accomplished by examining the frequency of specific youth protective factors and their caregivers' parenting skills. It was also accomplished by examining the differences in the total number of youth protective factors and the total number of their caregivers' parenting skills at entry into the child welfare system based on justice system involvement. We also sought to describe the demographic characteristics of youth protective factors and caregiver parenting skills. Using chi-square and analysis of variance (ANOVA) tests, study findings indicated that while the majority of children did not become justice involved, of those kids who did become justice involved, the majority of them were minority youth. There was also a higher proportion of youth with identified child-specific protective factors at baseline without later justice involvement compared to the proportion of youth who later became involved with the justice system. In addition, youth with a higher number of protective factors and caregiver parenting skills at baseline did not have future involvement with the justice system compared to youth with a lower number of protective factors and caregiver parenting skills. Lastly, in terms of parenting practices, the most notable demographic differences were related to race/ethnicity. Findings indicated that the biological parents and caregivers of White youth had more parenting skills compared to the biological parents and caregivers of minority youth. One of the implications of these findings is that reducing dual involvement for youth in the child welfare system may be achieved through strength building and providing additional services to youth and families at the beginning of the youth's care in the child welfare system.
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241 Study Objectives: To report the patients' ability to make and keep follow-up appointments, obtain analgesic prescriptions, and continued presence of pain for adult emergency department (ED) patients with sickle cell disease, seven... more
241 Study Objectives: To report the patients' ability to make and keep follow-up appointments, obtain analgesic prescriptions, and continued presence of pain for adult emergency department (ED) patients with sickle cell disease, seven and 30 days post ED visit. Barriers to making and keeping appointments and filling analgesic prescriptions were explored. Methods: A multi-center, prospective, longitudinal surveillance study enrolled patients from three academic medical centers (rural and urban). All ED patients ≥18 years with a chief complaint of a sickle cell pain episode were eligible for inclusion. Patients participated in an initial interview within 14 days of their ED visit and/or a second interview 21–37 days from their ED visit. Patients were interviewed at most once per month. The initial interview was conducted either during the hospitalization if admitted, or by follow-up phone call. The 2nd interview was conducted by phone. Pain scores at the time of both interviews we...
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The aim of this study is to explore the relationship between reported sleep, perceived fatigue and sleepiness, and cognitive performance. Although evidence suggests that fatigue and sleepiness affect the provision of care in inpatient... more
The aim of this study is to explore the relationship between reported sleep, perceived fatigue and sleepiness, and cognitive performance. Although evidence suggests that fatigue and sleepiness affect the provision of care in inpatient units, there is a lack of research on the sleep patterns of emergency nurses and the effects of disturbed sleep and fatigue on their cognitive abilities and susceptibility to medical errors. A quantitative correlational design was used in this study; in each of 7 different statistical models, zero-order relationships between predictors and the dependent variable were examined with appropriate inferential tests. Participants reported high levels of sleepiness and chronic fatigue that impeded full functioning both at work and at home. Although high levels of self-reported fatigue did not show any effects on cognitive function, other factors in the environment may contribute to delayed, missed, or inappropriate care. Further research is indicated.
Research Interests: Nursing, Cognition, Adolescent, Fatigue, Humans, and 8 moreFemale, Male, Young Adult, Sleep, Emergency Nursing, Aged, Middle Aged, and Adult
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Following termination of the SSI Drug Addiction and Alcoholism (DA&A) program, a nine-site study followed 1,764 randomly selected SSI beneficiaries over two years. This paper examines how loss of SSI affected use of alcohol and illegal... more
Following termination of the SSI Drug Addiction and Alcoholism (DA&A) program, a nine-site study followed 1,764 randomly selected SSI beneficiaries over two years. This paper examines how loss of SSI affected use of alcohol and illegal drugs. One-third of study respondents reported neither drinking nor using illegal drugs at baseline (just before the end of the program). Nevertheless, use of illegal drugs was 15 times more prevalent among the study sample (44%) than the general population, while use of alcohol was 1.3 times more prevalent (59%), and use of both alcohol and other drugs was significantly greater among those who would lose SSI than those who would retain it. During the follow-up period, prevalence of drinking and use of illegal drugs remained steady, but mean days of use declined for alcohol and illegal drugs other than marijuana. In three separate repeated measures ordinal regression models we examined the net effect of SSI retention on use of alcohol, marijuana and o...
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Background Vaso-occlusive crisis (VOC) management of patients with sickle cell disease (SCD) in emergency departments (EDs) is typically reported as sub-optimal. As part of a larger research and quality improvement study, a... more
Background Vaso-occlusive crisis (VOC) management of patients with sickle cell disease (SCD) in emergency departments (EDs) is typically reported as sub-optimal. As part of a larger research and quality improvement study, a nurse-initiated high dose, opioid protocol for adults with VOC was implemented in one ED. The protocol allowed for administration of a total of morphine sulfate (MS) 50 mg, or hydromorphone 10 mg intravenous push (IVP), over three doses (every 20 minutes) and within 60 minutes for patients who received opioid therapy in the last 24 hours, and half the dose for patients who had not taken opioids in the last 24 hours. Additional analgesic administration was at the discretion of the ED physician. Objective Protocol fidelity [total IV MS equivalents (IVMSE) in mgs administered] and safety was evaluated. Methods A structured medical record (MR) review was conducted for all ED visits in patients with a diagnosis of VOC during the 13 month time period immediately after ...
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Threatening and assaultive behaviors against healthcare workers is a growing national concern. To assess the incidence and impact of aggression against healthcare workers, a safety and quality improvement project was initiated in an... more
Threatening and assaultive behaviors against healthcare workers is a growing national concern. To assess the incidence and impact of aggression against healthcare workers, a safety and quality improvement project was initiated in an academic, tertiary care, and urban hospital. Through the Northwestern Academy of Quality and Safety Initiatives program, an invitation to complete an online survey was sent to healthcare workers. The survey inquired about prevalence, location, and type of experience of physical or verbal abuse by patients or families. Other goals were: 1) worker knowledge and use of reporting systems 2)effect on healthcare worker engagement, and 3) report of posttraumatic symptoms. 34.4% of healthcare workers reported any incident of verbal or physical violence in the proceeding 12 months, with 13.5% reporting physical assault. Of those with any incident of physical or verbal violence, 60.2% endorsed at least one posttraumatic symptom, 9.4% missed work, and 30.1% had tho...