Browsing by Author "Brosnan, Amanda"
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Item Addressing the Impact of COVID-19 Restrictions on Depression and Eating Disorders in Pediatric Populations(2024-03-21) Hendon, Allison; Griner, Stacey; Brosnan, AmandaPurpose: The mental health of global youth populations has been a serious topic of concern, especially following the onset of the COVID-19 pandemic. Early research has shown that the global prevalence of adolescent and pediatric mental health episodes has increased following the pandemic; with a 25% increase in depressive symptoms and a 20% increase in anxiety symptoms. It is also known that there is a strong correlation between depression and eating disorders; with each diagnosis increasing the risk of the other. Prior to the pandemic, it was estimated that the lifetime prevalence of eating disorders in adolescents was 2.7%, which was more prevalent among females (3.8%) vs. males (1.5%). Despite these known statistics, minimal research has been performed in the U.S. evaluating eating disorders among pediatric populations following the pandemic. Therefore, given the declining mental health of our youth following COVID-19, it is imperative to consider the development of eating disorders and/or depression in these vulnerable populations. The purpose of the present study is to explore the presence of eating disorders and depression in pediatric populations following the COVID-19 pandemic, and how these rates differ between males and females. Methods: A literature review was conducted using PubMed and Google Scholar electronic databases. Relevant articles were screened using the following keywords found in either the title or abstract: depression, major depressive disorder, eating disorders, anorexia nervosa, bulimia nervosa, binge eating, adolescence, pediatrics, children, COVID-19, pandemic. This search was limited to articles with the following criteria: written in English (i) inclusion of adolescents or children as research participants (ii), and research conducted after 2018 (iii). Studies selected based on the above criteria included longitudinal studies, comparative studies, and systematic reviews. Results: Recent studies have shown an increase in the prevalence of both depression and eating disorders in global youth populations following the COVID-19 pandemic. As a result of the mandated COVID-19 lockdown, many pediatric populations were isolated from their friends, classmates, and family members. A cross-sectional study in China found that children who were left alone throughout the day without a companion during COVID-19 had higher levels of depressive symptoms (22%) and anxiety (27%) as compared to those who had company throughout the day. The mandated COVID-19 lockdowns have differing affects across gender identity. A longitudinal study of children in Australia found that when compared to their male cohort, females experienced higher levels of generalized anxiety and depressive symptoms as well as lower life satisfaction during the pandemic. Conclusion: These findings indicate that children, especially females, are at increased risk for depression and eating disorders both during and following the COVID-19 pandemic. Increased rates of depression and other psychological conditions leaves the pediatric and adolescent populations vulnerable to future health and developmental complications later in life and across the life course. At the public policy level, safeguards need to be put in place to ensure that the mental health of children remains protected and a public health priority during future pandemics.Item ADHD Management in Adolescents and its Impact to Lower Incidence of Risky Sexual Behavior(2024-03-21) Gillespie, Amelia; Brosnan, Amanda; Griner, StaceyBackground: Attention-deficit/hyperactivity disorder (ADHD) is a neurological condition that is recognized by an ongoing pattern of inattention with or without hyperactivity and impulsivity that interferes with functioning or development. In 2020, it was reported that ADHD affects 9.6% of children ages 6-11 and 13.6% of adolescents ages 12-17. Therapies that include medications and/or interventions can aid in reducing symptoms and improving functioning. ADHD can be associated with sexual health outcomes such as higher rates of sexually transmitted infections and elevated rates of risky sexual behavior, like condomless sex. Adolescents with ADHD have an earlier age of intercourse, more lifetime sexual partners, higher rates of pregnancy, and higher rates of lifetime STIs. However, few studies have investigated sexual health promotion for those diagnosed with ADHD. Purpose: The purpose of the present study is to explore current literature examining the relationship between ADHD and risky sexual behavior among adolescents. Methods: A literature review process was conducted using PubMed and Google Scholar. The reference list of the relevant articles was screened for titles and abstracts containing the keywords: Attention-deficit hyperactivity disorder, ADHD, risky sexual behaviors, STI, Sexually Transmitted Infections, Syphilis, Chlamydia, human papillomavirus, herpes, sexually transmitted diseases. The retrospective search was limited to articles in English, from 2010 or later, and included the keywords listed above in the title or abstract. Articles reviewed included qualitative and quantitative studies and systematic reviews. Results: In current literature, the incidence of risky sexual behavior has been shown to decrease with either stimulant medication therapy or behavioral therapy for comorbid psychiatric disorders like substance abuse. There are varying conclusions in published literature giving attributes of lowering risky sexual behavior through drug intervention and others to behavioral therapy. These different conclusions of effective therapy come from our limited current understanding of ADHD and the vast array of patient circumstances, such as the varying severity of ADHD, other psychiatric symptoms, and other behavioral influences in the patient's life. Through these studies, we can conclude that patient-centered approaches are pivotal in addressing risky sexual behaviors. Conclusion: These results indicate that ADHD symptoms can be managed with stimulant medication; however, psychiatric therapy shows a promising effect on decreasing risky sexual behavior among adolescents with ADHD, especially for those presenting with psychiatric comorbidities. To decrease risky sexual behavior and its consequences, medication alone may not be effective for most adolescent patients with ADHD, and early intervention for adolescents with ADHD is essential. By translating these findings into clinical care, we can move toward reducing the negative sexual health outcomes experienced by adolescents with ADHD.Item Oral Health Educational Needs Among HIV Health Care Providers in North Texas(2024-03-21) Garcia-Ponce, Alejandra; Teplitskiy, Nathaniel; McRae, Alison; Hodge, Crystal; Brosnan, Amanda; Neelamegam, Malinee; Allison, Waridibo; Griner, StaceyPurpose: Understanding connections between HIV and oral health is vital for providing comprehensive care to people with HIV (PWH). Due to compromised immune function associated with HIV, PWH are more susceptible to oral health disease and infections. In Texas, there is a need for improved access and provision of oral healthcare services for PWH, particularly amongst marginalized populations. The purpose of this study is to identify HIV/AIDS healthcare providers’ (HCPs) and non-clinical providers’ gaps in oral health knowledge and preferred educational strategies and models. Results can inform educational programming for providers, ultimately improving the quality of oral healthcare to PWH in North Texas. Methods: A targeted needs assessment (Qualtrics survey) was conducted among a sample of major HIV organizations in North Texas to assess the educational and training needs of their HCPs. The survey, administered in January 2024, featured multiple-choice and open-ended questions. Participants were presented with lists of topics based on existing programming and literature: (i) topics on oral health and HIV, such as oral microbiome and antiretroviral therapy; (ii) key populations, such as pregnant persons; and (iii) preferred learning models, such as workshops, webinars, and case studies. They were asked to select all topics of interest. Results: Of the 33 total responses, 8 were excluded due to incomplete surveys. The respondent’s credentials included DMD/DDS (n=4), MD/DO (n=1), PharmD (n=1), RN/NP (n=2), RDH (n=2), LSW/LPC (n=2). When prompted about general areas of interest within the HIV/AIDS care continuum, there was interest in learning about approaches to reduce patients lost to care, reduce HIV stigma in healthcare settings, and expand pre-exposure prophylaxis in routine oral care. Substance use disorder as it relates to HIV and oral healthcare was reiterated as an educational need. Specific educational gaps included oral manifestations of HIV (60%), HIV-related oral cancers (56%), and therapeutics such as antiretroviral therapy (48%) and other emerging treatments (48%). Clinical management of oral health conditions and HIV, dental implants and prosthetics, and innovations in diagnostics in the dental setting were other educational needs selected. Additionally, respondents indicated a need to learn more about specific key populations such as people living with substance use disorders (80%), people living without housing (76%), and transgender and gender diverse communities (64%). Pregnant persons, incarcerated persons, and aging populations were other groups of interest. Results indicate a significant preference for webinar (68%), seminar (52%), and workshop (44%) learning models. Podcasts (24%) and case studies (20%) were also selected often, but other major telementoring models (ECHO, self-paced learning and adapted community health clubs) did not receive the same preference. Conclusion: The results of this survey reveal knowledge gaps and oral healthcare needs among HCPs that should be addressed in order to enhance oral healthcare for PWH in North Texas. While synchronous educational methods like webinars and workshops were favored, HCPs may benefit from additional active learning models (e.g., ECHO) into their continuing education. By developing and implementing education on the identified topics, HCPs can advance efforts to end the HIV epidemic and ensure PWH receive comprehensive care, including addressing their oral health needs.