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Browsing by Author "Davis, Stephanie"
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Item Bookmobile Service in Indiana: Its History, Its Present, and Its Future(H.W. Wilson Company, 2001) Davis, Stephanie; Harnish, Cynthia; Wallace, JanetTraditionally, the bookmobile has played an important role in meeting the needs of the reading public and in providing information to a broad segment of society. But in the past few years, bookmobiles have fallen on hard times, and their demise has long been predicted. They have fallen victim to such things as the gas crisis, construction of branch libraries, and automation.Item Communication about ADHD and its treatment during pediatric asthma visits(Springer, 2014-02) Sleath, Betsy; Sulzer, Sandra H.; Carpenter, Delesha M.; Slota, Catherine; Gillette, Christopher; Sayner, Robyn; Davis, Stephanie; Sandler, Adrian; Department of Pediatrics, IU School of MedicineThe objectives of the study were to examine provider-family communication about attention deficit disorder during pediatric asthma visits. Children with asthma, aged 8 through 16 and their parents were recruited at five pediatric practices. All medical visits were audio-taped. There were 296 asthmatic children enrolled into the study and 67 of them also had attention deficit hyperactivity disorder (ADHD). ADHD communication elements suggested by national guidelines were discussed infrequently. Providers were more likely to discuss, educate, and ask one or more questions about ADHD medications if the visit was non-asthma related. Providers included child input into the ADHD treatment regimen during 3% of visits and they included parent input during 4.5% of visits. Only one child and three parents asked questions about ADHD. Providers may neglect essential aspects of good ADHD management and communication in children who have ADHD plus another chronic condition such as asthma. Providers should set appropriate treatment expectations, establish target symptoms, and encourage children and parents to ask questions so mutual decision-making can occur.Item Glutathione-S-transferase P1 may predispose children to a decline in pulmonary function after stem cell transplant(Wiley, 2017-07) Stark, Julie; Renbarger, Jamie; Slaven, James; Yu, Zhangsheng; Then, Jenny; Skiles, Jodi; Davis, Stephanie; Pediatrics, School of MedicineRATIONALE: Pulmonary complications after hematopoietic stem cell transplant (SCT) are associated with increased mortality. Genetic markers for those at risk for pulmonary impairment post-SCT have not been widely investigated. METHODS: Forty-nine patients were retrospectively selected from a single institution's biorepository with linked clinical data. All subjects performed pre-SCT PFTs. Genotyping was conducted using the Infinium Exome-24 BeadChip. Four single nucleotide polymorphisms (SNPs) were selected (rs1800871, rs1695, rs1800629, rs12477314) and evaluated for association with PFT parameters as change over time from baseline. Associations between SNPs and PFT parameters were assessed and adjusted for the following confounding variables: age, gender, and race. RESULTS: Using the recessive genetic model, patients with one or two minor alleles for the glutathione S-transferase P1 (GSTP1) SNP rs1695 had a lower decline in FEV1 and FEF25-75 at 1-year post-SCT compared to patients who were homozygous for the ancestral allele (adjusted P-values <0.01 and 0.02, respectively). No other SNPs were significantly associated with other PFT parameters. CONCLUSIONS: Our findings suggest that GSTP1 genotype may be associated with lung function during the first year post-SCT. Identifying and investigating genes that predispose patients to pulmonary complications after SCT may allow for more personalized patient management based on pre-emptive genetic testing. The glutathione S-transferase gene merits further investigation.Item A pediatric airway atlas and its application in subglottic stenosis(IEEE, 2013-04) Hong, Yi; Niethammer, Marc; Andruejol, Johan; Kimbell, Julia S.; Pitkin, Elizabeth; Superfine, Richard; Davis, Stephanie; Zdanski, Carlton J.; Davis, Brad; Department of Pediatrics, IU School of MedicineYoung children with upper airway problems are at risk for hypoxia, respiratory insufficiency and long term morbidity. Computational models and quantitative analysis would reveal airway growth patterns and benefit clinical care. To capture expected growth patterns we propose a method to build a pediatric airway atlas as a function of age. The atlas is based on a simplified airway model in combination with kernel regression. We show experimental results on children with subglottic stenosis to demonstrate that our method is able to track and measure the stenosis in pediatric airways.Item Pediatric Pulmonology Year in Review 2014: Part 2(Wiley, 2015-11) Noah, Terry L.; Auten, Richard; Schwarze, Jurgen; Davis, Stephanie; Department of Pediatrics, IU School of MedicineItem Pediatric Pulmonology Year in Review 2015: Part 1(Wiley, 2016-07) Auten, Richard; Schwarze, Jurgen; Ren, Clement; Davis, Stephanie; Noah, Terry L.; Department of Pediatrics, IU School of MedicineOur journal covers a broad range of research and scholarly topics related to children's respiratory disorders. For updated perspectives on the rapidly expanding knowledge in our field, we will summarize the past year's publications in our major topic areas, as well as selected publications in these areas from the core clinical journal literature outside our own pages. The current review covers articles on neonatal lung disease, pulmonary physiology, and respiratory infection.Item Pediatric sleep-related breathing disorders: advances in imaging and computational modeling(IEEE, 2014-09) Ward, Sally L. Davidson; Amin, Raouf; Arens, Raanan; Chen, Zhongping; Davis, Stephanie; Gutmark, Ephraim; Superfine, Richard; Wong, Brian; Zdanski, Carlton; Khoo, Michael C.K.; Department of Medicine, IU School of MedicineWe understand now that sleep of sufficient length and quality is required for good health. This is particularly true for infants and children, who have the added physiologic task of growth and development, as compared to their adult counterparts. Sleep-related breathing disorders (SRBDs) are common in childhood and if unrecognized and not treated can result in significant morbidity. For example, children with obstructive sleep apnea (OSA) can exhibit behavioral, mood, and learning difficulties. If left untreated, alterations in the function of the autonomic nervous system and a chronic inflammatory state result, contributing to the risk of heart disease, stroke, glucose intolerance, and hypertension in adulthood.Item Quantitative assessment of the upper airway in infants and children with subglottic stenosis(Wiley, 2016-05) Zdanski, Carlton; Davis, Stephanie; Hong, Yi; Miao, Di; Quammen, Cory; Mitran, Sorin; Davis, Brad; Niethammer, Marc; Kimbell, Julia; Pitkin, Elizabeth; Fine, Jason; Fordham, Lynn; Vaughn, Bradley; Superfine, Richard; Department of Pediatrics, IU School of MedicineOBJECTIVES/HYPOTHESIS: Determine whether quantitative geometric measures and a computational fluid dynamic (CFD) model derived from medical imaging of children with subglottic stenosis (SGS) can be effective diagnostic and treatment planning tools. STUDY DESIGN: Retrospective chart and imaging review in a tertiary care hospital. METHODS: Computed tomography scans (n = 17) of children with SGS were analyzed by geometric and CFD methods. Polysomnograms (n = 15) were also analyzed. Radiographic data were age/weight flow normalized and were compared to an atlas created from radiographically normal airways. Five geometric, seven CFD, and five polysomnography measures were analyzed. Statistical analysis utilized a two-sample t test with Bonferroni correction and area under the curve analysis. RESULTS: Two geometric indices (the ratio of the subglottic to midtracheal airway, the percent relative reduction of the subglottic airway) and one CFD measure (the percent relative reduction of the hydraulic diameter of the subglottic airway) were significant for determining which children with SGS received surgical intervention. Optimal cutoffs for these values were determined. Polysomnography, the respiratory effort-related arousals index, was significant only prior to Bonferroni correction for determining which children received surgical intervention. CONCLUSIONS: Geometric and CFD variables were sensitive at determining which patients with SGS received surgical intervention. Discrete quantitative assessment of the pediatric airway was performed, yielding preliminary data regarding possible objective thresholds for surgical versus nonsurgical treatment of disease. This study is limited by its small, retrospective, single-institution nature. Further studies to validate these findings and possibly optimize treatment threshold recommendations are warranted.Item Unexplained Practice Variation in Primary Care Providers' Concern for Pediatric Obstructive Sleep Apnea(APA, 2018) Honaker, Sarah; Dugan, Tamara; Daftary, Ameet; Davis, Stephanie; Saha, Chandan; Baye, Fitsum; Freeman, Emily; Downs, Stephen; Pediatrics, School of MedicineObjective To examine primary care provider (PCP) screening practice for obstructive sleep apnea (OSA) and predictive factors for screening habits. A secondary objective was to describe the polysomnography (PSG) completion proportion and outcome. We hypothesized that both provider and child health factors would predict PCP suspicion of OSA. Methods A computer decision support system that automated screening for snoring was implemented in five urban primary care clinics in Indianapolis, Indiana. We studied 1086 snoring children between 1 and 11 years seen by 26 PCPs. We used logistic regression to examine the association between PCP suspicion of OSA and child demographics, child health characteristics, provider characteristics, and clinic site. Results PCPs suspected OSA in 20% of snoring children. Factors predicting PCP concern for OSA included clinic site (p < .01; OR=0.13), Spanish language (p < .01; OR=0.53), provider training (p=.01; OR=10.19), number of training years (p=.01; OR=4.26) and child age (p<.01), with the youngest children least likely to elicit PCP concern for OSA (OR=0.20). No patient health factors (e.g., obesity) were significantly predictive. Proportions of OSA suspicion were variable between clinic sites (range 6% to 28%) and between specific providers (range 0% to 63%). Of children referred for PSG (n=100), 61% completed the study. Of these, 67% had OSA. Conclusions Results suggest unexplained small area practice variation in PCP concern for OSA amongst snoring children. It is likely that many children at-risk for OSA remain unidentified. An important next step is to evaluate interventions to support PCPs in evidence-based OSA identification.Item The Virtual Pediatric Airways Workbench(IOS Press, 2016) Quammen, Cory W.; Taylor, Russell M.; Krajcevski, Pavel; Mitran, Sorin; Enquobahrie, Andinet; Superfine, Richard; Davis, Brad; Davis, Stephanie; Zdanski, Carlton; Pediatrics, School of MedicineThe Virtual Pediatric Airways Workbench (VPAW) is a patient-centered surgical planning software system targeted to pediatric patients with airway obstruction. VPAW provides an intuitive surgical planning interface for clinicians and supports quantitative analysis regarding prospective surgeries to aid clinicians deciding on potential surgical intervention. VPAW enables a full surgical planning pipeline, including importing DICOM images, segmenting the airway, interactive 3D editing of airway geometries to express potential surgical treatment planning options, and creating input files for offline geometric analysis and computational fluid dynamics simulations for evaluation of surgical outcomes. In this paper, we describe the VPAW system and its use in one case study with a clinician to successfully describe an intended surgery outcome.