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Browsing by Author "Stupiansky, Nathan"
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Item Eating Disorders in Adulthood(Office of the Vice Chancellor for Research, 2013-04-05) Mensah, Nicole Lurline; Rohr-Kirchgraber, Theresa; Stupiansky, Nathan; Teat, RachelThe lifetime prevalence of acquiring an Eating Disorder (ED) in the US is 0.6–4.5%. The focus of ED research has traditionally been in adolescents with minimal focus on adults. We aimed to compare and contrast the etiology and disease progression between two groups of adult patients with EDs: those diagnosed in adulthood versus those diagnosed in childhood (introduction). Thirty adult patient’s (29 females and 1 male) charts were reviewed from one eating disorders center. Data was extracted using a pre-constructed template and SPSS was used to determine existing trends (method). 50% were diagnosed with an ED in childhood and 50% in adulthood. The majority of the patients with an adult-onset ED were diagnosed with Eating Disorder not-otherwise-specified (ED-NOS). Common events that triggered the disease onset included death/ illness of a parent or child, and work-related stressors. In contrast, patients diagnosed as children had more varied diagnoses including ED-NOS, Bulimia Nervosa (BN), and Anorexia Nervosa (AN). Sexual abuse, personal illness, and the termination of a romantic relationship were common triggers in this patient group. Among all patients fatigue, emesis, constipation, diarrhea, heart palpitations, amenorrhea or irregular menses, and acid erosion of tooth enamel were common comorbidities. Psychiatric comorbidities, Major Depressive Disorder and Anxiety Disorder, were primarily seen and 29/30 patients were taking psychotropic medication to treat an underlying psychiatric illness at time of their first Eating disorder visit (results). The triggers and behaviors of patients diagnosed with EDs as children are different from patients diagnosed in adulthood. Regardless of the age of onset, comorbidities are equally severe and should be treated as such. The longer and ED remains untreated, the harder it is to get it into remission, therefore, adult health care providers must incorporate screening for ED’s when caring for this population (conclusion).Item The Effects of a Computer-Based Driving Game on Hypoglycemia Education Among Adolescents with Type-1 Diabetes(2011-02) Stupiansky, Nathan; Faiola, Anthony; Defazio, JosephItem IUPUI Center for HPV Research: Effects of a Brief Health Messaging Intervention on HPV Vaccine Acceptability among Parents of Adolescent Sons(Office of the Vice Chancellor for Research, 2014-04-11) Donahue, Kelly; Stupiansky, Nathan; Cox, Anthony; Cox, Dena; Zimet, GregoryBackground: Human papillomavirus (HPV) is an very common infection that is a primary cause of warts and many cancers, including cervical, anal, vaginal, vulvar, penile, and head and neck cancers. In an effort to address the problems associated with HPV infection and prevention, the Center for HPV Research at IUPUI (Zimet & Fortenberry, Co-Directors) fosters collaboration among investigators from multiple disciplines and departments at IUPUI, IU Bloomington, Purdue University, and University of Notre Dame. There currently are 25 faculty and 7 pre- and post-doctoral trainees who are members of the Center. The Center for HPV Research was established in July, 2012 with funds from the IUPUI Signature Center Initiative, The Department of Pediatrics, and the IU Simon Cancer Center. In this abstract we highlight a study representing a collaboration among 5 center members, including our current center-supported post-doc. Objectives: HPV vaccination coverage remains very low among adolescent males in the U.S. We explored the effect of brief Web-based health messages on parents’ willingness to vaccinate their sons against HPV. Methods: A U.S. national sample of parents of 11-17-year-old sons (N=779) completed a Web-based survey assessing attitudes and behaviors related to HPV vaccination. Parents of non-vaccinated sons (79% of the sample) were randomized to a two-level normalizing message (NM) condition: no message vs. NM (“Millions of doses of the vaccine have been administered to adolescent girls in the US at this time.”) and a three-level protection message (PM) condition: no message vs. son-only PM (“The HPV vaccine can protect your son from most kinds of genital warts and anal cancers,”) vs. son+partner PM (son-only message plus “If your son gets vaccinated it can also protect his future spouse from genital warts and cancer.”). Parents then reported willingness to vaccinate their sons against HPV on a scale of 1-100. Intervention effects were analyzed using a 2×3 between-subjects ANOVA. Results: Mean willingness was 55.2 (SD=29.7). A significant interaction was found between health messaging conditions, F(2,576) = 3.17, p = 0.043). Parents receiving the son-only PM reported significantly lower willingness if they received the NM vs. no NM (p=.014). Parents receiving no NM reported significantly higher willingness if they received the son + partner PM vs. no PM (p=.029). Conclusions: Reading brief online health messages affected parents’ willingness to vaccinate their adolescent sons against HPV. Overall, presenting normalizing information pertaining to adolescent females (for whom routine immunization was first recommended) appeared to lower parent willingness to vaccinate their adolescent sons. Presenting information about protecting their son and/or son’s partner against HPV-associated outcomes appeared to increase parent willingness to vaccinate in the absence of such normalizing information.Item A model of health care provider decision making about HPV vaccination in adolescent males(Elsevier, 2015-08) Alexander, Andreia B.; Best, Candace; Stupiansky, Nathan; Zimet, Gregory D.; Department of Pediatrics, IU School of MedicineIntroduction In the U.S., HPV vaccination of adolescent males remains low, despite the recommendation for routine vaccination. Although research has highlighted that health care provider (HCP) recommendation is very influential in HPV vaccine uptake, research on this topic in the male population is lacking. Accordingly, we used a qualitative approach to identify HCP knowledge, attitudes, and behaviors regarding adolescent male HPV vaccination, one year, after routine vaccination of adolescent males was recommended. Method A total of 20 U.S. pediatric HCPs participated in 20–30 min interviews about knowledge, attitudes, and practices regarding male HPV vaccination. Interviews were audio-recorded, transcribed and, analyzed using inductive content analysis. Results The providers had been in practice for 1–35 years, 75% were female, and 75% were White. Opinions on HPV vaccination were shaped by knowledge/perception of the risks and benefits of vaccination. Although all providers frequently offered HPV vaccine to male patients, the strength and content of the offer varied greatly. Vaccination opinions determined what issues were emphasized in the vaccine offer (e.g., stressing herd immunity, discussing prevention of genital warts), while adolescent age influenced if and how they pitched their vaccine offer (e.g., HPV as a STI). Most providers agreed with the ACIP recommendations, however, several expressed that providers’ preexisting opinions might remain unchanged despite the recommendations. Consistent with the literature on determinants of HPV vaccination, providers believed that their own recommendation was a major factor in a family's decision to vaccinate. Barriers to vaccination included the “newness” and sexual nature of the vaccine, lack of insurance coverage, and the vaccine not being mandated. Conclusions Providers’ opinions about, and approaches to offering, HPV vaccination to males were highly variable. Interventions designed to improve male HPV vaccination should focus on helping providers to routinely recommend the vaccine to all of their eligible patients, both males and females.