Physician Assistant Studies Program Works
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Item Lesbian, Gay, Bisexual, Transgender, Queer, Plus Curriculum in Physician Assistants/Associate Education: A Call to Action(Wolters Kluwer, 2024-09) Lechien, Nathan M.; Dempsey, Shea A.; Physician Assistant Studies Program, School of Health and Human SciencesHealthcare avoidance of the LGBTQIA+ community is growing, in part, due to a knowledge gap in medical learners on LGBTQIA+-related topics. Barriers of including LGBTQIA+ topics in medical education include perceived lack of applicability and preceptor knowledge gaps. Advocating for a weave-like integration approach, topics such as personal biases, hormone replacement therapy, STI prevention, and health inequities should be included. It is imperative that PA educators use this call to action to avoid perpetuating the cultural incompetence of new graduate PAs.Item The Role of Permission, Supervision, and Precipitating Events in Childhood Pool/Spa Submersion Incidents, United States, 2000–2017(MDPI, 2021-08-19) Anderson, Kristina R.; Ramos, William D.; Schuman, James T.; Physician Assistant Studies Program, School of Health and Human SciencesDrowning is a leading cause of fatality among children in the United States, and pool/spa aquatic structures represent common locations of submersion incidents. This study employed narrative case review to understand characteristics related to permission, supervision, and precipitating events in childhood submersion incidents. Retroactive analysis of 1537 fatal and non-fatal submersion incidents among children age 13 years old and younger was conducted using the U.S. Consumer Products Safety Commission In-Depth Investigations dataset from 2000–2017. Narrative descriptions were coded according to the themes of permission, supervision, and precipitating events. In most (86%) incidents, the child did not have permitted water access, and 80% of narratives indicated the child was alone at time of incident. These attributes were significantly associated with a fatal outcome (No permission: OR 11.98, 95% CI 7.97–18.06; Alone: OR 34.93, 95% CI 19.69–61.96). The average length of inactive supervision time was 15.6 min; this duration significantly differed by non-fatal (3.2 min) and fatal (16.1 min) outcomes (p < 0.001). More than half of cases occurred under the supervision type of a parent (56%), followed by grandparents (14%) and childcare provider (10%). Submersion incidents with a non-parent supervisor were two times more likely to result in a fatal outcome (OR 1.87, 95% CI 1.07–3.64). The most frequently occurring precipitating events included outdoor play (46%), a social gathering (36%), and previous water play (15%). Narrative excerpts further illustrate how tragic submersion events can unfold quickly and unpredictably. Education campaigns should target all adults that supervise children and reiterate key findings in that many submersion incidents occur (1) without permitted pool use, (2) without active supervision, and (3) when a caregiver is distracted. Multiple strategies should be utilized to add layers of projection against submersion injury.Item Type 1 Diabetes Mellitus and Cognitive Impairments: A Systematic Review(IOS, 2017) Li, Wei; Huang, Edgar; Gao, Sujuan; Physician Assistant Studies Program, School of Health and Rehabilitation SciencesType 1 diabetes mellitus (T1DM) is a major subtype of diabetes and is usually diagnosed at a young age with insulin deficiency. The life expectancy of T1DM patients has increased substantially in comparison with that three decades ago due to the availability of exogenous insulin, though it is still shorter than that of healthy people. However, the relation remains unclear between T1DM and dementia as an aging-related disease. We conducted a systematic review of existing literature on T1DM and cognition impairments by carrying out searches in electronic databases Medline, EMBASE, and Google Scholar. We restricted our review to studies involving only human subjects and excluded studies on type 2 diabetes mellitus or non-classified diabetes. A meta-analysis was first performed on the relationship between T1DM and cognitive changes in youths and adults respectively. Then the review focused on the cognitive complications of T1DM and their relation with the characteristics of T1DM, glycemic control, diabetic complications, comorbidities, and others. First, age at onset, disease duration, and glycemic dysregulation were delineated for their association with cognitive changes. Then diabetic ketoacidosis, angiopathy, and neuropathy were examined as diabetic complications for their involvement in cognitive impairments. Lastly, body mass index and blood pressure were discussed for their relations with the cognitive changes. Future studies are needed to elucidate the pathogenesis of T1DM-related cognitive impairments or dementia.Item Age at Injury is Associated with the Long-Term Cognitive Outcome of Traumatic Brain Injuries(Elsevier, 2017) Li, Wei; Risacher, Shannon L.; McAllister, Thomas W.; Saykin, Andrew J.; Physician Assistant Studies Program, School of Health and Rehabilitation SciencesAbstract Introduction The association between age at injury (AAI) and long-term cognitive outcome of traumatic brain injuries (TBI) is debatable. Methods Eligible participants with a history of TBI from Alzheimer's Disease Neuroimaging Initiative were divided into a childhood TBI (cTBI) group (the AAI ≤ 21 years old) and an adult TBI (aTBI) group (the AAI > 21 years old). Results The cTBI group has a higher Everyday Cognition total score than the aTBI group. All perceived cognitive functions are worse for the cTBI group than for the aTBI group except memory. By contrast, the cTBI group has higher assessment scores on either the Boston Naming Test or Rey Auditory Verbal Learning Test than the aTBI group. Discussion The AAI is associated with the long-term cognitive outcomes in older adults with a history of TBI.