First name
Kenneth
Middle name
R
Last name
Ginsburg

Title

A Survivor-Derived Approach to Addressing Trafficking in the Pediatric ED.

Year of Publication

2020

Date Published

2020 Dec 17

ISSN Number

1098-4275

Abstract

<p><strong>OBJECTIVES: </strong>Our objective was to elicit the perspectives of survivors of child trafficking on addressing trafficking in the pediatric emergency department (ED) and, secondarily, to provide a survivor-derived framework to help pediatric emergency medicine (PEM) providers discuss trafficking with their patients.</p>

<p><strong>METHODS: </strong>We conducted in-depth, semistructured interviews with young adults who experienced trafficking as children and/or as adolescents. In the interviews, we employed a novel video-elicitation method designed by the research team to elicit detailed participant feedback and recommendations on the pediatric ED through an interactive, immersive discussion with the interviewer. A grounded theory approach was employed.</p>

<p><strong>RESULTS: </strong>Seventeen interviews were conducted revealing the following themes, which we present in an integrated framework for PEM providers: (1) fear is a significant barrier; (2) participants do want PEM providers to ask about trafficking, and it is not harmful to do so; (3) PEM providers should address fear through emphasizing confidentiality and privacy and encouraging agency; (4) PEM providers should approach the patient in a direct, sensitive, and nonjudgmental manner; and (5) changes to the ED environment may facilitate the conversation. Suggested wordings and tips from survivors were compiled.</p>

<p><strong>CONCLUSIONS: </strong>Trafficking survivors feel that the pediatric ED can be a place where they can be asked about trafficking, and that when done in private, it is not harmful or retraumatizing. Fear is a major barrier to disclosure in the pediatric ED setting, and PEM providers can mitigate this by emphasizing privacy and confidentiality and increasing agency by providing choices. PEM providers should be direct, sensitive, and nonjudgmental in their approach to discussing trafficking.</p>

DOI

10.1542/peds.2020-0772

Alternate Title

Pediatrics

PMID

33334922

Title

The role of resilience in healthcare transitions among adolescent kidney transplant recipients.

Year of Publication

2019

Number of Pages

e13559

Date Published

2019 Aug 22

ISSN Number

1399-3046

Abstract

<p><strong>PURPOSE: </strong>AYAs with KTs experience high rates of premature allograft loss during the HCT. There is a critical need to identify protective factors associated with stable HCT. Resilience-the ability to adapt and thrive in the setting of adversity-has known positive impact on health outcomes. This study explored the novel role of resilience constructs as protective factors in securing stable HCT among AYA with KT.</p>

<p><strong>METHODS: </strong>We conducted semi-structured interviews of adolescents and young adults who transitioned from a single pediatric transplant center to multiple adult nephrology centers between 2010 and 2017. Interviews explored the role of key resilience constructs in participants' lives around the time of HCT. Participants were stratified into stable or unstable HCT groups based on biological markers of allograft function and clinical data from chart review. Content analyses of interview transcripts were reviewed and compared among HCT groups.</p>

<p><strong>RESULTS: </strong>Thirty-two participants enrolled (17 stable; 15 unstable). Key resilience constructs more salient in the stable versus unstable HCT group were confidence in and connection to one's healthcare team. Reports of healthcare self-management competencies were similar across both HCT groups.</p>

<p><strong>CONCLUSIONS: </strong>Confidence in and connection to one's healthcare team appear to be linked with a stable HCT among AYA with KT. This suggests that interdependence, the ability to foster connections with and elicit support from healthcare providers, as opposed to complete independence or autonomy, which is often advised in the HCT process, is a critical component of resilience linked to stable HCT.</p>

DOI

10.1111/petr.13559

Alternate Title

Pediatr Transplant

PMID

31441191

Title

The Role of Patient and Parental Resilience in Adolescents with Chronic Musculoskeletal Pain.

Year of Publication

2019

Date Published

2019 Apr 10

ISSN Number

1097-6833

Abstract

<p><strong>OBJECTIVES: </strong>To assess the level of resilience among patients with chronic musculoskeletal pain and their parents and to determine factors associated with patient and parental resilience.</p>

<p><strong>STUDY DESIGN: </strong>Cross-sectional cohort study of children aged 13-17&nbsp;years diagnosed with chronic musculoskeletal pain and their parents. Patient-parent pairs were seen for initial consultation in the pediatric rheumatology pain clinic at Children's Hospital of Philadelphia between March and May 2018 and were administered a series of questionnaires including measures of resilience (Connor-Davidson Resilience Scale 10 item, The 14-item Resilience Scale, and the 7Cs of Resilience Tool). We calculated Pearson correlation coefficients to examine the relationship between the variables of interest and resilience.</p>

<p><strong>RESULTS: </strong>According to all resilience measures, patients and parents had low to moderate levels of resilience. These levels were lower than those previously reported among healthy populations, as well as those with chronic medical conditions. According to the Connor-Davidson Resilience Scale 10 item, patient-level resilience was negatively correlated with pain level (r&nbsp;=&nbsp;-0.48), physical disability (r&nbsp;=&nbsp;-0.54), and symptom severity (r&nbsp;=&nbsp;-0.53). The level of resilience among patients was positively correlated with energy level (r&nbsp;=&nbsp;0.57) and health-related quality of life (r&nbsp;=&nbsp;0.64). Parental resilience was positively correlated with parental mental health (r&nbsp;=&nbsp;0.61).</p>

<p><strong>CONCLUSIONS: </strong>Higher patient resilience was correlated with reduced disease severity among adolescents with chronic musculoskeletal pain. Future research should explore whether fostering resilience in adolescents with chronic musculoskeletal pain via the application of resilience-training interventions mitigates disease burden in this vulnerable patient population.</p>

DOI

10.1016/j.jpeds.2019.03.006

Alternate Title

J. Pediatr.

PMID

30981421

Title

Attitudes and Beliefs Pertaining to Sexual and Reproductive Health Among Unmarried, Female Bhutanese Refugee Youth in Philadelphia.

Year of Publication

2017

Date Published

2017 Sep 18

ISSN Number

1879-1972

Abstract

<p><strong>PURPOSE: </strong>We explored attitudes and beliefs pertaining to sexual and reproductive health (SRH) among unmarried, female, resettled Bhutanese refugees 16-20&nbsp;years.</p>

<p><strong>METHODS: </strong>Fourteen interviews were analyzed using the constant comparison method, and major themes were identified.</p>

<p><strong>RESULTS: </strong>SRH was stigmatized for unmarried youth, making seeking information about SRH or accessing family planning difficult. There were many misconceptions about access to SRH.</p>

<p><strong>CONCLUSIONS: </strong>Universal, culturally, and linguistically appropriate comprehensive SRH education is recommended for female Bhutanese refugee youth. Terminology used should take into account&nbsp;differences in conceptualization of concepts like dating. Educators and health care providers should clearly describe consent and confidentiality laws regarding adolescent SRH services.</p>

DOI

10.1016/j.jadohealth.2017.06.011

Alternate Title

J Adolesc Health

PMID

28935387

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