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3 results on '"Debra Glazer"'

1. The role of doulas in supporting perinatal mental health – a qualitative study

Author

Joanne Quiray, Elizabeth Richards, Yesenia Navarro-Aguirre, Debra Glazer, Jamie Adachi, Emily Trujillo, Dila Perera, Elizabeth Perez Garcia, and Amritha Bhat

Subjects
perinatal mental health, maternal mental health, doula, screening, qualitative, needs assessment, Psychiatry, RC435-571
Abstract

ObjectiveThe perinatal period presents several opportunities to identify and treat perinatal mental health and substance use disorders by integrating into existing care pathways. We aimed to examine the role of birth doulas in supporting their clients’ perinatal mental health.MethodsThematic content analysis of focus groups with doulas, and interviews with doula clients was used to characterize the doula-client relationship, investigate whether and how doulas provide mental health and substance use support, and identify barriers and recommendations for doulas to support their clients’ mental health. Participants were doula clients from communities underserved due to race, income, language and culture.ResultsDoulas and clients reported positive relationships, supported by congruence in culture, language, and lived experiences. Doulas varied in their confidence in identifying perinatal mental health problems, though most agreed that doulas could support their clients’ mental health to different degrees. Barriers to engaging in perinatal mental health treatments included low perceived need and socio-economic burden.ConclusionsWith adequate support and training, doulas can play an important role in supporting their client’s emotional well-being.

Published
2024
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2. Characterizing the use of botulinum toxin in patients with Hirschsprung disease treated at referral institutions for pediatric colorectal surgery

Author

Samuel E. Rice-Townsend, Lauren Nicassio, Debra Glazer, Jeffrey Avansino, Megan M. Durham, Casey M. Calkins, Rebecca M. Rentea, Matthew W. Ralls, Richard J. Wood, Michael D. Rollins, Erin M. Garvey, Katelyn E. Lewis, Ron Reeder, and Caitlin A. Smith

Subjects
Botulinum Toxins, Adolescent, Infant, Newborn, Infant, General Medicine, Treatment Outcome, Child, Preschool, Pediatrics, Perinatology and Child Health, Humans, Surgery, Hirschsprung Disease, Botulinum Toxins, Type A, Child, Colorectal Surgery, Referral and Consultation, Retrospective Studies
Abstract

Botulinum toxin (BT) is used to treat pediatric patients with Hirschsprung disease (HD) with obstructive symptoms. We aimed to characterize use of BT in HD patients across pediatric colorectal surgery referral centers.A multicenter retrospective study of BT use in children (0-18y) with HD was performed using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) between 2017 and 2021. Sites with10 HD patients recorded were excluded. Patterns were evaluated using Fisher's exact, Wilcoxon rank-sum, Kruskal-Wallis, and Cochran-Armitage trend test.494 patients at 8 centers were included. 118 (23.9%) received at least one BT injection. Among patients who required redo pullthrough procedures, 53.1% received BT compared to 22.7% of patients who only underwent one pullthrough (p0.001). Age at pullthrough was also significantly associated (p = 0.021). A lower proportion of Hispanic patients received BT (9.6% vs. 26.3%;p = 0.006). Percentage of HD patients receiving BT varied significantly across sites (p0.001).Use of BT in patients with HD varies widely with greater use in patients who underwent redo surgery and in those who underwent pullthrough at an older age. Hispanic patients received less BT. These findings highlight the need to develop consensus guidelines and for further study on timing of injections and potential disparities in care.III.

Published
2022

3. Urinary continence disparities in patients with anorectal malformations

Author

Richard J. Wood, Debra Glazer, Mark P. Cain, Paul A. Merguerian, Matthew W. Ralls, Jennifer Ahn, Katelyn E. Lewis, Megan Fuller, Casey M. Calkins, Rebecca M. Rentea, Belinda H. Dickie, Caitlin A. Smith, Megan M. Durham, Michael D. Rollins, Payam Saadai, Ron W Reeder, Justin Lee, Samuel E. Rice-Townsend, Jason S. Frischer, Lauren Nicassio, and Jeffrey R. Avansino

Subjects
Pediatrics, medicine.medical_specialty, Population, Urinary Bladder, Urinary incontinence, Medicine, Fecal incontinence, Humans, In patient, education, Child, Socioeconomic status, Retrospective Studies, education.field_of_study, Urinary continence, business.industry, Retrospective cohort study, General Medicine, Anorectal Malformations, Urinary Incontinence, Child, Preschool, Pediatrics, Perinatology and Child Health, Etiology, Surgery, medicine.symptom, business, Fecal Incontinence
Abstract

Purpose While fecal incontinence is a primary concern for many children with anorectal malformations (ARM), urinary incontinence is also prevalent in this population. Racial, ethnic, and socioeconomic disparities in urinary continence have been observed in other conditions, but have not been previously evaluated in ARM. We aimed to evaluate urinary continence and associated demographic and socioeconomic characteristics in individuals with ARM. Methods We performed a multicenter retrospective study of ARM patients evaluated at sites participating in the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC). We included all patients with ARM 3 years and older. The primary outcome was urinary continence which was categorized as complete (no accidents), daytime (accidents at night), partial (rare or occasional accidents), and none (frequent accidents or no continence). We evaluated for associations between urinary continence and race, sex, age, insurance status, and adoption status, employing Kruskal-Wallis and trend tests. Secondary outcomes included bladder management strategies such as clean intermittent catheterization and continence surgery. P-value Results A total of 525 patients with ARM were included. Overall, 48% reported complete urinary continence, and continence was associated with greater age. For school-aged children (age ≥ 5 years), 58% reported complete continence, while 30% reported none. Public insurance and adoption status were associated with decreased likelihood of incontinence. Conclusions We observed a novel finding of disparities in urinary continence for children with ARM related to insurance and adoption status. Further investigation regarding the etiologies of these inequities is needed in order to affect clinical outcomes.

Published
2021

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