A5086391503- Autoimmune and Inflammatory Disorders Research
- Adolescent and Pediatric Healthcare
- Childhood Cancer Survivors' Quality of Life
- Kawasaki Disease and Coronary Complications
- Acute Lymphoblastic Leukemia research
- Systemic Lupus Erythematosus Research
- Inflammasome and immune disorders
- Rheumatoid Arthritis Research and Therapies
- Family and Disability Support Research
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Ocular Diseases and Behçet’s Syndrome
- Urticaria and Related Conditions
- Renal Diseases and Glomerulopathies
- Immunodeficiency and Autoimmune Disorders
- Diabetes and associated disorders
- Romani and Gypsy Studies
- Sports injuries and prevention
- Migration, Health and Trauma
- COVID-19 and healthcare impacts
- Sex and Gender in Healthcare
- Telemedicine and Telehealth Implementation
- Child and Adolescent Health
- Ethics and Legal Issues in Pediatric Healthcare
- Celiac Disease Research and Management
- Healthcare Systems and Technology
Connecticut Children's Medical Center
2024
Cincinnati Children's Hospital Medical Center
2011-2023
Amgen (United States)
2021
City, University of London
2020
University of Cincinnati
1990-2018
Center for Rheumatology
2011
Boston Children's Hospital
1999
University of Cincinnati Medical Center
1992
Indiana University School of Medicine
1987
Indiana University
1987
Objective. In a cohort of 70 patients with childhood-onset systemic lupus erythematosus (cSLE): to determine the baseline adherence medications and visits; investigate effects cellular text messaging reminders (CTMR) on clinic study influence CTMR use hydroxychloroquine (HCQ). Methods. were sent prior visits for 14 months. A subgroup evaluated medication HCQ: 19 receiving each scheduled HCQ dose compared 22 randomized standard care education about HCQ. Visit was measured using administrative...
To design, implement, and assess the impact of an office-based intervention designed to improve rheumatologists' identification risk behaviors, especially alcohol use sexual activity, among adolescents young adults with chronic rheumatologic conditions.Prospective study.Midwestern academic pediatric rheumatology practice.Ten attending rheumatologists fellows 178 patients (mean age, 18.1 years; 67% female; 88% white; 69% juvenile rheumatoid arthritis) seen in practice during baseline...
Objective To investigate the hypothesis that children with juvenile rheumatoid arthritis (JRA) would have more social and emotional problems than case–control classmates. Methods Using a design, JRA (n = 74), ages 8–14, were compared classmates 74). Peer relationships, well-being, behavior, based on peer-, teacher-, parent-, self-report scores common measures, using analysis of variance. Results Relative to classmates, similar all measures functioning behavior. Mothers reported internalizing...
On the basis of surname, 6418 Asians were identified out a total 109 187 deaths and discharges Leicestershire residents who had been treated in hospitals Trent Regional Health Authority over two years. After linkage to Hospital Activity Analysis computerised records, hospital morbidity non-Asians was compared. Asian patients certain age groups more likely than non-Asian be diagnosed as having asthma; leukaemia; diabetes mellitus; blood, thyroid, eye disorders; forms heart disease;...
Objective To determine the relationship between serum levels of S100A8/A9 and S100A12 maintenance clinically inactive disease during anti–tumor necrosis factor (anti‐ TNF ) therapy occurrence flare following withdrawal anti‐ in patients with polyarticular forms juvenile idiopathic arthritis (JIA). Methods In this prospective, multicenter study, 137 polyarticular‐course JIA whose was while receiving were enrolled. Patients observed for an initial 6‐month phase which treatment continued. For...
Abstract Objective The aim of this study was to report the interim 5-year safety and effectiveness abatacept in patients with JIA PRINTO/PRCSG registry. Methods Abatacept Registry (NCT01357668) is an ongoing observational children receiving abatacept; enrolment started January 2013. Clinical sites enrolled starting or currently abatacept. Eligible were assessed for (primary end point) over 10 years. Effectiveness measured by clinical 10-joint Juvenile Arthritis Disease Activity Score...
The ability to assess quality of care is a necessary component continuous improvement. assessment typically accomplished by determination compliance with defined set measures (QMs). objective this effort was establish QMs for the process in juvenile idiopathic arthritis (JIA).A 12-member working group composed representatives from American College Rheumatology, Academy Pediatrics, Board and Association Rheumatology Health Professionals assembled guide project. Delphi questionnaires were sent...
Objective. Nonadherence is currently an underrecognized and potentially modifiable obstacle to care in juvenile idiopathic arthritis (JIA). The purpose of our study was design implement a standardized approach identifying adherence barriers for youth with JIA across 7 pediatric rheumatology clinics through the Pediatric Rheumatology Care Outcomes Improvement Network (PR-COIN) assess frequency patients their caregivers treatment modalities. Methods. An iterative process using coproduction...
Randomized trials have demonstrated the efficacy of patient decision aids to facilitate shared making in clinical situations with multiple medically reasonable options for treatment. However, little is known about how best implement these tools into routine practice. In addition, reliable implementation has been elusive and spread within pediatrics slow. We sought develop reliably a aid treatment children juvenile idiopathic arthritis. To design our aid, we partnered patient, parent,...
To describe the selection, development, and implementation of quality measures (QMs) for juvenile idiopathic arthritis (JIA) by Pediatric Rheumatology Care Outcomes Improvement Network (PR-COIN), a multihospital learning health network using improvement methods leveraging QMs to drive improved outcomes across JIA population since 2011.An American College Rheumatology-endorsed multistakeholder process previously selected initial QMs. Clinicians in PR-COIN parents children with collaboratively...
Abstract Objective To determine the relationship between health insurance status and disease outcome in children with juvenile rheumatoid arthritis (JRA). Methods JRA patients followed at a tertiary pediatric rheumatology center were assessed for number of active joints limited range motion. Disease activity, patient well‐being, pain measured. Disability was by Childhood Health Assessment Questionnaire, health‐related quality life Pediatric Quality Life Inventory (PedsQL) Generic Core Scale,...
Objective To determine the frequency, time to flare, and predictors of disease flare upon withdrawal anti–tumor necrosis factor (anti‐ TNF ) therapy in children with polyarticular forms juvenile idiopathic arthritis ( JIA who demonstrated ≥6 months continuous clinically inactive disease. Methods In 16 centers 137 patients were receiving anti‐ (42% whom also methotrexate [ MTX ]) prospectively followed up. If remained for initial 6 study, was stopped assessed at 1, 2, 3, 4, 6, 8 months....
Objective Treat to target (T2T) is a strategy of adjusting treatment until reached. An international task force recommended T2T for juvenile idiopathic arthritis (JIA) treatment. Implementing in standard and reliable way clinical practice requires agreement on critical elements (1) setting, (2) strategy, (3) identifying barriers implementation, (4) patient eligibility. A consensus conference was held among Pediatric Rheumatology Care Outcomes Improvement Network (PR-COIN) stakeholders inform...
Healthcare providers were rapidly forced to modify the way they practiced medicine during coronavirus disease 2019 (COVID-19) pandemic. Many transitioned from seeing their patients in person virtually using telemedicine platforms with limited training and experience this medium. In pediatric rheumatology, was further complicated as musculoskeletal exams typically require hands-on assessment of patients. The objective study examine adoption into rheumatology practices, assess its benefits...
Abstract Objective To examine educational and occupational outcomes among young adults with juvenile idiopathic arthritis (JIA) peers during the transition from adolescence to emerging adulthood. Methods Families were recruited when children JIA 8–14 years old. At that time, each child was matched a classmate of similar age, sex, race for inclusion in comparison group. For current followup (12.64 postdiagnosis), 45 participants JIA, 46 peers, their parents completed questionnaires soon after...
To determine the frequency of laboratory abnormalities with methotrexate (MTX) use in patients juvenile idiopathic arthritis (JIA); to identify potential risk factors for MTX toxicity requiring medical interventions; and compare liver function treated those not MTX.Results surveillance testing (SLT) available clinical databases were reviewed 588 children JIA. Information on demographics, JIA features, previously associated increased SLT was obtained.Results performed at least 4-month...
Objective To measure agreement among raters when scoring the physician/provider global assessment (PGA) of disease activity in patients with juvenile idiopathic arthritis (JIA) no apparent activity, and to identify clinical laboratory parameters that most strongly influence provider PGA. Methods Profiles findings from 20 JIA were given 51 providers, who asked score PGA using a 21‐circle visual analog scale (range 0–10). Following initial scoring, providers discussed each profile reasons for...
Background/Purpose: Medication options for juvenile idiopathic arthritis (JIA) are increasing. Medications differ on a variety of attributes, including mechanisms action, dosing intervals, modes administration, safety profiles, and cost. Some parents children with JIA left questions concerns about medications suggesting need improved clinician‐parent communication. Decisions like this, multiple reasonable that in ways matter to families, conducive “Shared Decision Making” (SDM). SDM is...
ABSTRACT: Juvenile rheumatoid arthritis (JRA) may cause a variety of school problems. Twenty‐four children with JRA, 24 their parents, and 14 teachers completed questionnaires regarding the frequency 40 potential problems extent teacher's responsibility in helping deal 28 medical, academic, or social issues. Though respondents viewed as occurring infrequently, parents more frequently than noted that occurred (p < .05). Children felt self‐concept peer relationships most frequently, while...
Initial benchmarking of childhood-onset systemic lupus erythematosus (cSLE) quality indicators revealed suboptimal performance across multiple centers. Our aim was to improve cardiovascular and bone health screenings at a tertiary treatment center for cSLE. This included annual measurements vitamin D, lipid profiles, mineral density through dual-energy x-ray absorptiometry (DXA).Quality improvement methodology applied design implement standardized previsit planning process electronically...