Searched for: person:coblec01
in-biosketch:true
Selecting optimal progestational agents either alone or in combination in common pediatric endocrine settings: challenges of unmet needs
Reich, Jenna; Badrinath Murthy, Deepa; Coble, Chanelle; Shah, Bina
Progesterone is a natural hormone, mainly produced by the corpus luteum, with the foremost endocrine function on the secretory glands of the endometrium. Since being isolated, both natural and synthetic forms have been produced and are utilized for several purposes, including regulating the menstrual cycle and preventing endometrial hyperplasia. Specifically, the use of progestational agents is essential in the treatment of many common endocrine conditions, including Polycystic Ovary Syndrome, Congenital Adrenal Hyperplasia, Turner Syndrome, and Functional Hypothalamic Amenorrhea. Although these agents are essential for disease management, literature that focuses on the benefits of specific progestins as well as the effects on glucocorticoid receptors (GR), mineralocorticoid receptors (MR), and androgenic receptors (AR) is limited. In this review, we provide a disease specific summary of the available literature and highlight where more information is needed.
PMID: 39404069
ISSN: 2191-0251
CID: 5718452
Parent Education and Adolescent Health Outcomes: The Potential Role of Adolescent Academic Intention
Chen, Sabrina; Nita, Abigail; Coble, Chanelle; Ortiz, Robin; Leong, Carol Duh
Parental educational attainment significantly shapes child socioeconomic status, potentially influencing various aspects of adolescent health. This study aimed to uncover the relationships between parental education and self-reported adolescent health outcomes, including overall health, mental well-being, and body mass index (BMI). Analyzing data from 1,448 participants in the Future of Families and Child Wellbeing Study, we identified notable associations. Our findings revealed that higher maternal and paternal education correlated with reduced odds of adolescent obesity. Furthermore, increased adolescent academic intention was associated with better overall and mental health in adolescents. Notably, it also played a mediating role in lowering adolescent BMI, thereby potentially explaining the association between parent education and adolescent BMI category (overweight vs. obese). These findings emphasize the significant impact of both parent education and adolescent academic intention on adolescent health. Future research should explore interventions leveraging academic intention to positively influence the health trajectory of adolescents.
PMID: 38828585
ISSN: 1548-6869
CID: 5695062
Social Capital and Sleep Outcomes Across Childhood in United States Families
Duh-Leong, Carol; Fuller, Anne E; Johnson, Sara B; Coble, Chanelle A; Nagpal, Nikita; Gross, Rachel S
OBJECTIVE:To examine whether aspects of social capital, or benefits received from social relationships, are associated with regular bedtime and sleep duration across childhood in US families with lower income. METHODS:Cross-sectional study using the 2018-19 National Survey of Children's Health in participants with incomes <400% federal poverty level. Separately for early childhood (0-5 years), school-age (6-12 years), and adolescence (13-17 years), we used weighted logistic regression to examine associations between social capital (measured by family social cohesion, parent social support, child social support) and sleep (measured by regular bedtime, sleep duration, adequate sleep per American of Academy of Sleep guidelines). Path analysis tested whether regular bedtime mediated associations between social capital and sleep duration. RESULTS:In our sample (N = 35,438), 84.9% had a regular bedtime, 60.2% had adequate sleep. Family social cohesion was associated with sleep duration and adequate sleep (infancy: adjusted odds ratio [aOR] 2.18 [95% confidence interval [CI], 1.32, 3.60]; school age: aOR 2.03 [95% CI, 1.57, 2.63]; adolescence: aOR 2.44 [95% CI, 1.94, 3.09]). In toddlerhood, parent social support was associated with adequate sleep (aOR 1.44 [95% CI, 1.06, 1.96]). In adolescence, child social support was associated with regular bedtime (aOR 1.70 [95% CI, 1.25, 2.32]. Across childhood, associations between family social cohesion and sleep duration were partially mediated by regular bedtime. CONCLUSIONS:Family social cohesion was associated with adequate sleep across childhood, this was partially mediated by regular bedtime. Associations between social support and sleep outcomes varied by development stage. Future work should consider how supportive relationships may influence child sleep outcomes.
PMID: 36641090
ISSN: 1876-2867
CID: 5426342
A Closer Look: Examination of Suicide Risk Screening Results and Outcomes for Minoritized Youth in Subspecialty Pediatrics
Lois, Becky H; Mournet, Annabelle M; Menz, Reagan; King, Mya; Malizia, Rebecca; Haines, Elizabeth; Coble-Sadaphal, Chanelle; Liaw, K Ron-Li
OBJECTIVE:To describe a sample of minoritized youth who screened positive for suicide risk within medical subspecialty pediatrics, compared to non-minoritized youth and describe the screening outcomes of these youth. METHODS:This retrospective chart review from October 2018 to April 2021 used electronic medical record data from an academic pediatric medical subspecialty clinic that screens universally for suicide risk for all patients ages 9 and up. Chart reviews were conducted for 237 minoritized youth (operationalized as identifying as non-White or Hispanic/Latinx, identifying as a gender minority, and having a preferred language other than English) who screened positive for suicide risk. Descriptive statistics include need for escalation to an emergency room, connection to mental health care, receival of a mental health referral, and attendance at follow-up visits. RESULTS:Minoritized youth were more likely to screen positive and report a history of suicide attempt when compared to non-minoritized peers. Youth identifying as gender expansive had significant elevation in suicide risk. The majority of youth in this sample were already connected to mental health care, with youth preferring a language other than English being the least likely to be connected. CONCLUSIONS:Findings indicate heightened suicide risk for minoritized youth, with gender expansive youth having particularly elevated suicide risk. A need to support youth with a preferred language other than English in getting connected to mental health care was also revealed.
PMID: 35597439
ISSN: 1876-2867
CID: 5247752
Teaching SSHADESS v HEADSS to Medical Students:Association with Improved Communication and Increased Psychosocial Assessments
Coble, Chanelle; Srivastav, Shivani; Glick, Alexander; Bradshaw, Chanda; Osman, Cynthia
OBJECTIVE:The most recent Bright Futures edition describes both the HEADSS (Home, Education, Drugs, Sexuality, Safety) and the strength-based SSHADESS (Strengths, School, Home, Activities, Drugs, Emotions, Sexuality, Safety) frameworks for conducting an adolescent psychosocial history. We found limited research comparing the effectiveness of these two frameworks. Our study objective was to examine whether teaching medical students SSHADESS versus HEADSS is associated with increased communication skills and/or completion of the psychosocial assessment. METHODS:In this retrospective cohort study of pediatric clerkship students at NYU Grossman School of Medicine, we collected data from observer (faculty, fellow, and resident) and standardized patient (SP) assessments during Objective Structured Clinical Examinations. Primary outcomes were observer and SP-rated usage of communication skills. Secondary outcomes were observer-rated assessment of six psychosocial factors. Our predictor variable was whether students were taught HEADSS (11/2015-10/2016) or SSHADESS (11/2016-10/2017). We used Fisher's exact tests and then logistic regressions to adjust for pediatrics clerkship timing and baseline communication skills. RESULTS:200 students were assessed (n=97 HEADSS cohort, n=103 SSHADESS cohort). In adjusted analyses of observer scores, the SSHADESS cohort was more likely to use all communication skills (adjusted odds ratio [aOR] 3.2, 95% CI 1.7-6.3]) and assess all psychosocial factors (aOR 1.9, [95% CI 1.01-3.4]). There was no significant difference in SP communication scores. DISCUSSION/CONCLUSIONS:Teaching SSHADESS was associated with higher observer-rated communication skills scores and improved completeness in assessment of psychosocial factors. Future work should examine the efficacy of SSHADESS through workplace-based assessments and 360 degree assessments from adolescent patients.
PMID: 36130691
ISSN: 1876-2867
CID: 5328592
Recognizing and treating the emotional and behavioral effects of child maltreatment
Chapter by: Jablonka, Olga; Coble, Chanelle; Palusci, Vincent J.
in: Behavioral Pediatrics: Mental Health and Management. Fifth Edition by
[S.l.] : Nova Science Publishers, Inc., 2022
pp. 33-59
ISBN: 9798886970609
CID: 5369012
Resident Education Curriculum in Pediatric and Adolescent Gynecology: The Short Curriculum 3.0
Gibson, Marie Eve S; Alaniz, Veronica I; Coble, Chanelle; Dumont, Tania; Howell, Jennifer O; Karjane, Nicole W; Lawson, Ashli A; Nur, Marcella; Parks, Melissa; Teelin, Karen L; Thieu, Hong-Thao; Romano, Mary
Exposure to pediatric and adolescent gynecology (PAG) varies across residency programs in obstetrics and gynecology, family medicine, and pediatrics, as well as fellowship programs in adolescent medicine. Nevertheless, these programs are responsible for training residents and fellows and providing opportunities within their programs to fulfill PAG learning objectives. To that end, the North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG education by creating and systematically updating the Short Curriculum. This curriculum outlines specific learning objectives that are central to PAG education and lists essential resources for learners' reference. This updated curriculum replaces the previous 2018 publication with added content, resources, and updated references.
PMID: 33810968
ISSN: 1873-4332
CID: 4851222
99. SIMULATED FIRST NIGHT-ONCALL (FNOC): ESTABLISHING COMMUNITY AND A CULTURE OF PATIENT SAFETY FOR INCOMING PEDIATRIC INTERNS [Meeting Abstract]
Famiglietti, H S; Phillips, D; Howell, H; Goonan, M; Coble, C; Zabar, S
Background: The transition from medical student to intern presents a major patient safety concern. Our institution implemented an immersive First Night OnCall (FNOC) simulation to support transitioning trainees and cultivate a culture of safety.
Objective(s): Engage pediatric interns in a pediatric focused FNOC simulation to ensure readiness to recognize and address common safety issues in practice.
Method(s): Interns were asked to recognize patient safety hazards in a simulated patient room and participate in case based safety discussions. Interns then participated in GOSCEs (Group Observed Standardized Clinical Encounters). GOSCEs tasked trainees to obtain informed consent, evaluate a decompensating patient, recognize a mislabeled culture bottle, and give an effective patient handoff. Faculty debriefed all activities. Learners completed pre and post program assessments and a program evaluation.
Result(s): Twenty incoming interns completed FNOC. Only 11% reported any prior formal training in patient safety. Interns recognized 46% of the environmental patient safety hazards. Out of the 5 GOSCE groups, 3 called a rapid response team, 3 noted the label error for the culture bottle, and 3 obtained complete informed consent. After FNOC, 92% of interns reported increased comfort (4 or 5 on 1-5 scale) in speaking to a supervisor, escalating a situation, and reporting a medical error. All interns agreed that the case based safety discussions and the patient safety room increased readiness for internship. Almost all of the interns (85%) agreed or strongly agreed that FNOC was an effective way to learn patient safety, a good approach to improve readiness, fun, and engaging.
Conclusion(s): Incoming interns are not consistently able to demonstrate common safety practices. Engaging, immersive, simulation based experiences like FNOC may reduce this variability, while simultaneously instilling aspirational institutional norms, promoting a culture of safety, and providing a framework for effective on-boarding strategies for new trainees.
Copyright
EMBASE:2002370111
ISSN: 1876-2867
CID: 4021172
41. THE EFFECT OF AN ACADEMIC HALF DAY CURRICULUM ON ITE SCORES AND RESIDENT SATISFACTION WITH BOARD PREPARATION [Meeting Abstract]
Chieco, D; Chen, X; Thabit, C; Kariuki, E; Goonan, M; Coble-Sadaphal, C; Famiglietti, H; Howell, H; Poitevien, P
Background: Resident didactics often occur during noon conferences. In 2017, the New York University School of Medicine Pediatric Residency Program transitioned from daily noon conferences to a weekly 3-hour Academic Half Day (AHD). While internal medicine residency programs have shown an association between AHD and higher in-training exam (ITE) scores1, the impact of AHD on pediatric resident ITE scores or satisfaction with preparation for the General Pediatric Board Exam is not well studied.
Objective(s): To investigate the impact of AHD on resident ITE scores and satisfaction with board preparation.
Method(s): We compared PGY2 raw ITE scores between the 2018 and 2019 graduating resident classes using a 2-sample t-test. We performed the same comparison for the PGY3 raw ITE scores. For the year between exams, the Class of 2018 received noon conferences, while the Class of 2019 received AHD. To assess resident satisfaction with board preparation, residents completed a survey prior to starting AHD and after 1 year. Satisfaction was reported on a Likert scale. Responses were categorized as "agree", "neutral", or "disagree" and analyzed with a chi-square test.
Result(s): There was no significant difference between the mean PGY2 ITE scores for the Class of 2018 (63.8 +/- 7.2) and 2019 (63.3 +/- 7.2) (p=0.8). The Class of 2019 had a significantly higher PGY3 ITE score (73.8 +/- 5.2) than the Class of 2018 (67.7 +/- 7.4) (p=0.01). When rating the statement "the current curriculum prepares me to take the boards", the percent of residents responding "agree" was 18% pre-AHD and 73% 1-year post-AHD. The association between initiation of AHD and satisfaction with exam preparation was statistically significant (X2=23.1, p<0.001).
Conclusion(s): The transition to an AHD had a positive impact on ITE scores and resident satisfaction with board preparation.
Copyright
EMBASE:2002370067
ISSN: 1876-2867
CID: 4021182
Case of a Girl with Vaginal Discharge Who Has Sex with Girls
Chapter by: Coble, Chanelle; Futterman, Donna
in: Adolescent gynecology : a clinical casebook by Talib, Hina J
[S.l.] : Springer International, 2018
pp. 127-136
ISBN: 9783319669779
CID: 2793662