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News Article | December 6, 2016

BUFFALO, N.Y. - Churches and other faith-based communities are an untapped resource that health-care providers should consider when suggesting treatment options for African-American and Latina mothers who have histories of postpartum depression (PPD), according to the findings of a newly published study by a University at Buffalo-led research team. "There is nothing ambiguous about it," said Robert Keefe, an associate professor in UB's School of Social Work and the paper's lead author. "Church, religion and spirituality really matter when it comes to treating mothers of color with PPD symptoms." Keefe's paper with Carol Brownstein-Evans, a professor in Nazareth College's Department of Social Work, and UB doctoral candidate Rebecca S. Rouland Polmanteer, published recently in the journal Mental Health, Religion & Culture, suggests an ongoing need for research and best practices that focus on working with nontraditional providers and how their services can be reimbursable under the Affordable Care Act (ACA). "Section 10212 of the ACA focuses on allowing the states to reimburse services provided by faith-based and other nontraditional organizations in collaboration with traditional health-care providers. The mechanism for how states will reimbursed the care hasn't been developed, so we're not sure how those nontraditional services will be reimbursed," said Keefe. "What we do know is that many new mothers of color have their faith communities to help them in relieving PPD, so we're hopeful that we can help health-care providers and faith-based organizations to work collaboratively to assist new mothers with PPD." Roughly 12 percent of new mothers in the general population are diagnosed with PPD, but for mothers of color the figure rises to about 38 percent. Compounding the more than three-fold difference is that women of color are less apt to use formal services and also feel less comfortable in their interactions with formal service providers. "What we have found in our research in general is the mothers' interactions with providers are more guarded when it comes to disclosing personal information about PPD. As a result, these mothers don't feel they're getting much from the services and have concerns whether traditional providers are sensitive to their needs," said Keefe. "It's no wonder we have higher rates of PPD and no wonder why we have worse treatment outcomes." The current study emerged from previous research on the ineffectiveness of formal interventions for PPD management in mothers of color. "When we began this study, we didn't anticipate that we would find so many mothers reporting how faith-based services were helpful to them," said Keefe. "These mothers tell us they get so much relief by going to church, and by participating in various faith-based or spiritual practices." The researchers interviewed 30 participants who had experienced PPD symptoms. All but three spoke of their faith definitely helping to overcoming the symptoms they were facing - and the others spoke of a need to start going to church. "As we began the interviews and began to hear the stories of faith and church we started talking with various pastors to ask, 'What do you make of this?'" said Keefe. The ministers said their churches provide structure through a formalized approach to their operations. In fact, many of the mothers talked about the difficulty they had structuring their lives because they have so many other things going on. "When they go into the church they have that structure and relationships with people who are willing to help and pastors who are willing to listen." said Keefe. "As one of the mothers said to us, 'I find peace there.'" The researchers developed and identified six specific themes based on their interviews: stress relief; feeling valued and less alone; experiencing gratitude; developing perspective; changing and developing relationships; preventing self-harm. "Some of the women talked of not wanting to wake up, but realized the church mattered and that they mattered as part of the church," said Keefe. "They hit a low point, but going to church, and engaging in prayer, meditation and listening to sermons or reading the church website, helped them to get going. There's a sense of community with churches and a willingness to pull people together that's so valuable, according to Keefe. It can be as simple as offering a ride, suggesting stores that offer credit or finding housing possibilities, things that traditional providers might not be aware of. It's an environment where people get what they need, but one that also allows them to give something back as well. "Sharing a social network has a lot of intrinsic reward," he said.

O'brien S.R.,Nazareth College | Xue Y.,University of Rochester
Disability and Rehabilitation | Year: 2014

Purpose: Few studies have investigated the ability of treatment teams to predict functional improvement and whether an association between predicted goals and discharge function in patients with stroke exists. This study investigated goal prediction during stroke rehabilitation delivered in inpatient rehabilitation facilities (IRF) and the factors associated with goal prediction. Methods: A serial, cross-sectional design analyzing the Medicare IRF Patient Assessment Instrument dataset. The sample included 179 479 admissions for stroke aged over 65 years in 968 IRFs. Generalized estimating equations (GEE) controlled for facility cluster effects were used for analysis of time trends for length of stay (LOS), predicted Functional Independence Measure (FIM) scores, discharge FIM scores and predicted-discharge difference FIM scores (goal FIM scores minus discharge FIM scores). GEE models were employed to determine the correlation between predicted FIM and discharge FIM scores and factors associated with goal achievement. Results: Mean LOS, predicted FIM scores and discharge FIM scores decreased 1.8 d, 2.2 points and 3.6 points, respectively, while predicted-discharge difference FIM scores increased 1.3 points. Discharge goals were not met 78.9% of the time. After controlling for patient characteristics, each predicted FIM point was associated with 0.6 discharge FIM points (p < 0.0001). Factors associated with not meeting or exceeding goals were: age (odds ratio; OR = 0.997), African Americans (OR = 0.905), number of comorbidities (OR = 0.970), number of complications (OR = 0.932) and right brain stroke (OR = 0.869). Factors associated with meeting or exceeding goals were: LOS (OR = 1.03), admission FIM score (OR = 1.02) and females (OR = 1.05). Conclusions: Trends for lower goals and lower discharge function occurred over time. A correlation existed between predicted FIM scores and discharge FIM scores. Patient factors were associated with goal achievement. © 2014 Informa UK Ltd.

O'Brien S.R.,Nazareth College | Xue Y.,University of Rochester
Physical Therapy | Year: 2016

Background. In the United States, people 85 years of age or older have a growing number of strokes each year, and this age group is most at risk for disability. Inpatient rehabilitation facilities (IRFs) adhere closest to post-acute stroke rehabilitation guidelines and have the most desirable outcomes compared with skilled nursing facilities. As stroke is one of the leading causes of disability, knowledge of postrehabilitation outcomes is needed for this age group, although at present such information is limited. Objective. The purpose of this study was to describe functional and discharge outcomes after IRF rehabilitation in people with stroke aged 85 years or older. Design. A serial, cross-sectional design was used. Methods. Inpatient Rehabilitation Facility–Patient Assessment Instrument data were analyzed beginning in 2002 for the first 5.5 years after implementation of the prospective payment system and included 71,652 cases. Discharge function, measured using the Functional Independence Measure (FIM), and community discharge were the discharge outcome measures. Sample description used frequencies and means. Generalized estimating equations (GEEs) with post hoc testing were used to analyze the annual trends for discharge FIM and community discharge by age group (85–89, 90–94, 95–99, and ≥ 100 years). Risk-adjusted linear and logistic GEE models, with control for cluster, were used to analyze the association between both outcome measures and age group. Results. Over 5.5 years, mean discharge FIM scores decreased by 3.6 points, and mean achievement of community discharge decreased 5.5%. Approximately 54% of the sample achieved community discharge. Continuous and logistic GEEs revealed factors associated with discharge outcomes. Limitations. Results obtained using an observational design should not be viewed as indicating causation. The lack of control for a caregiver may have altered results. Conclusions. The very elderly people admitted to IRF stroke rehabilitation made functional gains, and most were able to return to the community. © 2016 American Physical Therapy Association.

Riek L.M.,Nazareth College | Ludewig P.M.,University of Minnesota | Nawoczenski D.A.,Ithaca College
Journal of Rehabilitation Research and Development | Year: 2013

The purpose of the study was to determine whether wheelchair-based circuit resistance training (CRT) exercises place the shoulder at risk for mechanical impingement. Using a novel approach, we created a mechanical impingement risk score for each exercise by combining scapular and glenohumeral kinematic and exposure data. In a case series design, 18 individuals (25-76 yr old) with paraplegia and without substantial shoulder pain participated. The mean mechanical impingement risk scores at 45-60 degrees humerothoracic elevation were rank-ordered from lowest to highest risk as per subacromial mechanical impingement risk: overhead press (0.6 +/- 0.5 points), lat pulldown (1.2 +/- 0.5 points), chest press (2.4 +/- 2.8 points), row (2.7 +/- 1.6 points), and rickshaw (3.4 +/- 2.3 points). The mean mechanical impingement risk scores at 105-120 degrees humerothoracic elevation were rank-ordered from lowest to highest risk as per internal mechanical impingement risk: lat pulldown (1.2 +/- 0.5 points) and overhead press (1.3 +/- 0.5 points). In conclusion, mechanical impingement risk scores provided a mechanism to capture risk associated with CRT. The rickshaw had the highest subacromial mechanical risk, whereas the overhead press and lat pulldown had the highest internal mechanical impingement risk. The rickshaw was highlighted as the most concerning exercise because it had the greatest combination of magnitude and exposure corresponding with increased subacromial mechanical impingement risk.

Kinuthia J.N.,Nazareth College
2015 Americas Conference on Information Systems, AMCIS 2015 | Year: 2015

The purpose of this study was to determine the differences between organizations that adopted Cloud Enterprise Resource Planning (Cloud ERP) systems and organizations that did not adopt Cloud ERP systems based on the Technological, Organizational, and Environmental (TOE) factors. Using an online survey, data were collected from individuals throughout the United States of America who identified themselves as working in an Information Technology (IT) job. Analysis from 159 respondents indicated that all the proposed TOE factors were significant predictors of Cloud ERP systems. In comparison to organizations that did not adopt Cloud ERP systems, organizations that adopted Cloud ERP systems had the following characteristics: higher level of relative advantage, higher level of compatibility, higher level of security concern, higher top management support, higher level of organization readiness, bigger sizes, more centralized, more formalized, higher competitive pressure, and perceived Cloud ERP system vendors as offering more support.

Heavey E.,New York University | Maher M.D.,Nazareth College
Nursing | Year: 2015

Placental abruption, or detachment of the placenta from the uterine wall before delivery, can result in severe frank or concealed hemorrhage. This article describes the nurse's role in caring for a woman experiencing a severe placental abruption threatening the lives of mother and infant alike. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Hebert E.B.,Nazareth College
Focus on Autism and Other Developmental Disabilities | Year: 2014

Due to the numerous interventions available for children with autism, parents are faced with challenging decisions regarding treatments from the time of diagnosis and throughout their child's life. This exploratory qualitative study investigated the reasons behind parents' decisions about interventions for their child with autism. In-depth interviews were conducted with 23 parents from 18 families making decisions for 19 young children to understand their perspectives on deciding a philosophical approach, choosing a preschool program, and/or deciding on alternative treatments. Children had a diagnosis of pervasive developmental disorder not otherwise specified or autistic disorder and were below the age of 7 years. Parents' considerations were categorized into the themes of parental, child, and program attributes. Recommendations were made regarding areas to explore with families to provide support as they weigh the numerous options available. Recommendations for policy changes that could improve diagnostic and treatment services for children with autism and their families were discussed. © Hammill Institute on Disabilities 2014.

Matney B.,Nazareth College
Nordic Journal of Music Therapy | Year: 2015

People have used percussion instruments to promote health throughout history. Contemporary health practitioners have documented their use of percussion instruments. However, no comprehensive review of this discourse appears to exist in a peer-reviewed journal article. This content analysis study, examining international peer-reviewed literature regarding the use of percussion in therapy, aimed to better understand (a) how many articles, over time, have discussed the use of percussion in therapy; (b) what types of articles were written; (c) what instruments were used; (d) with what populations was percussion used; (e) how percussion was used in therapy; and (f) why percussion was used in therapy. Results suggest an increased interest in the use of percussion for health over time. Investigators have studied percussion use with a broad range of populations, using a variety of research methodologies. The analysis includes categories of therapeutic application and therapeutic function in order to highlight trends in the literature. An intercoder reliability check of 10% of studies suggested acceptable percentage agreement regarding article types, populations, and instrumentation. Recommendations for future research, training, and practice based on instrumentation use, therapeutic applications, and therapeutic functions are offered. © 2015 GAMUT – The Grieg Academy Music Therapy Research Centre

Ek B.,Rochester Institute of Technology | Verschneider C.,Nazareth College | Narayan D.A.,Rochester Institute of Technology
Physica A: Statistical Mechanics and its Applications | Year: 2013

The distance d(i,j) between any two vertices i and j in a graph is the number of edges in a shortest path between i and j. If there is no path connecting i and j, then d(i,j)=∞. In 2001, Latora and Marchiori introduced the measure of efficiency between vertices in a graph (Latora and Marchiori, 2001) [1]. The efficiency between two vertices i and j is defined to be â̂̂i,j=j. In this paper, we investigate the efficiency of star-like networks, and show that networks of this type have a high level of efficiency. We apply these ideas to an analysis of the Metropolitan Atlanta Rapid Transit Authority (MARTA) Subway system, and show this network is 82% as efficient as a network where there is a direct line between every pair of stations. © 2013 Elsevier B.V. All rights reserved.

Mariappan E.,Nazareth College | Paramasivan B.,National Engineering College
International Journal of Soft Computing | Year: 2015

Wireless Sensor Networks (WSNs) consists of distributed autonomous sensors without central base controller to monitor environmental conditions. Scalability, energy efficiency, network lifetime and load balancing are important issues in sensor network applications. Clustering and energy efficient routing is an effective technique for achieving above cited issues. This study proposed an Energy Efficient Cluster based Transmission Protocol (ECTP) which uses the report sensing mechanism through the sink with the help of link aware sensory network to improve network lifetime and energy saving. The report generation can be done with the subsidiary analysis of efficient scaling and dynamic Clustering algorithm. In this study, Broadcast Incremental Power algorithm (BIP) is used to find the minimum power tree from the source node for achieving energy efficient broadcasting in the network. It is a sensible methodology to predict the energy efficient and modulated routing path. The transmitted packet delivery ratio and latency outrages the sequential analysis of the cluster path and route navigations. The qualification of cluster head election predominate the route discovery mechanism. The ECTP protocol determines the optimal path for determining the cluster head and route navigation with best path approaches. The ECTP significantly outperforms the energy aware cluster and LEACH. This approach also compared of various network parameters is done with various clustering protocols. Simulation results have shown that ECTP give better performance than other protocols like LEACH and EC in terms of prolong network lifetime and energy efficiency. © Medwell Journals, 2015.

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