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Hepatitis C (HCV) care cascades have been described in diverse clinical settings, patient populations and countries, highlighting the steps in HCV care where improvements can be made and resources allocated. However, more research is needed to examine barriers to HCV treatment in rural, underserved populations and in Federally Qualified Health Centers (FQHCs). As part of a quality improvement (QI) project, this study aimed to describe and evaluate the HCV treatment cascade in an FQHC serving a large rural patient population in the Western United States. Standardized chart abstraction was utilized to aggregate data regarding patient demographics, the percentage of patients achieving each step in the treatment cascade, and relevant patient (i.e., viral load) and service variables (i.e., whether and when patients received treatment or medication). 389 patients were identified as having HCV and 86% were aware of their diagnosis. Fifty-five percent had their infection confirmed via viral load, 21% were staged for liver disease, 24% received a prescription for treatment, and 19% achieved cure. Compared to national data, the current regional sample had greater rates of diagnosis awareness and access to care, as well as sustained virologic response (SVR), but lower rates of viral load confirmation. Current findings suggest that rural patients living with HCV who receive care at FQHCs struggle to navigate the treatment cascade and achieve a cure, particularly with regard to infection confirmation, liver staging, and prescription. However, compared to national estimates, patients had greater rates of diagnosis awareness/treatment access and SVR.

Date Presented 03/26/20 The influence of infant equipment (walkers, jumpers, exersaucers, high chairs, etc.) use on early motor development is unclear. The results of this study suggest that greater use of equipment during infancy is related to fewer motor behaviors that represent developmentally important milestones. OT is well positioned to provide caregivers and their infants with resources to help establish habits and routines that support motor development through occupational engagement. Primary Author and Speaker: Bryan Gee Contributing Authors: Hillary Swann, Nicki Aubuchon-Endsley, Michele Brumley

Date Presented 03/28/20 The findings from this cohort of infants and toddlers are similar to the scores of the foundational or national sample within the SP2 manual and may represent increased measurement reliability of typically developing infants and toddlers. Additionally, caregiver perceptions of their child’s sensory processing may be consistent across time as the infant or toddler develops. Primary Author and Speaker: Bryan Gee Additional Authors and Speakers: Tyler Holloway, Nicole Zovi-Kammerman Contributing Authors: Nicki Aubuchon-Endsley, Abby Prow

This study is the first report examining the relationship between pretreatment expectancy and treatment outcome in Osage Native Americans receiving mental health services. Results reveal that in Na...

Background Most research on women veterans' mental health has focused on postraumatic stress disorder (PTSD) or reactions to military sexual trauma. Although depression is also a frequent diagnosis among women veterans, little is known about its characteristics, including comorbid conditions and patterns of disorder onset. We investigated lifetime diagnoses of major depressive disorder (MDD) and comorbid conditions in a primarily treatment-seeking research sample of male and female veterans to determine frequency of lifetime MDD, comorbid disorders and their temporal onset. Method The 1700 veterans (346 women; 1354 men) completed diagnostic interviews as participants in a research registry. Rates of and gender differences in lifetime MDD and comorbid conditions (PTSD, other anxiety disorders, substance use and eating disorders) were calculated. We assessed the percentage of cases in which MDD preceded the comorbid condition (primary onset MDD). Results Lifetime MDD was frequent in this sample, and significantly more common in women (46.5%) than in men (36.3%). Gender differences in comorbidity were found for anxiety and eating disorders (more common in women); and for alcohol and nicotine use disorders (more common in men). However, primary onset MDD was no more common among women than among men, and was in neither case the predominant pattern of comorbid lifetime disorder onset. Limitations The sample is not representative of all veterans, and lifetime diagnoses were based on retrospective recall. Conclusions MDD usually follows the onset of other comorbid disorders among women veterans, indicating the need to assess for earlier lifetime disorders in veterans with MDD.

Several recent studies have supported relations between infant behaviour (alertness and responsiveness) and nutrition in addition to investigating infant behaviour within the context of changes in iron status over time. Existing research is typically limited to the investigation of the effects of a single vitamin or mineral, and no studies have been found that examined the influence that early alertness and responsiveness have on growth in early infancy, despite the fact that relations between behaviour and nutritional status may be bidirectional. The current study used a sample of Ethiopian infants and investigated anthropometrics, haemoglobin, the frequency of alertness and the frequency of responsiveness at 6 and 9 months of age. Six-month weight-for-age predicted 9-month frequency of alertness, while 6-month haemoglobin predicted 9-month frequency of responsiveness. Compared with responsive infants, non-responsive infants at 6 months remained more non-responsive at 9 months, although weight-for-age for both groups converged at 9 months. Results support relations between nutrition and behaviour (alertness and responsiveness) and provide evidence of a potentially useful tool (the Laboratory Temperament Assessment Battery) that was adapted to evaluate these relations in Ethiopia.

Background As breastfeeding duration increases, it is important to understand diets of breastfeeding women and other factors salient to maternal/offspring health, including stress. It is important to further consider sociodemographic factors, given their associations with nutritional deficiencies and perceived stress. Objective We cross-sectionally compared breastfeeding women's dietary intakes from a food frequency questionnaire (assessing from pregnancy through 3 months postpartum) with Estimated Average Requirements (EARs). We hypothesized that dietary intake was related to sociodemographic variables and parenting stress. Design We examined a cohort of predominately breastfeeding women. Food frequency questionnaire results were compared with EARs, the Parenting Stress Index: Short Form, and a demographic questionnaire. Participants/setting Participants included 101 women (of 289 recruited) who breastfed singleton, full-term infants for the first 3 months while using Statistical analyses Mean and standard deviation or frequencies were reported. One-sample t tests compared EARs with mean dietary intakes over the past 12 months. Pearson correlations and one-way analyses of variance explored relationships among dietary, sociodemographic, and stress variables. Results Twenty-two percent of women did not meet EAR minimum energy recommendations and >40% did not meet protein recommendations. Despite widespread supplement use, some consumed less than the EAR for vitamin E (35%), calcium (22%), and vitamin C (19%). Carbohydrate consumption was positively related to the difficult child scale ( r =0.19; P =0.05). Dietary riboflavin ( r =–0.19; P =0.05) and vitamin D intake ( r =–0.19; P =0.05) were negatively related to the parent–child dysfunction scale. Conclusions Despite efforts to enhance education and counseling regarding adequate perinatal nutrition-related practices, even well-educated women may not meet EARs. This poor dietary intake may be associated with parenting stress and have potential long-term implications for child health.

Maternal weight before and during pregnancy is associated with offspring neurobehaviour in childhood. We investigated maternal weight prior to and during pregnancy in relation to neonatal neurobehaviour. We hypothesized that maternal obesity and excessive gestational weight gain would be associated with poor neonatal attention and affective functioning. Participants (n = 261) were recruited, weighed and interviewed during their third trimester of pregnancy. Pre-pregnancy weight was self-reported and validated for 210 participants, with robust agreement with medical chart review (r = 0.99). Neurobehaviour was measured with the NICU Network Neurobehavioural Scale (NNNS) administered on Days 2 and 32 postpartum. Maternal exclusion criteria included severe or persistent physical or mental health conditions (e.g. chronic disease or diagnoses of Bipolar Disorder or Psychotic Spectrum Disorders), excessive substance use, and social service/foster care involvement or difficulty understanding English. Infants were from singleton, full-term (37-42 weeks gestation) births with no major medical concerns. Outcome variables were summary scores on the NNNS (n = 75-86). For women obese prior to pregnancy, those gaining in excess of Institute of Medicine guidelines had infants with poorer regulation, lower arousal and higher lethargy. There were no main effects of maternal pre-pregnancy body mass index on neurobehaviour. Women gaining above Institute of Medicine recommendations had neonates with better quality of movement. Additional studies to replicate and extend results past the neonatal period are needed. Results could support underlying mechanisms explaining associations between maternal perinatal weight and offspring outcomes. These mechanisms may inform future prevention/intervention strategies. © 2016 Blackwell Publishing Ltd.

Purpose was to identify correlates of amount of formula fed to 9 mo infants who had been predominantly breastfed at 3 mo. Participants were 117 mothers and infants (68 female, 49 male) weighed and ...