Publications by authors named "Ellen OʼDonnell"

12 Publications

  • Page 1 of 1

Measuring the Impact of Burn Injury on the Parent-Reported Health Outcomes of Children 1 to 5 Years: A Conceptual Framework for Development of the Preschool Life Impact Burn Recovery Evaluation Profile CAT.

J Burn Care Res 2020 01;41(1):84-94

Shriners Hospitals for Children-Boston, Massachusetts.

Due to the rapid developmental growth in preschool-aged children, more precise measurement of the effects of burns on child health outcomes is needed. Expanding upon the Shriners Hospitals for Children/American Burn Association Burn Outcome Questionnaire 0 to 5 (BOQ0-5), we developed a conceptual framework describing domains important in assessing recovery from burn injury among preschool-aged children (1-5 years). We developed a working conceptual framework based on the BOQ0-5, the National Research Council and Institute of Medicine's Model of Child Health, and the World Health Organization's International Classification of Functioning, Disability, and Health for Children and Youth. We iteratively refined our framework based on a literature review, focus groups, interviews, and expert consensus meetings. Data were qualitatively analyzed using methods informed by grounded theory. We reviewed 95 pediatric assessments, conducted two clinician focus groups and six parent interviews, and consulted with 23 clinician experts. Three child health outcome domains emerged from our analysis: symptoms, functioning, and family. The symptoms domain describes parents' perceptions of their child's pain, skin-related discomfort, and fatigue. The functioning domain describes children's physical functioning (gross and fine motor function), psychological functioning (internalizing, externalizing, and dysregulation behavior; trauma; toileting; resilience), communication and language development (receiving and producing meaning), and social functioning (connecting with family/peers, friendships, and play). The family domain describes family psychological and routine functioning outcomes.
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http://dx.doi.org/10.1093/jbcr/irz110DOI Listing
January 2020

Competency-based Professional Advancement Model for Advanced Practice RNs.

J Nurs Adm 2019 Feb;49(2):66-72

Author Affiliations: Nurse Practitioner (Dr Paul), Center for Motility and Functional Gastrointestinal Disorders; Clinical Nurse Specialist (Ms Abecassis), Medical Intensive Care; Clinical Nurse Specialist (Ms Freiberger), Pulmonary/Pediatric Transplant Center; Clinical Nurse Specialist (Ms Hamilton), Medical Surgical Intensive Care; Nurse Practitioner (Ms Kelly), Urology and Urodynamics; Clinical Nurse Specialist (Ms Klements), Asthma and Medicine Patient Services; Nurse Practitioner (Dr LaGrasta), Cardiovascular Surgical Services; Nurse Practitioner (Mss Lemire, O'Donnell, and Phinney), General Surgery; Nurse Practitioner (Ms Patisteas), Orthopedic Surgery; Professional Development Specialist (Ms Conwell), Clinical Education and Informatics; Nurse Practitioner (Dr Saia), Cardiology; Nurse Practitioner (Ms Whelan), Cardiac Intensive Care; Senior VP, Patient Care Operations and Chief Nursing Officer (Dr Wood); and Nurse Practitioner (Ms O'Brien), Cardiology: Boston Children's Hospital, Massachusetts.

The process of developing a 3-tiered advanced practice RN (APRN) competency-based professional advancement model at Boston Children's Hospital is described. The model recognizes the contributions of entry-level and expert APRNs to advanced clinical practice and outcomes, impact, and leadership, while incorporating the tenets of Patricia Benner's Novice to Expert Model and the American Association of Critical- Care Nurses Synergy Model of Care.
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http://dx.doi.org/10.1097/NNA.0000000000000719DOI Listing
February 2019

Cross-Disorder Cognitive Impairments in Youth Referred for Neuropsychiatric Evaluation.

J Int Neuropsychol Soc 2018 01 4;24(1):91-103. Epub 2017 Aug 4.

1Department of Psychiatry,Massachusetts General Hospital,Boston,Massachusetts.

Objectives: Studies suggest that impairments in some of the same domains of cognition occur in different neuropsychiatric conditions, including those known to share genetic liability. Yet, direct, multi-disorder cognitive comparisons are limited, and it remains unclear whether overlapping deficits are due to comorbidity. We aimed to extend the literature by examining cognition across different neuropsychiatric conditions and addressing comorbidity.

Methods: Subjects were 486 youth consecutively referred for neuropsychiatric evaluation and enrolled in the Longitudinal Study of Genetic Influences on Cognition. First, we assessed general ability, reaction time variability (RTV), and aspects of executive functions (EFs) in youth with non-comorbid forms of attention-deficit/hyperactivity disorder (ADHD), mood disorders and autism spectrum disorder (ASD), as well as in youth with psychosis. Second, we determined the impact of comorbid ADHD on cognition in youth with ASD and mood disorders.

Results: For EFs (working memory, inhibition, and shifting/ flexibility), we observed weaknesses in all diagnostic groups when participants' own ability was the referent. Decrements were subtle in relation to published normative data. For RTV, weaknesses emerged in youth with ADHD and mood disorders, but trend-level results could not rule out decrements in other conditions. Comorbidity with ADHD did not impact the pattern of weaknesses for youth with ASD or mood disorders but increased the magnitude of the decrement in those with mood disorders.

Conclusions: Youth with ADHD, mood disorders, ASD, and psychosis show EF weaknesses that are not due to comorbidity. Whether such cognitive difficulties reflect genetic liability shared among these conditions requires further study. (JINS, 2018, 24, 91-103).
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http://dx.doi.org/10.1017/S1355617717000601DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789455PMC
January 2018

Maternal Social Information Processing and the Frequency and Severity of Mother-Perpetrated Physical Abuse.

Child Maltreat 2016 Nov 19;21(4):308-316. Epub 2016 Sep 19.

5 Clark University, Worcester, MA, USA.

The frequency and severity of physical abuse influences children's outcomes, yet little theory-based research has explored what predicts its course. This study examined the potential role of social information processing (SIP) factors in the course of abuse. Mothers with histories of perpetrating physical abuse ( N = 62) completed measures of SIP, and the frequency and severity of mother-perpetrated physical abuse were collected from Child Protection Services records. Poorer problem-solving capacities were significantly related to greater frequency of physical abuse. Hostile attributions toward children were positively associated with abuse severity. Controlling for demographics and co-occurrence of neglect, SIP factors together accounted for a significant proportion of variance in the frequency of physical abuse, but not severity. With the exception of unrealistic expectations, preliminary evidence supported a link between maternal SIP and the course of abuse perpetration. Future research directions and implications for intervention are discussed.
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http://dx.doi.org/10.1177/1077559516668047DOI Listing
November 2016

Extending the 'cross-disorder' relevance of executive functions to dimensional neuropsychiatric traits in youth.

J Child Psychol Psychiatry 2016 Apr 28;57(4):462-71. Epub 2015 Sep 28.

Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.

Background: Evidence that different neuropsychiatric conditions share genetic liability has increased interest in phenotypes with 'cross-disorder' relevance, as they may contribute to revised models of psychopathology. Cognition is a promising construct for study; yet, evidence that the same cognitive functions are impaired across different forms of psychopathology comes primarily from separate studies of individual categorical diagnoses versus controls. Given growing support for dimensional models that cut across traditional diagnostic boundaries, we aimed to determine, within a single cohort, whether performance on measures of executive functions (EFs) predicted dimensions of different psychopathological conditions known to share genetic liability.

Methods: Data are from 393 participants, ages 8-17, consecutively enrolled in the Longitudinal Study of Genetic Influences on Cognition (LOGIC). This project is conducting deep phenotyping and genomic analyses in youth referred for neuropsychiatric evaluation. Using structural equation modeling, we examined whether EFs predicted variation in core dimensions of the autism spectrum disorder, bipolar illness, and schizophrenia (including social responsiveness, mania/emotion regulation, and positive symptoms of psychosis, respectively).

Results: We modeled three cognitive factors (working memory, shifting, and executive processing speed) that loaded on a second-order EF factor. The EF factor predicted variation in our three target traits, but not in a negative control (somatization). Moreover, this EF factor was primarily associated with the overlapping (rather than unique) variance across the three outcome measures, suggesting that it related to a general increase in psychopathology symptoms across those dimensions.

Conclusions: Findings extend support for the relevance of cognition to neuropsychiatric conditions that share underlying genetic risk. They suggest that higher-order cognition, including EFs, relates to the dimensional spectrum of each of these disorders and not just the clinical diagnoses. Moreover, results have implications for bottom-up models linking genes, cognition, and a general psychopathology liability.
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http://dx.doi.org/10.1111/jcpp.12463DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876048PMC
April 2016

Cognitive and patient-reported outcomes in adults with pediatric-onset multiple sclerosis.

Mult Scler 2016 Mar 3;22(3):354-61. Epub 2015 Jun 3.

Partners Multiple Sclerosis Center, Brigham and Women's Hospital, USA

Background: Little is known about long-term cognitive and patient-reported outcomes of pediatric-onset multiple sclerosis (POMS).

Objective: The objective of this paper is to compare cognitive and patient-reported outcomes in adults with POMS vs. adult-onset MS (AOMS).

Methods: We compared standardized patient-reported measures MSQOL54, MFIS, CES-D and SDMT in adult patients with MS onset prior to and after age 18, using data gathered in the Comprehensive Longitudinal Investigations in MS at Brigham and Women's Hospital (CLIMB) study.

Results: Fifty-one POMS and 550 AOMS patients were compared. SDMT scores were significantly lower in POMS after adjusting for age (-7.57 (-11.72, -3.43; p < 0.001), but not after adjusting for disease duration. Estimated group difference demonstrated lower normative z scores in POMS vs. AOMS in unadjusted analysis (-0.74 (95% CI: -1.18, -0.30; p = 0.0009) and after adjusting for disease duration (-0.60; 95%CI: -1.05, -0.15; p = 0.0097). Findings were unchanged in a subset of POMS diagnosed prior to age 18. In unadjusted and adjusted analyses, no significant differences were observed in health-related quality-of-life, fatigue, depression or social support between POMS and AOMS.

Conclusions: Younger age of onset was associated with more impairment in information-processing speed in adults with POMS compared to AOMS, and remained significant when controlling for disease duration in age-normed analysis. The two groups were similar in terms of patient-reported outcomes, suggesting similar qualitative experiences of MS.
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http://dx.doi.org/10.1177/1352458515588781DOI Listing
March 2016

Teen Advisory Committee: lessons learned by adolescents, facilitators, and hospital staff.

Pediatr Nurs 2014 Nov-Dec;40(6):289-96

The Teen Advisory Committee (TAC), Boston Children's Hospital (BCH), began in 2002 and has been meeting monthly since that time. The top lessons learned by adolescents, committee facilitators, and hospital staff incorporate principles of adolescent development, joint decision-making, and a respect and commitment to patient and family-centered care. The program addresses the unique needs of teens with chronic illness from their perspective through special projects that have led to the development of hospital policies, procedures, and quality improvement initiatives. The discussion of the framework of the TAC and lessons learned are intended to support youth-driven initiatives and models for improvement at children's hospitals nationally.
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May 2015

Depressive symptoms in low-income, urban adolescents: cognitive and contextual factors.

J Prev Interv Community 2014 ;42(3):183-95

a Frances L. Hiatt School of Psychology , Clark University , Worcester , Massachusetts , USA.

This study examined the relationships among cognitive variables, family immigration history, negative life events, and depressive symptoms in a sample of 306 low-income, urban fifth- and sixth-grade children. Explanatory style and negative automatic thoughts were the cognitive variables examined. There were three key findings. First, children who were immigrants reported significantly more depressive symptoms, more negative life events, and more negative automatic thoughts than children who were not immigrants. Second, both explanatory style and negative automatic thoughts were significantly associated with depressive symptoms above and beyond the effects of child immigration history and negative life events. Finally, negative automatic thoughts mediated the relationship between child immigration history and depressive symptoms. We discuss the clinical and research implications of these findings.
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http://dx.doi.org/10.1080/10852352.2014.916575DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113720PMC
April 2015

Cognitive impairment occurs in children and adolescents with multiple sclerosis: results from a United States network.

J Child Neurol 2013 Jan 15;28(1):102-7. Epub 2012 Nov 15.

Department of Neuropsychology, University of California San Francisco, San Francisco, CA, USA.

In the largest sample studied to date, we measured cognitive functioning in children and adolescents with pediatric multiple sclerosis (n = 187) as well as those with clinically isolated syndrome (n = 44). Participants were consecutively enrolled from six United States Pediatric Multiple Sclerosis Centers of Excellence. Participants had a mean of 14.8 ± 2.6 years of age and an average disease duration of 1.9 ± 2.2 years. A total of 65 (35%) children with multiple sclerosis and 8 (18%) with clinically isolated syndrome met criteria for cognitive impairment. The most frequent areas involved were fine motor coordination (54%), visuomotor integration (50%), and speeded information processing (35%). A diagnosis of multiple sclerosis (odds ratio = 3.60, confidence interval = 1.07, 12.36, P = .04) and overall neurologic disability (odds ratio = 1.47, confidence interval = 1.10, 2.10, P = .03) were the only independent predictors of cognitive impairment. Cognitive impairment may occur early in these patients, and prompt recognition is critical for their care.
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http://dx.doi.org/10.1177/0883073812464816DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652651PMC
January 2013

Interparental conflict, parenting, and childhood depression in a diverse urban population: the role of general cognitive style.

J Youth Adolesc 2010 Jan 6;39(1):12-22. Epub 2008 Nov 6.

Clark University, Worcester, MA, USA.

Research on the mechanisms by which interparental conflict (IPC) affects child depression suggests that both parenting and children's conflict appraisals play important roles, but few studies have explored the role of general cognitive style or included both parenting and cognitions in the same design. Moreover, the effects of IPC on minority children are not well understood. In this longitudinal study, parenting was examined as a mediator of the relation between increasing IPC and change in depression. General cognitive style was included as a moderator. The combined influence of parenting and cognitions was also explored. A racially and ethnically diverse sample of 88 fifth and sixth graders from two urban schools reported their cognitive style, depressive symptoms, and perceptions of conflict and parenting at two time points separated by one year. Parental warmth/rejection mediated the relation between IPC and depression, and general cognitive style acted as a moderator. Parenting, cognitive style, and IPC did not significantly interact to predict change in depression over time. Findings indicate that both parenting and children's general cognitive style play a role in understanding the impact of increasing IPC on children's well-being.
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http://dx.doi.org/10.1007/s10964-008-9357-9DOI Listing
January 2010

Self-esteem in pure bullies and bully/victims: a longitudinal analysis.

J Interpers Violence 2010 Aug 29;25(8):1489-502. Epub 2009 Dec 29.

Frances L. Hiatt School of Psychology, Clark University, 950 Main Street, Worcester, MA 01610, USA.

Past research on the self-esteem of bullies has produced equivocal results. Recent studies have suggested that the inconsistent findings may be due, in part, to the failure to account for bully/victims: those children who both bully and are victims of bullying. In this longitudinal study, we examined the distinctions among pure bullies, pure victims, bully/victims, and noninvolved children in a sample of 307 middle school students. Analyses of cross-sectional and longitudinal results supported the importance of distinguishing between pure bullies and bully/victims. In addition, results revealed some interesting sex differences: girls in the pure bully and bully/victim groups reported significant increases in self-esteem over time, with girls in the pure bully group reporting the greatest increase, whereas boys in these groups reported no significant changes in self-esteem over time.
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http://dx.doi.org/10.1177/0886260509354579DOI Listing
August 2010

Inpatient surgical bowel preps: making them work.

J Pediatr Nurs 2007 Jun;22(3):245-50

Nurse Practitioner Surgical Programs, Children's Hospital Boston, Boston, MA 02115, USA.

This article will describe the evidence-based approach our hospital developed to best prepare children for abdominal surgery. Our evidence-based interdisciplinary approach was based on the work of [McCallin, A. (2001). Interdisciplinary practice--A matter of teamwork: An integrated literature review. Journal of Clinical Nursing, 10, 419-428], [Melnyk, B. M. (2002). Evidence-based practice. Strategies for overcoming barriers in implementing evidence-based practice. Pediatric Nursing, 28, 159-161], [Melnyk, B. M., & Fineout-Overholt, E. (2002). Evidence-based practice. Key steps in implementing evidence-based practice: Asking compelling, searchable questions and searching for the best evidence. Pediatric Nursing, 28, 262-266], [Sierchio, G. P. (2003). A multidisciplinary approach for improving outcomes. Journal of Infusion Nursing, 26, 34-43], and [Wojner, A. W. (1996). Outcomes management: An interdisciplinary search for best practice. AACN Clinical Issues, 7, 133-145]. At our hospital, a leading children's hospital in an eastern urban setting, we surgically manage children, from newborns to young adults, with a variety of diagnoses. These diagnoses include the following: inflammatory bowel diseases, such as Crohn's disease and UC, imperforate anus, necrotizing enterocolitis, and abdominal tumors. The bowel prep is an integral part of these children's surgical preparation.
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http://dx.doi.org/10.1016/j.pedn.2006.09.002DOI Listing
June 2007