Publications by authors named "Nicole Fledderman"

3 Publications

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Integrated Behavioral Health: Definitions and Contexts.

Pediatr Clin North Am 2021 Jun;68(3):511-518

Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA.

Most children and adolescents with behavioral and mental health concerns first present to their pediatricians. Although pediatricians are fully cognizant of the importance of addressing behavioral and mental health concerns, they often find it difficult to deliver such care effectively and efficiently within a typical practice setting. Integration of medical and behavioral health care has emerged as a model to deliver such care. In the pediatric primary care practice, integrated behavioral health has been shown to be a cost-effective way to deliver high-quality care. This article describes basic definitions and contexts of integrated pediatric behavioral health.
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http://dx.doi.org/10.1016/j.pcl.2021.02.007DOI Listing
June 2021

An Ethical Framework to Manage Patient Requests for Medical Marijuana.

J Am Board Fam Med 2020 Jan-Feb;33(1):147-151

From the Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI.

An increasing number of states are legalizing marijuana use for medicinal purposes despite marijuana use remaining criminalized at the federal level and continued Schedule I status by the US Food and Drug Administration. Many of those states in which medical marijuana is legal require physician involvement to facilitate patient access. In addition, physicians may have ethical objections to medical marijuana use or may not believe there is adequate scientific evidence to support its use. The constellation of these factors creates an ethical quandary for physicians when approached by patients for assistance in accessing medical marijuana. This article provides an ethical framework that provides guidance to physicians in managing these patient requests taking into consideration the above ethically relevant factors.
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http://dx.doi.org/10.3122/jabfm.2020.01.190216DOI Listing
April 2021

Complex and non-redundant signals from individual odor receptors that underlie chemotaxis behavior in Drosophila melanogaster larvae.

Biol Open 2014 Sep 19;3(10):947-57. Epub 2014 Sep 19.

Department of Biological Sciences, Dominican University, 7900 West Division Street, Parmer Hall 244, River Forest, IL 60305, USA

The rules by which odor receptors encode odors and allow behavior are still largely unexplored. Although large data sets of electrophysiological responses of receptors to odors have been generated, few hypotheses have been tested with behavioral assays. We use a data set on odor responses of Drosophila larval odor receptors coupled with chemotaxis behavioral assays to examine rules of odor coding. Using mutants of odor receptors, we have found that odor receptors with similar electrophysiological responses to odors across concentrations play non-redundant roles in odor coding at specific odor concentrations. We have also found that high affinity receptors for odors determine behavioral response thresholds, but the rules for determining peak behavioral responses are more complex. While receptor mutants typically show loss of attraction to odors, some receptor mutants result in increased attraction at specific odor concentrations. The odor receptor mutants were rescued using transgenic expression of odor receptors, validating assignment of phenotypes to the alleles. Vapor pressures alone cannot fully explain behavior in our assay. Finally, some odors that did not elicit strong electrophysiological responses are associated with behavioral phenotypes upon examination of odor receptor mutants. This result is consistent with the role of sensory neurons in lateral inhibition via local interneurons in the antennal lobe. Taken together, our results suggest a complexity of odor coding rules even in a simple olfactory sensory system.
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http://dx.doi.org/10.1242/bio.20148573DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197443PMC
September 2014