Amy Alexander

All Publications

• The Impact of Paid Maternity Leave on the Mental and Physical Health of Mothers and Children: A Review of the Literature and Policy Implications. Harvard review of psychiatry Van Niel, M. S., Bhatia, R., Riano, N. S., de Faria, L., Catapano-Friedman, L., Ravven, S., Weissman, B., Nzodom, C., Alexander, A., Budde, K., Mangurian, C. ; 28 (2): 113?26

  Abstract

  For decades, national paid maternity leave policies of 12 weeks or more have been established in every industrialized country except the United States. Despite women representing 47% of the current U.S. labor force, only 16% of all employed American workers have access to paid parental leave through their workplace. As many as 23% of employed mothers return to work within ten days of giving birth, because of their inability to pay living expenses without income. We reviewed recent studies on the possible effects of paid maternity leave on the mental and physical health of mothers and children. We found that paid maternity leave is associated with beneficial effects on (1) the mental health of mothers and children, including a decrease in postpartum maternal depression and intimate partner violence, and improved infant attachment and child development, (2) the physical health of mothers and children, including a decrease in infant mortality and in mother and infant rehospitalizations, and an increase in pediatric visit attendance and timely administration of infant immunizations, and (3) breastfeeding, with an increase in its initiation and duration. Given the substantial mental and physical health benefits associated with paid leave, as well as favorable results from studies on its economic impact, the United States is facing a clear, evidence-based mandate to create a national paid maternity leave policy. We recommend a national paid maternity leave policy of at least 12 weeks.

  View details for DOI 10.1097/HRP.0000000000000246

  View details for PubMedID 32134836

• Psychiatric complications of treatment with corticosteroids: Review with case report PSYCHIATRY AND CLINICAL NEUROSCIENCES Kenna, H. A., Poon, A. W., de los Angeles, C. P., Koran, L. M. 2011; 65 (6): 549-560

  Abstract

  Corticosteroids are widely used in modern medicine but can result in troubling psychiatric side-effects. Physicians and other medical professionals should be aware of the potential for these side-effects, possible means of prevention, and efficacious treatments. Herein, we review adult case report data published during the past quarter-century on adverse corticosteroid-induced psychiatric effects, and present a case of corticosteroid-induced psychotic depression. PubMed and PsychLit databases were searched using the terms 'corticosteroids', 'steroids', and the generic names of corticosteroid medications with terms for psychiatric symptoms or syndromes, including psychosis, mania, hypomania, depression, apathy, anxiety, panic, depersonalization, delirium, confusion, hallucinations, delusions, paranoia, cognitive impairment and dementia. Fifty-five cases and a number of clinical trials investigating the incidence and treatment of these psychiatric symptoms and syndromes were identified. Data on incidence, drug dose, risk factors, course of illness and treatment (when present) were tabulated. We conclude that the cumulative data indicate that psychiatric complications of corticosteroid treatment are not rare and range from clinically significant anxiety and insomnia, to severe mood and psychotic disorders, delirium and dementia. While tapering or discontinuation of the corticosteroid treatment may remedy these adverse side-effects, psychotropic medications are often required because of the medical necessity of the corticosteroid or the severity of the psychiatric symptom. Further studies are needed to better understand the deleterious psychiatric effects associated with corticosteroids.

  View details for DOI 10.1111/j.1440-1819.2011.02260.x

  View details for Web of Science ID 000296045500002

  View details for PubMedID 22003987

• Cultural competence: Serving Latino patients JOURNAL OF PEDIATRIC ORTHOPAEDICS Poon, A. W., Gray, K. V., Franco, G. C., Cerruti, D. M., Schreck, M. A., Delgado, E. D. 2003; 23 (4): 546-549

  Abstract

  Culturally competent strategies are necessary as populations in many countries become increasingly diverse. In the United States, Latinos are the fastest-growing minority group. In this study, the authors interviewed Latino patients and families, collected demographics from 570 patients in pediatric orthopedic practices in California, and conducted population census and literature reviews. Based on these sources of information, the authors identified barriers to health care for Latino pediatric orthopedic patients and propose culturally competent strategies to overcome these barriers. This approach can be applied to other populations so that culturally competent care is available to patients from all ethnic, racial, and cultural backgrounds.

  View details for Web of Science ID 000183819100024

  View details for PubMedID 12826958