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Mental and Social Health

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2023

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Articles 1 - 30 of 96

Full-Text Articles in Medicine and Health Sciences

Modeling, Analysis, And Simulation Of High School Student Mental Health Using Compartmental Models And Physics Informed Neural Networks, Sashwat Ravishankar, Padmanabhan Seshaiyer Nov 2023

Modeling, Analysis, And Simulation Of High School Student Mental Health Using Compartmental Models And Physics Informed Neural Networks, Sashwat Ravishankar, Padmanabhan Seshaiyer

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.


The Double Edged Sword Of The Pandemic: Exploring Associations Between Covid-19 And Social Isolation In The Usa, Alexander Fulk Nov 2023

The Double Edged Sword Of The Pandemic: Exploring Associations Between Covid-19 And Social Isolation In The Usa, Alexander Fulk

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.


Mathematical Modeling, Analysis And Simulation Of Patient Detox Journey, Adan Baca, Diego Gonzalez Nov 2023

Mathematical Modeling, Analysis And Simulation Of Patient Detox Journey, Adan Baca, Diego Gonzalez

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.


Mathematical Modeling, Analysis And Simulation Of Patient Detox Journey, Adan Baca, Diego Gonzalez Nov 2023

Mathematical Modeling, Analysis And Simulation Of Patient Detox Journey, Adan Baca, Diego Gonzalez

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.


Trauma, Identity, And Vietnamese Diaspora: Using The Medicine Wheel As A Healing-Focused Conflict Analysis Framework, Ha B. Dong Nov 2023

Trauma, Identity, And Vietnamese Diaspora: Using The Medicine Wheel As A Healing-Focused Conflict Analysis Framework, Ha B. Dong

Peace and Conflict Studies Journal Conference

No abstract provided.


Reducing Burnout Among Pediatric Oncology Nurses, Karlie Devore, Madison Jarvis Oct 2023

Reducing Burnout Among Pediatric Oncology Nurses, Karlie Devore, Madison Jarvis

Scholars Week

No abstract provided.


A Covid-19-Inspired Comprehensive Approach To Resident Wellness And 360-Degree Approach To Pandemic Preparedness And Disinfection Practices, Preet Gudimella, Unnam Nasir, Heidi Pareja Oct 2023

A Covid-19-Inspired Comprehensive Approach To Resident Wellness And 360-Degree Approach To Pandemic Preparedness And Disinfection Practices, Preet Gudimella, Unnam Nasir, Heidi Pareja

Research Colloquium

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak that had led to the coronavirus disease 2019 (COVID-19) pandemic caused stress for medical residents on the frontline. This motivated our team to implement changes in our residency program’s inpatient service. We approached resident wellness in a comprehensive manner. The changes we implemented at our site had crucial benefits for our inpatient teams. Not only did we implement conventional best practices on infection prevention, we also executed additional safety measures, addressed mental and physical health, and had COVID-19-specific skills training. Consequently, our residents were less stressed, better prepared, and more focused …


A Case Of Cannabis Smoking Induced Leukocytosis, Ramiro A. Rodriguez Jr., Rukayat Akande, Nevin Varghese Oct 2023

A Case Of Cannabis Smoking Induced Leukocytosis, Ramiro A. Rodriguez Jr., Rukayat Akande, Nevin Varghese

Research Colloquium

Background: Leukocytosis relates to infections, malignancies, stress response, and multiple intoxicants. Like other intoxicants, cannabis smoking can result in a persistent leukocytosis. Here we report a case of cannabis-induced leukocytosis.

Case Presentation: A 20-year-old Hispanic female with a history of anxiety disorder presented with 3-days of nausea, vomiting, and colicky abdominal pain. She endorsed heavy marijuana smoking as self-medication and compulsive hot showers for symptom relief. She was admitted for oral intake intolerance, concerning for cannabis hyperemesis syndrome. Her history demonstrated multiple admission for cannabis hyperemesis syndrome during which she demonstrated a leukocytosis which improved with abstinence of marijuana. Her …


Well-Being And Resilience: A Survey Of Physician Needs During Covid-19, Delta, And Omicron, Melinda M. Wilding Oct 2023

Well-Being And Resilience: A Survey Of Physician Needs During Covid-19, Delta, And Omicron, Melinda M. Wilding

Research Colloquium

Background: Physician moral distress during COVID-19, Delta, and Omicron has resulted in a decrease in self-care and a reduction in empathy for patients. Determining physician well-being and resilience assists clinicians in maintaining pliancy during times of uncertainty.

Methods: An IRB quantitative survey aims to illustrate levels of moral distress, self-care tactics, and physician fortitude during the three waves of the pandemic from 2020-2022. The questionnaire elicits responses regarding how physicians have pivoted to remain healthy during the pandemic, what measures physicians have engaged in maintaining empathy and ethics towards patients, and what physicians need in the future to retain self-care. …


Subacute Combined Degeneration Due To Nitrous Oxide-Induced Vitamin B-12 Deficiency, Jorge Nadal, Daniela Hernandez, Brandon Cantazaro Oct 2023

Subacute Combined Degeneration Due To Nitrous Oxide-Induced Vitamin B-12 Deficiency, Jorge Nadal, Daniela Hernandez, Brandon Cantazaro

Research Colloquium

Background: Nitrous oxide also known as “laughing gas” is a naturally occurring gas that is colorless, odorless, nonflammable, and nontoxic. It has been used as an inhalant anesthetic in the medical field for more than 150 years for dental and surgical procedures. Due to its wide availability and ability to cause euphoria, recreational use is on the rise.1 Here, I will present a case of subacute combined degeneration in the setting of nitrous oxide induced vitamin B-12 deficiency.

Case presentation: 23-year-old right-handed gentleman with no past medical history presented to the ED complaining of 1 week of bilateral lower extremity …


Improving Health Literacy Among Transgender/ Gender Non-Conforming People Using Social Media, Isha Mittal, Michelle Cordoba Kissee Oct 2023

Improving Health Literacy Among Transgender/ Gender Non-Conforming People Using Social Media, Isha Mittal, Michelle Cordoba Kissee

Research Colloquium

Background: Health literacy has been elicited as a barrier to healthcare amongst LGBT individuals. Social media has become a popular force in transmitting health information, but often time lacks evidence-based information.

Aims/purpose: The TikTok channel GenderDefenders was created to address the lack of reliable evidence-based information for transgender and gender-non conforming (TGNC) individuals.

Methods: Data was collected from current TikTok videos that were tagged with TGNC terminology to identify gaps in knowledge and commonly asked questions. Themes were selected and educational video recordings were created using WPATH and UCSF guidelines for transgender healthcare. Some topics included what …


Illness Trajectory From Prodromal Symptoms To Incident Bipolar Disorder And Schizophrenia, Manuel A. Gardea Resendez, Javier Ortiz-Orendain, Brandon J. Coombes, Aysegul Ozerdem, Monica J. Taylor-Desir, Balwinder Singh, Alastair J. Mckean, Mark Frye Sep 2023

Illness Trajectory From Prodromal Symptoms To Incident Bipolar Disorder And Schizophrenia, Manuel A. Gardea Resendez, Javier Ortiz-Orendain, Brandon J. Coombes, Aysegul Ozerdem, Monica J. Taylor-Desir, Balwinder Singh, Alastair J. Mckean, Mark Frye

Research Symposium

Background: The concept of prodrome is highly variable but, when applied retrospectively in cohorts who progress to meet diagnostic criteria for bipolar disorder (BD) and schizophrenia (SZ), it can contribute to clarify early origins and trajectory of the illness. In the context of race and ethnicity, studies with population-based and registry-based cohorts, such as the Rochester Epidemiology Project (REP), can potentially identify, through retrospective assessment of the prodromes of BD and SZ, differences while addressing the heterogeneous nature of the illness.

Objective: We aim to describe and compare the illness trajectories of individuals with BD or SZ prior to the …


The Eyes Beyond The Screen: Digital Media Policy And Child Health, Yahia Al-Qudah Sep 2023

The Eyes Beyond The Screen: Digital Media Policy And Child Health, Yahia Al-Qudah

Research Symposium

Background: Modern communication technology and digital media have provided society with a foundation for instant messaging. Pictures, videos, and texts connect individuals with families, friends, and the world. Consequently, digital media has accelerated exposure to risk in which children and adolescents are most vulnerable. This project’s objective is to 1) congregate and highlight current knowledge about the impact of digital media on child health, and 2) underline deficiencies in related laws and regulations as well as offer solutions in digital media policy.

Methods: A systematic literature review was conducted through the JAMA Pediatrics database with keywords such as “digital media,” …


The Fortify Resilience Initiative, Nausheen Jamal, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii Sep 2023

The Fortify Resilience Initiative, Nausheen Jamal, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii

Research Symposium

Purpose: The Fortify Resilience Initiative focuses on building and sustaining a culture of wellbeing for Residents and Fellows (R/Fs) at The University of Texas Rio Grande Valley (UTRGV) School of Medicine’s (SOM) Graduate Medical Education (GME) residency and fellowship programs. In order to address the multitude of threats to physician wellness and to mitigate the silent, but pernicious effects of burnout on these physician learners serving in the RGV, this Initiative from the Office of GME will strengthen existing wellbeing pathways while expanding additional solutions that will work to sustain wellbeing. Utilizing a combination of prevention, promotion, and intervention strategies …


Interdisciplinary Integrated Primary And Behavioral Healthcare (I2pbh) Initiative, John Ronnau, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz Sep 2023

Interdisciplinary Integrated Primary And Behavioral Healthcare (I2pbh) Initiative, John Ronnau, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz

Research Symposium

Purpose: The Interdisciplinary Integrated Primary and Behavioral Healthcare (I2PBH) initiative will train University of Texas Rio Grande Valley (UTRGV) mental health graduates to deliver high quality, evidence-based Integrated Behavioral Health (IBH) services in the Rio Grande Valley (RGV) – a high-need, high-demand, medically underserved Hispanic region along the US-Mexico border. Specifically, the I2PBH initiative will train 24 UTRGV mental health graduates annually to deliver high-quality Integrated Behavioral Health (IBH) clinical services through the evidence based Primary Care Behavioral Health (PCBH) model. With a training emphasis on basic/advanced theory and clinical skills in the PCBH model, students …


Comparing Stroke Symptom Recognition And Intervention Times In The Rio Grande Valley, Joshua M. Ninan, Kelsey Baker Sep 2023

Comparing Stroke Symptom Recognition And Intervention Times In The Rio Grande Valley, Joshua M. Ninan, Kelsey Baker

Research Symposium

This is a retrospective study that aims to evaluate the duration from onset of stroke-like symptoms to presentation to medical facilities for aid in the Rio Grande Valley. The main goal of the study is to understand the extent of pre-hospital delays with regards to the treatment of stroke in the RGV.


Representation Of Racial And Ethnic Minorities And Their Preferences For Mood Stabilizing Treatment Selection For Bipolar Disorder: A Systematic Review, Francisco J. Barrera, Manuel Gardea, Juan Garzon, Ryan Toledo, Ana Paula Bonner, Andrea Maraboto, Mark Frye, Ihsan Salloum Sep 2023

Representation Of Racial And Ethnic Minorities And Their Preferences For Mood Stabilizing Treatment Selection For Bipolar Disorder: A Systematic Review, Francisco J. Barrera, Manuel Gardea, Juan Garzon, Ryan Toledo, Ana Paula Bonner, Andrea Maraboto, Mark Frye, Ihsan Salloum

Research Symposium

Background: The use of second-generation antipsychotics for bipolar disorder (BD) has increased in the past years1Concerns on potential serious medical side effects and need for blood level monitoring of some traditional mood stabilizers along with other factors have influenced this change. Shared decision-making (SDM) strategies have been implemented in clinical settings due to their ability to engage patients in the process of treatment selection.2 Within minority groups with mental illnesses, socioeconomic factors, individual concerns, and cultural variations in clinical presentations, are often overlooked or misrepresented when assessing the patient’s treatment preferences. Although several studies evaluating the …


Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (Pcbh Paths), Kristan Diaz-Rios, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii Sep 2023

Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (Pcbh Paths), Kristan Diaz-Rios, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii

Research Symposium

Purpose: Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (PCBH PATHS) is a workforce development pipeline project aimed at permanently augmenting UTRGV’s institutional capacity to address shortage of an Integrated Behavioral Health (IBH) competent workforce locally, regionally and nationally. Our initiative, aligned with UTRGV strategic priorities and key initiatives, will integrate basic(model specific strategy and operational elements), mid-level (role identity and profession specific behavioral competencies specific to each health profession), and advanced (behavioral medicine clinical skills) applications of the evidence based PCBH model of delivery. A PCBH focused delivery system (clinical and educational), in which primary care providers …


Pro- And Anti-Inflammatory Biomarkers As Predictors Of Response To Valproate In Patients With Comorbid Alcohol Use And Bipolar Disorder-Preliminary Findings, Ilya Blokhin, Lisa Harlow, Eleonore Beurel, Feng Miao, Dana Ascherman, Claes Wahlestedt, Ihsan Salloum Sep 2023

Pro- And Anti-Inflammatory Biomarkers As Predictors Of Response To Valproate In Patients With Comorbid Alcohol Use And Bipolar Disorder-Preliminary Findings, Ilya Blokhin, Lisa Harlow, Eleonore Beurel, Feng Miao, Dana Ascherman, Claes Wahlestedt, Ihsan Salloum

Research Symposium

Objective/Hypothesis: Bipolar disorder (BD) has the highest association with alcohol and other substance use disorders compared to other major psychiatric disorders. This patient population is particularly challenging to treat. We have previously shown that some patients with co-occurring alcohol use and bipolar disorders respond to the GABAergic agonist valproate (VPA), which is known to modulates the dopaminergic system, and also as an epigenetic modifier. Predictors of therapeutic response to VPA in patients with AUD/BD are not known, and the subgroup which would benefit from VPA is still to be identified. Recent evidence suggests that AUD promotes a pro-inflammatory state while …


Residential Treatment Of Substance Use Disorder And Related Comorbidities In Older Adults, Dale J. Dyben Sep 2023

Residential Treatment Of Substance Use Disorder And Related Comorbidities In Older Adults, Dale J. Dyben

Research Symposium

Purpose: Substance Use Disorders (SUD) are a leading contributor to health problems and premature mortality in the United States. Stigma and misconceptions about persons with SUD contribute to negative outcomes. The misconception that older adults do not suffer from severe SUD has contributed to a paucity of treatment options that meet the unique needs this population.

Description: The Center for Older Adult Recovery (COAR) at Hanley Center in West Palm Beach, Florida provides a model for residential treatment of older 65 and older with severe SUD and related medical and mental health comorbidities. Older adults who meet DSM-V diagnostic …


Adverse Childhood Experiences And Resilience In Medical School Students: A Scope Of Medical Literature, Andrea Soto Abarca, Yvette Cortino, Juan Carlos Lopez Alvarenga, Maya Guevara Sep 2023

Adverse Childhood Experiences And Resilience In Medical School Students: A Scope Of Medical Literature, Andrea Soto Abarca, Yvette Cortino, Juan Carlos Lopez Alvarenga, Maya Guevara

Research Symposium

Background: Adverse childhood experiences (ACEs) represent types of childhood trauma that are associated with long-term negative effects on health and wellbeing. An elevated number of ACEs can lead to depression, suicidality, alcoholism, and substance use. Factors that can protect a person from increased health risks include resilience, which is broadly defined as the ability to bounce back from adversity. Few studies have analyzed the exposure of ACEs in medical students, however, there is extensive literature on how low levels of resilience are linked to higher rates of depression, fatigue, and burnout among medical students. Little is known about the …


Fragilidades No Apoio Social À Pessoa Idosa: Uma Revisão De Escopo, Michele Klotz Da Rosa, Irani Iracema De Lima Argimon, Dan Roger Pozza, Pedro Henrique Dall Onder Martins Sep 2023

Fragilidades No Apoio Social À Pessoa Idosa: Uma Revisão De Escopo, Michele Klotz Da Rosa, Irani Iracema De Lima Argimon, Dan Roger Pozza, Pedro Henrique Dall Onder Martins

AMNET XX Conferencia Internacional

OBJETIVO: Identificar elementos caracterizadores da Síndrome da Insuficiência Familiar (SIF) na pessoa idosa que vive na comunidade. MÉTODO: Scoping Review, desenvolvida segundo Prisma-ScR Checklist, com busca de documentos em português, inglês e espanhol nas bases PUBMED, SCOPUS, APA-PSYCNET, CINAHL, LILACS e EMBASE, sem limite temporal. Critérios de elegibilidade/exclusão foram construídos a partir da estratégia PCC: a) População - pessoas acima de 60 anos e redes de apoio; b) Conceito - literatura sobre apoio social e suas fragilidades; e c) Contexto - estudos transversais e longitudinais, revisões, artigos teóricos, capítulos de livro, teses e dissertações, focados na população de idosos comunitários. …


Avaliação Da Intervenção Psicossocial Letramento Em Saúde Mental Na Adolescência Para Professores: Um Estudo Quase Experimental, Magliane Soares Trindade, Pontificia Universidade Catolica Do Rio Grande Do Sul Sep 2023

Avaliação Da Intervenção Psicossocial Letramento Em Saúde Mental Na Adolescência Para Professores: Um Estudo Quase Experimental, Magliane Soares Trindade, Pontificia Universidade Catolica Do Rio Grande Do Sul

AMNET XX Conferencia Internacional

Objetiva-se avaliar o impacto da intervenção no conhecimento dos professores sobre saúde mental e na qualidade de vida dos mesmos. A intervenção ocorreu em cinco módulos semanais, totalizando 16 horas. Os temas se referem à Saúde Mental, Determinantes Sociais da Saúde, Estigma, Fatores de proteção e risco na adolescência, transtornos mentais, formas de autocuidado, acolhimento e encaminhamento em situações de sofrimento mental. O delineamento é quantitativo, longitudinal e de natureza quase experimental, avaliado em três tempos, pré e pós teste em um intervalo de 4 meses. Na amostragem por conveniência os professores foram alocados em dois grupos: 25 no grupo …


The Impact Of School-Based Support Services On Mental Health And Academic Performance, Joshua A. Kent Jun 2023

The Impact Of School-Based Support Services On Mental Health And Academic Performance, Joshua A. Kent

2023 Symposium

Background: There has been a continued presence of mental health issues among high-school aged youth. As a result, many have a diminished ability to be successful in school. It is a societal problem as discussed in the literature. Legislation within the last 23 years has created more access for students but there is still a gap in services. This gap is mostly seen by not having enough personnel to address the amount of students that need assistance. There is also an inconsistent use of school-based health centers and other school-based interventions. Too many schools are using different interventions and …


Engagement In Religious Activity Compared To Peer Support: An Intervention For Suicidal Ideation Among High School Students., Meradythe Edson, Natalie Goobes, Danielle Thayer May 2023

Engagement In Religious Activity Compared To Peer Support: An Intervention For Suicidal Ideation Among High School Students., Meradythe Edson, Natalie Goobes, Danielle Thayer

School of Psychology, Family, and Community Research Conference

Suicidal ideation (SI) can lead to suicide. Suicide is the second leading cause of death among children ages 10-14 and the third leading cause of death among adolescents ages 15-24 (CDC). This study compares active engagement in religious activities versus peer support as an effective resource in decreasing SI among high school students in the United States. The research explains how active engagement in religious activities will produce better results than peer support alone for decreasing SI in the targeted population. Semi-structured interviews of high school students and self-report questionnaires are utilized in this study. Our research hopes to support …


The Effectiveness Of Video Game Therapy In Helping Adolescent Clients To Build Connections With Their Families, Qichang Yang May 2023

The Effectiveness Of Video Game Therapy In Helping Adolescent Clients To Build Connections With Their Families, Qichang Yang

School of Psychology, Family, and Community Research Conference

This study explores the role of video game therapy in enhancing family connections among adolescents. Using a mixed-methods approach, we use surveys and interviews to assess changes in family relationships for adolescents undergoing video game therapy. Preliminary findings indicate that video game therapy could be a great tool for improving familial bonds. This research adds to the understanding of non-traditional therapeutic interventions and their potential impact on family dynamics and adolescent mental health.


A Systematic Review Of Bottom-Up And Top-Down Psychotherapy Methods For The Treatment Of Posttraumatic Stress Disorder (Ptsd), Kristen Sievert May 2023

A Systematic Review Of Bottom-Up And Top-Down Psychotherapy Methods For The Treatment Of Posttraumatic Stress Disorder (Ptsd), Kristen Sievert

School of Psychology, Family, and Community Research Conference

While numerous studies have investigated the efficacy of either Top-Down or Bottom-Up modalities in reducing PTSD symptoms, there is a paucity of research focused on comparing differences in treatment effects of Bottom-Up and Top-Down therapies. Top-Down interventions are built on an individual’s ability to become conscious of their thoughts and their subsequent capacity to change those thoughts, while Bottom-Up interventions rely on an individual’s body sensations an/or movements to access and process trauma. We investigated this gap by conducting a systematic review of Top-down and Bottom-up treatments for PTSD. To be included in the review, studies needed to examine adults …


Effectiveness Of Couples-Based Exposure And Response Prevention (Erp) Therapy Vs. Individual Erp Treatment For Ocd Symptom Reduction And Overall Couple Satisfaction, Priscilla Nguyen, Shana O'Connor-Wolf May 2023

Effectiveness Of Couples-Based Exposure And Response Prevention (Erp) Therapy Vs. Individual Erp Treatment For Ocd Symptom Reduction And Overall Couple Satisfaction, Priscilla Nguyen, Shana O'Connor-Wolf

School of Psychology, Family, and Community Research Conference

Obsessive-Compulsive Disorder (OCD) is a debilitating, chronic condition characterized by recurrent intrusive thoughts followed by persistent behavioral urges and time-consuming rituals that attempt to neutralize anxiety and distress caused by those unwanted obsessive thoughts (American Psychiatric Association, 2013). This research study aims to explore the effectiveness of Couples-Based ERP in decreasing individual symptoms of OCD and evaluating the impact of treatment on relationship satisfaction. Using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Dyadic-Adjustment Scale (DAS) to measure our constructs, we hypothesize that Couples-Based ERP will be effective in not only decreasing OCD symptoms, but also increasing overall relationship satisfaction.


Efficacy Of Solution Focused Therapy With At Risk Youth, Garret Patterson May 2023

Efficacy Of Solution Focused Therapy With At Risk Youth, Garret Patterson

School of Psychology, Family, and Community Research Conference

Dating back to the 1980’s, Solution Focused Brief Therapy (SFBT) is a therapy approach that helps clients put problems in their life into context as measurable, manageable, and fixable. For many, this solution forward approach helps to improve symptoms and resolve stuck behavior patterns often stemming from childhood. This client driven, not knowing approach helps clients discover their own autonomy and understand that not only are their problems solvable, but that they themselves have the internal resources by which to solve them. However, there is still much interest as to who can benefit most from this form of therapy. However, …


The Effectiveness Of Combining Play Therapy With Emotionally Focused Family Therapy For The Treatment Of Children, Ages 3-6., Britney Roark May 2023

The Effectiveness Of Combining Play Therapy With Emotionally Focused Family Therapy For The Treatment Of Children, Ages 3-6., Britney Roark

School of Psychology, Family, and Community Research Conference

Present literature on emotionally focused family therapy (EFFT) overlooks treatment involving young children (Willis et al., 2016). Because preschool-aged children learn and express emotion best through the medium of play (Schaefer & Drewes, 2011), I hypothesize that EFFT will prove most effective with children ages 3-6 when combined with play therapy techniques. Marriage and family therapy interns, trained in EFFT concepts, who treat children in this age group will complete a training course on combining play therapy with EFFT. A control group will not. Initial and final measures will determine the success of treatment over a 12-week period.