Medicine and Health Sciences Commons^™

Differential Impairment As An Indicator Of Sex Bias In Dsm-Iv Criteria For Four Personality Disorders, Christina D. Boggs, Leslie C. Morey, Andrew E. Skodol, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Mary C. Zanarini, John G. Gunderson

Charles A. Sanislow, Ph.D.

The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were assessed with both self-report and semistructured interview. The authors used a regression model of bias to identify bias as differences in slopes or intercepts between men and women in the relationship between each diagnostic criterion and level of impairment. The results suggest that most of the diagnostic criteria examined do not seem …

Evaluation Of The Federal Government's Human Health Preparedness Plan Developed In Response To The H5n1 Threat., Chiehwen Ed Hsu

Chiehwen Ed Hsu

Dr. Hsu reacted to President Bush's Avian Flu Preparedness and Response Plan in a media briefing panel at the National Press Club, Washington DC.

The Collaborative Longitudinal Personality Disorders Study (Clps): Overview And Implications, Andrew E. Skodol, John G. Gunderson, M. Tracie Shea, Thomas H. Mcglashan, Leslie C. Morey, Charles A. Sanislow, Donna S. Bender, Carlos M. Grilo, Mary C. Zanarini, Shirley Yen, Maria E. Pagano, Robert L. Stout

Charles A. Sanislow, Ph.D.

The Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000) was developed to fill gaps in our understanding of the nature, course, and impact of personality disorders (PDs). Here, we review published findings to date, discuss their implications for current conceptualizations of PDs, and raise questions that warrant future consideration. We have found that PDs are more stable than major depressive disorder, but that meaningful improvements are possible and not uncommon. We have confirmed also that PDs constitute a significant public health problem, with respect to associated functional impairment, extensive treatment utilization, negative prognostic impact on major depressive disorder, …

Dimensional Representations Of Dsm-Iv Personality Disorders: Relationships To Functional Impairment, Andrew E. Skodol, John M. Oldham, Donna S. Bender, Ingrid R. Dyck, Robert L. Stout, Leslie C. Morey, M. Tracie Shea, Mary C. Zanarini, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: This study compared three-dimensional representations of DSM-IV personality disorders and standard categories with respect to their associations with psychosocial functioning.

METHOD: Six hundred sixty-eight patients with semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders or with major depressive disorder and no personality disorder completed questionnaires assessing three-factor and five-factor dimensional models of personality. Personality disorder categories, dimensional representations of the categories based on criteria counts, and three- and five-factor personality dimensions were compared on their relationships to impairment in seven domains of functioning, as measured by the Longitudinal Interval Follow-up Evaluation-Baseline Version.

RESULTS: Both the categorical …

Avoidant Personality Disorder And Social Phobia: Distinct Enough To Be Separate Disorders?, Elizabeth Ralevski, Charles A. Sanislow, Carlos M. Grilo, Andrew E. Skodol, John G. Gunderson, M. Tracie Shea, Shirley Yen, Donna S. Bender, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: Existing evidence from anxiety disorder research indicates that social phobics (SP) with avoidant personality disorder (AVPD) experience more anxiety and show more impairment than patients with SP alone. The purpose of this study was to examine whether in patients diagnosed with AVPD, the co-occurrence of SP adds to its severity. We hypothesized that the addition of SP will not add to the severity of AVPD alone.

Method: Two groups of patients (AVPD = 224; AVPD/SP = 101) were compared at baseline and 2 years later on multiple demographic and clinical variables.

Results: Patients with AVPD and an additional diagnosis …

Inequalities In Neighbourhood Socioeconomic Characteristics: Potential Evidence-Base For Neighbourhood Health Planning., Agricola Odoi, R Wray, M Emo, S Birch, B Hutchison, J Eyles, T Abernathy

Agricola Odoi

BACKGROUND: Population health planning aims to improve the health of the entire population and to reduce health inequities among population groups. Socioeconomic factors are increasingly being recognized as major determinants of many aspects of health and causes of health inequities. Knowledge of socioeconomic characteristics of neighbourhoods is necessary to identify their unique health needs and enhance identification of socioeconomically disadvantaged populations. Careful integration of this knowledge into health planning activities is necessary to ensure that health planning and service provision are tailored to unique neighbourhood population health needs. In this study, we identify unique neighbourhood socioeconomic characteristics and classify the …

Chronic Obstructive Pulmonary Disease In 2025 - Where Are We Headed?, David M. Mannino

David M. Mannino

Comment on

A dynamic population model of disease progression in COPD. [Eur Respir J. 2005]

Perioperative Beta-Blocker Therapy And Mortality After Major Noncardiac Surgery, Peter K. Lindenauer, Penelope Susan Pekow, Kaijun Wang, Dheeresh K. Mamidi, Benjamin Gutierrez, Evan M. Benjamin

Penelope Susan Pekow

Background: Despite limited evidence from randomized trials, perioperative treatment with beta-blockers is now widely advocated. We assessed the use of perioperative beta-blockers and their association with in-hospital mortality in routine clinical practice.

Methods: We conducted a retrospective cohort study of patients 18 years of age or older who underwent major noncardiac surgery in 2000 and 2001 at 329 hospitals throughout the United States. We used propensity-score matching to adjust for differences between patients who received perioperative beta-blockers and those who did not receive such therapy and compared in-hospital mortality using multivariable logistic modeling.

Results: Of 782,969 patients, 663,635 (85 percent) …

Perioperative Beta-Blocker Therapy And Mortality After Major Noncardiac Surgery, Peter K. Lindenauer, Penelope Susan Pekow, Kaijun Wang, Dheeresh K. Mamidi, Benjamin Gutierrez, Evan M. Benjamin

Peter Lindenauer MD

Background: Despite limited evidence from randomized trials, perioperative treatment with beta-blockers is now widely advocated. We assessed the use of perioperative beta-blockers and their association with in-hospital mortality in routine clinical practice.

Methods: We conducted a retrospective cohort study of patients 18 years of age or older who underwent major noncardiac surgery in 2000 and 2001 at 329 hospitals throughout the United States. We used propensity-score matching to adjust for differences between patients who received perioperative beta-blockers and those who did not receive such therapy and compared in-hospital mortality using multivariable logistic modeling.

Results: Of 782,969 patients, 663,635 (85 percent) …

Book Review 5 Confidence: How Winning Streaks And Losing Streaks Begin And End By Rosabeth Moss Kanter, William C. Mcpeck

William C. McPeck

This is my personal review of Confidence: How Winning Streaks and Losing Streaks Begin and End by Rosabeth Moss Kanter and published by Crown Business in 2004.

Does Sex Influence The Impact That Smoking, Treatment Interruption And Impaired Pulmonary Function Have On Outcomes In Limited Stage Small Cell Lung Cancer Treatment?, Gregory Videtic, Pauline Truong, Robert Ash, Edward Yu, Walter Kocha, Mark Vincent, Anna Tomiak, A Dar, Frances Whiston, Larry Stitt

Edward Yu

PURPOSE: To look for survival differences between men and women with limited stage small cell lung cancer (LS-SCLC) by examining stratified variables that impair treatment efficacy. METHODS: A retrospective review of 215 LS-SCLC patients treated from 1989 to 1999 with concurrent chemotherapy-radiotherapy modelled on the 'early-start' thoracic radiotherapy arm of a National Cancer Institute of Canada randomized trial. RESULTS: Of 215 LS-SCLC patients, 126 (58.6%) were men and 89 (41.4%) were women. Smoking status during treatment for 186 patients (86.5%) was: 107 (58%) nonsmoking (NS) (76 [71%] male [M]; 31 [29%] female [F]) and 79 (42%) smoking (S) (36 M …

Longitudinal Comparison Of Depressive Personality Disorder And Dysthymic Disorder, John C. Markowitz, Andrew E. Skodol, Eva Petkova, Hui Xie, Jianfeng Cheng, David J. Hellerstein, John G. Gunderson, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: Few studies have compared the related diagnostic constructs of depressive personality disorder (DPD) and dysthymic disorder (DD). The authors attempted to replicate findings of Klein and Shih in longitudinally followed patients with personality disorder or major depressive disorder (MDD) in the Collaborative Longitudinal Personality Disorders Study.

METHODS: Subjects (N = 665) were evaluated at baseline and over 2 years (n = 546) by reliably trained clinical interviewers using semistructured interviews and self-report personality questionnaires.

RESULTS: Only 44 subjects (24.6% of 179 DPD and 49.4% of 89 early-onset dysthymic subjects) met criteria for both disorders at baseline. Depressive personality disorder …

Book Review 4 Leadership And Self Deception: Getting Out Of The Box, William C. Mcpeck

William C. McPeck

This is my personal review of Leadership and Self Deception: Getting Out of the Box by the Arbinger Institute and published by Berrett-Koehler Publishers in 2002.

Two-Year Prevalence And Stability Of Individual Dsm-Iv Criteria For Schizotypal, Borderline, Avoidant, And Obsessive-Compulsive Personality Disorders: Toward A Hybrid Model Of Axis Ii Disorders, Thomas H. Mcglashan, Carlos M. Grilo, Charles A. Sanislow, Elizabeth Ralevski, Leslie C. Morey, John G. Gunderson, Andrew E. Skodol, M. Tracie Shea, Mary C. Zanarini, Donna S. Bender, Robert L. Stout, Shirley Yen, Maria E. Pagano

Charles A. Sanislow, Ph.D.

OBJECTIVE: This study tracked the individual criteria of four DSM-IV personality disorders-borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders-and how they change over 2 years.

METHOD: This clinical sample of patients with personality disorders was derived from the Collaborative Longitudinal Personality Disorders Study and included all participants with borderline, schizotypal, avoidant, or obsessive-compulsive personality disorder for whom complete 24-month blind follow-up assessments were obtained (N=474). The authors identified and rank-ordered criteria for each of the four personality disorders by their variation in prevalence and changeability (remission) over time.

RESULTS: The most prevalent and least changeable criteria over 2 years were paranoid …

Cardiorespiratory Hospitalizations Associated With Smoke Exposure During The 1997, Southeast Asian Forest Fires, Joshua A. Mott, David M. Mannino, Clinton J. Alverson, Andrew Kiyu, Jamilah Hashim, Tzesan Lee, Kenneth Falter, Stephen C. Redd

David M. Mannino

We investigated the cardiorespiratory health effects of smoke exposure from the 1997 Southeast Asian Forest Fires among persons who were hospitalized in the region of Kuching, Malaysia. We selected admissions to seven hospitals in the Kuching region from a database of all hospital admissions in the state of Sarawak during January 1, 1995 and December 31, 1998. For several cardiorespiratory disease classifications we used Holt-Winters time-series analyses to determine whether the total number of monthly hospitalizations during the forest fire period (August 1 to October 31, 1997), or post-fire period (November 1, 1997 to December 31, 1997) exceeded forecasted estimates …

Lack Of Occupational Health Research In Nepal, Krishna Poudel, Masamine Jimba, Kalpana Poudel-Tandukar, Susumu Wakai

Krishna C. Poudel

In his article on occupational health research in developing countries, Nuwayhid emphasized that many developing countries need to translate scientific findings into effective actions with regard to occupational health.1 Nuwayhid suggested that to improve the situation, we should focus on social and political contexts first and then address the particularities of the workplace—that we should start with the “external-contextual domain” and move to the “internal domain” of occupational health. In Nepal, the second long-term health plan (1997–2017)2 has identified occupational health as one of the emerging priority health issues. However, the long-term health plan document has not dealt with this …

How Well Does B-Type Natriuretic Peptide Predict Death And Cardiac Events In Patients With Heart Failure: Systematic Review, Jenny Doust, Eva Pietrzak, Annette Dobson, Paul Glasziou

Jenny Doust

Objective To assess how well B-type natriuretic peptide (BNP) predicts prognosis in patients with heart failure. Design Systematic review of studies assessing BNP for prognosis in patients with heart failure or asymptomatic patients. Data sources Electronic searches of Medline and Embase from January 1994 to March 2004 and reference lists of included studies. Study selection and data extraction We included all studies that estimated the relation between BNP measurement and the risk of death, cardiac death, sudden death, or cardiovascular event in patients with heart failure or asymptomatic patients, including initial values and changes in values in response to treatment. …

Occupational Exposure To Snowmobile Emission At Yellowstone National Park, Wendy Campbell, Ryan Morris, Dale Stephenson, Terry Spear

Dale J. Stephenson

In recent years, regulations regarding snowmobile recreation in Yellowstone National Park have become more restrictive. New regulations limit the number of snowmobiles entering the park, restrict the engine type, and require that all riders must utilize a licensed guide. Given these regulations, it is hypothesized that occupational exposures to the combustion products from snowmobile exhaust have decreased. This research project performed occupational exposure monitoring of National Park Service Employees while working at the West Entrance to Yellowstone National Park during the 2004-2005 winter season. Products of snowmobile exhaust including carbon monoxide, nitrous oxides, volatile organic compounds, fine particulates, and noise …

Stability Of Functional Impairment In Patients With Schizotypal, Borderline, Avoidant, Or Obsessive Compulsive Personality Disorder Over Two Years, Andrew E. Skodol, Maria E. Pagano, Donna S. Bender, M. Tracie Shea, John G. Gunderson, Shirley Yen, Robert L. Stout, Leslie C. Morey, Charles A. Sanislow, Carlos M. Grilo, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period.

METHOD: Six hundred treatment-seeking or treated patients were recruited primarily from clinical services in four metropolitan areas …

Two-Year Prospective Naturalistic Study Of Remission From Major Depressive Disorder As A Function Of Personality Disorder Comorbidity, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Andrew E. Skodol, Robert L. Stout, John G. Gunderson, Shirley Yen, Donna S. Bender, Maria E. Pagano, Mary C. Zanarini, Leslie C. Morey, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

In this study, the authors examined prospectively the 24-month natural course of remission from major depressive disorder (MDD) as a function of personality disorder (PD) comorbidity. In 302 participants (196 women, 106 men), psychiatric and PDs were assessed at baseline with diagnostic interviews, and the course of MDD was assessed with the Longitudinal Interval Follow-Up Evaluation at 6-, 12-, and 24-month follow-ups. Survival analyses revealed an overall 24-month remission rate of 73.5% for MDD that differed little by gender. Participants with MDD who had certain forms of coexisting PD psychopathology (schizotypal, borderline, or avoidant) as their primary PD diagnoses had …

Recent Life Events Preceding Suicide Attempts In A Personality Disorder Sample: Findings From The Collaborative Longitudinal Personality Disorders Study, Shirley Yen, Maria E. Pagano, M. Tracie Shea, Carlos M. Grilo, John G. Gunderson, Andrew E. Skodol, Thomas H. Mcglashan, Charles A. Sanislow, Donna S. Bender, Mary C. Zanarini

Charles A. Sanislow, Ph.D.

Few studies have examined the relationship between life events, suicide attempts, and personality disorders (PDs), in spite of the strong associations between PDs and suicidal behavior, and the poor coping strategies often exhibited by these individuals. The authors examined whether participants with PDs who attempted suicide during the first 3 years of a prospective, longitudinal study were more likely to experience specific life events in the month during and preceding the suicide attempt. Of 489 participants with PDs, 61 attempted suicide during the 3-year, follow-up interval. Results indicated that negative life events, particularly those pertaining to love-marriage or crime-legal matters, …

Book Review 3 What Is Lean Six Sigma By Michael L. George, William C. Mcpeck

William C. McPeck

This is my personal review of What is Lean Six Sigma by Michael L. George and published by McGraw-Hill in 2003.

Lipid Adjustment In The Analysis Of Environmental Contaminants And Human Health Risks, Enrique Schisterman, Brian Whitcomb, Germaine Buck Louis, Thomas Louis

Brian W. Whitcomb

The literature on exposure to lipophilic agents such as polychlorinated biphenyls (PCBs) is conflicting, posing challenges for the interpretation of potential human health risks. Laboratory variation in quantifying PCBs may account for some of the conflicting study results. For example, for quantification purposes, blood is often used as a proxy for adipose tissue, which makes it necessary to model serum lipids when assessing health risks of PCBs. Using a simulation study, we evaluated four statistical models (unadjusted, standardized, adjusted, and two-stage) for the analysis of PCB exposure, serum lipids, and health outcome risk (breast cancer). We applied eight candidate true …

“Interaction” And Research Utilisation In Health Policies And Programs: Does It Work?, Anita Kothari, Stephen Birch, Cathy Charles

Anita Kothari

The objective of this study was to assess if interaction between users and producers of research is associated with a greater level of adoption of research findings in the design and delivery of health care programs. Responses to the dissemination of a research report on breast cancer prevention were compared between two groups of public health units in Ontario, Canada. Although all public health units received the report, only a subset of units was involved in the development of the report, while others were not. Research utilisation was conceptualized in terms of stages, including reading the report, information processing, and …

Higher Burden Of Hemorrhagic Stroke Among Women An Autopsy-Based Study In São Paulo, Brazil, Paulo A. Lotufo

Paulo A Lotufo

The aim of this study was to verify the gender difference in sudden cardiovascular death, mainly comparing brain infarction and hemorrhagic stroke. We analyzed 970 autopsy cases from a total of 3,802 nonviolent deaths (448 considered as sudden deaths, 296 undetermined, and 226 non-sudden deaths) including patients aged 30–69 years. All cardiovascular diseases were responsible for 69% of sudden deaths, and all types of stroke for only 14%. The proportions of sudden death for all cardiovascular diseases, coronary heart disease and ischemic stroke deaths were similar for both sexes. However, sudden deaths due to all types of stroke (women 20.0%; …

Stroke In Brazil: A Neglected Disease, Paulo A. Lotufo

Paulo A Lotufo

The turning point in the transition from infectious diseases to non-transmittable diseases in Brazil occurred in the 1960s, taking the country as a whole. However, considering the main cities, such as São Paulo and Rio de Janeiro, cerebrovascular disease mortality rates have surpassed the “old cardiovascular diseases” like rheumatic heart disease and syphilitic aortic disease since the end of World War II. Until the end of the 1980s, the burden of stroke mortality observed in the main Brazilian cities was higher than in the United States, Canada and western European countries, and similar to what is observed in Eastern Europe …

Trends Of Stroke Subtypes Mortality In Sao Paulo, Brazil (1996-2003), Paulo A. Lotufo, Isabela M. Bensenor

Paulo A Lotufo

The decline of stroke mortality rates has been described in Brazil; however, there is no data about stroke subtypes. We described the changes of stroke mortality rates in the city of Sao Paulo (1996-2003) emphasizing intracerebral hemorrhage and cerebral infarction. We categorized mortality data by gender and 10-year age-strata from 30 to 79 years-old. For men, an annual reduction of all types of stroke (-3.9%), and of stroke subtypes as intracerebral hemorrhage (-3.0%) and cerebral infarction was observ e d (-2.7%) as well as, a decline of ill-defined stroke (-7.4%). For women, a decline was observed for all types of …

Why Brazil Does Not Have An Epidemic Of Chronic Diseases: Some Answers From Cardiovascular Diseases, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

The "Common Soil" Theory: Coronary Disease, Diabetes And Inflammation., Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Progress Testing: Evaluation Of Four Years Of Application In The School Of Medicine, University Of São Paulo, Paulo A. Lotufo

Paulo A Lotufo

Progress testing is a longitudinal tool for evaluating knowledge gains during the medical school years. Objectives: (1) To implement progress testing as a form of routine evaluation; (2) to verify whether cognitive gain is a continuous variable or not; and (3) to evaluate whether there is loss of knowledge relating to basic sciences in the final years of medical school. Methods: A progress test was applied twice a year to all students from 2001 to 2004. The mean percentage score was calculated for each school year, employing ANOVA with post hoc Bonferroni test evaluation for each test. Results:Progress testing was …