Medicine and Health Sciences Commons^™

‘The Psychological Effects Of Euthanasia And Physician-Assisted Suicide On The Administering Doctor’., M Hicks

Madelyn Hsiao-Rei Hicks

No abstract provided.

Ethnicity And Mental Health Treatment Utilization By Patients With Personality Disorders, Donna S. Bender, Andrew E. Skodol, Ingrid R. Dyck, John C. Markowitz, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Anthony Pinto, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson, Maria T. Daversa, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

The authors examined the relationship between ethnicity and treatment utilization by individuals with personality disorders (PDs). Lifetime and prospectively determined rates and amounts of mental health treatments received were compared in over 500 White, African American, and Hispanic participants with PDs in a naturalistic longitudinal study. Minority, especially Hispanic, participants were significantly less likely than White participants to receive a range of outpatient and inpatient psychosocial treatments and psychotropic medications. This pattern was especially pronounced for minority participants with more severe PDs. A positive support alliance factor significantly predicted the amount of individual psychotherapy used by African American and Hispanic …

Correction: Using Participatory Design To Develop (Public) Health Decision Support Systems Through Gis, S. Michelle Driedger, Anita Kothari, Jason Morrison, Michael Sawada, Eric J. Crighton, Ian D. Graham

Anita Kothari

Background: Organizations that collect substantial data for decision-making purposes are often characterized as being 'data rich' but 'information poor'. Maps and mapping tools can be very useful for research transfer in converting locally collected data into information. Challenges involved in incorporating GIS applications into the decision-making process within the non-profit (public) health sector include a lack of financial resources for software acquisition and training for nonspecialists to use such tools. This on-going project has two primary phases. This paper critically reflects on Phase 1: the participatory design (PD) process of developing a collaborative web-based GIS tool.

Methods: A case study …

Co-Management In Healthcare: Negotiating Professional Boundaries, Catherine Schryer, Olga Gladkova, Marlee Spafford, Lorelei Lingard

Lorelei Lingard

This article investigates discursive practices associated with the co-management of patients between healthcare providers. Specifically, we focus on two genres (38 referral letters and 37 consultant reports) written by optometrists and ophthalmologists — two groups who are experiencing interprofessional tension over their scopes of practice. In our analysis we foreground four kinds of modality associated with verbs — epistemic, deontic, phatic and subjective. We found that these healthcare providers shared in the epistemic resources used to hedge their sense of clinical certainty, and that ophthalmologists used deontic resources to control future action. However, we also noted that both professions used …

Negotiating The Politics Of Identity In An Interdisciplinary Research Team, Lorelei Lingard, Catherine Schryer, Marlee Spafford, Sandra Campbell

Lorelei Lingard

This article explores the politics of identity in an interdisciplinary health research team that has been engaged in a qualitative research program for over five years. We draw on sociological theories of power and knowledge to explore our experiences of identity conflict, team socialization, and knowledge production. Structurally, our article integrates individual and group perspectives through personal narratives and collaborative critique as we explore the complex negotiations required to realize and maintain our team dynamic. These negotiations take place not only with one another as particularly positioned individuals, but also with the ideological and organizational forces that structure our scholarly …

The Potential Role Of Probiotics In Reducing Poverty-Associated Infections In Developing Countries, Kingsley C. Anukam

Kingsley C Anukam

Probiotics are defined by the Food and Agricultural Organization/ World Health Organization as “live microorganisms which when administered in adequate amounts confer a health benefit on the host” [1]. The potential benefits of their use have not been adequately investigated, especially in the developing world. Japan introduced Yakult, a probiotic fermented food drink in 1935, and in the Northern hemisphere, research and use of probiotics has gained an unprecedented momentum in the last decade [2]. Use of probiotics is not uncommon in Europe [3], but in many developing countries use of probiotics in its present definition is a foreign concept. …

Managing A Widespread E-Procurement Implementation In Public Healthcare, Tommaso Federici, Andrea Resca

Federici Tommaso

In large parts of Europe, the development of healthcare is subject to contrasting forces. On the one hand, there has been an explosion in spending and, at the same time, governments are faced with strict budget constraints. On the other hand, public healthcare is under pressure to be innovative, technologically advanced and to provide increasingly better quality of services. In this context, eprocurement can be seen as an instrument to offer a solution to the first issue of this dilemma. However, e-procurement initiatives in such domain have not been widely deployed, and most of them have not fully delivered the …

Implementation Of The Intervention-Based Family Assessment Procedure: A Case Study, Jeanne Jenkins, Audrey Ellenwood

Jeanne E. Jenkins

Chronic illness is a worldwide phenomenon impacting the emotional stability and daily functioning of families across cultures. Families with a chronically ill member are in need of interventions and therapy, yet, time constraints and care-taking demands make it difficult for families to seek traditional family therapy services. The objectives of this article are to (1) overview the Intervention-Based Family Assessment Procedure (IBFA) and (2) present a case vignette demonstrating the implementation of the procedure. The IBFA is an effective diagnostic tool and intervention strategy to help family therapists alter the dysfunctional and rigid structural dynamics of families with a chronically …

Questioning Competence: A Discourse Analysis Of Attending Physicians' Use Of Questions To Assess Trainee Competence, Tara Kennedy, Lorelei Lingard

Lorelei Lingard

BACKGROUND: Attending physicians (APs) must constantly assess trainees' competence to act independently, to promote learning while ensuring quality of care. This study aimed to explore, through discourse analysis of case presentations, the process of competence assessment for case-specific clinical independence.

METHOD: Twenty-six case presentations in emergency medicine were observed and audiorecorded. A discourse analysis was conducted, focusing on APs' use of questioning strategies.

RESULTS: Questioning strategies involved clarifying questions (to ensure APs' understanding of the case), probing questions (to probe trainees' understanding of a case or their underlying knowledge), and challenging questions (to challenge presuppositions). Case-related probing questions and challenging …

Public Health Citation Patterns: An Analysis Of The American Journal Of Public Health, 2003-2005, Melissa L. Rethlefsen, Lisa C. Wallis

Lisa C. Wallis, MSPH, MS

Mainstreaming And Integrating The Substance And Spectacle Of Scholar-Baller: A New Game Plan For The Ncaa, Higher Education And Society, Keith Harrison

Dr. C. Keith Harrison

The purpose of this chapter is to theoretically and empirically capture the cultural divide between education and sport and entertainment in American society. The NCAA Academic Reform Movement has evolved from holding individuals accountable to presently monitoring institutions and their retention and graduation success of college student athletes. This movement will require a deeper examination of how culture influences academic attitudes and lifelong learning. Based on empirical data from different methodologies, this chapter proposes that student athletes; especially African American males, are often stereotyped with few strategies to empower their academic and athletic identities. The Scholar-Baller Paradigm is designed to …

The Sensitivity And Psychometric Properties Of A Brief Computer-Based Cognitive Screening Battery In A Depression Clinic, S A. Langenecker, A Caveney, B Giordani, E A. Young, Kristy Nielson, L J. Rapport, L A. Bieliauskas, M J. Mordhorst, S Marcus, N Yodkovik, K Kerber, S Berent, J K. Zubieta

Kristy Nielson

At present, there is poor accuracy in assessing cognitive and vegetative symptoms in depression using clinician or self-rated measures, suggesting the need for development of standardized tasks to assess these functions. The current study assessed the psychometric properties and diagnostic specificity of a brief neuropsychological screening battery designed to assess core signs of depression; psychomotor retardation, attention and executive functioning difficulties, and impaired emotion perception within an outpatient psychiatry setting. Three hundred eighty-four patients with mood disorders and 77 healthy volunteers participated. A large percentage of patients met diagnostic criteria for Major Depressive Disorder alone (49%) or with another comorbid …

Does State Certification Or Licensure Influence Outpatient Substance Abuse Treatment Program Practices?, Jamie Chriqui, Yvonne Terry-Mcelrath, Duane C. Mcbride, S Eidson, Curtis Vanderwaal

Duane McBride

In the United States, state governments legally authorize outpatient substance abuse treatment programs. In some states, programs are certified or accredited (ideal standards). Other states license programs (minimal standards). Additionally, some states authorize programs through "deemed status", which is afforded to programs attaining accreditation from a national accrediting body. Primary legal research and the National Survey of Substance Abuse Treatment Services' (N-SSATS) data were used to examine the relationships between state authorization type (certification/accreditation vs licensure with and without deemed status) and outpatient treatment program practices. Programs in certification/accreditation (vs licensure) states had significantly higher odds of offering wrap-around and …

Midwifery Education And Maternal And Neonatal Health Issues: Challenges In Pakistan, Tazeen S. Ali Dr, Beth Mcmanis Dr, Rafat Jan Rukanuddin Dr

Tazeen S Ali Dr

neonatal mortality rates still remain a challenge. Developed countries have reduced maternal and neonatal mortality rates by improving the skill and knowledge levels of nurse-midwives. This paper reviews maternal and neonatal health issues, challenges in current midwifery education, and the role of government and international agencies in Pakistan. The exact maternal and neonatal mortality rates in Pakistan are unknown; a census has not occurred since 1998, and data provided in more recent studies were presented in summary format. A number of factors that contribute to the high mortality rate could easily be controlled by using competent nurse-midwives throughout all levels …

Web Du Bois And The "Negro Problem": Thoughts On Violence In Philadelphia, Amy Hillier

Amy Hillier

This sermon, delivered at First Unitarian Church of Philadelphia, might also be called "Why a white girl from New Hampshire is studying The Philadelphia Negro." This essay/sermon connects Du Bois's 1896 survey of Philadelphia to the violence currently plaguing Philadelphia.

Temporally Graded Activation Of Neocortical Regions In Response To Memories Of Different Ages, J Woodard, M Seidenberg, Kristy Nielson, S Miller, M Franczak, P Antuono, K Douville, S Rao

Kristy Nielson

The temporally graded memory impairment seen in many neurobehavioral disorders implies different neuroanatomical pathways and/or cognitive mechanisms involved in storage and retrieval of memories of different ages. A dynamic interaction between medial-temporal and neocortical brain regions has been proposed to account for memory’s greater permanence with time. Despite considerable debate concerning its time-dependent role in memory retrieval, medial-temporal lobe activity has been well studied. However, the relative participation of neocortical regions in recent and remote memory retrieval has received much less attention. Using functional magnetic resonance imaging, we demonstrate robust, temporally graded signal differences in posterior cingulate, right middle frontal, …

Faculty And Male Student Athletes In Higher Education: Racial Differences In The Environmental Predictors Of Academic Achievement, Keith Harrison

Dr. C. Keith Harrison

Studies have examined the impact of environmental variables on academic achievement among student athletes in the revenue-generating sports of men’s basketball and football. However, while evidence concerning the positive impact of male student athlete and faculty interaction is virtually unequivocal, we are not certain whether the benefits accruing from particular types of interaction vary across different racial/ethnic groups. This study explores the relationship between male Black and White student athletes and faculty as well as the impact of specific forms of student athlete– faculty interaction on academic achievement. Data are drawn from the Cooperative Institutional Research Program’s 2000 Freshman Survey …

Comparison Of Alternative Models For Personality Disorders, Leslie C. Morey, Christopher J. Hopwood, John G. Gunderson, Andrew E. Skodol, M. Tracie Shea, Shirley Yen, Robert L. Stout, Mary C. Zanarini, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: The categorical classification system for personality disorder (PD) has been frequently criticized and several alternative dimensional models have been proposed.

METHOD: Antecedent, concurrent and predictive markers of construct validity were examined for three models of PDs: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP) model and the DSM-IV in the Collaborative Study of Personality Disorders (CLPS) sample.

RESULTS: All models showed substantial validity across a variety of marker variables over time. Dimensional models (including dimensionalized DSM-IV) consistently outperformed the conventional categorical diagnosis in predicting external variables, such as subsequent suicidal gestures and hospitalizations. FFM facets …

Positive Childhood Experiences: Resilience And Recovery From Personality Disorder In Early Adulthood, Andrew E. Skodol, Donna S. Bender, Maria E. Pagano, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Carlos M. Grilo, Maria T. Daversa, Robert L. Stout, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: Recent follow-along studies of personality disorders have shown significant improvement in psychopathology over time. The purpose of this study was to prospectively investigate the association between positive childhood experiences related to resiliency and remission from personality disorder.

METHOD: Five hundred twenty patients with DSM-IV-based semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders were evaluated 6 times over 4 years between September 1996 and June 2002. Positive childhood experiences, including achievements, positive interpersonal relationships with others, and caretaker competencies, were measured using the Childhood Experiences Questionnaire-Revised. The effects of positive childhood experiences on clinically significant remission from …

Psychosocial Impairment And Treatment Utilization By Patients With Borderline Personality Disorder, Other Personality Disorders, Mood And Anxiety Disorders, And A Healthy Comparison Group, Emily B. Ansell, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

This study compared psychosocial functioning and treatment utilization in 130 participants who were diagnosed with a borderline personality disorder (BPD), a non-BPD personality disorder (OPD), a mood and/or anxiety disorder (MAD), or had no current psychiatric diagnosis and served as a healthy comparison group. Diagnostic and Statistical Manual of Mental Disorders (4th Edition) diagnoses, psychosocial functioning, and treatment utilization were determined by using well-established semistructured research interviews conducted by trained doctoral-level clinicians. Analysis of variance revealed the most severe deficits in functioning characterized the BPD group across areas of global functioning with more moderate impairments in functioning occurring in OPD …

Are Unhygienic Practices During The Menstrual, Partum And Postpartum Periods Risk Factors For Secondary Infertility?, Tazeen S. Ali Dr, Neelofar Sami Dr, Ali Khan Khuwaja Dr

Tazeen S Ali Dr

This study was aimed at identifying practices during the menstrual, partum and postpartum periods posing possible risk factors contributing towards secondary infertility in women of a selected population in Karachi, Pakistan. A matched case-control study was conducted from April 2003 to March 2004. Four hundred cases were selected from five infertility clinics affiliated with tertiary-care hospitals, and 400 age-matched controls were recruited from the neighborhood of each case. After taking written consents, trained interviewers conducted interviews using a pretested structured questionnaire. Factors found to be independently associated with secondary infertility were: previous delivery at an unclean place (adjusted odds ratio …

Collective Creativity: Ideas For The Super Library Organism, Lisa Forrest, Dennis Reed

Lisa A Forrest

No abstract provided.

Assessing Chronic Disease Management Strategies Through Community Based Participatory Research, Kevin D. Willison

Kevin D Willison

Comprehensive chronic disease management (CDM) strategies aim to improve such aspects as continuity of care, health-related quality of life and, overall population health. Here, consideration is made of how CDM may be enhanced through a more integrated and holistic health care system by incorporating a community based participatory research (CBPR) approach. This has the potential to provide meaningful participation by citizens in public health policy development. That CBPR may garner improved assessment of the effectiveness of existing CDM strategies, as imbedded in such practices as (regulated) complementary/alternative medicine (CAM), public health, and transcultural health care initiatives, should not be overlooked.

Longitudinal Diagnostic Efficiency Of Dsm-Iv Criteria For Borderline Personality Disorder: A 2-Year Prospective Study, Carlos M. Grilo, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Robert L. Stout, Donna S. Bender, Shirley Yen, M. Tracie Shea, Leslie C. Morey, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: To examine the longitudinal diagnostic efficiency of the DSM-IV criteria for borderline personality disorder (BPD). METHODS: At baseline, we used semistructured diagnostic interviews to determine criteria and diagnoses; blinded assessments were performed 24 months later with 550 participants. Diagnostic efficiency indices (specifically, conditional probabilities, total predictive power, and kappa) were calculated for each criterion determined at baseline, with the independent BPD diagnosis at follow-up used as the standard. RESULTS: Longitudinal diagnostic efficiencies for the BPD criteria varied, with the criteria of suicidality or self-injury and unstable relationships demonstrating the most predictive utility. CONCLUSIONS: BPD criteria differ in their predictive …

Asana To America: The Advent Of Yoga In The West, M. Popovic, Don Morrow

Donald Morrow

No abstract provided.

Natural Course Of Bulimia Nervosa And Of Eating Disorder Not Otherwise Specified: 5-Year Prospective Study Of Remissions, Relapses, And The Effects Of Personality Disorder Psychopathology, Carlos M. Grilo, Maria E. Pagano, Andrew E. Skodol, Charles A. Sanislow, Thomas H. Mcglashan, John G. Gunderson, Robert L. Stout

Charles A. Sanislow, Ph.D.

OBJECTIVE: To examine prospectively the natural course of bulimia nervosa and eating disorder not otherwise specified (EDNOS) and to test for the effects of personality disorder psychopathology on remission and relapse.

METHOD: Subjects were 92 female patients with current bulimia nervosa (N = 23) or EDNOS (N = 69) at baseline enrollment in the Collaborative Longitudinal Personality Disorders Study. Axis I psychiatric disorders (including eating disorders) were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Version, and personality disorders were assessed with the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). The course of eating disorders was assessed …

Texshare Rx For Robust Health Resources, Chris Childs, A. Faltinek, L. Heinz, J. Vanschaik

Chris A. Childs

No abstract provided.

Benefits Of Training Family Caregivers, Jung Kwak, Jennifer Salmon, Kimberly D. Acquaviva, Katherine Brandt

Kimberly D. Acquaviva, PhD, MSW

during the last years of life that focuses on the emotional, spiritual, and practical aspects of life and relationship completion and closure. This study evaluated the effectiveness of CGLE in improving three major outcomes: comfort with caregiving, closure, and caregiver gain. Family caregivers (n = 2,025) participated in programs facilitated by health and human service professionals (n = 142) who completed a CGLE train-the-trainer workshop conducted by The Hospice Institute of the Florida Suncoast. The caregivers completed training rosters and pre- and/or post-surveys. Group differences are reported in baseline characteristics and change in three outcomes for caregivers who completed 1) …

Physician Colorectal Cancer Screening Recommendations: An Explanation Based On Informed Decision-Making, Yelena N. Tarasenko, Sarah B. Wackerbarth, Jennifer M. Joyce, Steven A. Haist

Yelena N. Tarasenko

Objective: The purpose of this research was to examine the content of physicians’ colorectal cancer screening recommendations. More specifically, using the framework of informed decision making synthesized by Braddock and colleagues, we conducted a qualitative study of the content of recommendations to describe how physicians are currently presenting this information to patients.

Methods: We conducted semi-structured interviews with 65 primary care physicians. We analyzed responses to a question designed to elicit how the physicians typically communicate their recommendation.

Results: Almost all of the physicians (98.5%) addressed the “nature of decision” element. A majority of physicians discussed “uncertainties …

The Summit Series: Iconic Cornucopia Of Canadian Cultural Values, Don Morrow

Donald Morrow

No abstract provided.