Medicine and Health Sciences Commons^™

Medicine In The Americas, Kristine A. Petre Mls, Cm, Ahip

Kristine A Petre, MLS, CM, AHIP

Medicine in the Americas is a freely available, searchable collection of historical medical Americana. The collection is part of the Digital Collections repository at the National Library of Medicine’s online digital archives. This review discusses the contents, searching functions, and additional features available in the collection.

Assessing Oral Health Curriculum In Us Family Medicine Residency Programs: A Cera Study, Hugh Silk, Ronnelle King, Ian M. Bennett, Alexander W. Chessman, Judith A. Savageau

Judith A. Savageau

BACKGROUND AND OBJECTIVES: During the past decade, national initiatives have called for improved oral health training for physicians. We do not know, however, how family medicine residency programs have answered this call. METHODS: Family medicine residency directors completed a survey that asked how many hours of oral health teaching are included in their programs in addition to what topics are covered and the perceived barriers to this education. The response rate was 35%. RESULTS: A total of 72% of respondents agreed that oral health is an important topic, but only 32% are satisfied with their residents' competency in oral health. …

What Aspect Of Dependence Does The Fagerström Test For Nicotine Dependence Measure?, Joseph R. Difranza, Robert J. Wellman, Judith A. Savageau, Ariel Beccia, W. W. Sanouri A. Ursprung, Robert Mcmillen

Judith A. Savageau

Although the Fagerström Test for Nicotine Dependence (FTND) and the Heaviness of Smoking Index (HSI) are widely used, there is a uncertainty regarding what is measured by these scales. We examined associations between these instruments and items assessing different aspects of dependence. Adult current smokers ( , mean age 33.3 years, 61.9% female) completed a web-based survey comprised of items related to demographics and smoking behavior plus (1) the FTND and HSI; (2) the Autonomy over Tobacco Scale (AUTOS) with subscales measuring Withdrawal, Psychological Dependence, and Cue-Induced Cravings; (3) 6 questions tapping smokers’ wanting, craving, or needing experiences in response …

An Ounce Of Prevention: How Are We Managing The Early Assessment Of Residents' Clinical Skills?: A Cera Study, Tracy Kedian, Lisa S. Gussak, Judith A. Savageau, Andreas Cohrssen, Ilene Abramson, Kelly Everard, Alison Dobbie

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Clinical skills deficits in residents are common but when identified early can result in decreased cost, faculty time, and stress related to remediation. There is currently no accepted best practice for early assessment of incoming residents' clinical skills. This study describes the current state of early PGY-1 clinical skills assessment in US family medicine residencies.

METHODS: Eleven questions were embedded in the nationwide CERA survey to US family medicine residency directors regarding the processes, components, and barriers to early PGY-1 assessment. Responses are described, and bivariate analyses of the relationship between assessment variables and percentage of international …

Adrenoceptor Function And Expression In Bladder Urothelium And Lamina Propria, Christian Moro, Lotti Tajouri, Russ Chess-Williams

Russ Chess-Williams

Objective - To investigate the role of adrenoceptor subtypes in regulating the spontaneous contractile activity of the inner lining of the urinary bladder (urothelium/lamina propria).Materials and Methods - The responses of isolated strips of porcine urothelium/lamina propria to noradrenaline, phenylephrine, and isoprenaline were obtained in the absence and presence of receptor subtype-selective antagonists. Quantitative reverse-transcriptase polymerase chain reaction was undertaken to assess the expression of adrenoceptor genes.Results - The tissues expressed all α1- and β-adrenoceptor subtypes, with the α1A-, α1B-, and β2-adrenoceptors the predominant receptors at the messenger RNA level. In the functional experiments, the rate of phasic contractions and …

Adrenoceptor Function And Expression In Bladder Urothelium And Lamina Propria, Christian Moro, Lotti Tajouri, Russ Chess-Williams

Lotti Tajouri

Objective - To investigate the role of adrenoceptor subtypes in regulating the spontaneous contractile activity of the inner lining of the urinary bladder (urothelium/lamina propria).Materials and Methods - The responses of isolated strips of porcine urothelium/lamina propria to noradrenaline, phenylephrine, and isoprenaline were obtained in the absence and presence of receptor subtype-selective antagonists. Quantitative reverse-transcriptase polymerase chain reaction was undertaken to assess the expression of adrenoceptor genes.Results - The tissues expressed all α1- and β-adrenoceptor subtypes, with the α1A-, α1B-, and β2-adrenoceptors the predominant receptors at the messenger RNA level. In the functional experiments, the rate of phasic contractions and …

Pain In Parkinson’S Disease: Characteristics And Responses In Ambulatory Care Patients, Lisette Bunting-Perry

Lisette K Bunting-Perry

Pain is often a disabling symptom in Parkinson’s disease (PD), and is currently underassessed, underdiagnosed, and undertreated in this population of primarily older adults. Guided by the Rugh Model of Psychological Components of Pain, an exploration of the characteristics of pain experienced by individuals with PD, and the relationships among the emotional, cognitive, perceptual, and behavioral aspects of pain was undertaken. A convenience sample of 125 patients with PD reporting average daily pain as 2 or greater on the Brief Pain Inventory-Short Form, were recruited for a cross-sectional descriptive survey from two large urban movement disorder centers. Multiple measures were …

Lack Of Correlation Of Wais Digit Span With Clox 1 And The Dementia Rating Scale In Mci, Jevin Jay Lortie, Ruth Remington, Heather Hoffman, Thomas B. Shea

Ruth Remington

No abstract provided.

Reconditioning Post Injury: Part 1 Musculoskeletal Injuries: Mechanisms And Causes, Rob Marc Orr

Rob Marc Orr

No abstract provided.

Trajectories Of Depression And Their Relationship With Health Status And Social Service Use, Chun-Min Chen, Judy Mullan, David Griffiths, Irene A. Kreis, Tzuo-Yun Lan, Herng-Chia Chiu

Professor David Griffiths

This longitudinal study was conducted between 1994 and 2004 in a cohort of Southern Taiwan community-living elderly residents. The study aims to explore the trajectories of depression and how these patterns differed between respondents who survived and those who died during data collection phases; this study also investigated how health status change and health/social service use predicted the different trajectories of depression. Eight hundred and ten participants had completed all six waves of the survey or were followed-up at each wave until death in the prospective study in Kaohsiung City. Depressive symptoms were evaluated by the Short Psychiatric Evaluation Schedule …

The Longitudinal Relationship Between Depression Symptoms And Disability For Older Adults: A Population-Based Study, Chun-Min Chen, Judy Mullan, Yung-Yu Su, David Atherton Griffiths, Irene Kreis, Herng-Chia Chiu

Professor David Griffiths

Background. Although depressive symptoms in older adults are common, their relationship with disability and the influence of disability on the development of depressive symptoms over time is not well understood. This longitudinal study investigates the change trajectories of both depressive symptoms and disability, as well as their associations over time. Methods. Participants included 442 community-dwelling older adults living in Taiwan, aged 65 years or older, who completed six waves of survey interviews. Depression was scored with the Short Psychiatric Evaluation Schedule and disability with the instrumental and physical activities of daily living measure during each consecutive data collection wave. The …

أمراض الأطفال المزمنة, Suad Fahad Alferaih

Dr. Suad Fahad AlFuraih

No abstract provided.

Genetic Determinants Of Cerebral Edema In Severe Traumatic Brain Injury: A Pilot Study Of The Role Of Cacna1 And Aqp4 Gene Mutations, Raphael A. Carandang, Susanne Muehlschlegel, Wiley R. Hall, Cynthia Ouillette, Robert H. Brown Jr.

Dr Robert Brown

Cerebral edema is the one of the most significant predictors of poor outcome after traumatic brain injury. It is still unclear what the pathophysiological and cellular mechanisms and predictors of post-traumatic edema are. The exponential growth in genetic information has opened an avenue for investigation in traumatic brain injury and implicated specific genes in the pathophysiology of post-traumatic injury edema. Two examples are the Aquaporin-4 and CACNA1 genes, which respectively encode water and calcium channels. The Aquaporin-4 gene on chromosome 18q11.2-12.1 encodes the Aquaporin-4 protein (AQP4) water channel. AQP4 is one of the bidirectional high capacity water channels that is …

Identification Of Small Subunits Of Mammalian Serine Palmitoyltransferase That Confer Distinct Acyl-Coa Substrate Specificities, Gongshe Han, Sita D. Gupta, Kenneth Gable, Somashekarappa Niranjanakumari, Prasun Moitra, Florian Eichler, Robert H. Brown Jr., Jeffrey M. Harmon, Teresa M. Dunn

Dr Robert Brown

Serine palmitoyltransferase (SPT) catalyzes the first committed step in sphingolipid biosynthesis. In yeast, SPT is composed of a heterodimer of 2 highly-related subunits, Lcb1p and Lcb2p, and a third subunit, Tsc3p, which increases enzyme activity markedly and is required for growth at elevated temperatures. Higher eukaryotic orthologs of Lcb1p and Lcb2p have been identified, but SPT activity is not highly correlated with coexpression of these subunits and no ortholog of Tsc3p has been identified. Here, we report the discovery of 2 proteins, ssSPTa and ssSPTb, which despite sharing no homology with Tsc3p, each substantially enhance the activity of mammalian SPT …

Homologous Recombination Mediates Functional Recovery Of Dysferlin Deficiency Following Aav5 Gene Transfer, William E. Grose, K. Reed Clark, Danielle Griffin, Vinod Malik, Kimberly M. Shontz, Chrystal L. Montgomery, Sarah Lewis, Robert H. Brown Jr., Paul M. L. Janssen, Jerry R. Mendell, Louise R. Rodino-Klapac

Dr Robert Brown

The dysferlinopathies comprise a group of untreatable muscle disorders including limb girdle muscular dystrophy type 2B, Miyoshi myopathy, distal anterior compartment syndrome, and rigid spine syndrome. As with other forms of muscular dystrophy, adeno-associated virus (AAV) gene transfer is a particularly auspicious treatment strategy, however the size of the DYSF cDNA (6.5 kb) negates packaging into traditional AAV serotypes known to express well in muscle (i.e. rAAV1, 2, 6, 8, 9). Potential advantages of a full cDNA versus a mini-gene include: maintaining structural-functional protein domains, evading protein misfolding, and avoiding novel epitopes that could be immunogenic. AAV5 has demonstrated unique …

Complex Adaptive Systems As A Model For Evaluating Organisational Change Caused By The Introduction Of Health Information Systems, Kieren Diment Mr, Ping Yu, K. Garrety

Dr Ping Yu

This paper documents the preliminary development of a framework for evaluating organisational change processes during the implementation of an electronic nursing documentation system in residential aged care facilities. It starts with a brief outline of organisational change processes. This is followed by a more detailed exposition of the principles underlying complex adaptive systems (CAS) theory, where we explain how mathematical concepts can be used to illuminate qualitative research approaches. Finally we present some preliminary findings on the facilitators and barriers for the introduction of the electronic documentation system, explained with reference to the CAS theory, based on analysis of interviews …

Model Selection For Cox Models With Time-Varying Coefficients, Jun Yan

Dr Jun Yan

Cox models with time-varying coefficients offer great flexibility in capturing the temporal dynamics of covariate effects on right censored failure times. Since not all covariate coefficients are time-varying, model selection for such models presents an additional challenge, which is to distinguish covariates with time-varying coefficient from those with time-independent coefficient. We propose an adaptive group lasso method that not only selects important variables but also selects between time-independent and time-varying specifications of their presence in the model. Each covariate effect is partitioned into a time-independent part and a time-varying part, the latter of which is characterized by a group of …

A Framework For Fetecting Interactions Between Co-Incident Clinical Processes, Aditya K. Ghose, Kerry Hinge, Andrew Alexis Miller

Professor Aditya K. Ghose

The detection of treatment conflicts between multiple treatment protocols that are co-incident is a difficult and open problem that is particularly exacerbated regarding the treatment of multiple medical conditions co-occurring in aged patients. For example, a clinical protocol for prostate cancer treatment requires the administration of androgen-suppressing medication, which may negatively interact with another, co-incident protocol if the same patient were being treated for renal disease via haemodialysis, where androgen-enhancers are frequently administered. These treatment conflicts are subtle and difficult to detect using automated means. Traditional approaches to clinical decision support would require significant clinical knowledge. In this paper, the …

Setting Directions For Research Capacity Building In Primary Health Care: A Survey Of A Research Network, Karin Ried, Elizabeth Farmer, Kathryn M. Weston

Elizabeth Farmer

Background The South Australian Research Network 'SARNet' aims to build research capacity in primary health care, as part of a national government-funded strategy to integrate research into clinical practice. Internationally, research networks have been a fundamental part of research culture change, and a variety of network models exist. The 'SARNet' model uses a whole system, multidisciplinary approach to capacity building and supports individuals and groups. We undertook a descriptive baseline survey in order to understand the background and needs of SARNet members and to tailor network activities towards those needs. Methods A questionnaire survey, assessing members' professional background, research experience, …

General Practice Research Training: Impact Of The Australian Registrar Research Workshop On Research Skills, Confidence, Interest And Involvement Of Participants, 2002-2006, Karin Ried, Brett D. Montgomery, Nigel P. Stocks, Elizabeth A. Farmer

Elizabeth Farmer

Background. An intensive 3-day training programme, the ‘Registrar Research Workshop’ (RRW), has aimed to build research capacity among Australian general practice registrars since 1994. Objectives. To investigate the impact of the RRW on participants' skills, confidence, interest in research and research activity. Methods. Cross-sectional postal survey in 2006 of five groups of registrars who participated in the annual workshop in 2002–2006 (response rate: 64%; 77 of 121). Outcome measures included research experience and skills prior to and after the workshop; impact of the workshop on capacity, confidence, attitude and interest in research; and research involvement as measured by publications and …

Tai Chi For Stress Management And Well-Being In Medical Students, Susan J. Thomas, Teresa M. Treweek, Elizabeth Farmer, John A. Bushnell

Elizabeth Farmer

No abstract provided.

Research Networks: Enhancing Change In Australian Primary Health Care, Elizabeth Farmer, Raechel L. Waters, Kathryn M. Weston

Elizabeth Farmer

As primary health care disciplines evolve and strengthen both in Australia and internationally, primary care practitioners need to develop their research capacity at all levels. This paper discusses the changing face of primary health care and the emergence of primary care research networks as agents for research skills capacity building. Much can be learnt from international experiences, such as those in the United Kingdom, in terms of network models and approaches that have demonstrated successful outcomes including increased grant applications, research higher degree completions and publications. However, these outcomes are at least partly dependent on different contexts of health care …

Linking Primary Health Care Researchers In South Australia: A Network Strategy, Sarnet, Raechel L. Waters, Kathryn M. Weston, Elizabeth Farmer

Elizabeth Farmer

In response to the changing definitions of primary care delivery there is a growing need for research to be practitioner-driven and multidisciplinary. This paper addresses the strategies used to enhance multidisciplinary participation and capacity building in research in the South Australian Primary Health Care Research Network (SARNet). This network has 198 members currently. Membership is strongly multidisciplinary and spans all levels of research expertise. The services offered by the network are member-driven and include competitive bursary funding for research and evaluation skills development, writing groups, training events, access to web-based resources and information, special interest groups, and email alerts. Potential …

Determining Level Of Care Appropriateness In The Patient Journey From Acute Care To Rehabilitation, C. Poulos, Christopher A. Magee, Guy M. Bashford, Kathy Eagar

Kathy Eagar

Background: The selection of patients for rehabilitation, and the timing of transfer from acute care, are important clinical decisions that impact on care quality and patient flow. This paper reports utilization review data on inpatients in acute care with stroke, hip fracture or elective joint replacement, and other inpatients referred for rehabilitation. It examines reasons why acute level of care criteria are not met and explores differences in decision making between acute care and rehabilitation teams around patient appropriateness and readiness for transfer. Methods: Cohort study of patients in a large acute referral hospital in Australia followed with the InterQual …

Nutrition Status Of Primary Care Patients With Depression And Anxiety, Adrienne K. Forsyth, Peter G. Williams, Frank P. Deane

Frank Deane

The objective of this study was to evaluate the nutrition status of people referred to a nutrition and physical activity program for the management of mental health in a general practice.

Predicting Dropout In The First 3 Months Of 12-Step Residential Drug And Alcohol Treatment In An Australian Sample, Frank P. Deane, David J. Wootton, Ching-I Hsu, Peter J. Kelly

Frank Deane

Objective: Premature termination from treatment is a major factor associated with poorer drug and alcohol treatment outcomes. The present study investigated client-related baseline predictors of dropout at 3 months from a faith-based 12-step residential drug treatment program. Method: Data were collected over a period of 14 months from eight residential drug and alcohol treatment programs run by The Australian Salvation Army. The final sample consisted of 618 participants, including 524 men (84.8%) and 94 women (15.2%). Predictor variables of interest were age, gender, primary drug of concern, criminal involvement, psychological distress, drug cravings, self-efficacy to abstain, spirituality, forgiveness of self …

Prevalence Of Smoking And Other Health Risk Factors In People Attending Residential Substance Abuse Treatment, Peter J. Kelly, Amanda L. Baker, Frank P. Deane, Frances Kay-Lambkin, Billie Bonevski, Jenna Tregarthen

Frank Deane

Introduction and Aims. People attending substance abuse treatment have an elevated risk of developing cardiovascular disease (CVD) and cancer. Consequently, there have been increasing calls for substance abuse treatment services to address smoking.The current study examined smoking behaviours of people attending residential substance abuse treatment. Additionally, the study examined rates of other potentially modifiable health risk factors for the development of CVD and cancer. Design and Methods. A cross-sectional survey was completed by participants attending Australian Salvation Army residential substance abuse treatment services (n = 228). Rates of smoking, exercise, dietary fat intake, body mass index and depression were identified …

A Comparison Of Treatment Outcomes For Individuals With Substance Use Disorder Alone And Individuals With Probable Dual Diagnosis, Elizabeth K. Cridland, Frank P. Deane, Ching-I Hsu, Peter J. Kelly

Frank Deane

The co-occurrence of substance use and mental health problems, often referred to as dual diagnosis (DD), is increasingly recognised as commonplace within substance abuse treatment programs. Two-hundred and thirty-four individuals from 9 Australian Salvation Army drug and alcohol rehabilitation programs completed a 3-month post-discharge telephone follow-up. Using a cut-off score from the Psychiatric Subscale of the Addiction Severity Index (5th ed.), 66.7% were classified as likely to have DD and 33.3% as substance use disorder only (SUD). Both groups reported comparable and decreased substance use levels at follow-up, yet DD individuals perceived less improvement in substance use problems. Comparable improvements …

Low Frequency Vibrations Induce Malformations In Two Aquatic Species In A Frequency-, Waveform-, And Direction-Specific Manner, Laura Vandenberg, Claire Stevenson, Michael Levin

Laura Vandenberg

Environmental toxicants such as industrial wastes, air particulates from machinery and transportation vehicles, and pesticide run-offs, as well as many chemicals, have been widely studied for their effects on human and wildlife populations. Yet other potentially harmful environmental pollutants such as electromagnetic pulses, noise and vibrations have remained incompletely understood. Because developing embryos undergo complex morphological changes that can be affected detrimentally by alterations in physical forces, they may be particularly susceptible to exposure to these types of pollutants. We investigated the effects of low frequency vibrations on early embryonic development of two aquatic species, Xenopus laevis (frogs) and Danio …

Impact Study Of A Central Lines Simulation Training Program Using Kirkpatrick’S Four-Level Evaluation Model, James P. Orlando Edd, Andrew C. Miller Do, William Bond Md, Ms, Valerie A. Rupp Rn, Bsn, Bryan G. Kane Md, Cindy Umbrell Rn, Msn, Michael Pasquale Md

Bryan G Kane MD

No abstract provided.