Medicine and Health Sciences Commons^™

A Review Of Baobab (Adansonia Digitata) Products: Effect Of Processing Techniques, Medicinal Properties And Uses, Donatien Kabore, Hagrétou Sawadogo-Lingani, Bréhima Diawara, Clarise Compaoré, Mamoudou H. Dicko Prof., Mogens Jacobsen

Pr. Mamoudou H. DICKO, PhD

A general literature review including the effect of processing techniques, medicinal value and uses of baobab tree is reported in this manuscript. Baobab tree has multi-purpose uses, as it produces food and non-food products such as medicines, fuel, timber, fodder. Every part of the baobab tree is reported to be useful. The seeds, leaves, roots, flowers, fruit pulp and bark of baobab are edible. Baobab leaves are used in the preparation of soup. Seeds are used as a thickening agent in soups, but they can be fermented and used as a flavouring agent or roasted and eaten as snacks. The …

Identifying Characteristics Of Effective Small Group Learning Valued By Medical Students And Facilitators, Diana T. Robillard, Laura M. Spring, Susan J. Pasquale, Judith A. Savageau

Judith A. Savageau

Background: Small group teaching is an important part of undergraduate medical education, providing the ideal setting for learners to clarify misunderstandings, test hypotheses and evaluate ideas. Many schools undergoing curriculum reform have increased the time students spend in small group learning. However, there is an overall paucity of literature examining case-based small group sessions in medical school.

Objective: This study was designed to examine student and facilitator perceptions of effective case-based small group teaching in the pre-clinical years and compare results in order to identify similarities and differences and identify key areas of disconnect so that the small …

Improving Prenatal Education In A Health Center: A Pilot Study, Marcy Keddy Boucher, Hugh Silk, Judith A. Savageau, Katharine C. Barnard, Mary Flynn

Judith A. Savageau

Background: Currently, the timing and variety of health education topics that are covered during prenatal visits are decided upon by the individual physician caring for the patient. Consequently, some patients do not gain exposure to important subject matter that could potentially improve their satisfaction and pregnancy outcomes. Previously reported studies have found evidence that improved patient education may increase rates of breastfeeding (as well as duration), seat belt use during pregnancy, and decrease preterm low birth weight infants. In addition, one study has shown that when prenatal visits are targeted to specific objectives, the number of prenatal visits can …

Can Evidence-Based Medicine And Clinical Quality Improvement Learn From Each Other?, Paul Glasziou, Greg Ogrinc, Steve Goodman

Paul Glasziou

The considerable gap between what we know from research and what is done in clinical practice is well known. Proposed responses include the Evidence-Based Medicine (EBM) and Clinical Quality Improvement. EBM has focused more on ‘doing the right things’dbased on external research evidenced whereas Quality Improvement (QI) has focused more on ‘doing things right’ based on local processes. However, these are complementary and in combination direct us how to ‘do the right things right’. This article examines the differences and similarities in the two approaches and proposes that by integrating the bedside application, the methodological development and the training of …

Patterns Of 'Leakage' In The Utilisation Of Clinical Guidelines: A Systematic Review, Sharon Mickan, Amanda Burls, Paul Glasziou

Paul Glasziou

Background Research: Evidence is insufficient to change physicians’ behaviour. In 1996, Pathman developed a four step model: that physicians need to be aware of, agree with, adopt, and adhere to guidelines. Objective: To review evidence in different settings on the patterns of ‘leakage’ in the utilisation of clinical guidelines using Pathman’s awareness-to-adherence model.Methods: A systematic review was conducted in June 2010. Primary studies were included if they reported on rates of awareness and agreement and adoption and/or adherence.Results: 11 primary studies were identified, reporting on 29 recommendations. Descriptive analyses of patterns and causes of leakage were tabulated and graphed. Leakage …

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Nina Silverstein

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

Transdisciplinary Assignments In Graduate Health Education As A Model For Future Collaboration, Catherine Christie, A Russell Smith Jr., Michele Bednarzyk

Catherine Christie

Transdisciplinary health care continues to be at the forefront of patient treatment in the medical arena, in part due to escalating health care costs, an increasing aging population, and the development of multiple chronic diseases. Gaining the knowledge, experience, and principles associated with transdisciplinary teamwork to successfully prepare for modern-day practice is therefore essential for individuals of various health care professions. This report describes an assignment developed and implemented to facilitate professional interaction between graduate physical therapy, nutrition, and nursing students. The objectives of this assignment were to determine through student evaluation the effects of a transdisciplinary experience on students' …

Reference Bias: Presentation Of Extreme Health States Prior To Eq-Vas Improves Health-Related Quality Of Life Scores. A Randomised Cross-Over Trial, Steven Mcphail, Elaine Beller, Terry Haines

Elaine Beller

Background - Clinical practice and clinical research has made a concerted effort to move beyond the use of clinical indicators alone and embrace patient focused care through the use of patient reported outcomes such as health-related quality of life. However, unless patients give consistent consideration to the health states that give meaning to measurement scales used to evaluate these constructs, longitudinal comparison of these measures may be invalid. This study aimed to investigate whether patients give consideration to a standard health state rating scale (EQ-VAS) and whether consideration of good and poor health state descriptors immediately changes their self-report.

Methods …

Development And Validation Of Decision Rules To Guide Frequency Of Monitoring Cd4 Cell Count In Hiv-1 Infections Before Starting Antiretroviral Therapy, Thierry Buclin, Amalio Telenti, Rafael Perera, Chantal Csajka, Hansjakob Furrer, Jeffrey K. Aronson, Paul P. Glasziou

Paul Glasziou

Background: Although CD4 cell count monitoring is used to decide when to start antiretroviral therapy in patients with HIV-1 infection, there are no evidence-based recommendations regarding its optimal frequency. It is common practice to monitor every 3 to 6 months, often coupled with viral load monitoring. We developed rules to guide frequency of CD4 cell count monitoring in HIV infection before starting antiretroviral therapy, which we validated retrospectively in patients from the Swiss HIV Cohort Study.Methodology/Principal Findings: We built up two prediction rules (‘‘Snap-shot rule’’ for a single sample and ‘‘Track-shot rule’’ for multiple determinations) based on a systematic review …

Male Circumcision For Hiv Prevention: Current Evidence And Implementation In Sub-Saharan Africa, Richard G. Wamai, Brian J. Morris, Stefan A. Bailis, David Sokal, Jeffrey D. Klausner, Ross Appleton, Nelson Sewankambo, David A. Cooper, John Bongaarts, Guy De Bruyn, Alex D. Wodak, Joya Banerjee

Richard G. Wamai

Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major …

Map Kinases Couple Hindbrain-Derived Catecholamine Signals To Hypothalamic Adrenocortical Control Mechanisms During Glycemia-Related Challenges, Arshad M. Khan, Kimberly L. Kaminski, Graciela Sanchez-Watts, Todd A. Ponzio, J. Brent Kuzmiski, Jaideep S. Bains, Alan G. Watts

Arshad M. Khan, Ph.D.

No abstract provided.

Do Exercise Motives Predict Obligatory Exercise?, Mary Pritchard, Jessica L. Beaver

R. Eric Landrum

Few studies have examined whether factors predicting obligatory exercise differ by gender. 303 participants completed the Obligatory Exercise Questionnaire and the Reason for Exercise Inventory. All variables correlated significantly. However, the correlation between exercising for fitness and obligatory exercise was significantly stronger in women than men. In women, obligatory exercise was predicted by exercising to improve body tone, fitness, and to enhance mood; in men, obligatory exercise was predicted by exercising to improve body tone, enjoyment, and perceived attractiveness. Implications for treatment are discussed.

Site-Directed Mutations In The C-Terminal Extension Of Human Αb-Crystallin Affect Chaperone Function And Block Amyloid Fibril Formation, T. M. Treweek, Heath Ecroyd, D. M. Williams, S. Meehan, J. A. Carver, M. J. Walker

Heath Ecroyd

Alzheimer’s, Parkinson’s and Creutzfeldt-Jakob disease are associated with inappropriate protein deposition and ordered amyloid fibril assembly. Molecular chaperones, including αBcrystallin, play a role in the prevention of protein deposition. A series of site-directed mutants of the human molecular chaperone, αB-crystallin, were constructed which focused on the flexible C-terminal extension of the protein. We investigated the structural role of this region as well as its role in the chaperone function of αB-crystallin under different types of protein aggregation, i.e. disordered amorphous aggregation and ordered amyloid fibril assembly. It was found that mutation of lysine and glutamic acid residues in the C-terminal …

Effect Of Particle Breakage On Cyclic Densification Of Ballast: A Dem Approach, P K. Thakur, Jayan S. Vinod, Buddhima Indraratna

Buddhima Indraratna

In this paper, an attempt has been made to investigate the effect of particle breakage on densification behaviour of ballast under cyclic loading using Discrete Element Method (DEM). Numerical simulations using PFC2D have been carried out on an assembly of angular particles with and without incorporation of particle breakage. Two-dimensional projection of angular ballast particles were simulated using clusters of bonded circular particles. Degradation of the bonds within a cluster was considered to represent particle breakage. Clump logic was used to make the cluster of particles unbreakable. DEM simulation results highlight that the particle breakage has a profound influence on …

Risk Factors For Driving Cessation Vary By Race And Ethnicity, Elizabeth Dugan, Frank Porell, Chae Man Lee

Frank Porell

Driving is related to our identity and independence as well as allowing us to get needed goods, services, and social opportunities that enrich daily life. Yet with increasing age, the risk for developing threats to medical fitness to drive increases. Driving cessation is related to a long list of negative outcomes, such as: depression, social isolation, diminished access to health care, and diminished quality of life. We investigated risks for driving cessation, paying close attention to racial differences. This study used data from the Health and Retirement Study (HRS), 1998-2008. The study included N=46, 528 older people (age 65 and …

Risk Factors For Driving Cessation Vary By Race And Ethnicity, Elizabeth Dugan, Frank Porell, Chae Man Lee

Elizabeth Dugan

Driving is related to our identity and independence as well as allowing us to get needed goods, services, and social opportunities that enrich daily life. Yet with increasing age, the risk for developing threats to medical fitness to drive increases. Driving cessation is related to a long list of negative outcomes, such as: depression, social isolation, diminished access to health care, and diminished quality of life. We investigated risks for driving cessation, paying close attention to racial differences. This study used data from the Health and Retirement Study (HRS), 1998-2008. The study included N=46, 528 older people (age 65 and …

Hallucination Proneness, Schizotypy And Meta-Cognition, John Stirling, Emma Barkus, Shon Lewis

Emma Barkus

Disordered or maladaptive meta-cognitive processing appears to be a prominent feature for some individuals with a diagnosis of schizophrenia. We sought to establish whether healthy individuals distinguished either in terms hallucination proneness (HP) or level of schizotypy could also be differentiated on the sub-scales of the Meta-cognitions Questionnaire (MCQ), or a modified version of it in which items about worry were replaced with items specifically related to thinking. A total of 106 healthy volunteers completed the Oxford and Liverpool Inventory of Feelings and Experiences and Launay-Slade hallucination scale, the Schizotypal Personality Questionnaire and two versions of the MCQ: the original …

Ecstasy (Mdma) And Its Relationship With Self Report Depression, Anxiety And Schizotypy, Lisa Woods, Emma Barkus

Emma Barkus

Abstract. Aims: The relationship between ecstasy and affective psychological symptoms are still subject to debate. We aimed to examine the relationship between Ecstasy use and self-report depression, anxiety and schizotypy. Design: Data were collected via structured remote self-report questionnaires. Participants: Participants were split into three groups: a control group with no ecstasy use, a light ecstasy user group (<50 >times), and a heavy ecstasy user group (>50 times). Measurements: Amount and patterns of ecstasy use were recorded, the Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) measured depression and anxiety respectively, and schizotypal traits were measured using the …

Cannabis-Induced Psychosis-Like Experiences Are Associated With High Schizotypy, Emma Barkus, John Stirling, Richard Hopkins, Shon Lewis

Emma Barkus

OBJECTIVE: Recent studies have suggested that cannabis use is a risk factor for developing schizophrenia. We tested the hypothesis that cannabis use increases the likelihood of psychosis-like experiences in non-clinical participants who scored highly on a measure of schizotypy. METHOD: The psychological effects of cannabis were assessed in 137 healthy individuals (76% female, mean age 22 years) using a newly developed questionnaire concerned with subjective experiences of the drug: the Cannabis Experiences Questionnaire. The questionnaire has three subscales: Pleasurable Experiences, Psychosis-Like Experiences and After-Effects. Respondents also completed the brief Schizotypal Personality Questionnaire. RESULTS: Cannabis use was reported by 72% of …

Cannabis-Induced Psychotic-Like Experiences Are Predicted By High Schizotypy. Confirmation Of Preliminary Results In A Large Cohort., John Stirling, Emma Barkus, L Nabosi, S Irshad, G Roemer, B Schreudergoidheijt, Shon Lewis

Emma Barkus

Background: Cannabis use has been identified as a possible risk factor for developing schizophrenia. In a previous paper we reported preliminary evidence that cannabis use increases the likelihood of psychosis-like experiences in non-clinical respondents who scored highly on a measure of schizotypy. We now present findings from pooled data from 3 new follow-up studies comprising a sample of 477 respondents, of whom 332 reported using cannabis at least once. Sampling and Methods: As in our previous study, the psychological effects of cannabis were assessed with the Cannabis Experiences Questionnaire, from which 3 subscales can be derived; encompassing pleasurable experiences, psychosis-like …

Suggestibility, Dissociation And Positive Schizotypy, Emma Barkus, John Stirling, John Cavill

Emma Barkus

Abstract. 94 participants, drawn from a parent sample of 1206 individuals who had previously taken part in an assessment of the factor structure of the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE), were designated into groups differentiated in terms of low, moderate or high levels of positive schizotypy. All also completed the dissociative experiences scale (DES) and the Inventory of Suggestibility (IS). Our findings suggest that higher reported levels of dissociative experiences and higher suggestibility both independently predict higher scores of positive schizotypy, although suggestibility appears to be a stronger predictor than dissociation.

Schizotypy And Psychosis-Like Experiences From Recreational Cannabis In A Non-Clinical Sample, Emma Barkus, Shon Lewis

Emma Barkus

Background. The relationship between cannabis use and psychosis is still a matter for debate. Accounting for the individual differences in subjective experiences to recreational cannabis use in the general population may hold some clues to the aetiological relationship between cannabis and psychotic symptoms. We hypothesized that schizotypy would account for the individual differences in subjective experiences after cannabis use but not in patterns of use. Method. In a sample of 532 young people who had used cannabis at least once, we examined the relationship between the Cannabis Experiences Questionnaire (CEQ) and the Schizotypal Personality Questionnaire (SPQ). Additionally, we examined the …

Distress And Metacognition In Psychosis Prone Individuals: Comparing High Schizotypes To The At-Risk Mental State, Emma Barkus, John Stirling, Paul French, Anthony Morrison, Richard Bentall, Shon Lewis

Emma Barkus

Both schizotypy and at-risk mental states (ARMS: prodromal states) define individuals at risk for psychotic symptoms. However, the relationship between the 2 is unclear. ARMS individuals are, by definition, help-seeking and therefore at greater risk. We tested whether high schizotypes and ARMS exist along the same continuum by examining maladaptive metacognitions and distress. About 95 healthy volunteers (39% male; mean age, 22.8 years) completed the Schizotypal Personality Questionnaire, the Launay-Slade Hallucinations Scale, Metacognitions Questionnaire (MCQ), and the General Health Questionnaire, and 58 help seeking individuals with ARMS status (41% male; mean age, 22.2 years) completed the Metacognitions Questionnaire and General …

Personality And Cannabis Use, Emma Barkus

Emma Barkus

Cannabis is one of the most widely used illegal substances in the world. Its use has been reported to be over-represented in many psychiatric conditions and has frequently been found to predate the onset of psychiatric symptoms. However, cannabis may also have detrimental effects on the general population. Factors that predict the onset of use are receiving increased attention to aid in identifying groups of young people who may be more prone to consume cannabis. Personality traits may be one such factor as they are readily identifiable and offer information that can be used for improved targeting of educational material …

Senior Transportation Abstracts: A Focus On Options, Helen Kerschner, Nina M. Silverstein

Nina Silverstein

This collection of abstracts represents a publication of importance for understanding the needs, challenges, solutions, and/or every day issues related to senior transportation services. While several of the abstracts include information about senior driver safety, the collection’s primary purpose is to present a holistic approach to transportation options for older adults. Such a collection is timely because, although the practice of providing transportation to older adults is not new, research and preparation of practical informational and technical materials related to older adult transportation service needs and service delivery are quite recent.

Challenging The Views Of Self Management For Asthma, Kelly L. Andrews, Sandra C. Jones, Melinda Williams, Judy Mullan

Judy Mullan

• Individual nature of asthma and the asthmatic are not well understood or prioritised as a starting point to improve the uptake of self management strategies • Fuller understanding of 4 P’s from a consumer perspective required • Preliminary audience segmentation herein provide a sound platform for future investigations • Consumer focused evaluations are necessary to understand the present barriers and future facilitators of health behaviour change.

Rain, Smog, Fog And Printed Educational Material, Judy Mullan, Patrick A. Crookes, Heather Yeatman

Judy Mullan

Patient education is central to the practice of all health professionals. Pharmacists often use printed educational material, such as consumer medicine information, as adjuncts to verbal communication and education of patients about their medications. A relatively large proportion of the Australian population have low literacy skills and cannot read or understand written patient educational materials which are typically written at levels equivalent to year 9 and above. By using simple readability assessment tools such as RAIN, SMOG or FOG and the UK's Department of Health 'Toolkit for producing patient information' health professionals can ensure that printed educational materials are simple …

Challenges Of Older Patients’ Knowledge About Warfarin Therapy, Sayeed Nasser, Judy Mullan, Beata Bajorek

Judy Mullan

Objective: To review the challenges of warfarin education for older patients (aged 65 years or older) in terms of knowledge, access to warfarin education, and education resources. Methods: A quasi-systematic review of the literature was performed via electronic database searches (eg, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts, Meditext, and Google Scholar) from 1990 to May 2011. Results: The 62 articles reviewed found that improved patient knowledge results in better anticoagulation control. The review also found that between 50% and 80% of older patients have inadequate knowledge about the basic aspects of warfarin therapy …

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

Judy Mullan

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 …

Midwifery And The Context Of Care: Is It Possible To Be 'Woman Centred'?, Moira Williamson, Lindsey Harrison

Moira Williamson

Title: Midwifery and the context of care: Is it impossible to be ‘woman centred’? Dr Moira Williamson, School of Nursing, Midwifery and Indigenous Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia, ph. +61 2 4221 3381, email: moiraw@uow.edu.au Dr Lindsey Harrison, School of Health Sciences, University of Wollongong Background: Findings from a qualitative study show that the context of care can inhibit midwives’ provision of woman centred care; especially impacted is their ability to provide culturally appropriate care. Aim of the Study: The aims of the study were to gain an understanding of midwives’ concepts of culture and …