Medicine and Health Sciences Commons^™

Make A (Mission) Statement, Diana V. Macri

Publications and Research

Ethics are standards of right and wrong that prescribe what humans ought to do; principles such as veracity, courage, integrity, forthrightness, consistency, creativity, humility, altruism, quality, accountability, excellence, compassion, innovation, social justice, wisdom, kindness, trust, balance and fairness. Creating a mission statement offers one the opportunity to establish which principles are most important and helps reinforce them when tested.

Saludableomaha: Improving Readiness To Address Obesity Through Healthy Lifestyle In A Midwestern Latino Community, 2011–2013, Leah Frerichs, Jeri Brittin, Regina Robbins, Sharalyn Steenson, Catherine Stewart, Christopher Fisher, Terry T-K Huang

Publications and Research

Background A community’s readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities.

Community Context This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles.

Methods SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning …

The Regulatory Function Of Sphingosine-1-Phosphate Signaling Axis On Regulatory T Cells In Colorectal Cancer, Andrew V. Nguyen, Yuan-Yuan Wu, Elaine Y. Lin

Publications and Research

In tumors associated with inflammation such as inflammatory bowel disease (IBD) and colorectal cancer (CRC), high numbers of regulatory T cells (Tregs) are associated with both favorable and poor prognoses. The functions of Tregs in CRC remain elusive and have yet to be clearly defined. With new evidence supporting many subsets of Tregs, the research on the development and functions of these cells has begun to come to fruition. The sphingosine 1 phosphate (S1P) pathway was recently reported to regulate the development and function of regulatory T cells. This pathway may shine new light into the pleiotropic nature of these …

Maternal Characteristics And Clinical Diagnoses Influence Obstetrical Outcomes In Indonesia, Asri Adisasmita, Carl V. Smith, Ayman A.E. El-Mohandes, Poppy Elvira Deviany, Judith J. Ryon, Michele Kiely, Quail Rogers-Bloch, Reginald F. Gipson

Publications and Research

This Indonesian study evaluates associations between near-miss status/death with maternal demographic, health care characteristics, and obstetrical complications, comparing results using retrospective and prospective data. The main outcome measures were obstetric conditions and socio-economic factors to predict near-miss/death. We abstracted all obstetric admissions (1,358 retrospective and 1,240 prospective) from two district hospitals in East Java, Indonesia between 4/1/2009 and 5/15/2010. Prospective data added socio-economic status, access to care and referral patterns. Reduced logistic models were constructed, and multivariate analyses used to assess association of risk variables to outcome. Using multivariate analysis, variables associated with risk of near-miss/death include postpartum hemorrhage (retrospective …

Variation In Rheumatoid Hand And Wrist Surgery Among Medicare Beneficiaries: A Population-Based Cohort Study, Lin Zhong, Kevin C. Chung, Onur Baser, David A. Fox, Huseyin Yuce, Jennifer F. Waljee

Publications and Research

Objective. To examine the rate and variation in rheumatoid arthritis (RA)-related hand and wrist surgery among Medicare (elderly) beneficiaries in the United States, and to identify the patient and provider factors that influence surgical rates.

Methods. Using the 2006–2010 100% Medicare claims data of beneficiaries with RA diagnosis, we examined rates of rheumatoid hand and wrist arthroplasty, arthrodesis, and hand tendon reconstruction in the United States. We used multivariate logistic regression models to examine variation in receipt of surgery by patient and regional characteristics (density of providers, intensity of use of biologic disease-modifying antirheumatic drugs).

Results. Between 2006 and 2010, …

The Impact Of Dentures On The Nutritional Health Of The Elderly, Michelle Gellar, Daniel Alter

Publications and Research

No abstract provided.

Bayesian Nonparametric Cross-Study Validation Of Prediction Methods, Lorenzo Trippa, Levi Waldron, Curtis Huttenhower, Giovanni Parmigiani

Publications and Research

We consider comparisons of statistical learning algorithms using multiple data sets, via leave-one-in cross-study validation: each of the algorithms is trained on one data set; the resulting model is then validated on each remaining data set. This poses two statistical challenges that need to be addressed simultaneously. The first is the assessment of study heterogeneity, with the aim of identifying a subset of studies within which algorithm comparisons can be reliably carried out. The second is the comparison of algorithms using the ensemble of data sets. We address both problems by integrating clustering and model comparison. We formulate a Bayesian …

Benchmarking Hospital Performance Using Health Analytics, Viju Raghupathi, Wullianallur Raghupathi

Publications and Research

Background: The objective of this study is to investigate hospital performance using an emerging analytics approach. Given that hospital care accounts for a large segment of healthcare spending, it is essential that hospital performance be measured over time to determine whether and where there is room for improvement in some of its critical success factors, and if there are savings to be found.

Methods: Employing indicators such as hospital cost, in-hospital death rate, length of hospital stay, and the number of discharges from the hospital, we look at the trends for these indicators over a 10-year period. Data was extracted …

A Neural Network Analysis Of Treatment Quality And Efficiency Of Hospitals, Viju Raghupathi, Wullianallur Raghupathi

Publications and Research

Objectives: Due to the escalating healthcare expenditure and the number of hospitalizations, it is becoming increasingly important for healthcare organizations to evaluate the cost and improve the quality and efficiency of treatment.

Method: We deploy neural networks to examine the strategic association between hospitalization experience and treatment results. The healthcare data for the years 2009-2012 are downloaded from the Statewide Planning and Research Cooperative System (SPARCS) of the New York State Department of Health (NYSDOH). We operationalize the hospitalization experience using the indicators facility ID, procedure description, type of admission, patient disposition upon discharge, APR severity of illness, source of …

What The Obesity Prevention Field Can Learn From The Gay Marriage Movement, Sergio Costa, Emily Ferris, Terry T-K Huang

Publications and Research

In the US, two-thirds of adults and one-third of children continue to be affected by overweight or obesity despite two decades and billions of dollars' spent in public health efforts. In the last decade, public health has stepped up its call for greater emphasis on environmental and policy interventions, including active designs in urban planning and restrictions on food marketing to children, to incentivize healthy behaviors and disincentivize less healthy ones. However, there has been little success in policy change to prevent obesity. Voters in Berkeley, CA recently passed a one-cent-per-ounce soda tax, but a similar measure was defeated by …

Patchy Progress On Obesity Prevention: Emerging Exemplars, Entrenched Barriers, And New Thinking, Christina A. Roberto, Boyd Swinburn, Corinna Hawkes, Terry T-K Huang, Sergio Costa, Marice Ashe, Lindsey Zwicker, John H. Cawley, Kelly D. Brownell

Publications and Research

Although there have been positive pockets of change, no country has yet turned around its obesity epidemic. Preventing an increase in obesity prevalence will require urgent actions from government as well as a broader spectrum of stakeholders than previously emphasized. In this paper, we review a number of regulatory and non-regulatory actions taken around the world to address obesity and discuss some of the reasons for the patchy progress. In addition, we preview the papers in this Lancet series, which each identify priority actions on key obesity issues and challenge some of the entrenched dichotomies that present obesity and its …

Challenging Race-Based Stereotypes About Gay And Bisexual Men’S Sexual Behavior And Perceived Penis Size And Size Satisfaction, Christian Grov, Lena D. Saleh, Jonathan M. Lassiter, Jeffrey T. Parsons

Publications and Research

Racial prejudice and stereotyping in gay and bisexual communities may be important contextual factors that contribute to racial disparities in HIV. In an effort to challenge race-based stereotypes regarding gay and bisexual men’s sexuality, we sought to determine the extent to which race and ethnicity were associated with (1) racial homophily (i.e., same-race partnerships), (2) sexual behavior (e.g., number of partners, condomless anal sex (CAS), sexual position (top/versatile/bottom)), and (3) perceived penis size and size satisfaction. Data were taken from a survey of 1,009 gay and bisexual men recruited using a street-intercept method at gay, lesbian, and bisexual community events …

Is Burnout Separable From Depression In Cluster Analysis? A Longitudinal Study, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Purpose: Whether burnout and depression represent distinct pathologies is unclear. The aim of this study was to examine whether burnout and depressive symptoms manifest themselves separately from each other or are so closely intertwined as to reflect the same phenomenon.

Methods: A two-wave longitudinal study involving 627 French schoolteachers (73 % female) was conducted. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire.

Results: Burnout and depressive symptoms clustered both at baseline and follow-up. Cluster membership at time 1 (T1) predicted cases of burnout and depression at time 2 …

Is It Time To Consider The "Burnout Syndrome" A Distinct Illness?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The "burnout syndrome" has been defined as a combination of emotional exhaustion, depersonalization, and reduced personal accomplishment caused by chronic occupational stress. Although there has been increasing medical interest in burnout over the last decades, it is argued in this paper that the syndrome cannot be elevated to the status of diagnostic category, based on (1) an analysis of the genesis of the burnout construct, (2) a review of the latest literature on burnout-depression overlap, (3) a questioning of the three-dimensional structure of the burnout syndrome, and (4) a critical examination of the notion that burnout is singularized by its …

Obesity, Food Intake And Exercise: Relationship With Ghrelin, G. Tiryaki-Sonmez, Serife Vatansever, Burcin Olcucu, Brad J. Schoenfeld

Publications and Research

Obesity, a disorder of body composition, is defined by a relative or absolute excess of body fat. In general adult population, obesity has been associated with a diverse array of adverse health outcomes, including major causes of death such as cancer, diabetes, cardiovascular disease, as well as functional impairment from problems such as osteoarthritis and sleep apnea. Ghrelin is a newly discovered peptide hormone which plays an important role in obesity. It is a powerful, endogenous orexigenic peptide and has a crucial function in appetite regulation, as well as short – and long-term energy homeostasis. In the presence of increased …

Physical, Cognitive, Social And Mental Health In Near-Centenarians And Centenarians Living In New York City: Findings From The Fordham Centenarian Study, Daniela S. Jopp, Min-Kyung S. Park, Jonathan Lehrfeld, Michelle E. Paggi

Publications and Research

Background: Despite their strong increase, the population of the very old, including near-centenarians and centenarians, represent an unstudied and underserved population. Available studies mostly concentrate on predictors of exceptional longevity, but rarely extend their focus to other areas of functioning. Also, little is known about what contributes to experiencing a quality life in very old age. The present population-based study aims at providing a comprehensive picture of key domain of functioning, including physical, cognitive, social and mental function in very old individuals and to determine predictors of mental health indicators.

Methods: A total of 119 individuals aged 95 to 107 …

A Qualitative Study Of Stress In Individuals Self-Employed In Solo Businesses, Irvin Sam Schonfeld, Joseph J. Mazzola

Publications and Research

This qualitative study involved 54 individuals who were self-employed in a variety of solo businesses. All participants were administered a semistructured interview that inquired into various aspects of their work experience with the data subject to reliability and validity checks. The study identified stressful incidents, coping strategies, and emotional strains arising from those stressful incidents. Uncertainty about income was a common background stressor. Recent specific stressors included dramatic slowdowns in business, reputational threat, betrayal, unreasonable customers, and medical problems. Commonly occurring strains included apprehension/anxiety, frustration, anger, and sadness/depression. The self-employed used problem-focused coping much more often than emotion-focused coping. We …

Comparative Analysis Of Prostate Cancer Gene Regulatory Networks Via Hub Type Variation, Pegah Khosravi, Vahid H. Gazestani, Mohammad Akbarzadeh, Samira Mirkhalaf, Mehdi Sadeghi, Bahram Goliaei

Publications and Research

Background

Prostate cancer is one of the most widespread cancers in men and is fundamentally a genetic disease. Identifying regulators in cancer using novel systems biology approaches will potentially lead to new insight into this disease. It was sought to address this by inferring gene regulatory networks (GRNs). Moreover, dynamical analysis of GRNs can explain how regulators change among different conditions, such as cancer subtypes.

Methods

In our approach, independent gene regulatory networks from each prostate state were reconstructed using one of the current state-of-art reverse engineering approaches. Next, crucial genes involved in this cancer were highlighted by analyzing each …

Burnout: Absence Of Binding Diagnostic Criteria Hampers Prevalence Estimates, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Comments on an article by Jef Adriaenssens et al. (see record 2015-00662-015). In a recent review paper, Adriaenssens et al. concluded that about 26% of emergency nurses (EN) suffer from burnout and described their results as alarming. While commentators applaud Adriaenssens et al. efforts to provide a clearer picture of ill-health in EN, they thought that these authors' conclusions were weakened by a fundamental fact, namely, the absence of consensual, clinically valid diagnostic criteria for burnout. Trying to determine the prevalence of a condition that has no binding diagnostic criteria is problematic. Indeed, depending on how researchers decide to …

Interpersonal Rejection Sensitivity Predicts Burnout: A Prospective Study, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

We examined whether interpersonal rejection sensitivity (IRS)—the hallmark of atypical depression – prospectively predicted burnout, controlling for baseline symptoms, history of depressive disorders, antidepressant intake, gender, age, and length of employment (mean between-assessment duration: 21 months; n = 578; 74% female). IRS was related to a 119% increased risk of burnout at follow-up. Three of four burned out participants reported to be affected by IRS, or 2.5 times the rate observed in participants with no (or subthreshold) burnout symptoms. Our study highlights a dispositional factor in burnout’s etiology also known to be a key component of atypical depression’s etiology. The …

Burnout-Depression Overlap: A Review, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Whether burnout is a form of depression or a distinct phenomenon is an object of controversy. The aim of the present article was to provide an up-to-date review of the literature dedicated to the question of burnout–depression overlap. A systematic literature search was carried out in PubMed, PsycINFO, and IngentaConnect. A total of 92 studies were identified as informing the issue of burnout–depression overlap. The current state of the art suggests that the distinction between burnout and depression is conceptually fragile. It is notably unclear how the state of burnout (i.e., the end stage …

Burnout Does Not Help Predict Depression In French Schoolteachers, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Objectives: Burnout has been viewed as a phase in the development of depression. However, supportive research is scarce. We examined whether burnout predicted depression among French school teachers.

Methods: We conducted a 2-wave, 21-month study involving 627 teachers (73% female) working in French primary and secondary schools. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire (PHQ-9). The PHQ-9 grades depressive symptom severity and provides a provisional diagnosis of major depression. Depression was treated both as a continuous and categorical variable using linear and logistic regression analyses. We controlled …

Predicting Antidepressant Treatment Without Controlling For Depression Is Ill-Advised, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

All in all, the link observed by Madsen et al. (2015) between burnout and antidepressant intake may well conceal an expected relationship between depression and antidepressant intake. The impossibility of ruling out this reasonable alternative hypothesis renders the study inconclusive. We recommend that future research on (psychotherapeutic or pharmacologic) treatments for burnout incorporate measures of depression in order to facilitate research advance on burnout's characterization and burnout-depression overlap.

Nosh-Aspirin (Nbs-1120), A Dual Nitric Oxide And Hydrogen Sulfide-Releasing Hybrid, Reduces Inflammatory Pain, Miriam D. Fonseca, Fernando Q. Cunha, Khosrow Kashfi, Thiago M. Cunha

Publications and Research

The development of nitric oxide (NO)- and hydrogen sulfide (H2S)-releasing nonsteroidal anti-inflammatory drugs (NSAIDs) has generated more potent anti-inflammatory drugs with increased safety profiles. A new hybrid molecule incorporating both NO and H2S donors into aspirin (NOSH-aspirin) was recently developed. In the present study, the antinociceptive activity of this novel molecule was compared with aspirin in different models of inflammatory pain. It was found that NOSH-aspirin inhibits acetic acid-induced writhing response and carrageenan (Cg)-induced inflammatory hyperalgesia in a dosedependent (5–150 lmol/kg, v.o.) manner, which was superior to the effect of the same doses of aspirin. NOSH-aspirin’s antinociceptive effect was also …

Orbitofrontal 18f-Dopa Uptake And Movement Preparation In Parkinson’S Disease, Lucio Marinelli, Arnoldo Piccardo, Laura Mori, Silvia Morbelli, Nicola Girtler, Antonio Castaldi, Agnese Picco, Carlo Trompetto, Maria Felice Ghilardi, Giovanni Abbruzzese, Flavio Nobili

Publications and Research

In Parkinson’s disease (PD) degeneration of mesocortical dopaminergic projections may determine cognitive and behavioral symptoms. Choice reaction time task is related to attention, working memory, and goal-directed behavior. Such paradigm involves frontal cortical circuits receiving mesocortical dopamine which are affected early in PD. The aim of this study is to characterize the role of dopamine on the cognitive processes that precede movement in a reaction time paradigm in PD.We enrolled 16 newly diagnosed and untreated patientswith PDwithout cognitive impairment or depression and 10 control subjectswith essential tremor. They performed multiple-choice reaction time task with the right upper limb and brain …

Heterometallic Titanium–Gold Complexes Inhibit Renal Cancer Cells In Vitro And In Vivo, Jacob Fernandez-Gallardo, Benelita T. Elie, Tanmoy Sadhukha, Swayam Prabha, Mercedes Sanau, Susan A. Rotenberg, Joe W. Ramos, Maria Contel

Publications and Research

Following recent work on heterometallic titanocene–gold complexes as potential chemotherapeutics for renal cancer, we report here on the synthesis, characterization and stability studies of new titanocene complexes containing a methyl group and a carboxylate ligand (mba ¼ S–C6H4–COO) bound to gold(I)-phosphane fragments through a thiolate group [(h-C5H5)2TiMe(m-mba)Au(PR3)]. The compounds are more stable in physiological media than those previously reported and are highly cytotoxic against human cancer renal cell lines. We describe here preliminary mechanistic data involving studies on the interaction of selected compounds with plasmid (pBR322) DNA used as a model nucleic acid, and with selected protein kinases from a …

Role Of Home Environment, Parental Care, Parents’ Personality And Their Relationship To Adolescent Mental Health, Sibnath Deb, Kevin Mcgirr, Banhisikah Bhattacharya, Jiandong Sun

Publications and Research

The study examined relationships among home environment, parents’ personality and mental health of adolescents with a focus on adjustment, anxiety, self-concept and self-confidence. A group of 370 adolescents were interviewed using a semi-structured questionnaire and three psychological tests; subjects were selected following a two-stage sampling technique. Participation of the adolescent students in the study was voluntary. Results indicate that parental care was associated with high self-confidence while parental pressure associated with high anxiety. Fathers’ “friendliness” associated with low emotional adjustment and high self-concept while mothers’ short-temper associated with high anxiety. Disturbed families contributed to adolescent anxiety, inability to share personal …