Mental and Social Health Commons^™

Antidepressant-Induced Mania With Concomitant Mood Stabilizer In Patients With Comorbid Substance Abuse And Bipolar Disorder., Daniel Z Lieberman, George Kolodner, Suena H Massey, Kenneth P Williams

Psychiatry and Behavioral Sciences Faculty Publications

Antidepressant use in the treatment of bipolar disorder is controversial due the risks of affective switching and cycle acceleration. Studies of non-comorbid samples suggest that the risk can be mitigated with the use of a concomitant mood stabilizer. However, the majority of patients with bipolar disorder will experience a comorbid substance use disorder and little is known about these individuals because they are typically excluded from clinical trials. Patients entering a substance abuse treatment program who had a history of bipolar disorder were interviewed to evaluate antidepressant-induced affective switching with and without concomitant mood stabilizer. Among 41 comorbid participants, the …

Switching And Selecting Atypical Antipsychotic Drugs: Quetiapine, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Consanguinity Among The Risk Factors For Underweight In Children Under Five: A Study From Rural Sindh, S. F. Hasnain, S. K. Hashmi

Community Health Sciences

BACKGROUND: Malnutrition is a common problem, especially in developing countries. Of the 11 million children under 5 who die each year in the developing countries mainly from preventable causes, the death of about 54% are either directly or indirectly attributable to malnutrition. The objectives of this study were to assess the prevalence and associated factors for underweight in rural Sindh.METHODS: A cross-sectional survey was conducted in Jhangara Town, located in District Dadu, Sindh. Eight hundred children under 5 years of age were enrolled. A questionnaire was used to elicit required information and anthropometric measurements were made.RESULTS: The overall prevalence for …

Improving The Health Of Diabetic Patients Through Resident-Initiated Group Visits, Chris Wheelock, Judith A. Savageau, Hugh Silk, Scott Lee

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Group visits have the potential to benefit patients with chronic illnesses. Our objective was to implement resident-run diabetic group visits that would improve patient education and help patients become more involved in their care. METHODS: We developed systems to promote, coordinate, and lead the visits. Residents' responsibilities were delegated through a preparation checklist. A standardized progress note was developed to encourage patient goal setting and to track relevant laboratory test results. To evaluate our program, we conducted surveys to determine patients' behavioral changes and satisfaction levels and assessed the effect on group visit participants' glycated hemoglobin (HbA1c) …

Symptoms Of Diminished Autonomy Over Cigarettes With Non-Daily Use, Judith A. Savageau, Paul D. Mowery, Joseph R. Difranza

Judith A. Savageau

Data from a nationally representative sample of smokers (ages 12-22 years, n=2,091) was examined to investigate the prevalence of symptoms of diminished autonomy over cigarettes. Six symptoms were assessed: failed cessation, smoking despite a desire to quit, and a need or urge to smoke, irritability, restlessness, or disrupted concentration attributed to nicotine withdrawal. One or more of the six symptoms were present in 18.9% of subjects who smoked less often than once per week. Among subjects who had not smoked 20 cigarettes in their lifetime, 12.6% had symptoms of nicotine withdrawal, and 25% had made an unsuccessful quit attempt.

Community Dimensions And Hpsa Practice Location: 30 Years Of Family Medicine Training, Suzanne B. Cashman, Judith A. Savageau, Warren J. Ferguson, Daniel H. Lasser

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Our objective was to assess practicing family physicians' confidence and participation in a range of community-related activities. Additionally, we assessed the strength of the relationship between the physicians' reported medical school and residency training in community-related activities and their current community activities, as well as whether they were practicing in an underserved location. METHODS: All 347 graduates of the University of Massachusetts Family Medicine Residency were surveyed about practice location and type, involvement and training in community work, confidence in community-related skills, and sociodemographic characteristics. Analyses were conducted by residency graduation decade (1976-1985, 1986-1995, and 1996-2005). RESULTS: …

Family Medicine Residency Characteristics Associated With Practice In A Health Professions Shortage Area, Warren J. Ferguson, Suzanne B. Cashman, Judith A. Savageau, Daniel H. Lasser

Judith A. Savageau

BACKGROUND AND OBJECTIVES: While some family medicine residency programs are designed to train residents in community health centers (CHCs) for future careers serving underserved populations, there are few outcome studies on such programs. Our residency program provides three options for ambulatory health center training, but otherwise residents participate in the same curriculum. We analyzed relationships between ambulatory training site and likelihood of practice in health professions shortage areas (HPSAs).

METHODS: We sent a mail survey to all graduates of one family medicine residency about practice locations, types, and populations; influences on practice choice; and sociodemographic characteristics.

RESULTS: Training in a …

Lesson In A Pill Box: Teaching About The Challenges Of Medication Adherence, Darlene M. O'Connor, Judith A. Savageau, David B. Centerbar, Kimberly N. Wamback, Jennifer S. Ingle, Nicole J. Lomerson

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Medication mismanagement is a serious health issue affecting elders and people with disabilities, who often manage multiple medications. This project's goal was to educate medical and nursing students about the challenges patients face when managing complex medication regimens.

METHODS: A total of 104 first-year medical students and 40 second-year nursing students were randomly assigned to participate in a 1-week regimen of mock prescriptions or to read a description of the regimen and make predictions about what the experience would be like had they participated.

RESULTS: Quantitative results in combination with qualitative information suggest that the students taking …

Enforcement Of Underage Sales Laws As A Predictor Of Daily Smoking Among Adolescents: A National Study, Joseph R. Difranza, Judith A. Savageau, Kenneth E. Fletcher

Judith A. Savageau

BACKGROUND: With a goal to reduce youth smoking rates, the U.S. federal government mandated that states enforce laws prohibiting underage tobacco sales. Our objective was to determine if state compliance with tobacco sales laws is associated with a decreased risk of current daily smoking among adolescents.

METHODS: Data on tobacco use were obtained from a nationally representative sample of 16,244 adolescents from the 2003 Monitoring the Future survey. The association between merchant compliance with the law from 1997-2003 and current daily smoking was examined using logistic regression while controlling for cigarette prices, state restaurant smoking policies, anti-tobacco media, and demographic …

Switching And Selecting Atypical Antipsychotic Drugs: Quetiapine, Amresh Srivastava

Psychiatry Presentations

No abstract provided.

Ageing Population: Status, Challenges And Opportunities For Health Care Providers In Pakistan, Waris Qidwai Dr

Department of Family Medicine

No abstract provided.

Comparison Of Urdu Version Of Strengths And Difficulties Questionnaire (Sdq) And The Child Behaviour Check List (Cbcl) Amongst Primary School Children In Karachi, Ehsan Ullah Syed, Sajida Abdul Hussein, Syed Iqbal Azam, Abdul Ghani Khan

Department of Psychiatry

OBJECTIVE: To compare CBCL (Child Behaviour Check Llist) Urdu, with the validated Urdu version of Strengths and Difficulties Questionnaire (SDQ) used as "gold standard" among school children in Karachi, Pakistan, and to develop local cutoffs for CBCL using SDQ as a gold standard.

STUDY DESIGN: A cross-sectional study.

PLACE AND DURATION OF STUDY: Schools of Karachi metropolitan area from January to December 2006.

METHODOLOGY: The Strengths and Difficulties Questionnaire (SDQ) and Child Behaviour Check List (CBCL) was completed by parents of 5-11 years old primary school children in Karachi. Appropriate cutoff points for total problem, internalizing and externalizing scales were …

Acetabular Morphometry And Prevalence Of Hip Dysplasia In The South Asian Population, Masood Umer, Yasir J. Sepah, Sharjeel Asif, Iqbal Azam Syed, Muhammad Umar Jawad

Section of Orthopaedic Surgery

We carried out a cross-sectional study to measure the association of the seven acetabular parameters with pelvic morphometry and prevalence of hip dysplasia in our population. Convenience sampling was carried out and 250 consecutive patients who came to AKUH for intravenous pyelogram and had no complaints in the region of the hip joint were enrolled in the study. Post-micturition standardized plain antero-posterior pelvic radiographs of 250 asymptomatic adults (500 hip joints) was studied. There were 136 males (54.4%) and 114 females (45.6%). Mean age of our study population was 38 years (15-78 years). The average center edge angle was 35.5±6.6° …

Benzodiazepine: Slow Sand Of Addiction, Haider Naqvi, Sajjad Hussan, Fatema Dossa

Department of Psychiatry

No abstract provided.

Vih Y Alcohol En Arica, Chile: Percepciones De Portadores Y Profesionales, Lena Sessions

Independent Study Project (ISP) Collection

This paper investigated the relationship between alcohol consumption and HIV in Arica, Chile. The objectives of this investigation were to understand the demographics of HIV positive Ariqueños who consume alcohol, and understand their perceptions of alcohol consumption with respect to whether they believed they had a drinking problem, whether they believed that the consumption of alcohol facilitated their contracting HIV, and whether the consumption of alcohol affected their treatment. Although there is no literature that specifically addresses the topic of how HIV positive individuals who consume alcohol perceive their disease, former research suggests that a significant number (25-50%) of individuals …

Living In Rural New England Amplifies The Risk Of Depression In Patients With Hiv, Siddharth H. Sheth, Paul T. Jensen, Timothy Lahey

Dartmouth Scholarship

The importance of depression as a complication of HIV infection is increasingly understood, and people living in rural areas are at increased risk for depression. However, it is not known whether living in rural areas amplifies the risk of depression in patients with HIV. We compared the prevalence of depression between rural and metropolitan HIV patients seen at the Dartmouth-Hitchcock HIV Program in a retrospective cohort study. Using the validated Rural-Urban Commuting Area Score, we categorized patients as living in small town/rural areas, micropolitan or metropolitan towns. Then, using a multivariate logistic regression model to adjust for demographic factors that …

Social Cognitive Predictors Of Diabetes Outcomes In Latinos And Whites, Diana Brown

Loma Linda University Electronic Theses, Dissertations & Projects

Investigating health care disparities in ethnic minority populations is an increasingly urgent issue as these disparities lead to higher morbidity and mortality in minorities (National Center of Health Statistics, 2000). There is clear evidence that Latino Americans, the fastest growing minority group in the United States, are more likely to be diagnosed with and experience more severe complications from type 2 diabetes than Anglo Americans. This study surveyed 38 White and 33 Latino diabetes patients from outpatient clinics in an academic medical center. Cultural values (individualism and collectivism), mental health (social support, mental health), and self-efficacy (diabetes and exercise) were …

Dr. Samuel B. Woodward: A 19th Century Pioneer In American Psychiatric Care, Janet L. Dadoly, Len Levin, Lisa A. Palmer

Lisa A. Palmer

Objective: Showcase the life and work of Dr. Samuel B. Woodward, the medical superintendent of one of the first public hospitals for the mentally ill in the U.S., the Worcester State Hospital in Worcester, Mass. Dr. Woodward overcame then-popular views of mental illness to champion compassionate, optimistic, and individualized treatment for patients.

Methods: Dr. Samuel B. Woodward brought a significant paradigm shift to the dark world of mentally ill indigent citizens of Massachusetts in the early 19th century. When Dr. Woodward became the first superintendent of Worcester State Hospital in 1833, mentally ill patients were viewed with suspicion and fear …

Overweight Children And Adolescents: Impact On Psychological And Social Development, Kimberly K. Mcclanahan, Marlene B. Huff, Hatim A. Omar

Pediatrics Faculty Publications

The global epidemic of childhood and adolescent overweight has become a major public health concern. Not only are these youth more likely to become obese as adults, and thus more prone to obesity-related diseases than their non overweight peers, they are also likely to suffer emotional and social effects associated with overweight. Overweight in youth has been linked to depression, low self-esteem, eating disorders, negative body image, and stigma. It appears to be bi-directional in nature, with overweight sometimes predicting certain psychological effects and psychosocial issues sometimes predicting overweight. Effective assessment and treatment of psychological and mental health issues in …

Association Of Antipsychotic Use With Hospital Events And Mortality Among Medicare Beneficiaries Residing In Long-Term Care Facilities, Linda Simoni-Wastila, Priscilla T. Ryder, Jingjing Qian, Ilene H. Zuckermann, Thomas Shaffer, Lirong Zhao

Scholarship and Professional Work – COPHS

Objective—Antipsychotic (AP) utilization has grown significantly in long-term care (LTC) settings. Although a growing literature associates AP use with higher mortality in elderly with dementia, the association of APs with hospital events is unclear. The authors examine prevalence and trends in AP use by Medicare beneficiaries residing in LTC and the association of APs and other drug use variables with hospital events and mortality.

Design—Retrospective analysis using sequential multivariate Cox proportional hazards models.

Setting—Medicare Current Beneficiary Survey linked to Institutional Drug Administration and Minimum Data Set files.

Participants—A total of 2,363 LTC Medicare beneficiaries, 1999–2002. Measurements—Trends in LTC AP use …

Dispensing Collaboration, Valerie Lucus Cem, Cbcp

Valerie Lucus-McEwen CEM CBCP

Collaboration between UC Davis and Yolo County Public Health to provide a real-time POD (Point of Distribution).

No Effect Of Prenatal Alcohol Exposure On Activity In Three Inbred Strains Of Mice, Chris Downing, Christina Balderrama-Durbin, Jonathan Hayes, Thomas E. Johnson, David Gilliam

SPS Faculty Publications

Aims: Prenatal exposure to alcohol can have adverse effects on the developing fetus. Two of the hallmarks of children exposed to alcohol prenatally are attention deficits and hyperactivity. While hyperactivity has been observed in rats following prenatal ethanol exposure, few studies have examined these effects in mice. The present study investigated the effects of prenatal ethanol exposure on activity in mice from three inbred strains: C57BL/6 (B6), Inbred Long Sleep (ILS) and Inbred Short Sleep (ISS).

Methods: On days 7 through 18 of gestation, mice were intragastrically intubated twice daily with either 3.0 g/kg Ethanol (E) or an isocaloric amount …

Social Work Involvement In Supporting Survivors Of An Unexpected Death In An Emergency Department, Jennifer E. Buchanan

All Graduate Theses, Dissertations, and Other Capstone Projects

People occasionally present to a hospital’s emergency department (ED) after an event such as a heart attack or a motor vehicle accident that results in their sudden and unexpected death. Although members of the ED attempt to support the survivors as much as possible, due to the fast pace of the environment and responsibilities to other patients, the survivors may not always be provided with the necessary resources and support. This can leave survivors feeling isolated and confused about the appropriate course of action after this type of experience. A planned, organized approach delivered by educated and sensitive staff can …