Mental and Social Health Commons^™

Evaluation Of The Stability And Validity Of Participant Samples Recruited Over The Internet., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

Research conducted via the Internet has the potential to reach important clinical populations of participants who would not participate in traditional studies. Concerns exist, however, about the validity of samples recruited in this manner, especially when participants are anonymous and never have contact with study staff. This study evaluated two anonymous samples that were recruited over the Internet to test an online program designed to help problem drinkers. The two studies were conducted 3 years apart, and different recruitment strategies were utilized. Despite these differences, the two samples were highly similar in demographic and clinical features. Correlations that have been …

Gender Differences In Motivation To Resolve Eating And Body Image Concerns In College Students, Harold L. Merriman, C. Jayne Brahler, Laura Dinan, Lauren Finzer

Physical Therapy Faculty Publications

The objective of this study was to identify similarities and differences between college women and men with respect to their eating and body image concerns, weight fluctuation and level of motivation to resolve these concerns. 101 University of Dayton students participated in this study. Students completed an eating and body concern survey online.

Body image concerns were significantly greater for females compared to males (p=0.007) and significantly greater as motivation level to resolve the concerns increased (p=0.019). Eating concerns followed the same trends but did not reach statistical significance. Weight fluctuation in both genders increased significantly as motivation level increased …

Factors Associated With Non-Adherence Among Psychiatric Patients At A Tertiary Care Hospital, Karachi, Pakistan: A Questionnaire Based Cross-Sectional Study, Fawad Taj, Mansoor Tanwir, Zarmeneh Aly, Ameer Ali Khowajah, Asma Tariq, Fahd Khalid Syed, Fahd Waqar, Khezar Shahzada

Department of Psychiatry

OBJECTIVE: To elucidate predictors of non-adherence among psychiatric patients presenting at a tertiary care hospital of Pakistan, for follow-up with consultant psychiatrist.

METHODS: A convenient sampleof psychiatric patients from Aga Khan University Hospital was enrolled between April and May, 2005. An interviewer assisted, standardized questionnaire was used for data collection. Patients with cognitive deficit or psychosis and those presenting for the first time were not included in the study.

RESULTS: Out of 128 patients, those with co-morbidity (32.81%) were less adherent than those without comorbidity (p-value:0.002). Adherence among depressed was 61.53%; psychotic was 58.82%; bipolar disorder was 73.91%. Reasons for …

Pathways To Change: The Effect Of A Web Application On Treatment Interest., Daniel Z Lieberman, Suena H Massey

Psychiatry and Behavioral Sciences Faculty Publications

Most individuals with drinking problems do not receive treatment, generally because they do not perceive the need for it. It is difficult to access this population of problem drinkers in order to encourage treatment-seeking. A Web-based program was written, designed to increase motivation for change. The program guided non-treatment-seekers through a multi-stage assessment and provided them with feedback. The level of interest in treatment was measured pre-and post-intervention. Compared to baseline, after the intervention, significantly more individuals rated themselves "very interested" in participating in some form of traditional treatment (19% vs. 28%), and their focus on a specific modality increased.

A Pooled Analysis Of Two Placebo-Controlled Trials Of Desvenlafaxine In Major Depressive Disorder., Daniel Z Lieberman, Stuart A Montgomery, Karen A Tourian, Claudine Brisard, Gregory Rosas, Krishna Padmanabhan, Jean-Michel Germain, Bruno Pitrosky

Psychiatry and Behavioral Sciences Faculty Publications

The efficacy, safety, and tolerability of desvenlafaxine (administered as desvenlafaxine succinate) were evaluated in two similarly designed, phase 3, randomized, double-blind, placebo-controlled, venlafaxine-extended-release-referenced, flexible-dose studies of outpatients with a primary diagnosis of major depressive disorder. Owing to a high placebo response, the individual studies were underpowered. Therefore, a post-hoc pooled analysis was performed (desvenlafaxine and placebo data were pooled; venlafaxine extended release data were not, owing to different flexible-dose regimens in the two studies). The primary outcome measure was the change from baseline on the 17-item Hamilton Rating Scale for Depression; the Clinical Global Impressions-Improvement item score was a secondary …

The Effect Of Medical Students' International Experiences On Attitudes Toward Serving Underserved Multicultural Populations, Michael A. Godkin, Judith A. Savageau

Judith A. Savageau

BACKGROUND: We evaluated the effect of international electives on the attitudes of preclinical and clinical-year medical students with respect to serving underserved multicultural populations. METHODS: A self-assessment instrument was used to measure attitudes of 146 students before and after participating in international electives. The same attitudinal items were also analyzed at two time intervals for 18 students who completed international electives as preclinical students and 76 class cohorts who did not. RESULTS: Analyses show that the effect of international experiences is different for preclinical students and clinical students. For both groups, however, these experiences can develop and support perceptions and …

Primary Care: A Mandatory Requirement For Effective Health Care, Waris Qidwai

Department of Family Medicine

No abstract provided.

A Program To Change The Approach To Care Of Children With Asthma In The Primary Care Setting Did Not Reduce Rates Of Hospital Admissions: Lessons Learned From A Descriptive Study, Sheniz Moonie, Robert C. Strunk, Mario Castro

Environmental & Occupational Health Faculty Publications

Asthma is a critical global health issue. It affects people of all ages in countries throughout the world. The prevalence of asthma is increasing in most countries among young children who also represent the greatest proportion of health care utilization. Outpatient asthma-treatment programs managed by chest physicians or allergists have reduced hospitalizations, yet programs in pediatric offices have not successfully impacted hospitalizations. The Community Asthma Program (CAP) was designed to support pediatrician use of clinical guidelines in their everyday office practice. The goal was to reduce asthma hospitalizations by 15 percent from selected pediatric practices. A study was done in …

A Technological Approach To Reaching A Hidden Population Of Problem Drinkers., Daniel Z Lieberman, Suena W Huang

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVE: The most common obstacle to the treatment of individuals with drinking problems is that most do not seek treatment. This study compared a group of treatment-seeking patients with users of an alcohol-evaluation Web site to determine whether an Internet application could reach a population of problem drinkers who are distinct from those served by currently available forms of care.

METHODS: An open-source application was developed that was modeled on the Drinker's Check-Up, which has been shown to increase motivation for behavior change while presenting itself as a nonthreatening evaluation. To recruit non-treatment seekers, the program was offered as a …

Social Factors Affecting Treatment Of Cervical Cancer: Ethical Issues And Policy Implications, Shannon N. Westin, Dan Bustillos, Jacalyn B. Gano, Margaret M. Fields, Ann L. Coker, Charlotte C. Sun, Lois M. Ramondetta

CRVAW Faculty Journal Articles

Health care in the United States has become a privilege rather than a right. Patients who have the greatest need are the ones most likely to be denied this privilege. Despite recent advances in disease detection and treatment, many patients do not receive even the bare minimum of care. The high complexity of the health care system in the setting of patients with low levels of health literacy significantly affects the ability to seek and receive treatment in a timely fashion. In addition, lack of insurance, transportation, and social support further complicate access to care. To truly provide a standard …

Schizophrenia: A Concept, Haider A Naqvi

Department of Psychiatry

Much of the current research-work into biological basis of mental disorders is predicted on implicit concept of disease that is less critical and sophisticated as it should be. It is remarkable, how the fundamental conceptual frame work of schizophrenia, as proposed by Professor Emil Kraepelin has stayed the same, since its inception almost 100-years ago. This review explores these issues besides highlighting alternative disease classification that suits behavioural neuroscience research.

Tooth Mortality In Smokers And Nonsmokers In A Selected Population In Sana'a, Yemen, Awang Bulgiba

Awang Bulgiba Awang Mahmud

Background and Objective: Tobacco smoking has been shown to be a major risk factor for tooth loss. The present study was designed to examine tooth mortality and the patterns of tooth loss in smokers and nonsmokers over a wide age range in a selected population from Sana'a, Yemen. Material and Methods: A total of 2506 persons between the ages of 15 and 64 years were examined, and every permanent tooth was assessed. Missing teeth included both extracted and missing teeth. Individuals currently smoking one or more boxes of cigarettes (20 cigarettes) a day for 5 years were considered as smokers, …

Obesity, Hypertension, And Mental Health Evaluation In Adolescents: A Comprehensive Approach, Stefan G. Kiessling, Kimberly K. Mcclanahan, Hatim A. Omar

Pediatrics Faculty Publications

The global epidemic of childhood and adolescent obesity in developing and developed countries has become a major public health concern. Given the relation between obesity and hypertension as documented in several landmark studies, it is no surprise that as the prevalence of obesity has increased in the pediatric population, the rates of hypertension have also increased substantially. Hypertension is one of the most important risk factors for cardiovascular diseases and stroke; therefore, evaluation and initiation of appropriate treatment are extremely important in the pediatric population. Evaluation for secondary causes of hypertension, including renovascular, renoparenchymal, and endocrine disease is the approach …

Predicting Content Preference: Applying Lessons Learned From The Commercial Web To Therapeutic Software, Daniel Z. Lieberman Md, Suena H. Massey Md, Vilmaris Quiñones Cardona, Kenneth P. Williams Md

Psychiatry and Behavioral Sciences Faculty Publications

Objective: An automated web-based program was developed to deliver a form of motivational enhancement therapy to individuals with drinking problems. The objective of this study was to evaluate its ability to predict user preferences for specific psychoeducational modules based on responses to questionnaire items from the evaluation portion of the program.
Methods: Nine items from three standardized alcohol assessment questionnaires were used to predict viewing of one or more educational modules related to alcohol cessation. The instruments included the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), the Alcohol Use Disorders Identification Test (AUDIT), and the Decisional Balance Questionnaire. …

Antidepressant Medications, Amir A. Afkhami

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Translating The Research Diagnostic Criteria For Temporomandibular Disorders Into Malay: Evaluation Of Content And Process, Awang Bulgiba

Awang Bulgiba Awang Mahmud

Aims: To develop a Malay-language version of the Axis II Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a formal translation/back-translation process and to summarize available data about the psychometric properties of the translated scales. Methods: To cross-culturally adapt the instrument, the RDC/TMD underwent translation using a forward-backward method. Subjects were recruited to test the congruency between translated and original versions of the RDC/TMD. The psychometric properties of 3 domains (Graded Chronic Pain Scale, Nonspecific Physical Symptoms, and Depression) of the RDC/TMD were examined, and the literature on this topic was reviewed. Results: All the items scored 93% to 100% …

Combinations Of Dsm-Iv-Tr Criteria Sets For Bipolar Disorders., Daniel Z Lieberman, Roger Peele, Maryam Razavi

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: DSM-IV-TR is the standard for making psychiatric diagnoses in many countries. The diagnostic categorization of DSM-IV-TR is valued for its reliability, however it is well accepted that patients with the same diagnosis demonstrate substantial heterogeneity. In order to quantitatively characterize the degree of possible heterogeneity that can exist, combinatorial mathematics was used to calculate the number of possible ways to satisfy symptom criteria for the diagnosis of bipolar disorder as an example of this problem.

SAMPLING AND METHODS: The formula n!/(r!(n - r)!), which calculates the number of different ways of choosing an unordered number of items without repetition …

The Impact Of Traumatic Stress And Alcohol Exposure On Youth: Implications For Lawyers, Judges, And Courts, Frank E. Vandervort

Articles

Since its inception in the late nineteenth century, the juvenile court has been concerned with the legal problems of children and their families. From the court’s earliest days, it has sought to address child abuse and neglect and juvenile delinquency as social problems that result from familial and community breakdown. Over the decades, researchers from various disciplines have provided varying explanations of how and why family systems break down, why some parents fail to nurture their children, why some physically or sexually abuse their children, and why some children become delinquent.

Living Past Your Expiration Date: A Phenomenological Study Of Living With Stage Iv Cancer Longer Than Expected, Cynthia Levine

Antioch University Full-Text Dissertations & Theses

More treatment options exist today for persons diagnosed with terminal cancerextending lives longer than expected though there is little known about the psychosocial needs or resources for these individuals. This study describes the experience of living past the expiration date and still living with Stage IV cancer. A transcendental phenomenological approach was used to elucidate vivid expressions of this experience in a sample population of five Caucasian women. The women survived beyond their prognoses of an earlier expiration are not close to imminent death and are still living with incurable breast cancer metastases. The aim of this phenomenological inquiry is …