Digital Commons Network^™

Antidepressant Medications, Amir A. Afkhami

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Making Affordable Assisted Living Work: The Mountainside Senior Living Story, Cheryl Cooper, Gordon Walker

Case Studies from Age in Action

Educational Objectives

1. Describe the challenges of providing affordable assisted living in Virginia.

2. Describe the experience of the Jefferson Area Board for the Aging (JABA), an Area Agency on Aging, in becoming owner and operator of an assisted living facility.

3. Describe the culture change that made Mountainside a unique and award-winning facility.

The Aging Together Partnership: Collaborating To Improve Quality Of Life For Older Adults, April Holmes, Chris Miller

Case Studies from Age in Action

Educational Objectives 1. Demonstrate how the Aging Together experience improves services for older adults. 2. Describe the partnership structure and participation that makes this an effective model for community services amidst demographic changes. 3. Illustrate tangible service improvements resulting from Aging Together collaborations.

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 …

2007 Cancer Care Annual Report, Children's Mercy Hospital

Cancer Center Annual Reports

Annual report of cancer care and oncology services at the Children's Mercy Hospital, Kansas City MO, a pediatric medical center.

The Psychosocial Effects Of Pediatric Cancer On Young Adult Cancer Survivors, Jacob D. Schaefer

Graduate Research Papers

Childhood cancer is a current problem in our society. Today survivor rates are increasing. There are increased numbers of childhood survivors dealing with the after affects of cancer as they move into adulthood. Research correlations between childhood problems and adulthood problems have emerged. Issues of psychological, social, and physical concerns have created difficulties for childhood cancer survivors. However, there have been mixed results as some researches show healthy adaptation while others indicate abnormal daily functioning of children and young adults. Future research areas should focus on individual coping methods, social function of young adult survivors, and the human developmental process …

Com Outlook Winter 2008, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

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. …

Isolated Right Temporal Lobe Stroke Patients Present With Geschwind Gastaut Syndrome, Frontal Network Syndrome And Delusional Misidentification Syndromes, Michael Hoffmann

Neurology Faculty Publications

Background: Right temporal lobe lesion syndrome elicitation presents a clinical challenge. Aside from occasional covert quadrantanopias, heralding elementary neurological deficits are absent.Aim: Isolated right and left temporal lobe stroke patients were analyzed for the panoply of known temporal and frontal cognitive and neuropsychiatric syndromes.Methods: Temporal lobe stroke patients were analyzed, derived from a dedicated cognitive stroke registry. Patients were screened by a validated bedside cognitive battery and a neuropsychological test battery, including the Bear Fedio Inventory for diagnosis of the Geschwind Gastaut (GG) syndrome, frontal network syndrome testing (FNS), emotional intelligence testing and delusional misidentification syndromes (DMIS). NIH …

Frequency Of Abnormal Pap Smears And Assessment Of Risk Factors For Cervical Cancer In An Out-Patient Clinic, Firdous Jahan, Naheed Nabi, Waris Qidwai, Iqbal Azam

Department of Family Medicine

No abstract provided.

Etiology Of Frontal Network Syndromes In Isolated Subtentorial Stroke, Michael Hoffmann, Lourdes Benes Cases

Neurology Faculty Publications

Background: The neurobiology of the frontal network syndrome (FNS) that may occur with isolated subtentorial stroke is unknown.Aim: Evaluate for frontal network syndromes in young people post subtentorial stroke who have recovered neurologically and compare to a stroke lesion group least likely to manifest frontal network syndromes.Methods: Young people (18–49 years) with isolated cerebellar or brainstem subtentorial stroke (ST) that had recovered to independency (Rankin score ࣘ 2) with minimal or no residual neurological deficit (NIHSS ࣘ 4) with neurological recovery enabling resumption of former employment. Comparison was made to age and education matched young people with posterior …

Endovascular Stenting For Carotid Artery Stenosis: Results Of Local Experience At Aga Khan University Hospital, Karachi, Muhammad Azeem Uddin, Tanveer Ul Haq, Ishtiaque Ahmed Chishty, Zafar Sajjad, Basit Salam

Department of Radiology

Objective: To evaluate the results, complications and initial follow-up of patients after percutaneous stent placement for carotid artery disease.Methods: A retrospective study was carried out on patients treated with carotid artery stenting at the Radiology Department of Aga Khan University Hospital, Karachi, from September 2002 to December 2005. The patients were selected according to the institutional guidelines for Carotid Angioplasty and stenting. Preliminary angiogram was performed in all patients followed by stent deployment. Distal protection device was used in 12 patients. All patients underwent pre and post procedure independent neurological examinations. Follow-up consisted of serial duplex ultrasonography and clinical assessment.Results: …

Oncolog Volume 53, Number 05, May 2008, John Lebas, Joe Munch, Alexander V. Prokhorov Md, Phd

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Hepatocellular Carcinoma: New Standards in Therapy Emerging
• House Call: When Diagnosis Meets Denial
• In Brief: Overweight, Obese Patients Fare Worse with Breast Cancer, Researchers Find
• DiaLog: ASPIRE to Stop Teen Smoking, by Alexander V. Prokhorov, MD, PhD, Project Director, ASPIRE, Professor, Department of Behavioral Science
• A Reverse Approach to Adrenal Gland Resection

Oncolog Volume 53, Number 06, June 2008, Karen Stuyck, Virginia M. Mohlere, David Stouter, David Jenkins

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Psychotherapy Extends Cancer Care Beyond the Physical
• House Call: Understanding How Cancer Spreads
• DiaLog: Teaming Spiritual and Medical Care, by Rev. David Stouter, Chaplain, Department of Chaplaincy and Pastoral Education, and Rev. David Jenkins, Director, Department of Chaplaincy and Pastoral Education
• Radical Trachelectomy: A Fertility-Sparing Option for Invasive Cervical Cancer

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 2008), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 2008 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates and Kudos
• Women in Medicine: A Legacy of Achievement
• Reflections from the Past
• Leaders in Academic Medicine
• Advocates of Women’s Health
• Physician Workforce Issues: Bridging the Gender Gap
• Specialties: Breaking Down Barriers
• Founders’ Day
• James H. Black, DO ’62, O.J. Snyder Memorial Medal
• Sallee Ann Eckler, PhD, (DO ’08), Mason W. Pressly Memorial Medal
• Harm Reduction Therapy
• Willing and Able to Make a Difference
• Class Notes
• In Memoriam
• My Turn Essay
• Alumni Weekend 2008
• PCOM Events

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.

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 …

Reducing Hiv/Aids In Young People In Sub-Sahara Africa: Gaps In Research And The Role Of Theory, Kristien Michielsen, Marleen Bosmans, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

This paper discusses the role of education in preventing HIV in children and young people in sub-Sahara Africa and presents the results of policy advisory research conducted on behalf of the Belgian Development Cooperation. The research consisted of a literature review and a field study in Rwanda. Relative to the high number of HIV prevention activities in sub-Sahara Africa, there is a limited number of scientific data on HIV risk reduction interventions for young people in this region. Longitudinal studies are especially scarce. Preliminary results show that many interventions have only a marginal impact on reducing sexual risk behaviour. Factors …

Comparison Of Doppler Studies In Obstetrics With Fetal Outcome, Sheila Waa

Master of Medicine in Imaging and Diagnostic Radiology

Purpose: to compare umbilical artery and middle cerebral Doppler ultrasound values in normal and high risk pregnancies with fetal outcome. Method: 121 consecutive pregnancies (at or over 28 weeks gestation), stratified into low and high risk pregnancies based on clinician information were prospectively examined with doppler ultrasound of UA and MCA. Results: outcome was available for 100 of the 121 patients. 26% of pregnancies had poor outcome. Of these 73% (19) and 27% (7) were classified as high risk and low risk respectively. UA alone or in combination with MCA was shown to have 100% specificity for predicting fetal outcome. …

Knowledge, Attitude And Use Of Labour Pain Relief Methods Among Women Attending Antenatal Clinic In Nairobi, Vitalis Mung’Ayi, David Nekyon, Robinson Karuga

Anaesthesiology, East Africa

Background: Labour analgesia has rapidly gained popularity in obstetric practice. Low usage in the developing world has raised concern.

Objectives: To assess the knowledge, attitude and use of labour pain relief methods in women attending antenatal clinic in Nairobi.

Design: A prospective study.

Setting: Aga Khan University Hospital, a teaching and referral hospital in Nairobi, Kenya.

Subjects: Two hundred and two consecutive expectant mothers attending antenatal clinic at the Aga Khan University Hospital, Nairobi.

Results: Fifty-six per cent of the participants had knowledge about labour pain relief methods. Friends, the antenatal clinic and books/leaflets were the major source on information. …

Understanding The Relationship Between The Diligence Inventory-Higher Education Edition And The Myers-Briggs Type Indicator In The Admission Of College Students To An Orthopaedics-Based Honors Program, Michael A. Harstine

Dissertations

Problem. The Orthopaedic Scholar Institute (OSI) Team realized its need for a more objective selection and admission process that, as much as possible, quantified the characteristics desired in OSI students rather than relying solely on referral perception, intuition, and an interview, but it did not have a clear method or approach to do so. Administering standardized inventories that highlighted these desired characteristics and aided in the selection and admission process seemed to be an objective approach to obtain more quantifiable data. The problem for my study was, therefore, whether the Myers- Briggs Type Inventory (MBTI) alone could measure a student’s …

P1: Effect Of Age, Oestradiol Levels And Endometrial Thickness On Determining Success Of Frozen Embryo Transfers, Alfred Murage, Maybeth Jamieson, Robin Yates, Isabel Traynor, Helen Lyall, Scott Nelson

Obstetrics and Gynaecology, East Africa

Introduction: Frozen-thawed embryo transfer (FET) is a widely used technique, with replacement of embryos during natural menstrual cycles or in cycles constructed by exogenous steroids having similar outcomes in many series. Multiple factors have been proposed to have a positive influence on the success rate of FET, including increased endometrial thickness, younger maternal age and lower circulating oestradiol. The impact of these variables in the context of constructed cycles, using GnRH agonists to facilitate suppression of ovarian function prior to exogenous steroid administration, is not known. The aim of this study was to determine the predictive ability of these indices …

Racial Differences In Birth Outcomes: The Role Of General, Pregnancy, And Racism Stress, Tyan Parker Dominguez, Christine Dunkel Schetter, Laura M. Glynn, Calvin J. Hobel, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: This study examined the role of psychosocial stress in racial differences in birth outcomes.

Design: Maternal health, sociodemographic factors, and 3 forms of stress (general stress, pregnancy stress, and perceived racism) were assessed prospectively in a sample of 51 African American and 73 non-Hispanic White pregnant women.

Main Outcome Measures: The outcomes of interest were birth weight and gestational age at delivery. Only predictive models of birth weight were tested as the groups did not differ significantly in gestational age.

Results: Perceived racism and indicators of general stress were correlated with birth weight and tested in regression analyses. In …

Timing Of Fetal Exposure To Stress Hormones: Effects On Newborn Physical And Neuromuscular Maturation, Lauren M. Ellman, Christine Dunkel Schetter, Calvin J. Hobel, Aleksandra Chicz-Demet, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

The purpose of the study was to determine the specific periods during pregnancy in which human fetal exposure to stress hormones affects newborn physical and neuromuscular maturation. Blood was collected from 158 women at 15, 19, 25, and 31 weeks' gestation. Levels of placental corticotropin-releasing hormone (CRH) and maternal cortisol were determined from plasma. Newborns were evaluated with the New Ballard Maturation Score. Results indicated that increases in maternal cortisol at 15, 19, and 25 weeks and increases in placental CRH at 31 weeks were significantly associated with decreases in infant maturation among mates (even after con trolling for length …

Stress And Blood Pressure During Pregnancy: Racial Differences And Associations With Birthweight, Clayton J. Hilmert, Christine Dunkel Schetter, Tyan Parker Dominguez, Cleopatra M. Abdou, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

OBJECTIVE: To extend findings that African American women report greater stress during pregnancy, have higher blood pressure (BP), and are twice as likely to have low birthweight infants relative to white women. This study examines a) racial differences in associations between stress and BP during pregnancy, and b) the combined effects of stress and BP on infant birthweight in a sample of 170 African American and white women.

METHODS: A prospective, longitudinal study of pregnant women was conducted in which measures of BP, stress, and other relevant variables were collected. Multiple measures of systolic and diastolic BP were taken at …

Beliefs, Perceptions, And Preferences For Treatment In Latinas With Breast Cancer, Barbara Ann Kreling

Walden Dissertations and Doctoral Studies

Research documents that breast cancer is the leading cause of death in Latina females. The exact numbers are unknown, but studies reveal that Latinas with breast cancer underuse recommended follow-up chemotherapy, decreasing their rates of survival. Although several factors may be responsible, cultural influences are a possible barrier. However, there is a gap in the literature about how culture affects decisions about breast cancer treatment. This focused ethnographic study examined the role of cultural beliefs and perceptions in the decision-making process for Latina women about whether or not to receive chemotherapy following a breast cancer diagnosis. Drawing from Douglas' cultural …

Off-Label Psychopharmacologic Prescribing For Children: History Supports Close Clinical Monitoring., Julie M Zito, Albert T Derivan, Christopher J Kratochvil, Daniel J Safer, Joerg M Fegert, Laurence L Greenhill

Department of Psychiatry and Human Behavior Faculty Papers

The review presents pediatric adverse drug events from a historical perspective and focuses on selected safety issues associated with off-label use of medications for the psychiatric treatment of youth. Clinical monitoring procedures for major psychotropic drug classes are reviewed. Prior studies suggest that systematic treatment monitoring is warranted so as to both minimize risk of unexpected adverse events and exposures to ineffective treatments. Clinical trials to establish the efficacy and safety of drugs currently being used off-label in the pediatric population are needed. In the meantime, clinicians should consider the existing evidence-base for these drugs and institute close clinical monitoring.

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

Antioch University 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 …

Poetic Leadership, A Territory Of Aesthetic Consciousness And Change, R. Amrit Kasten-Daryanani

Antioch University Dissertations & Theses

Poetic leadership is a new theoretical construct that views leadership as an activity that unites a lyrical intellect with keenly felt emotion for the purpose of producing changes in the consciousness of self and others. This change begins within the interiority of self, moving surely to broader realms of one's surroundings and society, provoking movement that impacts the developing potential of the individual and the cultural milieu in which they exist. Emotion is the primary trace into consciousness used in this dissertation, which serves to unite experiences of the heart with experiences of the mind. The unification of these disparate …

Genes In Glucose Metabolism And Association With Spina Bifida, Christina M Davidson, Hope Northrup, Terri M King, Jack M Fletcher, Irene Townsend, Gayle H Tyerman, Kit Sing Au

Faculty, Staff and Student Publications

The authors test single nucleotide polymorphisms (SNPs) in coding sequences of 12 candidate genes involved in glucose metabolism and obesity for associations with spina bifida. Genotyping was performed on 507 children with spina bifida and their parents plus anonymous control DNAs from Hispanic and Caucasian individuals. The transmission disequilibrium test was performed to test for genetic associations between transmission of alleles and spina bifida in the offspring (P < .05). A statistically significant association between Lys481 of HK1 (G allele), Arg109Lys of LEPR (G allele), and Pro196 of GLUT1 (A allele) was found ( P = .019, .039, and .040, respectively). Three SNPs on 3 genes involved with glucose metabolism and obesity may be associated with increased susceptibility to spina bifida.