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The Appropriateness Of Long-Term Opioids To Treat Chronic Back Pain, Thomas Watanabe, Michael Salino, Adam Schreiber

Department of Rehabilitation Medicine Faculty Papers

Point/Counterpoint Case Scenario: A 55-year old man presents to a pain clinic upon referral from his primary care physician. His symptom is axial low back pain. His pain started approximately 1 year earlier without a specific inciting event. He denies radiation of pain into the lower extremities. There is no bowel or bladder involvement. There is no directional preference. He reports pain "all the time," with minimal specific exacerbating or relieving factors. There is no medical-legal involvement. His medical history is significant for hypertension, hypercholesterolemia, obesity, and sleep apnea. He is a divorced father of 2 adult children. He is …

Psychostimulant Drug Abuse And Personality Factors In Medical Students, Joshua T. Buchner, Md, Duc M. Vu, Md, Mohammadreza Hojat

CRMEHC Faculty Papers

Purpose:

This study was designed to examine the prevalence of psychostimulant drug abuse among medical students and to test the hypothesis that medical students who use psychostimulant drugs for non-medical reasons are characterized by a sensation seeking and aggressive-hostility personality and exhibit lower empathy.

Subjective Outcome Evaluation And Factors Related To Perceived Effectiveness Of The Project P.A.T.H.S. In Hong Kong, Daniel T. L. Shek, Lu Yu, Vicky Y. T. Ho

Pediatrics Faculty Publications

Based on a sample of 24,457 participated students, the present study investigated participants' subjective evaluation of the Tier 2 Program of the Project P.A.T.H.S. in the 2009/2010 academic year. Participants generally held positive views toward the Tier 2 Program and program instructor and perceived the program to be beneficial to their development. Programs involving adolescents alone were evaluated more positively than programs involving parents and/or teachers. Students' grade and program type did not show significant impact on participants' subjective evaluation of the project. Consistent with previous reports, perceived effectiveness of the program was significantly predicted by students' perceptions about the …

The Project P.A.T.H.S. In Hong Kong--Lessons Learned And Implications For Positive Youth Development Programs, Daniel T. L. Shek, Rachel C. F. Sun

Pediatrics Faculty Publications

The Project P.A.T.H.S. is a positive youth development program which attempts to promote holistic development of junior secondary schools in Hong Kong. It is ground breaking in terms of the number of schools participating in the project and financial resources injected into the project. Based on the experiences gained from the implementation of the project and evaluation data collected from 2005 to 2011, several issues pertinent to the development of positive youth development programs in the Chinese culture are discussed. These issues include complexity of program development, importance of training, identification of factors governing program implementation, need for evaluation, and …

Helping Adolescents With Greater Psychosocial Needs: Subjective Outcome Evaluation Based On Different Cohorts, Daniel T. L. Shek, Tak Yan Lee

Pediatrics Faculty Publications

The Tier 2 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) is designed to help students with greater psychosocial needs. This paper examines nine sets of subjective outcome evaluation data collected from 2005 to 2009 (n = 60, 241 participants). Based on the consolidated data with schools as units, results showed that participants generally had positive perceptions of the program, implementers, and benefits of the program. The subjective outcome evaluation instrument was found to be internally consistent. Multiple regression analysis revealed that perceived qualities of the program and the program implementers predicted perceived effectiveness of the …

A Progressive Postresection Walking Program Significantly Improves Fatigue And Health-Related Quality Of Life In Pancreas And Periampullary Cancer Patients., Theresa Yeo, Sherry A Burrell, Patricia K Sauter, Eugene P Kennedy, Harish Lavu, Benjamin E Leiby, Charles Yeo

College of Nursing Faculty Papers & Presentations

BACKGROUND: As patients with pancreas and periampullary cancer (PPC) experience improved survival rates and longevity, the focus shifts toward living life while surviving cancer. Fatigue is the most commonly reported symptom in all cancer patients. Exercise has been found to effectively decrease fatigue levels and improve physical functioning in cancer patients.

STUDY DESIGN: One hundred two patients with resected PPC consented to participate in this study and were randomized to either an intervention group (IG) or a usual care group (UCG). Subjects completed visual analog scales, the FACIT-Fatigue Scale and the Short Form-36v2 after surgery and again 3 to 6 …

Useful Field Of View Predicts Driving In The Presence Of Distracters, Joanne M. Wood, Alex Chaparro, Philippe Lacherez, Louise Hickson

Publications

Purpose. The Useful Field of View (UFOV®) test has been shown to be highly effective in predicting crash risk among older adults. An important question which we examined in this study is whether this association is due to the ability of the UFOV to predict difficulties in attention-demanding driving situations that involve either visual or auditory distracters.

Methods. Participants included 92 community-living adults (mean age 73.6 +- 5.4 years; range 65– 88 years) who completed all three subtests of the UFOV involving assessment of visual processing speed (subtest 1), divided attention (subtest 2), and selective attention (subtest 3); driving safety …

Alternative Therapy And Treatment Of Type 2 Diabetes, Carmine R. Grieco

Human Movement Studies & Special Education Theses & Dissertations

The rise in prevalence and incidence of type 2 diabetes mellitus (T2D) in the developing world continues unabated. Current treatment strategies, however, fall short of achieving optimal glycemic control. The aim of project I was to investigate the effect of an acute bout of a yogic breathing exercise on heart rate variability (HRV) in individuals with T2D. Project II was designed to assess the effectiveness of the neurohormone melatonin in lowering short- and long-term glucose levels, lipids and oxidative stress in T2D. Project III investigated the differential effects of two different styles of aerobic exercise on postprandial glycemia, mood and …

The Pregnancy Project: Impact Of Ultrasound Use During Pregnancy Care, Paige Ricci

Annual Undergraduate Conference on Health and Society

Use of ultrasounds during pregnancy continues to increase and there is much debate as to what the best practice is regarding their use, for what types of patients, at what volume level. Current evidence suggests, the extended routine use of ultrasound technology should be for all women that present complications to screen for structural anomalies during pregnancy. However, others have suggested that excessive ultrasound use may be both unnecessary, costly and potentially harmful. Evidence further suggests that mothers find the use of technology to be security enhancing during pregnancy and through the process of care, and that ultrasound use is …

Coronary Artery Bypass Grafting: Quality Of Life Of Patients In Karachi, Rozina Barolia, Fauziya Ali, Salma Jaffar

School of Nursing & Midwifery

In the Third World, cardiac Patients often suffer not only from the nature of their illnesses, but also the insufficiency of the facilities available. Although the effectiveness of coronary artery bypass grafting (CABG) is being evaluated in terms of mortality, complications or recurrence of symptoms, empirical studies assessing the change in Patients' quality of life (QOL) after CABG within the Pakistani cultural context are lacking.
Aims: The aims of the present study are to assess and compare the change in health-related quality of life before and 1 month after CABG and to assess the differences in QOL with respect to …

Overlap Subtype Of Chronic Graft-Versus-Host Disease Is Associated With An Adverse Prognosis, Functional Impairment, And Inferior Patient-Reported Outcomes: A Chronic Graft-Versus-Host Disease Consortium Study, Joseph Pidala, Georgia Vogelsang, Paul Martin, Xiaoyu Chai, Barry Storer, Steven Pavletic, Daniel Weisdorf, Madan Jagasia, Corey Cutler, Jeanne Palmer, David Jacobsohn, Sally Arai, Stephanie J. Lee

Pediatrics Faculty Publications

Background

The National Institutes of Health Consensus Conference proposed the term “overlap” graft-versus-host disease to describe the situation when both acute and chronic graft-versus-host disease are present.

Design and Methods

We examined whether the overlap subtype of graft-versus-host disease was associated with a different prognosis, functional limitations, or patient-reported outcomes compared to “classic” chronic graft-versus-host disease without any acute features.

Results

Prospective data were collected from 427 patients from nine centers. Patients were classified as having overlap (n=352) or classic chronic (n=75) graft-versus-host disease based on reported organ involvement. Overlap …

Recommendations For The Use Of Common Outcome Measures In Pediatric Traumatic Brain Injury Research, Stephen R. Mccauley, Elisabeth A. Wilde, Vicki A. Anderson, Gary Bedell, Sue R. Beers, Thomas F. Campbell, Sandra B. Chapman, Linda Ewing-Cobbs, Joan P. Gerring, Gerard A. Gioia, Harvey S. Levin, Linda J. Michaud, Mary R. Prasad, Bonnie R. Swaine, Lyn S. Turkstra, Shari L. Wade, Keith O. Yeates

Psychiatry and Behavioral Sciences Faculty Publications

This article addresses the need for age-relevant outcome measures for traumatic brain injury (TBI) research and summarizes the recommendations by the inter-agency Pediatric TBI Outcomes Workgroup. The Pediatric Workgroup's recommendations address primary clinical research objectives including characterizing course of recovery from TBI, prediction of later outcome, measurement of treatment effects, and comparison of outcomes across studies. Consistent with other Common Data Elements (CDE) Workgroups, the Pediatric TBI Outcomes Workgroup adopted the standard three-tier system in its selection of measures. In the first tier, core measures included valid, robust, and widely applicable outcome measures with proven utility in pediatric TBI from …

Digest Of The Philadelphia College Of Osteopathic Medicine (Spring 2012), Philadelphia College Of Osteopathic Medicine

Digest

The Spring 2012 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Message from the President
• PCOM Updates
• Development News
• Tug of War
• Founders’ Day 2012
• Building Social and Emotional Competence in Preschool Children
• Pioneering Color in MRI Imaging
• Class Notes
• In Memoriam
• My Turn Essay
• The Fund for PCOM

Impact Of A Medically Supervised Weight Management Program On Obese And Morbidly Obese Persons, Gemechu Abraham Kurfessa

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Overweight and obesity represent a major public health problem. While some studies indicate that a clinic-based, healthy-lifestyle program can result in significant weight loss, a systemic review of major commercial weight loss programs concluded that the evidence to support the use of such programs is minimal. While few argue for the need for weight loss in obese individuals it is important to identify factors associated with successful weight loss. These factors could include financial incentives, frequency of intervention sessions, use of adjunctive weight loss medications and supplemental diet products, and availability of group vs. individual therapy sessions. In addition, …

Old Remedies For Epilepsy: Avicenna's Medicine., A A Asadi-Pooya, A R Nikseresht, E Yaghoubi

Department of Neurology Faculty Papers

BACKGROUND: The history of epilepsy and its treatments dates back to at least 4 millennia. Avicenna, c. 980 AD in Bukhara, Khorasan-1037 in Hamedan was a Persian-speaking Iranian physician, who has many recommendations and suggested various therapies for epilepsy in his book, The Canon of Medicine.

METHODS: We first reviewed the most important ancient treatments for epilepsy mentioned by Avicenna and considered those as the key words for our next step. Then, we made a literature search (medline and scopus) with those key words to find out new scientific findings in modern medicine about the Avicenna's suggestions.

RESULTS: Among the …

Irritable Bowel Syndrome And Psychiatric Disorders In Pakistan: A Case Control Study., Amna Subhan Butt, Mohammad Salih, Wasim Jafri, Javed Yakoob, Mohammad Wasay, Saeed Hamid

Section of Gastroenterology

Background:The psychiatric disorders like anxiety and depression could have a profound influence on onset, expression, and course of Irritable bowel syndrome (IBS). Aim: To estimate the frequency and strength of association of common mental disorders (CMDs) in Patients with IBS and Patients with other chronic diseases, that is, migraine and hypertension. Method: This was a case control study. Individuals aged 18-70 years diagnosed as IBS were enrolled as cases. The control groups consisted of Patients without IBS but diagnosed to have a chronic disease, that is, migraine or HTN. Self-Reporting Questonnaire-20(SRQ-20) was used as a screening tool for the …

Alcohol And Marijuana Use While Driving-An Unexpected Crash Risk In Pakistani Commercial Drivers: A Cross-Sectional Survey, Mohammed Umer Mir, Imran Khan, Bilal Ahmed, J. Razzak

Department of Emergency Medicine

Background:A significant proportion of road traffic crashes are attributable to alcohol and marijuana use while driving globally. Sale and use of both substances is illegal in Pakistan and is not considered a threat for road traffic injuries. However literature hints that this may not be the case. We did this study to assess usage of alcohol and marijuana in Pakistani commercial drivers.
Methods:A sample of 857 commercial bus and truck drivers was interviewed in October 2008 at the largest commercial vehicle station in Rawalpindi and Islamabad, Pakistan. Time location cluster sampling was used to select the subjects and …

Music Therapy To Sever The Silence Of A Childhood Holocaust Survivor, Amy Clements-Cortés

Music Faculty Publications

No abstract provided.

A Community-Integrated Home Based Depression Intervention For Older African Americans: Descripton Of The Beat The Blues Randomized Trial And Intervention Costs., Laura N Gitlin, Lynn Fields Harris, Megan Mccoy, Nancy L Chernett, Eric Jutkowitz, Laura T Pizzi

Center for Applied Research on Aging and Health Research Papers

ABSTRACT: BACKGROUND: Primary care is the principle setting for depression treatment; yet many older African Americans in the United States fail to report depressive symptoms or receive the recommended standard of care. Older African Americans are at high risk for depression due to elevated rates of chronic illness, disability and socioeconomic distress. There is an urgent need to develop and test new depression treatments that resonate with minority populations that are hard-to-reach and underserved and to evaluate their cost and cost-effectiveness. METHODS/DESIGN: Beat the Blues (BTB) is a single-blind parallel randomized trial to assess efficacy of a non-pharmacological intervention to …

Neuroscience Of Personality: Principles Of The Psyche As A Living System, Dario Nardi

Systems Science Friday Noon Seminar Series

The brain is a complex living system. Using colorful slides and anecdotes, Dario Nardi, PhD will overview his hands-on research of the past 5 years in his social neuroscience lab using EEG technology to better understand the neocortex. He spends 2 to 3 hours with each subject, offering a variety of tasks from solo activities like meditating, drawing, and recalling to social activities like poker and speed-dating. The results are in. The neocortex relies upon a dynamic of modules, circuits, and holistic modes to continuously coordinate with the environment in both a top-down and a bottom-up manner. Moreover, individual differences …

Integrating Spiritual Care Within Palliative Care: An Overview Of Nine Demonstration Projects, Shirley Otis-Green, Betty Ferrell, Tami Borneman, Christina Puchalski, Gwen Uman, Andrea Garcia

Medicine Faculty Publications

No abstract provided.

Medical Evaluation And Triage Of The Agitated Patient: Consensus Statement Of The American Association For Emergency Psychiatry Project Beta Medical Evaluation Workgroup, Kimberly Nordstrom, Leslie S. Zun, Michael P. Wilson, Victor Stiebel, Anthony T. Ng, Benjamin Bregman, Eric L. Anderson

Psychiatry and Behavioral Sciences Faculty Publications

Numerous medical and psychiatric conditions can cause agitation, some of these causes are life threatening. It is important to be able to differentiate between medical and non-medical causes of agitation so that patients can receive appropriate and timely treatment. This article aims to educate all clinicians in non-medical settings, such as mental health clinics, and medical settings on the differing levels of severity in agitation, basic triage, use of de-escalation, and factors, symptoms, and signs in determining whether a medical etiology is likely. Lastly, this article focuses on the medical workup of agitation when a medical etiology is suspected or …

The Evidence-Based Pharmacological Treatment Of Paediatric Adhd., Brigette S. Vaughan, John S. March, Christopher J. Kratochvil

Journal Articles: Psychiatry

Attention deficit hyperactivity disorder (ADHD) is common in children, adolescents, and adults, with extensive research establishing it as a valid neurobiological disorder. Without intervention, ADHD can result in significant impairment throughout the lifespan for the individuals it afflicts. Fortunately, multiple evidence-based options are available for the treatment of ADHD, including several efficacious pharmacotherapies. The role of medication, including stimulants as well as non-stimulants, is well-documented by an extensive body of literature. Although there may be less enthusiasm for behavioural and other psychosocial interventions as stand-alone treatments for moderate to severe ADHD, they are recommended as first-line treatment for ADHD management …

Vitamin D: Does It Play A Role In Psychiatry, Mukesh Mohan Bhimani

Department of Psychiatry

No abstract provided.

Functional, Cognitive And Psychological Outcomes, And Recurrent Vascular Events In Pakistani Stroke Survivors: A Cross Sectional Study., Maria Khan, Bilal Ahmed, Maryam Ahmed, Myda Najeeb, Emmon Raza, Farid Khan, Anoosh Moin, Dania Shujaat, Ahmed Arshad, Ayeesha Kamran Kamal

Department of Medicine

Background: There is little direct data describing the outcomes and recurrent vascular morbidity and mortality of stroke survivors from low and middle income countries like Pakistan. This study describes functional, cognitive and vascular morbidity and mortality of Pakistani stroke survivors discharged from a dedicated stroke center within a nonprofit tertiary care hospital based in a multiethnic city with a population of more than 20 million.

Methods: Patients with stroke, aged > 18 years, discharged alive from a tertiary care centre were contacted via telephone and a cross sectional study was conducted. All the discharges were contacted. Patients or their legal surrogate …

Treatment Response Of Opium Smoking Hmong Refugees To Methadone Maintenance, Muhammad Waqar Azeem M.D., Gregory A. Carlson B.A., Chomehanh Soudaly Lpn

Jefferson Journal of Psychiatry

Objective: To examine the outcome of methadone maintenance in opium dependent Hmong refugees.

Methods: Medical records were searched for Hmong patients in methadone treatment between 01/1995 and 09/1997. Patient's progress was assessed over nine months.

Results: 44 Hmong patients were found. Data was available on 40 patients, mean age of 47.7 years, 33 males/7 females. At admission 100% met the DSM-IV criteria for Opium Dependence, 75% Major Depressive Disorder and 68% PTSD. Patients showed marked improvement by having mostly negative urine drug screens, improvement on Addiction Severity Index and 70% being highly successful on outcome criteria modified by Drug Abuse …

Longitudinal Impact Of The Project Paths On Adolescent Risk Behavior: What Happened After Five Years?, Daniel T. L. Shek, Lu Yu

Pediatrics Faculty Publications

The present study investigated the longitudinal impact of the Project PATHS, a large-scale curriculum-based positive youth development program in Hong Kong, on the development of adolescents' risk behavior over a period of five years. Using a longitudinal randomized controlled design, eight waves of data were collected from 19 experimental schools in which students participated in the Project PATHS (N = 2,850 at Wave 8) and 24 control schools without joining the Project PATHS (N = 3,640 at Wave 8). At each wave, students responded to measures assessing their current risk behaviors, including delinquency, use of different types of drug, and …

Primary Care Providers’ Perspectives On Online Weight-Loss Programs: A Big Wish List, Kevin O Hwang, Heather L Stuckey, Monica C Chen, Jennifer L Kraschnewski, Samuel N Forjuoh, Jennifer M Poger, Kathleen M Mctigue, Christopher N Sciamanna

Faculty, Staff and Student Publications

BACKGROUND: Integrating online weight-loss programs into the primary care setting could yield substantial public health benefit. Little is known about primary care providers' perspectives on online weight-loss programs.

OBJECTIVE: To assess primary care providers' perspectives on online weight-loss programs.

METHODS: We conducted focus group discussions with providers in family medicine, internal medicine, and combined internal medicine/pediatrics in Texas and Pennsylvania, USA. Open-ended questions addressed their experience with and attitudes toward online weight-loss programs; useful characteristics of existing online weight-loss programs; barriers to referring patients to online weight-loss programs; and preferred characteristics of an ideal online weight-loss program. Transcripts were analyzed …

Personality Traits In Juvenile Delinquents: Associations With Peer And Family Relations, Jeffrey J. Wilson M.D., Sharon E. Willams Ph.D., Evan Garner M.D., Elaine Duxbury B.A., Hans Steiner Dr. Med. Univ.

Jefferson Journal of Psychiatry

Objective: To establish family and peer correlates of personality traits shown to be predictive of future criminal recidivism.

Method: 137 incarcerated boys aged 13-18 (x = 16 ± 1.2), 35% black, 21% Hispanic, 43% white, and 1% other completed the Weinberger Adjustment Inventory (WAI) and a psychosocial history obtained by a social worker. Records were summarized using two raters who assigned numerical ratings to dimensions of family and peer relations.

Results: As expected, observer ratings of family and peer relationships were correlated with the personality characteristics of distress, denial and restraint as measured by the WAI.

Conclusion: Family and peer …

Folie A Famille Associated With Amphetamine Use, Kevin P. Hill B.A., Ashwin A. Patkar M.D., Stephen P. Weinstein Ph.D.

Jefferson Journal of Psychiatry

Shared Psychotic Disorder involving an entire family (folie a famille) is extremely rare. Only two cases of Shared Psychotic Disorder linked to stimulant abuse have been documented in the literature. We report a case of folie a famille that involved 5 members of a family, and was associated with amphetamine use in the primary individual. Our case shares many clinical and etilogical factors with previously reported cases of shared psychotic disorders. A wide variety of psychotic manifestations are associated with amphetamine use and clinicians should be aware of this uncommon syndrome among stimulant-using population, particularly due to the recent increase …