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Prevalence And Risk Factors Of Major Depressive Disorder In Hiv/Aids As Seen In Semi-Urban Entebbe District, Uganda, Eugene Kinyanda, Susan Hoskins, Juliet Nakku, Saira Nawaz, Vikram Patel

Dartmouth Scholarship

Background:

Not much is known about the risk factors of major depressive disorder (MDD) in HIV/AIDS in the African socio-cultural context. Therefore a study was undertaken to examine the prevalence and risk factors of MDD in HIV/AIDS in semi-urban Uganda.

Methods:

A cross-sectional study was undertaken among 618 respondents attending two HIV clinics in Uganda.

Results:

Prevalence of MDD was 8.1%. Factors associated with MDD at univariate analysis only were female gender, family history of mental illness, negative coping style, alcohol dependency disorder, food insecurity and stress; not associated with MDD were social support, neurocognitive impairment, CD4 counts and BMI. …

Triterpenoid Modulation Of Il-17 And Nrf-2 Expression Ameliorates Neuroinflammation And Promotes Remyelination In Autoimmune Encephalomyelitis, Tej K. Pareek, Abdelmadjid Belkadi, Sashi Kesavapany, Anita Zaremba, Sook L. Loh, Lianhua Bai, Mark L. Cohen, Colin Meyer, Karen T. Liby, Robert H. Miller, Michael B. Sporn, John J. Letterio

Dartmouth Scholarship

Inflammatory cytokines and endogenous anti-oxidants are variables affecting disease progression in multiple sclerosis (MS). Here we demonstrate the dual capacity of triterpenoids to simultaneously repress production of IL-17 and other pro-inflammatory mediators while exerting neuroprotective effects directly through Nrf2-dependent induction of anti-oxidant genes. Derivatives of the natural triterpene oleanolic acid, namely CDDO-trifluoroethyl-amide (CDDO-TFEA), completely suppressed disease in a murine model of MS, experimental autoimmune encephalomyelitis (EAE), by inhibiting Th1 and Th17 mRNA and cytokine production. Encephalitogenic T cells recovered from treated mice were hypo-responsive to myelin antigen and failed to adoptively transfer the disease. Microarray analyses showed significant suppression of …

A Perceptual Metric For Photo Retouching, Eric Kee, Hany Farid

Dartmouth Scholarship

In recent years, advertisers and magazine editors have been widely criticized for taking digital photo retouching to an extreme. Impossibly thin, tall, and wrinkle- and blemish-free models are routinely splashed onto billboards, advertisements, and magazine covers. The ubiquity of these unrealistic and highly idealized images has been linked to eating disorders and body image dissatisfaction in men, women, and children. In response, several countries have considered legislating the labeling of retouched photos. We describe a quantitative and perceptually meaningful metric of photo retouching. Photographs are rated on the degree to which they have been digitally altered by explicitly modeling and …

An Epididymal Form Of Cauxin, A Carboxylesterase-Like Enzyme, Is Present And Active In Mammalian Male Reproductive Fluids, Heath W. Ecroyd, Maya Belghazi, Jl Dacheux, M Miyazaki, T Yamashita, Jl Gatti

Heath Ecroyd

Mass spectrometric analysis of a prion protein (PrP)-containing complex isolated from ram cauda epididymal fluid revealed a protein that showed homology to a carboxylesterase-like protein previously identified in cat urine (cauxin). Using anticauxin antibodies, immunoreactive bands were detected in corpus and cauda epididymal fluid from all mammals tested (ram, boar, mouse, and cat). In the ram, the protein was also present in seminal fluid but not found to be associated with sperm. The bands reacting with the anti-cauxin antibody coincided with those having esterase activity in a zymographic assay and its levels paralleled the esterase activity of native epididymal fluids. …

Development Of Abbreviated Measures To Assess Patient Trust In A Physician, A Health Insurer, And The Medical Profession, Elizabeth Dugan, Felicia Trachtenberg, Mark Hall

Elizabeth Dugan

BACKGROUND: Despite the recent proliferation in research on patient trust, it is seldom a primary outcome, and is often a peripheral area of interest. The length of our original scales to measure trust may limit their use because of the practical needs to minimize both respondent burden and research cost. The objective of this study was to develop three abbreviated scales to measure trust in: (1) a physician, (2) a health insurer, and (3) the medical profession. METHODS: Data from two samples were used. The first was a telephone survey of English-speaking adults in the United States (N = 1117) …

Patient Education About Anticoagulant Medication: Is Narrative Evidence Or Statistical Evidence More Effective?, Kathleen Mazor, Joann Baril, Elizabeth Dugan, Frederick Spencer, Pamela Burgwinkle, Jerry Gurwitz

Elizabeth Dugan

OBJECTIVE: To determine the relative impact of incorporating narrative evidence, statistical evidence or both into patient education about warfarin, a widely used oral anticoagulant medication.

METHODS: 600 patients receiving anticoagulant therapy were randomly assigned to view one of three versions of a video depicting a physician-patient encounter where anticoagulation treatment was discussed, or usual care (no video). The videos differed in whether the physician used narrative evidence (patient anecdotes), statistical evidence, or both to highlight key information. 317 patients completed both the baseline and post-test questionnaires. Questions assessed knowledge, beliefs and adherence to medication and laboratory monitoring regimens.

RESULTS: All …

Wnt Signaling Exerts An Antiproliferative Effect On Adult Cardiac Progenitor Cells Through Igfbp3., Angelos Oikonomopoulos, Konstantina-Ioanna Sereti, Frank Conyers, Michael Bauer, Annette Liao, Jian Guan, Dylan Crapps, Jung-Kyu Han, Hanhua Dong, Ahmad F Bayomy, Gabriel C Fine, Karen Westerman, Travis L Biechele, Randall T Moon, Thomas Force, Ronglih Liao

Center for Translational Medicine Faculty Papers

RATIONALE: Recent work in animal models and humans has demonstrated the presence of organ-specific progenitor cells required for the regenerative capacity of the adult heart. In response to tissue injury, progenitor cells differentiate into specialized cells, while their numbers are maintained through mechanisms of self-renewal. The molecular cues that dictate the self-renewal of adult progenitor cells in the heart, however, remain unclear.

OBJECTIVE: We investigate the role of canonical Wnt signaling on adult cardiac side population (CSP) cells under physiological and disease conditions.

METHODS AND RESULTS: CSP cells isolated from C57BL/6J mice were used to study the effects of canonical …

Histone Deacetylase Inhibitor Valproic Acid Suppresses The Growth And Increases The Androgen Responsiveness Of Prostate Cancer Cells., Yu-Wei Chou, Nagendra K. Chaturvedi, Shougiang Ouyang, Fen-Fen Lin, Dharam Kaushik, Jue Wang, Isaac Kim, Ming-Fong Lin

Journal Articles: Biochemistry & Molecular Biology

We identified the molecular target by histone deacetylase (HDAC) inhibitors for exploring their potential prostate cancer (PCa) therapy. Upon HDAC inhibitors-treatment, LNCaP cell growth was suppressed, correlating with increased cellular prostatic acid phosphatase (cPAcP) expression, an authentic protein tyrosine phosphatase. In those cells, ErbB-2 was dephosphorylated, histone H3/H4 acetylation and methylation increased and cyclin proteins decreased. In PAcP shRNA-transfected C-81 cells, valproic acid (VPA) efficacy of growth suppression was diminished. Further, VPA pre-treatment enhanced androgen responsiveness of C-81, C4-2 and MDA PCa2b-AI cells. Thus, cPAcP expression is involved in growth suppression by HDAC inhibitors in PCa cells, and VPA pre-treatments …

Effects Of Prenatal Food And Micronutrient Supplementation On Child Growth From Birth To 54 Months Of Age: A Randomized Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Eva-Charlotte Ekström, Kajsa Åsling-Monemi, Dewan Shamsul Alam, Edward A. Frongillo Jr., Md Yunus, Shams Arifeen, Lars-Åke Persson

Faculty Publications

Background: There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.

Methods: In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled …

Maternal Separation Affects Dopamine Transporter Function In The Spontaneously Hypertensive Rat: An In Vivo Electrochemical Study, Jacqueline S. Womersley, Jennifer H. Hsieh, Lauriston A. Kellaway, Greg A. Gerhardt, Vivienne A. Russell

Neuroscience Faculty Publications

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder characterised by symptoms of inattention, impulsivity and hyperactivity. The spontaneously hypertensive rat (SHR) is a well-characterised model of this disorder and has been shown to exhibit dopamine dysregulation, one of the hypothesised causes of ADHD. Since stress experienced in the early stages of life can have long-lasting effects on behaviour, it was considered that early life stress may alter development of the dopaminergic system and thereby contribute to the behavioural characteristics of SHR. It was hypothesized that maternal separation would alter dopamine regulation by the transporter (DAT) in ways that distinguish SHR …

Perceived Parental Attachment And Achievement Motivation, Mena Bal, Imants Barušs

Psychology

A significant amount of research in attachment theory has been devoted to factors affecting academic achievement, but less attention has been given to the role of attachment in the relation between academic achievement and achievement motivation. The current preliminary study examined the role of perceived parental attachment in achievement motivation. Self-report data obtained from the Parental Attachment Questionnaire, Achievement Goals Questionnaire, and the Performance Failure Appraisal Inventory were collected from 50 university students with a mean age of 18.8 yr. Correlation and regression analyses indicated that parental facilitation of independence correlated significantly and negatively with fear of failure. Results yielded …

The Burden Of Moderate-To-Heavy Soil-Transmitted Helminth Infections Among Rural Malaysian Aborigines: An Urgent Need For An Integrated Control Programme, Init Ithoi

Init Ithoi

Background: Soil-transmitted helminth (STH) infections, among the most common neglected tropical diseases, continue to be a major threat to the health and socioeconomic wellbeing of infected people especially children in developing countries. Methods: A cross-sectional study among 254 aboriginal schoolchildren was conducted in order to determine the current prevalence and intensity of infections and to investigate the potential risk factors associated with moderate-to-heavy burden of STH infections among these children. Results: Overall, 93.7% of children were found to be infected with one or more STH species. The prevalence of trichuriasis, ascariasis and hookworm infections were 84.6%, 47.6% and 3.9%, respectively. …

Changes In Spirituality Partly Explain Health-Related Quality Of Life Outcomes After Mindfulness-Based Stress Reduction., Jeffrey M Greeson, Daniel M Webber, Moria J Smoski, Jeffrey G Brantley, Andrew G Ekblad, Edward C Suarez, Ruth Quillian Wolever

College of Science & Mathematics Departmental Research

Mindfulness-Based Stress Reduction is a secular behavioral medicine program that has roots in meditative spiritual practices. Thus, spirituality may partly explain Mindfulness-Based Stress Reduction outcomes. Participants (N = 279; M (SD) age = 45(12); 75% women) completed an online survey before and after an 8-week Mindfulness-Based Stress Reduction program. Structural equation modeling was used to test the hypothesis that, following Mindfulness-Based Stress Reduction, the relationship between enhanced mindfulness and improved health-related quality of life is mediated by increased daily spiritual experiences. Changes in both spirituality and mindfulness were significantly related to improvement in mental health. Although the initial mediation hypothesis …

Specific Contributions Of Ventromedial, Anterior Cingulate, And Lateral Prefrontal Cortex For Attentional Selection And Stimulus Valuation., Daniel Kaping, Martin Vinck, R Matthew Hutchison, Stefan Everling, Thilo Womelsdorf

Brain and Mind Institute Researchers' Publications

Attentional control ensures that neuronal processes prioritize the most relevant stimulus in a given environment. Controlling which stimulus is attended thus originates from neurons encoding the relevance of stimuli, i.e. their expected value, in hand with neurons encoding contextual information about stimulus locations, features, and rules that guide the conditional allocation of attention. Here, we examined how these distinct processes are encoded and integrated in macaque prefrontal cortex (PFC) by mapping their functional topographies at the time of attentional stimulus selection. We find confined clusters of neurons in ventromedial PFC (vmPFC) that predominantly convey stimulus valuation information during attention shifts. …

Factors Affecting Growth In Infants With Single Ventricle Physiology: A Report From The Pediatric Heart Network Infant Single Ventricle Trial., Richard V. Williams, Victor Zak, Chitra Ravishankar, Karen Altmann, Jeffrey Anderson, Andrew M. Atz, Carolyn Dunbar-Masterson, Nancy Ghanayem, Linda Lambert, Karen Lurito, Barbara Medoff-Cooper, Renee Margossian, Victoria L. Pemberton, Jennifer Russell, Mario Stylianou, Daphne Hsu, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To describe growth patterns in infants with single ventricle physiology and determine factors influencing growth.

STUDY DESIGN: Data from 230 subjects enrolled in the Pediatric Heart Network Infant Single Ventricle Enalapril Trial were used to assess factors influencing change in weight-for-age z-score (z) from study enrollment (0.7 ± 0.4 months) to pre-superior cavopulmonary connection (SCPC; 5.1 ± 1.8 months, period 1) and pre-SCPC to final study visit (14.1 ± 0.9 months, period 2). Predictor variables included patient characteristics, feeding regimen, clinical center, and medical factors during neonatal (period 1) and SCPC hospitalizations (period 2). Univariate regression analysis was performed, …

Relationship Between Vancomycin Trough Concentrations And Nephrotoxicity: A Prospective Multicenter Trial, John A. Bosso, Jean Nappi, Celeste Rudisill, Marlea Wellein, P Brandon Bookstaver, Jenna Swindler, Patrick D. Mauldin

Faculty Publications

Several single-center studies have suggested that higher doses of vancomycin, aimed at producing trough concentrations of >15 mg/liter, are associated with increased risk of nephrotoxicity. We prospectively assessed the relative incidence of nephrotoxicity in relation to trough concentration in patients with documented methicillin-resistant Staphylococcus aureus (MRSA) infections at seven hospitals throughout South Carolina. Adult patients receiving vancomycin for at least 72 h with at least one vancomycin trough concentration determined under steady-state conditions were prospectively studied. The relationship between vancomycin trough concentrations of >15 mg/ml and the occurrence of nephrotoxicity was assessed using univariate and multivariate analyses, controlling for age, …

Informational Needs Of Caregivers Of Terminal Patients In A Rural State, Virginia Conley, M. Burman

Virginia M. Conley

Home care of a terminally ill family member is stressful, especially in rural areas. This qualitative study sought to determine informational needs of rural caregivers and how that information is obtained. Although most caregivers stated satisfaction with available information, mostly obtained from physicians and nurses, their behavior belied their satisfaction. Assertive and self-reliant, they used informal communications rather than written information to meet most of their needs. Approaches home care nurses can use to help caregivers obtain important information are presented.

Never Did I Know: Iowa Nurses Association Resolution 2010 #2, Virginia Conley

Virginia M. Conley

No abstract provided.

Conflict And Retention Of New Graduate Nurses, Diane Gardner

Diane Huber

No abstract provided.

Career Commitment In Nursing, Diane Gardner

Diane Huber

There are different patterns and styles to careers in nursing. The concept of career commitment in nursing is explored, and the results of some research are discussed for their implications for nursing careers. A longitudinal, repeated-measures descriptive survey was used to measure career commitment and explore its relationship to turnover and work performance in 320 newly employed registered nurses at one hospital. Career commitment scores dropped significantly over the first year. Although career commitment does correlate with turnover, and there is a relationship with job performance, the direct association is weak. Career commitment is not a stable phenomenon in the …

Patient Preferences And Discharge Planning Transitions, Diane Huber, E. Mcclelland

Diane Huber

Discharge planning is an urgently needed nursing intervention. The purpose of this article is to investigate the importance of patient and family preferences and participation for discharge planning and to describe the pilot testing of an instrument to measure patient preferences for discharge planning. The results identified a lack of congruence between patients' and caregivers' preferences, suggesting the need to assess both patients' and families' preferences early and incorporate this in discharge planning that begins at admission to a hospital. The instrument, Patient Participation Preferences Assessment (PPPA), is shown to be a useful, reliable, and valid instrument that can be …

Psychometric Evaluation Of The Structured Clinical Interview For Dsm-Iv Childhood Diagnoses (Kid-Scid), D. Smith, Diane Huber, J. Hall

Diane Huber

The purpose of this study was to evaluate the reliability and validity of selected modules of the Structured Clinical Interview for DSM IV (KID-SCID, Version 1.0). The Disruptive Behavior Disorders (i.e., ADHD, ODD, CD) and Substance Related Disorders modules of the KID-SCID were administered to 50 adolescents receiving residential treatment for substance abuse and severe behavioral problems. This study examined available evidence for inter-rater reliability and convergent validity. Convergent validity was demonstrated for the Disruptive Behavior Disorders module, however, the Substance Abuse Disorders module failed to converge with frequency of use for most substances. Inter-rater reliability was generally high. This …

Evaluating The Impact Of Case Management Dosage, Diane Huber, M. Sarrazin, T. Vaughn, J. Hall

Diane Huber

BACKGROUND: Because of the broad range of activities involved and high variance in clients' needs, it is challenging to measure the actual dose of case management in order to assess quality and manage outcomes. OBJECTIVE: The purpose of this research is to evaluate the impact of intervention dosage on client outcomes in different case management models within substance abuse treatment. METHOD: A descriptive and repeated measures analysis from a clinical trials data set measured the dosage of case management and evaluated impact on client outcomes. A sample of 598 clients from a substance abuse treatment facility was randomized into one …

Telephone Nursing Interventions In Ambulatory Care, Diane Huber, K. Blanchfield

Diane Huber

Telephone nursing practice is becoming a major nursing activity in ambulatory care settings, yet little is known about the type and extent of nursing interventions that occur during telephone interactions. A pilot study was conducted in two sites to see whether nursing diagnoses and interventions could be captured and related to nursing care during telephone consultation. This initial pilot demonstrated that nurses have an appropriate role in telephone interactions and that standardized nursing language can be used in telephone nursing to document nursing care despite the many challenges in its use in the field.

Client Satisfaction With Rural Substance Abuse Case Management Services, T. Kopelman, Diane Huber, B. Kopelman, M. Sarrazin, J. Hall

Diane Huber

Although many substance abuse organizations offer case management services, little is known about clients' satisfaction as consumers of case management services. The purpose of this study was to evaluate consumer preferences regarding the delivery of case management services in a rural substance abuse treatment program. For this study, 120 clients (30 in each of four research conditions) were interviewed about their experiences in the Iowa Case Management Project (ICMP), a field-based clinical trial evaluating a strengths-based model of case management for rural clients in drug abuse treatment. A mixed-method approach evaluated clients' responses from a semistructured interview. Most clients preferred …

A Brief Overview Of Adolescent Developmental Problems In Hong Kong, Daniel T. L. Shek, Hing Keung Ma, Rachel C. F. Sun

Pediatrics Faculty Publications

Several adolescent developmental problems in Hong Kong are briefly reviewed in this paper. First, rising adolescent substance abuse trends are described. Second, Internet use problems and Internet addiction among young people are examined. Third, worrying trends in adolescent sexuality are identified. Fourth, phenomena on bullying among young people are reviewed. Finally, phenomena related to adolescent materialistic orientation are focused upon. With reference to these adolescent developmental problems, possible solutions are briefly discussed particularly with reference to the ecological perspective. It is argued that the related scientific literature provides useful pointers for designing the curriculum in the extension phase of the …

Madness, Maleness And Method, Darach Murphy

Conference papers

A common perception prevails in contemporary society that men don’t talk. Research such as that entitled ‘Death rather than Disclosure’ even suggests that taking one’s own life is preferred by men, than the disclosing of deep psychological distress. However a number of Men’s Groups in Dublin contradict this common and disturbing perception. These Men’s Groups contain individuals who have been affected by some of the most difficult psychological issues experienced in contemporary society. They come to the Men’s Groups in order to deal with the legacy of these issues and they do this by communicating their own personal experience in …

Percutaneous Implantation Of The Edwards Sapien Transcatheter Heart Valve For Conduit Failure In The Pulmonary Position: Early Phase 1 Results From An International Multicenter Clinical Trial., Damien Kenny, Ziyad M. Hijazi, Saibal Kar, John Rhodes, Michael Mullen, Raj Makkar, Girish S. Shirali, Mark Fogel, John Fahey, Mary G. Heitschmidt, Christopher Cain

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this study was to evaluate the safety and effectiveness of the Edwards SAPIEN transcatheter heart valve (Edwards Lifesciences LLC, Irvine, California) in the pulmonary position in patients with moderate to severe pulmonary regurgitation with or without stenosis.

BACKGROUND: Transcatheter pulmonary valve replacement is evolving, but to date, experience has been limited to the Melody valve (Medtronic Inc., Minneapolis, Minnesota).

METHODS: Eligible patients with dysfunctional right ventricle-to-pulmonary artery conduits were screened if body weight was ≥35 kg and the in situ conduit diameter was ≥16 mm and ≤24 mm. Standardized implantation and follow-up protocols were used.

RESULTS: …

Catastrophic Reactions And Other Behaviors Of Alzheimer's Residents: Special Unit Compared With Traditional Units, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter

Elizabeth A. Swanson

Using a quasi-experimental pretest/posttest design, the effects of a Special Care Unit (SCU) on the incidence of catastrophic reactions and other behaviors of nursing home residents with Alzheimer's disease (AD) were examined. Findings indicate significantly fewer catastrophic reactions and other selected behavior changes occurred during the posttest period for subjects in the experimental group compared with the subjects in the control group. Implications for psychiatric consultation/liaison nurses (PCLNs) working with this vulnerable population are discussed.

Outcomes Of Family Involvement In Care Intervention For Caregivers Of Individuals With Dementia, Meridean Maas, D. Reed, M. Park, Janet Specht, D. Schutte, Lisa Skemp Kelley, Elizabeth Swanson, Toni Tripp-Reimer, Kathleen Buckwalter

Elizabeth A. Swanson

BACKGROUND: Despite the increasing number of individuals with dementia relocated from caregiving at home to a nursing home, there is only a small body of literature examining the influence of institutional family-oriented practices on family member perceptions of care and family-staff relationships. OBJECTIVE: The study tested the effects of the Family Involvement in Care partnership intervention on family members' perceptions of their caregiving role, relationships with staff, and satisfaction with the care of relatives with dementia residing in special care units as well as the effects on staff attitudes toward families and staff satisfaction with a caregiving role. METHODS: A …