Digital Commons Network^™

Prerequisites In Behavioral Science And Business: Opportunities For Dental Education., David G. Dunning, Brian M. Lange, Robert D. Madden, Koko K. Tacha

Journal Articles: College of Dentistry

There is increasing pressure on recent dental school graduates to understand and successfully utilize patient management and business management strategies to run a productive dental office. Dental schools are faced with the dilemma to either add more credit hours in their already crowded curriculum or adjust predental school requirements. All fifty-nine U.S. dental schools were assessed online to determine admission requirements in the areas of behavioral science and business education. Results show that only 11.9 percent of the schools require prerequisite course work in behavioral science and no school requires prerequisite course work in business. However, 64.4 percent and 30.5 …

Modeling The Development Of Pronunciation In Infant Speech Acquisition., Is Howard, P Messum

School of Engineering, Computing and Mathematics

Pronunciation is an important part of speech acquisition, but little attention has been given to the mechanism or mechanisms by which it develops. Speech sound qualities, for example, have just been assumed to develop by simple imitation. In most accounts this is then assumed to be by acoustic matching, with the infant comparing his output to that of his caregiver. There are theoretical and empirical problems with both of these assumptions, and we present a computational model- Elija-that does not learn to pronounce speech sounds this way. Elija starts by exploring the sound making capabilities of his vocal apparatus. Then …

Attention Deployment During Memorizing And Executing Complex Instructions., Jens K. Apel, Gavin F. Revie, Angelo Cangelosi, Rob Ellis, Jeremy Goslin, Martin H. Fischer

School of Psychology

We investigated the mental rehearsal of complex action instructions by recording spontaneous eye movements of healthy adults as they looked at objects on a monitor. Participants heard consecutive instructions, each of the form "move [object] to [location]". Instructions were only to be executed after a go signal, by manipulating all objects successively with a mouse. Participants re-inspected previously mentioned objects already while listening to further instructions. This rehearsal behavior broke down after 4 instructions, coincident with participants' instruction span, as determined from subsequent execution accuracy. These results suggest that spontaneous eye movements while listening to instructions predict their successful execution.

Measuring Alcohol Craving: Development Of The Alcohol Craving Experience Questionnaire., Dixie J. Statham, Jason P. Connor, David J. Kavanagh, Gerald F.X. Feeney, Ross Mc D. Young, Jon May, Jackie Andrade

School of Psychology

To develop a measure of craving based on the Elaborated Intrusion (EI) theory of desire and to examine the construct, concurrent and discriminant validity of the instrument.

Association Of Retinoic Acid Receptor Genes With Meningomyelocele, Phong X Tran, Kit Sing Au, Alanna C Morrison, Jack M Fletcher, Kathryn K Ostermaier, Gayle H Tyerman, Hope Northrup

Faculty, Staff and Student Publications

BACKGROUND: Neural tube defects (NTDs) occur in as many as 0.5-2 per 1000 live births in the United States. One of the most common and severe neural tube defects is meningomyelocele (MM) resulting from failed closure of the caudal end of the neural tube. MM has been induced by retinoic acid teratogenicity in rodent models. We hypothesized that genetic variants influencing retinoic acid (RA) induction via retinoic acid receptors (RARs) may be associated with risk for MM.

METHODS: We analyzed 47 single nucleotide polymorphisms (SNPs) that span across the three retinoic acid receptor genes using the SNPlex genotyping platform. Our …

Improving Gene Expression Data Interpretation By Finding Latent Factors That Co-Regulate Gene Modules With Clinical Factors, Tianwei Yu, Yun Bai

PCOM Scholarly Works

Background: In the analysis of high-throughput data with a clinical outcome, researchers mostly focus on genes/proteins that show first-order relations with the clinical outcome. While this approach yields biomarkers and biological mechanisms that are easily interpretable, it may miss information that is important to the understanding of disease mechanism and/or treatment response. Here we test the hypothesis that unobserved factors can be mobilized by the living system to coordinate the response to the clinical factors.Results: We developed a computational method named Guided Latent Factor Discovery (GLFD) to identify hidden factors that act in combination with the observed clinical factors to …

Reflections On A Heart Surgery Career With Insights For Western-Trained Medical Specialists In Developing Countries, Sami S Kabbani

The Texas Heart Institute Journal

Herein, I describe my experience (spanning 40 years) in helping to develop the specialty of cardiovascular surgery in Syria. Especially in the early years, the challenges were daunting. We initially performed thoracic, vascular, and closed-heart operations while dealing with inadequate facilities, bureaucratic delays, and poorly qualified personnel. After our independent surgical center was established in early 1976, we performed 1 open-heart and 1 closed-heart procedure per day. Open-heart procedures evolved from the few and simple to the multiple and complex, and we solved difficulties as they arose. Today, our cardiac surgical center occupies an entire 6-floor building. We have 12 …

Referrals To A Regional Allergy Clinic - An Eleven Year Audit., Ray B. Jones, Paul Hewson, Edward R. Kaminski

School of Nursing and Midwifery

BACKGROUND: Allergy is a serious and apparently increasing public health problem yet relatively little is known about the types of allergy seen in routine tertiary practice, including their spatial distribution, co-occurrence or referral patterns. This study reviewed referrals over an eleven year period to a regional allergy clinic that had a well defined geographical boundary. For those patients confirmed as having an allergy we explored: (i) differences over time and by demographics, (ii) types of allergy, (iii) co-occurrence, and (iv) spatial distributions. METHODS: Data were extracted from consultant letters to GPs, from September 1998 to September 2009, for patients confirmed …

Prospective Evaluation Of A Cognitive Vulnerability-Stress Model For Depression: The Interaction Of Schema Self-Structures And Negative Life Events., Pamela M Seeds, David J A Dozois

Psychology Publications

This study tested the diathesis-stress component of Beck's (1967) cognitive theory of depression. Initially, participants completed measures assessing cognitive organization of the self-schema and depressive symptoms. One year later, participants completed measures assessing cognitive organization of the self-schema, depressive symptoms, and negative life events. Hierarchical multiple regression analyses, controlling for initial depression, indicated that more tightly interconnected negative content was associated with greater elevations in depressive symptoms following the occurrence of life events. More diffusely interconnected positive content for interpersonal self-referent information also interacted with life events to predict depressive symptoms. Cognitive organization dimensions showed moderate to high stability across …

Priming In Interpersonal Contexts: Implications For Affect And Behavior., Na Wyer, G Calvini, A Nash, N Miles

School of Psychology

Priming stereotypes can lead to a variety of behavioral outcomes, including assimilation, contrast, and response behaviors. However, the conditions that give rise to each of these outcomes are unspecified. Furthermore, theoretical accounts posit that prime-to-behavior effects are either direct (i.e., unmediated) or mediated by cognitive processes, whereas the role of affective processes has been largely unexplored. The present research directly investigated both of these issues. Three experiments demonstrated that priming a threatening social group ("hoodies") influences both affect and behavior in an interpersonal context. Hoodie priming produced both behavioral avoidance and several affective changes (including social apprehension, threat sensitivity, and …

Integrating The Promotion Of Physical Activity Within A Smoking Cessation Programme: Findings From Collaborative Action Research In Uk Stop Smoking Services., Adrian H. Taylor, Emma S. Everson-Hock, Michael Ussher

Peninsula Medical School

BACKGROUND: Within the framework of collaborative action research, the aim was to explore the feasibility of developing and embedding physical activity promotion as a smoking cessation aid within UK 6/7-week National Health Service (NHS) Stop Smoking Services. METHODS: In Phase 1 three initial cycles of collaborative action research (observation, reflection, planning, implementation and re-evaluation), in an urban Stop Smoking Service, led to the development of an integrated intervention in which physical activity was promoted as a cessation aid, with the support of a theoretically based self-help guide, and self monitoring using pedometers. In Phase 2 advisors underwent training and offered …

Automated Classification Of Breast Pathology Using Local Measures Of Broadband Reflectance, Ashley M. Laughney, Venkataramanan Krishnaswamy, Pilar Beatriz Garcia-Allende, Olga M. Conde, Wendy A. Wells, Keith D. Paulsen, Brian W. Pogue

Dartmouth Scholarship

We demonstrate that morphological features pertinent to a tissue's pathology may be ascertained from localized measures of broadband reflectance, with a mesoscopic resolution (100-μm lateral spot size) that permits scanning of an entire margin for residual disease. The technical aspects and optimization of a k-nearest neighbor classifier for automated diagnosis of pathologies are presented, and its efficacy is validated in 29 breast tissue specimens. When discriminating between benign and malignant pathologies, a sensitivity and specificity of 91 and 77% was achieved. Furthermore, detailed subtissue-type analysis was performed to consider how diverse pathologies influence scattering response and overall classification efficacy. The …

Patient-Orientated Longitudinal Study Of Multiple Sclerosis In South West England (The South West Impact Of Multiple Sclerosis Project, Swims) 1: Protocol And Baseline Characteristics Of Cohort., John P. Zajicek, Wendy M. Ingram, Jane Vickery, Siobhan Creanor, Dave E. Wright, Jeremy C. Hobart

Peninsula Medical School

BACKGROUND: There is a need for greater understanding of the impact of multiple sclerosis (MS) from the perspective of individuals with the condition. The South West Impact of MS Project (SWIMS) has been designed to improve understanding of disease impact using a patient-centred approach. The purpose is to (1) develop improved measurement instruments for clinical trials, (2) evaluate longitudinal performance of a variety of patient-reported outcome measures, (3) develop prognostic predictors for use in individualising drug treatment for patients, particularly early on in the disease course. METHODS: This is a patient-centred, prospective, longitudinal study of multiple sclerosis and clinically isolated …

Differential Effects Of Mindful Breathing, Progressive Muscle Relaxation, And Loving-Kindness Meditation On Decentering And Negative Reactions To Repetitive Thoughts., Greg Feldman, Jeffrey M. Greeson, Joanna Senville

College of Science & Mathematics Departmental Research

Decentering has been proposed as a potential mechanism of mindfulness-based interventions but has received limited empirical examination to date in experimental studies comparing mindfulness meditation to active comparison conditions. In the present study, we compared the immediate effects of mindful breathing (MB) to two alternative stress-management techniques: progressive muscle relaxation (PMR) and loving-kindness meditation (LKM) to test whether decentering is unique to mindfulness meditation or common across approaches. Novice meditators (190 female undergraduates) were randomly assigned to complete one of three 15-min stress-management exercises (MB, PMR, or LKM) presented by audio recording. Immediately after the exercise, participants completed measures of …

The Pathways To Mental Health Care Of First-Episode Psychosis Patients: A Systematic Review., Kelly K. Anderson, Rebecca Fuhrer, Ashok K. Malla

Epidemiology and Biostatistics Publications

BACKGROUND: Although there is agreement on the association between delay in treatment of psychosis and outcome, less is known regarding the pathways to care of patients suffering from a first psychotic episode. Pathways are complex, involve a diverse range of contacts, and are likely to influence delay in treatment. We conducted a systematic review on the nature and determinants of the pathway to care of patients experiencing a first psychotic episode.

METHOD: We searched four databases (Medline, HealthStar, EMBASE, PsycINFO) to identify articles published between 1985 and 2009. We manually searched reference lists and relevant journals and used forward citation …

Maintenance Of Activity And Eating Change After A Clinical Trial Of Tailored Newsletters With Older Rural Women., Susan Noble Walker, Carol H. Pullen, Patricia A. Hageman, Linda S. Boeckner, Melody A. Hertzog, Maureen K. Oberdorfer, Matthew J. Rutledge

Journal Articles: College of Nursing

BACKGROUND: In the Wellness for Women Project, a randomized-by-site 1-year controlled clinical trial, the efficacy of generic newsletters and newsletters tailored on Health Promotion Model behavior-specific cognitions, eating behavior, and activity behavior were compared among 225 women aged 50 to 69 years.

OBJECTIVES: The purpose of this study was to compare the maintenance of change in healthy eating and physical activity over the 12 months following the tailored versus generic mailed newsletter intervention.

METHODS: Outcomes at 18 and 24 months included behavioral markers and biomarkers of physical activity and eating. Data were analyzed using the multivariate approach to repeated measures …

Expanding Access To Hepatitis C Virus Treatment--Extension For Community Healthcare Outcomes (Echo) Project: Disruptive Innovation In Specialty Care, Sanjeev Arora, Summers Kalishman, Karla Thornton, Denise Dion, Glen Murata, Paulina Deming, Brooke Parish, John Brown, Miriam Komaromy, Kathleen Colleran, Arthur Bankhurst, Joanna Katzman, Michelle Harkins, Luis Curet, Ellen Cosgrove, Wesley Pak

Project ECHO Bibliography

The Extension for Community Healthcare Outcomes (ECHO) Model was developed by the University of New Mexico Health Sciences Center as a platform to deliver complex specialty medical care to underserved populations through an innovative educational model of team-based interdisciplinary development. Using state-of-the-art telehealth technology, best practice protocols, and case-based learning, ECHO trains and supports primary care providers to develop knowledge and self-efficacy on a variety of diseases. As a result, they can deliver best practice care for complex health conditions in communities where specialty care is unavailable. ECHO was first developed for the management of hepatitis C virus (HCV), optimal …

Asian Race/Ethnicity As A Risk Factor For Bile Duct Injury During Cholecystectomy., Stephanie R. Downing, Ghazala Datoo, Tolulope A. Oyetunji, Terrence Fullum, David C. Chang, Nita Ahuja

Manuscripts, Articles, Book Chapters and Other Papers

Iatrogenic bile duct injury (BDI) is an uncommon but serious complication of cholecystectomy, with identified risk factors of acute cholecystitis, male sex, older age, and aberrant biliary anatomy. The Nationwide Inpatient Sample (1998-2006) was queried for cholecystectomy performed on hospital day 0 or 1. Bile duct injury repair procedure codes were used as a surrogate for BDI. We identified 377,424 patients who underwent cholecystectomy, with 1124 BDIs (0.3%). On multivariate logistic regression analysis, Asian race/ethnicity was a significant risk factor for BDI (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.59-3.23; P < .001). This persisted for laparoscopic (OR, 2.62; 95% CI, 1.28-5.39; P = .009) and open (2.21; 1.59-3.07; P < .001) cholecystectomies. No other race/ethnicity was identified as a risk factor for BDI. We report a new finding that Asian race/ethnicity is a significant risk factor for BDI in laparoscopic and open cholecystectomies.

Multiple Mechanisms Of Consciousness: The Neural Correlates Of Emotional Awareness., Jayna M Amting, Steven G Greening, Derek G V Mitchell

Brain and Mind Institute Researchers' Publications

Emotional stimuli, including facial expressions, are thought to gain rapid and privileged access to processing resources in the brain. Despite this access, we are conscious of only a fraction of the myriad of emotion-related cues we face everyday. It remains unclear, therefore, what the relationship is between activity in neural regions associated with emotional representation and the phenomenological experience of emotional awareness. We used functional magnetic resonance imaging and binocular rivalry to delineate the neural correlates of awareness of conflicting emotional expressions in humans. Behaviorally, fearful faces were significantly more likely to be perceived than disgusted or neutral faces. Functionally, …

Vestibular Heading Discrimination And Sensitivity To Linear Acceleration In Head And World Coordinates, Paul R. Macneilage, Martin S. Banks, Gregory C. Deangelis, Dora E. Angelaki

Open Access Publications

Effective navigation and locomotion depend critically on an observer's ability to judge direction of linear self-motion, i.e., heading. The vestibular cue to heading is the direction of inertial acceleration that accompanies transient linear movements. This cue is transduced by the otolith organs. The otoliths also respond to gravitational acceleration, so vestibular heading discrimination could depend on (1) the direction of movement in head coordinates (i.e., relative to the otoliths), (2) the direction of movement in world coordinates (i.e., relative to gravity), or (3) body orientation (i.e., the direction of gravity relative to the otoliths). To quantify these effects, we measured …

The Role Of Gender In Single Vs Married Individuals With Bipolar Disorder., Daniel Z Lieberman, Suena H Massey, Frederick K Goodwin

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: Despite the importance of marriage as a source of social support, it has been largely neglected in studies of bipolar disorder; and differential effects on men and women have not been explored.

METHODS: Data on episodes of depression, mania, and mixed states were collected for the previous 2 years from a sample of 282 bipolar individuals using the National Institute of Mental Health Life Chart Methodology.

RESULTS: Effects unique to women included the following: Bipolar women were significantly more likely to be married. Married women had fewer episodes of depression during the past 2 years than never-married women, and …

Somatic Symptom Overlap In Beck Depression Inventory-Ii Scores Following Myocardial Infarction., Brett D Thombs, Roy C Ziegelstein, Louise Pilote, David J A Dozois, Aaron T Beck, Keith S Dobson, Samantha Fuss, Peter De Jonge, Sherry L Grace, Donne E Stewart, Johan Ormel, Susan E Abbey

Psychology Publications

BACKGROUND: Depression measures that include somatic symptoms may inflate severity estimates among medically ill patients, including those with cardiovascular disease.

AIMS: To evaluate whether people receiving in-patient treatment following acute myocardial infarction (AMI) had higher somatic symptom scores on the Beck Depression Inventory-II (BDI-II) than a non-medically ill control group matched on cognitive/affective scores.

METHOD: Somatic scores on the BDI-II were compared between 209 patients admitted to hospital following an AMI and 209 psychiatry out-patients matched on gender, age and cognitive/affective scores, and between 366 post-AMI patients and 366 undergraduate students matched on gender and cognitive/affective scores.

RESULTS: Somatic symptoms …

Deficits In Attention To Emotional Stimuli Distinguish Youth With Severe Mood Dysregulation From Youth With Bipolar Disorder., Brendan A Rich, Melissa A Brotman, Daniel P Dickstein, Derek G V Mitchell, R James R Blair, Ellen Leibenluft

Brain and Mind Institute Researchers' Publications

Studying attention in the context of emotional stimuli may aid in differentiating pediatric bipolar disorder (BD) from severe mood dysregulation (SMD). SMD is characterized by chronic irritability, arousal, and hyper-reactivity; SMD youth frequently receive a BD diagnosis although they do not meet DSM-IV criteria for BD because they lack manic episodes. We compared 57 BD (14.4 +/- 2.9 years old, 56% male), 41 SMD (12.6 +/- 2.6 years old, 66% male), and 33 control subjects (13.7 +/- 2.5 years old, 52% male) using the Emotional Interrupt task, which examines how attention is impacted by positive, negative, or neutral distracters. We …

A Randomized Comparison Of Online And Paper Mood Charts For People With Bipolar Disorder., Daniel Z Lieberman, Tammas F Kelly, Lanny Douglas, Frederick K Goodwin

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: Longitudinal mood instability is the essential feature of bipolar disorder, however most rating scales are cross sectional in nature, and focus on acute symptoms. By contrast, the NIMH Life Chart Methodology (LCM) characterizes in detail the severity, duration, and frequency of mood episodes. Adherence to daily rating, however, tends to be low. In this study an online version of the LCM, designed to enhance adherence, was compared to the standard paper version.

METHODS: Patients from a mood disorders specialty clinic were randomized to the standard LCM or an online, open-source adaptation. The online version used hypertext links embedded in …

Ethics, Empathy, And The Education Of Dentists, David A. Nash

Oral Health Science Faculty Publications

Professional education in dentistry exists to educate good dentists-dentists equipped and committed to helping society gain the benefits of oral health. In achieving this intention, dental educators acknowledge that student dentists must acquire the complex knowledge base and the sophisticated perceptual-motor skills of dentistry. The graduation of knowledgeable and skilled clinicians in dentistry is a necessary, but not sufficient, condition for ensuring quality oral health care. The further requirement is the commitment of graduates to applying their abilities with moral integrity: providing appropriate and quality care in their patients' best interest. Ultimately, good dentistry depends on individuals committed to treating …

Vampirism, Vampire Cults And The Teenager Of Today, Megan White, Hatim A. Omar

Pediatrics Faculty Publications

The aim of this paper is to summarize the limited literature on clinical vampirism, vampire cults and the involvement of adolescents in vampire-like behavior. The various definitions of clinical vampirism are outlined and the emergence of vampire cults from Gothic culture is examined. Further, the clinical features of cult behavior, the attraction to cults, the risk factors for cult involvement, and the clinical management of cult members are discussed. Additionally, vampire popular media is briefly introduced and a case study presented.

Defining And Measuring The Patient-Centered Medical Home., Kurt C Stange, Paul A Nutting, William L Miller, Carlos R Jaén, Benjamin F Crabtree, Susan A Flocke, James M Gill

Department of Family & Community Medicine Faculty Papers

The patient-centered medical home (PCMH) is four things: 1) the fundamental tenets of primary care: first contact access, comprehensiveness, integration/coordination, and relationships involving sustained partnership; 2) new ways of organizing practice; 3) development of practices' internal capabilities, and 4) related health care system and reimbursement changes. All of these are focused on improving the health of whole people, families, communities and populations, and on increasing the value of healthcare. The value of the fundamental tenets of primary care is well established. This value includes higher health care quality, better whole-person and population health, lower cost and reduced inequalities compared to …

The Transition From Medical Student To Junior Doctor: Today's Experiences Of Tomorrow's Doctors., Nicola Brennan, Oonagh Corrigan, Jon Allard, Julian Archer, Rebecca Barnes, Alan Bleakley, Tracey Collett, Bere Sr De

Peninsula Medical School

CONTEXT Medical education in the UK has recently undergone radical reform. Tomorrow's Doctors has prescribed undergraduate curriculum change and the Foundation Programme has overhauled postgraduate education. OBJECTIVES This study explored the experiences of junior doctors during their first year of clinical practice. In particular, the study sought to gain an understanding of how junior doctors experienced the transition from the role of student to that of practising doctor and how well their medical school education had prepared them for this. METHODS The study used qualitative methods comprising of semi-structured interviews and audio diary recordings with newly qualified doctors based at …

Evaluation Of A Comprehensive Tobacco Cessation Curriculum For Dental Hygiene Programs, Joan M. Davis Rdh, Ms, Margaret S Stockdale, Martha Cropper

Journal Articles

Dental health care providers continue to offer inconsistent and limited tobacco use cessation (TUC) interventions even though smoking-related morbidity and mortality continue to be a substantial health concern. Our purpose was to conduct a comprehensive, three-year (2003-06) TUC curriculum evaluation that included assessment of existing TUC education offered; dental hygiene educators' readiness to incorporate TUC education into the curriculum; and development of a pre-test/post-test assessment instrument and faculty development program. This curriculum study was carried out alongside a research study to evaluate the effectiveness of a peer-reviewed tobacco curriculum (Tobacco Free! Curriculum). Faculty members (baseline n=97; third-year n=42) from the …

Examining The Neuroscience Evidence For Sensory-Driven Neuroplasticity: Implications For Sensory-Based Occupational Therapy For Children And Adolescents., Shelly J. Lane, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

When Ayres first presented the theory of sensory integration (SI), she grounded it in the neuroscience literature. Neuroplasticity was then, and is today, considered to be at the heart of this theory. This evidence-based review sought to critically examine the basic science literature to specifically identify evidence for the assumptions and tenets of Ayres' theory of SI. We reviewed literature between 1964 and 2005, within psychological, physiological, and biomedical areas, addressing neuroplasticity. The review focused on sensorimotor-based neuroplasticity; explored the data that addressed the links among sensory input, brain function, and behavior; and evaluated its relevance in terms of supporting …