Medicine and Health Sciences Commons^™

Motivational Interviewing (Mi) Using Co-Active Life Coaching Skills As A Treatment For Obesity, Courtney Newnham-Kanas, Jennifer Irwin, Don Morrow

Donald Morrow

No abstract provided.

Lowering The Risk Of Spreading Hiv Among Heterosexual Men In Africa, Richard Wamai

Richard G. Wamai

No abstract provided.

Status Of Epa’S Proposed Rule To Strengthen The Ozone Standard, Dale Stephenson

Dale J. Stephenson

On January 6, 2010 the EPA rolled out a proposal to reduce the 8-hour primary standard for tropospheric (ground level) ozone from its current level of 0.075 ppm to somewhere between 0.060 ppm and 0.070 ppm. This reduction has the potential for many US airsheds to be declared as nonattainment with the new standard (including many in the Rocky Mountain West). Such a declaration will require state regulatory agencies to initiate implementation plans to bring affected airsheds back into attainment. This presentation will summarize the current status of and reasoning for EPA’s proposed reduction to the primary ozone standard and …

Factors Associated With Attendance In 12-Step Groups (Alcoholics Anonymous/Narcotics Anonymous) Among Adults With Alcohol Problems Living With Hiv/Aids, John Orwat, Jeffrey Samet, Christopher Tompkins, Debbie Cheng, Michael Dentato, Richard Saitz

Michael P. Dentato, PhD, MSW

Clinical Diagnostic Criteria For Isolating Patients Admitted To Hospital With Suspected Pandemic Influenza, John Gerrard, Gerben Keijzers, Ping Zhang, Caleb Vossen, Deborough Macbeth

Gerben Keijzers

Extract: Australian hospitals have now experienced the first wave of pandemic H1N1 influenza during a southern hemisphere winter. Patients admitted to Australian hospitals with suspected pandemic influenza during this period were identified by use of approved national clinical diagnostic criteria. However, the imprecise nature of clinical diagnosis limited the ability of hospitals to isolate infectious patients effectively before the laboratory confirmation of infection (which typically takes a minimum of 48 h).

Review Of The Quality Of Complementary Medicines Information Resources: Summary Report, Treasure Mcguire, Julie Walters, Angela Dean, Mieke Van Driel, Chris Del Mar, Vicki Kotsirilos, Geraldine Moses, Steven Chong, Gary Deed, Barbara Eldred, Janet Hardy, Honey Heussler, Samantha Hollingsworth, Loretta Marron, Joy Mendel, David Pache, Kathryn Steadman, Helen Trenerry, Jared Brown, Margaret Williamson

Treasure McGuire

Recent research conducted by the National Prescribing Service (NPS) has shown the need for improving complementary medicines (CMs) information availability and awareness for Australian health professionals and consumers. CMs information resources have been reported to be of variable quality, with some identified as inaccurate or misleading. To date, there has been no comprehensive evaluation of available information resources to help the Australian community make better informed decisions around the quality use of CMs, in order to meet the demand for high quality information on CMs.

Prognosis Of Acute Myocardial Infarction Complicated By Complete Heart Block (The Worcester Heart Attack Study), Robert Goldberg, Juan Zevallos, Jorge Yarzebski, Joseph Alpert, Joel Gore, Z. Chen, James Dalen

Jorge L. Yarzebski

As part of a community-based study of patients hospitalized with acute myocardial infarction (AMI) in the Worcester, Massachusetts, metropolitan area, changes over time in the incidence rates of complete heart block (CHB) complicating AMI, and the prognostic impact of CHB on the in-hospital and long-term survival of these patients were examined. In all, 4,762 patients with validated AMI hospitalized at 16 hospitals in the Worcester metropolitan area during 1975, 1978, 1981, 1984, 1986 and 1988 constituted the study sample. The incidence rates of CHB complicating AMI remained relatively stable at 5.8% over the 13-year (1975 to 1988) period studied. The …

Long-Term Trends (1986-2003) In The Use Of Coronary Reperfusion Strategies In Patients Hospitalized With Acute Myocardial Infarction In Central Massachusetts, Robert J. Goldberg, Frederick A. Spencer, Joseph Okolo, Darleen M. Lessard, Jorge L. Yarzebski, Joel M. Gore

Jorge L. Yarzebski

BACKGROUND: The objectives of our study were to examine long-term (1986-2003) trends in the use of percutaneous coronary interventions (PCI) and thrombolytic therapy in the management of patients hospitalized at all Central Massachusetts medical centers with acute myocardial infarction (AMI). Our secondary study goal was to examine factors associated with use of these coronary reperfusion strategies. Limited contemporary data are available about changing trends in the use of coronary reperfusion strategies, particularly from a population-based perspective. METHODS: The sample consisted of 9422 greater Worcester (MA) residents hospitalized with AMI at all metropolitan Worcester medical centers in 10 annual periods between …

Effect Of Elevated Leukocyte Count On In-Hospital Mortality Following Acute Myocardial Infarction, Mark Furman, Richard Becker, Jorge Yarzebski, Judith Savageau, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

The peripheral white blood cell count on presentation with acute myocardial infarction directly correlates with short-term in-hospital mortality. This association is independent of other prognostic factors, including extent and size of the acute myocardial infarction.

A Community-Wide Perspective Of Gender Differences And Temporal Trends In The Use Of Diagnostic And Revascularization Procedures For Acute Myocardial Infarction, David Chiriboga, Jorge Yarzebski, Robert Goldberg, Z. Chen, Jerry Gurwitz, Joel Gore, Joseph Alpert, James Dalen

Jorge L. Yarzebski

This study compares the overall use, as well as temporal trends, of various diagnostic and revascularization procedures for acute myocardial infarction (AMI) in men and women. The study sample comprised a total of 2,924 men and 1,838 women with validated AMI admitted to any of the 16 teaching and community hospitals in the Worcester, Massachusetts, metropolitan area during 1975, 1978, 1981, 1984, 1986 and 1988. During the period under study there was a significant increase in use of each of the examined procedures during hospitalization for AMI in both men and women. Increasing use of multiple procedures was also seen …

Differences In Discharge Medication After Acute Myocardial Infarction In Patients With Hmo And Fee-For-Service Medical Insurance, Danny Mccormick, Jerry Gurwitz, Judith Savageau, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVE: To assess the impact of fee-for-service (FFS) versus HMO medical insurance coverage on receipt of aspirin, beta-blockers, and calcium channel blockers at the time of hospital discharge following an acute myocardial infarction. DESIGN: Prospective, population-based study. SETTING: All 16 community and tertiary care hospitals in the metropolitan area of Worcester, Massachusetts. PATIENTS: The study population consisted of patients under 65 years of age hospitalized with a validated acute myocardial infarction in all hospitals in the Worcester (Massachusetts) Standard Metropolitan Statistical Area (1990 census estimate, 437,000) during 1986, 1988, 1990, 1991, and 1993. MEASUREMENTS AND MAIN RESULTS: After adjustment for …

Age-Related Trends (1986-1993) In The Use Of Thrombolytic Agents In Patients With Acute Myocardial Infarction. The Worcester Heart Attack Study, Harish Chandra, Jorge Yarzebski, Robert Goldberg, Judith Savageau, Colleen Singleton, Jerry Gurwitz, Joel Gore

Jorge L. Yarzebski

OBJECTIVE: To examine age-related differences and temporal trends in the use of thrombolytic therapy in a community-wide study of patients hospitalized with acute myocardial infarction (AMI) between 1986 and 1993. METHODS: All hospitals in the Worcester, Mass, metropolitan area (1990 census population, 4370000) were included. A total of 3824 patients with validated AMI categorized according to age comprised the study sample: younger than 55 years (n = 577), 55 to 64 years (n = 758), 65 to 74 years (n = 1143), and 75 years or older (n = 1346). RESULTS: Use of thrombolytic therapy increased during the period under …

Temporal Trends And Factors Associated With Extent Of Delay To Hospital Arrival In Patients With Acute Myocardial Infarction: The Worcester Heart Attack Study, Jorge Yarzebski, Robert Goldberg, Joel Gore, Joseph Alpert

Jorge L. Yarzebski

Factors associated with delay to hospital arrival after the onset of symptoms suggestive of acute myocardial infarction (AMI) were examined in the late 1960s and 1970s, but recent data concerning these characteristics are limited. The purpose of the present study was to examine overall and temporal distributions of the extent of patients' delay from the time of onset of AMI symptoms to hospital arrival and factors associated with delay in seeking medical care from a multihospital, population-based perspective. Review of medical records was undertaken of patients hospitalized with a discharge diagnosis of AMI in 16 teaching and community hospitals in …

Patient Delay And Receipt Of Thrombolytic Therapy Among Patients With Acute Myocardial Infarction From A Community-Wide Perspective, Robert Goldberg, Jerry Gurwitz, Jorge Yarzebski, J. Landon, Joel Gore, Joseph Alpert, P. Dalen, James Dalen

Jorge L. Yarzebski

The duration of patient delay from the time of onset of symptoms of acute myocardial infarction (AMI) to hospital presentation, and the relation of delay time and various patient characteristics to receipt of thrombolytic therapy were examined as part of a community-based study of patients hospitalized with AMI in the Worcester, Massachusetts, metropolitan area. In all, 800 patients with validated AMI hospitalized at 16 hospitals in the Worcester metropolitan area in 1986 and 1988 constituted the study sample. Patients delayed on average 4 hours between noting symptoms suggestive of AMI and presenting to area-wide emergency departments with no significant change …

Health Insurance Coverage And Outcome Following Acute Myocardial Infarction. A Community-Wide Perspective, Silvia Kreindel, Ronald Rosetti, Robert Goldberg, Judith Savageau, Jorge Yarzebski, Joel Gore, Arthur Russo, Carol Bigelow

Jorge L. Yarzebski

BACKGROUND: Several studies have suggested that type of medical insurance coverage is associated with hospital utilization rates and receipt of selected diagnostic or treatment approaches. To our knowledge no studies, however, have examined the relation between medical insurance coverage and short-term outcomes following acute myocardial infarction (AMI) from a multihospital, community-wide perspective. OBJECTIVE: To examine the association between medical insurance coverage and in-hospital case-fatality rates as well as length of hospital stay following AMI. METHODS: The study sample consisted of 3735 residents of the Worcester, Mass, metropolitan area hospitalized with validated AMI during 1986, 1988, 1990, 1991, and 1993 at …

Qualidade De Vida No Trabalho: Indicadores E Instrumentos De Medidas / Quality Of Work Life: Indicators And Instruments Of Measure, Everton Fernando Alves

Everton Fernando Alves

The measurement of Quality of Life at Work (QLW) has been emerging in the scientific community as an important tool for investigating and evaluating the occupational health of individuals in a holistic manner. The measurement instruments are developed for many different purposes and directions, being held by generic scales of health status and specific scales to a given situation. The objective of this study is to discuss important aspects related to QLW and present in a systematic concept, indicators and measurement instruments used and validated in Brazil. Was conducted a study of narrative review of available knowledge in the literature, …

Should ‘Risk Syndrome Of Psychosis’ Be Included In Dsm V As A Diagnosis? A Road Towards Preventive Psychiatry”, Amresh Srivastava

Amresh Srivastava

Psychiatric diagnosis has acquired a position of a quasi-legal document for mental health services and agencies working with mental health. Its utility has gone far beyond ‘clinical diagnosis for treatment’.

The concept of risk syndrome for schizophrenia has been thoroughly researched in last ten years or so. Significant advancement has been made in phenomenology, diagnostic criteria, classification, & neurobiology. The research of prodromal or at-risk or Ultra high-risk psychosis has significantly contributed to the body of knowledge of aetio-pathogenesis of schizophrenia.

The science of risk syndrome has apparently matured and its proponents are ready for its inclusion in DSM V …

Outcome, Early Intervention & Dup: The Matrix Of Research In Early Psychosis, Amresh Srivastava, Megan Johnston

Amresh Srivastava

There has been little investigation of the relationship of DUP to other long-term outcomes such as negative symptoms and cognitive functioning neither have the possible confounds of DUP been widely investigated or controlled. It is important that there should be more thorough investigations of DUP, its correlates, and the extent to which it does mediate any advantages of earlier intervention. Shorter duration of untreated psychosis was associated with greater response to antipsychotic treatment, as measured by severity of global psychopathology, positive symptoms, negative symptoms, and functional outcomes. At the time of treatment initiation, duration of initially untreated psychosis was associated …

Optimizing Outcome Measures For Schizophrenia: From Research To Clinics, Amresh Srivastava, Nina Schoolar, Alexander Miller, Jitenra Trivedi

Amresh Srivastava

Outcome measures in schizophrenia have evolved considerably to bring in more objectivity, uniformity and attempt to reflect ‘real-life’ situation. It has significantly moved away from measurement of symptom remission to assessment of level of functioning and quality of life parameters. Schizophrenia is a complex neurobehavioral disorder afflicting approximately 1% population, with onset in early adolescence, across the world. It cause immense burden of patients, families and caregivers. The economic cost of schizophrenia is enormous. It is therefore important that assessment of schizophrenia be reflective of ground reality, scientific, evidence-based and comprehensive. Several researchers have proposed multidimensional outcome parameters. The heterogeneity …

Cognitive Factors In Long Term Outcome Of First Episode Psychosis, Amresh Srivastava, Megan Johnston, Nilesh Shah, Meghana Thakar, Larry Stitt

Amresh Srivastava

Cognitive factors in long term outcome of first episode psychosis

Amresh Shrivastava, Megan Johnston, Nilesh Shah , Meghana Thakar , and Larry Stitt

a Excecutive Director , Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602, Currently: Assistant Professor of Psychiatry, The University of western Ontario, & associate Scientist, Lawson Health Research Institute, London, Ontario,Canada, E Mail : amresh.edu@gmail.com b Professor of Psychiatry LTMG Hospital, University of Mumbai, Sion, Mumbai, Maharashtra, India 400 022 c Clinical psychologist, Silver Mind Hospital, Mumbai,India d Department of Epidemiology & …

Neurobiological Markers Of Schizophrenia: Findings From Indian Studies Of Early Psychoses, Amresh Srivastava, Megan Johnston, John John, Harsha Halahalli, Shivarama Varambally Varambally

Amresh Srivastava

Neurobiological Markers of Schizophrenia: Findings from Indian Studies of Early Psychoses. Amresh Srivastava, Megan Johnston, John John, Harsha Halahalli,Shivarama Varambally 1The University of Western Ontario, London, Ontario, Canada/3NIMHANS, Banglore , Karnataka , India OVERALL PANEL PROPOSAL: Advancement in technology together with early intervention studies have revealed a great deal about changes in neurobiological profile of brain in schizophrenia. In last fifteen years , there has been a trend all over the world to study early psychosis from the perspective of not only risk factors and causes of psychosis but also about brain vulnerability to understand what exactly happens that emotional …

Integrating Social & Clinical Parameters In Outcome Measures Of Schizophrenia: Clinician’S Perspective., Amresh Srivastava, Nilesh Shah, Yves Bureau

Amresh Srivastava

Schizophrenia is a complex neurobehavioral disorder for which there are many promising new treatments. There is, however, a discrepancy in outcome measure reports when they are obtained from patients, relatives, caregivers, or professionals, thus making it difficult to determine the level of recovery. The reason for this lack of agreement may be due to the limitations of the measurement tools themselves, which are not comprehensive and may be measuring different aspects of outcome. Alternatively, it could be that the conceptual understanding of outcome and recovery require development. Unfortunately for one of the above reasons or both, patients assessed as “recovered” …

Effects Of Duration Of Untreated Psychosis On Long-Term Outcome Of ‘People Hospitalized With First Episode Schizophrenia”, Amresh Srivastava, Larry Stitt, Meghana Thakar, Gurusamy Chinnasamy, Nilesh Shah

Amresh Srivastava

AIM: Duration of untreated psychosis (DUP), which has emerged as a reliable predictor of outcome continues to remain under scientific scrutiny . The present study examines effect of differential periods of DUP on long-term outcome of first episode schizophrenia at Mumbai, India. Method: This is a prospective, ten year follow up naturalistic study. Hospitalized patients of first episode schizophrenia were selected and followed up Results: The mean DUP was higher for group, which showed clinical recovery on Clinical Global Impression Scale [14.0 months (SD=8.0) in recovered and 10.8 months (SD=5.7) in non-recovered group (p=0.091)]. DUP was not found to be …

Improved Schizophrenia Patient’S Ability To Work And Live Independently In The Community: A Ten-Year Long-Term Outcome Study From Mumbai, India, Amresh Srivastava, Larry Stitt, Meghana Thakar, Nilesh Shah, Gurusamy Chinnasamy

Amresh Srivastava

Background: The outcome of schizophrenia has several determinants. Socio-ecological factors, particularly living conditions, migration, community and culture, not only affect the level of risk but also the outcome. Mega cities around the world show a unique socio-ecological condition which has several challenges for mental health. The present study reports the long-term status of patients with schizophrenia in such a mega city - Mumbai, India. Aim: This study aims to reveal long-term outcome of patients suffering from schizophrenia with special reference to clinical symptoms and social functioning. Methods: The cohort for this study was drawn from a 10-year follow-up of first …

Considerations For Culturally Appropriate Hiv/Aids Education Strategies In Belize: An Analytical Study Exploring The Relationship Between Knowledge And Stigma, C. Mcinnes, Treena Orchard, E. Druyts, R. Baird, W. Zhang, R. Hogg, P. Vandeusen

Dr. Treena Orchard

No abstract provided.

Persisting Symptoms In Recovered First Episode Schizophrenia Patients, Amresh Srivastava, Nilesh Shah, Meghana Thakar, Larry Stitt, Gurusamy Chinnasamy Chinnasamy

Amresh Srivastava

Persisting symptoms in recovered first episode schizophrenia patients

Amresh Shrivastavaa,*, Nilesh Shahb, Meghana Thakara, Larry Stittc, Gurusamy Chinnasamyd

aMental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602 bLTMG Hospital, University of Mumbai, Sion, Mumbai, Maharashtra, India 400 022 cDepartment of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada N6A 5C1 dResearch Office, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada N6A 5C1

*Corresponding author. Tel.: +1-519-631-8510; Fax: +1-519-631-2512. E-mail address: dr.amresh@gmail.com …

Assessing Risk Of Suicide In Clinical Practice: A Framework For Conceptualizing Risk., Amresh Srivastava, Charles Nelson Nelson

Amresh Srivastava

Assessing risk of suicide in clinical practice: A framework for conceptualizing risk. AmreshShrivastava MBBS, MD, DPM, MRC Psych 1 ψ Charles Nelson Ph.D., C. Psych.2 1. Assistant professor of psychiatry, Schulich School of Medicine & Dentistry, The University of Western Ontario, Regional Mental Health Care - St. Thomas, Associate scientist, Lawson health research Institute, London, Ontario, Canada, 2.Psychologist, Regional Mental Health Care - St. Thomas, Ontario, Adjunct Professor, Clinical Psychology, University of Western Ontario – London, Ontario Associate scientist, Lawson health research Institute, London, Ontario, Canada ψ. Corresponding author AmreshShrivastava MD, DPM, MRCPsych Regional mental health care, 467, Sunset Drive, …

Workers On The Margin: Who Drops Health Coverage When Prices Rise?, Edward Okeke, Richard Hirth, Kyle Grazier

Edward Okeke

We revisit the question of price elasticity of employer-sponsored insurance (ESI) take-up by directly examining changes in the take-up of ESI at a large firm in response to exogenous changes in employee premium contributions. We find that, on average, a 10% increase in the employee’s out-of-pocket premium increases the probability of dropping coverage by approximately 1%. More importantly, we find heterogeneous impacts: married workers are much more price-sensitive than single employees, and lower-paid workers are disproportionately more likely to drop coverage than higher-paid workers. Elasticity estimates for employees below the 25th percentile of salary distribution in our sample are nearly …

Lessons Learned From Prodromal Research: Bringing Early Identification And Intervention In Public Health Psychiatry, Amresh Srivastava

Amresh Srivastava

Lessons learned from Prodromal research: Bringing early identification and intervention in Public Health psychiatry Amresh Shrivastava MBBS, MD, DPM, MRCPsych. a Currently: Assistant Professor of Psychiatry, The University of western Ontario, & Associate Scientist, Lawson Health Research Institute, London, Physician team Leader: Early Intervention of Psychosis Program (Elgin-PEPP) Regional mental health care.St. Thomas.Ontario,Canada Executive Director , Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602, E Mail : amresh.edu@gmail.com Phone: 1-5196413233 Home, 1-5196318510 Office, fax 1-5196312512 word count : Abstract: 240 Text body : 6840 References: …

Implementation Issues For Mobile-Wireless Infrastructure And Mobile Health Care Computing Devices For A Hospital Ward Setting, Liza Heslop, Stephen Weeding, Linda Dawson, Julie Fisher, Andrew Howard

Associate Professor Linda Dawson

mWard is a project whose purpose is to enhance existing clinical and administrative decision support and to consider mobile computers, connected via wireless network, for bringing clinical information to the point of care. The mWard project allowed a limited number of users to test and evaluate a selected range of mobile-wireless infrastructure and mobile health care computing devices at the neuroscience ward at Southern Health’s Monash Medical Centre, Victoria, Australia. Before the project commenced, the ward had two PC’s which were used as terminals by all ward-based staff and numerous multidisciplinary staff who visited the ward each day. The first …