Medicine and Health Sciences Commons^™

The Change Program: Comparing An Interactive Versus Standardized Obesity Intervention On Students' Self-Esteem, Functional Health Status And Self-Efficacy For Performing Physical Activity And Nutrition Behaviours, Erin Pearson, Jennifer Irwin, Don Morrow

Donald Morrow

No abstract provided.

Health Care Practitioners’ Perceptions Of Motivational Interviewing Training For Facilitating Behavior Change Among Patients, Erin Wiley, Jennifer Irwin, Don Morrow

Donald Morrow

No abstract provided.

Prevention Of Fatal Opioid Overdose, Leo Beletsky

Leo Beletsky

Opioid overdose is a burgeoning public health crisis, accounting for at least 16,000 deaths annually in the United States. Opioid overdose occurs across sex, ethnic, age, and geographic strata and involves both medical and nonmedical opioid use. To date, federal government response has focused primarily on monitoring and securing the drug supply. This Viewpoint suggests various steps necessary to support a more comprehensive approach.

Commentary: The Role Of Food Culture And Marketing Activity In Health Disparities, Jerome Williams, David Crockett, Robert Harrison, Kevin Williams

David Crockett

Marketing activities have attracted increased attention from scholars interested in racial disparities in obesity prevalence, as well as the prevalence of other preventable conditions. Although reducing the marketing of nutritionally poor foods to racial/ethnic communities would represent a significant step forward in eliminating racial disparities in health, we focus instead on a critical-related question. What is the relationship between marketing activities, food culture, and health disparities? This commentary posits that food culture shapes the demand for food and the meaning attached to particular foods, preparation styles, and eating practices, while marketing activities shape the overall environment in which food choices …

The Impact Of A Temporary Medical Ward Closure On Emergency Department And Hospital Service Delivery Outcomes, Julia Crilly, Gerben Keijzers, Dirken Krahn, Michael Steele, David Green, Janeen Freeman

Gerben Keijzers

OBJECTIVE: To describe the effect of a 3-week closure of a 28-bed medical ward on Emergency Department (ED) and hospital outcomes.

METHODS: This was a prospective comparative observational study of all ED attendances (visits; n = 11 383) made to a regional teaching hospital in Queensland, Australia, during a 9-week period (November 24, 2008-January 4, 2009). A 3-week period of ward closure was compared with equal time periods before and after. Hospital health information systems data were linked manually to describe and compare outcomes: median ED length of stay, access block, hospital length of stay, and in-hospital mortality.

RESULTS: Ward …

Minimal Interventions To Decrease Long-Term Use Of Benzodiazepines In Primary Care: A Systematic Review And Meta-Analysis, Kayalvili Mugunthan, Treasure Mcguire, Paul Glasziou

Treasure McGuire

Background: Long-term use of benzodiazepines (BZDs) is common. Not only is such use ineffective, but it also has several risks in addition to dependence, and remains a significant problem among the older population.Aim: To systematically review randomised controlled trials that evaluate the effectiveness of minimal interventions to reduce the long-term use of BZDs in primary care.Design and setting: Systematic review and meta-analysis of randomised controlled trials in UK general practices.Method: Cochrane Central, MEDLINE, and Embase (1967-2010) were searched for trials of minimal interventions (such as a single letter or one consultation from a GP) for patients in primary care with …

Risky Alcohol Use And Age At Onset Of Regular Alcohol Consumption In Relation To Frontal Lobe Indices, Reward Sensitivity And Rash Impulsiveness, Michael Lyvers, Helen Duff, Penelope Hasking

Mike Lyvers

Excessive alcohol consumption has been linked to predisposing traits that may reflect frontal lobe functioning, an idea explored by this study. The study recruited 132 adults of both genders aged 18-68 years who completed an online questionnaire battery. Sensitivity to punishment was the primary variable associated with age of onset for weekly drinking. The relationship between disinhibition and drinking behavior, as assessed by the AUDIT, was partially mediated by sensitivity to reward. The findings of this study suggest that several interrelated and heritable personality and neurobehavioral traits may promote earlier as well as riskier alcohol consumption.

Strengthening The Case Against Functionally Significant Serotonergic Neurotoxicity In Human Mdma (Ecstasy) Users, Michael Lyvers

Mike Lyvers

Extract:Halpern and colleagues [1] have overcome some of the methodological issues raised previously [2] concerning their initial pilot study of ecstasy users [3]. Their latest study [1] found that of 15 neuropsychological tests tapping various cognitive and memory functions reported previously by others to differentiate ecstasy users from controls, only the Revised Strategy Applications Test (RSAT) showed a clear indication of poorer performance in heavy (but not moderate) ecstasy users compared to controls, ecstasy users were selected for low exposure to other illicit drugs and alcohol, whereas in most other studies of this type the influence of potentially confounding associations …

Incidence And Nature Of Anxiety-Depression Comorbidity In Prostate Cancer Patients, Christoper Sharpley, Vicki Bitsika, David Christie

Vicki Bitsika

Background: The aim of this study was to measure the incidence of anxiety-depression comorbidity among a sample of prostate cancer (PCa) patients and to investigate the total score, factor score and scale item differences across subgroups defined according to the presence of anxiety and/or depression. Methods: 491 PCa patients who had received their initial diagnosis between 1 and 113 months previously completed a survey of background variables, as well as the Zung Self-Rating Anxiety and Depression Scales (SAS, SDS). Results: Incidence of anxiety-depression comorbidity was nearly 16%, and higher than that previously reported in other samples. Although the directional differences …

Criticisms Of African Trials Fail To Withstand Scrutiny: Male Circumcision Does Prevent Hiv Infection, Richard Wamai, Brian Morris, Jake Waskett, Edward Green, Joya Banerjee, Robert Bailey, Jeffrey Klausner, David Sokal, Catherine Hankins

Richard G. Wamai

A recent article in the JLM (Boyle GJ and Hill G, "Sub-Saharan African Randomised Clinical Trials into Male Circumcision and HIV Transmission: Methodological, Ethical and Legal Concerns" (2011) 19 JLM 316) criticises the large randomised controlled trials (RCTs) that scientists, clinicians and policy-makers worldwide have concluded provide compelling evidence in support of voluntary medical male circumcision (VMMC) as an effective HIV prevention strategy. The present article addresses the claims advanced by Boyle and Hill, demonstrating their reliance on outmoded evidence, outlier studies, and flawed statistical analyses. In the current authors' view, their claims portray misunderstandings of the design, execution and …

Environmental Health And Service Learning, Kelly Tuohig, Dale Stephenson, Dean Lillquist, Justin Bird, Stephen Adler, Mark Babitz

Dale J. Stephenson

In developing curriculum for a Salt Lake City, Utah High School's Advance Placement--Environmental Studies class, one goal was a module on air quality/air pollution. University of Utah graduate students and faculty presented on air pollution topics. Community exposure to school bus emissions was identified and students developed a study design, performed air sampling, learned to interpret results, and communicate results and recommendations to various audiences. This project emphasized health impacts, public awareness, and policy recommendations to promote change.

An Analysis Of Vdt Monitor Placement And Daily Hours Of Use For Female Bifocal Users, J. Lyon, Dean Lillquist, S. Alder, Dale Stephenson, D. Bloswick

Dale J. Stephenson

A population of 72 bifocal wearers was studied to determine the relationship between VDT (video display terminal) placement for those who reported musculoskeletal pain and those who did not. The mean hours worked was 50.4 minutes (p=0.003) greater for those who reported head/neck pain versus those who did not and 48.6 minutes (p=0.004) greater for those who reported shoulder/arm pain that those who did not. There was no statistically significant difference between the means of monitor height, distance, or angle for those who reported pain symptoms versus those who did not. This study indicates that, self reported pain symptoms are …

Comparison Of Sampling Methods To Measure Exposure To Diesel Particulate Matter In An Underground Metal Mine, Dale Stephenson, T. Spear, M. Lutte

Dale J. Stephenson

Diesel particulate matter (DPM) continues to be scrutinized as an adverse occupational exposure agent. Currently, the air sampling protocol approved by the U.S. Mine Safety and Health Administration (MSHA) to quantify exposure to DPM in mines designates an SKC impactor as the sample collection device and limits exposure to the total carbon faction of a DPM aerosol. Because use of this impactor requires submission of the sample to an analytical laboratory, it inherently includes a lag time before workplace exposures can be determined. Thus, mine operators who use this MSHA-approved sampling device to monitor personal DPM exposures are faced with …

Side-By-Side Comparison Of Three Sampling Methods For Aerosolized Endotoxin In A Wastewater Treatment Facility, Dale Stephenson, F. Derosso, Dean Lillquist, D. Greene, G. White

Dale J. Stephenson

Research studies have established the occurrence of adverse health effects in individuals exposed to organic dusts and water aerosols laden with endotoxin. To determine what exposure levels cause these health effects, it is necessary to quantity airborne endotoxin. Several scientific studies have demonstrated that the quantification of detectable endotoxin is affected by differences in sampling media, analytical method, and aerosol composition, The study reported here performed side-by-side endotoxin sampling using a liquid impinger, a glass fiber filter, and a polycarbonate filter in a wastewater treatment plant. Results show levels of detected endotoxin appear to be highest with the impinger. Coefficients …

Reducing Treatment Delay For Early Intervention: Evaluation Of A Community Based Crisis Helpline, Amresh Srivastava

Amresh Srivastava

Background A limited number of studies have assessed the pathways to care of patients experiencing psychosis for the first time. Helpline/clinic programs may offer patients who are still functional but have potential for crisis an alternative that is free from judgment. Methods In this study we report on patient calling a round-the-clock crisis helpline for suicide prevention supported by psychiatric facilities in Mumbai, India. Chi-square and test of mean differences were used to compare outcomes between first-episode patients and those with a previous history. Results Within five years, the helpline received 15,169 calls. Of those callers, 2341 (15.4%) experienced suicidal …

Physical Activity Opportunities In Canadian Childcare Facilities: A Provincial/Territorial Review Of Legislation, Leigh Vanderloo, Patricia Tucker, Ali Ismail, Melissa Van Zandvoort

Trish Tucker

No abstract provided.

Why Match In Individually And Cluster Randomized Trials?, Laura Balzer, Maya Petersen, Mark Van Der Laan

Laura B. Balzer

The decision to match individuals or clusters in randomized trials is motivated by both practical and statistical concerns. Matching protects against chance imbalances in baseline covariate distributions and is thereby thought to improve study credibility. Matching is also implemented to increase study power. Analogue to Rose and van der Laan (2009), this article investigates the asymptotic efficiency of pair-matching individuals or clusters relative to not matching in randomized trials. We focus on estimating the average treatment effect. We use the efficient influence curve to understand the information provided by each design for estimation of the target causal parameter. Our approach …

Hiv Risk Perceptions And The Distribution Of Hiv Risk Among African, Caribbean And Other Black People: Mixed-Methods Results From The Blacch Study, Shamara M. Baidoobonso, Bauer Greta

Shamara M Baidoobonso, PhD

BACKGROUND: African, Caribbean and other Black people (ACBP) are a priority group for HIV prevention efforts in Canada. ACBP and service providers’ (SP) perceptions about HIV risk impact the uptake and delivery of prevention messages. These perceptions may not reflect actual risk among ACBP, so it is important to assess them and identify groups for which they may be valid. Emerging evidence from Sub-Saharan Africa shows that social determinants of health (SDOH) impact the distribution of HIV risk. However, SDOH are context-specific, and to date, virtually no research has explored their impact on HIV risk among ACBP in North America. …

Predictive Validity Of The Updrs Postural Stability Score And The Functional Reach Test, When Compared With Ecologically Valid Reaching Tasks, M. E. Jenkins, Andrew M. Johnson, J. D. Holmes, F. F. Stephenson, S. J. Spaulding

Andrew M. Johnson

Balance problems and falls are a common concern among individuals with Parkinson's disease (PD). Falls frequently occur during daily activities such as reaching into cupboards in the kitchen or bathroom. This study compared the correlation among two standard postural stability tests - the postural stability score on the Unified Parkinson's Disease Rating Scale (UPDRS) and the Functional Reach Test (FRT) - and ecologically valid reaching tasks that correspond to reaching at different cupboard heights among 20 individuals with PD and 20 age-matched controls. Both the FRT and the UPDRS postural stability tests are quick measures that can be performed during …

Building The Foundation For The Family Options Project, Joanne Nicholson, Kathleen Biebel, Valerie Williams, Karen Albert

Joanne Nicholson

This article describes how the long-standing partnership between Employment Options, Inc., a psychosocial rehabilitation agency in Marlborough, MA, and the University of Massachusetts Medical School's (UMMS) Center for Mental Health Services Research led to the development of the Family Options program.

Mothers With Mental Health Disorders: Mental Health Promotion In The Context Of Parenting, Joanne Nicholson, Elizabeth Aaker, Michael Agar, Karen Albert, Steven Banks, Kathleen Biebel, Bernice Gershenson, Antonia Seligowski, Valerie Williams, Brenda Warren, Sierra Williams, Katherine Woolsey

Joanne Nicholson

Parenting is a meaningful role for the majority of American women, including those with mental health disorders. Success in this role, particularly for women with mental health disorders, would seem to be intimately related to mental health promotion, the recovery process, and successful functioning in other major life domains (e.g., employment, community living, and personal health and well-being). The achievement of maximum social participation for women with mental health disorders may hinge on addressing the challenges they face as parents. Presented at Margins to Mainstream: World Congress on Mental Health Promotion and Prevention. Melbourne, Victoria, Australia, September 2008.

Exploring The Concept Of “Young Carer” In Families Living With Parental Mental Illness, Antonia Seligowski, Peter Mcnamee, Karen Albert, Valerie Williams, Joanne Nicholson

Joanne Nicholson

Background Information: The concept of “young carers” has been framed in the literature as children providing care and assuming household responsibilities when parents have physical and/or mental disabilities (Aldridge & Becker, 2003). In the United Kingdom, young carers have been studied extensively, leading to increased access to services and supports (Dearden & Becker, 2004). Our goal is to explore the concept of young carers in the U.S.

Aims: 1) To describe the care giving and household responsibilities of children and youth living with parents with mental illnesses, how often they are performed, and the feelings of children and youth about …

Programs For Families With Parental Mental Illness: Results Of A Us National Survey, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Lawrence Stier

Joanne Nicholson

Citation: Nicholson, J., Hinden, B., Biebel, K., Henry, A., & Stier, L. (2004). Programs for families with parental mental illness. Visions: British Columbia Mental Health and Addictions Journal, 2(2), 27-29. Available at: http://www.heretohelp.bc.ca/publications/visions/parenting. Summary: Survey of programs in the U.S. for parents with mental illness.

A Multi-Disciplinary, Whole-Of-Family Approach To Supporting Parents With Mental Illness, Joanne Nicholson

Joanne Nicholson

Summary: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness, carers & siblings. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders working in partnership. Citation: Nicholson, J. (2010, November). A multi-disciplinary, whole-of-family approach to supporting parents with mental illness. Presented as a plenary at the Developing Strength and Resilience in Children conference of Voksne for Barn, Oslo, Norway.

The Family Networks Implementation Study, Susan Maciolek, Joanne Nicholson, Nicole Dube, Jodi Adams, Bernice Gershenson

Joanne Nicholson

Family Networks is a comprehensive system transformation initiative to redesign and integrate traditional categorical services across Massachusetts into local systems of care for children, youth, and families served by the child welfare system. The Family Networks Implementation Study, a partnership between the Massachusetts Department of Social Services and the University of Massachusetts Medical School, is a two-year study of the process of implementing local systems of care that began in January 2007, and will continue through December 2008. Presented at the 21th Annual Research Conference. A System of Care for Children’s Mental Health: Expanding the Research Base. Tampa, Florida, February …

Mental Illness: Understanding The Impact On Families And How To Help, Joanne Nicholson

Joanne Nicholson

Abstract: Family is the context where mental health recovery takes place. Mental health services need to take a whole-of-family approach when working with people with a mental illness. Supporting people with a mental illness in their family roles actually improved the mental health outcomes of people participating in their programs. Citation: Nicholson, J. (2010, May). Mental illness: Understanding the impact on families and how to help. Presented as the 12th Annual Bruce Woodcock Memorial Lecture, Mental Illness Fellowship Victoria, Melbourne, Victoria, Australia.

The Responsiveness Of State Mental Health Authorities To Parents With Mental Illness, Kathleen Biebel, Joanne Nicholson, Valerie Williams, Beth Hinden

Joanne Nicholson

The majority of adults with serious mental illness living in the community are parents, many of whom may be receiving services from State Mental Health Authorities (SMHA). Innovative intervention approaches are available to improve outcomes for these parents and their children. Analyses of SMHA and state-level data, as well as qualitative interviews of administrators, service providers, and consumers, underscore the importance of organizational structure and philosophy, an advocacy presence, and available funding to SMHA efforts on behalf of parents and their families.

Family Members With Overlapping Mental Health Needs Require The Transformation Of Systems And Services, Joanne Nicholson, Kathleen Biebel, Beth Hinden, Valerie Williams, Bernice Gershenson, Judith Katz-Leavy

Joanne Nicholson

Women and men with a lifetime prevalence of psychiatric disorder are at least as likely to be parents as are adults without psychiatric disorder. The majority of adults in all diagnostic categories are parents, including those meeting criteria for affective and anxiety disorders, PTSD, and non-affective psychosis. Children with Serious Emotional Disturbance (SED) receiving services in Systems of Care (SOCs) programs may have multiple family risk factors. Family-centered, strengths-based practices require a paradigm shift in the way administrators and providers view and intervene with children and adults. Presented at The Santa Fe Summit on Behavioral Health, the American College of …

Using Organizational Data To Create The Essential Context For System Transformation In Child Welfare, William Deveney, Joanne Nicholson

Joanne Nicholson

The Massachusetts Department of Social Services (MA/DSS) has 29 area offices organized in 6 regions; 74,651 consumers (39,913 are children < 18 years of age); 10,863 children and youth in placement; and 3,400 employees (FY2005; 2nd quarter).

A comprehensive system transformation initiative is underway, to shift from the traditional “adversarial” child protective model, and translate the core values of “child-driven,” “family-centered,” “community-focused,” “strength-based,” “committed to diversity/ cultural competence,” and committed to continuous learning” into an active child welfare agenda. The “learning organization” is the guiding framework.

Continuous Quality Improvement (CQI) is an interactive, iterative, participatory process that reflects change in organizational values, and catalyzes and guides improvements in policy and practice. Data drive CQI, obtained as framed …

Creating Opportunities For Success: Working With Trauma Survivors In The Shelter Setting, Joanne Nicholson, Linda Weinreb, Tina Runyan, Kathleen Biebel

Joanne Nicholson

Summary: Training workshop with the following objectives: Increase knowledge, awareness, & understanding of trauma & its impact; Provide information about skills & strategies; Suggest self care strategies. Citation: Nicholson, J., Weinreb, L., Runyan, T., & Biebel, K. (2010, November). Creating opportunities for success: Working with trauma survivors in the shelter setting. Presented at a training workshop for the Central Massachusetts Housing Alliance, Worcester, MA.