Medicine and Health Sciences Commons^™

Civility And Academic Freedom: Who Defines The Former (And How) May Imperil Rights To The Latter, Theodore W. Mcdonald, James D. Stockton, R. Eric Landrum

R. Eric Landrum

An alarming occurrence in academia involves the discipline of faculty, under the guise of violating civility or collegiality codes, for engaging in what should be protected academic free speech. This often occurs when unprincipled and/or corporate-minded administrators seek to punish or dissuade faculty from challenging or questioning their decisions or policy initiatives, or for speaking up about policy violations or lack of due process. The ambiguity of terms such as civility and collegiality, when selectively defined by administrators, can be used to stifle, dissuade or punish academic free speech. Ways to identify and address these problems are presented.

Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer

Kristin M. Mattocks

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits.

METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among …

A Coordinated School Health Approach To Obesity Prevention Among Appalachian Youth: Middle School Student Outcomes From The Winning With Wellness Project, William T. Dalton Iii, Karen Schetzina, Elizabeth Conway-Williams

Karen E. Schetzina

The Winning With Wellness (WWW) project was a school-based obesity prevention program that was developed to promote healthy eating and physical activity in youth residing in rural Appalachia. The project was based on the Coordinated School Health model (Centers for Disease Control and Prevention (CDC), 2013a) and used a community-based participatory research approach with an emphasis on feasibility and sustainability. The purpose of this study was to examine self-reported health outcomes for middle school students across the course of the intervention. Sixth grade middle school students (N = 149; 52% girls) from four schools in Northeast Tennessee completed a …

Measuring Damages For Lost Enjoyment Of Life: The View From The Bench And The Jury Box, Susan Poser, Brian H. Bornstein, Erinn Kiernan Mcgorty

Susan Poser

Civil jury instructions are inconsistent in defining what constitutes noneconomic damages, which may include pain, suffering, disability, disfigurement, and loss of enjoyment of life (LEL), among other injury sequelae. This inconsistency has been manifested recently in court decisions that have considered whether LEL should be treated as a separate element of noneconomic damages, distinct from pain and suffering. This paper reviews the case law on this issue and also describes a jury simulation experiment. Mock jurors awarded damages after they received instructions on noneconomic damages in which LEL was (1) not identified as a distinct element of damages; (2) defined …

Education Mitigates The Relationship Of Stress And Mental Disorders Among Rural Indian Women, Nisha Fahey, Apurv Soni, Jeroan J. Allison, Jagdish Vankar, Anusha Prabhakaran, Tiffany A. Moore Simas, Nancy Byatt, Ajay Phatak, Eileen O'Keefe, Somashekhar Nimbalkar

Apurv Soni

BACKGROUND: Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics.

OBJECTIVES: To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics.

METHODS: Cross-sectional survey of 700 women from rural Gujarat, India. …

Parsing The Behavioral And Brain Mechanisms Of Third-Party Punishment, Owen D. Jones, Matthew Ginther, Richard J. Bonnie, Morris B. Hoffman, Francis X. Shen, Kenneth W. Simons, Rene Marois

Owen Jones

The evolved capacity for third-party punishment is considered crucial to the emergence and maintenance of elaborate human social organization and is central to the modern provision of fairness and justice within society. Although it is well established that the mental state of the offender and the severity of the harm he caused are the two primary predictors of punishment decisions, the precise cognitive and brain mechanisms by which these distinct components are evaluated and integrated into a punishment decision are poorly understood.

Using a brain-scanning technique known as functional magnetic resonance imaging (fMRI), we implemented a novel experimental design to …

Organizations As Evil Structures, Cary Federman, Dave Holmes

Cary Federman

Nursing practice in forensic psychiatry opens new horizons in nursing. This complex, professional, nursing practice involves the coupling of two contradictory socioprofessional mandates: to punish and to provide care. The purpose of this chapter is to present nursing practice in a disciplinary setting as a problem of governance. A Foucauldian perspective allows us to understand the way forensic psychiatric nursing is involved in the governance of mentally ill criminals through a vast array of power techniques (sovereign, disciplinary, and pastoral), which posit nurses as “subjects of power.” These nurses are also “objects of power” in that nursing practice is constrained …

The Intersection Of Marital Problems, Unhealthy Lifestyles, And Adhd Challenges.Pdf, Ron J. Hammond, Christopher Anderson Ph.D., Devin Gilbert, Justin Wilbert, Michelle Chatterly

Ron J. Hammond

Relation Of Depression Symptoms To Sustained Reward And Loss Sensitivity, Michael P. Berry, Ema Tanovic, Jutta Joormann, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

The Effects Of Limiting Punitive Damage Awards, Edith Greene, David Coon, Brian H. Bornstein

David R. Coon

In response to concerns that jury awards in tort cases are excessive and unpredictable, nearly every state legislature has enacted some version of tort reform that is intended to curb extravagant damage awards. One of the most important and controversial reforms involves capping (or limiting) the maximum punitive damage award. We conducted a jury analogue study to assess the impact of this reform. In particular, we examined the possibility that capping punitive awards would cause jurors to inflate their compensatory awards to satisfy their desires to punish the defendant, particularly in situations where the defendant’s conduct was highly reprehensible. Relative …

Exploring The Boundaries Of Command And Control Models Of Distributed Team Performance In Aviation And Aerospace Operations, Haydee M. Cuevas, Barrett S. Caldwell

Haydee M. Cuevas

Traditional command and control (C2) models focus on a centralized command managing and directing one or more subordinate elements to perform required functions. However, in distributed C2 environments, a human commander has less ability to fully understand and control the behavior of "agents" (either human domain experts or autonomous automated systems) in real-time operations. In this paper, we explore the situational, information, and human performance issues that constrain the appropriateness of classical C2 system design, and highlight the need for distributed C2 information flow capabilities, in contemporary humanhuman and human-automation teams. We discuss these issues in the context of modern …

Investigating Uas Operator Characteristics Influencing Mission Success, Haydee M. Cuevas, Kristina M. Kendrick, Zane A. Zeigler, David J. Hamilton

Haydee M. Cuevas

The two objectives of this study were to 1) evaluate how specific operator characteristics (prior experience in manned and unmanned flight, teamwork, and gaming) influence mission success in unmanned aircraft systems (UAS) operations; and 2) evaluate the potential utility of a performance assessment tool. Mission success was assessed using a modified version of the Situation Awareness Linked Indicators Adapted to Novel Tasks (SALIANT) methodology. Eighteen participants completed a UAS scenario (port security) as part of 9 two-person crews (pilot and sensor operator). Results showed that the SALIANT measure was able to discriminate differences in performance among the UAS crews. Results …

Gratitude Intervention Modulates P3 Amplitude In A Temporal Discounting Task, Andrea L. Patalano, Sydney L. Lolli, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

Designing A Mobile Application To Support The Indicated Prevention And Early Intervention Of Childhood Anxiety, Mandar Patwardhan, Ashish Amresh, Ryan Stoll, Kevin A. Gary, Derek B. Hamel, Armando Pina

Ashish Amresh

This paper presents the design of an mHealth application for prevention and early intervention of childhood anxiety. The application is based on REACH, a preventative-early intervention protocol for childhood anxiety. This paper describes the multidisciplinary design process, sharing lessons learned in developing an effective mHealth application. This mHealth application is unique due to participant age, preventive-early intervention focus, and utilization of mobile technology in a situated manner. A design process inspired by user-centered leveraging key informant interviews was used to identify application features, including game based strategies and an animated motivational avatar. Validation was performed through external review and a …

Massachusetts Medicaid Members That Smoked In 2008: Characteristics Associated With Smoking Status In 2014, Alexis D. Henry, John Gettens, Judith A. Savageau, Doris Cullen, Anna Landau

Judith A. Savageau

The smoking rate among non-elderly Medicaid enrollees is more than double the rate for those privately insured; smoking-related conditions account for 15% of Medicaid expenditures. Under state health reform, Massachusetts Medicaid (MassHealth) made tobacco cessation treatment available beginning in 2006. We used surveys conducted in 2008 and 2014 to examine changes in smoking abstinence rates among MassHealth members identified as smokers and to identify factors associated with being a former smoker. Members previously identified as smokers were surveyed by mail or phone; 2008 and 2014 samples included 3,116 and 2,971 members, respectively. Surveys collected demographic and health information, asked members …

Prevalence And Correlates Of Indoor Tanning And Sunless Tanning Product Use Among Female Teens In The United States, Megan Quinn, Arsham Alamian, Joel J. Hillhouse, Colleen Scott, Rob Turrisi, Katie Baker

Arsham Alamian

Background

Indoor tanning (IT) before the age of 35 increases melanoma risk by 75%. Nevertheless, IT and sunless tanning product (STP) use have gained popularity among youth. However, there are limited data on the prevalence and sociodemographic correlates of both IT and STP use in a representative sample of American teens.

Methods

Teenage females (N = 778) aged 12–18 years were recruited as part of an on-going longitudinal study conducted between May 2011 and May 2013. Descriptive statistics explored IT and STP usage in teen females at baseline. Logistic regression was used to determine sociodemographic correlates of IT and STP …

Every Word, Every Gesture, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Two nonverbal patients teach a novice clinician the power and often hidden impact of the physician-patient relationship.

Improving Huntington’S Disease Education For New Staff In A Voluntary Mental Health Facility, Joe Ogunbode

Joe Ogunbode

Where Do You Want To Live? A Pilot Study To Establish Housing Preferences Of Young Adults With Fetal Alcohol Syndrome Disorders, Autism Spectrum Disorder, An Traumatic Brain Injury., Julie Elaine N. Irish, Noorh Aldadi, Marilyn J. Bruin

Julie Elaine Irish

Self-Injurious Behaviors In Prisons: A Nationwide Survey Of Correctional Mental Health Directors, Kenneth L. Appelbaum, Judith A. Savageau, Robert L. Trestman, Jeffrey L. Metzner

Judith A. Savageau

Self-injurious behavior (SIB) by inmates has serious health, safety, operational, security and fiscal consequences. Serious incidents require a freeze in normal facility operations. Injuries that need outside medical attention create additional security risks, including potential escape attempts. The interruption of normal operations, diversion of staff, cost of outside care, and drain on medical and mental health resources all have significant fiscal consequences. This session will present the results and implications of a survey of the Mental Health Directors in all 51 state and federal prison systems on the extent of SIB by inmates, including incidence and prevalence, adverse consequences, and …

Evaluation Of The Massachusetts Peer Specialist Training And Certification Program (Phase Two), Linda M. Cabral, Kathy Muhr, Laura A. Sefton, Judith A. Savageau

Judith A. Savageau

Most public mental health systems are shifting to a recovery-oriented system of care; however, offering recovery-oriented and peer support services to various cultural and linguistic groups is challenging. This study sought to better understand how persons with mental health conditions from two cultural groups – Latinos and Deaf and Hard of Hearing (D/HH) - access recovery-based services. Interviews with national key informants were conducted prior to data collection to better formulate instruments. Cultural brokers, identified as leaders in their communities who also have mental health conditions, were hired to aid in recruitment and data collection. Interviews and focus groups were …

Rumination Is Associated With Diminished Performance Monitoring, Ema Tanovic, Greg Hajack, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Trait Hope And Preparation For Future Care Needs Among Older Adult Primary Care Patients, Jodi L. Southerland, Deborah L. Slawson, Robert Pack, Silvia Sörensen, Jeffrey M. Lyness, Jameson K. Hirsch

Jameson K. Hirsch

We examined associations between trait hope and preparation for future care needs (PFCN) among 66 older adult primary care patients in western New York. Participants completed a questionnaire assessing PFCN (awareness, information gathering, decision-making, concrete planning, and avoidance), and the Adult Trait Hope Scale. In multivariate regressions, lower hope, particularly less agency, was associated with more awareness of needing care, whereas higher hopefulness, particularly pathways thinking, was associated with increased decision-making and concrete planning. Greater hopefulness appears to be linked to goal-directed planning behaviors, although those with lower hope may actually be more aware of the need for planning. Evidence-based …

Basic Psychological Needs, Suicidal Ideation, And Risk For Suicidal Behavior In Young Adults, Peter C. Britton, Kimberly A. Van Orden, Jameson K. Hirsch, Geoffrey C. Williams

Jameson K. Hirsch

Associations between the satisfaction of basic psychological needs of autonomy, competence, and relatedness with current suicidal ideation and risk for suicidal behavior were examined. Two logistic regressions were conducted with a cross-sectional database of 440 university students to examine the association of need satisfaction with suicidal ideation and risk for suicidal behavior, while controlling for demographics and depressive symptoms. Suicidal ideation was reported by 15% of participants and 18% were found to be at risk for suicidal behavior. A one standard deviation increase in need satisfaction reduced the odds of suicidal ideation by 53%, OR (95% CI) = 0.47 (0.33–0.67), …

Optimism And Planning For Future Care Needs Among Older Adults, Silvia Sörensen, Jameson K. Hirsch, Jeffrey M. Lyness

Jameson K. Hirsch

Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism …

Perceived Health In Lung Cancer Patients: The Role Of Positive And Negative Affect, Jameson K. Hirsch, Andrea R. Floyd, Paul R. Duberstein

Jameson K. Hirsch

Purpose: To examine the association of affective experience and health-related quality of life in lung cancer patients, we hypothesized that negative affect would be positively, and positive affect would be negatively, associated with perceived health.

Methods: A sample of 133 English-speaking lung cancer patients (33% female; mean age = 63.68 years old, SD = 9.37) completed a battery of self-report surveys.

Results: Results of our secondary analysis indicate that trait negative affect was significantly associated with poor physical and social functioning, greater role limitations due to emotional problems, greater bodily pain, and poor general health. Positive affect was significantly associated …

The Interrelations Between Spiritual Well-Being, Pain Interference And Depressive Symptoms In Patients With Multiple Sclerosis, Sheri A. Nsamenang, Jameson K. Hirsch, Raluca Topciu, Andrew D. Goodman, Paul R. Duberstein

Jameson K. Hirsch

Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated …

Health Behaviors Among College Students: The Influence Of Future Time Perspective And Basic Psychological Need Satisfaction, Preston L. Visser, Jameson K. Hirsch

Jameson K. Hirsch

Health behavior change may prevent many fatal diseases, and may be influenced by social and motivational constructs. We assessed the interaction effect of future time perspective and basic psychological need fulfillment on positive and negative health behaviors. Future time perspective was associated with more positive, and less negative, health behaviors. Need fulfillment was associated with only positive health behaviors. In moderation analyses, individuals reporting both high need fulfillment and future perspective reported greater positive health behaviors, and were especially unlikely to smoke. Enhancing future-mindedness and supporting need satisfaction in interventions targeting modifiable health behaviors is encouraged.

Functional Impairment, Illness Burden, And Depressive Symptoms In Older Adults: Does Type Of Social Relationship Matter?, Joshua P. Hatfield, Jameson K. Hirsch, Jeffrey M. Lyness

Jameson K. Hirsch

Objective: The nature of interpersonal relationships, whether supportive or critical, may affect the association between health status and mental health outcomes. We examined the potential moderating effects of social support, as a buffer, and family criticism, as an exacerbating factor, on the association between illness burden, functional impairment and depressive symptoms.

Methods: Our sample of 735 older adults, 65 years and older, was recruited from internal and family medicine primary care offices. Trained interviewers administered the Hamilton Rating Scale for Depression, Duke Social Support Inventory, and Family Emotional Involvement and Criticism Scale. Physician-rated assessments of health, including the Karnofsky Performance …