Medicine and Health Sciences Commons^™

Comparing The Validity Of Five Participation Instruments In Persons With Spinal Conditions, Vanessa K. Noonan, Jacek A. Kopec, Luc Noreau, Joel Singer, Louise C. Mâsse, Hongbin Zhang, Marcel F. Dvorak

Publications and Research

Objective: To evaluate and compare the construct validity of 5 participation instruments developed using the International Classification of Functioning, Disability and Health (ICF). Methods: A total of 545 subjects diagnosed and treated for a spinal condition at an acute hospital were followed-up and consented to complete a questionnaire. Subjects completed 5 participation instruments (Impact on Participation and Autonomy (IPA), Keele Assessment of Participation (KAP), Participation Measure-Post Acute Care (PM-PAC), Participation Objective Participation Subjective (POPS), World Health Organization Disability Assessment Schedule II (WHODAS II)). In addition, each subject completed a health status instrument and a quality of life instrument. The dimensionality, …

Impact Of Insurance Status On Migraine Care In The United States, Andrew Wilper, Steffie Woolhandler, David U. Himmelstein, Rachel Nardin

Publications and Research

Objective
To determine whether insurance status is associated with differential outpatient treatment of migraine in the United States.

Methods
We analyzed 11 years of data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (1997–2007), which survey patient visits to doctors’ offices, hospital outpatient departments, and emergency departments (EDs) in the United States. We used logistic regression to determine whether insurance status was associated with the prescription of standard migraine therapy, defined as 1) a triptan or dihydroergotamine and 2) a prophylactic agent.

Results
We identified 6,814 individual patient visits for migraine, representing 68.6 million …

An Intervention To Reduce Environmental Tobacco Smoke Exposure Improves Pregnancy Outcomes, Ayman El-Mohandes, Michele Kiely, Susan M. Blake, Marie G. Gantz, M. Nabil El-Khorazaty

Publications and Research

Objective—We tested the efficacy of a cognitive-behavioral intervention in reducing environmental tobacco smoke exposure (ETSE) and improving pregnancy outcomes among African-American women.

Methods—We recruited 1,044 women to a randomized controlled trial during 2001-2004 in Washington, DC. Data on 691 women with self-reported ETSE were analyzed. A subset of 520 ETSE women and salivary cotinine levels (SCLs)/ml was also analyzed. Individually tailored counseling sessions adapted from evidence-based interventions for ETSE and other risks, were delivered to the intervention group. The usual care group received routine prenatal care as determined by their provider. Logistic regression models were used to predict …

Campaigns To Change Health Damaging Corporate Practices, Nicholas Freudenberg

Publications and Research

When corporations claim the same citizenship rights as human citizens, they exercise an undue influence on health policy and democratic processes. Surprisingly, the same basic repertoire of tactics has been found to be employed by corporations to effect this influence, regardless of the specific industry at work. In this book, authors from around the world reveal the range of tactics used across the corporate world that ultimately favor the bottom line over the greater good.

The Bottom Line or Public Health deconstructs some of the most ubiquitous tactics at play, including public relations, political influence, legal maneuvering, and financial power, …

An Integrated Intervention To Reduce Intimate Partner Violence In Pregnancy: A Randomized Trial, Michele Kiely, Ayman El-Mohandes, M. Nabil El-Khorazaty, Marie G. Gantz

Publications and Research

OBJECTIVE: We estimated the efficacy of a psycho-behavioral intervention in reducing intimate partner violence (IPV) recurrence during pregnancy and postpartum, and in improving birth outcomes in African-American women

METHODS: We conducted a randomized controlled trial in which 1,044 women were recruited. Individually-tailored counseling sessions were adapted from evidence-based interventions for IPV and other risks. Logistic regression was used to model IPV victimization recurrence, to predict minor, severe, physical and sexual IPV.

RESULTS: Women randomized to the intervention were less likely to have recurrent episodes of IPV victimization (OR=0.48, 95%CI=0.29-0.80). Women with minor IPV were significantly less likely to experience further …

Optimization And Analysis Of A Quantitative Real-Time Pcr-Based Technique To Determine Microrna Expression In Formalin-Fixed Paraffin-Embedded Samples, Rashmi S. Goswami, Levi Waldron, Jerry Machado, Nilva K. Cervigne, Wei Xu, Patricia Reis, Denis Bailey, Igor Jurisica, Michael R. Crump, Suzanne Kamel-Reid

Publications and Research

Background: MicroRNAs (miRs) are non-coding RNA molecules involved in post-transcriptional regulation, with diverse functions in tissue development, differentiation, cell proliferation and apoptosis. miRs may be less prone to degradation during formalin fixation, facilitating miR expression studies in formalin-fixed paraffin-embedded (FFPE) tissue.

Results: Our study demonstrates that the TaqMan Human MicroRNA Array v1.0 (Early Access) platform is suitable for miR expression analysis in FFPE tissue with a high reproducibility (correlation coefficients of 0.95 between duplicates, p < 0.00001) and outlines the optimal performance conditions of this platform using clinical FFPE samples. We also outline a method of data analysis looking at differences in miR abundance between FFPE and fresh-frozen samples. By dividing the profiled miR into abundance strata of high (Ct35), we show that reproducibility between technical replicates, equivalent dilutions, and FFPE vs. frozen samples is best in the high abundance stratum. We also demonstrate that the miR expression profiles of FFPE samples are comparable to those of fresh-frozen samples, with a correlation of up to 0.87 (p < 0.001), when examining all miRs, regardless of RNA extraction method used. Examining correlation coefficients between FFPE and fresh-frozen samples in terms of miR abundance reveals correlation coefficients of up to 0.32 (low abundance), 0.70 (medium abundance) and up to 0.97 (high abundance).

Conclusion: Our study thus demonstrates the utility, reproducibility, and optimization steps needed in miR expression studies using FFPE samples on a high-throughput quantitative PCR-based miR …

Family Structure, Parent-Child Conversation Time And Substance Use Among Chinese Adolescents, Kwok-Kei Mak, Sai-Yin Ho, G Neil Thomas, C Mary Schooling, Sarah M. Mcghee, Tai-Hing Lam

Publications and Research

Background: The family plays a vital role in shaping adolescent behaviours. The present study investigated the associations between family structure and substance use among Hong Kong Chinese adolescents.

Methods: A total of 32,961 Form 1 to 5 (grade 7-12 in the US) Hong Kong students participated in the Youth Smoking Survey in 2003-4. An anonymous questionnaire was used to obtain information about family structure, daily duration of parent-child conversation, smoking, alcohol drinking and drug use. Logistic regression was used to calculate the adjusted odds ratios (OR) for each substance use by family structure.

Results: Adjusting for sex, age, type of …

The Mds Mortality Risk Index: The Evolution Of A Method For Predicting 6-Month Mortality In Nursing Home Residents, Davina Porock, Debra Parker-Oliver, Gregory F. Petroski, Marilyn Rantz

Publications and Research

Background: Accurate prognosis is vital to the initiation of advance care planning particularly in a vulnerable, at risk population such as care home residents. The aim of this paper is to report on the revision and simplification of the MDS Mortality Rating Index (MMRI) for use in clinical practice to predict the probability of death in six months for care home residents.

Methods: The design was a secondary analysis of a US Minimum Data Set (MDS) for long term care residents using regression analysis to identify predictors of mortality within six months.

Results: Using twelve easy to collect …

Introducing A Multi-Site Program For Early Diagnosis Of Hiv Infection Among Hiv-Exposed Infants In Tanzania, Harriet Nuwagaba-Biribonwoha, Bazghina Werq-Semo, Aziz Abdallah, Amy Cunningham, John G. Gamaliel, Sevestine Mtunga, Victoria Nankabirwa, Isaya Malisa, Luis F. Gonzalez, Charles Massambu, Denis Nash, Jessica Justman, Elaine J. Abrams

Publications and Research

Background: In Tanzania, less than a third of HIV infected children estimated to be in need of antiretroviral therapy (ART) are receiving it. In this setting where other infections and malnutrition mimic signs and symptoms of AIDS, early diagnosis of HIV among HIV-exposed infants without specialized virologic testing can be a complex process. We aimed to introduce an Early Infant Diagnosis (EID) pilot program using HIV DNA Polymerase Chain Reaction (PCR) testing with the intent of making EID nationally available based on lessons learned in the first 6 months of implementation.

Methods: In September 2006, a molecular biology laboratory at …

Internalized Stigma As A Barrier To Improvement In Vocational Functioning Among People With Schizophrenia-Spectrum Disorders, Philip T. Yanos, Paul Lysaker, David Roe

Publications and Research

We examined the relationship between internalized stigma and changes in vocational function. Persons with schizophrenia or schizoaffective disorder (n=78) were assessed at baseline and 5 months after vocational rehabilitation. Internalized stigma and cognitive–behavioral treatment predicted change in vocational functioning, supporting the view that internalized stigma compromises vocational outcomes.

Acceptance, Communication Mode And Use Of Audio Computer- Assisted Self Interview Using Touchscreen To Identify Risk Factors Among Pregnant Minority Women, Jutta S. Thornberry, Kennan B. Murray, M. Nabil El-Khorazaty, Michele Kiely

Publications and Research

This paper evaluates the acceptability, communication mode and use of audio computer-assisted self-interview (A-CASI) among minority pregnant women receiving prenatal care in six Washington, DC sites. A total of 2,913 women were screened for demographic eligibility (18+ years old,gestation, Black/African-American or Hispanic) and risk (smoking, environmental tobacco smoke exposure, depression, intimate partner violence). Questions were displayed on touch screen laptop monitors and heard through earphones. The mean length of time to complete the screener was almost 6 minutes.

A-CASI experience, which included difficulty in using the computer, acceptability (enjoyment), and preferred communication mode, was compared across sites, the eligibility and …

Psychological Care For Persons Of Diverse Religions: A Collaborative Continuum, Glen Milstein, Anne Marie Yali

Publications and Research

The purpose of this paper is to describe to psychologists and other clinicians a continuum of mental health care for persons of diverse religions. The continuum delineates boundaries between clinical care provided by mental health professionals and religious care provided by clergy, as well as describes pathways of collaboration across these boundaries. A prevention science based model of Clergy Outreach and Professional Engagement (COPE) is offered to guide this collaboration. The model describes a continuum that moves from the care already present in religious communities, through professional clinical care provided in response to dysfunction and returns persons to their own …

Blood/Lust: Freud And The Trauma Of Killing In War, Nolen Gertz

Publications and Research

During World War I, Sigmund Freud and his followers held a special symposium in Budapest entitled "Psycho-Analysis and the War Neuroses." Their contributions centered on the importance of trying to understand what can cause a soldier to become traumatized in war by investigating the individual factors of each case as opposed to merely the situational factors. Thus by redefining such ambiguous illnesses as shell shock and war strain into the Freudian framework of the traumatic neuroses, they were able to do what the neurologists could not — explain the meaning behind the soldiers' symptoms and treat them with successful results. …

Prediction Of Birth Weight By Cotinine Levels During Pregnancy In A Population Of African American Smokers, Ayman A.E. El-Mohandes, Michele Kiely, Marie G. Gantz, Susan M. Blake, M Nabil El-Khorazaty

Publications and Research

Objective—The goal was to investigate the association between maternal salivary cotinine levels (SCLs) and pregnancy outcome among African Americans smokers

Methods—In a randomized controlled trial conducted in 2001-2004 in Washington, D.C. 714 women (126 active smokers (18%)) were tested for SCLs at the time of recruitment and later in pregnancy. Sociodemographic health risks and pregnancy outcomes were recorded.

Results—Birth weights were significantly lower for infants born to mothers with baseline SCLs of ≥20 ng/ml compared to/ml (p=0.024), ≥50 ng/ml compared to/ml (p=0.002), ≥100 ng/ml compared to/ml (p=0.002), in bivariate analyses. In linear regression analyses adjusting for sociodemographic …

Extra, Extra, Read All About It!, Irvin Sam Schonfeld

Publications and Research

No abstract provided.

Identifying Publication Outlets In Occupational Health Psychology: An Opinion Survey, Maria Karanika-Murray, Irvin Sam Schonfeld, Leigh Schmitt

Publications and Research

No abstract provided.

A Randomised-Controlled Trial Of Two Educational Modes For Undergraduate Evidence-Based Medicine Learning In Asia, Janice M. Johnston, Mary Schooling, Gabriel M. Leung

Publications and Research

Background
As the overall evidence for the effectiveness of teaching of evidence based medicine (EBM) is not strong, and the impact of cultural and societal influences on teaching method is poorly understood, we undertook a randomised-controlled trial to test the effectiveness and learning satisfaction with two different EBM teaching methods (usual teaching vs. problem based learning (PBL)) for undergraduate medical students.

Methods
A mixed methods study that included a randomised-controlled crossover trial with two intervention arms (usual teaching and PBL) and a nested qualitative study with focus groups to explore student perceptions of learning and to assess the effectiveness and …

Pivotal Role Of The A2a-Adrenoceptor In Producing Inflammation And Organ Injury In A Rat Model Of Sepsis, Michael Miksa, Padmalaya Des, Mian Zhou, Rongqian Wu, Weifeng Dong, Youxin Ji, Sanna M. Goyert, Thanjavur S. Ravikumar, Ping Wang

Publications and Research

Background: Norepinephrine (NE) modulates the responsiveness of macrophages to proinflammatory stimuli through the activation of adrenergic receptors (ARs). Being part of the stress response, early increases of NE in sepsis sustain adverse systemic inflammatory responses. The intestine is an important source of NE release in the early stage of cecal ligation and puncture (CLP)-induced sepsis in rats, which then stimulates TNF-a production in Kupffer cells (KCs) through the activation of the a2-AR. It is important to know which of the three a2-AR subtypes (i.e., a2A, a2B or a2C) is responsible for the upregulation of TNF-a production. The aim of this …

Suicide Associated With Military Service, Margo R. Genderson, Irvin Sam Schonfeld, Mark S. Kaplan, Michael J. Lyons

Publications and Research

Suicide rates among soldiers and veterans of Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) have been steadily growing since 2004, with sharp increases observed more recently. Suicides in the Army are a growing concern on Capitol Hill and in the media. Last month, the Senate Armed Services Committee held hearings on the growing incidence of suicides across the armed forces (Federal city digest, 2009, March 18). The Associated Press (AP) underlined the increasing suicide rates among Army personnel (Army reports sharp rise in suicides in January, 2009, Feb. 5). According to the AP, there were 64 suicides in 2004, and …

To See Or Not To See: Prestimulus Α Phase Predicts Visual Awareness, Kyle E. Mathewson, Gabriele Gratton, Monica Fabiani, Diane M. Beck, Tony Ro

Publications and Research

We often fail to see something that at other times is readily detectable. Because the visual stimulus itself is unchanged, this variability in conscious awareness is likely related to changes in the brain. Here we show that the phase of EEG α rhythm measured over posterior brain regions can reliably predict both subsequent visual detection and stimulus-elicited cortical activation levels in a metacontrast masking paradigm. When a visual target presentation coincides with the trough of an α wave, cortical activation is suppressed as early as 100 ms after stimulus onset, and observers are less likely to detect the target. Thus, …

Environmental Tobacco Smoke Avoidance Among Pregnant African-American Nonsmokers, Susan M. Blake, Kennan D. Murray, M. Nabil El-Khorazaty, Marie G. Gantz, Michele Kiely, Dana Best, Jill G. Joseph, Ayman El-Mohandes

Publications and Research

Background—Environmental tobacco smoke (ETS) exposure during pregnancy contributes to adverse infant health outcomes. Limited previous research has focused on identifying correlates of ETS avoidance. This study sought to identify proximal and more distal correlates of ETS avoidance early in pregnancy among African-American women. Methods—From a sample of low-income, black women (n=1044) recruited in six urban, prenatal care clinics (July 2001–October 2003), cotinine-confirmed nonsmokers with partners, household/ family members, or friends who smoked (n=450) were identified and divided into two groups: any past-7-day ETS exposure and cotinine-confirmed ETS avoidance. Bivariate and multivariate logistic regression analyses identified factors associated with ETS …

Alcohol And Cardio-Respiratory Deaths In Chinese: A Population-Based Case-Control Study Of 32,462 Older Hong Kong, Mary Schooling, Tai Hing Lam, Sai Yin Ho, Yao He, Kwok Hang Mak, Gabriel M. Leung

Publications and Research

Background
In observational studies moderate alcohol use reduces cardio-respiratory mortality. However observational studies may be biased by many factors including residual confounding by unmeasured differences between moderate alcohol users and other groups or by changes in alcohol use with ill-health and aging. We used two different analytic strategies in an under-studied population, i.e. southern Chinese, to provide an assessment of the specific impact of moderate alcohol use on mortality from ischemic heart disease (IHD) and chronic obstructive pulmonary diseases (COPD).

Methods
In a population-based case-control study of all adult deaths in Hong Kong Chinese in 1998, we used adjusted logistic …

Naloxone's Pentapeptide Binding Site On Filamin A Blocks Mu Opioid Receptor–Gs Coupling And Creb Activation Of Acute Morphine, Hoau-Yan Wang, Lindsay H. Burns

Publications and Research

Chronic morphine causes the mu opioid receptor (MOR) to switch its coupling from Gi/o to Gs, resulting in excitatory signaling via both Gαs and its Gβγ dimer. Ultra-low-dose naloxone (NLX) prevents this switch and attenuates opioid tolerance and dependence. This protective effect is mediated via a high-affinity interaction of NLX to a pentapeptide region in c-terminal filamin A (FLNA), a scaffolding protein interacting with MOR. In organotypic striatal slice cultures, we now show that acute morphine induces a dose-dependent Go-to-Gs coupling switch at 5 and 15 min that resolves by 1 hr. The acute Gs coupling induced by 100 µM …

A Role For The Igh Intronic Enhancer E Mu In Enforcing Allelic Exclusion, Fubin Li, Laurel A. Eckhardt

Publications and Research

The intronic enhancer (E mu) of the immunoglobulin heavy chain (IgH) locus is critical for V region gene assembly. To determine E mu's subsequent functions, we created an Igh allele with assembled V(H) gene but with E mu removed. In mice homozygous for this E mu-deficient allele, B cell development was normal and indistinguishable from that of mice with the same V(H) knockin and E mu intact. In mice heterozygous for the E mu-deficient allele, however, allelic exclusion was severely compromised. Surprisingly, this was not a result of reduced suppression of V-DJ assembly on the second allele. Rather, the striking …

School-Based Screening To Identify At-Risk Students Not Already Known To School Professionals: The Columbia Suicide Screen, Michelle A. Scott, Holly C. Wilcox, Irvin Sam Schonfeld, Mark Davies, Roger C. Hicks, J. Blake Turner, David Shaffer

Publications and Research

Objectives.Wesought todeterminethedegreeofoverlapbetweenstudents identified through school-based suicide screening and those thought to be at risk by school administrative and clinical professionals. Methods. Students from7 high schools in theNewYorkmetropolitan area completed the Columbia Suicide Screen; 489 of the 1729 students screened had positive results. The clinical status of 641 students (73% of those who had screened positive and 23%of thosewho had screened negative) was assessedwithmodules from the Diagnostic Interview Schedule for Children. School professionals nominated by their principal and unaware of students’ screening and diagnostic status were asked to indicate whether they were concerned about the emotional well-being of each participating student. …

Taking Evidence-Based Practice To The Bedside: Innovative Methods Of Keeping Patients Informed, Carlos Arguelles, Myrta Rabinowitz, Lily Thomas, Nicole C. Lemoine, Kathleen Palafox

Publications and Research

No abstract provided.

Wikipedia, Me, And Ohp, Irvin Sam Schonfeld

Publications and Research

No abstract provided.

Impetus Of Diabetic Crisis To Improve Self Management, Emma Kontzamanis

Publications and Research

No abstract provided.

Neural Substrates Of Sound–Touch Synesthesia After A Thalamic Lesion, Michael S. Beauchamp, Tony Ro

Publications and Research

Neural plasticity induced by stroke can mediate positive outcomes, such as recovery of function, but can also result in the formation of abnormal connections with negative consequences for perception and cognition. In three experiments using blood-oxygen level dependent (BOLD) functional magnetic resonance imaging, we examined the neural substrates of acquired auditory-tactile synesthesia, in which certain sounds can produce an intense somatosensory tingling sensation in a patient with a thalamic lesion. Compared with nine normal controls, the first experiment showed that the patient had a threefold greater BOLD response to sounds in the parietal operculum, the location of secondary somatosensory cortex. …

Meta-Analysis: Prophylactic Drainage And Bleeding Complications In Thyroid Surgery, Steven A. Kennedy, Robert A. Irvine, Brian D. Westerberg, Hongbin Zhang

Publications and Research

Objective: To conduct a comprehensive systematic review and high-quality meta-analysis to determine whether prophylactic drain placement reduces adverse bleeding events in thyroid surgery.

Data Sources: MEDLINE (OVID and PubMed), CENTRAL, CDSR, ACP Journal Club, DARE, EMBASE, PREMEDUNE, OLDMEDLINE, CINAHL, BIOSIS Previews, LILACS, KOREAMED, SAMED, IndMED, SIGLE, ScienceDirect, and INGENTACONNECT.

Review Methods: Studies for evaluation included all prospective trials assessing the use of drainage in thyroid surgery. We excluded case studies, retrospective studies, reviews, and studies that had a "selective" method of postoperative drainage that was not defined or was based on surgeon preference. Search strategies were broad and …