Medicine and Health Sciences Commons^™

How Clinicians Feel About Working With Spouses Of The Chronically Ill, Douglas Ingram

NYMC Faculty Publications

Clinicians who provide psychotherapy to spouses or partners of the chronically ill were solicited through listserves of psychodynamic and other organizations. The current report excluded those therapists working with spouses of dementia patients. Interviews were conducted with clinicians who responded. The interviews highlight the challenges commonly encountered by psychotherapeutic work with this cohort of therapy patients. A comparison is drawn that shows both overlap and distinctions between the experiences of those therapists engaging with spouses of chronically ill patients without a dementing process and those working with spouses of chronically ill patients who do suffer from a dementing process.

Left Ventricular Mechanical Dysfunction In Diet-Induced Obese Mice Is Exacerbated During Inotropic Stress: A Cine Dense Cardiovascular Magnetic Resonance Study, Christopher M. Haggerty, Andrea C. Mattingly, Sage P. Kramer, Cassi M. Binkley, Linyuan Jing, Jonathan D. Suever, David K. Powell, Richard J. Charnigo, Frederick H. Epstein, Brandon K. Fornwalt

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: Obesity is a risk factor for cardiovascular disease. There is evidence of impaired left ventricular (LV) function associated with obesity, which may relate to cardiovascular mortality, but some studies have reported no dysfunction. Ventricular function data are generally acquired under resting conditions, which could mask subtle differences and potentially contribute to these contradictory findings. Furthermore, abnormal ventricular mechanics (strains, strain rates, and torsion) may manifest prior to global changes in cardiac function (i.e., ejection fraction) and may therefore represent more sensitive markers of cardiovascular disease. This study evaluated LV mechanics under both resting and stress conditions with the hypothesis …

Change In Overactive Bladder Symptoms After Surgery For Stress Urinary Incontinence In Women, Halina Zyczynski, Michael E Albo, Howard B Goldman, Clifford Y Wai, Larry T Sirls, Linda Brubaker, Peggy Norton, R E Varner, Maude Carmel, Hae-Young Kim

NYMC Faculty Publications

OBJECTIVE: To assess change in overactive bladder (OAB) symptoms up to 5 years after surgery and to identify associated predictors of change from baseline.

METHODS: This is a secondary analysis of data from three multicenter urinary incontinence (UI) surgical trials of women with stress-predominant mixed UI assigned to Burch colposuspension, autologous fascial sling, or retropubic or transobturator midurethral slings. The primary outcome was improvement of 70% or greater from baseline in symptoms measured by the Urinary Distress Inventory-Irritative subscale. Surgical groups were compared within respective trials. Generalized linear models were fit using 1-year and up to 5-year data.

RESULTS: Significant …

Missing Data Frequency And Correlates In Two Randomized Surgical Trials For Urinary Incontinence In Women, Linda Brubaker, Heather J Litman, Hae-Young Kim, Philippe Zimmern, Keisha Dyer, John W Kusek, Holly E Richter, Anne Stoddard

NYMC Faculty Publications

INTRODUCTION AND HYPOTHESIS: Missing data is frequently observed in clinical trials; high rates of missing data may jeopardize trial outcome validity.

PURPOSE: We determined the rates of missing data over time, by type of data collected and compared demographic and clinical factors associated with missing data among women who participated in two large randomized clinical trials of surgery for stress urinary incontinence, the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr) and the Trial of Midurethral Sling (TOMUS).

METHODS: The proportions of subjects who attended and missed each follow-up visit were calculated. The chi-squared test, Fisher's exact test and t test …

Achilles Tendons From Decorin- And Biglycan-Null Mouse Models Have Inferior Mechanical And Structural Properties Predicted By An Image-Based Empirical Damage Model., Joshua A. Gordon, Benjamin R. Freedman, Andrey Zuskov, Renato V. Iozzo, David E. Birk, Louis J. Soslowsky

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Achilles tendons are a common source of pain and injury, and their pathology may originate from aberrant structure function relationships. Small leucine rich proteoglycans (SLRPs) influence mechanical and structural properties in a tendon-specific manner. However, their roles in the Achilles tendon have not been defined. The objective of this study was to evaluate the mechanical and structural differences observed in mouse Achilles tendons lacking class I SLRPs; either decorin or biglycan. In addition, empirical modeling techniques based on mechanical and image-based measures were employed. Achilles tendons from decorin-null (Dcn(-/-)) and biglycan-null (Bgn(-/-)) C57BL/6 female mice (N=102) were used. Each tendon …

Complementary And Alternative Medicine And Japanese Chronic Disease Patients’ Quality Of Life And Perceived Stress, Hideaki Tanaka

FIU Electronic Theses and Dissertations

This mixed methods study examined the association between the frequency of five lifestyle-related complementary and alternative medicine (CAM) practices and perceived quality of life (QOL) and stress among patients in Japan diagnosed with chronic disease, and also examined why patients decided to receive Okada purifying therapy [(OPT) biofield therapy]. Data from 1,190 patients were analyzed using bivariate and multiple regression analysis, followed by analysis of one-on-one in-depth interviews conducted among 25 patients on reasons why patients decided to practice OPT. Grounded theory methodology was used to analyze transcribed interview data.

Results of multiple regression analysis indicated that engaging in arts …

Is It Time To Consider The “Burnout Syndrome” A Distinct Illness?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The “burnout syndrome” has been defined as a combination of emotional exhaustion, depersonalization, and reduced personal accomplishment caused by chronic occupational stress. Although there has been increasing medical interest in burnout over the last decades, it is argued in this paper that the syndrome cannot be elevated to the status of diagnostic category, based on (1) an analysis of the genesis of the burnout construct, (2) a review of the latest literature on burnout-depression overlap, (3) a questioning of the three-dimensional structure of the burnout syndrome, and (4) a critical examination of the notion that burnout is singularized by its …

Quantification Of Atrial Dynamics Using Cardiovascular Magnetic Resonance: Inter-Study Reproducibility., Johannes T. Kowallick, Geraint Morton, Pablo Lamata, Roy Jogiya, Shelby Kutty, Gerd Hasenfuß, Joachim Lotz, Eike Nagel, Amedeo Chiribiri, Andreas Schuster

Journal Articles: Cardiology

BACKGROUND: Cardiovascular magnetic resonance (CMR) offers quantification of phasic atrial functions based on volumetric assessment and more recently, on CMR feature tracking (CMR-FT) quantitative strain and strain rate (SR) deformation imaging. Inter-study reproducibility is a key requirement for longitudinal studies but has not been defined for CMR-based quantification of left atrial (LA) and right atrial (RA) dynamics.

METHODS: Long-axis 2- and 4-chamber cine images were acquired at 9:00 (Exam A), 9:30 (Exam B) and 14:00 (Exam C) in 16 healthy volunteers. LA and RA reservoir, conduit and contractile booster pump functions were quantified by volumetric indexes as derived from fractional …

The Preparatory Set: A Novel Approach To Understanding Stress, Trauma, And The Bodymind Therapies, Peter Payne, Mardi A. Crane-Godreau

Dartmouth Scholarship

Basic to all motile life is a differential approach/avoid response to perceived features of environment. The stages of response are initial reflexive noticing and orienting to the stimulus, preparation, and execution of response. Preparation involves a coordination of many aspects of the organism: muscle tone, posture, breathing, autonomic functions, motivational/emotional state, attentional orientation, and expectations. The organism organizes itself in relation to the challenge. We propose to call this the "preparatory set" (PS). We suggest that the concept of the PS can offer a more nuanced and flexible perspective on the stress response than do current theories. We also hypothesize …

Drink Like A Lawyer: The Neuroscience Of Substance Use And Its Impact On Cognitive Wellness, Debra S. Austin

Sturm College of Law: Faculty Scholarship

Lawyers suffer from higher levels of anxiety and depression than the rest of the population, but most do not enter law school with these mental health issues. Disciplinary actions against attorneys involve substance abuse 50 to 75 percent of the time. However, neuroscience research has shown that both the brain and the genes enjoy the power of plasticity, which means that personal choices and environments shape the development of lawyers throughout their lives. Legal educators need a better understanding of what aspects or characteristics of legal education contribute to the decline in mental health of law students, lawyers, and judges, …

Mindfulness: Being Present In The Moment, Stephanie Ann Stathas, Christine Frazer

Walden Faculty and Staff Publications

This article serves to enlighten childbirth educators’ knowledge about mindfulness and the mother-baby benefits associated with incorporating mindfulness- based interventions into practice. Jon Kabat-Zinn, who developed the Mindfulness Based Stress Reduction program, brought the concept of mindfulness into the world of healthcare and mainstream society. Mindfulness is the practice of bringing awareness to the here and now using a variety of methods. Nancy Bardacke has taken the practice of mindfulness further and developed a program for expecting mothers, known as Mindfulness Based Childbirth and Parenting. This program has been shown to reduce stress responses that may be harmful to a …

Effect Of Perceived Stress On Cytokine Production In Healthy College Students, Vorachai Sribanditmongkol, Jeremy L. Neal, Laura A. Szalacha, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

Chronic psychological stress impairs antibody synthesis following influenza vaccination. Chronic stress also increases circulating levels of proinflammatory cytokines and glucocorticoids in elders and caregivers, which can impair antibody synthesis. The purpose of this study was to determine whether psychological stress increases ex vivo cytokine production or decreases glucocorticoid sensitivity (GCS) of peripheral blood leukocytes from healthy college students. A convenience sample of Reserve Officer Training Corps (ROTC) students completed the Perceived Stress Scale (PSS). Whole blood was incubated in the presence of influenza vaccine and dexamethasone to evaluate production of interleukin-6 (IL-6), interleukin-1-beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and interferon-gamma …

Drug Synergy Drives Conserved Pathways To Increase Fission Yeast Lifespan, Xinhe Huang, Markos Leggas, Robert C. Dickson

Pharmaceutical Sciences Faculty Publications

Aging occurs over time with gradual and progressive loss of physiological function. Strategies to reduce the rate of functional loss and mitigate the subsequent onset of deadly age-related diseases are being sought. We demonstrated previously that a combination of rapamycin and myriocin reduces age-related functional loss in the Baker's yeast Saccharomyces cerevisiae and produces a synergistic increase in lifespan. Here we show that the same drug combination also produces a synergistic increase in the lifespan of the fission yeast Schizosaccharomyces pombe and does so by controlling signal transduction pathways conserved across a wide evolutionary time span ranging from yeasts to …

Somatic Experiencing: Using Interoception And Proprioception As Core Elements Of Trauma Therapy, Peter Payne, Peter A. A. Levine, Mardi A. Crane-Godreau

Dartmouth Scholarship

Here we present a theory of human trauma and chronic stress, based on the practice of Somatic Experiencing(®) (SE), a form of trauma therapy that emphasizes guiding the client's attention to interoceptive, kinesthetic, and proprioceptive experience. SE™ claims that this style of inner attention, in addition to the use of kinesthetic and interoceptive imagery, can lead to the resolution of symptoms resulting from chronic and traumatic stress. This is accomplished through the completion of thwarted, biologically based, self-protective and defensive responses, and the discharge and regulation of excess autonomic arousal. We present this theory through a composite case study of …

The Minimum Important Difference For The International Consultation On Incontinence Questionnaire-Urinary Incontinence Short Form In Women With Stress Urinary Incontinence, Larry Sirls, Sharon Tennstedt, Linda Brubaker, Hae-Young Kim, Ingrid Nygaard, David Rahn, Jonathan Shepherd, Holly Richter

NYMC Faculty Publications

INTRODUCTION: Minimum important difference (MID) estimates the minimum degree of change in an instrument's score that correlates with a patient's subjective sense of improvement. We aimed to determine the MID for the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) using both anchor based and distribution based methods derived using data from the Trial of Midurethral Slings (TOMUS).

MATERIALS AND METHODS: Instruments for the anchor-based analyses included the urogenital distress inventory (UDI), incontinence impact questionnaire (IIQ), patient global impression of improvement (PGI-I), incontinence episodes (IE) on 7-day bladder diary, and satisfaction with surgical results. After confirming moderate correlation …

Factors Facilitating Constructive Coping With Stress, Kamilla Bargiel-Matusiewicz, Hatim A. Omar

Pediatrics Faculty Publications

This review focuses on coping with stress, with particular emphasis on mechanisms facilitating constructive coping with stress. An important area of contemporary research is the attempt to identify factors that make it possible to stay mentally healthy or preventing the weakening of the cognitive and social functioning. The currently prevailing approach to stress is the relational approach. According to this approach, the criterion for the occurrence of stress is the cognitive assessment of the situation made by an individual. This review presents the most recent proposals concerning the analysis of specific methods of coping with stress, in particular from the …

Paper I: Stress In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

It is well known that adolescents experience stress. In this article, sources of adolescent stress will be discussed as well as the physiological effects of stress on the body. Stress disorders will also be briefly reviewed. Mainly, research on stress management strategies that have been evaluated in adolescents will be presented. Many studies have a small number of participants and lack control groups. Therefore, there is a need for ongoing research in this important area.

Part Ii - Stress And Stress Management Strategies In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

It is well known that adolescents experience stress. In this article, sources of adolescent stress will be discussed as well as the physiological effects of stress on the body. Stress disorders will also be briefly reviewed. Mainly, research on stress management strategies that have been evaluated in adolescents will be presented. Many studies have a small number of participants and lack control groups. Therefore, there is a need for ongoing research in this important area.

Identifying Molecular Features Associated With Psychoneurological Symptoms In Women With Breast Cancer Using Multivariate Mixed Models, Qing Zhou, Colleen Jackson-Cook, Debra Lyon, Robert Perera, Kellie Archer

Biostatistics Publications

Breast cancer (BC) is the second most common cancer among women. Research shows many women with BC experience anxiety, depression, and stress (ADS). Epigenetics has recently emerged as a potential mechanism for the development of depression.1 Although there are growing numbers of research studies indicating that epigenetic changes are associated with ADS, there is currently no evidence that this association is present in women with BC. The goal of this study was to identify high-throughput methylation sites (CpG sites) that are associated with three psychoneurological symptoms (ADS) in women with BC. Traditionally, univariate models have been used to examine …

The Effects Of Home-Based Pilates In Healthy College-Age Females, Betsy Donahoe-Fillmore, Mary Insana Fisher, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: To quantify and determine the effects of Pilates on core endurance, hamstring flexibility, balance, body composition/mass and perceived stress level in healthy college age females.

Study Design: Randomized controlled trial design.

Background: Emerging research on the Pilates technique is inconclusive regarding benefits to core endurance, flexibility, balance, body mass, and perceived stress.

Methods and Measures: Female college students (n=57; 18-35 years old) were randomly assigned to a Pilates group, who exercised at home with a DVD, or a control group who did not engage in Pilates practice. Core endurance, hamstring flexibility, balance, body composition and stress measurements were taken …

Psychosocial Risk Factors For Acute Myocardial Infarction: Results Of A Case-Control Study In A Teaching Hospital At Karachi, Pakistan, Kiran Abdul Sattar, Waris Qidwai, Kashmira Nanji

Department of Family Medicine

Objective: To determine psychosocial risk factors for acute myocardial infarction at a teaching hospital in Karachi. Methods: One hundred and fifty three cases were recruited from cardiology clinics and 153 controls from internal medicine and family medicine clinics of Aga Khan University Hospital, Karachi, through non-probability sampling using a structured questionnaire. Cases were those who were diagnosed with acute myocardial infarction for the first time in past month. Controls were selected from family medicine and internal medicine clinics of the same hospital and included patients above the age of 40 years without acute myocardial infarction. Associations between psychosocial risk …

Burnout-Depression Overlap: A Review, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Whether burnout is a form of depression or a distinct phenomenon is an object of controversy. The aim of the present article was to provide an up-to-date review of the literature dedicated to the question of burnout–depression overlap. A systematic literature search was carried out in PubMed, PsycINFO, and IngentaConnect. A total of 92 studies were identified as informing the issue of burnout–depression overlap. The current state of the art suggests that the distinction between burnout and depression is conceptually fragile. It is notably unclear how the state of burnout (i.e., the end stage …

Support After Brain Tumor Means Different Things: Family Caregivers' Experiences Of Support And Relationship Changes, T. Ownsworth, E. Goadby, Suzanne K. Chambers

Research outputs 2014 to 2021

Shorter hospital stays and greater emphasis on outpatient care means that family members have the primary responsibility for supporting a person with brain tumor to manage the physical, cognitive, behavioral, and emotional effects of the illness and its treatment. Given the integral role of family caregivers, it is essential to understand their experience of the impact of brain tumor and their own support needs. Accordingly, this qualitative study aimed to investigate family caregivers' experiences of support and relationship changes in the context of brain tumor. In-depth interviews were conducted with 11 family caregivers (8 spouse/partner, 3 parents) of people with …

Aerobic And Resistance Training Improves Mood State Among Adults Living With Hiv., Jason R. Jaggers, Gregory A. Hand, Wesley D. Dudgeon, Stephanie Burgess, Kenneth D. Phillips, Larry Durstine, Steven N. Blair

Faculty Scholarship

The purpose of this investigation was to examine the effects of combined aerobic and resistance exercise training among self-reported mood disturbances, perceived stress, frequency of self-reported symptoms, and symptom distress in a sample of HIV+ adults. For this purpose, 49 participants were randomly assigned into an exercise (EX) or control (CON) group. Those in the EX group completed 50 min of supervised aerobic and resistance training at a moderate intensity twice a week for 6 weeks. The CON group reported to the university and engaged in sedentary activities. Data were collected at baseline before randomization and 6 weeks post intervention. …