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Articles 1651 - 1680 of 3703
Full-Text Articles in Medicine and Health Sciences
Optimism And Smoking Cessation : The Effect Of Positive Expectations On Participation And Success In Interventions To Promote Smoking Cessation, Chelsea Mao
Public Health Theses
Optimism has been shown to predict both positive health outcomes and positive health behavior. This study aimed to determine whether optimism could predict greater success in smoking cessation and intervention adherence among smokers enrolled in a randomized control trial comparing two six-week smoking interventions. Optimism was measured prior to intervention initiation using a measure of dispositional optimism (LOT-R), and a measure of situational optimism designed by the author. Objective measures of expired carbon monoxide and intervention attendance data were used to evaluate three outcomes: smoking cessation, smoking reduction, and intervention adherence. Linear and logistic regression models were used to assess …
Inside Unlv, Shane Bevell, Mamie Peers, David Ashley, Diane Russell, Michelle Mouton, Grace Russell
Inside Unlv, Shane Bevell, Mamie Peers, David Ashley, Diane Russell, Michelle Mouton, Grace Russell
Inside UNLV
No abstract provided.
Practice Of Use Of Antiemetic In Patients For Laparoscopic Gynaecological Surgery And Its Impact On The Early (1st Two Hrs) Postoperative Period, Samina Ismail
Department of Anaesthesia
There is no agreed technique for minimizing PONV (Postoperative Nausea and Vomiting) although some techniques are associated with low rate. Best practice involves identifying high risk patients and surgeries and use of prophylactic antiemetic where appropriate. Laparoscopic gynaecological surgery has high incidence of PONV (54-92%). An audit on the practice of antiemetic use in diagnostic laparoscopic gynaecological surgery was done in the department of anaesthesia of Aga Khan University Hospital from 1st January to 30th June 2006. We included all the patients scheduled for this procedure lasting less than 90 minutes. Anaesthetist involved in the audit identified the patient falling …
Unlv Magazine, Tony Allen, Afsha Bawany, Barbara Cloud, Holly Ivy De Vore, Gian Galassi, Matthew K. Jacobsen, Michelle Mouton, Erin O'Donnell, Shane Bevell, Cate Weeks
Unlv Magazine, Tony Allen, Afsha Bawany, Barbara Cloud, Holly Ivy De Vore, Gian Galassi, Matthew K. Jacobsen, Michelle Mouton, Erin O'Donnell, Shane Bevell, Cate Weeks
UNLV Magazine
No abstract provided.
Volume 01, Jessica Fields, Stephanie Neeley, Derek W. Hambright, Mary E. Lehman, Andrew R. Grzankowski, Zachary Johnson, Boone M. Prentice, Ashley M. Swandby, Victoria Morgan, Katie Williamson, Kristine G. Bender, Katelyn N. Romaine, D. Nicole Swann, Jessica Fox, Mike Mcateer, Alex Grabiec, Laura Nodtvedt, Nick Costa, Rachel Wolfe, Zack Dalton
Volume 01, Jessica Fields, Stephanie Neeley, Derek W. Hambright, Mary E. Lehman, Andrew R. Grzankowski, Zachary Johnson, Boone M. Prentice, Ashley M. Swandby, Victoria Morgan, Katie Williamson, Kristine G. Bender, Katelyn N. Romaine, D. Nicole Swann, Jessica Fox, Mike Mcateer, Alex Grabiec, Laura Nodtvedt, Nick Costa, Rachel Wolfe, Zack Dalton
Incite: The Journal of Undergraduate Scholarship
Introduction from Dean Dr. Charles Ross
Three Decades of Digging: Undergraduate Archeology at Longwood by Jessica Fields and Stephanie Neeley
Interactions of Allelopathy and Heat Stress in Plants by Derek W. Hambright and Mary E. Lehman
Inertial Electrostatic Confinement D-D Fusion Device: Construction and Simulation by Andrew R. Grzankowski
Shackled Nim by Zachary Johnson
Development of GC-MS and Chemometric Methods for the Analysis of Accelerants in Arson Cases by Boone M. Prentice
A Comparison of Image Analysis Methods in cDNA Microarrays by Ashley M. Swandby
Perceived Sexual Activity of Short and Long-Term Relationships by Victoria Morgan and Katie Williamson
Elderly …
Leadership, Bonnie M. Jennings, Joanne Disch, Laura Senn
Leadership, Bonnie M. Jennings, Joanne Disch, Laura Senn
Faculty Research, Scholarly, and Creative Activity
No abstract provided.
Lsuhsc Facilities Daily Update: April 2008, Lsuhsc Property And Facilities Management
Lsuhsc Facilities Daily Update: April 2008, Lsuhsc Property And Facilities Management
LSUHSC Facilities Daily Updates: 2008
LSUHSC Dailly Facilities Updates from April 2008. These updates describe damage and a timeline of repairs at the LSU Health Sciences Center - New Orleans campus due to Hurricane Katrina which made landfall August 29, 2005.
Lsuhsc Facilities Biweekly Update: April 2008, Lsuhsc Property And Facilities Management
Lsuhsc Facilities Biweekly Update: April 2008, Lsuhsc Property And Facilities Management
LSUHSC Facilities Biweekly Updates: 2008
LSUHSC Facilities Biweekly Updates from April 11 and 25, 2008.
These updates describe damage and a timeline of repairs at the LSU Health Sciences Center - New Orleans campus due to Hurricane Katrina which made landfall August 29, 2005.
Faisabilité De L’Étude Sur Les Gaz De Fermentation Et Sur La Ventilation En Silo À Échelle Réduite, Ali Bahloul, Brigitte Roberge, Rodrigue Gravel
Faisabilité De L’Étude Sur Les Gaz De Fermentation Et Sur La Ventilation En Silo À Échelle Réduite, Ali Bahloul, Brigitte Roberge, Rodrigue Gravel
Rapports de recherche scientifique
Les silos utilisés en milieu agricole sont réputés être des espaces clos selon le Règlement sur la santé et la sécurité du travail (RSST). Ils ont été le site d’accidents graves et souvent mortels. Afin de tenir compte des dangers et des risques dans des silos à fourrage à tour conventionnelle, l’utilisation de silos à échelle réduite a été envisagée pour la réalisation d’une étude sur les silos. Dans la présente étude préliminaire, un silo à l’échelle réduite a été conçu en laboratoire afin d’estimer la faisabilité de les utiliser et de les modifier, s’il y a lieu. Le …
Jefferson Alumni Bulletin – Volume 57, Number 2, Spring 2008
Jefferson Alumni Bulletin – Volume 57, Number 2, Spring 2008
The Bulletin (formerly the Jefferson Medical College Alumni Bulletin)
Jefferson Alumni Bulletin – Volume 57, Number 2, Spring 2008
Dean's Column; Page 2
Findings; Page 4
On Campus; Page 8
John H. Moore, Jr., MD, GS'84, FACS; Page 10
Out of the Office; Page 12
The Birth and Growth of a Medical School; Page 20
Class Notes; Page 24
In Memoriam; Page 28
By the Numbers: 1824; Page 29
Retinal Pigment Epithelial Tears After Intravitreal Bevacizumab Injection For Exudative Age-Related Macular Degeneration., Sunir Garg, Roy Brod, David Kim, R Gary Lane, Joseph Maguire, David Fischer
Retinal Pigment Epithelial Tears After Intravitreal Bevacizumab Injection For Exudative Age-Related Macular Degeneration., Sunir Garg, Roy Brod, David Kim, R Gary Lane, Joseph Maguire, David Fischer
Wills Eye Hospital Papers
PURPOSE: To determine the incidence of and the risk factors for the development of retinal pigment epithelial (RPE) tears after intravitreal bevacizumab (Avastin) injection for the treatment of exudative age-related macular degeneration (AMD).
METHODS: A retrospective, multicentre, consecutive interventional case series of all patients with subfoveal exudative AMD treated with intravitreal bevacizumab between August 2005 and April 2007. The main outcome measures were pre- and post-RPE tear visual acuity and choroidal neovascular membrane lesion types, incidence of tears and time from first injection until development of the tear.
RESULTS: A total of 920 eyes with exudative AMD were treated with …
High Prevalence Of Helicobacter Pylori Infections By Multiple Strains In Patients With Dyspepsia From A Developing Country, Shahab Abid, Javed Yakoob, Wasim Jafri, Khalid Mumtaz, Nida Jafri, Z Abbas, Syed H Shah, Saeed Hamid, Rashida Ahmed
High Prevalence Of Helicobacter Pylori Infections By Multiple Strains In Patients With Dyspepsia From A Developing Country, Shahab Abid, Javed Yakoob, Wasim Jafri, Khalid Mumtaz, Nida Jafri, Z Abbas, Syed H Shah, Saeed Hamid, Rashida Ahmed
Section of Gastroenterology
No abstract provided.
Revitalizing The Human Spirit Together: A Case Study Of Movimento De Saúde Mental Comunitária Do Bom Jardim In Bom Jardim, Fortaleza, Ceará, Ana Bonilla
Independent Study Project (ISP) Collection
My research will delve into the workings of the community of Bom Jardim in Fortaleza, Ceará, in their endeavors for positive mental and physical community development through the tactics of their base organization Movimento de Saúde Mental Comunitária do Bom Jardim (MSMCBJ). Specifically I am looking at the Terapia Comunitária (community therapy) program, one of the many branches of MSMCBJ, and how through their projects do they fulfill their goal of organizing a community from the roots to blossom into a healthier and more vibrant one. I will also look into how this model is sustainable and why this method …
Urf: Islamic Biomedical Ethics In Rural Mali, Amanda Reider
Urf: Islamic Biomedical Ethics In Rural Mali, Amanda Reider
Independent Study Project (ISP) Collection
Anxious faces gather at the entrance to La Grande Mosquée de Sanankoroba, an imposing cement structure amongst small mud homes, awaiting the imam’s decision. He is not a mujtahid , but offers fatwas nonetheless; today’s is on birth control. Men crowd around—and a few women at the rear—to hear him speak out against birth control, against the use of oral contraception, for being against Islam and against God’s plan. And when his speech finishes, the faces disappear, back into their homes, and little discussion ensues. Instead, men return to their wives to share the verdict, to denounce family planning as …
Obstetric Fistula In Mali, Chandler O’Connell
Obstetric Fistula In Mali, Chandler O’Connell
Independent Study Project (ISP) Collection
Obstetric fistula is arguably the most devastating result of childbirth complications, aside from maternal and neonatal mortality, the latter of which almost always occurs during deliveries which result in fistula. Defined as a hole in the birth canal, obstetric fistula is generally caused by prolonged obstructed labor in the absence of prompt medical intervention.20 This injury results in chronic incontinence through the vagina as well as many other secondary health consequences.33 Additionally, it is impossible to measure the extensive social and psychological burdens suffered by women because of this affliction. Despite the fact that obstetric fistula is both preventable and …
The Influence Of Medicinal Plants On The Spiritism, Religion, And Science Of Tulear, Madagascar, Meghan Sweet
The Influence Of Medicinal Plants On The Spiritism, Religion, And Science Of Tulear, Madagascar, Meghan Sweet
Independent Study Project (ISP) Collection
Medicinal plants are polyvalent remedies used in industry and medicine. They have curative and preventative powers when used internally and externally on humans. They are also used for agricultural and veterinary purposes. They are necessary to the human body to give health and strength. Medicinal plants influence spiritism, religion, and science. These three worldviews make value judgments regarding medicinal plants. This study determines some limits and interdependencies of each worldview by looking at how they are influenced by medicinal plants in Tulear, Madagascar.
South Africa’S Unsung “She-Roes”: A Practicum Study Of Npo Grandmothers Against Poverty And Aids, Khayelitsha Township, Cape Town, Rachel Pryzby
South Africa’S Unsung “She-Roes”: A Practicum Study Of Npo Grandmothers Against Poverty And Aids, Khayelitsha Township, Cape Town, Rachel Pryzby
Independent Study Project (ISP) Collection
Across Africa, the AIDS pandemic has forced HIV+ individuals and orphaned children into the care of elderly women. Though this has occurred in millions of families, little support has been offered for the grandmothers supporting children and grandchildren on a limited income. This study reports on a practicum study at Grandmothers Against Poverty and AIDS (GAPA), the first African organization to recognize the important role played by grandmothers in light of HIV/AIDS. The study was conducted in April 2008 at the GAPA center in Khayelitsha Township, Cape Town. The main objective of the study was to evaluate the organization’s origin, …
Fat Embolism Syndrome., Renu Saigal, M Mittal, A Kansal, Y Singh, P R. Kolar, Shobhit Jain
Fat Embolism Syndrome., Renu Saigal, M Mittal, A Kansal, Y Singh, P R. Kolar, Shobhit Jain
Manuscripts, Articles, Book Chapters and Other Papers
Fat embolism syndrome is a rare complication occurring in 0.5 to 2% of patients following a long bone fracture. It is believed to be caused by the toxic effects of free fatty acids. Diagnosis is clinical, based on respiratory, cerebral and dermal manifestations. Treatment is only supportive, directed mainly at maintaining respiratory functions.
Pediatric Safety And Quality, Susan R. Lacey, Janis B. Smith, Karen Cox
Pediatric Safety And Quality, Susan R. Lacey, Janis B. Smith, Karen Cox
Manuscripts, Articles, Book Chapters and Other Papers
Excerpt
Pediatric care is complex due to developmental and dependency issues associated with children. How these factors impact the specific processes of care is an area of science in which little is known. We are only beginning to understand the relationship between nurse staffing and adverse events in hospitalized children; effects that may be compounded by inadequate numbers of pediatric nurses. Throughout health care providing safe and high quality patient care continues to provide significant challenges. Efforts to improve the safety and quality of care are resource intensive and take continued commitment not only by those who deliver care, but …
J Am Coll Dent 2008 75 2
Journal of the American College of Dentists
The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.
Histologic And Histomorphometric Analysis Of Posterior Region Of The Human Temporomandibular Disc, Luis Eduardo Almeida, Carla S. Baioni, Ana Paula C. Martins, Sergio Roberto P. Line, Lucia Noronha, Paula C. Trevilatto, Antonio Adilson S. De Lima, Marco Antonio De Oliveira Filho, Sergio Aparecido Ignacio
Histologic And Histomorphometric Analysis Of Posterior Region Of The Human Temporomandibular Disc, Luis Eduardo Almeida, Carla S. Baioni, Ana Paula C. Martins, Sergio Roberto P. Line, Lucia Noronha, Paula C. Trevilatto, Antonio Adilson S. De Lima, Marco Antonio De Oliveira Filho, Sergio Aparecido Ignacio
School of Dentistry Faculty Research and Publications
Objective
The aim of this study was to analyze histologic and histomorphometric features of the articular disc in groups with and without disc displacement.
Study design
A sample of 39 temporomandibular joints TMJs (31 case specimens, 8 control specimens) from 28 patients (mean age 31.2 years) were recruited for this study. The patients were considered to be affected and treated surgically with disc repositioning when presenting painful clinical signs of disc displacement after unsuccessful nonsurgical treatment for at least 6 months. Of the control patients, 4 presented condyle fracture which required opening to be reduced for treatment, and 4 displayed …
Metastatic Disease To The Pancreas And Spleen, Shayna L. Showalter, Eric Hager, Charles J. Yeo
Metastatic Disease To The Pancreas And Spleen, Shayna L. Showalter, Eric Hager, Charles J. Yeo
Department of Surgery Faculty Papers
Isolated metastases to the pancreas and spleen are a rare occurrence. When they are diagnosed, pancreatic metastases are most often from renal cell carcinoma, lung cancer, and breast cancer. The most common source of splenic metastases is gynecological in origin; the overwhelming majority is ovarian. If extensive staging studies reveal these metastases to be isolated, then curative resection may be warranted. This review will demonstrate that long-term survival may be achieved in patients with isolated metastases and a prolonged disease-free interval.
Effectiveness Of Assigning Bi-Rads Category-3 To Breast Lesion With Respect To Follow-Up, Imrana Masroor
Effectiveness Of Assigning Bi-Rads Category-3 To Breast Lesion With Respect To Follow-Up, Imrana Masroor
Department of Radiology
OBJECTIVE: To determine the effectiveness of assigning BI-RADS category-3 to breast lesion with respect to follow-up.STUDY DESIGN: A cohort study.
PLACE AND DURATION OF STUDY: Radiology Department, the Aga Khan University Hospital, Karachi, from January 2002 to December 2004.
PATIENTS AND METHODS: Women undergoing X-ray mammography and assigned BI-RADS category-3 and recommended short-term (6-monthly) follow-up were included. Out of these, 44 patients were lost to follow-up and were excluded from the study. The lesions that remained stable after short-term follow-up were recommended routine (annual) follow-up. Needle localization and open surgical biopsy was performed, if the lesion progressed or calcifications increased …
Treg Depletion Inhibits Efficacy Of Cancer Immunotherapy: Implications For Clinical Trials., James Curtin, Marianela Candolfi, Tamer Fakhouri, Chunyan Liu, Anderson Alden, Matthew Edwards, Pedro Lowenstein, Maria Castro
Treg Depletion Inhibits Efficacy Of Cancer Immunotherapy: Implications For Clinical Trials., James Curtin, Marianela Candolfi, Tamer Fakhouri, Chunyan Liu, Anderson Alden, Matthew Edwards, Pedro Lowenstein, Maria Castro
Articles
BACKGROUND: Regulatory T lymphocytes (Treg) infiltrate human glioblastoma (GBM); are involved in tumor progression and correlate with tumor grade. Transient elimination of Tregs using CD25 depleting antibodies (PC61) has been found to mediate GBM regression in preclinical models of brain tumors. Clinical trials that combine Treg depletion with tumor vaccination are underway to determine whether transient Treg depletion can enhance anti-tumor immune responses and improve long term survival in cancer patients. FINDINGS: Using a syngeneic intracrabial glioblastoma (GBM) mouse model we show that systemic depletion of Tregs 15 days after tumor implantation using PC61 resulted in a decrease in Tregs …
Peripheral Intravenous Catheters Started In Prehospital And Emergency Department Settings, Ligia Zarate, Barbara Mandleco, Russell Wilshaw, Patricia K. Ravert
Peripheral Intravenous Catheters Started In Prehospital And Emergency Department Settings, Ligia Zarate, Barbara Mandleco, Russell Wilshaw, Patricia K. Ravert
Faculty Publications
The purpose of this study was to determine the rates of phlebitis in trauma patients according to where the peripheral intravenous catheter (PIVC) was inserted in a prehospital setting or in an emergency department setting. Variables investigated also included where the catheter was anatomically placed, the gauge of the catheter, and the patients' Injury Severity Score. The overall phlebitis rate was 5.79%. The rate of phlebitis was 2.92% when started by an RN in the emergency department, 6.09% when started by an intermediate emergency medical technician and 7.78% when started by a paramedic in prehospital setting. There was no significant …
Tetanus And Rabies Eradication In Pakistan; A Mission Not Impossible, Mohammad Wasay, Ismail A. Khatri, Naseem Salahuddin
Tetanus And Rabies Eradication In Pakistan; A Mission Not Impossible, Mohammad Wasay, Ismail A. Khatri, Naseem Salahuddin
Department of Medicine
No abstract provided.
The Effect Of Dexmedetomidine On The Mini-Cog Score And High-Mobility Group Box 1 Levels In Elderly Patients With Postoperative Neurocognitive Disorders Undergoing Orthopedic Surgery, Joan M Mastrobattista, Mark A Klebanoff, J Christopher Carey, John C Hauth, Cora A Macpherson, J Ernest, Margaret Cotroneo, Kenneth J Leveno, Ronald Wapner, Michael Varner, Jay D Iams, Atef Moawad, Baha M Sibai, Menachem Miodovnik, Mitchell Dombrowski, Mary J O'Sullivan, J Peter Vandorsten, Oded Langer
The Effect Of Dexmedetomidine On The Mini-Cog Score And High-Mobility Group Box 1 Levels In Elderly Patients With Postoperative Neurocognitive Disorders Undergoing Orthopedic Surgery, Joan M Mastrobattista, Mark A Klebanoff, J Christopher Carey, John C Hauth, Cora A Macpherson, J Ernest, Margaret Cotroneo, Kenneth J Leveno, Ronald Wapner, Michael Varner, Jay D Iams, Atef Moawad, Baha M Sibai, Menachem Miodovnik, Mitchell Dombrowski, Mary J O'Sullivan, J Peter Vandorsten, Oded Langer
Faculty, Staff and Student Publications
Our objective was to determine the effect of body mass index (BMI) on response to bacterial vaginosis (BV) treatment. A secondary analysis was conducted of two multicenter trials of therapy for BV and TRICHOMONAS VAGINALIS. Gravida were screened for BV between 8 and 22 weeks and randomized between 16 and 23 weeks to metronidazole or placebo. Of 1497 gravida with asymptomatic BV and preconceptional BMI, 738 were randomized to metronidazole; BMI was divided into categories: < 25, 25 to 29.9, and > or = 30. Rates of BV persistence at follow-up were compared using the Mantel-Haenszel chi square. Multiple logistic regression was used to evaluate the effect …
Factors Influencing In-Hospital Length Of Stay And Mortality In Cancer Patients Suffering From Febrile Neutropenia, Amar Lal, Yasmin Bhurgri, Nida Rizvi, Mohni Virwani, Rasheed Uddin Memon, Wajeeha Saeed, Muhammad Rizwan Sardar, Pawan Kumar, Asim Jamal Shaikh, Salman Adil, Nehal Masood, Mohammad Khurshid
Factors Influencing In-Hospital Length Of Stay And Mortality In Cancer Patients Suffering From Febrile Neutropenia, Amar Lal, Yasmin Bhurgri, Nida Rizvi, Mohni Virwani, Rasheed Uddin Memon, Wajeeha Saeed, Muhammad Rizwan Sardar, Pawan Kumar, Asim Jamal Shaikh, Salman Adil, Nehal Masood, Mohammad Khurshid
Section of Haematology/Oncology
Introduction: Febrile neutropenia (FN) is a major complication of chemotherapy, costly in terms of morbidity, mortality and associated financial expenditure. The present study was conducted with the goal of highlighting FN as a serious problem in Pakistan, with the longer term objective of improved cancer survival, reduction in length of stay (LOS) in hospital, morbidity, mortality and costs in our existing developing country scenario. Methods: A cross-sectional descriptive study was conducted on Patients, > or =18 years, admitted with FN as a consequence of chemotherapy at a referral hospital in Karachi from 1st September 2006 to 30th April 2007. Results: A …
Excess Adenosine In Murine Penile Erectile Tissues Contributes To Priapism Via A2b Adenosine Receptor Signaling, Tiejuan Mi, Shahrzad Abbasi, Hong Zhang, Karen Uray, Janci L Chunn, Ling Wei Xia, Jose G Molina, Norman W Weisbrodt, Rodney E Kellems, Michael R Blackburn, Yang Xia
Excess Adenosine In Murine Penile Erectile Tissues Contributes To Priapism Via A2b Adenosine Receptor Signaling, Tiejuan Mi, Shahrzad Abbasi, Hong Zhang, Karen Uray, Janci L Chunn, Ling Wei Xia, Jose G Molina, Norman W Weisbrodt, Rodney E Kellems, Michael R Blackburn, Yang Xia
Faculty, Staff and Student Publications
Priapism, abnormally prolonged penile erection in the absence of sexual excitation, is associated with ischemia-mediated erectile tissue damage and subsequent erectile dysfunction. It is common among males with sickle cell disease (SCD), and SCD transgenic mice are an accepted model of the disorder. Current strategies to manage priapism suffer from a poor fundamental understanding of the molecular mechanisms underlying the disorder. Here we report that mice lacking adenosine deaminase (ADA), an enzyme necessary for the breakdown of adenosine, displayed unexpected priapic activity. ADA enzyme therapy successfully corrected the priapic activity both in vivo and in vitro, suggesting that it was …
Barriers To Rural Mental Health Care: Perspectives From Those Who Live There, Amanda R. Turlington
Barriers To Rural Mental Health Care: Perspectives From Those Who Live There, Amanda R. Turlington
Faculty Publications - Doctor of Psychology (PsyD) Program
This research evaluated barriers to mental health care according to the perceptions o f rural dwellers. A survey was mailed to randomly selected registered voters in Lincoln County, Washington, in order to assess their perceptions of barriers to mental health care. The survey consisted of a request for demographic information, Lik:ert-style questions, and forced-choice responses that inquired about barriers to mental health care from the rural respondent' s perspective. Response patterns were then compared to (a) historical factors identified as barriers to mental health care: transportation, cost, accessibility, stigma, and self-reliance, and (b) the additional factors: distrust of outsiders, rural …