Medicine and Health Sciences Commons^™

The Swedish Studies Of The Adopted Children Of Alcoholics, Jill Littrell

jill l littrell Dr.

The authors of the widely cited studies analyzing the Swedish adoption records of the children of alcoholics have advanced the notion that there are three distinct paths for the inheritance of alcoholism. One path results in moderate alcoholism in men and a form of somatization but no alcoholism in women. A second path results in severe and mild alcoholism in men and alcoholism in women. The third path results in a particular variety of alcohol abuse in men and a particular variety of somatization in women. This article analyzes the authors' claims. It is argued that the data were improperly …

Incorporating Information From Neuroscience And Endocrinology Regarding Sexual Orientation Into Social Work Education, Jill Littrell

jill l littrell Dr.

The brains of heterosexual males and heterosexual females are different. Moreover, the brains of gay men are similar to heterosexual females whereas the brains of lesbians are similar to heterosexual males. Neuroscience research supporting these postulates is reviewed. The gestational processes that might explain the differences in brain structure and function corresponding with gender are reviewed. Following a discussion of the physiological bases for sexual orientation, a discussion of the physiological bases for the expression of gender related traits and a discussion of factors contributing to sexual identity are provided. Throughout the article, alternative ways to think about gender are …

Is There Evidence For The Bipolar Spectrum And The Safety Of Pharmaceutical Interventions?, Jill Littrell

jill l littrell Dr.

Social workers constitute a high proportion of mental health professionals and a high percentage of social workers provide mental health care. Thus, psychiatric diagnoses and pharmaceutical interventions are relevant for many social workers. This paper reviews the rise in the diagnoses of Bipolar spectrum disorders for both children and adults. It considers the safety of antipsychotic medications, a mainstay of treatment for children and adults, which, in addition to other well-documented negative side effects, have recently been shown to decrease brain volume by a significant percent. These issues are particularly relevant for children in the foster care system.

Taking The Perspective That A Depressive State Reflects Inflammation: Implications For The Use Of Antidepressants, Jill Littrell

jill l littrell Dr.

This paper reviews both the evidence that supports the characterization of depression as an inflammatory disorder and the different biochemical mechanisms that have been postulated for the connection between inflammation and depression. This association offers credible explanation for the short term efficacy of antidepressants, which have short term anti-inflammatory effects. Evidence for those anti-inflammatory effects is discussed. Evidence of the contrary long-term effects of antidepressants, which increase rather than decrease inflammation, is also reviewed. It is argued that this increase in inflammation would predict an increase in chronicity among depressed patients that have been treated with antidepressants drugs, which has …

Can A Diagnosis Be Epidemic, With Therapeutic Efforts The Catastrophe?, Jill Littrell

jill l littrell Dr.

The diagnosis of Bipolar Spectrum Disorders (BSD) given for office visits has risen 40 fold for children and has risen dramatically for adults as well. Some of the growth may have been fueled by re-categorization of individuals who would previously have received diagnoses of major depression along with the widening of diagnostic criteria for BSD. Concomitant with the rise in BSD diagnoses, the number of adults and children receiving atypical antipsychotics has increased dramatically. Recent evidence finds that atypical antipsychotics cause considerable reduction in brain volume. It is thus imperative to ensure that those with diagnoses comprising BSD—Bipolar I, Bipolar …

How Addiction Happens, How Change Happens, And What Social Workers Need To Know To Be Effective Facilitators Of Change, Jill Littrell

jill l littrell Dr.

During the last two decades, neuroscience research has proliferated examining brain mechanisms that explain why some people are compelled to pursue drugs and alcohol. The findings suggest that addiction is independent of pleasure, and that drug seeking can be triggered outside of conscious awareness (Berridge, Robinson, & Aldridge, 2009; Goldstein et al., 2009; Kalivas, Volkow, & Seamans, 2005). The observations and conclusions from this research can be used to advantage in treating addiction. The use of social psychological principles, in the context of motivational interviewing, offers a platform for taking advantage of these new insights. After a brief sketch of …

Children In Foster Care And Excessive Medications, Jill Littrell

jill l littrell Dr.

Children in foster care system are more likely to receive diagnoses of major mental illness and to be medicated with powerful medications such as antipsychotic drugs. Reasons for the increased risk of the actual mental illnesses and for the diagnoses of illness among children in foster care are reviewed. The reliabilities of various diagnoses are considered. The legitimacy of the rationale for early medications to prevent later disability is discussed. The very real hazards of medicating with antipsychotics, anticonvulsants, stimulants, mood stabilizers and antidepressants are reviewed. A discussion of advocacy efforts occurring around the United States on behalf of medicated …

Book Review: “Mental Illness In The Family: Issues And Trends”, Jill Littrell

jill l littrell Dr.

No abstract provided.

The Mind-Body Connection: Not Just A Theory Anymore, Jill Littrell

jill l littrell Dr.

The field of psychoneuroimmunology has witnessed an explosion of empirical findings during the last two decades. Research has documented the mechanisms through which stressful emotions alter white blood cell function. Stress diminishes white blood cell response to viral infected cells and to cancer cells. Moreover, vaccination is less effective in those who are stressed and wounds heal less readily in those who are stressed. While stress decreases the activity of some white blood cells, stress does not compromise the function of all types of white blood cells. Indeed, some types of autoimmune disease, which involve particular subsets of white blood …

New Developments In Understanding Cardiovascular Disease And The Implications For Social Work, Jill Littrell

jill l littrell Dr.

Cardiovascular disease is now viewed as an inflammatory disease. An index of chronic inflammation (viz., C-Reactive Protein) is as good a predictor of heart attacks as are fats in blood. The data suggest that stressful events are so closely associated with chronic inflammatory states, that the body’s stress response can be viewed as an inflammatory state. This paper summarizes and explains the link between stress and cardiovascular disease. Negative health outcomes, particularly for cardiovascular diseases, are higher among those of lower socio-economic status. Differential stress among socio-economic tiers is considered as an explanation for the disparities. The literature linking cardiovascular …

Lymphoma Research Foundation Featured Researcher, Goldi Kozloski

Goldi A Kozloski

Avatars: Bringing Case-Studies To Life, Rachel Ramsey, Cheryl Rockwell

Cheryl Lynn Rockwell

No abstract provided.

Secrets Of Successful Short Grant Applications, Patricia Groves, Susan Rawl, Mary Wurzbach, Nancy Fahrenwald, Marlene Cohen, Donna Mccarthy, Julie Zerwic, Barbara Given, Donna Algase, Gregory Alexander, Vicki Conn

Gregory S Alexander

Nursing doctoral programs prepare students for research-focused careers within academic settings. The purpose of this Editorial Board Special Article is to provide PhD students and advisors with suggestions for making the most of their doctoral experience. Editorial Board members provide their individual insights on the skills and attributes students must acquire during the course of their doctoral education in order to succeed. The authors provide practical tips and advice on how to excel in a PhD program, including how to select an advisor and a dissertation committee, the importance of attending conferences to increase visibility and develop a network of …

Nursing Graduates' Ability To Address Incivility: Kirkpatrick's Level-3 Evaluation, Cynthia Clark, Sara Ahten, Rosemary Macy

Sara M. Ahten

Background Addressing incivility in nursing education has an important twofold purpose, to increase civility within the nursing education experience and to lay the groundwork for creating cultures of civility in professional nursing practice. Given the serious impact of incivility, it is imperative to prepare students to foster civility in their nursing practice upon graduation. Methods In a previous article, the authors described how a classroom-centered, problem-based learning (PBL) scenario, simulating a nurse-to-nurse uncivil encounter, was used to assess student learning according to Level 1 and Level 2 of Kirkpatrick's Model of Evaluation. This subsequent article presents the findings of a …

The Fit-Hansa Demonstrates Reliability And Convergent Validity Of Functional Performance In Patients With Shoulder Disorders, Prajyot Kumta, Joy Macdermid, Saurabh Mehta, Paul Stratford

Saurabh Mehta

Study

DesignPsychometric study design.

Objectives

To assess the test-retest reliability and convergent validity of the Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA) in patients with shoulder disorders.

Background

Performance tests that assess functional ability of patients with shoulder disorders can provide useful information for making clinical or return-to-activity decisions. No performance-based shoulder test has yet demonstrated sufficient relevance or clinical measurement properties. The FIT-HaNSA examines upper extremity performance during repetitive tasks that emphasize shoulder reaching and static postures and, therefore, has greater relevance for assessing performance.

Methods

Thirty-six patients with shoulder disorders and 65 healthy controls were recruited for the study. …

Chronic Pain Grade Questionnaire, Manraj Kaur, Saurabh Mehta

Saurabh Mehta

The Chronic Pain Grade Questionnaire (CPGQ) is a seven item instrument designed to evaluate overall severity of chronic pain based on two dimensions, pain intensity and pain-related disability, in individuals who suffer from chronic pain that has lasted for at least six months. The notion of graded classification of chronic pain severity was derived from the dysfunctional chronic pain concept provided by Turk and Rudy (1988). The two disability items were adopted from the Multidimensional Pain inventory (Von Korff et al 1992).

Effect Of Apolipoprotein Ε4 On Hippocampal And Brain Volume In Intractable Temporal Lobe Epilepsy, Robyn Busch, Darlene Floden, Tara Lineweaver, Jessica Chapin, Kanjana Ungwongse, Tim Wehner, Ramon Diaz-Arrastia, Imad Najm

Tara T. Lineweaver

This study investigated the relationship between the apolipoprotein (APOE) ε4 allele and brain volumes in patients with medically intractable temporal lobe epilepsy (TLE). MRI-based volumetric analyses of the hippocampi, cerebral hemispheres, and whole brain were conducted in 59 patients with TLE (31 with left TLE, 28 with right TLE) with hippocampal sclerosis (HS). There were no differences in hippocampal, hemispheric, or whole brain volumes as a function of ε4 status even after correcting for hemispheric and total brain volumes. However, APOE ε4 carriers showed a trend toward having a smaller discrepancy between ipsilateral and contralateral hippocampal volumes than patients without …

Mesothelioma - Update On Management, Patricia Tai, Kurian Joseph, Avi Assouline, Joseph Au, Edward Yu

Edward Yu

Mesothelioma is an often fatal cancer arising from the lining of pleura, peritoneum, pericardium and tunica vaginalis (of the testis). In the past decade, investigators have met with limited or minimal success in demonstrating improvements in survival compared to supportive care or observation. Radical surgery such as extrapulmonary pleurectomy is associated with perioperative mortality rates of 6-30% by different institutions, compared to 3% with extended pleurectomy and decortication. Talc pleurodesis is preferred over video-assisted thorascopic partial pleurectomy in the setting of pleural effusion due to fewer complications and shorter hospital stay. To spare normal tissues, radiotherapy with IMRT (intensity-modulated radiation …

Treatment-Associated Changes In Body Composition, Health Behaviors, And Mood As Predictors Of Change In Body Satisfaction In Obese Women, James Annesi, Gisele Tennant, Nicole Mareno

Nicole Mareno

Synchronous Opening And Closing Motions Are Essential For Camp-Dependent Protein Kinase A Signaling, Atul K. Srivastava, Leanna R. Mcdonald, Alessandro Cembran, Jonggul Kim, Larry R. Masterson, Christopher L. Mcclendon, Susan S. Taylor, Gianluigi Veglia

Larry Masterson

Enhanced Proprioceptive Acuity At The Knee In The Competitive Athlete, Carol Courtney, Rose Rine, Drew Jenk, P. Collier, Andrew Waters

Rose Marie Rine P.T., Ph.D.

STUDY DESIGN: Controlled laboratory study: cross-sectional.

OBJECTIVE: To determine if proprioception, measured by the threshold to detection of passive motion (TDPM), differed in individuals who regularly participate in moderate-intensity exercise for fitness as compared to individuals involved in high-intensity skilled exercise.

BACKGROUND: Previous research has been equivocal as to whether exercise training is associated with superior proprioceptive acuity, in particular, exercise that includes dynamic postural challenges such as cutting and pivoting.

METHODS: Two groups of 25 healthy individuals (18-32 years old) were recruited. One group consisted of individuals who performed moderate-activity level exercises for 5 to 10 hours per …

Vestibular Function Assessment Using The Nih Toolbox, Rose Rine, Michael Schubert, Susan Whitney, Dale Roberts, Mark Redfern, Mark Musolino, Jennica Roche, Daniel Steed, Bree Corbin, Chia-Cheng Lin, Greg Marchetti, Jennifer Beaumont, John Carey, Neil Shepard, Gary Jacobson, Diane Wrisley, Howard Hoffman, Gabriel Furman, Jerry Slotkin

Rose Marie Rine P.T., Ph.D.

Objective: Development of an easy to administer, low-cost test of vestibular function. Methods: Members of the NIH Toolbox Sensory Domain Vestibular, Vision, and Motor subdomain teams collaborated to identify 2 tests: 1) Dynamic Visual Acuity (DVA), and 2) the Balance Accelerometry Measure (BAM). Extensive work was completed to identify and develop appropriate software and hardware. More than 300 subjects between the ages of 3 and 85 years, with and without vestibular dysfunction, were recruited and tested. Currently accepted gold standard measures of static visual acuity, vestibular function, dynamic visual acuity, and balance were performed to determine validity. Repeat testing was …

Motor Assessment Using The Nih Toolbox, David Reuben, Susan Magasi, Heather Mccreath, Richard Bohannon, Ying-Chih Wang, Deborah Bubela, William Rymer, Jennifer Beaumont, Rose Rine, Jin-Shei Lai, Richard Gershon

Rose Marie Rine P.T., Ph.D.

Motor function involves complex physiologic processes and requires the integration of multiple systems, including neuromuscular, musculoskeletal, and cardiopulmonary, and neural motor and sensory-perceptual systems. Motor-functional status is indicative of current physical health status, burden of disease, and long-term health outcomes, and is integrally related to daily functioning and quality of life. Given its importance to overall neurologic health and function, motor function was identified as a key domain for inclusion in the NIH Toolbox for Assessment of Neurological and Behavioral Function (NIH Toolbox). We engaged in a 3-stage developmental process to: 1) identify key subdomains and candidate measures for inclusion …

Evidence Of Progressive Delay Of Motor Development In Children With Sensorineural Hearing Loss And Concurrent Vestibular Dysfunction, Rose Rine, Gabrielle Cornwall, Karen Gan, Christian Locascio, Todd O'Hare, Emily Robinson, Michele Rice

Rose Marie Rine P.T., Ph.D.

Gross motor development, and the effect of age, sex and vestibular function on it, was examined in 39 24- to 83-mo.-old children with sensorineural hearing impairment. Repeated testing was completed on 18 children. Delayed gross motor development was evident regardless of age, but only children less than 5 years of age had developmental balance deficits on initial testing. Both gross motor and balance development scores were lower on repeated testing. Furthermore, vestibular function scores facilitated identification of those children with a deficit in balance development as well as those with a progressive delay in motor or balance development. Implications for …

Patient Characteristics Associated With False Arrhythmia Alarms In Intensive Care [Abstract 19717], Patricia Harris, Jessica K. Zègre-Hemsey, Tina Mammone, Daniel Schindler, Xiao Hu, Yong Bai, Steven M. Paul, Barbara J. Drew

Patricia Harris

Hemopericardium And Cardiac Tamponade Associated With Dabigatran Use, Eliza Dy, Dane Shiltz

Dane L. Shiltz

OBJECTIVE: To describe 2 cases of hemopericardium following treatment with dabigatran. CASE SUMMARIES: A 70-year-old male with a history of dabigatran use presented with cough, fatigue, and bloody stools. The patient had a large hyperdense pericardial effusion caused by accumulation of bloody fluid, leading to hypotension and shock. Approximately 1000 mL of hemorrhagic fluid was drained from the pericardial space. A 77-year-old female was admitted for treatment of pneumonia and atrial fibrillation. Dabigatran was initiated and, after 6 doses, the patient developed abdominal pain, respiratory distress, and shock. She was diagnosed with pericardial effusion leading to cardiac tamponade. Pericardiocentesis and …

Back Talk: The Medicine Cabinet, Dane Shiltz

Dane L. Shiltz

Presenation to pharmacists at Butler CE Symposium, June 2012, Indianapolis, Indiana.

System-Wide Implementation Of The Use Of An Extended-Infusion Piperacillin/Tazobactam Dosing Strategy: Feasibility Of Utilization From A Children's Hospital Perspective, Kristen Nichols, Chad Knoderer, Elaine Cox

Chad A. Knoderer

Background

Use of extended infusions of piperacillin/tazobactam (PT) in adult patients has been described, but data in children are limited.

Objective

The goal of this study was to determine the feasibility of using an extended-infusion PT dosing strategy as the standard of care in a children's hospital.

Methods

This was a prospective observational study of patients aged >30 days who received PT after admission to a freestanding, tertiary care children's hospital. After institution of an extended-infusion PT dosing protocol as the standard dosing option, patients receiving PT were prospectively assessed for presence of and reasons for changes in dosing regimen. …

Assessment Of The Validity Of Reported Antibiotic Allergic Reactions In Pediatric Patients, Lauren Miller, Chad Knoderer, Elaine Cox, Martin Kleinman

Chad A. Knoderer

Study Objective. To determine whether a reported antibiotic allergy was likely to have been immunologically mediated. Design. Questionnaire-based study. Setting. Tertiary care, freestanding children's hospital. Patients. One hundred patients aged 1 month-18 years for whom guardians reported an allergy to an antibiotic at the time of hospital admission between October 2009 and March 2010. Intervention. Guardians of the patients were interviewed by using a standardized allergy assessment questionnaire. Measurements and Main Results. Based on answers to the questionnaire, the reported allergic reactions were categorized to determine if they were true allergies or adverse reactions. Among the 100 patients, reported allergies …

Outcomes Of Extended-Infusion Piperacillin/Tazobactam In Pediatric Patients., Kristen Nichols, Katie Andricopulos, Ashley Crumby, Elaine Cox, Chad Knoderer

Chad A. Knoderer

Poster presented at: ID Week 2013, October 2013, San Francisco, California.