Medicine and Health Sciences Commons^™

Appropriate Medication Prescribing In Elderly Patients: How Knowledgeable Are Primary Care Physicians? A Survey Study In Parma, Italy., Vittorio Maio, Pharmd, Ms, Mph, Eric Jutkowitz, Ba, Karina Herrera Ba, Ms, Safiya Abouzaid Pharmd, Giavanna Negri, Pharmd, Stefano Del Canale, Md, Phd

College of Population Health Faculty Papers

What is known and Objective:  Increasing attention is being paid to inappropriate medication prescribing for the elderly. A growing body of studies have detected a prevalence of inappropriate prescribing ranging from 12% to 40% worldwide, including Regione Emilia-Romagna, Italy. To improve quality of prescribing, a multi-phase pilot project in the Local Health Unit (LHU) of Parma, Regione Emilia-Romagna, was established. This phase aimed to assess primary care physicians' knowledge of appropriate prescribing in elderly patients. Methods:  In total, 155 primary care physicians (51% of the total), convened by the LHU of Parma for an educational session, were asked to complete …

Pathways To Sexual Risk Taking Among Female Adolescent Detainees, Vera Lopez, Albert M. Kopak, Alyssa G. Robillard, Mary Rogers Gillmore, Rhonda Conerly Holliday, Ronald L. Braithwaite

Faculty Publications

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement …

Depressive Symptoms In Mothers Of Children With New-Onset Epilepsy: A Prospective Study, Mark Anthony Ferro

Electronic Thesis and Dissertation Repository

Having a child diagnosed with a chronic illness such as epilepsy is a major source of stress for caregivers. Up to half of mothers of children with epilepsy are at increased risk for clinical depression and symptoms of maternal depression are associated with poorer health outcomes in these children. The purpose of this study was to: 1) estimate the prevalence and course of depressive symptoms over 24 months among mothers of children with new-onset epilepsy; 2) identify subgroups of mothers that share similar trajectories of depressive symptoms; and, 3) assess the family factors involved in the causal pathway between maternal …

The Association Between Vitamin D And Depression Among College-Aged Women, Constance M. Barysauskas

Masters Theses 1911 - February 2014

Approximately 15 million Americans are diagnosed with a major depressive disorder each year, with higher rates among women and college-aged adults. Recent research suggests a vitamin D insufficiency may be associated with an increased risk of depression among the elderly. However, studies have not been conducted among young women. A recent study of young adults in Massachusetts suggests that two-thirds of this population is vitamin D deficient. We evaluated the association between dietary vitamin D intake and serum levels of 25-hydroxyvitamin D (25(OH)D₃) and history of depression using data from the UMass Vitamin D Status Study, a cross-sectional …

Hippocampal Volume Differences In Gulf War Veterans With Current Versus Lifetime Posttraumatic Stress Disorder Symptoms, Brigitte A. Apfel, Jessica Ross, Jennifer Hlavin, Dieter J. Meyerhoff, Thomas J. Metzler, Charles R. Marmar, Michael W. Weiner, Norbert Schuff, Thomas C. Neylan

Public Health Resources

Background: Decreased hippocampal volume is described in posttraumatic stress disorder (PTSD) and depression. However, it is not known whether it is a risk factor for the development of PTSD or a consequence of PTSD. We sought to determine the effects of PTSD and depressive symptoms on hippocampal volume.

Methods: Clinical and magnetic resonance imaging data were collected in a cross sectional study of 244 GulfWarveterans. Measures included lifetime and current Clinician Administered PTSD Scale, Hamilton Depression Scale, Life Stressor Checklist, and Lifetime Drinking History. Magnetic resonance imaging data were acquired with a 1.5-T scanner and analyzed with automated …

Factors Associated With Suicidal Ideation In Oef/Oif Veterans, Chad M. Lemaire, David P. Graham

Public Health Resources

Background: The purpose of this projectwas to examine factors associated with suicidal ideation in returning Iraq and Afghanistan war veterans.

Methods: A cross-sectional review of 1740 veterans' initial mental health screening evaluations. One-hundred and thirteen (6.5%) OEF/OIF veterans reported active suicidal ideation at the time of the interview.

Results: Prior exposures of physical or sexual abuse and having a history of a prior suicide attempt(s) were associated with the presence of current suicidal ideation, as were having a diagnosis of a psychotic disorder, a depressive disorder, or posttraumatic stress disorder (PTSD). Deployment concerns related to training (protective), …

Electroconvulsive Therapy For Major Depression Within The Veterans Health Administration, Paul N. Pfeiffer, Marcia Valenstein, Katherine J. Hoggatt, Dara Ganoczy, Dan Maixner, Erin M. Miller, Kara Zivin

Public Health Resources

Objectives: Electroconvulsive therapy (ECT) is the most effective treatment for severe or treatment resistant depression; however, the lack of widely accepted methods for determining when ECT is indicated may contribute to disparities and variation in use. We examined receipt of ECT among depressed patients in the largest coordinated health system in the US, the Veterans Health Administration.

Methods: Using administrative data, we conducted a multivariable logistic regression to identify individual clinical and sociodemographic predictors of receiving ECT, including variables of geographic accessibility to ECT, among patients diagnosed with major depressive disorder between 1999 and 2004.

Results: 307 (0.16%) …

Prenatal Maternal Stress Programs Infant Stress Regulation, Elyssia Poggi Davis, Laura M. Glynn, Feizal Waffarn, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.

Methods: The study sample comprised 116 women and their full term infants. Maternal plasma cortisol and report of stress, anxiety and depression were assessed at 15, 19, 25, 31 and 36 + weeks' gestational age. Infant cortisol and behavioral responses to the painful stress of a heel-stick blood draw were evaluated at 24 hours after …

Association Between Depression And C-Reactive Protein, Yunsheng Ma, David E. Chiriboga, Sherry L. Pagoto, Milagros C. Rosal, Wenjun Li, Philip A. Merriam, James R. Hébert, Matthew C. Whited, Ira S. Ockene

Faculty Publications

Objective. Depression has been associated with increased cardiovascular disease risk, and a depression-related elevation of high sensitivity C-reactive protein (hs-CRP) has been proposed as a possible mechanism. The objective of this paper is to examine association between depression and high sensitivity C-reactive protein (hs-CRP). Methods. Subjects consisted of 508 healthy adults (mean age 48.5 years; 49% women, 88% white) residing in central Massachusetts. Data were collected at baseline and at quarterly intervals over a one-year period per individual. Multivariable linear mixed models were used to assess the association for the entire sample and by gender. Results. The …