Medical Specialties Commons^™

Multiple Anti-Epileptic Drug Use In Children With Epilepsy In Mulago Hospital, Uganda: A Cross Ectional Study, Martha Sajatovic

Faculty Scholarship

Background: Seizures in up to one third of children with epilepsy may not be controlled by the first anti-epileptic drug (AED). In this study, we describe multiple AED usage in children attending a referral clinic in Uganda, the factors associated with multiple AED use and seizure control in affected patients. Methods: One hundred thirty nine patients attending Mulago hospital paediatric neurology clinic with epilepsy and who had been on AEDs for ≥6months were consecutively enrolled from July to December 2013 to reach the calculated sample size. With consent, the history and physical examination were repeated and the neurophysiologic and imaging …

Caregiver Opinion Of In-Hospital Screening For Unmet Social Needs By Pediatric Residents., Jeffrey D. Colvin, Jessica L. Bettenhausen, Kaston D. Anderson-Carpenter, Vicki Collie-Akers, Paul J. Chung

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Child health is strongly influenced by social determinants. Little is known about the opinions of primary caregivers regarding the physicians' role in addressing social needs. Our objective was to examine caregivers' opinions about that role and any associations between those opinions, previous exposure to screening for needs by pediatric residents, and socioeconomic status (SES).

METHODS: Cross-sectional survey study of caregivers of hospitalized children. The survey collected information on caregiver opinion regarding their ability to ask physicians for help with social needs, whether physicians know how to help with those needs, and whether physicians should ask about social needs. The …

More Illness In Offspring Of Bipolar Patients From The U.S. Compared To Europe., Robert M. Post, Lori L. Altshuler, Ralph Kupka, Susan L. Mcelroy, Mark A. Frye, Michael Rowe, Heinz Grunze, + 4 More

Psychiatry and Behavioral Sciences Faculty Publications

Background

Evidence suggests that patients with bipolar disorder from the United States have an earlier age of onset and a more difficult course of illness than those from Germany and the Netherlands. These characteristics were related to a greater family burden of psychiatric illness and the experience of more psychosocial adversity in childhood. We hypothesized that this greater illness burden would extend to the offspring of the US patients.

Methods

968 outpatients (average age 41) with bipolar illness gave informed consent for participation in a treatment outcome network and filled out a detailed questionnaire about their illness and family history …

Psychiatric Boarding In New Hampshire: Violation Of A Statutory Right To Treatment, James A. Mcclure

The University of New Hampshire Law Review

[Excerpt] "New Hampshire law provides for the involuntary commitment of a patient such as Jane when she is a danger to herself or others as a result of mental illness. The patient has a right to treatment under N.H. Rev. Stat. Ann. § 135-C:1, et seq. Specifically, the patient should receive "adequate and humane treatment" pursuant to an "individual service plan" and "in the least restrictive environment necessary." However, appropriate facilities often are not available for patients waiting in emergency rooms, and patients can become trapped for hours or even days. This phenomenon is called "psychiatric boarding."

New Hampshire is …

A Nursing Approach To Self-Management Education For Individuals With Mental Illness And Diabetes, Edna Fuentes-Casiano, Martha Sajatovic

Faculty Scholarship

Patients with serious mental illness (SMI) and diabetes often seek care in primary care settings and have worse health outcomes than patients who have either illness alone. Individual, provider, and system-level barriers present challenges to addressing both psychiatric and medical comorbidities. This article describes the feasibility, acceptability, and implementation of Targeted Training and Illness Management (TTIM), a self-management intervention delivered by trained nurse educators and peer educators to groups of individuals with SMI and diabetes to improve self-management of both diseases. TTIM is intended to be delivered in a primary care setting. Findings are intended to support the future development …

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …

Hiv/Aids Care And Prevention Infrastructure In The U.S. Deep South, Susan S. Reif, Kristen Sullivan, Elena Wilson, Miriam Berger, Carolyn Mcallaster

Faculty Scholarship

No abstract provided.

Art Therapy And Cancer Care: A Qualitative Analysis Of Visual Oncology Narratives, Jill Mcnutt

Expressive Therapies Dissertations

This document reviews the artworks created in the form of visual narratives of cancer survivors. The work sought to explore the subjective experience of cancer and explore potential functions of art therapy in oncology care. Previous research found stages of the cancer trajectory and psychosocial benefits of art therapy. Fifteen adult cancer survivors created visual narratives and participated in this qualitative inquiry. The research was action-based and used arts based and qualitative methodologies. Eight themes emerged and reflected stages of the cancer experience and corresponding functions of art therapy participation. The themes included: diagnosis and the onset of the cancer …

Embodied Creative Arts Therapy Interventions With Trauma: A Qualitative Study, Brian Timothy Harris

Expressive Therapies Dissertations

With the primary purpose to extend therapists’ knowledge base, open dialogue on treatment efficacy, and stimulate creative yet effective interventions, this two-phase qualitative study pursued the guiding research question, How do creative arts therapists use embodied interventions in the treatment of psychological trauma? Phase One of the study was conducted with music therapists who had extensive experience with trauma and reported on their experiences with and awareness of embodied trauma treatment through a broad spectrum of creative modalities. Phase Two was grounded in theories of body awareness and creative arts therapy applications and included therapists specializing in music, dance/movement, art, …

A Culture That Fosters Concussions: Does Increased Education Lead To More Accurate Reporting Of Concussions?, Michael Heptig

PCOM Psychology Dissertations

With over 1.7 million incidents reported annually, concussion has become the most common class of traumatic brain injury (TBI) in the United States (Bazarian, Zhu, Blyth, Borrino, & Zhong, 2012). As staggering a statistic as this may be, many believe it fails to represent the true number of concussions because the non-reporting of symptoms has been commonplace among athletes (Khurana & Kaye, 2012; Williamson & Goodman, 2006). The aim of this study was to determine those factors that influence the reporting of concussion symptoms. Specific variables that were examined include the amount of concussion education provided (determined by requisite amount …

Low Self-Esteem Leads To Depression Among Elderly: Case Study Of Nursing Home, Savera Aziz Ali, Nadir Suhail, Sumera Aziz Ali

School of Nursing & Midwifery

Background: Self-esteem is defined as “how we value our self”; it affects our trust and relationships in every part of life. Person with low self-esteem may feel powerless and incompetent about himself/herself. Moreover, low self-esteem operates as a risk factor for depression, which is most common disorder among elderly people both in developed and developing countries, causing multiple behavioral changes as well as may increase the chances of depression and suicide among the elderly people. Objective: The objective of this case study was to understand the problems faced by elderly people in the nursing home and to relate the self-esteem …

Perceptions And Attitudes Of A Sample Of Primary Care Patients Receiving Psychological Care From Their Pcp, Nadine Henzes Gowarty

PCOM Psychology Dissertations

With millions of Americans suffering from a mental health disorder and slightly more than half receiving treatment, the demand for psychological services far outweighs the number of practitioners available to provide direct care. Therefore, the majority of all primary-care visits are based on psychosocial factors; one third of a PCP’s caseloads consist of patients with mental-health problems. Given the fact that PCPs provide comprehensive psychosocial care, it is important to determine the beliefs and perceptions of their patients. Results from this study identified numerous factors that influence the relationship between patients receiving mental health care from their PCP. Specifically, if …

The Effects Of A Trauma-Informed Care Training Program On Mental Health Professionals Knowledge, Skills, And Attitudes With The Smi, Angelina Pelletier

PCOM Psychology Dissertations

Trauma has been found to be highly prevalent among individuals diagnosed with SMIs. Mental health professionals have been reported to misdiagnose or avoid addressing trauma in this population. There is a need to provide information about trauma and to foster awareness among mental health professionals who are treating individuals diagnosed with SMIs. With a TIC approach, operating from a recovery-oriented philosophy, there have been interventions created to address trauma and SMIs with the aim of developing awareness about trauma and the impact it may have on someone’s life. With these factors in mind, mental health professionals should be competent in …

The Relationship Between Emotion Regulation, Social Support, And Alcohol-Related Problems Among Racially Diverse Adolescents., Briana A. Woods-Jaeger, Richard H. Nobles, Linnea Warren, Mary E. Larimer

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Development And Evaluation Of A Peer-To-Peer Intervention To Increase Self-Management Among Adult In-Center Hemodialysis Patients, Jennifer J. St Clair Russell

Theses and Dissertations

Background: Peer-to-peer (P2P) support programs have the potential to assist ESRD patients in managing their disease and improve outcomes. Yet, there is little research examining P2P programs’ impact on psychosocial outcomes and disease management behaviors.

Methods: A 4-month P2P mentoring intervention was designed and piloted in a facility serving 249 in-center hemodialysis patients in Lynchburg, Virginia. Preceded by a social marketing effort, which included a program naming contest and participant recruitment, the intervention included: (1) mentor training, (2) pairing of mentees and mentors, (3) kick-off social mixers, (4) ongoing meetings between mentees and mentors, (5) mentor training booster, and (6) …

Reasons For Tubal Sterilisation, Regret And Depressive Symptoms, Karina M. Shreffler, Arthur L. Greil, Julia Mcquillan, Kami L. Gallus

Department of Sociology: Faculty Publications

Objective—To examine the associations between sterilisation reasons, regret, and depressive symptoms.

Study Design—Black, Hispanic, and non-Hispanic White US women ages 25–45 who participated in the National Survey of Fertility Barriers (NSFB) and reported a tubal sterilisation surgery were included in the sample for this study (n=837). Logistic regression was used to examine how characteristics of the sterilisation surgery (reasons for sterilisation, time since sterilisation, and new relationship since sterilisation) are associated with the odds of sterilisation regret, and linear regression was used to examine associations between sterilisation regret, sociodemographic factors, and depressive symptoms.

Results—Findings revealed that 28 …

Examination Of The Relationship Between Caesarean Section Births And Attention Deficit Hyperactivity Disorder, Breea M. Rosas

All Master's Theses

Attention Deficit/Hyperactivity Disorder, a neurological disorder characterized by inattentive and hyperactive behaviors, has become increasingly more prevalent (CDC, 2010). Recent research has found associations between this disorder and Caesarean section births (Amiri et al., 2012; Juarez et al., 2008). The current study examined the relationship between C-section birth and self-reported symptoms of ADHD by college students on the Internal Restlessness Scale (Weyandt et al., 2003). Results of the study indicate a significant difference in mean ratings of ADHD symptoms between C-section and vaginally born participants (t = 3.683, p < .000). The current study supports previous findings of a relationship between C-sections and ADHD.

Healthcare Access In Women’S Prisons: An Intersectional Perspective, Megan R. Bray

Undergraduate Research Posters

This project will be identifying the key factors that contribute to the significant lack of health care in prisons in the U.S., specifically in women’s correctional facilities. I will be lending my focus to disparities in mental health, HIV/AIDs care, reproductive health, trans health, and physical health issues among women who are either currently incarcerated or those who have completed their sentences and are at higher risk for re-entry after attempting re-integration. There is a lack of care, access, and proper treatment for women inmates in U.S. prisons and reform is needed. I foresee the best possible way to accomplish …

The Efficacy Of Psychosocial Services In Comprehensive Cancer Care: A Program Evaluation, Nicola B. Mucci

Antioch University Dissertations & Theses

On average, regardless of other factors, persons affected by cancer will experience some level of distress associated with the disease and its sequelae. Left untreated, psychosocial problems can, and often do, adversely affect a person's health and healthcare treatment. As a result, national initiatives have been implemented to recognize and treat psychosocial stressors to optimize a person's functioning and facilitate successful movement through the medical system. A program evaluation was conducted to examine how Providence Regional Cancer Partnership has addressed the psychosocial needs of its patient population. Specifically, the psychosocial services department, Patient Support Services, was evaluated to understand how …

794 Evaluating Disability In Adult Burn Injury Patients Treated At A Tertiary-Care Burn Unit In Karachi, Pakistan: A Longitudinal Study Using Who Disability Assessment Schedule Ii, Nukhba Zia, Asim Durrani, Safia Awan, Madiha Hashmi, Mazhar Nizam, Asad Latif

Department of Anaesthesia

Background: Disability after burn injury is not assessed in the context of Pakistan. This study assesses disability among adult burn injury patients presenting to a burn unit in Karachi, Pakistan.
Methods: This longitudinal study was conducted at a burn centre is Karachi, Pakistan. Adult patients(>18 years) who were discharge after 24-hour admission were enrolled from August 2014–March 2015. Baseline assessment before discharge and follow-up at 2,6 and 12 weeks after discharge via telephone was done using 12-item WHODAS 2.0 (5 -point likert-scale; 1 = none; 2 = mild; 3 = moderate; 4 = severe; and 5 = extreme) related …

Initiation And Retention In Couples Outpatient Treatment For Parents With Drug And Alcohol Use Disorders, Abbly L. Braitman, Michelle L. Kelley

Psychology Faculty Publications

The focus of the current study was to identity mental health, relationship factors, substance use related problems, and individual factors as predictors of couples-based substance abuse treatment initiation and attendance. Heterosexual couples with children that met study criteria were invited to attend 12 sessions of outpatient behavioral couples therapy. Men were more likely to initiate treatment if they had a higher income, had greater relationship satisfaction, were initiating treatment for alcohol use disorder only, were younger when they first suspected a problem, and had higher depression but lower hostility or phobic anxiety. Men attended more treatment sessions if they reported …

Prevalence And Determinants Of Postpartum Depression In A Tertiary Care Hospital, Shiyam Sunder Tikmani, Tufail Soomro, Prashant Tikmani

Community Health Sciences

Purpose: Postpartum depression is one of the common complication of postpartum period and a major public health issue. It adversely affects the mother, her child, and the family. To determine the prevalence and determinants of postpartum depression in women delivered in a tertiary hospital Karachi.
Methods: This was a cross-sectional study carried out in a private hospital of Karachi, from 1^st February 2014 to 31^st January 2016. All women having age between 20-49 years between 4-6 weeks postpartum period consented to participate were included. Women with pre-existing co-morbid like diabetes mellitus, hypertension, physical and psychiatric illnesses, having multigestation …

Depression With Pain Co Morbidity Effect On Quality Of Life Among Hiv Positive Patients In Uganda: A Cross Sectional Study, Shirley Moore, Martha Sajatovic

Faculty Scholarship

Background: Depression with pain comorbidity (DPC) has not been clearly defined among HIV positive patients in sub-Saharan Africa. It still remains a challenge despite many studies in Africa documenting a high prevalence of pain and depression among people living with HIV/AIDS. Both are associated with a grave impact on the health related outcomes in this pandemic. This study aimed at determining the prevalence, factors associated and effect on quality of life of DPC among HIV positive patients. Methods: In a cross-sectional survey, 345 HIV positive patients were enrolled into the study. Using a pre-tested standardised questionnaire the presence of DPC …

Knowledge, Attitudes And Perceptions Of Stroke: A Cross-Sectional Survey In Rural And Urban Uganda, Svetlana Pundik, Anthony J. Furlan, Martha Sajatovic

Faculty Scholarship

Background: Information regarding the increasing burden of non-communicable diseases such as stroke is largely unknown among the vulnerable communities. This analysis, which is part of a larger U.S. National Institute of Heath-funded Medical Education Partnership Initiative neurological disorder survey, assessed community knowledge and attitudes on stroke and stroke risk factors. Methods: A population cross-sectional survey was conducted in urban and rural Mukono, district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants who were interviewed about selected aspects of stroke knowledge, attitudes and perception using a pretested structured questionnaire. Results: A total of 377 participants …

Knowledge, Attitudes, And Intentions Toward Fertility Awareness And Oocyte Cryopreservation Among Obstetrics And Gynecology Resident Physicians, L. Yu, Brennan Peterson, M. C. Inhorn, Julia K. Boehm, P. Patrizio

Marriage and Family Therapy Faculty Articles and Research

STUDY QUESTION What knowledge, attitudes and intentions do US obstetrics and gynecology (OB/GYN) residents have toward discussing age-related fertility decline and oocyte cryopreservation with their patients?

SUMMARY ANSWER Most OB/GYN residents believe that age-related fertility decline, but not oocyte cryopreservation, should be discussed during well-woman annual exams; furthermore, nearly half of residents overestimated the age at which female fertility markedly declines.

WHAT IS KNOWN ALREADY Oocyte cryopreservation can be utilized to preserve fertility potential. Currently, no studies of US OB/GYN residents exist that question their knowledge, attitudes, and intentions toward discussing age-related fertility decline and oocyte cryopreservation with patients.

STUDY …

Asenapine For Bipolar Disorder, Thomas Scheidemantel, Irina Korobkova, Martha Sajatovic

Faculty Scholarship

Asenapine (Saphris®) is an atypical antipsychotic drug which has been approved by the US Food and Drug Administration for the treatment of schizophrenia in adults, as well as the treatment of acute manic or mixed episodes of bipolar I in both adult and pediatric populations. Asenapine is a tetracyclic drug with antidopaminergic and antiserotonergic activity with a unique sublingual route of administration. In this review, we examine and summarize the available literature on the safety, efficacy, and tolerability of asenapine in the treatment of bipolar disorder (BD). Data from randomized, double-blind trials comparing asenapine to placebo or olanzapine in the …

Post-Stroke Depression Among Stroke Survivors Attending Two Hospitals In Kampala Uganda, Martha Sajatovic, Kathyleen Smyth

Faculty Scholarship

Background: The burden of stroke worldwide is increasing rapidly. There is paucity of data on post-stroke depression (PSD) among stroke survivors in Uganda, despite the high prevalence of PSD reported elsewhere. Methods: In a cross-sectional study, we assessed adult participants with confirmed first stroke with a standardized questionnaire. The Patient Health Questionnaire-9 was used to assess for depression among non-aphasic patients while the Aphasic Depression Rating Scale was administered to aphasic patients. Univariable and multivariable analyses performed to describe associations with PSD. Results: Forty three females (58.9%) and 30 males (41.1%) who had a stroke participated. Fifty eight (79.5%) had …

The Effect Of Mindfulness Meditation On Emotional Distress In Adult Cancer Patients, Marie A. Benoit

Evidence-Based Practice Project Reports

Significant advances in cancer treatments have been made over recent decades resulting in state of the art screening and treatment options that have contributed to higher rates of cancer survivorship. However, despite the increase in cancer survivors, a cancer diagnosis continues to be associated with a significant amount of emotional distress and psychological issues that further add to the burden of the disease. The Institute of Medicine (2008), recognizes that a failure to adequately address this problem results in needless suffering and may obstruct quality of care; thereby, leading to a potentially negative impact on the disease course. Among the …

Knowledge And Attitudes Of Parkinson's Disease In Rural And Urban Mukono District, Uganda: A Cross-Sectional, Community-Based Study, Martha Sajatovic

Faculty Scholarship

Background. Parkinson's disease (PD) negatively affects the quality of life. There is limited information on PD published from Africa. Lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care for individuals with PD. Methods. A cross-sectional survey was conducted in urban and rural Mukono district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants, interviewed on selected aspects of PD knowledge and attitudes. Results. Of the 377 participants, 47% were from urban settings and 68% (260/377) were women with a median age (IQR) of 34 (26-48) years. Half of the …

Standards Of Evidence For Efficacy, Effectiveness, And Scale-Up Research In Prevention Science: Next Generation., Denise C. Gottfredson, Thomas D. Cook, Frances E.M. Gardner, Deborah Gorman-Smith, George W. Howe, Irwin N. Sandler, Kathryn M. Zafft

Psychiatry and Behavioral Sciences Faculty Publications

A decade ago, the Society of Prevention Research (SPR) endorsed a set of standards for evidence related to research on prevention interventions. These standards (Flay et al., Prevention Science 6:151-175, 2005) were intended in part to increase consistency in reviews of prevention research that often generated disparate lists of effective interventions due to the application of different standards for what was considered to be necessary to demonstrate effectiveness. In 2013, SPR's Board of Directors decided that the field has progressed sufficiently to warrant a review and, if necessary, publication of "the next generation" of standards of evidence. The Board convened …