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Articles 1 - 30 of 92
Full-Text Articles in Mental and Social Health
Toward A Unified Neuroaesthetic Framework For Art-Based Interventions In Substance Use Recovery - A Review, Piper Hutson, James Hutson
Toward A Unified Neuroaesthetic Framework For Art-Based Interventions In Substance Use Recovery - A Review, Piper Hutson, James Hutson
Faculty Scholarship
Art-based interventions have gained increasing recognition as complementary strategies for substance use disorder (SUD) recovery and prevention, yet the field remains fragmented across clinical art therapy, community-based programs, and expressive digital practices. This article advances a unified neuroaesthetic framework that integrates sensory regulation, narrative integration, and interpersonal synchronization as the core mechanisms of healing. Drawing on recent U.S.-based empirical studies (post-2020), the paper synthesizes evidence from multiple modalities, including visual arts, music therapy, dance/movement practices, and digital storytelling, each demonstrating measurable effects on craving reduction, stress regulation, identity reconstruction, and social connection. Neuroscientific insights are central: findings highlight how creative …
Gaming As Therapeutic Modality For Military Veterans: Evidence, Mechanisms, And Program Design, Piper Hutson, James Hutson
Gaming As Therapeutic Modality For Military Veterans: Evidence, Mechanisms, And Program Design, Piper Hutson, James Hutson
Faculty Scholarship
This study synthesizes interdisciplinary evidence on game-based interventions for military veterans, mapping neurological mechanisms to clinically relevant outcomes while outlining design principles for community programs that leverage interactive media. The review characterizes how structured gameplay supports emotional regulation through attentional control, predictable feedback schedules, and reward-mediated learning that elevates motivation and mood; links to dopaminergic signaling and reduced rumination suggest plausible pathways for affective stabilization. Executive functions receive targeted engagement via strategy, puzzle, and action mechanics that demand working memory, cognitive flexibility, inhibition, and rapid decision-making, providing ecologically valid practice with measurable transfer to daily functioning. Social architectures in multiplayer …
Integrating Art Therapy And Emerging Technologies For Enhanced Neuroplasticity And Ptsd Intervention, Piper Hutson, James Hutson
Integrating Art Therapy And Emerging Technologies For Enhanced Neuroplasticity And Ptsd Intervention, Piper Hutson, James Hutson
Faculty Scholarship
Post-traumatic stress disorder (PTSD) remains resistant to many conventional treatments, underscoring the need for integrative approaches that harness neuroplasticity. Art therapy, with its capacity to facilitate nonverbal trauma processing and multisensory engagement, has shown distinctive advantages over verbal and pharmacological interventions. Recent innovations, including virtual reality (VR), artificial intelligence (AI), and biofeedback have amplified the therapeutic efficacy of art-based interventions by enabling adaptive, real-time modulation of emotional and physiological states. This review synthesizes current research on technologically enhanced art therapy, comparing it to established treatments such as cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). Findings indicate …
Systematic Review On The Treatment Of Emotional Abuse Victimization In Women By An Intimate Partner, Günnur Karakurt, Rhea D’Silva, Çerağ Oğuztüzün, Ankita Choudhary, Keming Gao, Shari Bolen
Systematic Review On The Treatment Of Emotional Abuse Victimization In Women By An Intimate Partner, Günnur Karakurt, Rhea D’Silva, Çerağ Oğuztüzün, Ankita Choudhary, Keming Gao, Shari Bolen
Faculty Scholarship
Purpose: Emotional partner abuse, often closely intertwined with physical assault, involves persistent emotional mistreatment by an intimate partner. Despite its significance, research specifically focusing on emotional IPV is limited. This study systematically reviews the effectiveness of treatments for women victimized by emotional abuse from an intimate partner. Methods: Following the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions, we identified four relevant studies published between 2010 and 2019 with interventions designed for survivors of IPV. Results: The total sample size of 857 was included in the current study (I2 = 95%). Our systematic review revealed two …
Development Of A Self-Management Tool For Individuals With Seizure Clusters: Trial Design And Methodological Report, Molly Mcvoy, Eytan Hirsch, Luisa Londono, Kari Colón-Zimmermann, Jin Seok Cho, Martha Sajatovic
Development Of A Self-Management Tool For Individuals With Seizure Clusters: Trial Design And Methodological Report, Molly Mcvoy, Eytan Hirsch, Luisa Londono, Kari Colón-Zimmermann, Jin Seok Cho, Martha Sajatovic
Faculty Scholarship
Background: Despite advances in anti-seizure medications (ASMs) for people with epilepsy (PWE), adverse outcomes, negative health events (NHEs), and breakthrough seizures remain common. Rescue medication (RM) can better manage repetitive seizures, but barriers to RM use persist. Self-management for PWE and a history of NHEs (SMART) is an evidence-based epilepsy self-management program aimed at reducing barriers and maximizing facilitators to self-care in high-risk PWE. Methods: This 2-phase, ongoing clinical trial adapts SMART to integrate RM support for PWE with repetitive seizures. Phase 1, now completed, used input from an advisory board (AB) of PWE, caregivers, and clinicians to adapt the …
Psychosocial Burden And Suicidality In Epilepsy: A Public Health Concern, Martha Sajatovic
Psychosocial Burden And Suicidality In Epilepsy: A Public Health Concern, Martha Sajatovic
Faculty Scholarship
The increased risk for psychosocial burden and suicidality in people with epilepsy compared to the general population is a well-established global public health concern. Suicidality risk is also increased in patients with functional seizures. The timely identification of patients at highest risk for psychosocial burden and self-harm is vital. This can pose a significant challenge for multidisciplinary clinicians caring for people with epilepsy. Early identification of social stressors and comorbid psychiatric contributors via screening are required to assist with the development of predictive models for self-harm in epilepsy; and subsequent options for treatment and the provision of adjunct supports in …
Opportunities To Address Health Disparities In Suicidality For Sexual And Gender Minority Youth In Public Systems, Dana M. Prince, Kathleen Lewis, Peter S. Hovmand
Opportunities To Address Health Disparities In Suicidality For Sexual And Gender Minority Youth In Public Systems, Dana M. Prince, Kathleen Lewis, Peter S. Hovmand
Faculty Scholarship
No abstract provided.
Psychological Distress Among Family Caregivers Of Persons With Alzheimer’S Disease And Related Dementias In Uganda, Martha Sajatovic
Psychological Distress Among Family Caregivers Of Persons With Alzheimer’S Disease And Related Dementias In Uganda, Martha Sajatovic
Faculty Scholarship
Background: Alzheimer's disease and related dementias (ADRD) present growing global health challenges, especially in aging populations, such as Uganda. In Uganda, familial caregiving, predominantly undertaken by female relatives, is the primary form of support provided to patients with ADRD. Cultural stigma around dementia and limited access to support services amplify caregivers' challenges. This study examined psychological distress, depression, and quality of life (QoL) among family caregivers of patients with ADRD in Wakiso District, Uganda. Methods: This cross-sectional study involved 90 caregivers from three sub-counties in Wakiso, selected through purposive sampling to capture diverse experiences. Participants included caregivers aged 18 years …
Administration Patterns Of Magnesium Sulphate For Women With Preeclampsia And Immediate Newborn Outcomes In Kawempe National Referral Hospital-Uganda: A Cohort Study, Christopher J. Burant, Shirley Moore, Carol Blixen, Martha Sajatovic
Administration Patterns Of Magnesium Sulphate For Women With Preeclampsia And Immediate Newborn Outcomes In Kawempe National Referral Hospital-Uganda: A Cohort Study, Christopher J. Burant, Shirley Moore, Carol Blixen, Martha Sajatovic
Faculty Scholarship
Background: Preeclampsia is the second leading cause of maternal death in Uganda. WHO recommends using magnesium sulphate (MgSO4) to prevent and treat preeclampsia with severe features (PEC) and eclampsia. MgSO4 is used to prevent eclampsia and treat women who experience an eclamptic convulsion to avoid severe maternal/infant illnesses and death. We set out to assess MgSO4 administration patterns in women with PEC or eclampsia and the immediate newborn outcomes of neonates. Methods: This was an analytical observational cohort study at Kawempe National Referral Hospital in Uganda. Two hundred ten pregnant mothers with PEC or eclampsia were recruited in the study …
Examining Ptsd Prevalence Among Underserved Populations In The Integrated Community Mental Health Setting 2019 To 2022, Siran Koroukian, Stephen Zyzanski, Kurt C. Stange
Examining Ptsd Prevalence Among Underserved Populations In The Integrated Community Mental Health Setting 2019 To 2022, Siran Koroukian, Stephen Zyzanski, Kurt C. Stange
Faculty Scholarship
Background: The prevalence of Post Traumatic Stress Disorder (PTSD) has been rising since the start of the COVID-19 pandemic, and affects females, sexual and gender minorities, and individuals with social risks at higher rates. Objective: This study examines if the prevalence of PTSD increased from 2019 to 2022 among patients who received care in a national network of safety-net, community-based health centers with integrated behavioral health programs that serve patients at high risk for PTSD. Methods: We analyzed electronic health record data from patients with 1 or more behavioral health visits during 2019 to 2022 using repeated cross-sectional data to …
Early Use Of Long-Acting Injectable Antipsychotics In Bipolar Disorder Type I: An Expert Consensus, Martha Sajatovic
Early Use Of Long-Acting Injectable Antipsychotics In Bipolar Disorder Type I: An Expert Consensus, Martha Sajatovic
Faculty Scholarship
Introduction: Long-acting injectable antipsychotics (LAIs) are not routinely offered to patients living with bipolar disorder type I (BP-I), despite widespread evidence that supports their benefits over oral antipsychotics, particularly in early disease. Methods: A round-table meeting of psychiatrists convened to discuss barriers and opportunities and provide consensus recommendations around the early use of LAIs for BP-I. Results: LAIs are rarely prescribed to treat BP-I unless a patient has severe symptoms, sub-optimal adherence to oral antipsychotics, or has experienced multiple relapses. Beyond country-specific accessibility issues (e.g., healthcare infrastructure and availability/approval status), primary barriers to the effective use of LAIs were identified …
Proceedings Of The 2022 “Lifestyle Intervention For Epilepsy (Life)” Symposium Hosted By Cleveland Clinic, Martha Sajatovic
Proceedings Of The 2022 “Lifestyle Intervention For Epilepsy (Life)” Symposium Hosted By Cleveland Clinic, Martha Sajatovic
Faculty Scholarship
Lifestyle interventions are strategies used to self-manage medical conditions, such as epilepsy, and often complement traditional pharmacologic and surgical therapies. The need for integrating evidence-based lifestyle interventions into mainstream medicine for the treatment of epilepsy is evident given that despite the availability of a multitude of treatments with medications and surgical techniques, a significant proportion of patients have refractory seizures, and even those who are seizure-free report significant adverse effects with current treatments. Although the evidence base for complementary medicine is less robust than it is for traditional forms of medicine, the evidence to date suggests that several forms of …
Clinical Correlates Of Perceived Stigma Among People Living With Epilepsy Enrolled In A Self-Management Clinical Trial, Martha Sajatovic, Martha Sajatovic, Jessica Black, Jacqueline Krehel-Montgomery, Grace Mcdermott, Joy Yala, Richard Barigye, Clara Adeniyi, Farren Briggs
Clinical Correlates Of Perceived Stigma Among People Living With Epilepsy Enrolled In A Self-Management Clinical Trial, Martha Sajatovic, Martha Sajatovic, Jessica Black, Jacqueline Krehel-Montgomery, Grace Mcdermott, Joy Yala, Richard Barigye, Clara Adeniyi, Farren Briggs
Faculty Scholarship
Background and Purpose: Stigma is a pervasive barrier for people living with epilepsy (PLWE) and can have substantial negative effects. This study evaluated clinical correlates of perceived stigma in a research sample of PLWE considered to be at high risk due to frequent seizures or other negative health events. Methods: Analyses were derived from baseline data from an ongoing Centers for Disease Control and Prevention (CDC)-funded randomized controlled trial (RCT) testing an epilepsy self-management approach. Standardized measures assessed socio-demographics, perceived epilepsy stigma, epilepsy-related self-efficacy, epilepsy self-management competency, health literacy, depressive symptom severity, functional status, social support and epilepsy-related quality of …
Preferences For Attributes Of Oral Antipsychotic Treatments: Results From A Discrete-Choice Experiment In Respondents With Schizophrenia Or Bipolar I Disorder, Martha Sajatovic
Preferences For Attributes Of Oral Antipsychotic Treatments: Results From A Discrete-Choice Experiment In Respondents With Schizophrenia Or Bipolar I Disorder, Martha Sajatovic
Faculty Scholarship
Background: Antipsychotic medications are effective treatments for schizophrenia (SZ) and bipolar I disorder (BD-I), but when presented with different treatment options, there are tradeoffs that individuals make between clinical improvement and adverse effects. As new options become available, understanding the attributes of antipsychotic medications that are valued and the tradeoffs that individuals consider when choosing among them is important. Methods: A discrete-choice experiment (DCE) was administered online to elicit preferences across 5 attributes of oral antipsychotics: treatment efficacy (i.e., improvement in symptom severity), weight gain over 6 months, sexual dysfunction, sedation, and akathisia. Eligible respondents were aged 18–64 years with …
A 6-Month, Prospective, Randomized Controlled Trial Of Customized Adherence Enhancement Versus A Bipolar-Specific Educational Control In Poorly Adherent Adolescents And Young Adults Living With Bipolar Disorder, Jennifer B. Levin, Molly Mcvoy, Joy Yala, Jessica Black, Carla Conroy, Martha Sajatovic
A 6-Month, Prospective, Randomized Controlled Trial Of Customized Adherence Enhancement Versus A Bipolar-Specific Educational Control In Poorly Adherent Adolescents And Young Adults Living With Bipolar Disorder, Jennifer B. Levin, Molly Mcvoy, Joy Yala, Jessica Black, Carla Conroy, Martha Sajatovic
Faculty Scholarship
Objective: Few studies have addressed medication adherence in adolescents and young adults (AYAs) with bipolar disorder (BD). This 6-month prospective randomized-controlled trial (RCT) tested customized adherence enhancement for adolescents and young adults (CAE-AYA), a behavioral intervention for AYAs versus enhanced treatment as usual (ETAU). Methods: Inclusion criteria were AYAs age 13–21 with BD type I or II with suboptimal adherence defined as missing ≥20% of medications. Assessments were conducted at Screening, Baseline, and weeks 8, 12 and 24. Primary outcome was past 7 day self-reported Tablets Routine Questionnaire (TRQ) validated by electronic pillbox monitoring (SimpleMed). Symptom measures included the Hamilton …
Excess Prevalence Of Preexisting Chronic Conditions In Older Adults With Incident Epilepsy, Siran M. Koroukian, Hannah L. Fein, Long Vu, Wyatt P. Bensken, Nicholas K. Schiltz, Martha Sajatovic
Excess Prevalence Of Preexisting Chronic Conditions In Older Adults With Incident Epilepsy, Siran M. Koroukian, Hannah L. Fein, Long Vu, Wyatt P. Bensken, Nicholas K. Schiltz, Martha Sajatovic
Faculty Scholarship
Objective: Prior studies have examined chronic conditions in older adults with prevalent epilepsy, but rarely among those with incident epilepsy. Identifying the chronic conditions with which older adults present at epilepsy incidence assists with the evaluation of disease burden in this patient population and informs coordinated care development. The aim of this study was to identify preexisting chronic conditions with excess prevalence in older adults with incident epilepsy compared to those without. Methods: Using a random sample of 4 999 999 fee-for-service Medicare beneficiaries aged >65 years, we conducted a retrospective cohort study of epilepsy incidence in 2019. Non-Hispanic Black …
Development Of An International Standard Set Of Outcomes And Measurement Methods For Routine Practice For Infants, Children, And Adolescents With Epilepsy: The International Consortium For Health Outcomes Measurement Consensus Recommendations, Martha Sajatovic
Faculty Scholarship
At present, there is no internationally accepted set of core outcomes or measurement methods for epilepsy clinical practice. The International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group of experts in epilepsy, people with epilepsy, and their representatives to develop minimum sets of standardized outcomes and outcome measurement methods for clinical practice. Using modified Delphi consensus methods with consecutive rounds of online voting over 12 months, a core set of outcomes and corresponding measurement tool packages to capture the outcomes were identified for infants, children, and adolescents with epilepsy. Consensus methods identified 20 core outcomes. In addition …
Violence Exposure And Trauma Screener For Youth (Vetsy), Daniel Joseph Flannery, Ivette Noriega, Mark Singer, Jeff Kretschmar
Violence Exposure And Trauma Screener For Youth (Vetsy), Daniel Joseph Flannery, Ivette Noriega, Mark Singer, Jeff Kretschmar
Faculty Scholarship
Background: Youth exposed to violence are at serious risk for physical, emotional, behavioral, and mental distress. Reliable and prompt detection is necessary to mitigate the psychological consequences of youth violence exposure and trauma. Objective: To describe the initial creation of the VETSY screener and its construct validity and potential use. Methods: From 2014 through 2022 we surveyed 20,532 at-risk youth aged 8–18 years from a diverse metropolitan community participating in the Defending Childhood Initiative (DCI). Youth completed a 17-item self-report screener. An Exploratory Factor Analysis (EFA) was used to determine the reliability and variable grouping for this brief screener. Violence …
Development Of An International Standard Set Of Outcomes And Measurement Methods For Routine Practice For Adults With Epilepsy: The International Consortium For Health Outcomes Measurement Consensus Recommendations, Martha Sajatovic
Faculty Scholarship
At present, there is no internationally accepted set of core outcomes or measurement methods for epilepsy clinical practice. Therefore, the International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group of experts in epilepsy, people with epilepsy and their representatives to develop minimum sets of standardized outcomes and outcomes measurement methods for clinical practice that support patient–clinician decision-making and quality improvement. Consensus methods identified 20 core outcomes. Measurement tools were recommended based on their evidence of strong clinical measurement properties, feasibility, and cross-cultural applicability. The essential outcomes included many non-seizure outcomes: anxiety, depression, suicidality, memory and attention, sleep …
“So, Do Not Fear”: Religion And The Prevalence, Persistence, And Severity Of Anxiety Disorders Among Black Americans, Ann W. Nguyen, Nichole Cobb, Kedong Ding
“So, Do Not Fear”: Religion And The Prevalence, Persistence, And Severity Of Anxiety Disorders Among Black Americans, Ann W. Nguyen, Nichole Cobb, Kedong Ding
Faculty Scholarship
Background: There is a dearth of scholarship that explicates the effects of religious participation on anxiety disorders among Black Americans. A better understanding of the links between religious participation, a coping resource, and anxiety disorders among Black Americans remains essential, given Black Americans are less likely than their white counterparts to seek professional treatment for mental health problems, leading to greater unmet mental health needs. The aim of this study was to investigate whether religious participation is associated with the prevalence, persistence, and severity of anxiety disorders among Black adults. Methods: We used a national sample of Black adults (N …
Earlier Use Of Long-Acting Injectable Paliperidone Palmitate Once-Monthly Versus Oral Antipsychotics In Patients With Schizophrenia: An Integrated Patient-Level Meta Analysis Of The Prosipal And Pride Studies, Martha Sajatovic
Faculty Scholarship
Purpose: A previous integrated patient-level analysis demonstrated a significant benefit of implementing once-monthly injectable paliperidone palmitate (PP1M) earlier in the treatment course for schizophrenia. Earlier therapeutic interventions during the first 3–5 years after disease onset can positively impact long-term outcomes in schizophrenia. This present analysis evaluated the risk of relapse both overall and by different durations of illness (0–3 years, >3–5 years, and >5 years from diagnosis) in adult patients with schizophrenia who received PP1M or oral antipsychotics (OAPs). Patients and Methods: This analysis included integrated patient-level data from the Paliperidone Palmitate Research in Demonstrating Effectiveness (PRIDE) and Prevention of …
The Sense Of Safety Theoretical Framework: A Trauma-Informed And Healing-Oriented Approach For Whole Person Care, Kurt C. Stange
The Sense Of Safety Theoretical Framework: A Trauma-Informed And Healing-Oriented Approach For Whole Person Care, Kurt C. Stange
Faculty Scholarship
Objectives: This research describes four aspects of the development of the Sense of Safety Theoretical Framework for whole person care: exploring the meaning of the phrase “sense of safety”—the whole person language; the range of human experience that impacts sense of safety—whole person scope; the dynamics that build sense of safety—the healing goals; and the personal and cross-disciplinary trauma-informed practitioner skills and attitudes that facilitate sense of safety. Methods: This qualitative participatory study was conducted in two phases. Researchers iteratively explored the concept of sense of safety using focus groups and semi-structured interviews. Overarching research questions were: “Does the transdisciplinary …
Leczenie Uzależnień Materiały Na Zamówienie [Addiction Treatment: Requested Materials], Jaroslaw Richard Romaniuk
Leczenie Uzależnień Materiały Na Zamówienie [Addiction Treatment: Requested Materials], Jaroslaw Richard Romaniuk
Faculty Scholarship
Książka będąca poradnikiem i przewodnikiem po świecie uzależnień jest zbiorem wcześniej opublikowanych artykułów autora, który ma bardzo bogate doświadczenie teoretyczne i praktyczne w tym zakresie. Autor pokazuje swoje spojrzenie na uzależnienia chemiczne i behawioralne, na rolę stresu i traumy w leczeniu uzależnień. Niejako przy okazji dzieli się szeroką i ugruntowaną wiedzą o najnowszych metodach leczenia w USA i wyjaśnia wiele kwestii związanych poruszanymi zagadnieniami, jednocześnie wskazując na wiele wątpliwości i pytań, na które trudno udzielić jednoznacznej odpowiedzi. Tym samym dowodzi, że problematyka uzależnień i ich leczenia jest wielowymiarowa i skomplikowana, co utrudnia stosowanie metod i praktyk.
Głównym walorem tej książki …
Crushing The Contents Of Valbenazine Capsules For Potential Addition To Soft Foods Or Administration Via Gastrostomy Tube, Martha Sajatovic
Crushing The Contents Of Valbenazine Capsules For Potential Addition To Soft Foods Or Administration Via Gastrostomy Tube, Martha Sajatovic
Faculty Scholarship
Purpose: One-capsule, once-daily valbenazine is approved for tardive dyskinesia and under evaluation for chorea associated with Huntington's disease, conditions in which patients often experience dysphagia. In vitro studies were conducted to assess the suitability of crushing the contents of valbenazine capsules (40 and 80 mg) for mixing with soft foods or liquids or administration via a gastrostomy tube (G-tube). Methods: In study 1, the dissolution of whole valbenazine capsules and crushed capsule contents were measured serially for 1 hour. In study 2, valbenazine recovery was evaluated after crushed contents were mixed with soft foods, buffer solutions (pH range, 1.2–6.8), and …
Demographic And Clinical Associations To Employment Status In Older-Age Bipolar Disorder: Analysis From The Gage-Bd Database Project, Amulya Mallu, Carol K. Chan, Kaylee Sarna, Joy Yala, Farren B.S. Briggs, Martha Sajatovic
Demographic And Clinical Associations To Employment Status In Older-Age Bipolar Disorder: Analysis From The Gage-Bd Database Project, Amulya Mallu, Carol K. Chan, Kaylee Sarna, Joy Yala, Farren B.S. Briggs, Martha Sajatovic
Faculty Scholarship
Objective: The current literature on employment in older adults with bipolar disorder (OABD) is limited. Using the Global Aging and Geriatric Experiments in Bipolar Disorder Database (GAGE-BD), we examined the relationship of occupational status in OABD to other demographic and clinical characteristics. Methods: Seven hundred and thirty-eight participants from 11 international samples with data on educational level and occupational status were included. Employment status was dichotomized as employed versus unemployed. Generalized linear mixed models with random intercepts for the study cohort were used to examine the relationship between baseline characteristics and employment. Predictors in the models included baseline demographics, education, …
Evidence-Supported Interventions For Reducing Secondary Stroke Risk In Sub-Saharan Africa: A Systematic Review, Alyssa M. Edwards, Christopher J. Burant, Shirley M. Moore, Carol Blixen, Maratha Sajatovic
Evidence-Supported Interventions For Reducing Secondary Stroke Risk In Sub-Saharan Africa: A Systematic Review, Alyssa M. Edwards, Christopher J. Burant, Shirley M. Moore, Carol Blixen, Maratha Sajatovic
Faculty Scholarship
The study set out to perform a systematic literature review of evidence-based interventions that target the reduction of secondary stroke risk in Africa. The review analyzed longitudinal intervention studies conducted in Sub-Saharan Africa, focusing on adult participants who had suffered a prior stroke. It encompassed publications and peer-reviewed papers sourced from reputable databases, including PubMed, Ovid, Cochrane, and Web of Science. Three randomized clinical trial (RCT) studies were included with sample sizes ranging from 16 to 400 participants, mean age ranged between 50 and 66 years, with 64.5% male participants. All studies applied multidisciplinary team interventions of enhanced patient follow-up …
Fibrinogen; A Predictor Of Injury Severity And Mortality Among Patients With Traumatic Brain Injury In Sub-Saharan Africa: A Cross-Sectional Observational Study, Michael Devereaux, Martha Sajatovic
Fibrinogen; A Predictor Of Injury Severity And Mortality Among Patients With Traumatic Brain Injury In Sub-Saharan Africa: A Cross-Sectional Observational Study, Michael Devereaux, Martha Sajatovic
Faculty Scholarship
Studies show that fibrinogen concentrations <2 g/L in patients with traumatic brain injury (TBI) is associated with increased mortality. However, little is known regarding fibrinogen levels and TBI severity as well as mortality in sub-Saharan Africa despite shouldering a high burden of TBI. We therefore set out to determine whether fibrinogen levels are associated with TBI severity and outcome. To determine the sensitivity and specificity of fibrinogen levels and the association with severity and mortality among TBI patients at Mulago Hospital. We prospectively enrolled 213 patients with TBI aged between 13 and 60 years of age and presenting within 24 hours of injury. Patients with preexisting coagulopathy, concurrent use of anticoagulant or antiplatelet agents, preexisting hepatic insufficiency, diabetes mellitus and who were pregnant were excluded. Fibrinogen levels were determined using the Clauss fibrinogen assay. Logistic regression analyses were conducted to identify the association between fibrinogen level and 7-day outcomes. Majority of the patients were male (88.7%) and nearly half were aged 30 or less (48.8%). Fibrinogen levels <2 g/L were observed in 35.1% of the study participants. The average time spent in the study was 3.7 ± 2.4 days. The sensitivity and specificity using fibrinogen <2 g/L was 56.5% and 72.9% respectively. Fibrinogen levels predict TBI severity with an AUC = 0.656 (95% CI 0.58-0.73: P = .000) Fibrinogen levels <2 g/L (hypofibrinogenemia) were independently associated with severe TBI. (Adjusted odds ratio 2.87 CI, 1.34-6.14: P = .007). Levels above 4.5 g/L were also independently associated with injury severity (adjusted odds ratio 2.89, CI 1.12-7.48: P < .05) Fibrinogen levels more than 4.5 g/L were independently associated with mortality (OR 4.5, CI; 1.47-13.61, P < .05). The fibrinogen level is a useful tool in predicting severity including mortality of TBI. Fibrinogen levels may be used as an additional tool to screen TBI patients for injury severity especially among patients with Glasgow coma scale scores of <14.
Blood Pressure Variability And Early Neurological Outcomes In Acute And Subacute Stroke In Southwestern Uganda, Shirley M. Moore, Martha Sajatovic
Blood Pressure Variability And Early Neurological Outcomes In Acute And Subacute Stroke In Southwestern Uganda, Shirley M. Moore, Martha Sajatovic
Faculty Scholarship
Background: Greater blood pressure variability has detrimental effects on clinical outcome after a stroke; its effects are controversial and have not been evaluated in Sub-Saharan Africa (SSA). Methods: We conducted a prospective study of patients with CT head confirmed ischemic and hemorrhagic strokes admitted to a tertiary hospital within 7 days of onset of unilateral neurological deficits. Blood pressure variability indices, standard deviation (SD) and coefficient of variation (CV) of systolic and diastolic blood pressure between day 0 and day 7, were calculated with a subsequent modified Rankin Scale (mRS) score on day 14 post-stroke. Linear regression was performed to …
Aggressive End-Of-Life Care Across Gradients Of Cognitive Impairment In Nursing Home Patients With Metastatic Cancer, Siran M. Koroukian, Sara L. Douglas, Long Vu, Hannah L. Fein, Nicholas K. Schiltz, Jennifer Cullen, Cynthia Owusu, Martha Sajatovic, Johnie Rose
Aggressive End-Of-Life Care Across Gradients Of Cognitive Impairment In Nursing Home Patients With Metastatic Cancer, Siran M. Koroukian, Sara L. Douglas, Long Vu, Hannah L. Fein, Nicholas K. Schiltz, Jennifer Cullen, Cynthia Owusu, Martha Sajatovic, Johnie Rose
Faculty Scholarship
Background: Studies examining end-of-life (EOL) care in older cancer patients are scarce, and prior studies have not accounted for gradients of cognitive impairment (COG-I). We examine EOL care patterns across COG-I gradients, hypothesizing that greater COG-I severity is associated with lower odds of receiving aggressive EOL care. Methods: Using data from the linked Surveillance Epidemiology and End Results (SEER) -Medicare -Minimum Data Set (MDS) 3.0, we identified patients with nursing facility stays (NFS) and who died with metastatic cancer from 2013 to 2017. Markers of aggressive EOL care were: cancer-directed treatment, intensive care unit admission, >1 emergency department visit, or …
Treatment Of Trauma Using Horse Assisted Education In Poland, Kathleen J. Farkas, Jaroslaw Richard Romaniuk
Treatment Of Trauma Using Horse Assisted Education In Poland, Kathleen J. Farkas, Jaroslaw Richard Romaniuk
Faculty Scholarship
Trauma-informed care requires a sound therapeutic relationship to address trauma symptoms. People with trauma symptoms often cannot use their communication skills or do not possess the emotional stability to talk with others, and many drop out of treatment. Horse Assisted Education employs a partnership of horse and humans which leads to engagement and participation in experiential and narrative trauma treatment leading to sustained change and recovery. This paper illustrates a model of Horse Assisted Education in Poland, its application in the treatment of trauma symptoms. Three case studies are used to discuss the ways in which the human-animal partnerships foster …