Pullout strength and load to failure properties of self-tapping cortical screws in synthetic and cadaveric environments representative of healthy and osteoporotic bone.
*Bone Screws; *Bone Substitutes; *Models; *Osteoporosis; *Shear Strength; Biological; Biomechanical Phenomena; Cadaver; Equipment Design; Humans; Materials Testing/*methods; Mechanical; Stress
BACKGROUND: The parameters of self-tapping screw (STS) performance in normal and osteoporotic bone have been defined in representative environments, but the question remains as to the clinical application of such findings. The goal of this study was to analyze the biomechanical performance of STSs in cadaveric and synthetic environments representative of healthy and osteoporotic bone. METHODS: Ninety-six Synthes STSs were inserted into cadaveric and synthetic models representative of osteoporotic and healthy bone. Screws were inserted to depths of 1 mm short of the far cortex, flush and 1 mm and 2 mm beyond the far cortex. Screws were tested with an Instron 8511 material testing system utilizing axial pullout forces. A SAS procedure was used to conduct analysis of variance for unbalanced datasets. RESULTS: Substantial differences were appreciated with respect to screw performance between osteoporotic and healthy bone specimens. Although a similar pattern of increased pullout strength and loading energy with increasing depth of insertion was demonstrated, absolute values were lower in osteoporotic specimens. Although performance trends were similar in cadaveric and synthetic testing models for both osteoporotic and healthy bone, values obtained during testing were different. Incomplete insertion of STSs resulted in a 21.5% and 37% reduction of biomechanical properties in osteoporotic and normal bone, respectively. CONCLUSIONS: These results indicate that previously published findings on the performance of STSs in synthetic models cannot reasonably be applied to the clinical realm. Although trends may be similar, screw performance in synthetic, as compared with cadaveric, models is markedly different.
Schoenfeld Andrew J; Battula Suneel; Sahai Vivek; Vrabec Gregory A; Corman Steven; Burton Lyndsey; Njus Glen O
The Journal of trauma
2008
2008-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/TA.0b013e318169cd71" target="_blank" rel="noreferrer noopener">10.1097/TA.0b013e318169cd71</a>
Lack of bone stiffness/strength contribution to osteoarthritis–evidence for primary role of cartilage damage.
Animal; Animals; Articular/physiopathology; Biomechanical Phenomena; Bird Diseases/*physiopathology; Birds; Bone and Bones/*physiopathology; Cartilage; Disease Models; Mechanical; Osteoarthritis/*physiopathology/*veterinary; Species Specificity; Stress
OBJECTIVES: This study was performed to assess osseous contributions to osteoarthritis, obviating the analysis challenges presented by confounding factors in humans and rarity of osteoarthritis in free-ranging mammals. METHODS: Frequency of osteoarthritis in 21 bird species was examined and contrasted with measures of afflicted element bone stiffness and strength and compression/tension-resistant characteristics. RESULTS: Osteoarthritis was present in the ankle of 0-16% of bird species analysed, independent of bone laminarity, cortical thickness, circularity, polarization, cross-sectional diameter, length and pneumatization. CONCLUSIONS: No correlation of frequency of osteoarthritis with parameters of bone strength and biomechanical parameters was found, suggesting that bone is only secondarily affected in osteoarthritis and that cartilage is the initial target of the disease.
Rothschild B M; Panza R K
Rheumatology (Oxford, England)
2007
2007-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/rheumatology/kel263" target="_blank" rel="noreferrer noopener">10.1093/rheumatology/kel263</a>
Physiological Indices of Stress Prior to and Following Total Knee Arthroplasty Predict the Occurrence of Severe Post-Operative Pain.
*Cardiovascular; *Cortisol; *Epinephrine; *Post-operative Pain; *Severity of Illness Index; *Stress; *Surgery; 80 and over; 80 and Over; Aged; Arthroplasty; Catecholamines – Urine; Center for Epidemiological Studies Depression Scale; Cohort Studies; Data Analysis Software; Descriptive Statistics; Effect Size; Female; Human; Humans; Hydrocortisone – Urine; Knee; Knee/*adverse effects/psychology; Male; Middle Age; Middle Aged; Nonexperimental Studies; Ohio; Pain; Pain Measurement/methods; Physiological; Postoperative Pain – Risk Factors; Postoperative/*diagnosis/etiology/*psychology; Predictive Value of Tests; Prospective Studies; Psychological/complications/*diagnosis/*psychology; Regression; Replacement; Scales; Stress; Summated Rating Scaling; Treatment Outcome
OBJECTIVE: The severe pain and disability associated with osteoarthritis often motivate individuals to undergo arthroplastic surgery. However, a significant number of surgical patients continue to experience pain following surgery. Prior research has implicated both the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) in the sensitization of pain receptors and chronic pain conditions. This study uses a prospective, observational, cohort design to examine whether physiological stress responses before and after surgery could predict post-operative pain severity. SUBJECTS: Participants included 110 patients undergoing total knee arthroplasty. METHODS: Physiological indices of stress included the measurement of catecholamine and cortisol levels in 15-hour urine samples collected prior to and 1 month following surgery, as well as in-hospital heart rate and blood pressure (before and after surgery), which were abstracted from medical records. Patients completed the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [Bellamy et al., J Orthop Rheumatol 1: , 95 (1988)] 2.5 weeks prior to surgery and at a
Cremeans-Smith Julie K; Greene Kenneth; Delahanty Douglas L
Pain medicine (Malden, Mass.)
2016
2016-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/pm/pnv043" target="_blank" rel="noreferrer noopener">10.1093/pm/pnv043</a>
Mindfulness as a predictor of positive reappraisal and burnout in standardized patients.
*Adaptation; *Emotions; *Patient Satisfaction; 80 and over; Adult; Aged; Burnout; Clinical Assessment Tools; Coefficient Alpha; Convenience Sample; Descriptive Statistics; Education; Female; Human; Humans; Job Characteristics; Male; Medical; Middle Aged; Mind Body Techniques; Models; Multiple Regression; Ohio; Patient Simulation; Professional – Risk Factors; Psychological; Psychological/*complications/psychology; Psychometrics; Questionnaires; Regression Analysis; Risk Assessment; Statistics as Topic; Stress; Summated Rating Scaling
BACKGROUND: Standardized patients (SPs) portray emotionally intense roles that can have unintended deleterious effects including burnout. PURPOSE: This study explored SP characteristics that could serve as protective factors against these adverse effects. The literature suggests that positive reappraisal and mindfulness are protective factors, with positive reappraisal mediating the relationship between mindfulness and burnout. METHODS: Seventy-six SPs completed an instrument measuring burnout, positive reappraisal, and mindfulness. Multiple regression was performed to test the hypothesized mediator model. RESULTS: The results revealed that mindfulness and positive reappraisal explained a meaningful portion of SP burnout variance (R (2) = .31 p \textless .01). Germane to the mediator model, all correlations were significant: mindfulness and positive reappraisal (a) r = .668; positive reappraisal and burnout (b) r = -.527; and mindfulness and burnout (c) r = -.496, p \textless 01. When positive reappraisal and mindfulness were included in the model, the previously significant relationship c was no longer statistically significant. The combination of these three relationships supports a mediator model. CONCLUSIONS: Education to enhance mindfulness and positive reappraisal offers a way to offset the adverse effects of portraying intense emotional patient experiences.
Gerzina Holly A; Porfeli Erik J
Teaching and learning in medicine
2012
2012
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/10401334.2012.715255" target="_blank" rel="noreferrer noopener">10.1080/10401334.2012.715255</a>
A multi-level modeling approach examining PTSD symptom reduction during prolonged exposure therapy: moderating effects of number of trauma types experienced, having an HIV-related index trauma, and years since HIV diagnosis among
*HIV/AIDS; *prolonged exposure therapy; *PTSD; *trauma history; Adult; Descriptive Statistics; DESCRIPTIVE statistics; Female; HIV Infections/*psychology; HIV-Infected Patients – Psychosocial Factors; Human; Humans; Implosive Therapy/*methods; LONGITUDINAL method; Male; Middle Aged; Post-Traumatic – Symptoms; Post-Traumatic – Therapy; POST-traumatic stress disorder; Post-Traumatic/diagnosis/*psychology/*therapy; Prospective Studies; Psychological/*psychology/therapy; PSYCHOLOGY of HIV-positive people; Stress; Stress Disorders; Time; TIME; Time Factors; Trauma – Classification; Trauma – History; TREATMENT effectiveness; TREATMENT of post-traumatic stress disorder; Treatment Outcome; Treatment Outcomes – Evaluation; United States; UNITED States; WOUNDS & injuries – Classification; WOUNDS & injuries – History
People living with HIV (PLWH) have extensive interpersonal trauma histories and higher rates of posttraumatic stress disorder (PTSD) than the general population. Prolonged exposure (PE) therapy is efficacious in reducing PTSD across a variety of trauma samples; however, research has not examined factors that influence how PTSD symptoms change during PE for PLWH. Using multi-level modeling, we examined the potential moderating effect of number of previous trauma types experienced, whether the index trauma was HIV-related or not, and years since HIV diagnosis on PTSD symptom reduction during a 10-session PE protocol in a sample of 51 PLWH. In general, PTSD symptoms decreased linearly throughout the PE sessions. Experiencing more previous types of traumatic events was associated with a slower rate of PTSD symptom change. In addition, LOCF analyses found that participants with a non-HIV-related versus HIV-related index trauma had a slower rate of change for PTSD symptoms over the course of PE. However, analyses of raw data decreased this finding to marginal. Years since HIV diagnosis did not impact PTSD symptom change. These results provide a better understanding of how to tailor PE to individual clients and aid clinicians in approximating the rate of symptom alleviation. Specifically, these findings underscore the importance of accounting for trauma history and index trauma type when implementing a treatment plan for PTSD in PLWH.
Junglen Angela G; Smith Brian C; Coleman Jennifer A; Pacella Maria L; Boarts Jessica M; Jones Tracy; Feeny Norah C; Ciesla Jeffrey A; Delahanty Douglas L
AIDS care
2017
2017-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/09540121.2017.1300625" target="_blank" rel="noreferrer noopener">10.1080/09540121.2017.1300625</a>
Alterations in the mechanical properties and composition of skin in human growth hormone transgenic mice.
*Biomechanical Phenomena; *Skin Physiological Phenomena; Animals; Elasticity; Female; Human Growth Hormone/*genetics; Humans; Male; Mechanical; Mice; Sex Characteristics; Skin/anatomy & histology/*chemistry; Stress; Transgenic
Growth hormone is known to stimulate connective tissue, but the degree to which it influences skin biomechanical properties is unclear. This study tested the hypothesis that human growth hormone transgene expression changes the material properties and structural composition of adult mouse skin. Fracture toughness and elastic modulus were measured on freshly dissected dorsal skin and fixed samples were analyzed histologically. Transgenics had higher elastic moduli than their sex-matched non transgenic littermates, and male transgenics demonstrated increased fracture toughness. Male transgenics also had thicker skin than controls with a selectively increased dermis. In contrast, female transgenics had thinner skin than controls due to a reduced hypodermis. Biomechanical and histological variables were strongly correlated. Significant sex differences were present in nearly all comparisons indicating a dimorphic response to growth hormone in the skin. These data demonstrate that constant low-level growth hormone expression in marrow differentially affects skin layer thickness and concomitantly alters its biomechanical properties.
Serrat Maria A; Vinyard Christopher J; King Donna
Connective tissue research
2007
1905-6
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/03008200601021373" target="_blank" rel="noreferrer noopener">10.1080/03008200601021373</a>
A metabolic stress-inducible miR-34a-HNF4alpha pathway regulates lipid and lipoprotein metabolism.
Animals; Apolipoproteins E/genetics; Atherosclerosis/genetics/metabolism; Diabetes Mellitus; Experimental/genetics/metabolism; Hep G2 Cells; Hepatocyte Nuclear Factor 4/*genetics/metabolism; Humans; Knockout; LDL/genetics; Lipid Metabolism/*genetics; Lipoproteins/metabolism; Liver/metabolism; Mice; MicroRNAs/*genetics/metabolism; Middle Aged; Non-alcoholic Fatty Liver Disease/*genetics/metabolism; Physiological/*genetics; Receptors; Stress; Triglycerides/*metabolism
Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases, but its underlying mechanism is poorly understood. Here we show that hepatocyte nuclear factor 4alpha (HNF4alpha), a liver-enriched nuclear hormone receptor, is markedly inhibited, whereas miR-34a is highly induced in patients with non-alcoholic steatohepatitis, diabetic mice and mice fed a high-fat diet. miR-34a is essential for HNF4alpha expression and regulates triglyceride accumulation in human and murine hepatocytes. miR-34a inhibits very low-density lipoprotein secretion and promotes liver steatosis and hypolipidemia in an HNF4alpha-dependent manner. As a result, increased miR-34a or reduced HNF4alpha expression in the liver attenuates the development of atherosclerosis in Apoe(-/-) or Ldlr(-/-) mice. These data indicate that the miR-34a-HNF4alpha pathway is activated under common conditions of metabolic stress and may have a role in the pathogenesis of NAFLD and in regulating plasma lipoprotein metabolism. Targeting this pathway may represent a novel approach for the treatment of NAFLD.
Xu Yang; Zalzala Munaf; Xu Jiesi; Li Yuanyuan; Yin Liya; Zhang Yanqiao
Nature communications
2015
2015-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1038/ncomms8466" target="_blank" rel="noreferrer noopener">10.1038/ncomms8466</a>
WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 2: breast.
*Practice Guidelines as Topic; artifacts; Breast; Breast Cancer; Breast Neoplasms/*diagnostic imaging/*physiopathology; Elastic Modulus; Elasticity Imaging Techniques/*standards; elastography; Female; guidelines; Humans; Internationality; Mammography/*standards; Mechanical; Radiology/*standards; Shear Strength; Shear wave; strain; Stress; Tensile Strength
The breast section of these Guidelines and Recommendations for Elastography produced under the auspices of the World Federation of Ultrasound in Medicine and Biology (WFUMB) assesses the clinically used applications of all forms of elastography used in breast imaging. The literature on various breast elastography techniques is reviewed, and recommendations are made on evidence-based results. Practical advice is given on how to perform and interpret breast elastography for optimal results, with emphasis placed on avoiding pitfalls. Artifacts are reviewed, and the clinical utility of some artifacts is discussed. Both strain and shear wave techniques have been shown to be highly accurate in characterizing breast lesions as benign or malignant. The relationship between the various techniques is discussed, and recommended interpretation based on a BI-RADS-like malignancy probability scale is provided. This document is intended to be used as a reference and to guide clinical users in a practical way.
Barr Richard G; Nakashima Kazutaka; Amy Dominique; Cosgrove David; Farrokh Andre; Schafer Fritz; Bamber Jeffrey C; Castera Laurent; Choi Byung Ihn; Chou Yi-Hong; Dietrich Christoph F; Ding Hong; Ferraioli Giovanna; Filice Carlo; Friedrich-Rust Mireen; Hall Timothy J; Nightingale Kathryn R; Palmeri Mark L; Shiina Tsuyoshi; Suzuki Shinichi; Sporea Ioan; Wilson Stephanie; Kudo Masatoshi
Ultrasound in medicine & biology
2015
2015-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ultrasmedbio.2015.03.008" target="_blank" rel="noreferrer noopener">10.1016/j.ultrasmedbio.2015.03.008</a>
WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 3: liver.
*Practice Guidelines as Topic; Elastic Modulus; Elasticity Imaging Techniques/*standards; elastography; focal liver lesions; guidelines; Internationality; liver; Liver Cirrhosis/*diagnostic imaging/*physiopathology; liver diseases; liver fibrosis; liver stiffness; Liver/*diagnostic imaging/*physiopathology; Mechanical; Shear Strength; shear wave elastography; strain elastography; Stress; transient elastography; ultrasound; WFUMB
The World Federation for Ultrasound in Medicine and Biology (WFUMB) has produced these guidelines for the use of elastography techniques in liver disease. For each available technique, the reproducibility, results, and limitations are analyzed, and recommendations are given. Finally, recommendations based on the international literature and the findings of the WFUMB expert group are established as answers to common questions. The document has a clinical perspective and is aimed at assessing the usefulness of elastography in the management of liver diseases.
Ferraioli Giovanna; Filice Carlo; Castera Laurent; Choi Byung Ihn; Sporea Ioan; Wilson Stephanie R; Cosgrove David; Dietrich Christoph F; Amy Dominique; Bamber Jeffrey C; Barr Richard; Chou Yi-Hong; Ding Hong; Farrokh Andre; Friedrich-Rust Mireen; Hall Timothy J; Nakashima Kazutaka; Nightingale Kathryn R; Palmeri Mark L; Schafer Fritz; Shiina Tsuyoshi; Suzuki Shinichi; Kudo Masatoshi
Ultrasound in medicine & biology
2015
2015-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ultrasmedbio.2015.03.007" target="_blank" rel="noreferrer noopener">10.1016/j.ultrasmedbio.2015.03.007</a>
Prenatal stress changes courtship vocalizations and bone mineral density in mice.
*Bone mineral density; *Corticosterone; *Courtship; *GR; *Prenatal stress; *Testosterone; *Ultrasonic vocalizations; Animal/*physiology; Animals; Bone Density/*physiology; Female; Inbred C57BL; Male; Mice; Pregnancy; Prenatal Exposure Delayed Effects/*metabolism/*physiopathology; Psychological/*metabolism/*physiopathology; Stress; Vocalization
Stress during the prenatal period has various effects on social and sexual behavior in both human and animal offspring. The present study examines the effects of chronic restraint stress in the second vs third trimester in pregnancy and glucocorticoid receptor (GR) heterozygous mutation on C57BL/6N male offspring's vocal courtship behavior in adulthood by applying a novel analyzing method. Finally, corticosterone and testosterone levels as well as bone mineral density were measured. Prenatal stress in the third, but not in the second trimester caused a significant qualitative change in males' courtship vocalizations, independent of their GR genotype. Bone mineral density was decreased also by prenatal stress exclusively in the third trimester in GR mutant and wildtype mice and - in contrast to corticosterone and testosterone - highly correlated with courtship vocalizations. In Gr(+/-) males corticosterone serum levels were significantly increased in animals that had experienced prenatal stress in the third trimester. Testosterone serum levels were overall increased in Gr(+/-) males in comparison to wildtypes as a tendency - whereas prenatal stress had no influence. Prenatal stress alters adult males' courtship vocalizations exclusively when applied in the third trimester, with closely related changes in bone mineral density. Bone mineral density seems to reflect best the complex neuroendocrine mechanisms underlying the production of courtship vocalizations. Besides, we demonstrated for the first time elevated basal corticosterone levels in Gr(+/-) males after prenatal stress which suggests that the Gr(+/-) mouse model of depression might also serve as a model of prenatal stress in male offspring.
Schmidt Michaela; Lapert Florian; Brandwein Christiane; Deuschle Michael; Kasperk Christian; Grimsley Jasmine M S; Gass Peter
Psychoneuroendocrinology
2017
2017-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.psyneuen.2016.11.003" target="_blank" rel="noreferrer noopener">10.1016/j.psyneuen.2016.11.003</a>
Evidence for noradrenergic involvement in mediating the FG 7142 discriminative stimulus.
Adrenergic alpha-Antagonists/pharmacology; Animals; Appetite Depressants/*pharmacology; Carbolines/*pharmacology; Clonidine/pharmacology; Dioxanes/pharmacology; Discrimination (Psychology)/*drug effects; Electroshock; Generalization; Idazoxan; Male; Norepinephrine/*physiology; Psychological/psychology; Rats; Sprague-Dawley; Stimulus/drug effects; Stress; Yohimbine/pharmacology
Rats were trained to discriminate the stimulus properties of the benzodiazepine receptor partial inverse agonist beta-carboline-3-carboxylate acid methyl amide (FG 7142) (5.0 mg/kg) or the alpha 2-adrenergic receptor antagonist 17 alpha-hydroxyyohimban-16 alpha-carboxylic acid methyl ester (yohimbine) (3.0 mg/kg) from vehicle in a two-lever, food-motivated operant task. These compounds have in common a beta-carboline structure and anxiogenic behavioral profiles. The yohimbine discriminative stimulus was mimicked by the alpha 2-adrenergic receptor antagonist idazoxan and antagonized by the alpha 2-adrenergic receptor agonist clonidine, indicating that the yohimbine stimulus was mediated through the alpha
Leidenheimer N J; Schechter M D
Pharmacology, biochemistry, and behavior
1992
1992-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/0091-3057(92)90641-r" target="_blank" rel="noreferrer noopener">10.1016/0091-3057(92)90641-r</a>
A single restraint stress exposure potentiates analgesia induced by intrathecally administered DAGO.
Ala(2)-MePhe(4)-Gly(5)-; Analgesics/*pharmacology; Analysis of Variance; Animals; Drug Synergism; Enkephalin; Enkephalins/*pharmacology; Injections; Male; Pain Measurement; Physical; Physiological/*physiopathology; Rats; Reaction Time; Restraint; Spinal; Sprague-Dawley; Stress
In rats, restraint exposure potentiates the magnitude and duration of analgesia following both the peripheral and intracerebroventricular administration of several opioid agonists as compared to non-stressed controls. It has been suggested that the site of action whereby restraint leads to potentiated opioid analgesia is located supraspinally. However, the possible contribution of spinal analgesic mechanisms also warrants investigation. Thus, the purpose of the present study was two-fold: (1) to determine whether a single exposure to restraint stress would result in the dose-dependent potentiation of analgesia following the intrathecal (i.t.) administration of the mu (mu)-receptor selective opioid agonist [D-Ala2,N-Me-Phe4,Gly5-ol]enkephalin (DAGO) and (2) to quantify the degree of analgesia in restrained vs. non-restrained rats using the tail-flick and hot-plate analgesic assays. Using rats implanted with chronic i.t. cannula, dose- and time-course curves were observed following the i.t. administration of DAGO. The results demonstrate that both the duration and magnitude of analgesia was significantly potentiated in restrained rats compared to non-restrained controls. Restraint-treated rats receiving 0.15-0.6 micrograms of DAGO i.t. showed 1.3-1.5-fold potentiation of analgesia in the tail-flick assay and a 2.3-5.6-fold potentiation using the hot-plate assay. Restraint immobilization potentiated the magnitude and duration of DAGO-induced analgesia administered by the i.t. route as measured by the tail-flick and hot-plate assays. These data suggest that spinal analgesic mechanisms significantly contribute to the enhanced analgesic potency of opioids in subjects exposed to restraint stress.
Calcagnetti D J; Stafinsky J L; Crisp T
Brain research
1992
1992-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/0006-8993(92)91689-c" target="_blank" rel="noreferrer noopener">10.1016/0006-8993(92)91689-c</a>
Lacking a Primary Care Physician Is Associated With Increased Suffering in Patients With Severe Mental Illness.
*Health Services Accessibility; *Primary Health Care; Adolescence; Adolescent; Adult; Aged; Community; Comorbid conditions; Cost of Illness; Economic Aspects of Illness; Female; Health outcomes; Health Services Accessibility; Hospitalization; Hospitals; Humans; Life Style; Lifestyle problems; Male; Mental Disorders – Complications; Mental Disorders – Psychosocial Factors; Mental Disorders – Therapy; Mental Disorders/complications/*psychology/*therapy; Middle Age; Middle Aged; Preventative services; Primary Health Care; Psychological – Etiology; Psychological – Psychosocial Factors; Psychological/etiology/*psychology; Retrospective Design; Retrospective Studies; Stress; Young Adult
We evaluated the relationship between lack of a primary care physician (PCP) and patients with severe mental illness (SMI), who have poorer health and experience more suffering. Using a blinded retrospective record review of 137 patients with SMI, divided between inpatients (n = 70) and outpatients (n = 67), we compared the two groups to determine if lack of a PCP is associated with increased suffering and worse overall health. We included history of preventive services, having a PCP, and comorbid conditions. Multiple linear regressions determined the relationship between lacking a PCP and lifestyle problems, lack of preventive care, and Burden of Suffering. We found that in SMI patients, lack of a PCP is associated with increased lifestyle problems, lacking preventive care, increased Burden of Suffering and cervical dysplasia. Health policy changes are needed to improve outcomes for patients with SMI by increasing access to PCPs and preventive services.
Olsen Cynthia G; Boltri John M; Amerine Jenna; Clasen Mark E
The journal of primary prevention
2017
2017-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s10935-017-0490-7" target="_blank" rel="noreferrer noopener">10.1007/s10935-017-0490-7</a>
The Personal Social Networks of Resettled Bhutanese Refugees During Pregnancy in the United States: A Social Network Analysis.
Bhutan; Communication; Community health; Extended Family; Female; Human; Interpersonal Relations; Interviews; Maternal and child health; Ohio; Pregnancy; Psychological; Qualitative Studies; Refugees; Refugees – Psychosocial Factors – In Pregnancy; Social network analysis; Social Networks – Utilization – United States; Social support; Stress; United States
Women comprise 50% of the refugee population, 25% of whom are of reproductive age. Female refugees are at risk for experiencing significant hardships associated with the refugee experience, including after resettlement. For refugee women, the strength of their personal social networks can play an important role in mitigating the stress of resettlement and can be an influential source of support during specific health events, such as pregnancy. A personal social network analysis was conducted among 45 resettled Bhutanese refugee women who had given birth within the past 2 years in the Akron Metropolitan Area of Northeast Ohio. Data were collected using in-depth interviews conducted in Nepali over a
Kingsbury Diana M; Bhatta Madhav P; Castellani Brian; Khanal Aruna; Jefferis Eric; S Hallam Jeffery
Journal of community health
2018
2018-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s10900-018-0518-9" target="_blank" rel="noreferrer noopener">10.1007/s10900-018-0518-9</a>