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>
Diurnal Variations in the First 24/7 Mobile Stroke Unit
Cardiovascular System & Cardiology; diurnal variation; experience; mobile stroke unit; Neurosciences & Neurology; prehospital stroke; stroke; system of care; telemedicine; thrombolysis; time
Background and Purpose- Mobile Stroke Units (MSUs) provide innovative prehospital stroke care but their 24/7 operation has not been studied. Our study investigates 24/7 MSU diurnal variations related to transport frequency, patient characteristics, and stroke treatments. Methods- We compared transportation frequency, demographics, thrombolytic and mechanical thrombectomy administration, and treatment metrics across 8-hour shifts (morning, evening, and nocturnal) from our 24/7 MSU in Northwest Ohio prospective database. Results- One hundred ninety-five patients were transported by the MSU. Most transports occurred during the morning shift (52.3%) followed by evening shift (35.8%) and nocturnal shift (11.9%; P-trend<0.001). Twenty-three patients (11.9%) received intravenous thrombolytic in the MSU, most frequently in the morning shift (56.5%). No cases of mechanical thrombectomy were performed on MSU patients in the nocturnal shift. Conclusions- Morning and evening shifts account for the majority of our MSU transports (88.1%) and therapeutic interventions. Understanding temporal variations in a resource-intensive MSU is critical to its worldwide implementation.
Zaidat O O; Changal K H; Sultan-Qurraie A; de Havenon A; Calderon V J; Goins-Whitmore J; Patterson M S; Lin E
Stroke
2019
2019-07
<a href="http://doi.org/10.1161/strokeaha.119.024950" target="_blank" rel="noreferrer noopener">10.1161/strokeaha.119.024950</a>
Persistently positive culture results in a patient with community-acquired pneumonia due to Legionella pneumophila
azithromycin; clarithromycin; erythromycin; hospitalized-patients; Immunology; Infectious Diseases; legionnaires-disease; macrolides; Microbiology; pcr; pharmacokinetics; time
We describe a patient with community-acquired pneumonia due to Legionella pneumophila serogroup 6. This patient was found to have bronchoalveolar carcinoma of the lung by means of cytologic testing in 1 of 2 bronchoalveolar lavage samples, but no lesions were visible on bronchoscopy. Despite intravenous administration of azithromycin to the patient, repeat culture and polymerase chain reaction showed persistence of Legionella; the isolates remained susceptible to azithromycin. The patient did not respond to 14 doses of daily intravenously administered azithromycin. The poor outcome may have been partially due to the suspected underlying lung malignancy, as shown by cytologic examination, and by a delay in seeking medical attention.
Tan J S; File T M; DiPersio J R; DiPersio L P; Hamor R; Saravolatz L D; Stout J E
Clinical Infectious Diseases
2001
2001-06
Journal Article
<a href="http://doi.org/10.1086/320526" target="_blank" rel="noreferrer noopener">10.1086/320526</a>
The early radiations of cetacea (Mammalia): Evolutionary pattern and developmental correlations
archaeocete; artiodactyls; development; Environmental Sciences & Ecology; evolution; Evolutionary Biology; feet; fossil record; India; locomotor evolution; marine mammal; middle eocene; origin; pakistan; Stenella attenuata; time; whales
The origin and early evolution of Cetacea (whales, dolphins, and porpoises) is one of the best examples of macroevolution as documented by fossils. Early whales are divided into six families that differ greatly in their habitats, which varied from land to freshwater, coastal waters, and fully marine. Early cetaceans lived in the Eocene (55-37 million years ago), and they show an enormous morphological diversity. Toward the end of the Eocene the modem cetacean body plan originated, and this body plan remained more or less the same in the subsequent evolution. It is possible that some aspects of this body plan are rooted in constraints that are dictated by cetacean embryologic development and controlled by genes that affect many organ systems at once. It may be possible to use a study of patterns of correlations among morphological traits to test hypotheses of developmental links among organ systems.
Thewissen J G M; Williams E M
Annual Review of Ecology and Systematics
2002
2002
Journal Article
<a href="http://doi.org/10.1146/annurev.ecolysis.33.020602.095426" target="_blank" rel="noreferrer noopener">10.1146/annurev.ecolysis.33.020602.095426</a>
When it rains, it pours: The greater impact of resource loss compared to gain on psychological distress
conservation; depression; gender; model; multiple roles; Psychology; social support; stress; symptoms; time; womens mental-health
The authors prospectively investigated stress in 71, mostly European American pregnant women. Conservation of Resources (COR) theory was applied to assess the impact of resource losses and gains that occur in women's lives. Resources were defined as those things that people value or that act as a means to obtaining that which they value and include social, personal, object, and condition resources. The authors hypothesized that women's resource losses would better predict postpartum anger and depression than their resource gains (in the opposite direction). They also predicted that earlier resource boss would accelerate the negative impact of later resource loss on postpartum distress. Resource gain was expected to be most salient when resource losses co-occurred, such that resource gains buffered the negative impact of resource loss. The hypotheses were generally supported and argue for the primacy of resource loss in the stress process.
Wells J D; Hobfoll S E; Lavin J
Personality and Social Psychology Bulletin
1999
1999-09
Journal Article
<a href="http://doi.org/10.1177/01461672992512010" target="_blank" rel="noreferrer noopener">10.1177/01461672992512010</a>
Interactive effects of tamoxifen and oestrogen upon the nigrostriatal dopaminergic system: Long-term treatments
receptors; Neurosciences & Neurology; Endocrinology & Metabolism; estrogen; binding; catecholamines; brain; striatum; time; amphetamine; estradiol; antiestrogens; ovarian steroids; sexual-behavior; anti-oestrogens
In the present report adult female rats were ovariectomized (OVX) and assigned to one of four treatment conditions. Treatments consisted of administering pellets containing 17 beta-oestradiol (E), tamoxifen (TMX), a combination of TMX and E or no further treatment (OVX), Animals received these treatments immediately following OVX and were maintained in these conditions for a 40-day period. Subsequently, the corpus striatum (CS) was dissected from each animal and prepared for determinations of basal and amphetamine stimulated DA output using in-vitro superfusion. No statistically significant differences among the four treatment groups were obtained for basal dopamine output. The highest levels of amphetamine-stimulated dopamine responses were obtained from E treated rats. These values were significantly greater than that obtained from OVX rats and rats treated with a combination of TMX + E. The significance of these findings is that they indicate both a non-traditional central nervous system site and mechanism of action through which tamoxifen-oestrogen interactions can function. Such data may have important implications for administration of tamoxifen to premenopausal women as this anti-oestrogen may compromise nigrostriatal dopaminergic function under conditions where oestrogenic modulation is present.
McDermott J L; Anderson L I; Dluzen D E
Journal of Neuroendocrinology
1999
1999-10
Journal Article or Conference Abstract Publication
n/a
New Middle Eocene Archaeocetes (cetacea:mammalia) From The Kuldana Formation Of Northern Pakistan
artiodactyls; cetaceans; early whales; evolution; locomotion; mammalia; origin; Paleontology; time; transition
Cooper L N; Thewissen J G M; Hussain S T
Journal of Vertebrate Paleontology
2009
2009-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1671/039.029.0423" target="_blank" rel="noreferrer noopener">10.1671/039.029.0423</a>
Effects Of Exercise On C-reactive Protein In Healthy Patients And In Patients With Heart Disease: A Meta-analysis
Biological; body-composition; Cardiovascular System & Cardiology; cardiovascular-disease; Coronary disease; coronary-artery-disease; exercise; Heart disease; induced weight-loss; Inflammation; inflammatory markers; life-style intervention; marker c-reactive protein; Nursing; obese postmenopausal women; physical-activity; randomized controlled trial; Respiratory System; risk-factors; time
Decreases in circulating hsCRP have been associated with increased physical activity and exercise training, although the ability of exercise interventions to reduce hsCRP and which individuals benefit the most remains unclear. This meta-analysis evaluates the ability of exercise to reduce hsCRP levels in healthy individuals and in individuals with heart disease. A systematic review and meta-analysis was conducted that included exercise interventions trials from 1995 to 2012. Forty-three studies were included in the final analysis for a total of 3575 participants. Exercise interventions significantly reduced hsCRP (standardized mean difference -0.53 mg/L; 95% CI, -0.74 to -0.33). Results of sub-analysis revealed no significant difference in reductions in hsCRP between healthy adults and those with heart disease (p =.20). Heterogeneity between studies could not be attributed to age, gender, intervention length, intervention type, or inclusion of diet modification. Exercise interventions reduced hsCRP levels in adults irrespective of the presence of heart disease. (c) 2016 Elsevier Inc. All rights reserved.
Hammonds T L; Gathright E C; Goldstein C M; Penn M S; Hughes J W
Heart & Lung
2016
2016-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.hrtlng.2016.01.009" target="_blank" rel="noreferrer noopener">10.1016/j.hrtlng.2016.01.009</a>