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Automated Case Cancellation Review System Improves Systems-Based Practice.
Starnes JR, McEvoy MD, Ehrenfeld JM, Sandberg WS, Wanderer JP
(2015) J Med Syst 39: 134
MeSH Terms: Accreditation, Anesthesiology, Clinical Competence, Efficiency, Organizational, Health Knowledge, Attitudes, Practice, Humans, Information Systems, Internship and Residency, Interpersonal Relations, Preoperative Period, Problem-Based Learning, Professionalism, Time Factors
Show Abstract · Added October 17, 2015
BACKGROUND - Accreditation Council for Graduate Medical Education (ACGME) core competencies of systems-based practice and practice-based learning and improvement are difficult to assess, as they are often not directly measurable or observable. Reviewing day-of-surgery cancellations could provide resident learning opportunities in these areas.
OBJECTIVE - An automated system to facilitate anesthesiology resident review of cancelled cases was implemented on the Preoperative Evaluation Clinic (PEC) rotation at the authors' institution. This study aims to evaluate its impact on resident education.
METHODS - Residents on the PEC rotation during the 6 months preceding (n = 22) and following (n = 13) implementation in 2014 were surveyed about their experience performing cancelled case reviews in order to ascertain the effect of the intervention on their training.
RESULTS - Significant changes were reported in the number of cases reviewed by each resident (p < 0.0001), perceived importance of review (p = 0.03), and ease of review (p = 0.03) after system implementation. There was also an increase in the proportion of cancelled cases reviewed from 17.3% (34 of 196) to 95.6% (194 of 203) (p < 0.0001). Non-significant trends were seen in perceived rotation effect on ACGME competencies, including systems-based practice. Several specific improvements to our clinical practice, including the creation of standardized guidelines, arose from these case reviews.
CONCLUSION - Implementation of automated systems can improve compliance with educational goals by clarifying priorities and simplifying workflow. This system increased the number of cases reviewed by residents and the perceived importance of this review as a part of their educational experience.
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13 MeSH Terms
Improvement in social deficits in autism spectrum disorders using a theatre-based, peer-mediated intervention.
Corbett BA, Swain DM, Coke C, Simon D, Newsom C, Houchins-Juarez N, Jenson A, Wang L, Song Y
(2014) Autism Res 7: 4-16
MeSH Terms: Adolescent, Arousal, Awareness, Behavior Therapy, Camping, Child, Child Development Disorders, Pervasive, Emotional Intelligence, Facial Expression, Female, Humans, Hydrocortisone, Interpersonal Relations, Male, Outcome and Process Assessment (Health Care), Peer Group, Psychodrama, Social Behavior Disorders, Social Environment, Social Perception, Theory of Mind
Show Abstract · Added March 10, 2014
Social Emotional NeuroScience Endocrinology Theatre is a novel intervention program aimed at improving reciprocal social interaction in youth with autism spectrum disorder (ASD) using behavioral strategies and theatrical techniques in a peer-mediated model. Previous research using a 3-month model showed improvement in face perception, social interaction, and reductions in stress. The current study assessed a 2-week summer camp model. Typically developing peers were trained and paired with ASD youth (8-17 years). Social perception and interaction skills were measured before and after treatment using neuropsychological and parental measures. Behavioral coding by reliable, independent raters was conducted within the treatment context (theatre) and outside the setting (playground). Salivary cortisol levels to assess physiological arousal were measured across contexts (home, theatre, and playground). A pretest-posttest design for within-group comparisons was used, and prespecified pairwise comparisons were achieved using a nonparametric Wilcoxon signed-rank test. Significant differences were observed in face processing, social awareness, and social cognition (P < 0.05). Duration of interaction with familiar peers increased significantly over the course of treatment (P < 0.05), while engagement with novel peers outside the treatment setting remained stable. Cortisol levels rose on the first day of camp compared with home values yet declined by the end of treatment and further reduced during posttreatment play with peers. Results corroborate previous findings that the peer-mediated theatre program contributes to improvement in core social deficits in ASD using a short-term, summer camp treatment model. Future studies will explore treatment length and peer familiarity to optimize and generalize gains.
© 2013 International Society for Autism Research, Wiley Periodicals, Inc.
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21 MeSH Terms
Impact of prostate cancer on sexual relationships: a longitudinal perspective on intimate partners' experiences.
Ramsey SD, Zeliadt SB, Blough DK, Moinpour CM, Hall IJ, Smith JL, Ekwueme DU, Fedorenko CR, Fairweather ME, Koepl LM, Thompson IM, Keane TE, Penson DF
(2013) J Sex Med 10: 3135-43
MeSH Terms: Aged, Female, Humans, Interpersonal Relations, Male, Middle Aged, Personal Satisfaction, Prospective Studies, Prostatectomy, Prostatic Neoplasms, Sexual Behavior, Sexual Partners, Surveys and Questionnaires
Show Abstract · Added March 7, 2014
INTRODUCTION - In this prospective study of localized prostate cancer patients and their partners, we analyzed how partner issues evolve over time, focusing on satisfaction with care, influence of cancer treatment, and its impact on relationship with patient, cancer worry, and personal activities.
AIMS - Our study aims were twofold: (i) to determine whether the impact of treatment on patients and partners moderate over time and (ii) if receiving surgery (i.e., radical prostatectomy) influences partner issues more than other treatments.
METHODS - Patients newly diagnosed with localized prostate cancer and their female partners were recruited from three states to complete surveys by mail at three time points over 12 months.
MAIN OUTCOME MEASURES - The four primary outcomes assessed in the partner analysis included satisfaction with treatment, cancer worry, and the influence of cancer and its treatment on their relationship (both general relationship and sexual relationship).
RESULTS - This analysis included 88 patient-partner pairs. At 6 months, partners reported that cancer had a negative impact on their sexual relationship (39%--somewhat negative and 12%--very negative). At 12 months, this proportion increased substantially (42%--somewhat negative and 29%--very negative). Partners were significantly more likely to report that their sexual relationship was worse when the patient reported having surgery (P = 0.0045, odds ratio = 9.8025, 95% confidence interval 2.076-46.296). A minority of partners reported significant negative impacts in other areas involving their personal activities (16% at 6 months and 25% at 12 months) or work life (6% at 6 months, which increased to 12% at 12 months).
CONCLUSION - From partners' perspectives, prostate cancer therapy has negative impact on sexual relationships and appears to worsen over time.
© 2013 International Society for Sexual Medicine.
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13 MeSH Terms
Trajectories of illness intrusiveness domains following a diagnosis of breast cancer.
Sohl SJ, Levine B, Case LD, Danhauer SC, Avis NE
(2014) Health Psychol 33: 232-41
MeSH Terms: Activities of Daily Living, Adult, Aged, Breast Neoplasms, Female, Follow-Up Studies, Humans, Interpersonal Relations, Middle Aged, Quality of Life, Sexual Behavior, Surveys and Questionnaires, Time Factors
Show Abstract · Added March 10, 2014
OBJECTIVE - To identify trajectories of illness intrusiveness over the first 2 years after a breast cancer diagnosis and describe associated patient and treatment characteristics. Illness intrusiveness, or how much an illness disrupts life domains, has been shown to be highly related to quality of life.
METHODS - Women recruited within 8 months of a breast cancer diagnosis (n = 653) completed questionnaires at baseline and 6, 12, and 18 months postbaseline. Group-based trajectory modeling was used to identify trajectories in three established domains of illness intrusiveness: instrumental, intimacy, and relationships and personal development. Bivariate analyses identified contextual, disease/treatment, psychological, and social characteristics of women in trajectory groups.
RESULTS - Forty-one percent of women fell into a trajectory of consistently low illness intrusiveness (Low) across all three domains. Other women varied such that some reported illness intrusiveness that decreased over time on at least one domain (9-34%), and others reported consistently high intrusiveness on at least one domain (11-17%). A fourth trajectory of increased illness intrusiveness emerged in the relationship and personal development domain (9%). Characteristics of women in the Low group were being older; being less likely to have children at home; and having stage I cancer, fewer symptoms, and better psychosocial status.
CONCLUSIONS - Women experienced different patterns of illness intrusiveness in the first 2 years after a diagnosis of breast cancer with a high percentage reporting Low intrusiveness. However, women differentially followed the other trajectory patterns by domain, suggesting that the effect of breast cancer on some women's lives may be specific to certain areas.
PsycINFO Database Record (c) 2014 APA, all rights reserved.
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13 MeSH Terms
An intersectional approach to social determinants of stress for African American men: men's and women's perspectives.
Griffith DM, Ellis KR, Allen JO
(2013) Am J Mens Health 7: 19S-30S
MeSH Terms: Adult, Aged, Aged, 80 and over, Female, Focus Groups, Gender Identity, Health Status, Humans, Interpersonal Relations, Male, Men's Health, Middle Aged, Perception, Socioeconomic Factors, Stress, Psychological, United States, Workplace
Show Abstract · Added March 7, 2014
Stress is a key factor that helps explain racial and gender differences in health, but few studies have examined gendered stressors that affect men. This study uses an intersectional approach to examine the sources of stress in African American men's lives from the perspectives of African American men and important women in their lives. Phenomenological analysis was used to examine data from 18 exploratory focus groups with 150 African American men, ages 30 years and older, and eight groups with 77 African American women. The two primary sources of stress identified were seeking to fulfill socially and culturally important gender roles and being an African American man in a racially stratified society. A central focus of African American men's daily lives was trying to navigate chronic stressors at home and at work and a lack of time to fulfill roles and responsibilities in different life domains that are traditionally the responsibility of men. Health was rarely mentioned by men as a source of stress, though women noted that men's aging and weathering bodies were a source of stress for men. Because of the intersection of racism and economic and social stressors, men and women reported that the stress that African American men experienced was shaped by the intersection of race, ethnicity, age, marital status, and other factors that combined in unique ways. The intersection of these identities and characteristics led to stressors that were perceived to be of greater quantity and qualitatively different than the stress experienced by men of other races.
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17 MeSH Terms
"She looks out for the meals, period": African American men's perceptions of how their wives influence their eating behavior and dietary health.
Allen JO, Griffith DM, Gaines HC
(2013) Health Psychol 32: 447-55
MeSH Terms: African Americans, Aged, Diet, Female, Focus Groups, Food Preferences, Gender Identity, Humans, Interpersonal Relations, Male, Meals, Men's Health, Michigan, Middle Aged, Spouses
Show Abstract · Added March 27, 2014
OBJECTIVE - Women play a critical role in men's dietary health, but how men think about the nature and mechanisms of their wives' influence on their eating behavior is not well understood. This study examined how African American men described the roles their wives played in shaping their eating behavior.
METHODS - Thematic content analysis was used to analyze data from nine exploratory focus groups conducted with a convenience sample of 83 African American men who were middle aged or older and lived in southeast Michigan.
RESULTS - Men perceived having more freedom to choose what they ate while eating out, even when accompanied by their wives, compared with at home. The men indicated their wives influenced what they ate at home more than their own preferences. They described traditional gendered food roles at home and were satisfied that their wives played a dominant role in household food preparation and decision making. Men had mixed feelings about wives' efforts to prepare healthier meals. While they appreciated that their wives cared about their health, the men felt they were rarely consulted on how meals could be healthier and often disliked the healthy changes their wives made. The men prioritized keeping their wives happy, preserving spousal division of roles, and maintaining marital harmony over participating in food decision making or expressing their personal food preferences.
CONCLUSIONS - Interventions to improve married African American men's eating behaviors need to explicitly consider that men may prioritize marital harmony and the preservation of spousal food roles over their tastes, preferences, and desired food decision making roles.
2013 APA, all rights reserved
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15 MeSH Terms
Prostaglandin E2-mediated attenuation of mesocortical dopaminergic pathway is critical for susceptibility to repeated social defeat stress in mice.
Tanaka K, Furuyashiki T, Kitaoka S, Senzai Y, Imoto Y, Segi-Nishida E, Deguchi Y, Breyer RM, Breyer MD, Narumiya S
(2012) J Neurosci 32: 4319-29
MeSH Terms: 3,4-Dihydroxyphenylacetic Acid, Analysis of Variance, Animals, Benzazepines, Calcium-Binding Proteins, Corticosterone, Cyclooxygenase 1, Cyclooxygenase 2, Cyclooxygenase Inhibitors, Dinoprostone, Disease Models, Animal, Disease Susceptibility, Dominance-Subordination, Dopamine, Dopamine Antagonists, Homovanillic Acid, Interpersonal Relations, Maze Learning, Membrane Proteins, Mice, Mice, Inbred C57BL, Mice, Inbred ICR, Mice, Knockout, Microfilament Proteins, Neural Pathways, Oxidopamine, Prefrontal Cortex, Pyrazoles, Receptors, Prostaglandin E, Signal Transduction, Stress, Psychological, Sulfonamides, Time Factors, Tyrosine 3-Monooxygenase, Ventral Tegmental Area
Show Abstract · Added December 21, 2013
Various kinds of stress are thought to precipitate psychiatric disorders, such as major depression. Whereas studies in rodents have suggested a critical role of medial prefrontal cortex (mPFC) in stress susceptibility, the mechanism of how stress susceptibility is determined through mPFC remains unknown. Here we show a critical role of prostaglandin E(2) (PGE(2)), a bioactive lipid derived from arachidonic acid, in repeated social defeat stress in mice. Repeated social defeat increased the PGE(2) level in the subcortical region of the brain, and mice lacking either COX-1, a prostaglandin synthase, or EP1, a PGE receptor, were impaired in induction of social avoidance by repeated social defeat. Given the reported action of EP1 that augments GABAergic inputs to midbrain dopamine neurons, we analyzed dopaminergic response upon social defeat. Analyses of c-Fos expression of VTA dopamine neurons and dopamine turnover in mPFC showed that mesocortical dopaminergic pathway is activated upon social defeat and attenuated with repetition of social defeat in wild-type mice. EP1 deficiency abolished such repeated stress-induced attenuation of mesocortical dopaminergic pathway. Blockade of dopamine D1-like receptor during social defeat restored social avoidance in EP1-deficient mice, suggesting that disinhibited dopaminergic response during social defeat blocks induction of social avoidance. Furthermore, mPFC dopaminergic lesion by local injection of 6-hydroxydopamine, which mimicked the action of EP1 during repeated stress, facilitated induction of social avoidance upon social defeat. Taken together, our data suggest that PGE(2)-EP1 signaling is critical for susceptibility to repeated social defeat stress in mice through attenuation of mesocortical dopaminergic pathway.
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35 MeSH Terms
Peer relationships of bereaved siblings and comparison classmates after a child's death from cancer.
Gerhardt CA, Fairclough DL, Grossenbacher JC, Barrera M, Gilmer MJ, Foster TL, Compas BE, Davies B, Hogan NS, Vannatta K
(2012) J Pediatr Psychol 37: 209-19
MeSH Terms: Adolescent, Age Factors, Bereavement, Child, Female, Humans, Interpersonal Relations, Male, Neoplasms, Peer Group, Schools, Sex Factors, Siblings, Social Behavior, Social Support
Show Abstract · Added March 11, 2014
OBJECTIVES - To compare peer relationships among bereaved siblings and matched classmates, and to examine gender, grade level, and time since death as moderators.
METHODS - Families were recruited from cancer registries at four hospitals 3-12 months after a child's death. Measures of social behavior and peer acceptance were completed by children in the classrooms of 105 bereaved siblings (ages 8-17 years). Teachers also reported on children's social behavior. Three classmates were matched for gender, race, and age to each bereaved sibling to form a comparison group (n = 311).
RESULTS - Teachers reported bereaved siblings were more prosocial than comparison classmates. Peers perceived bereaved boys as more sensitive-isolated and victimized, while bereaved siblings in elementary grades were perceived by peers as less prosocial, more sensitive-isolated, less accepted, and as having fewer friends. Peers and teachers viewed bereaved siblings in middle/high school grades as higher on leadership-popularity.
CONCLUSIONS - Bereaved siblings who were male and in elementary grades were more vulnerable to social difficulties, while those in middle/high school may exhibit some strengths. Ongoing research to inform the development of interventions for bereaved siblings is warranted.
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15 MeSH Terms
Opposing roles of mGluR8 in measures of anxiety involving non-social and social challenges.
Duvoisin RM, Villasana L, Davis MJ, Winder DG, Raber J
(2011) Behav Brain Res 221: 50-4
MeSH Terms: Acetanilides, Aging, Anilides, Animals, Anxiety, Cyclohexanecarboxylic Acids, Disease Models, Animal, Dose-Response Relationship, Drug, Female, Interpersonal Relations, Male, Maze Learning, Mice, Mice, Inbred C57BL, Mice, Knockout, Receptors, Metabotropic Glutamate, Sensory Gating, Thioglycolates
Show Abstract · Added May 19, 2014
Metabotropic glutamate receptors (mGluRs) modulate glutamatergic and GABAergic neurotransmission. mGluR8, a member of group III receptors, is generally located presynaptically where it regulates neurotransmitter release. Previously we reported higher measures of anxiety in 6- and 12-month-old mGluR8(-/-) male mice than age- and sex-matched wild-type mice and that acute pharmacological stimulation with the mGluR8 agonist (S)-3,4,-dicarboxyphenylglycine (DCPG) or the Positive Allosteric Modulator (PAM) AZ12216052 reduced measures of anxiety in wild-type mice. As in humans and animals, ageing is associated with enhanced measures of anxiety following non-social and social challenges, increased understanding of these measures and how to potentially modulate them is particularly important in the elderly. Here we determined whether the effects of AZ12216052 on measures of anxiety are mediated by mGluR8 using 24-month-old mGluR8(-/-) and wild-type male mice. AZ12216052 also reduced measures of anxiety in the elevated zero maze and the acoustic startle response in mGluR8(-/-) mice. The remaining anxiolytic effects of AZ12216052 in mGluR8(-/-) mice might involve mGluR4, as the mGluR4 PAM VU 0155041 also reduced measures of anxiety in wild-type mice. In contrast, mGluR8(-/-) mice show enhanced social interaction but AZ12216052 does not affect social interaction in wild-type mice. Thus, while mGluR8 is an attractive target to modulate measures of anxiety and social interaction, the effects of AZ12216052 on measures of anxiety likely also involve receptors other than mGluR8.
Copyright © 2011 Elsevier B.V. All rights reserved.
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18 MeSH Terms
Violence against women and postpartum depression.
Garabedian MJ, Lain KY, Hansen WF, Garcia LS, Williams CM, Crofford LJ
(2011) J Womens Health (Larchmt) 20: 447-53
MeSH Terms: Adult, Battered Women, Cohort Studies, Confidence Intervals, Depression, Postpartum, Female, Humans, Interpersonal Relations, Life Change Events, Middle Aged, Odds Ratio, Population Surveillance, Prevalence, Regression Analysis, Risk Factors, Sexual Partners, Social Support, Spouse Abuse, United States, Women's Health, Young Adult
Show Abstract · Added September 18, 2013
BACKGROUND - Violence against women (VAW), including intimate partner violence (IPV) in its various forms (sexual, physical, or stalking), and childhood violence (sexual or physical) are common and are associated with depressive symptoms. We examined the association between these violence exposures and self-reported history of postpartum depression (PPD).
METHODS - Women from the Kentucky Women's Health Registry (KWHR) who reported at least one live birth were included in this study. Individual IPV and child abuse histories were examined for association with self-reported history of PPD. Multivariate regression analysis estimated adjusted risk ratios (aRR) and 95% confidence intervals (95% CI), controlling for age, obstetrical history, and substance abuse history.
RESULTS - The 5380 women in the KWHR reporting at least one live birth were included in this study. Of these women, 2508 (46.6%) reported a history of any VAW. A history of adult VAW was associated with a history of PPD (aRR 1.48, 95% CI 1.12-1.95). Physical IPV (aRR 1.48, 95% CI 1.12-1.95) and stalking IPV (aRR 1.39, 95% CI1.03-1.87) were individually associated with PPD. Other types of violence were not individually associated with a history of PPD. The strength of association increased with each additional type of violence experienced (aRR1.17, 95% CI 1.06-1.30).
CONCLUSIONS - Adult VAW is associated with self-reported history of PPD. With an increase in the number of types of abuse experienced, this association became stronger. Our findings highlight the need for thorough VAW screening in obstetrical populations.
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21 MeSH Terms