bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anxiety Symptoms and Healthcare Utilization among a Sample of Outpatients in an Internal Medicine Clinic
Authors: Sansone Randy A. , Hendricks C. Michael , Sellbom Martin , Reddington Anne 
Published: May 2005

Objective: In this study, we explored the role of anxiety symptoms (i.e., symptoms that would probably not fulfill DSM criteria) in relationship to healthcare utilization. Method: We surveyed 117 outpatients in an internal medicine clinic regarding four types of anxiety symptoms (i.e., mixed anxiety features, generalized anxiety, obsessive-compulsive personality features, worry), and through a retrospective review of medical records, examined healthcare utilization patterns. Results: Nearly 28% of participants endorsed “positive” results on at least three of the anxiety-symptom measures. When examined for relationships to healthcare utilization, only obsessive-compulsive personality features demonstrated a significant relationship. Conclusions: While anxiety symptoms were common in this primary care sample, their impact on healthcare utilization was limited, in that only obsessive-compulsive personality features demonstrated a relationship.
Obsessive-Compulsive Disorder and Immunocompetence
Authors: Dinn Wayne M. , Harris Catherine L. , McGonigal Kelly M. , Raynard Richard C. 
Published: May 2005

Objective: A postinfectious, autoimmune response may be associated with the development of pediatric obsessive-compulsive disorder (OCD). According to this model, antistreptococcal antibodies cross-react with basal ganglia neurons following streptococcus infection. This autoimmune reaction disrupts a basal ganglia-thalamocortical circuit and generates obsessive-compulsive symptoms. One implication of this model is that prolonged immunologic stress may be a risk factor for OCD. That is, immunologic stress may compromise the blood-brain barrier and permit the influx of antistriatal antibodies into the central nervous system. This article explores one part of this putative relationship by investigating whether adult OCD patients, compared to members of other psychiatric groups, demonstrate a higher incidence of recurrent infections and other conditions suggestive of compromised immune function. Method: To test this hypothesis, we conducted a medical records review of 100 consecutive patients evaluated at a private psychiatric clinic specializing in the treatment of anxiety disorders. Sixty-five patients met diagnostic criteria for an Axis-I syndrome. Primary diagnoses included OCD, posttraumatic stress disorder, social anxiety disorder, generalized anxiety disorder, panic disorder with agoraphobia, and dysthymic disorder. Each medical record was reviewed for the presence of target syndromes or presenting symptoms suggestive of compromised immune function. Results: Chart review revealed an increased rate of immune-related symptoms and syndromes among OCD patients in comparison to other anxiety and mood disorder groups. Groups did not differ significantly in the incidence of non-immune symptoms and syndromes. Conclusion: Adult OCD patients appear to have an increased rate of immune-related diseases above and beyond that seen in other psychiatric disorders.
Religious Attendance and Continuity of Care
Authors: King Dana E. , Pearson William S. 
Published: May 2005

Objective: The purpose of this study was to determine whether a relationship exists between religious attendance and continuity of care. Methods: We investigated this relationship in a large national database—the National Health and Nutrition Examination Survey III—which contains information on religious attendance, continuity of care, and potential confounders that might mediate the relationship such as health status and socioeconomic status. Results: A total of 18,162 participants 17 years of age or older were included in the analysis. People who attended religious services were more likely to have continuity with a provider than people who did not attend such services (65% vs. 35%, p < .001). This association persisted after controlling for demographic, socioeconomic, and health status variables using regression analysis. Conclusion: This study documents a significant association between attendance at religious services and continuity with a usual provider. Continuity with a regular medical provider may influence the association of religious attendance and health outcomes.
“Unfreezing” Lewin: The Case for Alternative Change Strategies in Health Education
Authors: Minkler Meredith 
Published: May 2005

Lewin's conceptualization of change as a three part process of unfreezing, changing and refreezing remains a key theoretical underpinning of health education practice. While the concept of refreezing change remains an important one in many health education situations, its application in other situations, e.g., those characterized by uncertainty and complexity, has often been problematic.It is in these instances that what Biller has termed “contingent change strategies” appear a valuable alternative to the non-contingent approaches of which refreezing is a classic example. Lewin's “spiral of steps” approach to action research, Kahn's “agnostic” use of information and theory, and Mathiesen's concept of “the unfinished” represent three such alternative change approaches. The last in particular, with its stress on the process of change rather than its completion, holds relevance for those situations in which health educators are concerned with broad system change rather than solely with short term reforms within the existing system.
Evaluation of Health Care Quality by Consumers
Authors: Kelman Howard R. 
Published: May 2005

Ideological and conceptual issues arising out of the involvement of consumers in health care quality determination are identified. Historically and currently, criteria and procedures for quality review and assessment have reflected the values and interests of the professional providers of health care. This perspective restricts the role of the consumer to that of either a nonparticipant or a data source, at best. If the social values and merits for health care provision of consumer involvement in quality determination are to be realized, then this perspective will need to be modified, and our knowledge base of consumer criteria of health care quality will need to be enlarged. Although the perspectives of providers and consumers are thought to be antagonistic, they may not, in fact, be so. Some suggested areas of needed research, necessary to policy development and implementation, are offered.
The Utility of the Ces-D as a Depression Screening Measure among Low-Income Women Attending Primary Care Clinics
Authors: Thomas Janet L. , Jones Glenn N. , Scarinci Isabel C. , Mehan Daniel J. , Brantley Phillip J. 
Published: May 2005

Objective: Depressive disorders are among the most common medical disorders seen in primary care practice. The Center for Epidemiologic Studies-Depression (CES-D) scale is one of the measures commonly suggested for detecting depression in these clinics. However, to our knowledge, there have been no previous studies examining the validity of the CES-D among low-income women attending primary care clinics. Method: Low-income women attending public primary care clinics ( n = 179, ages 20–77) completed the CES-D and the Diagnostic Interview Schedule for the DSM-IV (DIS-IV). Results: The results supported the validity of the CES-D. The standard cut-score of 16 and above yielded a sensitivity of .95 and specificity of .70 in predicting Major Depressive Disorder (MDD). However, over two-thirds of those who screened positive did not meet criteria for MDD (positive predictive value = .28). The standard cut-score appears valid, but inefficient for depression screening in this population. An elevated cut-score of 34 yielded a higher specificity (.95) and over 50 percent of the patients who screened positive had a MDD (positive predictive value = .53), but at great cost to sensitivity (.45). Conclusion: Results indicated that the CES-D appears to be as valid for low-income, minority women as for any other demographic group examined in the literature. Despite similar validity, the CES-D appears to be inadequate for routine screening in this population. The positive predictive value remains very low no matter which cut-scores are used. The costs of the false positive rates could be prohibitive, especially in similar public primary care settings.
Television and the Deaf
Authors: Braverman Barbara B. , Cronin Barry Jay 
Published: May 2005

“Television and the Deaf” considers two important assumptions: (1) television has had a significant impact on our culture, and (2) the deaf have been severely limited in the amount of information obtained from unadapted television programs. This paper presents a perspective on the limited access deaf people have had to television viewing. It addresses new legal and technological breakthroughs which will facilitate access. Finally, the paper focuses on instructional television. The need for researchers and television producers to address together the still unanswered questions about effective programming is explored. Capitalizing on the aspects of television formats for use with deaf audiences is emphasized.
Congenital Heart Disease and Childhood Adjustment
Authors: Auer Edward T. , Senturia Audrey G. , Shopper Moisy , Biddy Ralph L. 
Published: May 2005

This report deals with the findings from a study of twenty-eight children, all of whom had ventricular septal defects and were studied by the same cardiovascular team. One-half of the group had a surgical procedure for correction of the defect. The study investigated three problems in children with ventricular septal defect ( VSD). (1) Do children with surgical intervention for VSD show greater impairment of intellectual functioning than non-operated children? (2) Do children with surgical intervention show greater emotional disturbance than non-operated children? (3) Do children with surgical intervention show greater alteration of body image than do non-operated children? Data were collected using questionnaires, family interviews, subject interviews, medical records, school reports, physicians' reports and Human Figure Drawings, both inside and outside the body. The findings conclude that ( a) operated children do demonstrate significantly more impairment of intellectual functioning; ( b) there was no significant difference in the incidence of emotional disturbances between the two groups but that these twenty-eight children with VSD were more similar emotionally to children in a psychiatric clinic group than in a control group; and ( c) the only indication of altered body image was found in the greater frequency with which bones were drawn by the operated group.
The Arts: A Source of Comfort and Insight for Children who are Learning about Death
Authors: Bertman Sandra L. 
Published: May 2005

The expressive arts - literature, film, song - are mediums for dramatic exposure of human experience with loss which reflect concerns present in the student of any age. Expression of the human spirit is not the exclusive province of the professional artist. Students can respond to the artists' perceptions through art expressions of their own (dialogue, drawing). This paper (1) identifies concerns, consolations and fears of artist and student; (2) illustrates materials and techniques for eliciting feelings and for their expression in aesthetic frameworks; (3) underscores the “mutuality,” - the universality and yet individuality of each mortal experience; (4) sees the arts as a mode of learning to be trusted in its own right; and (5) views the classroom as an appropriate setting for such sharing and study.
Motivating Students with a Winning Assignment
Authors: Driskill L. P. 
Published: May 2005

This paper describes how members of the technical writing class at Rice University handled a major writing assignment that stimulated student interest and integrated many of the skills taught in the course. Phases of the assignment dealt with preparing of a memo describing the problem or question, the writing of an investigative report, organizing feasibility studies, and choosing the right audiences. Some of the feasibility studies attacked problems concerning the university. Others concerned community problems and summer job experiences. Included in the assignment were videotaped oral presentations.
Catatonia on the Consultation-Liaison Service: A Replication Study
Authors: Carroll Brendan T. , Spetie Lacramioara 
Published: May 2005

Objective: The aim of this study is to identify the frequency, presentation, identification, treatment recommendations and outcome of patients with catatonia in the general hospital setting. Method: All patients seen on a consultation-liaison (C-L) service over a six-month period were screened prospectively for catatonic disorders. Research and DSM-IV criteria for catatonic disorder were applied. Treatment and outcome were naturalistic. Results: Five (1.6%) of 297 patients met restrictive criteria for catatonic disorder. Data were extracted from medical charts. Case reports are presented to reflect the diagnosis and treatment. Extensive medical treatment was required in most cases and most had an unfavorable outcome. Conclusion: Catatonia is infrequent but underrecognized in medical-surgical settings. The C-L clinician should screen for catatonic signs in order to diagnose and treat patients with the catatonic disorders.
The Use of the Reader in Technical Writing
Authors: Coney Mary B. 
Published: May 2005

To communicate technical material effectively to a particular audience, a writer must not only analyze his readers' background and professional needs, but also incorporate that analysis into his text. This article introduces the concept of the mock reader as a means of giving body to an amorphic audience and relates that concept to the decisions a writer must make. Three situations are presented—writing to the operator, the expert, and the manager—to show how the mock reader can enhance the immediacy and coherence of a text.
Development of Culturally Appropriate Educational Material to Improve Home Case Management of Diarrhea in Rural Lombok, Indonesia
Authors: Muninjaya A. A. Gde , Widarsa Tangking 
Published: May 2005

Indonesia is a country of many different ethnic groups and cultural norms. Despite this fact, most health education materials in Indonesia have been designed for an overall national audience. These materials rarely take into account local cultural perceptions and ideas about disease causation and appropriate treatment. Once materials are developed, they are rarely pretested to ensure that they are understood and accepted by the communities for which they are intended. We believe that educational messages and illustrations should be based on thorough research and analysis, not only of the health problem, but also of the perceptions, beliefs, and cultural practices of the target audience. In order to develop a culturally sensitive health education campaign on appropriate home case management of diarrhea, we first conducted formative research with mothers of young children and health care providers in West Lombok, Indonesia. This research showed that the people recognize four different types of diarrhea according to signs and symptoms and perceived etiology. Based on the results of the formative research, a flipchart was designed incorporating five messages. The flipchart was then revised on the basis of two pretests. The pretest results showed that visual messages about child health, the course and treatment of diarrheal diseases, and the preparation of oral rehydration solutions were often misinterpreted or not considered in accordance with local cultural norms. Most of the respondents understood the messages but felt that several of the illustrations did not accurately reflect their ways of living. After changes were made, the materials were easily understood and accepted by respondents. To maximize the benefit of educational materials, the national health education sector should be more flexible in the adaptation of materials to local customs and perceptions.
Coping with Chronic Low Back Pain: An Idiographic Exploration through Focus Groups
Authors: Strong J. , Large R. G. 
Published: May 2005

Objective: This article explores the coping construct held by individuals with chronic low back pain. The research addresses two criteria identified as important for coping research: it looks at people's appraisals and responses to the specific stressor of living with chronic low back pain, and it seeks to identify what these individuals actually think and do in response to the ongoing stressor of living with chronic pain. Method: Fifteen people with chronic low back pain who responded to a media release participated in focus group discussions on coping with chronic pain. Results: Analysis indicated the desirability, if not need, for a somatic focus, the reliance on higher order cognitive strategies for planful action, and the use of a varied repertoire of coping strategies. Conclusions: These findings are discussed both in terms of adjustment to chronic illness and in relation to current pain management practices.
A Scientific Releaser
Authors: Ottilio C. J. 
Published: May 2005

“The aim of technology is not the triumph of matter, it is the triumph of man” (Louis Armand, Essays on Machines, Technology, and the Life of the Mind). Because the typical layman does not understand the scientific and technological accomplishments of our nation, a modern educational program must be created to bridge the gulf of misunderstanding between the scientist and the nonscientist. The underlying success of this creative program is founded on the effectiveness of technical communication.
Kallmann's Syndrome and Schizophrenia
Authors: Vagenakis George A. , Hyphantis Thomas N. , Papageorgiou Charalabos , Protonatariou Anthi , Sgourou Argyro , Dimopoulos Panayotis A. , Mavreas Venetsanos , Vagenakis Apostolos G. , Georgopoulos Neoklis A. 
Published: May 2005

Objective: Kallmann's Syndrome is a heritable disorder characterized by the association of hypogonadotropic hypogonadism and anosmia or hyposmia. A common pathogenesis for KS and schizophrenia had been proposed based on shared pathologies of these two disorders, although no such clinical associations have ever been reported. Method: We report a 35 year old man with schizophrenia and Kallmann's Syndrome. The patient presented with signs and symptoms of hypogonadism, severe hyposmia and normal endocrine functions of the anterior pituitary. Hyposmia has been attributed to the absence of the olfactory bulbs and tracts and atrophy of the olfactory gyri, but normal olfactory mucosa. The patient presented with paranoid schizophrenia with persecutory delusions, auditory hallucinations, thought disorder, depersonalization, and gradual but marked global deterioration. Results: Psychiatric evaluation revealed an entirely different psychopathological and personality profile between the patient and the six other Kallmann patients studied. Cycle sequencing analysis revealed a normal sequence of all 14 exons of the KAL gene. In conclusion, based on the presented case, Kallmann's Syndrome and schizophrenia represent a rare clinical association rather than a syndrome with a common pathogenesis, which if present should be confined to the olfactory dysfunction.
Altered Serotonergic Activity in Women with Dysphoric Premenstrual Syndromes
Authors: Halbreich Uriel , Tworek Henry 
Published: May 2005

Objective: Dysphoric Premenstrual Syndromes (PMS) are quite prevalent and in some women they are severe enough to warrant treatment. Their pathophysiology is still unknown, despite increased interest and research. Here we review the possible role of serotonin in the multidimensional interactive pathophysiology of PMS. Method: Over 170 articles are reviewed. An extensive library search has been conducted and articles are included because of their relevance to: 1) the phenomenology of PMS; 2) the putative association of serotonergic (5-HT) activity with syndromes that occur premenstrually; 3) changes in 5-HT activity along the menstrual cycle, especially the late luteal phase; 4) influence of gonadal hormones on serotonergic functions; 5) endocrine strategies for assessment of 5-HT abnormalities; and 6) treatment studies of PMS with serotonergic agonists. Results and Conclusions: The data presented here suggest that post-synaptic serotonergic responsivity might be altered during the late-luteal-premenstrual phase of the menstrual cycle. Some serotonergic functions of women with PMS might be altered during the entire cycle and be associated with a vulnerability trait. It is hypothesized that gonadal hormones might cause changes in levels of activity of 5-HT systems as part of a multidimensional interactive system. Strategies to evaluate 5-HT activities in the context of the menstrual cycle are discussed—leading to the conclusion that the most promising approach is active stimulation with specific post-synaptic serotonin agonists. Treatment outcome studies of some imperfect compounds that are currently applied as a symptomatic treatment of PMS support the notion that 5-HT is involved in the pathophysiology of these syndromes.
The Contribution of Information Technology to Improving Clinicians' Access to High Quality Evidence
Authors: Geddes John R. 
Published: May 2005

Objective: Rapid access to the results of high quality research studies for real time use during clinical care is the aim of evidence-based medicine. Methods: The current volume and methods of disseminating research findings are barriers to this goal. Electronic publishing, CD-ROMs for personal computers, and Internet-based databases and searching are tools helping to overcome these barriers. Results: Several examples in the United Kingdom and United States employing these tools are described. Conclusions: Technology is making traditional narrative reviews such as printed textbooks obsolete for the practice of evidence-based medicine.
Characteristics and Treatment of Women with Antenatal and Postpartum Depression
Authors: Steinberg Susanne I. , Bellavance François 
Published: May 2005

Objective: Investigations of the efficacy of treatment for non-psychotic pregnancy-related mood disorders are scarce. Thus, a prospective, longitudinal study of six months duration, involving ninety-six index cases and forty-five healthy women as a reference group, was implemented to determine the response of mood, parenting stress and dyadic adjustment to an eclectic management. Method: In this naturalistic study, the index cases were offered treatment consistent with their symptoms, context, and level of compliance. All women received individual psychotherapy combining strategies from Interpersonal and Cognitive Behavioral Psychotherapy and/or Marital Interventions and Pharmacology. Rating scales (Dyadic Adjustment Scale, Hamilton Rating Scale for Depression, Edinburgh Postnatal Depression Scale, Child Stress Inventory) scored monthly, were used to measure the response to treatment over time. Results: Depressive symptoms are generally alleviated by the second to third month of treatment. Dyadic discord accentuated by traditional sex role expectations and child care stress exacerbated by low self-esteem persisted throughout the trial at levels significantly different from the untreated reference group. Conclusions: Short-term interventions are cost-effective for the relief of mood disorders. However, creative solutions, during an era of economic restraints, are required to extend treatment sufficiently to address couple conflicts and facilitate the transition to parenthood for index cases.