Contributions of the Social Environment to Central Adiposity: Results from Etiologic and Intervention Studies.

Evidence is building regarding the relationship of the social environment to central adiposity risk. Proxies of the social environment include indicators of psychosocial stress, such as neighborhood poverty, perceived discrimination, and family stress. While some research has theorized that psychosocial stress influences central adiposity indirectly through poor health behaviors, other studies have theorized that psychosocial stress directly influences central adiposity via biophysiological pathways. However, these pathways have rarely been examined. The purpose of this dissertation is to examine both direct and indirect pathways that psychosocial stress may influence central adiposity. First, I examine several direct pathways that psychosocial stress (i.e. perceived discrimination, family stress, and cumulative stress index) may influence changes in central adiposity over time; and ways that neighborhood poverty, may influence changes in central adiposity through both direct and mediating pathways. Next, I examine indirect pathways that psychosocial stress may effect central adiposity. I examined a sample of 386 Non-Hispanic Black, Non-Hispanic White, and Hispanic adults of waves I and II of the Healthy Environments Partnership community surveys 2002-2003 and 2008, respectively. In addition, I analyzed an intervention study of 473 adults who were predominately NHB and Hispanic women. Results include 1) a positive association between perceived discrimination and central adiposity over time; 2) in general, a null association between multiple indicators of psychosocial stress and changes in central adiposity over time, with the exception of family stress; 3) a positive association between cumulative stress index (i.e. composite measure of psychosocial stress) at baseline changes in central adiposity over time; 4) neighborhood economic composition did not mediate the association between cumulative stress index and changes in central adiposity over time; and 5) a null association between perceived safety and participation in the physical-activity-intervention; 6) perceived safety modified the associations between participation and physical activity; however, perceived safety did not modify the association between physical activity and central adiposity. The understanding of these factors may help to elucidate the direct and indirect pathways between psychosocial stress and central adiposity, which may help public health professionals target interventions more effectively towards the factors that drives these changes.PHDHealth Behavior & Health EducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/107144/1/jamilah_1.pd

Validity of self- and parent-report scales in screening students for behavioral and emotional problems in elementary school

The comparative validity of the child-report Classroom Screening Scale (CLASS) from the Personality Inventory for Youth (PIY), and the parent-report Adjustment Scale (ADJ) from the Personality Inventory for Children (PIC) was examined. The subjects were 111 children from fourth- through sixth-grade regular education classrooms. Children were classified as positive or negative for risk status on each screening scale using a cutoff of 60 T. Parent description identified a higher proportion of children as at risk. Those identified as “at risk” by either parent or child report were more likely than others to have clinically elevated scores on both the PIC and PIY clinical scales. High scores on CLASS were more likely to have clinically significant elevations than were high scorers on ADJ. Parent report appeared to be sensitive to overt behavioral problems, while self-report was sensitive to mood disturbances and withdrawal. © 1998 John Wiley & Sons, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34547/1/2_ftp.pd

Risk and protective factors at age 10: Psychological adjustment in children with a cleft lip and/or Palate

© Copyright 2016 American Cleft Palate-Craniofacial Association. Objective: To explore psychological functioning in children with a cleft at age 10 from a broad perspective, including cognitive, emotional, behavioral, appearance-related, and social adjustment. High-risk groups were identified within each area of adjustment to investigate whether vulnerable children were found across domains or whether risk was limited to specific areas of adjustment. Methods: Retrospective chart review from psychological assessments at age 10 (N = 845). The effects of gender, cleft visibility, and the presence of an additional condition were investigated. Results were compared with large national samples. Measures: Personality Inventory for Children, Child Experience Questionnaire, Strengths and Difficulties Questionnaire, Satisfaction With Appearance scale. Results: The factor affecting psychological adjustment on most domains was the presence of an associated condition in addition to the cleft. As expected, no support was found for cleft visibility as a risk factor, while there were some gender differences related to emotional difficulties and attention. Correlation analyses of risk groups pointed to an association between social experiences and emotional adjustment and between social and behavioral adjustment; whereas, dissatisfaction with appearance was not related to any other domains of risk at age 10. Conclusions: The results point to the importance of early screening and assessment of children born with a cleft to identify possible associated conditions and offer adapted and appropriate treatment and care. Future research should investigate how protective factors could counteract potential risk in children with a cleft

Association of treatment satisfaction and psychopathological sub-syndromes among involuntary patients with psychotic disorders

Publisher's version: http://www.springerlink.com/content/rx24036274667t10

Diagnostic precision of image-guided multisampling core needle biopsy of suspected lymphomas in a primary care hospital

We evaluated the diagnostic quality of image-guided multisampling core needle biopsy (CNB) in patients investigated for suspected lymphoma in a primary care hospital. A total of 112 patients were consecutively assessed during a 3-year period. There were 80 lymphoid site biopsies and 32 non-lymphoid site biopsies. Eight to nine cores were obtained from different parts of the biopsy site. Two cores were systematically frozen, allowing for further morphological, immunochemistry and molecular studies. The diagnostic yield of CNB for malignancy was 100%. Only 47% (41/87) of patients with initial suspicion of lymphoma were finally diagnosed with Lymphoma. The diagnostic yield of CNB for lymphoma typing was 98% (62/63), according to the WHO classification. The diagnostic yield of CNB for complete lymphoma subtyping/grading was 86% (54/63). The diagnostic yield of CNB for a definite diagnosis of benignity was only 47% (8/17). In a primary care setting, multisampling CNB is a minimally invasive, and very accurate procedure for confirming malignancy in patients with suspected lymphoma, presenting with superficial/deep-seated, lymphoid/non-lymphoid site targets. With a very high diagnostic yield for lymphoma typing and a high diagnostic yield for complete lymphoma subtyping/grading a therapeutic decision can be taken in most patients

Association of Typical versus Atypical Antipsychotics with Symptoms and Quality of Life in Schizophrenia

BACKGROUND: Several reports on patients with chronic schizophrenia suggest that atypical versus typical antipsychotics are expected to lead to better quality of life (QOL) and cognitive function. Our aim was to examine the association of chronic treatment with typical or atypical antipsychotics with cognitive function, psychiatric symptoms, QOL, and drug-induced extrapyramidal symptoms in long-hospitalized patients with schizophrenia. METHODOLOGY AND PRINCIPAL FINDINGS: The Hasegawa Dementia Scale-Revised (HDS-R), Brief Psychiatric Rating Scale (BPRS), the Schizophrenia Quality of Life Scale, translated into Japanese (JSQLS), and the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) were used to evaluate cognitive function, psychiatric symptoms, QOL, and drug-induced extrapyramidal symptoms. We examined the correlation between the dose of antipsychotics and each measure derived from these psychometric tests. The student t-test was used to compare scores obtained from psychometric tests between patients receiving typical and atypical antipsychotics. Results showed significant correlations between chlorpromazine (CPZ)-equivalent doses of typical antipsychotics and atypical antipsychotics, and the total BPRS score and BPRS subscale scores for positive symptoms. CPZ-equivalent doses of typical antipsychotics were correlated with the JSQLS subscale score for dysfunction of psycho-social activity and DIEPSS score. Furthermore, the total BPRS scores, BPRS subscale score for positive symptoms, the JSQLS subscale score for dysfunction of psycho-social activity, and the DIEPSS score were significantly higher in patients receiving typical antipsychotics than atypical antipsychotics. CONCLUSION AND SIGNIFICANCE: These findings suggest that long-term administration of typical antipsychotics has an unfavorable association with feelings of difficulties mixing in social situations in patients with chronic schizophrenia

The Amsterdam Studies of Acute Psychiatry - II (ASAP-II): a comparative study of psychiatric intensive care units in the Netherlands

Background The number of patients in whom mental illness progresses to stages in which acute, and often forced treatment is warranted, is on the increase across Europe. As a consequence, more patients are involuntarily admitted to Psychiatric Intensive Care Units (PICU). From several studies and reports it has become evident that important dissimilarities exist between PICU's. The current study seeks to describe organisational as well as clinical and patient related factors across ten PICU's in and outside the Amsterdam region, adjusted for or stratified by level of urbanization. Method/Design This paper describes the design of the Amsterdam Studies of Acute Psychiatry II (ASAP-II). This study is a prospective observational cohort study comparing PICU's in and outside the Amsterdam region on various patient characteristics, treatment aspects and recovery related variables. Dissimilarities were measured by means of collecting standardized forms which were filled out in the framework of care as usual, by means of questionnaires filled out by mental health care professionals and by means of extracting data from patient files for every consecutive patient admitted at participating PICU's during a specific time period. Urbanization levels for every PICU were calculated conform procedures as proposed by the Dutch Central Bureau for Statistics (CBS). Discussion The current study may provide a deeper understanding of the differences between psychiatric intensive care units that can be used to promote best practice and benchmarking procedures, and thus improve the standard of care