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Patten CA, Lando HA, Desnoyers CA, Bock MJ, Alexie L, Decker PA, Hughes CA, Resnicow K, Burhansstipanov L, Boyer R, Klejka J. Healthy Pregnancies Project: Cluster Randomized Controlled Trial of a Community Intervention to Reduce Tobacco Use among Alaska Native Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9302. [PMID: 33322686 PMCID: PMC7764642 DOI: 10.3390/ijerph17249302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/07/2020] [Accepted: 12/11/2020] [Indexed: 11/23/2022]
Abstract
Substantial gaps remain in the evidence base for prenatal tobacco use interventions among Indigenous women. Using a cluster randomized controlled trial (RCT), the Healthy Pregnancies Project evaluated a community-level intervention for Alaska Native (AN) women in rural western Alaska. Sixteen villages were randomly assigned to usual care (control, n = 8 villages) or usual care plus a community-level intervention delivered by local AN "Native Sisters" (n = 8 villages). Outcomes were tobacco use rate at delivery and at 2 and 6 months postpartum, with biochemical confirmation obtained at 6 months. The program had high reach, enrolling 73% of all eligible women screened. Of the 352 participants, 67% used tobacco at baseline. No significant differences emerged between study groups on follow-up in tobacco use rates. More intervention than control participants made a quit attempt at 2 months postpartum (70% vs. 51%, respectively, p = 0.012). Participants in both study groups reported the program helped to raise awareness of healthy pregnancies in the study villages. This trial supports the reach of a community-level intervention, but not its efficacy for reducing tobacco use during pregnancy or postpartum. Efforts to sustain early quit attempts appear warranted. The community involvement, and reported impact on raising awareness of the importance of healthy pregnancies, supports the value of the research program in this community.
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Patten CA, Lando HA, Desnoyers CA, Klejka J, Decker PA, Bock MJ, Hughes CA, Alexie L, Boyer R, Resnicow K, Burhansstipanov L. Association of Tobacco Use During Pregnancy, Perceived Stress, and Depression Among Alaska Native Women Participants in the Healthy Pregnancies Project. Nicotine Tob Res 2020; 22:2104-2108. [PMID: 31566239 PMCID: PMC7593352 DOI: 10.1093/ntr/ntz189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 09/27/2019] [Indexed: 11/13/2022]
Abstract
INTRODUCTION In general population samples, higher levels of stress and depression have been associated with increased prevalence of smoking in pregnancy. Little is known about the association of prenatal tobacco use, stress, and depression among American Indian or Alaska Native (AI/AN) women. METHODS The Healthy Pregnancies Project is a cluster-randomized controlled trial, evaluating a community-level intervention compared with usual care, for reducing tobacco use during pregnancy and postpartum among AN women in 16 villages in western Alaska. This cross-sectional study analyzed baseline data from enrolled pregnant women. Baseline measures included the self-reported, 7-day, point-prevalence current use of any tobacco, Perceived Stress Scale (PSS), and the Center for Epidemiological Studies-Depression (CES-D). Generalized estimating equations (GEE) analyses adjusted for village, participant age, and gestational age. RESULTS Participants (N = 352) were on average (SD) 25.8 (5.0) years of age and at 26.8 (9.8) weeks gestation. 66.5% were current tobacco users, of which 77% used Iqmik, a homemade form of smokeless tobacco. Compared with nonusers, tobacco users reported lower PSS score (p = .020) and less clinical levels of depression (CES-D ≥ 16) (18.1% vs. 9.3%, p = .21). Findings were not accounted for by nicotine dependence severity or self-reported tobacco use before pregnancy. CONCLUSIONS In this sample of pregnant AN women, tobacco users report less stress and clinical levels of depression than nonusers. A potential challenge with tobacco treatment for pregnant AN women is to provide alternative ways of deescalating stress and affect management instead of using tobacco. IMPLICATIONS This study contributes novel information on the association of tobacco use, perceived stress, and depression among Alaska Native women enrolled in a clinical trial to promote healthy pregnancies. Most prior studies addressing this topic were conducted among general population samples of pregnant women who smoked cigarettes. Little is known about these associations with prenatal smokeless tobacco, or among American Indian or Alaska Native women. The results are contrary to findings reported previously, because current tobacco use was associated with less stress and depression than nonuse. The study findings have implications for cessation treatment for this tobacco-use disparity group.
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Hocking KM, Alvis BD, Baudenbacher F, Boyer R, Brophy CM, Beer I, Eagle S. Peripheral i.v. analysis (PIVA) of venous waveforms for volume assessment in patients undergoing haemodialysis. Br J Anaesth 2019; 119:1135-1140. [PMID: 29028929 DOI: 10.1093/bja/aex271] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 11/13/2022] Open
Abstract
Background The assessment of intravascular volume status remains a challenge for clinicians. Peripheral i.v. analysis (PIVA) is a method for analysing the peripheral venous waveform that has been used to monitor volume status. We present a proof-of-concept study for evaluating the efficacy of PIVA in detecting changes in fluid volume. Methods We enrolled 37 hospitalized patients undergoing haemodialysis (HD) as a controlled model for intravascular volume loss. Respiratory rate (F0) and pulse rate (F1) frequencies were measured. PIVA signal was obtained by fast Fourier analysis of the venous waveform followed by weighing the magnitude of the amplitude of the pulse rate frequency. PIVA was compared with peripheral venous pressure and standard monitoring of vital signs. Results Regression analysis showed a linear correlation between volume loss and change in the PIVA signal (R2=0.77). Receiver operator curves demonstrated that the PIVA signal showed an area under the curve of 0.89 for detection of 20 ml kg-1 change in volume. There was no correlation between volume loss and peripheral venous pressure, blood pressure or pulse rate. PIVA-derived pulse rate and respiratory rate were consistent with similar numbers derived from the bio-impedance and electrical signals from the electrocardiogram. Conclusions PIVA is a minimally invasive, novel modality for detecting changes in fluid volume status, respiratory rate and pulse rate in spontaneously breathing patients with peripheral i.v. cannulas.
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Sikka N, Siev A, Boyer R, Pourmand A. Tungiasis, a rare case of plantar inflammatory disease, a review of travelers skin lesions for emergency providers. Am J Emerg Med 2019; 37:1215.e5-1215.e7. [PMID: 30922527 DOI: 10.1016/j.ajem.2019.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 03/20/2019] [Indexed: 10/27/2022] Open
Abstract
Parasitic infections while common in underdeveloped nations are rarely seen in developed urban centers. We report a case of a thirty-three-year-old male with no past medical history who presented to the emergency department with a chief complaint of "eggs coming out of my foot" after returning home from Brazil. Based on clinical presentation, travel history, and appearance of the lesion, diagnosis was most consistent with tungiasis infection which was confirmed by the pathology examination. It is important to make the appropriate diagnosis when skin lesions are found in returning travelers and emergency providers should take broad differential diagnosis into consideration.
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Patten CA, Lando HA, Desnoyers CA, Barrows Y, Klejka J, Decker PA, Hughes CA, Bock MJ, Boyer R, Resnicow K, Burhansstipanov L. The Healthy Pregnancies Project: Study protocol and baseline characteristics for a cluster-randomized controlled trial of a community intervention to reduce tobacco use among Alaska Native pregnant women. Contemp Clin Trials 2019; 78:116-125. [PMID: 30703523 PMCID: PMC6407629 DOI: 10.1016/j.cct.2019.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/17/2019] [Accepted: 01/25/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Tobacco use prevalence is high among pregnant Alaska Native (AN) women but few interventions have been evaluated for this group. The Healthy Pregnancies Project aims to evaluate a multicomponent intervention for reducing tobacco use during pregnancy and the postpartum period among AN women. This report describes the study protocol and participant baseline characteristics. DESIGN Cluster-randomized controlled trial with village as the unit of assignment. Sixteen villages in rural southwest Alaska were stratified on village size and randomized to a multicomponent intervention (n = 8 villages) or usual care (n = 8 villages). METHODS Pregnant AN women from the study villages were enrolled. All participants receive the usual care provided to pregnant women in this region. Participants from intervention villages additionally receive individual phone counseling on healthy pregnancies plus a social marketing campaign targeting the entire community delivered by local AN "Native Sisters." Baseline measurements for all enrolled pregnant women have been completed. Follow-up assessments are ongoing at delivery, and at 2 and 6 months postpartum. The primary outcome is biochemically verified tobacco use status at 6 months postpartum. RESULTS Recruitment was feasible with 73% of eligible women screened enrolled. The program reached more than half (56%) of AN pregnant women from the study villages during the recruitment period. Participants are N = 352 pregnant AN women, 188 enrolled from intervention villages and 164 from control villages. At baseline, participants' mean (SD) age was 25.8 (5.0) years, they were at 26.8 (9.8) weeks gestation, and 66.5% were current tobacco users. DISCUSSION Processes and products from this project may have relevance to other Native American populations aiming to focus on healthy pregnancies in their communities.
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Patten CA, Bronars CA, Scott M, Boyer R, Lando H, Clark MM, Resnicow K, Decker PA, Brockman TA, Roland A, Hanza M. Tobacco use and preferences for wellness programs among health aides and other employees of an Alaska Native Health Corporation in Western Alaska. Prev Med Rep 2017; 6:228-235. [PMID: 28377849 PMCID: PMC5377012 DOI: 10.1016/j.pmedr.2017.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/18/2017] [Accepted: 03/13/2017] [Indexed: 11/01/2022] Open
Abstract
This study assessed health behaviors and preferences for wellness programs among employees of a worksite serving Alaska Native-people. Village-based Community Health Aides/Practitioners (CHA/Ps) were compared with all other employees on health indicators and program preferences. Using a cross-sectional design, all 1290 employees at the Yukon Kuskokwim Health Corporation (YKHC) in Western Alaska were invited in 2015 to participate in a 30-item online survey. Items assessed health behaviors, perceived stress, resiliency, and preferences for wellness topics and program delivery formats. Respondents (n = 429) were 77% female and 57% Alaska Natives. CHA/Ps (n = 46) were more likely than all other employees (n = 383) to currently use tobacco (59% vs. 36%; p = 0.003). After adjusting for covariates, greater stress levels were associated (p = 0.013) with increased likelihood of tobacco use. Employees reported lower than recommended levels of physical activity; 74% had a Body Mass Index (BMI) indicating overweight or obese. Top preferences for wellness topics were for eating healthy (55%), physical activity (50%), weight loss (49%), reducing stress (49%), and better sleep (41%). CHA/Ps reported greater interest in tobacco cessation than did other employees (37% vs. 21%; p = 0.016). Preferred program delivery format among employees was in-person (51%). The findings are important because tailored wellness programs have not been previously evaluated among employees of worksites serving Alaska Native people. Promoting healthy lifestyles among CHAP/s and other YKHC employees could ultimately have downstream effects on the health of Alaska Native patients and communities.
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Ruggieri JM, Boyer R, Doriath JY, Finck PJ. Accounting for Strong Localized Heterogeneities and Local Transport Effect in Core Calculation. NUCL SCI ENG 2017. [DOI: 10.13182/nse96-a24225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Boyer R, Morgan V, Donnelly E, Brown D, Omary R. Comparison of structure and influence of the #IRad and #Radiology social media networks. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Trudel G, Dargis L, Villeneuve L, Cadieux J, Boyer R, Préville M. Fonctionnement conjugal, sexuel et psychologique des couples aînés vivant à domicile : les résultats d’une enquête nationale avec méthodologie longitudinale (deuxième partie). SEXOLOGIES 2014. [DOI: 10.1016/j.sexol.2013.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Patten CA, Fadahunsi O, Hanza MMK, Smith CA, Decker PA, Boyer R, Ellsworth L, Brockman TA, Hughes CA, Bronars CA, Offord KP. Tobacco cessation treatment for Alaska native adolescents: group randomized pilot trial. Nicotine Tob Res 2014; 16:836-45. [PMID: 24532352 DOI: 10.1093/ntr/ntu004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Tobacco cessation treatments have not been evaluated among Alaska Native (AN) adolescents. This pilot study evaluated the feasibility and the potential efficacy of a targeted cessation intervention for AN youth using a group randomized design. METHODS Eight villages in western Alaska were randomly assigned to receive the intervention (n = 4 villages) or a delayed treatment control condition (written materials only; n = 4 villages). Ten adolescents aged 12-17 years were targeted from each village with a planned enrollment of 80. The intervention was held over a weekend, and youth traveled from their villages to quit tobacco use with other teens. The intervention comprised 8 hr of group-based counseling. Talking circles, personal stories from elders, and recreational activities were included to enhance cultural acceptability and participation. Newsletters were mailed weekly for 5-weeks postprogram. Assessments were conducted at baseline, week 6 (end-of-treatment), and 6 months. Self-reported tobacco abstinence was confirmed with salivary cotinine. RESULTS Recruitment targets were met in the intervention (41 enrolled) but not in control villages (27 enrolled). All intervention participants attended the weekend program. Retention was high; 98% of intervention and 86% of control participants completed 6-month follow-up. The 7-day point-prevalence self-reported tobacco abstinence rates for intervention and control participants were 10% (4/41) and 0% (0/27) at both week 6 and 6 months (p = .15). Only 1 adolescent in the intervention condition was biochemically confirmed abstinent at week 6 and none at 6 months. CONCLUSION The intensive individual-focused intervention used in this study was feasible but not effective for tobacco cessation among AN youth. Alternative approaches are warranted.
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Trudel G, Dargis L, Villeneuve L, Cadieux J, Boyer R, Préville M. Marital, sexual and psychological functioning of older couples living at home: The results of a national survey using longitudinal methodology (part one). SEXOLOGIES 2013. [DOI: 10.1016/j.sexol.2013.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Dargis L, Trudel G, Cadieux J, Villeneuve L, Préville M, Boyer R. Validation of the International Index of Erectile Function (IIEF) and presentation of norms in older men. SEXOLOGIES 2013. [DOI: 10.1016/j.sexol.2012.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Patten CA, Fadahunsi O, Hanza M, Smith CM, Hughes CA, Brockman TA, Boyer R, Decker PA, Luger E, Sinicrope PS, Offord KP. Development of a tobacco cessation intervention for Alaska Native youth. ADDICTION RESEARCH & THEORY 2013; 21:273-284. [PMID: 24058327 PMCID: PMC3775480 DOI: 10.3109/16066359.2012.714428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Tobacco cessation treatments have not been evaluated among Alaska Native (AN) adolescents. This pilot study evaluated the feasibility and acceptability of a targeted cessation intervention developed for AN youth. Intervention components were informed by prior focus groups assessing treatment preferences among AN youth, a social cognitive theoretical framework and feedback obtained from a teen advisory group. The intervention consisted of a weekend program where youth traveled by small airplane from their villages to stay overnight with other adolescents who quit tobacco use together. The program included recreational activities, talking circles, personal stories from elders and teen advisors, and cognitive behavioral counseling. Two intervention pilots were conducted from October 2010 to January 2011 using a non-randomized, uncontrolled study design with assessments at baseline and six-week follow-up. One village in Western Alaska was selected for each pilot with a targeted enrollment of 10 adolescents each. Participants were recruited for each pilot within five days, but recruitment challenges and ''lessons learned'' are described. The first pilot enrolled nine adolescents (all female) aged 13-16 years; all nine attended the intervention program and 78% (7/9) completed follow-up. The second pilot enrolled 12 adolescents (eight females, four males) aged 12-17 years, of which seven attended the intervention program. Six of these seven participants (86%) completed follow-up. In both pilots, participants rated the intervention as highly acceptable. A targeted cessation intervention was feasible and acceptable to AN youth. The intervention will be tested for efficacy in a subsequent randomized controlled trial.
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Dargis L, Trudel G, Cadieux J, Villeneuve L, Préville M, Boyer R. Validation de l’Index International de la Fonction Érectile (IIFE) et présentation de normes chez les hommes aînés. SEXOLOGIES 2013. [DOI: 10.1016/j.sexol.2012.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Trudel G, Dargis L, Cadieux J, Villeneuve L, Préville M, Boyer R. Validation de l’Index de la fonction sexuelle féminine (IFSF) et présentation de normes chez les femmes aînées. SEXOLOGIES 2012. [DOI: 10.1016/j.sexol.2012.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dargis L, Trudel G, Cadieux J, Villeneuve L, Préville M, Boyer R. Validation of the Female Sexual Function Index (FSFI) and presentation of norms in older women. SEXOLOGIES 2012. [DOI: 10.1016/j.sexol.2012.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Messier L, Schmitz N, Malla A, Lesage A, Boyer R, Wang J, Strychar I. Lifestyle and self-care behaviours among diabetics with major, minor and no depression: a population based study of adults with diabetes in Quebec. Can J Diabetes 2009. [DOI: 10.1016/s1499-2671(09)33141-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Trudel G, Poirier-Arbour A, Harvey P, Boyer R. T02-P-06 Marital and sexual life of pathological gamblers. SEXOLOGIES 2008. [DOI: 10.1016/s1158-1360(08)72696-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Trudel G, Anderson A, Villeneuve V, Boyer R, Bounader J. T02-P-05 Effects of a marital and sexual enhancement intervention for retired couples: the marital life and aging well program. SEXOLOGIES 2008. [DOI: 10.1016/s1158-1360(08)72695-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Černý M, Boyer R, Šob M, Yip S. Higher-energy Structures and Stability of Cu and Al Crystals Along Displacive Transformation Paths. ACTA ACUST UNITED AC 2006. [DOI: 10.1007/s10820-005-2086-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Drapeau A, Lesage A, Boyer R. 238: Interaction of Social Anchorage and Gender in the use of Mental Health Services. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s60a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
Several studies have reported that psychiatric disorders, mainly depression and anxiety disorders, were masked and undiagnosed among older adults, particularly frail elderly. This phenomenon could have a significant impact on elderly quality of life. In this study, we assessed the utility of three measures for detecting mental health disorders among frail elderly receiving home care services: (1) the PRIME-MD; (2) a standard psychological distress measure (PDI-29), and (3) the health care case manager'sa priori judgment on the subject's mental health status. Results obtained by home care nurses were compared to those obtained by clinical psychologists using a structured diagnostic interview (SCID for DSM-IV). The study was conducted in two community health service centres. During the study's period, all patients in the health care workers' caseload without cognitive impairment and not reporting significant stressful life events during the six-week period preceding the interview (n = 315) were asked to participate in the study. Results showed that 42.9% of the volunteers that agreed to meet a psychologist at home (n = 177) had a current SCID-IV diagnosis. The specificity of the PRIME-MD test performed by nurses was 83.8% and its sensitivity was 41.7%. The correct classification rate was 66.7%. Results indicated that the PDI-29 items showed better performance characteristics than the PRIME-MD in identifying current cases. The specificity of the PDI-29 was 59.0% and its sensitivity was 73.6%. These results lead us to the conclusion that the PRIME-MD, previously proposed by Spitzer, R.L., Williams, J.B., Kroenke, K., Linzer, M., DeGruy, F.V. 3rd, Hahn, S.R., et al. (1994, Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. Journal of the American Medical Association, 272 (22), 1749-1756.) to help physicians in primary care clinics, could be less appropriate than the PDI-29 when used by home care nurses in identifying undiagnosed mental health disorders in frail older adults living at home. Moreover, this study showed that the health care case manager'sa priori judgment on the care receiver's mental health status is not sufficient in identifying frail elderly mental health services needs. A two-stage screening procedure is proposed to help home care nurses.
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Stravynski A, Boyer R. Loneliness in relation to suicide ideation and parasuicide: a population-wide study. Suicide Life Threat Behav 2001; 31:32-40. [PMID: 11326767 DOI: 10.1521/suli.31.1.32.21312] [Citation(s) in RCA: 196] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Some links between loneliness and different manifestations of suicidal conduct have been reported in variety of subgroups (e.g., college students, the elderly, psychiatric patients). We tested this hypothesis by using the results of a population-wide survey. Strong associations among suicide ideation, parasuicide and different ways of being lonely and alone, defined either subjectively (i.e., the feeling), or objectively (i.e., living alone or being without friends), were observed. Moreover, prevalence of suicide ideation and parasuicide increased with the degree of loneliness. Only minimal differences between men and women were found.
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Sun X, Rodriguez M, Zeckner D, Sachs B, Current W, Boyer R, Paschal J, McMillian C, Chen SH. Synthesis and evaluation of oxodioxolenylmethyl carbamate prodrugs of pseudomycins. J Med Chem 2001; 44:2671-4. [PMID: 11472220 DOI: 10.1021/jm000425w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
With the aim of increasing therapeutic indexes of novel cyclic depsinonapeptide pseudomycins, we synthesized and evaluated a series of mono-, di-, and trioxodioxolenylmethyl carbamate prodrugs (2 and 4) of pseudomycin B 1 and pseudomycin C' 3. It is rather encouraging to note that several members of the newly synthesized prodrugs described herein (e.g., 2a, 2e, and 4e) exhibited comparable in vivo efficacy to that achieved by the parent compounds, yet free of tail vein irritation and histamine induced toxicity in vivo.
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Préville M, Hébert R, Boyer R, Bravo G. Correlates of psychotropic drug use in the elderly compared to adults aged 18-64: results from the Quebec Health Survey. Aging Ment Health 2001; 5:216-24. [PMID: 11575060 DOI: 10.1080/13607860120065014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study documents correlates of psychotropic drug use among older adults and compares the results observed in this group to those observed in individuals aged 18-64. A multivariate logistic regression analysis using data from the Quebec Health Survey (1992-1993) was employed to study predisposing and facilitating factors of this behavior. Results showed that 22% of the elderly reported having used anxiolytics, sedatives or hypnotics during the two days preceding the survey, compared to 4.9% of the respondents aged 18-64. Combining both samples, perceived health status, physical functional status, and health services utilization for psychological distress symptoms were the main health factors associated with psychotropic drug use. A significant difference was observed between the two age groups with regard to the association between the respondents' health status and the use of anxiolytics, sedatives or hypnotics. When the effect of other explanatory factors was controlled, older adults in poor health used anxiolytics, sedatives or hypnotics 2.21 times more than individuals aged 18-64 with a similar health condition, whereas older adults in good health used these drugs 7.49 times more than healthy individuals aged 18-64. Furthermore, after controlling for the effect of the respondents' physical and psychological health status, our results showed that more women than men used psychotropic drugs (OR = 1.57; 99% CI = 1.26-1.94). Low-income respondents were also more likely to report using these medications (OR = 1.53; 99% CI = 1.22-1.90). These results were interpreted as supporting the socio-cultural hypothesis of psychotropic drug use, which suggests that the prescribing and utilization of psychotropic drugs is influenced not only by symptoms but also by the social characteristics of individuals. It is suggested that future research may contribute to a better understanding of psychotropic drug utilization in the older adult community-dwelling population by examining consumers' attitudes and health care providers' social values concerning the appropriateness of this behavior.
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