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Boswell JF, Schwartzman CM, Constantino MJ, Scharff A, Muir HJ, Gaines AN, King BR, Kraus DR. A Qualitative Analysis of Stakeholder Attitudes Regarding Personalized Provider Selection and Patient-Therapist Matching. Adm Policy Ment Health 2023:10.1007/s10488-023-01302-w. [PMID: 37740813 DOI: 10.1007/s10488-023-01302-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
This study explored mental health care patients and therapists' perspectives on using therapists' measurement-based and problem-specific effectiveness data to inform case assignments - a type of treatment personalization that has been shown to outperform non-measurement-based case assignment as usual (Constantino et al., 2021). We conducted semi-structured qualitative interviews with 8 patients (75% women; M age = 33.75 years) and 8 therapists (75% women; M age = 47.50 years). The interview protocols were unique to stakeholder group. Recorded responses were transcribed and qualitatively analyzed by four judges using a blend of consensual qualitative research and grounded theory methods. Derived patient domains included preferred characteristics of a provider, and experiences and suggestions regarding provider selection. Within the domains, most patients expressed an interest in accessing more specific provider information online. Additionally, most patients indicated that both provider outcome track records and personal preference information (e.g., therapist characteristics) should be considered in the therapist selection process. All patients endorsed being comfortable with having the ability to select a provider based on a list of empirically well-matched recommendations. Derived therapist domains included using routine outcomes monitoring for patient-provider matching, referral source and direct patient use of preferred provider lists, and improvements to the provider selection process. Within the domains, all therapists remarked that outcome data would be useful for matching patients to providers; however, most also indicated that outcome data should not be the only factor used in provider selection. All therapists expressed a willingness to be included in preferred provider lists that incorporate track record data. Overall, both patients and therapists held generally positive views toward using therapist effectiveness data to help personalize mental health care. Yet, both stakeholder groups acknowledged that other personalization factors should be considered alongside these data. Based on these results, our team is in the process of implementing patient-therapist match strategies in larger and more diverse mental health care contexts.
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Affiliation(s)
- James F Boswell
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA.
| | - Carly M Schwartzman
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
| | - Michael J Constantino
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Adela Scharff
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
| | - Heather J Muir
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Averi N Gaines
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Brittany R King
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
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Harris BA, Aajmain S, Scharff A, Boswell JF. Outcome trajectories in a county mental health clinic before and after telemental health: a retrospective COVID-19 cohort study. Front Psychol 2023; 14:1095217. [PMID: 37260957 PMCID: PMC10227450 DOI: 10.3389/fpsyg.2023.1095217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/19/2023] [Indexed: 06/02/2023] Open
Abstract
Background/objectives Telemental health (TMH) care has received increased attention, most recently due to the COVID-19 pandemic. Many treatment settings and clinicians were forced to rapidly shift to TMH modalities, including clinicians with limited exposure to and possibly negative attitudes toward alternative treatment delivery formats. With the shift to new modalities, effectiveness research is necessary to understand if patients are receiving the same quality of care as before the pandemic and their receipt of mostly in person services. This study compared the naturalistic treatment outcome trajectories for a cohort of patients who received in-person services prior to the pandemic and a distinct cohort of patients who received TMH services after the onset of the pandemic, in a community mental health setting with limited exposure to TMH prior to the COVID-19 pandemic. Materials and methods We adopted a retrospective cohort design to examine treatment modality as a between-group moderator of symptom change trajectory on the self-report Patient Health Questionnaire (PHQ-9) in a sample of N = 958 patients in the Northeast United States. Treatment durations differed in the naturalistic treatment setting and we examined patient-reported outcomes up to a maximum of one year. Results Statistically significant average decreases in symptom severity were found over the course of up to one year of treatment, yet the average outcome trajectory was not significantly different between two modality cohorts (in person delivery before the pandemic versus TMH delivery after pandemic onset). Conclusion These findings suggest that even in a setting with limited exposure to or training in TMH, the average outcome trajectory for patients who received TMH was statistically similar to the outcome trajectory for patients in an earlier cohort who received in-person services prior to the pandemic onset. Overall, the results appear to support continued use of TMH services in community treatment settings.
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Harris BA, Scharff A, Smith M, Brooks G, Thompson‐Brenner H, Boswell JF. Trajectories of interpersonal problems in residential eating disorder treatment: Exploring the influence of primary diagnosis. Clin Psychol Psychother 2022; 30:302-316. [PMID: 36303012 DOI: 10.1002/cpp.2795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/15/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022]
Abstract
Baseline interpersonal problems have been associated with treatment outcome in eating disorders (ED) and are important for understanding ED maintenance and aetiology. Despite this evidence, little is known about trajectories of change in interpersonal problems in the context of treatment, particularly in intensive ED treatment. This study examined the trajectory of total interpersonal problems in residential ED treatment, as well as two subdomains previously highlighted in ED research of being overly Cold (interpersonally distant) or overly Domineering (interpersonally controlling), as a function of different primary presenting ED diagnoses: anorexia nervosa restricting subtype (AN-R), binge-purge subtype (AN-BP), and bulimia nervosa or binge eating (BN/BED). Interpersonal problem data were collected at admission, discharge, and 6-month follow-up. Trajectories were analysed with multilevel models. Results showed small-to-medium statistically significant reductions in interpersonal problems across diagnostic groups from admission to discharge for total interpersonal scores, and gains appeared to be maintained at follow-up for both AN groups. Patients diagnosed with primary AN experienced steeper declines in total interpersonal problems from admission to follow-up compared with patients diagnosed with BN/BED, with AN-R experiencing the steepest trajectory. Planned contrasts indicated anyone with relevant binge eating behaviours had higher average levels of both Cold, as well as Domineering problems. Exploratory contrasts suggested that patients who had more Domineering problems also exhibited more binge symptoms and were typically slower to improve. Overall, results suggest interpersonal problems are generally malleable in residential ED treatment, yet change patterns differ by presenting ED symptoms and interpersonal problem subdomain.
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Affiliation(s)
| | - Adela Scharff
- Department of Psychology University at Albany, SUNY Albany NY USA
| | | | | | | | - James F. Boswell
- Department of Psychology University at Albany, SUNY Albany NY USA
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Scharff A, Ortiz SN, Forrest LN, Smith AR, Boswell JF. Post‐traumatic stress disorder as a moderator of transdiagnostic, residential eating disorder treatment outcome trajectory. J Clin Psychol 2021; 77:986-1003. [DOI: 10.1002/jclp.23106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/09/2020] [Accepted: 12/24/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Adela Scharff
- Department of Psychology University at Albany—State University of New York Albany New York USA
| | | | | | - April R. Smith
- Department of Psychology Miami University Oxford Ohio USA
| | - James F. Boswell
- Department of Psychology University at Albany—State University of New York Albany New York USA
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Abstract
This study examined whether clinical characteristics among patients presenting to residential eating disorder (ED) treatment differed according to patients' trauma history and current PTSD diagnostic status. Participants (699 girls and women) completed surveys at treatment onset. One-way analysis of covariance (ANCOVA) tests assessed cross-sectional differences between three groups of patients: those reporting no trauma history (No Trauma, n = 185), those with trauma history but without PTSD (Trauma, n = 263), and those with current PTSD (PTSD, n = 251). Relative to the No Trauma group, the combined Trauma and PTSD groups reported greater ED symptoms, anxiety and depressive symptoms, experiential avoidance, anxiety sensitivity, and lower mindfulness. The PTSD group reported greater ED, anxiety, and depressive symptoms, greater anxiety sensitivity, and lower mindfulness, relative to the Trauma group. In sum, ED patients with any history of trauma experienced more symptoms and other psychopathology relative to patients who did not report trauma history. Among patients reporting trauma, those with current PTSD experienced even greater symptom severity. Interventions focused on improving emotional functioning could be especially beneficial for ED patients with trauma histories.
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Affiliation(s)
- Adela Scharff
- Department of Psychology, University at Albany - State University of New York , Albany, USA
| | - Shelby N Ortiz
- Department of Psychology, Miami University , Oxford, OH, USA
| | | | - April R Smith
- Department of Psychology, Miami University , Oxford, OH, USA
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Scharff A, Breiner CE, Ueno LF, Underwood SB, Merritt EC, Welch LM, Fonda C, Weil Malatras J, Lin B, Hormes JM, Pieterse AL, Gordis EB, Halpern LF, Pazienza R, Litchford GB. Shifting a training clinic to teletherapy during the COVID-19 pandemic: a trainee perspective. Counselling Psychology Quarterly 2020. [DOI: 10.1080/09515070.2020.1786668] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Adela Scharff
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Courtney E. Breiner
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Luna F. Ueno
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Shannon B. Underwood
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Edward C. Merritt
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Laura M. Welch
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Carrie Fonda
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Jennifer Weil Malatras
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Betty Lin
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Julia M. Hormes
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Alex L. Pieterse
- Department of Education and Counseling Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Elana B. Gordis
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Leslie F. Halpern
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - Rena Pazienza
- Department of Education and Counseling Psychology, University at Albany – State University of New York, Albany, NY, USA
| | - George B. Litchford
- Department of Psychology, University at Albany – State University of New York, Albany, NY, USA
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Ortiz SN, Espel-Huynh HM, Felonis C, Scharff A. Qualitative perceptions of and preferences for the research process among patients with eating disorders. Int J Eat Disord 2020; 53:41-51. [PMID: 31617609 DOI: 10.1002/eat.23176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 07/01/2019] [Accepted: 09/10/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Low participation and retention rates are persistent problems in eating disorder (ED) research. In order to improve the research process, this study used a qualitative approach to examine factors promoting and limiting research study participation among patients with EDs, and their preferences during research. METHOD Five 90-min focus groups were conducted with adult women (N = 29) enrolled at a residential ED treatment facility. Facilitators asked a series of open-ended questions about participants' experiences, opinions, and preferences with regard to ED treatment research. Transcript analysis identified themes using a consensual qualitative research approach. RESULTS It was revealed that preventing others' suffering, improving ED treatment, and having low participant burden were major themes facilitating research participation. Major barriers to research participation included concern that research interferes with self-care/recovery, burdensome nature of study design, and demeanor of the researchers/institutions involved with the study. Patients believed that the format of research assessments could be improved by better assessing the nuances of ED behaviors, examining non-ED outcomes, and including more open-ended questions. Patients anticipated that challenges in recovery, feelings of guilt, and logistical barriers could interfere with their ability to complete follow-up research assessments. DISCUSSION Factors related to the recruitment process, assessment format, follow-up methods, and communication throughout the research process may need to be addressed to increase participation and retention rates. Findings indicate that recruitment strategies should include emphasizing the broader impact of the research and increasing sensitivity to the nature of patients with EDs experiences.
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Affiliation(s)
- Shelby N Ortiz
- Department of Psychology, Miami University, Oxford, Ohio
| | | | | | - Adela Scharff
- Department of Psychology, University at Albany - State University of New York, Albany, New York
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Siegel DM, Burke TA, Hamilton JL, Piccirillo ML, Scharff A, Alloy LB. Social anxiety and interpersonal stress generation: the moderating role of interpersonal distress. Anxiety Stress Coping 2018; 31:526-538. [PMID: 29855206 DOI: 10.1080/10615806.2018.1482723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Existing models of social anxiety scarcely account for interpersonal stress generation. These models also seldom include interpersonal factors that compound the effects of social anxiety. Given recent findings that two forms of interpersonal distress, perceived burdensomeness and thwarted belongingness, intensify social anxiety and cause interpersonal stress generation, these two constructs may be especially relevant to examining social anxiety and interpersonal stress generation together. DESIGN The current study extended prior research by examining the role of social anxiety in the occurrence of negative and positive interpersonal events and evaluated whether interpersonal distress moderated these associations. METHODS Undergraduate students (N = 243; M = 20.46 years; 83% female) completed self-report measures of social anxiety, perceived burdensomeness, and thwarted belongingness, as well as a self-report measure and clinician-rated interview assessing negative and positive interpersonal events that occurred over the past six weeks. RESULTS Higher levels of social anxiety were associated only with a higher occurrence of negative interpersonal dependent events, after controlling for depressive symptoms. This relationship was stronger among individuals who also reported higher levels of perceived burdensomeness, but not thwarted belongingness. CONCLUSIONS It may be important to more strongly consider interpersonal stress generation in models of social anxiety.
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Affiliation(s)
- David M Siegel
- a Department of Psychology , Temple University , Philadelphia , PA , USA
| | - Taylor A Burke
- a Department of Psychology , Temple University , Philadelphia , PA , USA
| | - Jessica L Hamilton
- a Department of Psychology , Temple University , Philadelphia , PA , USA
| | | | - Adela Scharff
- a Department of Psychology , Temple University , Philadelphia , PA , USA
| | - Lauren B Alloy
- a Department of Psychology , Temple University , Philadelphia , PA , USA
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Scharff A, Palmer J, Moore CM. Divided attention limits perception of object shapes but not simple features. J Vis 2012. [DOI: 10.1167/12.9.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Scharff A, Palmer J, Moore CM. Object identification has fixed capacity: Evidence for serial processing in the formation of perceptual objects. J Vis 2011. [DOI: 10.1167/11.11.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Scharff A, Palmer J. Is object recognition serial or parallel? J Vis 2010. [DOI: 10.1167/10.7.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Rasmussen IP, Becker MW, Scharff A, Hickok A. Incidental memory for relevant locations in real world scenes. J Vis 2010. [DOI: 10.1167/6.6.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Thilmann A, Nachtmann A, Scharff A. [Neurological Reha-Score. An instrument to measure outcome and expenditure of neurologic rehabilitation]. Nervenarzt 2007; 77:1456-63. [PMID: 17131101 DOI: 10.1007/s00115-006-2167-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND A new measurement instrument was developed to combine common scores with the parameter of effort for rehabilitation, the latter being a control instrument for medical professionals and rehabilitational health organisations. METHODS The Neurological Rehabilitation Score (NRS) contains 61 items (including the ten from the Barthel Index) resulting in scores of 0 (worst patient condition) to 600 (best). The items are grouped into seven categories: activities of daily life (13), mobility (8), communication and social skills (7), arm and hand function (7), orientation and cognition skills (10), strength and pain (8), and coping and miscellaneous (8). We investigated 8,139 patients and determined reliability (kappa statistic) and responsivity (standardised response means). In 100 consecutive patients, we also measured the Functional Independence Measure (FIM) and Scandinavian Stroke Scale (SSS) to address validity. RESULTS With an average kappa value of 0.86 (range 0.62-0.98), the NRS showed excellent inter-rater reliability. There was a good correlation between NRS, FIM, and SSS. Response was good at 0.84. The ceiling effect was also less than 1%, compared to 17% in the Barthel Index. CONCLUSION The NRS was shown to be effective for evaluation of outcome and expenditure in neurological rehabilitation.
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Affiliation(s)
- A Thilmann
- Neurologische Abteilung, Fachklinik Rhein/Ruhr, Auf der Rötsch 2, 45219 Essen, Germany.
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Fleitlich-Bilyk B, Pinzon V, Cobelo A, Gonzaga A, Belluzzo P, Nicoletti M, Scharff A, Sousa A, Carvalho L, Mangiacavalli M. A clinical sample of children and adolescents with eating disorders in Brazil: Comorbidities and socio-demographic characteristics. Eur Psychiatry 2007. [DOI: 10.1016/j.eurpsy.2007.01.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Hubálek Z, Burda H, Scharff A, Heth G, Nevo E, Sumbera R, Pesko J, Zima J. Emmonsiosis of subterranean rodents (Bathyergidae, Spalacidae) in Africa and Israel. Med Mycol 2006; 43:691-7. [PMID: 16422298 DOI: 10.1080/13693780500179553] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The presence of adiaspores of the fungal genus Emmonsia was examined in the lungs of 85 mole rats representing 3 subterranean genera: blind mole rats (Spalax galili and S. golani) from Israel, Ansell's mole-rats (Cryptomys anselli) from Zambia, and silvery mole-rats (Heliophobius argenteocinereus) from Malawi and Zambia. Emmonsiosis was found in 28% of the blind mole rats, 100% of the Ansell's mole-rats, but in none of the silvery mole-rats. Infection in African mole-rats was caused by Emmonsia parva, and infection in Israeli blind mole rats was caused by E. parva and E. crescens. The study indicates that the perennial burrow system of the Ansell's mole-rat forms an appropriate microhabitat for the saprophytic growth of E. parva in Lusaka region, Zambia. We suggest that factors contributing to the striking difference in prevalence of emmonsiosis between the two African mole-rat genera (Cryptomys, Heliophobius) may be their differing burrow types, burrow longevity, and social lives.
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Affiliation(s)
- Z Hubálek
- Academy of Sciences of the Czech Republic, Institute of Vertebrate Biology Kvetná 8, CZ-60365 Brno, Czech Republic.
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Scharff A, Burda H, Tenora F, Kawalika M, Barus V. Parasites in social subterranean Zambian mole-rats (Cryptomysspp., Bathyergidae, Rodentia). J Zool (1987) 1997. [DOI: 10.1111/j.1469-7998.1997.tb04848.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Chlorprothixene was the first neuroleptic of the thioxanthene group and was marketed in 1959 under the trade names of Taractan and Truxal. Since then 20 years have passed and the authors were of the opinion that it would be opportune to study the literature published during these 20 years. They perused 801 publications, hereof 542 clinical works. Of these clinical works 109 were suited for statistical analysis. They represented 7109 patients. The other publications comprise 4378 patients which means that all the literature studied consists of a total of 11487 patients. The chlorprothixene proved to be a broad-spectrum neuroleptic with good therapeutic effects. Side effects, especially the extrapyramidal symptoms, appeared only seldom. Among the 11487 patients only 1.02% showed extrapyramidal symptoms and of these only 0.05% had tardive dyskinesias. Sme evidence seems to exist that these are schizophrenic patients showing extrapyramidal symptoms, without having received neuroleptics. It is the authors' opinion that chlorprothixene is still a neuroleptic of topical interest.
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Nielsen B, Sorensen AW, Szabo L, Pedersen EA, Scharff A. Kanamycin serum half-life and renal function: age and sex. Dan Med Bull 1973; 20:144-9. [PMID: 4770767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Sorenen AW, Szabo L, Pedersen A, Scharff A. Correlation between renal function and serum half-life of kanamycin and its application to dosage adjustment. Postgrad Med J 1967:Suppl:37-43. [PMID: 6042978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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