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Stoddard J, Reynolds E, Paris R, Haller SP, Johnson SB, Zik J, Elliotte E, Maru M, Jaffe AL, Mallidi A, Smith AR, Hernandez RG, Volk HE, Brotman MA, Kaufman J. The Coronavirus Impact Scale: Construction, Validation, and Comparisons in Diverse Clinical Samples. JAACAP Open 2023; 1:48-59. [PMID: 37359142 PMCID: PMC10010775 DOI: 10.1016/j.jaacop.2023.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2023] [Indexed: 06/12/2023]
Abstract
Objective This report is of the construction and initial psychometric properties of the Coronavirus Impact Scale in multiple large and diverse samples of families with children and adolescents. The scale was established to capture the impact of the coronavirus pandemic during its first wave. Differences in impact between samples and internal structure within samples were assessed. Method A total of 572 caregivers of children and adolescents or expecting mothers in diverse clinical and research settings completed the Coronavirus Impact Scale. Samples differed in regard to developmental stage, background, inpatient/outpatient status, and primary research or clinical setting. Model free methods were used to measure the scale's internal structure and to determine a scoring method. Differences between samples in specific item responses were measured by multivariate ordinal regression. Results The Coronavirus Impact Scale demonstrated good internal consistency in a variety of clinical and research populations. Across the groups studied, single, immigrant, predominantly Latinx mothers of young children reported the greatest impact of the pandemic, with noteworthy effects on food access and finances reported. Individuals receiving outpatient or inpatient care reported greater impacts on health care access. Elevated scores on the Coronavirus Impact Scale were positively associated with measures of caregiver anxiety and both caregiver- and child-reported stress at a moderate effect size. Conclusion The Coronavirus Impact Scale is a publicly available scale with adequate psychometric properties for use in measuring the impact of the coronavirus pandemic in diverse populations.
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Affiliation(s)
- Joel Stoddard
- University of Colorado, Anschutz Medical Campus, Aurora, Colorado, and Children's Hospital Colorado, Aurora, Colorado
| | | | - Ruth Paris
- Boston University School of Social Work, Boston, Massachusetts
| | - Simone P Haller
- National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Sara B Johnson
- Johns Hopkins School of Medicine, Baltimore
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jodi Zik
- University of Colorado, Anschutz Medical Campus, Aurora, Colorado, and Children's Hospital Colorado, Aurora, Colorado
| | - Eliza Elliotte
- University of Colorado, Anschutz Medical Campus, Aurora, Colorado, and Children's Hospital Colorado, Aurora, Colorado
| | - Mihoko Maru
- Boston University School of Social Work, Boston, Massachusetts
| | - Allison L Jaffe
- National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Ajitha Mallidi
- National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Ashley R Smith
- National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Raquel G Hernandez
- Johns Hopkins School of Medicine, Baltimore
- Johns Hopkins All Children's Center for Pediatric Health Equity Research, St. Petersburg, Florida
| | - Heather E Volk
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Melissa A Brotman
- National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Joan Kaufman
- Johns Hopkins School of Medicine, Baltimore
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, Maryland
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2
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Maru M, Paris R, Simhi M. The protective effects of social support and family functioning on parenting stress among Hispanic/Latino/a American immigrant parents with traumatic life experiences: A mediation analysis. Infant Ment Health J 2023; 44:348-361. [PMID: 36938714 PMCID: PMC10956510 DOI: 10.1002/imhj.22053] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 10/03/2022] [Accepted: 01/02/2023] [Indexed: 03/21/2023]
Abstract
Despite high rates of traumatic experiences reported among Hispanic/Latino/a immigrants in the U.S., the effect of post-traumatic stress on parenting stress among Hispanic/Latino/a immigrant parents with young children has been overlooked. The present study tested the direct and indirect relationships of self-reported maternal post-traumatic stress symptoms on parenting stress, and the mediating role of protective factors among Hispanic/Latino/a mothers with young children. Baseline data collected from mothers participating in a community-based child-parent dyadic intervention were analyzed. Measures included the post-traumatic stress disorder (PTSD) Checklist, the Protective Factors Survey, and the Parenting Stress Index-Short Form (PSI). The sample included 80 mothers with a child between ages 0-6 years. About 75% of these mothers were migrants from Central America. A multivariate regression analysis showed that maternal post-traumatic stress symptoms predicted higher levels of PSI, and two protective factors (social support and family functioning/resilience) fully mediated the relationship between maternal post-traumatic stress symptoms and PSI. Higher social support and family functioning/resiliency may have protective effects on Hispanic/Latino/a mothers with post-traumatic stress, leading to lower levels of stress related to parenting. Findings underscore the importance of interventions that enhance access to social support and promote family functioning/resilience for Hispanic/Latino/a immigrant mothers with trauma histories to cope better with parenting stress.
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Affiliation(s)
- Mihoko Maru
- Department of Psychiatry, Boston Medical Center, Boston, Massachusetts, USA
| | - Ruth Paris
- School of Social Work, Boston University, Boston, Massachusetts, USA
| | - Meital Simhi
- School of Social Work, Boston University, Boston, Massachusetts, USA
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3
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Paris R, Herriott AL, Holt M. Parenting stress and competence among mothers of young children with substance use disorders: The roles of trauma and reflective functioning. Infant Ment Health J 2023; 44:228-239. [PMID: 36808618 DOI: 10.1002/imhj.22040] [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: 05/27/2022] [Accepted: 11/22/2022] [Indexed: 02/22/2023]
Abstract
Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale-Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mothers with SUDs who had young children. Two multivariate regression analyses found that (1) lower parental reflective functioning and higher posttraumatic stress symptoms were associated with higher parenting stress, and (2) only higher posttraumatic stress symptoms were associated with lower levels of parenting sense of competence. Findings underscore the importance of addressing trauma symptoms and PRF when aiming to improve parenting experiences for women with an SUD.
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Buka SL, Beers LS, Biel MG, Counts NZ, Hudziak J, Parade SH, Paris R, Seifer R, Drury SS. The Family is the Patient: Promoting Early Childhood Mental Health in Pediatric Care. Pediatrics 2022; 149:186907. [PMID: 35503309 PMCID: PMC9847420 DOI: 10.1542/peds.2021-053509l] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 01/21/2023] Open
Abstract
Advances in developmental psychology, child psychiatry, and allied disciplines have pointed to events and experiences in the early years as the origin of many adult mental health challenges. Yet, children's mental health services still largely lack a developmental or prevention-focused orientation, with most referrals to mental health professionals occurring late, once problems are well established. An early childhood mental health system rooted in the principles of life-course health development would take a very different approach to designing, testing, and implementing prevention and intervention strategies directed toward early child mental health. Priorities for such a system include supporting healthy family environments, parent-child and family relationships, parents' emotional/behavioral health, and family routines as a means of providing the best possible neurobiological foundation for mental health across the life span. The system would include proactive, trauma-informed, multidisciplinary care, with integrated mental health and social services support embedded in pediatric primary care settings. Novel intervention approaches in need of further research include 2-generational dyadic interventions designed to improve the mental health of parents and children, mental health-oriented telemedicine, and contingency management (CM) strategies. Integral to this Life Course Health Development reformulation is a commitment by all organizations supporting children to primordial and primary prevention strategies to reduce racial and socioeconomic disparities in all settings. We contend that it is the family, not the individual child, that ought to be the identified target of these redesigned approaches, delivered through a transformed pediatric system with anticipated benefits for multiple health outcomes across the life course.
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Affiliation(s)
- Stephen L. Buka
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island,Address correspondence to Stephen Buka, ScD, Department of Epidemiology, Brown University School of Public Health, 121 South Main St, Providence, RI 02912. E-mail:
| | - Lee S. Beers
- Children’s National Hospital, Washington, District of Columbia,Child Health Advocacy Institute, Washington, District of Columbia
| | - Matthew G. Biel
- Departments of Psychiatry and Pediatrics, Georgetown University School of Medicine, Georgetown University Medical Center, Washington, District of Columbia
| | - Nathaniel Z. Counts
- Mental Health America, Alexandria, Virginia,Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, The Bronx, New York
| | - James Hudziak
- Division of Child Psychiatry, Vermont Center for Children, Youth, and Families, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Stephanie H. Parade
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island,Bradley/Hasbro Children’s Research Center, Bradley Hospital, East Providence, Rhode Island
| | - Ruth Paris
- Boston University School of Social Work, Boston, Massachusetts
| | - Ronald Seifer
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Stacy S. Drury
- Departments of Psychiatry,Pediatrics, Tulane University, New Orleans, Louisiana,Children’s Hospital New Orleans, New Orleans, Louisiana
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Walsh TB, Paris R, Ribaudo J, Gilkerson L. Locating Infant and Early Childhood Mental Health at the Heart of Social Work. Soc Work 2021; 66:187-196. [PMID: 34179984 DOI: 10.1093/sw/swab022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 06/13/2023]
Abstract
Infant and early childhood mental health (IECMH)-an interdisciplinary field dedicated to advancing understanding of early relationships, socioemotional development, and cultural and contextual influences on caregiving-offers essential tools for social workers to support the well-being of infants, toddlers, preschoolers, and their families. Even though social worker Selma Fraiberg was a founder of the field, and social workers are central to the work of assessment and intervention with young children and their caregivers in many settings, few schools of social work offer training in IECMH, and few social workers are familiar with its core principles, scholarship, and intervention approaches. In this article, faculty members from four U.S. social work programs address the vital role of IECMH in social work training, research, and practice as well as issue a call to the field to recover and renew commitment to a practice perspective and knowledge base with roots in social work. Twenty-five years ago, Social Work published a similar call, but the request has gone largely unheeded. The authors examine the changing landscape and argue that it is more important and timelier than ever for social workers to learn and integrate the relationship-based approach to promotion, prevention, intervention, and treatment offered by IECMH.
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Affiliation(s)
- Tova B Walsh
- assistant professor, School of Social Work, University of Wisconsin, 1350 University Avenue, Madison, WI 53706
| | - Ruth Paris
- associate professor and chair, Clinical Practice Department, School of Social Work, Boston University
| | - Julie Ribaudo
- clinical professor, School of Social Work, University of Michigan, Ann Arbor, and doctoral student, School of Social Work, Wayne State University, Detroit
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Paris R, Herriott AL, Maru M, Hacking SE, Sommer AR. Secrecy Versus Disclosure: Women with Substance Use Disorders Share Experiences in Help Seeking During Pregnancy. Matern Child Health J 2020; 24:1396-1403. [PMID: 33025236 DOI: 10.1007/s10995-020-03006-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Substance misuse during pregnancy can be harmful to the health of both mothers and infants. Existing recovery services or prenatal care for pregnant women with substance use disorders (SUD) in the U.S. and other countries typically fall short in providing the necessary specialized care women with SUDs need. Disclosure of substance misuse is one key factor in gaining access to specialized prenatal care; yet, barriers such as social stigma and internal shame and guilt lead many women to under-report any substance misuse during their pregnancy. This study sought to understand the process of how and why pregnant women with SUDs choose to disclose or not disclose their substance misuse to their providers when seeking prenatal care. METHODS Data were collected through interviews with N = 21 women with SUDs in the northeast U.S. whose young children had been exposed to opioids, cocaine, or MAT in utero. Thematic, inductive analysis using line-by-line coding was conducted to understand the perspectives of the women. RESULTS The women's narratives suggested a clear tension regarding whether to disclose their substance misuse to any providers during their pregnancy. Four themes describing the process of disclosure or non-disclosure were found, including reasons for and ways of being secret or choosing to disclose their substance misuse during pregnancy. CONCLUSIONS FOR PRACTICE The centrality of shame, guilt, and stigma regarding substance misuse must be addressed by medical and mental health providers in order to increase disclosure and improve access to care for women with SUDs.
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Affiliation(s)
- Ruth Paris
- Boston University School of Social Work, 264 Bay State Road, Boston, MA, 02215, USA.
| | - Anna L Herriott
- School of Social Service Administration, University of Chicago, Chapin Hall, Hyde Park Campus, Chicago, IL, 60637, USA
| | - Mihoko Maru
- Boston University School of Social Work, 264 Bay State Road, Boston, MA, 02215, USA
| | - Sarah E Hacking
- The Home for Little Wanderers, Preschool Outreach Program, 780 American Legion Highway, Roslindale, MA, 02131, USA
| | - Amy R Sommer
- Jewish Family & Children's Service, 1430 Main St., Waltham, MA, 02451, USA
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Anckaert E, Jank A, Petzold J, Rohsmann F, Paris R, Renggli M, Schönfeld K, Schiettecatte J, Kriner M. Extensive monitoring of the natural menstrual cycle using the serum biomarkers luteinising hormone, estradiol and progesterone. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.701] [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: 11/28/2022]
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Bosk EA, Paris R, Hanson KE, Ruisard D, Suchman NE. Innovations in Child Welfare Interventions for Caregivers with Substance Use Disorders and Their Children. Child Youth Serv Rev 2019; 101:99-112. [PMID: 32831444 PMCID: PMC7437721 DOI: 10.1016/j.childyouth.2019.03.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Families who enter the Child Welfare System (CWS) as a result of a caregiver's substance use fare worse at every stage from investigation to removal to reunification (Marsh et. al 2007). Intervening with caregivers with Substance Use Disorders (SUDs) and their children poses unique challenges related to the structure and focus of the current CWS. Research demonstrates that caregivers with SUDs are at a greater risk for maladaptive parenting practices, including patterns of insecure attachment and difficulties with attunement and responsiveness (Suchman, 2006). Caregivers with SUDs have also often experienced early adversity and trauma. However, traditional addiction services generally offer limited opportunities to focus on parenting or trauma, and traditional parenting programs rarely address the special needs of parents with SUDs. This article details four innovative interventions that integrate trauma-informed addiction treatments with parenting for families involved in the child welfare system. Common mechanisms for change across programs are identified as critical components for intervention. This work suggests the need for a paradigm shift in how cases involving caregivers with substance use disorders are approached in the child welfare system.
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Affiliation(s)
- Emily A Bosk
- Assistant Professor of Social Work, Rutgers University, the State University of New Jersey
| | - Ruth Paris
- Associate Professor and Chair, Clinical Practice Department, Boston University School of Social Work
| | - Karen E Hanson
- Assistant Clinical Professor of Social Work, Yale University School of Medicine, Yale Child Study Center
| | - Debra Ruisard
- Chief Clinical Officer, The Center for Great Expectations
| | - Nancy E Suchman
- Yale University School of Medicine, Department of Psychiatry and Yale Child Study Center
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9
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Paris R, Sommer A, Marron B. Project BRIGHT: An Attachment-Based Intervention for Mothers with Substance Use Disorders and Their Young Children. Motherhood in the Face of Trauma 2018. [DOI: 10.1007/978-3-319-65724-0_12] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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DeVoe ER, Paris R, Emmert-Aronson B, Ross A, Acker M. A randomized clinical trial of a postdeployment parenting intervention for service members and their families with very young children. ACTA ACUST UNITED AC 2017; 9:25-34. [DOI: 10.1037/tra0000196] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Saper RB, Lemaster CM, Elwy AR, Paris R, Herman PM, Plumb DN, Sherman KJ, Groessl EJ, Lynch S, Wang S, Weinberg J. Yoga versus education for Veterans with chronic low back pain: study protocol for a randomized controlled trial. Trials 2016; 17:224. [PMID: 27129472 PMCID: PMC4850721 DOI: 10.1186/s13063-016-1321-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 04/01/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic low back pain is the most frequent pain condition in Veterans and causes substantial suffering, decreased functional capacity, and lower quality of life. Symptoms of post-traumatic stress, depression, and mild traumatic brain injury are highly prevalent in Veterans with back pain. Yoga for low back pain has been demonstrated to be effective for civilians in randomized controlled trials. However, it is unknown if results from previously published trials generalize to military populations. METHODS/DESIGN This study is a parallel randomized controlled trial comparing yoga to education for 120 Veterans with chronic low back pain. Participants are Veterans ≥18 years old with low back pain present on at least half the days in the past six months and a self-reported average pain intensity in the previous week of ≥4 on a 0-10 scale. The 24-week study has an initial 12-week intervention period, where participants are randomized equally into (1) a standardized weekly group yoga class with home practice or (2) education delivered with a self-care book. Primary outcome measures are change at 12 weeks in low back pain intensity measured by the Defense and Veterans Pain Rating Scale (0-10) and back-related function using the 23-point Roland Morris Disability Questionnaire. In the subsequent 12-week follow-up period, yoga participants are encouraged to continue home yoga practice and education participants continue following recommendations from the book. Qualitative interviews with Veterans in the yoga group and their partners explore the impact of chronic low back pain and yoga on family relationships. We also assess cost-effectiveness from three perspectives: the Veteran, the Veterans Health Administration, and society using electronic medical records, self-reported cost data, and study records. DISCUSSION This study will help determine if yoga can become an effective treatment for Veterans with chronic low back pain and psychological comorbidities. TRIAL REGISTRATION ClinicalTrials.gov: NCT02224183.
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Affiliation(s)
- Robert B. Saper
- />Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA USA
| | - Chelsey M. Lemaster
- />Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA USA
| | - A. Rani Elwy
- />Center for Information Dissemination and Education Resources, VA Boston Healthcare System, Boston, MA USA
- />Department of Health Policy and Management, Boston University School of Public Health, Boston, MA USA
| | - Ruth Paris
- />Boston University School of Social Work, Boston, MA USA
| | | | - Dorothy N. Plumb
- />Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA USA
| | - Karen J. Sherman
- />Group Health Research Institute, Seattle, WA USA
- />Department of Epidemiology, University of Washington, Seattle, WA USA
| | - Erik J. Groessl
- />VA San Diego Healthcare System, San Diego, CA USA
- />Department of Family and Preventive Medicine, University of California San Diego School of Medicine, San Diego, CA USA
| | - Susan Lynch
- />There & Back Again, Inc., Wakefield, MA USA
| | - Shihwe Wang
- />Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA USA
| | - Janice Weinberg
- />Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
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Keosaian JE, Lemaster CM, Dresner D, Godersky ME, Paris R, Sherman KJ, Saper RB. "We're all in this together": A qualitative study of predominantly low income minority participants in a yoga trial for chronic low back pain. Complement Ther Med 2015; 24:34-9. [PMID: 26860799 DOI: 10.1016/j.ctim.2015.11.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 08/17/2015] [Revised: 11/23/2015] [Accepted: 11/28/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To explore the experiences of low-income minority adults taking part in a yoga dosing trial for chronic low back pain. DESIGN Individual semi-structured interviews were conducted with nineteen participants recruited from a randomized yoga dosing trial for predominantly low-income minority adults with chronic low back pain. Interviews discussed the impact of yoga on low back pain and emotions; other perceived advantages or disadvantages of the intervention; and facilitators and barriers to practicing yoga. Interviews were audio taped and transcribed, coded using ATLAS.ti software, and analyzed with inductive and deductive thematic analysis methods. SETTING Boston Medical Center, Boston, MA, USA. RESULTS Participants viewed yoga as a means of pain relief and attributed improved mood, greater ability to manage stress, and enhanced relaxation to yoga. Overall, participants felt empowered to self-manage their pain. Some found yoga to be helpful in being mindful of their emotions and accepting of their pain. Trust in the yoga instructors was a commonly cited facilitator for yoga class attendance. Lack of time, motivation, and fear of injury were reported barriers to yoga practice. CONCLUSIONS Yoga is a multidimensional treatment for low back pain that has the potential to favorably impact health in a predominantly low-income minority population.
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Affiliation(s)
- Julia E Keosaian
- Department of Family Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA.
| | - Chelsey M Lemaster
- Department of Family Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Danielle Dresner
- Department of Family Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Margo E Godersky
- Department of Family Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Ruth Paris
- Boston University School of Social Work, Boston, MA, USA
| | - Karen J Sherman
- Group Health Research Institute, Group Health Cooperative, WA and Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Robert B Saper
- Department of Family Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
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Paris R, Herriott A, Holt M, Gould K. Differential responsiveness to a parenting intervention for mothers in substance abuse treatment. Child Abuse Negl 2015; 50:206-17. [PMID: 26455262 DOI: 10.1016/j.chiabu.2015.09.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 09/10/2015] [Accepted: 09/14/2015] [Indexed: 05/04/2023]
Abstract
This study examines the relationship between levels of psychological distress in substance-dependent mothers and their differential response to a dyadic parent-child intervention. A sample of 66 mothers who were receiving treatment for substance abuse, as well as a simultaneous parenting intervention, were interviewed pre and post-treatment on measures of psychological distress, adult and child trauma history, parental reflective functioning, and child social-emotional development. Additionally, clinicians provided assessments of the parent-child relationships. As anticipated, trauma histories for mothers and children, children's social emotional development, and parental reflective functioning were associated with aspects of maternal psychological distress. Kruskal-Wallis and subsequent Wilcoxson signed rank tests revealed that women with highest levels of baseline psychological distress showed significant improvements in psychological functioning post-treatment while women with moderately elevated levels of psychological distress did not. Women who were most distressed at baseline showed increased levels of parental reflective functioning post-treatment while women with moderate and lower levels of baseline psychological distress showed improvements on clinician-rated assessments of parent-child relationships. Chi Square analyses showed that parents who endorsed the highest levels of distress at baseline reported that their children's risk status regarding social-emotional development decreased post-treatment. Despite similarities in substance dependence, mothers in this sample had different needs and outcomes in the context of this parenting intervention due to variation in mental health. Given this variation, parenting interventions for substance-dependent mothers need to account for the individual differences in levels of psychological distress.
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Affiliation(s)
- Ruth Paris
- Boston University, School of Social Work, 264 Bay State Road, Boston, MA 02215, USA
| | - Anna Herriott
- Boston University, School of Social Work, 264 Bay State Road, Boston, MA 02215, USA
| | - Melissa Holt
- Boston University, School of Education, 2 Silber Way, Boston, MA 02215, USA
| | - Karen Gould
- Institute for Health and Recovery, 349 Broadway, Cambridge, MA 02139, USA
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Speakman E, Paris R, Giojella ME, Hathaway J. "I didn't fight for my life to be treated like this!": The relationship between the experience of cancer and intimate partner abuse. Health Soc Work 2015; 40:51-58. [PMID: 25665291 DOI: 10.1093/hsw/hlu040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The current article seeks to further understanding of the high frequency of intimate partner abuse among cancer patients through qualitative analysis of semistructured interviews with 20 women and one man facing cancer and intimate partner abuse concurrently. Participants described a range of abusive and unsupportive behaviors by their intimate partners over the course of cancer treatment, which contributed to their reassessing and makinig changes in their relationships. Important factors in this process of change appear to be participants' increased focus on their own health, discovery of greater inner strength, and increased social support. Barriers to making changes in their relationships during their cancer treatment also were described. Participants who made significant changes in or left an abusive relationship usually did so after having recovered from cancer treatment. Implications of these findings for social workers in health care are discussed, as are directions for future research.
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Lemaster C, Keosaian J, Dorman E, Paris R, Saper R. Qualitative Study in a Randomized Trial Comparing Yoga, Physical Therapy, and Education for Low Back Pain in a Predominantly Minority Population. J Altern Complement Med 2014. [DOI: 10.1089/acm.2014.5154.abstract] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Chelsey Lemaster
- (1) Boston University School of Medicine, Boston, MA, USA
- (2) Department of Religion, Boston University, Boston, MA, USA
- (3) School of Social Work, Boston University, Boston, MA, USA
| | - Julia Keosaian
- (1) Boston University School of Medicine, Boston, MA, USA
- (2) Department of Religion, Boston University, Boston, MA, USA
- (3) School of Social Work, Boston University, Boston, MA, USA
| | - Eric Dorman
- (1) Boston University School of Medicine, Boston, MA, USA
- (2) Department of Religion, Boston University, Boston, MA, USA
- (3) School of Social Work, Boston University, Boston, MA, USA
| | - Ruth Paris
- (1) Boston University School of Medicine, Boston, MA, USA
- (2) Department of Religion, Boston University, Boston, MA, USA
- (3) School of Social Work, Boston University, Boston, MA, USA
| | - Robert Saper
- (1) Boston University School of Medicine, Boston, MA, USA
- (2) Department of Religion, Boston University, Boston, MA, USA
- (3) School of Social Work, Boston University, Boston, MA, USA
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Saper RB, Sherman KJ, Delitto A, Herman PM, Stevans J, Paris R, Keosaian JE, Cerrada CJ, Lemaster CM, Faulkner C, Breuer M, Weinberg J. Yoga vs. physical therapy vs. education for chronic low back pain in predominantly minority populations: study protocol for a randomized controlled trial. Trials 2014; 15:67. [PMID: 24568299 PMCID: PMC3944007 DOI: 10.1186/1745-6215-15-67] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 02/10/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Chronic low back pain causes substantial morbidity and cost to society while disproportionately impacting low-income and minority adults. Several randomized controlled trials show yoga is an effective treatment. However, the comparative effectiveness of yoga and physical therapy, a common mainstream treatment for chronic low back pain, is unknown. METHODS/DESIGN This is a randomized controlled trial for 320 predominantly low-income minority adults with chronic low back pain, comparing yoga, physical therapy, and education. Inclusion criteria are adults 18-64 years old with non-specific low back pain lasting ≥ 12 weeks and a self-reported average pain intensity of ≥ 4 on a 0-10 scale. Recruitment takes place at Boston Medical Center, an urban academic safety-net hospital and seven federally qualified community health centers located in diverse neighborhoods. The 52-week study has an initial 12-week Treatment Phase where participants are randomized in a 2:2:1 ratio into i) a standardized weekly hatha yoga class supplemented by home practice; ii) a standardized evidence-based exercise therapy protocol adapted from the Treatment Based Classification method, individually delivered by a physical therapist and supplemented by home practice; and iii) education delivered through a self-care book. Co-primary outcome measures are 12-week pain intensity measured on an 11-point numerical rating scale and back-specific function measured using the modified Roland Morris Disability Questionnaire. In the subsequent 40-week Maintenance Phase, yoga participants are re-randomized in a 1:1 ratio to either structured maintenance yoga classes or home practice only. Physical therapy participants are similarly re-randomized to either five booster sessions or home practice only. Education participants continue to follow recommendations of educational materials. We will also assess cost effectiveness from the perspectives of the individual, insurers, and society using claims databases, electronic medical records, self-report cost data, and study records. Qualitative data from interviews will add subjective detail to complement quantitative data. TRIAL REGISTRATION This trial is registered in ClinicalTrials.gov, with the ID number: NCT01343927.
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Affiliation(s)
- Robert B Saper
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, 1 Boston Medical Center Place, Dowling 5 South, Boston, MA 02118, USA
| | - Karen J Sherman
- Group Health Research Institute and Department of Epidemiology, University of Washington, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA
| | - Anthony Delitto
- School of Health and Rehabilitation Sciences, University of Pittsburgh, 4028 Forbes Tower, Pittsburgh, PA 15260, USA
| | - Patricia M Herman
- RAND Health Unit, RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, USA
| | - Joel Stevans
- School of Health and Rehabilitation Sciences, University of Pittsburgh, 4028 Forbes Tower, Pittsburgh, PA 15260, USA
| | - Ruth Paris
- Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA
| | - Julia E Keosaian
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, 1 Boston Medical Center Place, Dowling 5 South, Boston, MA 02118, USA
| | - Christian J Cerrada
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, 1 Boston Medical Center Place, Dowling 5 South, Boston, MA 02118, USA
| | - Chelsey M Lemaster
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, 1 Boston Medical Center Place, Dowling 5 South, Boston, MA 02118, USA
| | - Carol Faulkner
- Art & Soul Yoga Studio, 220 Pearl Street, Cambridge, MA 02139, USA
| | - Maya Breuer
- Santosha School of Yoga, 14 Bartlett Avenue, Cranston, RI 02905, USA
| | - Janice Weinberg
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, Crosstown, 3rd floor, Boston, MA 02118, USA
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19
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Todisco T, Dal Farra F, Ciliberti G, Pirina P, Guelfi R, Serra G, Paris R, Mancuso I, Cepparulo M. An Italian Experience of Sequential Intravenous and Oral Azithromycin Plus Intravenous Ampicillin/Sulbactam in Hospitalized Patients with Community-Acquired Pneumonia. J Chemother 2013. [DOI: 10.1179/joc.2008.20.6.768] [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: 10/31/2022]
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20
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Todisco T, Dal Farra F, Ciliberti G, Pirica P, Ghelfi R, Serra G, Paris R, Mancuso I, Cepparulo M. An Italian Experience of Sequential Intravenous and Oral Azithromycin Plus Intravenous Ampicillin/Sulbactam in Hospitalized Patients with Community-Acquired Pneumonia. J Chemother 2013; 20:225-32. [DOI: 10.1179/joc.2008.20.2.225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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21
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Bielle F, Fréneaux P, Jeanne-Pasquier C, Maran-Gonzalez A, Rousseau A, Lamant L, Paris R, Pierron G, Victor Nicolas A, Sastre-Garau X, Delattre O, Bourdeaut F, Peuchmaur M. L’immunomarquage PHOX2B : un nouvel outil pour le diagnostic des neuroblastomes indiffenciés au sein des tumeurs à petites cellules rondes de l’enfant. Ann Pathol 2012. [DOI: 10.1016/j.annpat.2012.09.171] [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: 11/15/2022]
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22
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Paris R, Bolton RE, Spielman E. Evaluating a home-based dyadic intervention: Changes in postpartum depression, maternal perceptions, and mother-infant interactions. Infant Ment Health J 2011; 32:319-338. [DOI: 10.1002/imhj.20299] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
Corporal punishment (CP) remains highly prevalent in the U.S. despite its association with increased risk for child aggression and physical abuse. Five focus groups were conducted with parents (n=18) from a community at particularly high risk for using CP (Black, low socioeconomic status, Southern) in order to investigate their perceptions about why CP use is so common. A systematic qualitative analysis was conducted using grounded theory techniques within an overall thematic analysis. Codes were collapsed and two broad themes emerged. CP was perceived to be: 1) instrumental in achieving parenting goals and 2) normative within participants' key social identity groups, including race/ethnicity, religion, and family of origin. Implications for the reduction of CP are discussed using a social ecological framework.
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Affiliation(s)
- Catherine A Taylor
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
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24
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Paris R, DeVoe ER, Ross AM, Acker ML. When a parent goes to war: effects of parental deployment on very young children and implications for intervention. Am J Orthopsychiatry 2010; 80:610-618. [PMID: 20950302 DOI: 10.1111/j.1939-0025.2010.01066.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Young children (birth through 5 years of age) are disproportionately represented in U.S. military families with a deployed parent. Because of their developmental capacity to deal with prolonged separation, young children can be especially vulnerable to stressors of parental deployment. Despite the resiliency of many military families, this type of separation can constitute a developmental crisis for a young child. Thus, the experience may compromise optimal child growth and development. This article reviews what is known about the effects of the military deployment cycle on young children, including attachment patterns, intense emotions, and behavioral changes and suggests an ecological approach for supporting military families with infants, toddlers, and preschoolers. Specifically, home-based family focused interventions seem to warrant the most serious consideration.
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Bourdeaut F, Herault A, Gentien D, Pierron G, Ballet S, Reynaud S, Paris R, Schleiermacher G, Baumann C, Philippe-Chomette P, Gauthier-Villars M, Peuchmaur M, Radvanyi F, Delattre O. Mosaicism for oncogenic G12D KRAS mutation associated with epidermal nevus, polycystic kidneys and rhabdomyosarcoma. J Med Genet 2010; 47:859-62. [DOI: 10.1136/jmg.2009.075374] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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26
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Currier JR, De Souza M, Ratto-Kim S, Paris R, Nguay V, Cox J, Earl P, Moss B, Sriplienchan S, Thongcharoen P, Kim J, Robb M, Michael N, Marovich M. OA04-03. Characterization of cell-mediated immune responses generated by recombinant modified vaccinia Ankara (rMVA)-HIV-1 in a phase I vaccine trial. Retrovirology 2009. [PMCID: PMC2767548 DOI: 10.1186/1742-4690-6-s3-o27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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27
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Paris R, Bolton RE, Weinberg MK. Postpartum depression, suicidality, and mother-infant interactions. Arch Womens Ment Health 2009; 12:309-21. [PMID: 19728036 DOI: 10.1007/s00737-009-0105-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Accepted: 08/17/2009] [Indexed: 11/29/2022]
Abstract
To date, few studies have examined suicidality in women with postpartum depression. Reports of suicidal ideation in postpartum women have varied (Lindahl et al. Arch Womens Ment Health 8:77-87, 2005), and no known studies have examined the relationship between suicidality and mother-infant interactions. This study utilizes baseline data from a multi-method evaluation of a home-based psychotherapy for women with postpartum depression and their infants to examine the phenomenon of suicidality and its relationship to maternal mood, perceptions, and mother-infant interactions. Overall, women in this clinical sample (n = 32) had wide ranging levels of suicidal thinking. When divided into low and high groups, the mothers with high suicidality experienced greater mood disturbances, cognitive distortions, and severity of postpartum symptomotology. They also had lower maternal self-esteem, more negative perceptions of the mother-infant relationship, and greater parenting stress. During observer-rated mother-infant interactions, women with high suicidality were less sensitive and responsive to their infants' cues, and their infants demonstrated less positive affect and involvement with their mothers. Implications for clinical practice and future research directions are discussed.
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Affiliation(s)
- Ruth Paris
- Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA.
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28
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Paris R, Dondini L, Tartarini S, Sansavini S, Bastia D, Mantovani V, Gualdi V, Piffanelli P. FIRST EVIDENCE OF D-HPLC EFFICIENCY FOR AN AUTOMATED CDNA-AFLP IN THE APPLE SCAB RESISTANCE MODEL. ACTA ACUST UNITED AC 2009. [DOI: 10.17660/actahortic.2009.839.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Paris R, Dondini L, Tartarini S, Bastia D, Mantovani V, Sansavini S. AN OPTIMIZED CDNA-AFLP PROTOCOL FOR THE IDENTIFICATION OF TDFS INVOLVED IN THE MALUS-VENTURIA INAEQUALIS INTERACTION. ACTA ACUST UNITED AC 2009. [DOI: 10.17660/actahortic.2009.814.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Although guilt is often identified as being a common emotion experienced by family caregivers in the clinical literature and in small descriptive studies, it has only recently emerged as a construct in the empirical research focused on identifying predictors of caregiver distress. Using Pearlin's stress process model, and based on data from 66 midlife adult daughters caring for aging mothers, we explored the extent to which guilt contributes to caregiver burden. Hierarchical regression analysis revealed that guilt was positively correlated with burden and that it accounted for a significant amount of the variance in caregiver's sense of burden even after contextual and stressor variables were controlled. Our research suggests the importance of clinicians seeking to understand how individuals judge their caregiving performance and targeting negative self-appraisals, which affect individuals' mental health, for change. The challenge for clinicians is to help guilt-ridden caregivers revise their evaluative standards and engage in self-forgiveness and self-acceptance.
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32
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Paris R, Confalonieri M, Dal Negro R, Ligia GP, Mos L, Todisco T, Rastelli V, Perna G, Cepparulo M. Efficacy and safety of azithromycin 1 g once daily for 3 days in the treatment of community-acquired pneumonia: an open-label randomised comparison with amoxicillin-clavulanate 875/125 mg twice daily for 7 days. J Chemother 2008; 20:77-86. [PMID: 18343748 DOI: 10.1179/joc.2008.20.1.77] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This randomised, open-label, non-inferiority study was designed to demonstrate that a 3-day course of oral azithromycin 1 g once daily was at least as effective as a standard 7-day course of oral amoxicillin-clavulanate 875/125 mg twice daily in the treatment of outpatients with community-acquired pneumonia (Fine class I and II). In total, 267 patients with clinically and radiologically confirmed community-acquired pneumonia were randomly assigned to receive either the azithromycin (n=136) or the amoxicillin-clavulanate (n=131) regimen. At screening, 60/136 (58.8%) and 61/131 (62.9%) respectively had at least one pathogen identified by sputum culture, PCR, or serology. The primary endpoint was the clinical response in the intent-to-treat population at the end of therapy (day 8 to 12). Clinical success rates were 126/136 (92.6%) for azithromycin and 122/131 (93.1%) for amoxicillin-clavulanate (treatment difference: - 0.48%; 95% confidence interval: - 5.66%; 4.69%). Clinical and radiological success rates at follow-up (day 22-26) were consistent with the end of therapy results, no patient reporting clinical relapse. Bacteriological success rates at the end of therapy were 32/35 (91.4%) for azithromycin and 30/33 (90.9%) for amoxicillin-clavulanate (treatment difference: 0.52%; 95% confidence interval - 10.81%; 11.85%). Both treatment regimens were well tolerated: the overall incidence of adverse events was 34/136 (25.0%) for azithromycin and 22/132 (16.7%) for amoxicillin-clavulanate. In both treatment groups, the most commonly reported events were gastrointestinal symptoms. Azithromycin 1g once daily for 3 days is at least as effective as amoxicillin-clavulanate 875/125 mg twice daily for 7 days in the treatment of adult patients with community-acquired pneumonia.
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Affiliation(s)
- R Paris
- Dept. of General Medicine, Gubbio Hospital, Italy
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33
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Abstract
Fourteen Latina immigrants participating in an innovative home visiting program for mothers of infants and young children at risk of child maltreatment were interviewed about their experiences coming to the United States, conditions they were living in after arriving, and perceptions of the intervention. Findings from the qualitative analyses detail rich, descriptive information regarding the struggles and adaptations of the immigrant mothers and families. Poverty in home countries propelled these women to move to the United States, leaving close family and sometimes children behind. Harrowing journeys to a new country are chronicled as well as the women's isolation and depression, and the strengths they utilized in adapting to new lives. Findings provide insight into the role of the bilingual/bicultural home visitors who were overwhelmingly perceived as helpful in providing emotional support, case management/advocacy, translation, education, and friendship. Implications include the need for mental health and social service providers to (a) appreciate viscerally the histories of immigrant clients, (b) understand the role of the home visitor-client relationship in enhancing client engagement and retention, and (c) recognize the multi-dimensional contribution of paraprofessional home visitors.
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Affiliation(s)
- Ruth Paris
- Boston University School of Social Work, Boston, MA 02215, USA.
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34
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Abstract
Research on the experiences of youth leaving foster care as they enter adulthood has noted that they often reconnect, and sometimes live with, members of their family of origin. This is often thought to be a curious finding because at some earlier point, the families were deemed unsafe, requiring removal of the child to foster care. Although this finding has been consistent, it has not been the central focus of a research study and, therefore, its implications have been largely unexamined. In this article, the authors review what is known about the extent to which young adults reunite with their families after they leave foster care. To provide guidance in thinking further about former foster youth reuniting with their families, the authors also examine research and theoretical literature on family development and family transition. Implications for research, policy, and practice are identified.
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35
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Bourdeaut F, Ribeiro A, Paris R, Pierron G, Couturier J, Peuchmaur M, Delattre O. In neuroblastic tumours, Schwann cells do not harbour the genetic alterations of neuroblasts but may nevertheless share the same clonal origin. Oncogene 2007; 27:3066-71. [PMID: 18071318 DOI: 10.1038/sj.onc.1210965] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Neuroblastic tumours are composed of variable proportions of neuroblasts and Schwann cells. Whether both components share a common neoplastic origin is highly debated and discrepant results have been reported about the presence of tumour-related genetic alterations in Schwann cells. We have used X-methylation analysis and array-CGH to investigate contiguous Schwannian and neuroblastic areas in tumours with a nodular pattern. A skewed X inactivation was observed in four out of five stromal components. Interestingly, in these four cases, the X-inactivation profiles of the neuroblastic components were identical to the matched stromal areas. However, whereas all neuroblastic areas displayed chromosomal imbalances, no alteration was found in any Schwann cell components. Similarly, no alteration was observed in a series of 19 tumours with a single stroma-rich component, which occasionally exhibited a skewed X-inactivation pattern (3/17 informative tumours). Altogether, this indicates that most stroma-rich tumours display a polyclonal proliferation and that Schwann cells do not derive from neuroblasts. However, in tumours with both stroma-rich and -poor components, our results suggest that cells from both areas share a common progenitor.
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Affiliation(s)
- F Bourdeaut
- INSERM, U830, Section de Recherche, Unité de Génétique et Biologie des Cancers, Institut Curie, Paris, France
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Kardash K, Hickey D, Berger E, Paris R, Westheich R, Palumbo A, Ghanbari H, Velly AM. 024: Discordant Reporting of Disability Between Physicians and Patients with Chronic Noncancer Pain. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s6c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Silfverberg-Dilworth E, Besse S, Paris R, Belfanti E, Tartarini S, Sansavini S, Patocchi A, Gessler C. Identification of functional apple scab resistance gene promoters. Theor Appl Genet 2005; 110:1119-26. [PMID: 15726316 DOI: 10.1007/s00122-005-1940-9] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Received: 10/27/2004] [Accepted: 01/24/2005] [Indexed: 05/23/2023]
Abstract
Apple scab (Venturia inaequalis) is one of the most damaging diseases affecting commercial apple production. Some wild Malus species possess resistance against apple scab. One gene, HcrVf2, from a cluster of three genes derived from the wild apple Malus floribunda clone 821, has recently been shown to confer resistance to apple scab when transferred into a scab-susceptible apple variety. For this proof-of-function experiment, the use of the 35S promoter from Cauliflower mosaic virus was reliable and appropriate. However, in order to reduce the amount of non-plant DNA in genetically modified apple to a minimum, with the aim of increasing genetically modified organism acceptability, these genes would ideally be regulated by their own promoters. In this study, sequences from the promoter region of the three members of the HcrVf gene family were compared. Promoter constructs containing progressive 5' deletions were prepared and used for functional analyses. Qualitative assessment confirmed promoter activity in apple. Quantitative promoter comparison was carried out in tobacco (Nicotiana glutinosa) and led to the identification of several promoter regions with different strengths from a basal level to half the strength of the 35S promoter from Cauliflower mosaic virus.
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Affiliation(s)
- E Silfverberg-Dilworth
- Plant Pathology, Institute of Plant Science, Swiss Federal Institute of Technology, ETH Zurich, Switzerland
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Pratesi D, Paris R, Negri P, Scotti A. AGROBACTERIUM-MEDIATED GENETIC TRANSFORMATION COMPETENCE OF DIFFERENT PRUNUS EXPLANTS, AS REVEALED BY GUS EXPRESSION. ACTA ACUST UNITED AC 2004. [DOI: 10.17660/actahortic.2004.663.87] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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39
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Paris R, Bejrachandra S, Karnasuta C, Chandanayingyong D, Kunachiwa W, Leetrakool N, Prakalapakorn S, Thongcharoen P, Nittayaphan S, Pitisuttithum P, Suriyanon V, Gurunathan S, McNeil JG, Brown AE, Birx DL, de Souza M. HLA class I serotypes and cytotoxic T-lymphocyte responses among human immunodeficiency virus-1-uninfected Thai volunteers immunized with ALVAC-HIV in combination with monomeric gp120 or oligomeric gp160 protein boosting. ACTA ACUST UNITED AC 2004; 64:251-6. [PMID: 15304005 DOI: 10.1111/j.1399-0039.2004.00270.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [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: 11/27/2022]
Abstract
Antigen-induced cellular immunogenicity may vary between populations due to differences in human leukocyte antigen (HLA) diversity and, hence, may play a critical role in the protection afforded by vaccines. In the setting of two, phase I/II human immunodeficiency virus-1 vaccine trials of a recombinant canarypox prime, and boosting with either recombinant monomeric gp120 or oligomeric gp160, we assessed the association between specific human leukocyte antigen (HLA) class I serotypes and the presence of cytotoxic T-lymphocyte response measured by 51Cr-release assay. HLA class I serotypes A11, A24, A33, B46, and B75 were the most common, present in 10% or more of 245 individuals studied. Forty of 187 (21.4%) Thai adults who received either ALVAC-HIV with gp120 or oligomeric gp160 or ALVAC alone had a precursor cytolytic CD8 T-cell response (pCTL). HLA-B44 was positively and significantly associated with a pCTL response (odds ratio 7.6, 95% CI: 2.7-21.2), whereas B46 was negatively associated but not robust when adjusted for multiple comparisons. Responses to Env proteins accounted for the majority (nine of 11) of pCTL activity among those persons with B44. This HLA class I serotype occurred in 9.4% of participants overall (including the placebo group), less commonly than what is reported from populations of European ancestry. These results strengthen the importance of assessing HLA class I distributions in conjunction with studies of vaccines designed to elicit cellular immunity in different populations.
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Affiliation(s)
- R Paris
- Department of Retrovirology, U.S. Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
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Berrebi D, Languepin J, Ferkdadji L, Foussat A, De Lagausie P, Paris R, Emilie D, Mougenot JF, Cezard JP, Navarro J, Peuchmaur M. Cytokines, chemokine receptors, and homing molecule distribution in the rectum and stomach of pediatric patients with ulcerative colitis. J Pediatr Gastroenterol Nutr 2003; 37:300-8. [PMID: 12960653 DOI: 10.1097/00005176-200309000-00018] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cytokines appear to play a significant role in the pathogenesis of inflammatory bowel disease (IBD) with a predominant Th2 pattern in colonic mucosa of patients with ulcerative colitis (UC). Chemokines and their receptors also regulate the migration of Th1 or Th2 lymphocytes to inflammatory tissues during the immune response. Although adult UC is usually confined to the colon, pediatric UC not uncommonly affects the stomach. AIMS The aim of this study was to compare expression of cytokines, chemokine receptors, and homing molecules in the rectal and the histologically characterized gastric mucosa of pediatric patients with UC. SUBJECTS Sixteen patients (11 girls and 5 boys; median age, 9 years) having all the features of UC were included in the study. METHODS Rectal and gastric mucosa obtained from UC cases were immunostained with antibodies against L-selectin, beta 7 integrin, CXCR3, CCR3, and CCR5. IL-4 and IL-12 p40 transcript expression was studied by in situ hybridization. RESULTS Chronic gastritis was found in 93.7% of cases and Helicobacter pylori (Hp) was found in 2 (13.3%) cases. In the rectal and gastric mucosa, CXCR3 was found in perivascular lymphocytes and CCR5 in a subset of CXCR3+ cells in the lamina propria. CCR3+ lymphocytes and IL-4-positive cells were always found, but there was no evidence of IL-12 production. Most of the lymphocytes infiltrating the gastric mucosa expressed beta 7 but not CD62L. In contrast, beta 7-positive cells were randomly dispersed in the rectal lamina propria, and the fraction of CD3+beta 7+ was low. CONCLUSIONS The authors conclude that gastritis is common in pediatric UC. The presence of CCR3+ lymphocytes, IL-4 transcript expression, without IL-12 p40 production in the stomach and in the rectum suggests a Th2 immune response. The presence of CCR3+, CD62L- activated Th2 cells may suggest that these gastric cells are recruited from colorectal primary lesions.
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Affiliation(s)
- D Berrebi
- Service d'Anatomie et de Cytologie Pathologiques and EA 3102, Université Paris VII, Paris, France.
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Abstract
This study examined the context of the early mothering experience and how that experience was related to personality change in 48 members of a longitudinal sample of women from age 21 (in 1958 or 1960), before any of them were married, to age 27 (in 1963 or 1964). Early motherhood was analyzed in terms of (a) how positively the woman described her experience and (b) how willing and able she was to maintain the full-time commitment considered necessary in the early 1960s. Path analyses showed that these two dimensions had somewhat different interrelations with mother's personality, the marriage, and husband's personality and participation as a father. However, both dimensions were related to relative increase in ego-resiliency and to relative decrease in feelings of vulnerability between ages 21 and 27, even when family and work variables were taken into account.
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Affiliation(s)
- Ruth Paris
- School of Social Work, Boston University, 264 Bay State Road, Boston, Massachusetts 02215, USA.
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42
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Vial F, Merlette B, Paris R, Roussel CH, Rulliere R. [Not Available]. Hist Sci Med 2001; 14:61-9. [PMID: 11628263] [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: 02/21/2023]
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43
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Paris R, Bradley CL. The challenge of adversity: three narratives of alcohol dependence, recovery, and adult development. Qual Health Res 2001; 11:647-667. [PMID: 11554193 DOI: 10.1177/104973201129119352] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Turning points have been known to reverse the downward spiral of alcoholism and its concomitant associations with divorce, depression, and work-related difficulties. In this study, the authors present the stories of 3 women from the Mills Longitudinal Study who were alcoholic. Using a narrative approach, the authors tracked the women's developmental gains during recovery using Erik Erikson's theory of psychosocial development, specifically focusing on the tasks of identity, intimacy, and generativity. Results show that despite similar personal problems and turning points that moved them to stop drinking, each woman followed a different path to self-reconstruction and psychological growth. These accounts offer important information about individual differences in recovery from alcoholism, which are often lost in larger aggregate accounts of personal change.
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44
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45
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Bertulezzi G, Paris R, Moroni M, Porta C, Nastasi G, Amadeo A. Atrial septal aneurysm in a patient with pseudoxanthoma elasticum. Acta Cardiol 1998; 53:223-5. [PMID: 9842408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Pseudoxanthoma elasticum (PXE) is a rare heritable disorder of the connective tissue characterized by marked clinical heterogeneity. Common cardiovascular complications of PXE include renovascular hypertension, premature coronary artery disease and calcification of peripheral arteries frequently leading to claudicatio intermittens; fibrous thickening of the endocardium and atrioventricular valves, leading to restrictive cardiomyopathy and/or mitral valve prolapse have been also described. We herein report on a PXE patient who developed an atrial septal aneurysm as a previously undescribed cardiologic manifestation of her disease.
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Affiliation(s)
- G Bertulezzi
- Divisione di Medicina Generale, Ospedale Pesenti-Fenaroli, Alzano Lombardo, Italy
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46
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Berrebi D, Besnard M, Fromont-Hankard G, Paris R, Mougenot JF, De Lagausie P, Emilie D, Cezard JP, Navarro J, Peuchmaur M. Interleukin-12 expression is focally enhanced in the gastric mucosa of pediatric patients with Crohn's disease. Am J Pathol 1998; 152:667-72. [PMID: 9502407 PMCID: PMC1858403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The stomach is frequently involved in children suffering from Crohn's disease (CD). Diagnosis of specific gastritis may be difficult when granulomas are absent. We have used in situ hybridization to examine the expression of interleukin (IL)-12, a key cytokine in the Th1 response. IL-12 p35 and p40 antisense probes were used to examine ileal specimens from 9 children with CD and gastric biopsies from 24 children (13 with CD, 6 with Helicobacter pylori chronic gastritis, and 5 with a normal gastric mucosa). In all patients with CD, many clusters of IL-12-positive cells were present in the lamina propria. This was the case in the ileal specimens as well as in gastric mucosa showing granulomatous gastritis or nongranulomatous gastritis. The same distribution patterns were found for the IL-12 p35 and p40. In three patients with Helicobacter pylori gastritis, few scattered IL-12-positive cells were found. No positive cells were found in the normal gastric mucosa. The focally enhanced IL-12 expression in the gastric mucosa of pediatric patients with CD, with or without specific lesions, suggests that both are indeed linked to the disease and supports the major part of IL-12 in initiating and maintaining of the cascade resulting in the Th1 responses.
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Affiliation(s)
- D Berrebi
- Services d'Anatomie et de Cytologie Pathologiques, Hôpital Robert Debré, Paris, France
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47
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Berrebi D, Banerjee A, Paris R, Potet F, Aigrain Y, Emilie D, Cezard JP, Hugot JP, Navarro J, Peuchmaur M. In situ Rantes and interferon-gamma gene expression in pediatric small bowel Crohn's disease. J Pediatr Gastroenterol Nutr 1997; 25:371-6. [PMID: 9327364 DOI: 10.1097/00005176-199710000-00001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Rantes (regulated upon activation, normal T cell expressed and secreted) is a chemotactic cytokine for memory T lymphocytes, monocytes, and eosinophils. The cytokine interferon-gamma (IFN-gamma) plays a key in the immune response. Their distributions and possible roles in the selective accumulation of inflammatory cells in Crohn's disease (CD) were examined by determining the expression of Rantes and IFN-gamma genes in patients with CD using in situ hybridization (ISH) on frozen and paraffin-embedded tissue sections. METHODS Intestinal and mesenteric lymph node samples from 9 children who had undergone ileal resection for CD were examined for the presence of epithelioid-giant cell granulomas (EGCG) and Rantes and IFN-gamma messenger RNA (mRNA). Normal pediatric intestine (n = 5) and lymph nodes (n = 2) served as controls. RESULTS Many cells in all CD specimens in the epithelial compartment, lamina propria, and the EGCG gave positive signal with the Rantes antisense probe. Labelled cells were identified on paraffin sections as lymphocytes, macrophages, and epithelioid cells. There were Rantes-positive cells in the control intestinal tissues, but many Rantes-positive cells in control lymph nodes that showed follicular hyperplasia. IFN-gamma-positive cells were present in all CD ileal and lymph node specimens, predominantly in close contact with EGCC. No positive signal was obtained with the Rantes and IFN-gamma sense control probes. CONCLUSIONS These findings suggest that Rantes and IFN-gamma contribute to the selective accumulation of macrophages and memory T helper lymphocytes inside the granulomas and inflammatory infiltrates that are characteristic of CD.
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Affiliation(s)
- D Berrebi
- Service d'Anatomie, Hôpital Robert Debré, Paris, France
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48
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de Lajarte AS, Brun P, Baudouin V, Paris R, Loirat C, Peuchmaur M. Detection of TIA-1 cytotoxic T-lymphocytes and epithelial apoptotic cells in renal allograft biopsies. Transplant Proc 1995; 27:2474-5. [PMID: 7652891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Crimlisk JT, Paris R, McGonagle EG, Calcutt JA, Farber HW. The closed tracheal suction system: implications for critical care nursing. Dimens Crit Care Nurs 1994; 13:292-300. [PMID: 7729318 DOI: 10.1097/00003465-199411000-00003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The Closed Tracheal Suction System (CTSS) is a multiple-use suction catheter available for suctioning the ventilator dependent patient. While research has been reported on its impact on oxygen desaturation, ventilator function, and nosocomial pneumonia, the practical issues of the technical design of the catheter and its advantage in decreasing exposure of staff to infected respiratory secretions have not been investigated. This study reports the critical care nurses' perceptions in the use of the SteriCath (Concord/Portex) CTSS focusing on hemodynamic stability, effectiveness of suctioning, patient safety and staff personnel exposure.
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Degott C, Messing B, Moreau D, Chazouillères O, Paris R, Colombel JF, Lebrec D, Potet F, Feldmann G, Benhamou JP. Liver phospholipidosis induced by parenteral nutrition: histologic, histochemical, and ultrastructural investigations. Gastroenterology 1988; 95:183-91. [PMID: 3131177 DOI: 10.1016/0016-5085(88)90309-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Histochemical and electron microscopic examinations of the liver were performed in 5 adults receiving parenteral nutrition for greater than 18 mo and in 4 adults receiving parenteral nutrition for less than 5 mo. Phospholipidosis, reflected by the presence of cytoplasmic phospholipid deposits at histochemical examination and the presence of multilamellar lysosomes at electron microscopy, was marked and present in hepatocytes, Kupffer cells, and portal macrophages in all 5 patients receiving parenteral nutrition for greater than 18 mo. Mild phospholipidosis, affecting only hepatocytes, was demonstrated in 3 of the 4 patients receiving parenteral nutrition for less than 5 mo. These findings indicate that liver phospholipidosis is relatively common in patients receiving parenteral nutrition and that the degree of liver phospholipidosis depends on the duration of parenteral nutrition. Liver phospholipidosis might be due to intrahepatic accumulation of intravenous phospholipids provided by fat-emulsion sources.
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Affiliation(s)
- C Degott
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Beaujon, Clichy, France
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