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Johnson PA, Johnson JC, Mardon AA. P18 Assessment of da Vinci robotic system for paediatric laparoscopic procedures. Br J Surg 2022. [DOI: 10.1093/bjs/znac231.018] [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] [Indexed: 11/06/2022]
Abstract
Abstract
Introduction
We aimed to evaluate the da Vinci surgical system in its application for robotic-assisted laparoscopic surgery in paediatric patients.
Methods
A narrative review of the literature on the use of this technology was performed following ENTREQ guidelines using PubMed/Medline, EMBASE, and Google Scholar databases with no setting or language restrictions.
Results
A total of 16 publications were selected for inclusion. Although the literature on the accuracy and precision of this technology are encouraging, its use in paediatric patients are still in its early stages and has yet to be explored in great detail. In addition to the technical intricacies, training and learning curve, port placement complications, cost, we identified concerning shortcomings including its bulkiness and lack of force feedback, which lead to procedural injuries notably, tearing of muscles, blood vessels, and nerves, as well as surgical error. For both, we propose sensory haptic feedback systems, soft tissue model, image-guided or virtual reality simulation training to reduce these injury-related complications. However, this does not replace the necessity for “supervised trial and error” operation of the robotic system in surgical settings.
Conclusion
Innovations in educational training for robotic surgery include tele-presence surgeries and robotic tele- mentoring, whereby expert surgeons share the same surgical field of view and controls as the training surgeon. In spite of this, there are inevitable risks associated with training when training surgeons must practice through trial and error on real patients and an emphasis must be placed on apposite pre-procedural surgical training.
Take-home message
Though promising, the use of the Da Vinci robotic system in children is still emerging and thus warrants further evaluation, training, and development prior to its routine implementation for use.
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Johnson JC, Hayden T, Taylor LA, Gilbert A, Mitchell MPH. LIGHT: A Church-Based Curriculum for Training African American Lay Health Workers to Support Advance Care Planning and End-of-Life Decision-Making. Health Equity 2020; 4:533-541. [PMID: 34095700 PMCID: PMC8175257 DOI: 10.1089/heq.2020.0042] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose: African Americans with life-limiting illnesses experience significant health inequities. Lay health workers (LHWs) may help overcome existing challenges of communicating with African Americans about advance care planning (ACP) and end-of-life decision-making. Church-based LHWs have some advantages over other LHWs but no curriculum exists to fully prepare them. This article describes the development, content, format, and implementation of a curriculum designed to meet this need. Methods: We created a church-based curriculum to train African American, LHWs as communications-facilitators who can support persons with life-limiting illnesses, not only with ACP but also with issues that arise as illnesses progress. Learners are church members whom we call comfort care supporters. The curriculum organizes the LHW interactions with clients by the mnemonic LIGHT: Listening, Identifying, Guiding, Helping, and Translating. Results: The final curriculum consists of three parts: (1) a 26-h classroom component delivered in nine modules organized around eight themes: meaning and prognosis of a life-limiting illness, spirituality and the meaning of death, understanding the dying process, major decisions and choices, goals of care, end-of-life services, and resources, intrafamily communication, and role and activities of the LHW; (2) a visit component; and (3) experiential, case-based discussions during monthly meetings. Conclusions: LHWs may improve quality of care and thus reduce health inequities at the end-of-life. Preparing LHWs for conversations about ACP is necessary but insufficient. This curriculum also prepares LHWs to attend to the spiritual needs of clients and to support clients with their other needs as their illness progresses.
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Affiliation(s)
- Jerry C Johnson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tara Hayden
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lynne Allen Taylor
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Babatunde OA, Jefferson M, Johnson JC, Hughes-Halbert C. Abstract C097: Navigation needs among African Americans. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp19-c097] [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] [Indexed: 11/16/2022] Open
Abstract
Abstract
Abstract Introduction: Patient navigation is emerging as a strategy for addressing barriers to cancer screening among African Americans; however, navigation should address the specific needs and barriers to obtaining screening. The purpose of this study was to identify navigation needs for cancer screening in a community-based sample of African American men and women. Methods: Participants were enrolled in an observational study of community-based navigation for cancer control. Eligibility criteria were African American men and women aged 50-75 years who resided in the Philadelphia, PA metropolitan area, and had no personal history or symptoms of prostate, breast and colon cancer. The main outcome variable was navigation needs for cancer screening. The exposure variables that were assessed were socioeconomic characteristics, sociocultural factors such perceived risk of developing cancer and future temporal orientation and perceptions of social integration, and history of family members with cancer. Chi square tests and analysis of variance were utilized to assess the associations between potential factors and identified barriers. Results: A total of 268 participants were enrolled in the study and of these, 161 (60%) identified navigation needs for cancer screening: cost/lack of insurance (66, 25%), ignorance/lack of knowledge (73, 27%) and provider issues (22, 8%). The main barrier identified by participants that were younger (<56 years) was cost/lack of insurance (51%) while the main barrier identified by older participants (>56 years) was ignorance/lack of knowledge (47%), [p: 0.04]. Most participants (63%) who had a higher perception of developing breast or prostate cancer identified ignorance/lack of knowledge as barrier to screening while most participants (51%) who had a higher perception of developing colon cancer had cost/lack of insurance as barrier to colon cancer screening, [p: 0.01]. Conclusions: Findings from this study suggest that navigation for cancer screening may need to address lack of knowledge and cost/lack of health insurance. Navigation programs for cancer screening may need to address different needs depending on the age and perceived risk of participants.
Citation Format: Oluwole A Babatunde, Melanie Jefferson, Jerry C Johnson, Chanita Hughes-Halbert. Navigation needs among African Americans [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C097.
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Richards K, Gooneratne N, Dicicco B, Hanlon A, Moelter S, Onen F, Wang Y, Sawyer A, Weaver TE, Lozano A, Carter P, Johnson JC. 0538 Effect of CPAP Adherence on Cognition in Older Adults with Mild Cognitive Impairment and Obstructive Sleep Apnea. Sleep 2019. [DOI: 10.1093/sleep/zsz067.536] [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: 11/14/2022] Open
Affiliation(s)
- Kathy Richards
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Nalaka Gooneratne
- Division of Sleep Medicine, Center for Sleep and Circadian Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Barry Dicicco
- School of Medicine, Virginia Commonwealth University & Pulmonary and Critical Care Specialists of Northern Virginia, Fairfax, VA, USA
| | - Alexandra Hanlon
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Stephen Moelter
- Department of Psychology, University of the Sciences in Philadelphia, Philadelphia, PA, USA
| | - Fannie Onen
- Center for Sleep and Circadian Neurobiology, School of Medicine, University of Pennsylvania, Department of Geriatrics CHU Bichat Claude Bernard, Paris, France
| | - Yanyan Wang
- Sleep Medicine Center, West China Hospital, Sichuan University, School of Nursing, The University of Texas at Austin, Texas, TX, USA
| | - Amy Sawyer
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Terri E Weaver
- College of Nursing, Department of Biobehavioral Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Alicia Lozano
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Patricia Carter
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Jerry C Johnson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Halbert CH, Bellamy S, Briggs V, Delmoor E, Purnell J, Rogers R, Weathers B, Johnson JC. A comparative effectiveness education trial for lifestyle health behavior change in African Americans. Health Educ Res 2017; 32:207-218. [PMID: 28335038 PMCID: PMC5914351 DOI: 10.1093/her/cyx039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/06/2017] [Indexed: 06/06/2023]
Abstract
Obesity and excess weight are significant clinical and public health issues that disproportionately affect African Americans because of physical inactivity and unhealthy eating. We compared the effects of alternate behavioral interventions on obesity-related health behaviors. We conducted a comparative effectiveness education trial in a community-based sample of 530 adult African Americans. Outcomes variables were physical activity (PA) and fruit and vegetable intake. Outcomes were evaluated at baseline and 1-month following interventions about shared risk factors for cancer and cardiovascular disease (CVD) (integrated, INT) or CVD only (disease-specific). Significant increases were found in the proportion of participants who met PA guidelines from baseline (47.4%) to follow-up (52.4%) (P = 0.005). In the stratified analysis that were conducted to examine interaction between education and intervention group assignment, this effect was most apparent among participants who had ≤high school education and were randomized to INT (OR = 2.28, 95% CI = 1.04, 5.00, P = 0.04). Completing the intervention was associated with a 1.78 odds of meeting PA guidelines (95% CI = 1.02, 3.10, P = 0.04). Education about risk factors for chronic disease and evidence-based strategies for health behavior change may be useful for addressing obesity-related behaviors among African Americans.
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Affiliation(s)
- Chanita Hughes Halbert
- Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Medical University of South Carolina, Ralph H. Johnson Veteran Administration Medical Center, Charleston, SC 29425, USA
| | - Scarlett Bellamy
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Vanessa Briggs
- Health Promotion Council of Southeastern Pennsylvania, Philadelphia, PA 19102, USA
| | - Ernestine Delmoor
- National Black Leadership Initiative on Cancer, Philadelphia Chapter, Philadelphia, PA 19104, USA
| | | | - Rodney Rogers
- Christ of Calvary Community Development Corporation, Philadelphia, PA 19143, USA
| | - Benita Weathers
- Department of Medicine, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jerry C. Johnson
- Department of Medicine, Division of Geriatric Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Rice LJ, Jefferson M, Briggs V, Delmoor E, Johnson JC, Gattoni-Celli S, Savage SJ, Lilly M, Prasad SM, Kittles R, Halbert CH. Discordance in perceived risk and epidemiological outcomes of prostate cancer among African American men. Prev Med Rep 2017; 7:1-6. [PMID: 28507891 PMCID: PMC5423348 DOI: 10.1016/j.pmedr.2017.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/19/2017] [Accepted: 04/23/2017] [Indexed: 11/16/2022] Open
Abstract
As guidelines for prostate cancer screening have changed from an annual screening recommendation starting at age 50 to discussing the benefits and harms of screening with health care providers, it is necessary to examine other types of factors that are important to prostate cancer screening decisions among African American men. Perceived risk of developing cancer has been shown to predict cancer control behaviors and is lower among African Americans. We characterized perceived risk of developing prostate cancer among African American men from November 2009 to 2011 and evaluated the relationship between prostate cancer risk perceptions and sociodemographic characteristics, health care experiences, and knowledge and exposure to health information about cancer. Chi square tests and logistic regression were employed to determine independent associations. Overall, men did not believe they were at increased risk of developing prostate cancer; they believed their risk was equivalent to or lower than men the same age. Perceived risk of prostate cancer was associated with income (OR = 0.59, 95% CI = 0.26, 1.34, p = 0.03), hypertension (OR = 2.68, 95% CI = 1.17, 6.16, p = 0.02), and beliefs about the association between race and cancer risk (OR = 2.54, 95% CI = 1.24, 5.20, p = 0.01). Clinic and community-based approaches to improve prostate cancer risk comprehension among African American men are needed to reduce the discordance between perceived risk and epidemiological data on prostate cancer risk factors. Risk education interventions that are developed for African American men may need to integrate information about susceptibility for multiple diseases as well as address strategies for risk reduction and prevention, and chronic disease management. Perceived risk was associated with income, hypertension and race and cancer risk. There is discordance in perceived risk for prostate cancer and risk outcomes data. Clinic and community-based approaches are needed to improve risk comprehension.
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Affiliation(s)
- LaShanta J Rice
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, United States.,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
| | - Melanie Jefferson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, United States
| | - Vanessa Briggs
- Health Promotion Services, Public Health Management Corporation, Pennsylvania, 260 South Broad Street, Philadelphia, PA 19102, United States
| | - Ernestine Delmoor
- Philadelphia Chapter, National Black Leadership Initiative on Cancer, 1415 N. Broad Street, Suite 221B, Philadelphia, PA 19122, United States
| | - Jerry C Johnson
- Department of Medicine, Division of Geriatrics, University of Pennsylvania, 3615 Chestnut St, Philadelphia, PA 19104-2676, United States
| | - Sebastiano Gattoni-Celli
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC 29425, United States.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, United States
| | - Stephen J Savage
- Department of Urology, Medical University of South Carolina, Charleston, SC, United States.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, United States
| | - Michael Lilly
- Department of Medicine, Division of Hematology/Oncology, Medical University of South Carolina, Charleston, SC, United States.,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
| | - Sandip M Prasad
- Department of Urology, Medical University of South Carolina, Charleston, SC, United States.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, United States
| | - Rick Kittles
- Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - Chanita Hughes Halbert
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, United States.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, United States.,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
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Halbert CH, Melvin C, Briggs V, Delmoor E, Rice LJ, Lynch C, Jefferson M, Johnson JC. Neighborhood Satisfaction and Colorectal Cancer Screening in a Community Sample of African Americans. J Community Health 2016; 41:38-45. [PMID: 26184107 DOI: 10.1007/s10900-015-0062-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Social determinants are important to cancer screening among African Americans. To evaluate the association between social determinants (e.g., psychological characteristics, perceived social environment, cultural beliefs such as present temporal orientation) and colorectal cancer (CRC) screening among African Americans. African American adults (n = 262) ages 50-75 completed a telephone interview. Multivariate logistic regression analysis was used to identify factors having significant independent associations with CRC screening. Only 57% of respondents reported having CRC screening. The likelihood of screening increased with greater neighborhood satisfaction (OR = 1.38, 95% CI = 1.01, 1.90, p = 0.04), older age (OR = 1.75, 95% CI = 1.24, 2.48, p = 0.002), greater self-efficacy (OR = 2.73, 95% CI = 1.40, 5.35, p = 0.003), and health care provider communication (OR = 10.78, 95% CI = 4.85, 29.94, p = 0.0001). Community resources are important precursors to CRC screening and outcomes among African Americans. In addition to addressing psychological factors and patient-provider communication, efforts to ensure the availability of quality health care facilities that provide CRC screening in the neighborhoods where African Americans live are needed.
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Affiliation(s)
- Chanita Hughes Halbert
- Department of Psychiatry and Behavioral Sciences, Center for Population Health and Outcomes, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC, 29425, USA. .,Ralph H. Johnson Veterans Administration Medical Center, 68 President Street, Suite BE103, Charleston, SC, 29425, USA.
| | - Cathy Melvin
- Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC, 29425, USA.,Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC, 29425, USA
| | - Vanessa Briggs
- Health Promotion Services, Public Health Management Corporation, Pennsylvania, 260 South Broad Street, Philadelphia, PA, 19102, USA
| | - Ernestine Delmoor
- Philadelphia Chapter, National Black Leadership Initiative on Cancer, 1415 N. Broad Street, Suite 221B, Philadelphia, PA, 19122, USA
| | - LaShanta J Rice
- Department of Psychiatry and Behavioral Sciences, Center for Population Health and Outcomes, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC, 29425, USA
| | - Cheryl Lynch
- Division of General Internal Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, Charleston, SC, 29425, USA.,Ralph H. Johnson Veterans Administration Medical Center, 135 Rutledge Ave, Charleston, SC, 29425, USA
| | - Melanie Jefferson
- Department of Psychiatry and Behavioral Sciences, Center for Population Health and Outcomes, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC, 29425, USA
| | - Jerry C Johnson
- Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut St, Philadelphia, PA, 19104-2676, USA
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Halbert CH, Gattoni-Celli S, Savage S, Prasad SM, Kittles R, Briggs V, Delmoor E, Rice LJ, Jefferson M, Johnson JC. Ever and Annual Use of Prostate Cancer Screening in African American Men. Am J Mens Health 2016; 11:99-107. [PMID: 26240090 DOI: 10.1177/1557988315596225] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Since prostate cancer continues to disproportionately affect African American men in terms of incidence, morbidity, and mortality, prostate-specific antigen (PSA) screening plays an important role in early detection, especially when men engage in informed decision making to accept or decline this test. The authors evaluated utilization of PSA testing among African American men based on factors that are important components of making informed decisions. Utilization of PSA testing was evaluated based on whether men had ever had PSA testing and PSA testing during the past year in a community-based sample of African American men ages 50 to 75 ( n = 132). Overall, 64% of men ( n = 85) reported that they had ever had a PSA test; the mean ( SD) age for first use of PSA testing was 47.7 ( SD = 7.4). The likelihood of ever having a PSA test increased significantly with physician communication (odds ratio [OR] = 14.2; 95% confidence interval [CI] = 4.20, 48.10; p = .0001) and with having an annual household income that was greater than $20,000 (OR = 9.80; 95% CI = 3.15, 30.51; p = .0001). The odds of ever having a PSA test were also decreased with each unit increase in future temporal orientation (OR = 0.66; 95% CI = 0.47, 0.93; p = .02). Of the men who had ever had PSA testing, 57% were screened during the past year. Only health insurance status had a significant independent association with having annual PSA testing (OR = 5.10; 95% CI = 1.67, 15.60; p = .004). Different factors were associated significantly with ever having PSA testing and annual testing among African American men. African American men may not be making an informed decision about prostate cancer screening.
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Affiliation(s)
- Chanita Hughes Halbert
- 1 Medical University of South Carolina, Charleston, SC, USA.,2 Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Sebastiano Gattoni-Celli
- 1 Medical University of South Carolina, Charleston, SC, USA.,2 Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Stephen Savage
- 1 Medical University of South Carolina, Charleston, SC, USA.,2 Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Sandip M Prasad
- 1 Medical University of South Carolina, Charleston, SC, USA.,2 Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | | | - Vanessa Briggs
- 4 Health Promotion Council of Southeastern Pennsylvania, Philadelphia, PA, USA
| | - Ernestine Delmoor
- 5 Philadelphia Chapter, National Black Leadership Initiative on Cancer, Philadelphia, PA, USA
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Rice LJ, Hughes B, Briggs V, Delmoor E, Jefferson M, Johnson JC, Halbert CH. Perceived Efficacy and Control for Neighborhood Change: the Cross-Cutting Role of Collective Efficacy. J Racial Ethn Health Disparities 2015; 3:667-675. [PMID: 27294763 DOI: 10.1007/s40615-015-0185-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 06/25/2015] [Revised: 10/22/2015] [Accepted: 10/29/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND The premise of community advocacy is to empower residents by increasing their capacity to address and change neighborhood and structural factors that contribute to adverse health outcomes. An underlying assumption is that community residents will advocate for public policy and other changes. However, limited empirical evidence exists on community residents' perceived ability to advocate for neighborhood change. In this study, we characterized perceived neighborhood control and efficacy for neighborhood change and evaluated independent associations between efficacy and control beliefs and sociodemographic factors, community involvement, and perceptions of social environment. METHODS Cross-sectional data from 488 African American adults were analyzed to describe efficacy and control beliefs and to characterize bivariate associations between these beliefs and sociodemographic factors, social environment, and community involvement variables. Variables with significant relationships (p < 0.10) were included in a multivariate logistic regression model to identify factors having significant independent associations with efficacy and control beliefs. RESULTS Overall, beliefs about neighborhood control and confidence were varied, yet approximately half of residents (49 and 55 %, respectively) reported having a little control over things that happen in their neighborhood and a little confidence in their ability to change things where they live. The likelihood of reporting confidence to make neighborhood improvements increased with greater collective efficacy (OR = 1.78, 95 % CI = 1.19-1.31, p = 0.002). In addition, participants who were involved in a community organization were more likely to report confidence to improve their neighborhood (OR = 2.03, 95 % CI = 1.21-3.42, p = 0.01). CONCLUSION Efforts are needed to improve residents' ability to become positive agents of change in their community. Creating a research infrastructure within academic community partnerships that focus on strengthening advocacy and public policy may improve resident's efficacy and ability to seek and encourage neighborhood change.
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Affiliation(s)
- LaShanta J Rice
- Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA. .,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC, 29425, USA.
| | - Brenda Hughes
- Department of Health and Environmental Control, Walterboro, SC, USA
| | - Vanessa Briggs
- Health Promotion Council of Southeastern Pennsylvania, Philadelphia, PA, USA
| | - Ernestine Delmoor
- National Black Leadership Initiative on Cancer, Philadelphia Chapter, Philadelphia, PA, USA
| | - Melanie Jefferson
- Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Jerry C Johnson
- Department of Medicine, Division of Geriatric Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chanita Hughes Halbert
- Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.,Ralph H. Johnson Veterans Medical Center, Charleston, SC, USA
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Jefferson MS, Briggs V, Delmoor E, Johnson JC, Hughes-Halbert C. Abstract B79: Colonoscopy screening in a community sample of African Americans. Cancer Epidemiol Biomarkers Prev 2014. [DOI: 10.1158/1538-7755.disp13-b79] [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] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background: Colonoscopy is an efficacious strategy for reducing morbidity and mortality from colorectal cancer. Low utilization of colonoscopy contributes to racial disparities in colorectal cancer outcomes. Predictors of colonoscopy have been examined in clinical samples, but decisions about cancer screening are made in a multidimensional context that includes social, psychological, socioeconomic factors. Evaluating the association between colonoscopy utilization and multidimensional factors in a community-based sample is needed to understand how screening decisions are made in a community context.
Objectives: To evaluate the independent associations between social, psychological, socioeconomic, and clinical factors on colonoscopy use in a community-based sample of urban African American adults.
Methods: Participants were 236 African American men and women ages 50-75 who were enrolled in a community-based navigation program for cancer control. Data on colonoscopy use and socioeconomic (e.g., income), clinical (e.g., provider communication about colonoscopy), social (e.g., neighborhood satisfaction), and psychological factors (e.g., self-efficacy) were obtained by self-report during a baseline telephone interview that was completed prior to navigation.
Results: Overall, 58% of participants reported having a colonoscopy. Factors having significant independent associations with colonoscopy included older age (OR=1.15, 95% CI=1.07, 1.24, p=0.0002), greater neighborhood satisfaction (OR=1.86, 95% CI=1.05, 3.30, p=0.03), physician recommendation (OR=12.69, 95% CI=5.33, 30.20, p=0.0001), greater self-efficacy (OR=2.60, 95% CI=1.29, 5.24, p=0.01) and higher income (OR=2.70, 95% CI=1.35, 5.37, p=0.005). Participants with greater levels of present temporal orientation were also more likely to report having a colonoscopy compared to those with lower levels (OR=1.18, 95% CI=0.99, 1.41, p=0.06)
Conclusions: Colonoscopy is sub-optimal in a community-based sample of African Americans. In addition to psychological factors, participants who were more satisfied with their neighborhood conditions and those who had greater levels of present temporal orientation were likely to have a colonoscopy. Social and cultural factors may need to be addressed to enhance colonoscopy use among African Americans.
Citation Format: Melanie S. Jefferson, Vanessa Briggs, Ernestine Delmoor, Jerry C. Johnson, Chanita Hughes-Halbert. Colonoscopy screening in a community sample of African Americans. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B79. doi:10.1158/1538-7755.DISP13-B79
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Affiliation(s)
| | - Vanessa Briggs
- 2Health Promotion Council of Philadelphia, Philadelphia, PA,
| | - Ernestine Delmoor
- 3National Black Leadership Initiative On Cancer, Greater Philadelphia Chapter, Inc, Philadelphia, PA,
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Halbert CH, Bellamy S, Briggs V, Bowman M, Delmoor E, Kumanyika S, Rogers R, Purnell J, Weathers B, Johnson JC. Collective efficacy and obesity-related health behaviors in a community sample of African Americans. J Community Health 2014; 39:124-31. [PMID: 24026302 DOI: 10.1007/s10900-013-9748-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The social environment is important to body mass index and obesity. However, it is unknown if perceptions of the social environment are associated with obesity-related behaviors in populations at greatest risk for being overweight or obese. We evaluated the relationship between collective efficacy and diet and physical activity in a community-based sample of African American adults who were residents in an urban area. Data were collected as part of an academic-community partnership from November 2009 to 2011. We evaluated whether participants met the recommended guidelines for diet and physical activity based on collective efficacy and their sociodemographic background, health care variables, and self-efficacy in a community-based sample of African American adults (n = 338) who were residents in the Philadelphia, PA metropolitan area. Overall, many participants did not meet the recommended guidelines for fruit and vegetable intake or physical activity. The likelihood of meeting the recommended guidelines for fruit intake increased with greater levels of collective efficacy (OR 1.56, 95 % CI 1.18, 2.07, p = 0.002) and self-efficacy for diet (OR 1.56, 95 % CI 1.19, 2.04, p = 0.001). Collective efficacy was not associated with physical activity and the positive association between collective efficacy and vegetable intake was not statistically significant (OR 1.25, 95 % CI 0.94, 1.65, p = 0.12). It is important to determine the most effective methods and settings for improving diet and physical activity behaviors in urban African Americans. Enhancing collective efficacy may be important to improving adherence to recommended guidelines for obesity-related health behaviors.
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Affiliation(s)
- Chanita Hughes Halbert
- Department of Psychiatry and Behavioral Sciences, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC, 29425, USA,
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Burda BU, Chambers AR, Johnson JC. Appraisal of guidelines developed by the World Health Organization. Public Health 2014; 128:444-74. [PMID: 24856197 DOI: 10.1016/j.puhe.2014.01.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [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: 07/22/2013] [Revised: 12/21/2013] [Accepted: 01/07/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To appraise the quality of guidelines developed by the World Health Organization (WHO) that were approved by its Guidelines Review Committee (GRC) and identify strengths and weaknesses in the guideline development process. STUDY DESIGN Cross-sectional. METHODS Three individuals independently assessed GRC-approved WHO guidelines using the Appraisal of Guidelines for Research and Evaluation II instrument (AGREE II). Scores were standardized across domains and overall quality was determined through consensus. RESULTS 124 guidelines met inclusion criteria and were assessed. 58 guidelines were recommended for use, 58 were recommended with modifications and eight were not recommended. The highest scoring domains across guidelines were scope and purpose, and clarity of presentation. The recommended guidelines had higher rigor of development and applicability domain scores in comparison to other guidelines. 77% of the guidelines referenced an underlying evidence review and 49% used GRADE to assess the body of evidence or the strength of the recommendation. The domains in need of improvement included stakeholder engagement, editorial independence, and applicability. Guidelines not recommended for use were generally insufficient in their rigor of development. CONCLUSIONS WHO guidelines need further improvement, most importantly in the rigor of their development (i.e., use of evidence reviews). Other areas for improvement include increased stakeholder engagement, a more explicit process for recommendation formulation and disclosure of interests, discussion of the facilitators, barriers, resource implications, and criteria for monitoring the outcomes of guideline implementation. WHO guidelines can improve through increased transparency, adherence to the WHO Handbook for Guideline Development, and better oversight by the GRC.
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Affiliation(s)
- B U Burda
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227, United States.
| | - A R Chambers
- School of Professional Psychology, Pacific University, 190 SE 8th Ave., Forest Grove, OR 97123, United States
| | - J C Johnson
- Hatfield School of Government, Portland State University, 506 S.W. Mill Street, Suite 650, Portland, OR 97201, United States
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Halbert CH, Bellamy S, Briggs V, Bowman M, Delmoor E, Johnson JC, Kumanyika S, Melvin C, Purnell J, Rogers R, Weathers B. Intervention completion rates among African Americans in a randomized effectiveness trial for diet and physical activity changes. Cancer Epidemiol Biomarkers Prev 2014; 23:1306-13. [PMID: 24755713 DOI: 10.1158/1055-9965.epi-13-1064] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The intervention completion rate is an important metric in behavioral and intervention research; trials with limited intervention completion rates may have reduced internal validity. We examined intervention completion rates among 530 African Americans who had been randomized to an integrated (INT) or disease-specific (DSE) risk education protocol as part of a comparative effectiveness trial from September 2009 to August 2012. METHODS The interventions were developed by an academic-community partnership using community-based participatory research. Intervention completion rates were determined based on attendance at all four intervention sessions. Intervention completers were participants who completed all four sessions and noncompleters were those who did not complete any session or only completed one to three sessions following randomization. RESULTS Seventy-three percent of participants were intervention completers and 27% were noncompleters. There were no differences in intervention completion based on randomization to INT (72%) or DSE (75%), sociodemographic factors, or body mass index (BMI) in the total sample. Different factors were associated significantly with intervention completion within study groups. Among participants randomized to INT, the odds of intervention completion were greater with higher levels of intrinsic motivation, less exposure to information about diet and cardiovascular disease, and greater BMI. Among participants randomized to DSE, the odds of completing the intervention were associated significantly with older age and greater dietary self-efficacy. CONCLUSIONS Many African Americans are likely to complete risk education interventions. IMPACT Psychologic characteristics should be considered when determining intervention completion rates following randomization in behavioral and intervention trials.
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Affiliation(s)
- Chanita Hughes Halbert
- Authors' Affiliations: Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center;
| | - Scarlett Bellamy
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics
| | | | - Marjorie Bowman
- Boonshoft School of Medicine, Wright State University, Dayton, Ohio
| | - Ernestine Delmoor
- National Black Leadership Initiative on Cancer, Philadelphia Chapter
| | | | - Shiriki Kumanyika
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics
| | - Cathy Melvin
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
| | | | - Rodney Rogers
- Christ of Calvary Community Development Corporation, Philadelphia, Pennsylvania; and
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Halbert CH, Briggs V, Bowman M, Bryant B, Bryant DC, Delmoor E, Ferguson M, Ford ME, Johnson JC, Purnell J, Rogers R, Weathers B. Acceptance of a community-based navigator program for cancer control among urban African Americans. Health Educ Res 2014; 29:97-108. [PMID: 24173501 PMCID: PMC3894667 DOI: 10.1093/her/cyt098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 09/10/2013] [Indexed: 06/02/2023]
Abstract
Patient navigation is now a standard component of cancer care in many oncology facilities, but a fundamental question for navigator programs, especially in medically underserved populations, is whether or not individuals will use this service. In this study, we evaluated acceptance of a community-based navigator program for cancer control and identified factors having significant independent associations with navigation acceptance in an urban sample of African Americans. Participants were African American men and women ages 50-75 who were residents in an urban metropolitan city who were referred for navigation. Of 240 participants, 76% completed navigation. Age and perceived risk of developing cancer had a significant independent association with navigation acceptance. Participants who believed that they were at high risk for developing cancer had a lower likelihood of completing navigation compared with those who believed that they had a low risk for developing this disease. The likelihood of completing navigation increased with increases in age. None of the socioeconomic factors or health care variables had a significant association with navigation acceptance. There are few barriers to using community-based navigation for cancer control among urban African Americans. Continued efforts are needed to develop and implement community-based programs for cancer control that are easy to use and address the needs of medically underserved populations.
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Affiliation(s)
- Chanita Hughes Halbert
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Vanessa Briggs
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Marjorie Bowman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Brenda Bryant
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Debbie Chatman Bryant
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Ernestine Delmoor
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Monica Ferguson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Marvella E. Ford
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Jerry C. Johnson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Joseph Purnell
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Rodney Rogers
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
| | - Benita Weathers
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Health Promotion Council of Southeastern Pennsylvania, 260 Broad Street, Philadelphia, PA 19102, USA, Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates, Philadelphia, PA 19104, USA, Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA, Philadelphia Chapter, National Black Leadership Initiative on Cancer, Leon Sullivan Human Resources Building, 1415 N Broad Street, Suite 221B, Philadelphia, PA 19122, USA, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Public Health Sciences, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC 29425, USA, Division of Geriatrics, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA, Southwest Action Coalition, 5214 Woodland Avenue, Philadelphia, PA 19143, USA and Christ of Calvary Community Development Corporation, 500 S 61st Street, Philadelphia, PA 19143, USA
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Greer JA, Northington GM, Harvie HS, Segal S, Johnson JC, Arya LA. Functional Status and Postoperative Morbidity in Older Women with Prolapse. J Urol 2013; 190:948-52. [DOI: 10.1016/j.juro.2013.03.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 03/01/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Joy A. Greer
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
| | - Gina M. Northington
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
| | - Heidi S. Harvie
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
| | - Saya Segal
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
| | - Jerry C. Johnson
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
| | - Lily A. Arya
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
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Twenhafel NA, Mattix ME, Johnson JC, Robinson CG, Pratt WD, Cashman KA, Wahl-Jensen V, Terry C, Olinger GG, Hensley LE, Honko AN. Pathology of experimental aerosol Zaire ebolavirus infection in rhesus macaques. Vet Pathol 2012; 50:514-29. [PMID: 23262834 DOI: 10.1177/0300985812469636] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
There is limited knowledge of the pathogenesis of human ebolavirus infections and no reported human cases acquired by the aerosol route. There is a threat of ebolavirus as an aerosolized biological weapon, and this study evaluated the pathogenesis of aerosol infection in 18 rhesus macaques. Important and unique findings include early infection of the respiratory lymphoid tissues, early fibrin deposition in the splenic white pulp, and perivasculitis and vasculitis in superficial dermal blood vessels of haired skin with rash. Initial infection occurred in the respiratory lymphoid tissues, fibroblastic reticular cells, dendritic cells, alveolar macrophages, and blood monocytes. Virus spread to regional lymph nodes, where significant viral replication occurred. Virus secondarily infected many additional blood monocytes and spread from the respiratory tissues to multiple organs, including the liver and spleen. Viremia, increased temperature, lymphocytopenia, neutrophilia, thrombocytopenia, and increased alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, total bilirubin, serum urea nitrogen, creatinine, and hypoalbuminemia were measurable mid to late infection. Infection progressed rapidly with whole-body destruction of lymphoid tissues, hepatic necrosis, vasculitis, hemorrhage, and extravascular fibrin accumulation. Hypothermia and thrombocytopenia were noted in late stages with the development of disseminated intravascular coagulation and shock. This study provides unprecedented insight into pathogenesis of human aerosol Zaire ebolavirus infection and suggests development of a medical countermeasure to aerosol infection will be a great challenge due to massive early infection of respiratory lymphoid tissues. Rhesus macaques may be used as a model of aerosol infection that will allow the development of lifesaving medical countermeasures under the Food and Drug Administration's animal rule.
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Affiliation(s)
- N A Twenhafel
- Pathology Division, US Army Medical Research Institute of Infectious Diseases, 1425 Porter St, Fort Detrick, MD 21702-5011, USA.
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Johnson JC, Van Emon JM. Quantitative enzyme-linked immunosorbent assay for determination of polychlorinated biphenyls in environmental soil and sediment samples. Anal Chem 2012; 68:162-9. [PMID: 21619232 DOI: 10.1021/ac950410j] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An enzyme-linked immunosorbent assay (ELISA) for the quantitative determination of Aroclors 1242, 1248, 1254, and 1260 in soil and sediments was developed and its performance compared with that of gas chromatography (GC). The detection limits for Aroclors 1242 and 1248 in soil are 10.5 and 9 ng/g, respectively. The assay linear dynamic range is 50-1333 ng/g. Cross-reactivity of the assay with 37 structurally related potential cocontaminants in environmental soil samples was examined; none of the chlorinated anisoles, benzenes, or phenols exhibited >3% cross-reactivity, with <0.1% cross-reactivity being the norm. Soil spike recoveries of 107% and 104% were obtained for Aroclors 1242 and 1248, respectively, for a spike level of 5 mg/kg, with corresponding relative standard deviations of 14% and 17%. One hundred forty-eight environmental soil, sediment, and paper pulp samples, obtained from two EPA listed Superfund sites, were analyzed by ELISA and standard GC methods. Samples were extracted for ELISA analysis by shaking with methanol. Additional extractions of the same samples were performed either with supercritical carbon dioxide or by Soxhlet extraction with methanol. ELISA results for both the supercritical fluid and the Soxhlet extracts were in close agreement with the GC results, while the ELISA results for the methanol shake extracts were not. The data for the environmental samples demonstrated the capability of the ELISA to provide accurate results and reinforced the dependence of any detection method, including ELISA, on appropriate extraction procedures.
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Affiliation(s)
- J C Johnson
- United States Environmental Protection Agency, National Exposure Research Laboratory, Characterization Research Division [Formula: see text] Las Vegas, Las Vegas, Nevada 89119
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Jayadevappa R, Malkowicz SB, Chhatre S, Johnson JC, Gallo JJ. The burden of depression in prostate cancer. Psychooncology 2011; 21:1338-45. [PMID: 21837637 DOI: 10.1002/pon.2032] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 06/05/2011] [Accepted: 06/08/2011] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We sought to analyze the prevalence and incremental burden of depression among elderly with prostate cancer. METHODS We adopted a retrospective cohort design using the Surveillance, Epidemiology and End Results-Medicare linked database between 1995 and 2003. Patients with prostate cancer diagnosed between 1995 and 1998 were identified and followed retrospectively for 1 year pre-diagnosis and up to 8 years post diagnosis. In this cohort of patients with prostate cancer, depression during treatment phase (1 year after diagnosis of prostate cancer) or in the follow-up phase was identified using the International Classification of Diseases-Ninth Revision depression-related codes. Poisson, general linear (log-link) and Cox regression models were used to determine the association between depression status during treatment and follow-up phases and outcomes-health resource utilization, cost and mortality. RESULTS Of the 50,147 patients newly diagnosed with prostate cancer, 4285 (8.54%) had a diagnosis of depression. A diagnosis of depression during treatment phase was associated with higher odds of emergency room visits (odds ratio (OR) = 4.45, 95% CI = 4.13, 4.80), hospitalizations (OR = 3.22, CI = 3.08, 3.37), outpatient visits (OR = 1.71, CI = 1.67, 1.75) and excess risk of death over the course of the follow-up interval (hazard ratio = 2.82, CI = 2.60, 3.06). Health care costs associated with depression remained elevated compared with costs for men without depression, over the course of the follow-up. CONCLUSIONS Depression during the treatment phase was associated with significant health resource utilization, costs and mortality among men with prostate cancer. These findings emphasize the need to effectively identify and treat depression in the setting of prostate cancer.
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Affiliation(s)
- Ravishankar Jayadevappa
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
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Weathers B, Barg FK, Bowman M, Briggs V, Delmoor E, Kumanyika S, Johnson JC, Purnell J, Rogers R, Halbert CH. Using a mixed-methods approach to identify health concerns in an African American community. Am J Public Health 2011; 101:2087-92. [PMID: 21330592 DOI: 10.2105/ajph.2010.191775] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We used qualitative and quantitative data collection methods to identify the health concerns of African American residents in an urban community and analyzed the extent to which there were consistencies across methods in the concerns identified. METHODS We completed 9 focus groups with 51 residents, 27 key informant interviews, and 201 community health surveys with a random sample of community residents to identify the health issues participants considered of greatest importance. We then compared the issues identified through these methods. RESULTS Focus group participants and key informants gave priority to cancer and cardiovascular diseases, but most respondents in the community health survey indicated that sexually transmitted diseases, substance abuse, and obesity were conditions in need of intervention. How respondents ranked their concerns varied in the qualitative versus the quantitative methods. CONCLUSIONS Using qualitative and quantitative approaches simultaneously is useful in determining community health concerns. Although quantitative approaches yield concrete evidence of community needs, qualitative approaches provide a context for how these issues can be addressed. Researchers should develop creative ways to address multiple issues that arise when using a mixed-methods approach.
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Affiliation(s)
- Benita Weathers
- Department of Psychiatry, University of Pennsylvania,Philadelphia, PA, USA.
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Jayadevappa R, Chhatre S, Johnson JC, Malkowicz SB. Variation in quality of care among older men with localized prostate cancer. Cancer 2010; 117:2520-9. [PMID: 24048800 DOI: 10.1002/cncr.25812] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [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: 08/17/2010] [Revised: 10/28/2010] [Accepted: 10/28/2010] [Indexed: 12/20/2022]
Abstract
BACKGROUND The objective of this study was to assess the racial and ethnic disparities in outcomes and their association with process-of-care measures for elderly Medicare recipients with localized prostate cancer. METHODS The Surveillance, Epidemiology, and End Results-Medicare databases for the period from 1995 to 2003 were used to identify African-American men, non-Hispanic white men, and Hispanic men with localized prostate cancer, and data were obtained for the 1-year period before the diagnosis of prostate cancer and up to 8 years postdiagnosis. The short-term outcomes of interest were complications, emergency room visits, readmissions, and mortality; the long-term outcomes of interest were prostate cancer-specific mortality and all-cause mortality; and process-of-care measures of interest were treatment and time to treatment. Cox proportional hazards regression, logistic regression, and Poisson regression were used to study the racial and ethnic disparities in outcomes and their association with process-of-care measures. RESULTS Compared with non-Hispanic white patients, African-American patients (Hazard ration [HR], 1.43; 95% confidence interval [CE], 1.19-1.86) and Hispanic patients (HR=1.39; 95% CI, 1.03-1.84) had greater hazard of long term prostate specific mortality. African-American patients also had greater odds of emergency room visits (odds ratio, 1.4; 95% CI, 1.2-1.7) and greater all-cause mortality (HR, 1.39; 95% CI, 1.3-1.5) compared with white patients. The time to treatment was longer for African-American patients and was indicative of a greater hazard of all-cause, long-term mortality. Hispanic patients who underwent surgery or received radiation had a greater hazard of long-term prostate-specific mortality compared with white patients who received hormone therapy. CONCLUSIONS Racial and ethnic disparities in outcomes were associated with process-of-care measures (the type and time to treatment). The current results indicated that there is an opportunity to reduce these disparities by addressing these process-of-care measures.
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Affiliation(s)
- Ravishankar Jayadevappa
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
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Abstract
PURPOSE Aging is associated with losses in hearing and vision. The objective of this study was to assess whether aging also is associated with less ability to detect and interpret afferent physiological information. DESIGN A cross-sectional mixed methods study was conducted with 29 persons with a confirmed diagnosis of chronic heart failure of at least 6 months duration. The sample was divided at the median to compare younger (<73 years) versus older (> or = 73 years) patients in the ability to detect and interpret their heart failure symptoms. METHODS Shortness of breath was stimulated using a 6-minute walk test (6MWT) and used to assess the ability of heart failure patients to detect shortness of breath using the Borg measure of perceived exertion compared with gold standard ratings of each person's shortness of breath by trained registered nurse research assistants (inter-rater congruence 0.91). Accuracy of ratings by older patients was compared with those of younger patients. In-depth interviews were used to assess symptom interpretation ability. FINDINGS Integrated quantitative and qualitative data confirmed that older patients had more difficulty in detecting and interpreting shortness of breath than younger patients. Older patients were twice as likely as younger to report a different level of shortness of breath than that noted by the registered nurse research assistants immediately after the 6MWT. CONCLUSIONS These results support our theory of an age-related decline in the ability to attend to internal physical symptoms. This decline may be a cause of poor early symptom detection. CLINICAL RELEVANCE The results of this study suggest that there is a need to develop interventions that focus on the symptom experience to help patients-particularly older ones-in somatic awareness and symptom interpretation. It may be useful to explore patients' statements about how they feel: "Compared to what? How do you feel today compared to yesterday?"
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Affiliation(s)
- Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA 9104-6096, USA.
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Holt RJ, Sklar AR, Darkow T, Goldberg GA, Johnson JC, Harley CR. Prevalence of Parkinson's disease-induced psychosis in a large U.S. managed care population. J Neuropsychiatry Clin Neurosci 2010; 22:105-10. [PMID: 20160217 DOI: 10.1176/jnp.2010.22.1.105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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] [Indexed: 11/30/2022]
Abstract
Using 10 years' enrollment history, patients with non-drug-induced Parkinson's disease were identified, and the prevalence of Parkinson's disease-induced psychosis (PDP) was estimated using three different claims algorithms based on an expert working group criteria. The estimated prevalence of PDP ranged from 4 to 45/1,000 Parkinson's disease patients. PDP patients were just as likely to be male as female and were significantly older than Parkinson's disease patients without PDP. PDP patients more commonly had evidence of dementia and use of atypical antipsychotics. PDP occurs in up to 45,000 Parkinson's disease patients in the United States but represents a unique neuropsychiatric finding with important treatment implications.
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Bozeman WP, Barnes DG, Winslow JE, Johnson JC, Phillips CH, Alson R. Immediate cardiovascular effects of the Taser X26 conducted electrical weapon. Emerg Med J 2009; 26:567-70. [PMID: 19625551 DOI: 10.1136/emj.2008.063560] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
STUDY OBJECTIVES To evaluate the immediate cardiac and cardiovascular effects of Taser X26 conducted electrical weapon (CEW) exposure in human volunteers, including heart rhythm, rate and blood pressure. METHODS Volunteer police officers participating in CEW training and testing each underwent a 5, 3 and 1 s exposure to the Taser X26 CEW. Continuous electrocardiogram (ECG) monitoring was performed before, during and after each exposure. Blood pressures were measured at rest before and within 1 minute after each exposure. Paired sample t-test analysis and confidence interval calculations were performed. RESULTS 84 Taser exposures were monitored among 28 subjects (24 men, four women) with an average age of 34 years (range 24-46, SD 5.6). No cardiac dysrhythmias or aberrantly conducted beats were seen. Mean heart rate increased by 10.9 beats per minute (bpm) (95% CI 8.2 to 13.7) from 121.7 to 132.6 (p<0.001). The QRS and QTc cardiac intervals did not change significantly. Mean blood pressure increased from 138.6/82.8 mm Hg at rest to 145.8/85.6 mm Hg after the standard 5-s CEW discharge. CONCLUSION CEW exposure produced no detectable dysrhythmias and a statistically significant increase in heart rate. Overall, Taser CEW exposure appears to be safe and well tolerated from a cardiovascular standpoint in this population. This study increases the cumulative human subject experience of CEW exposure with continuous ECG monitoring and includes 28 full 5-s exposures.
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Affiliation(s)
- W P Bozeman
- WFU Department of Emergency Medicine, Medical Center Boulevard, Winston Salem, NC 27106-1089, USA.
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Abstract
OBJECTIVE A complex relationship exists between Alzheimer's disease (AD) and other co-existing co-morbidities such as congestive heart failure (CHF) with implications for health resource utilization (HRU) and cost of care. Study objective was to assess HRU and cost of care in elderly with AD and with or without concomitant CHF. METHODS All elderly (> or =65 years) from an academic healthcare system diagnosed with AD in 1999 (n = 904) and matched AD-free controls (n = 3616). Each group was subdivided into those with and without a CHF diagnosis. Costs and HRU were obtained from Medicare databases for 1999 and 2000. Costs and HRU were compared using ANOVA and Wilcoxon rank sum tests. Regressions were used to model the effect of AD and CHF on outcomes. RESULTS Mean annual cost were 20,888 US dollars for AD + CHF group, 5,473 US dollars for only AD group, 17,700 US dollars for only CHF group and 4,578 US dollars for the control group (no-AD and no-CHF). After adjusting for covariates, AD + CHF group had an eight-fold increase in total cost, while only CHF group had five-fold increase in total cost, compared to the control group. Regressions for inpatient costs, outpatient costs and inpatient pharmacy costs exhibited comparable trends. CONCLUSIONS For elderly AD patients, a co-occurring diagnosis of CHF can result in a substantial increase in cost and HRU. This necessitates additional considerations if health care expenditures are to be reduced, particularly inpatient expenditure.
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Affiliation(s)
- Sumedha Chhatre
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Johnson JC, Hayden UT, Thomas N, Groce-Martin J, Henry T, Guerra T, Walker A, West W, Barnett M, Kumanyika S. Building Community Participatory Research Coalitions from the Ground Up: The Philadelphia Area Research Community Coalition. ACTA ACUST UNITED AC 2009; 3:61-72. [DOI: 10.1353/cpr.0.0052] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Jayadevappa R, Johnson JC, Bloom BS, Nidich S, Desai S, Chhatre S, Raziano DB, Schneider R. Effectiveness of transcendental meditation on functional capacity and quality of life of African Americans with congestive heart failure: a randomized control study. Ethn Dis 2007; 17:72-7. [PMID: 17274213 PMCID: PMC2048830] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVE To evaluate the effectiveness of a Transcendental Meditation (TM) stress reduction program for African Americans with congestive heart failure (CHF). DESIGN Randomized, controlled study PARTICIPANTS AND INTERVENTION We recruited 23 African American patients > or = 55 years of age who were recently hospitalized with New York Heart Association class II or III CHF and with an ejection fraction of < .40. Participants were randomized to either TM or health education (HE) group. MAIN OUTCOME MEASURES Primary outcome measure was six-minute walk test; secondary outcomes were generic and disease-specific health-related quality of life, quality of well being, perceived stress, Center for Epidemiologic Studies Depression Scale (CES-D), rehospitalizations, brain natriuretic peptide, and cortisol. Changes in outcomes from baseline to three and six months after treatment were analyzed by using repeated measures analysis of variance, covarying for baseline score. RESULTS For the primary outcome of functional capacity, the TM group significantly improved on the six-minute walk test from baseline to six months after treatment compared to the HE group (P = .034). On the secondary outcome measures, the TM group showed improvements in SF-36 subscales and total score on the Minnesota Living with Heart Failure scale. On the CES-D, the TM group showed significant decrease from baseline to six months compared to the HE group (P = .03). Also, the TM group had fewer rehospitalizations during the six months of followup. CONCLUSIONS Results indicate that TM can be effective in improving the quality of life and functional capacity of African American CHF patients. Further validation of outcomes is planned via a large, multicenter trial with long-term follow-up.
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Affiliation(s)
- Ravishankar Jayadevappa
- Department of Medicine, University of Pennsylvania, 224, Ralston-Penn Center, 3615 Chestnut Street, Philadelphia, PA 19104-2676, USA.
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Jayadevappa R, Johnson JC, Chhatre S, Wein AJ, Malkowicz SB. Ethnic variation in return to baseline values of patient-reported outcomes in older prostate cancer patients. Cancer 2007; 109:2229-38. [PMID: 17443664 DOI: 10.1002/cncr.22675] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [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: 01/17/2023]
Abstract
BACKGROUND Ethnic variation in patient-reported outcomes such as health-related quality of life (HRQoL) and satisfaction with care are understudied areas in the management of elderly prostate cancer (PCa) patients. METHODS In this prospective cohort study, between the years 2002 and 2004, the authors recruited 214 older (>or=65 years) men with newly diagnosed PCa from an urban academic hospital and a Veterans Administration hospital. Participants completed generic (SF-36), prostate-specific (UCLA-PCI) HRQoL, and satisfaction with care (CSQ-8) surveys at baseline and at 3, 6, and 12-months follow-up. Clinically significant difference was used to compute return to baseline. The authors compared time to return to baseline HRQoL after controlling for confounding variables by using ANOVA and log-linear models. Survival curves were used to compare time to return to baseline across ethnicity. RESULTS Regression analysis revealed that age and marital status, not ethnicity, were independent predictors of radical prostatectomy, rather than radiation treatment. African Americans reported lower HRQoL scores at diagnosis and required a longer time to return to baseline. Log-linear analysis indicated that African-American ethnicity was associated with lower 12-month scores for role physical (odds ratio [OR], 0.46; standard error [SE], 0.40), role emotional (OR, 0.37; SE, 0.43), bodily pain (OR, 0.74; SE, 0.10), urinary function (OR, 0.90; SE, 0.11), and urinary bother (OR, 0.72; SE, 0.17). Both groups reported comparably high levels of satisfaction with care. CONCLUSIONS African-American elderly exhibited poorer outcomes and required a longer time to return to baseline HRQoL. These differences highlight the need for discussion with patients and families prior to treatment about expectations and the need for support services post-treatment.
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Affiliation(s)
- Ravishankar Jayadevappa
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104-2676, USA.
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Lai JY, Doyle RJ, Bluhm JM, Johnson JC. Multiplexed PCR genotyping of HPVs from plantaris verrucae. J Clin Virol 2006; 35:435-41. [PMID: 16420985 DOI: 10.1016/j.jcv.2005.11.012] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 03/21/2005] [Revised: 10/12/2005] [Accepted: 11/09/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND Plantaris verrucae are a common diagnosis in childhood, consume a significant amount of health-care resources, have many painful treatment options and many recurrences. OBJECTIVES The objective of this study was to design and test a single site-anchored, multiplexed and expandable PCR assay for common types of cutaneous HPVs. STUDY DESIGN Common forward and unique reverse primers were selected from the E2 open reading frames of five cutaneous HPV genotypes. These were analyzed for sensitivity and selectivity using pHPV plasmids and several control DNAs in an optimized multiplexed assay. This standardized assay was used to analyze human verruca plantaris tissue for genome type and to evaluate the effect of a commonly used treatment protocol. RESULTS A sensitive, multiplexed PCR assay for human cutaneous HPV genotypes 1a, 2a and 4 was developed. Specific-unique primers and a consensus anchor primer were selected within the HPV E2 region to produce amplicons varying by greater than 100bp. In analytical sensitivity studies, fewer than 100 genome copies of HPV1a and 2a were detected, and fewer than 1000 copies of HPV4 were detected. The multiplexed assay did not amplify regions of human placenta, calf thymus, CaSki or SiHa DNA and E. coli, pBR322 or non-HPV virus DNAs. In combination with a forensic DNA extraction procedure, the multiplexed HPV assay detected and identified HPV types in 23 of 51 (45%) deep plantaris verrucae. Two patients were found with two different genotypes in single deep plantaris verruca. Detection of the HPV genome was followed as a function of tissue ablation and Mediplast treatment in one patient. In healing tissue, the genome content was reduced but had not totally disappeared. CONCLUSIONS The multiplexed HPV assay can be used to determine genotype prevalence that may correlate with treatment efficacy.
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Affiliation(s)
- J-Y Lai
- Department of Dermatology, Mayo Clinic College of Medicine, Rochester, MN 55905, United States
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Johnson JC, Slusar MB, Chaatre S, Johnsen P. Perceptions of cultural competency among elderly African Americans. Ethn Dis 2006; 16:778-85. [PMID: 17061727] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
We conducted a qualitative study of 23 subjects to determine how African Americans perceive culturally competent care by physicians. Our objectives were to understand patients' perceptions of: 1) high-quality health care by physicians; 2) the role of culture and ethnicity in the doctor-patient relationship; and 3) patients' expectations of doctors. We developed a discussion guide and a questionnaire to capture the perception of competent (desirable or high-quality) health care in the context of cultural beliefs and attitudes. We found that African Americans are concerned with traditional performance aspects of care. In addition to professional demeanor and appropriate diagnosis and treatment, communication and respect were critical aspects of the process of care. Most participants thought that physicians should know something about African American culture but only in the context of healthcare issues. For these individuals, a culturally competent doctor is one who provides effective treatment while showing respect and using effective communication methods, regardless of the ethnicity and sex of the doctor. Future research on cultural competence in the doctor-patient relationship must elicit the full range of patient values--technical performance, general (culture-nonspecific) process of care, and cultural-specific preferences.
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Affiliation(s)
- Jerry C Johnson
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Thornton GM, Johnson JC, Maser RV, Marchuk LL, Shrive NG, Frank CB. Strength of medial structures of the knee joint are decreased by isolated injury to the medial collateral ligament and subsequent joint immobilization. J Orthop Res 2005; 23:1191-8. [PMID: 16140200 DOI: 10.1016/j.orthres.2005.03.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [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] [Revised: 03/09/2005] [Indexed: 02/04/2023]
Abstract
Past studies of the healing of the medial collateral ligament (MCL) in animal models have been conducted over a variety of healing intervals, some as early as 1 week. One concern with testing at early healing intervals is the difficulty in identifying and isolating the tissues that carry load. The purpose of this study was to determine if isolation of the MCL and healing time are critical factors in the assessment of structural strength in this model. Furthermore, the effect of immobilization on these critical factors was investigated. Our approach was to calculate the load-sharing ratio between the MCL and the MCL plus capsule. A 4 mm gap was created in the midsubstance of both hindlimb MCLs of 52 female New Zealand White rabbits (n=104). Of these, 29 rabbits had their right hindlimb pin immobilized (immobilized group), leaving the left hindlimb non-immobilized. Testing was performed at 3 (n=12), 6 (n=22), and 14 (n=24) weeks. The remaining 23 rabbits, which had both limbs non-immobilized (non-immobilized group), were tested at 3 (n=10), 6 (n=12), 14 (n=12), and 40 (n=12) weeks. For both groups, half of the specimens at each healing interval were used to test the MCL alone and half to test the MCL plus capsule, except for 3 week immobilized joints where only the MCL plus capsule was tested. Additionally, MCL (n=12), MCL plus capsule (n=6), and capsule alone (n=5) were tested from normal animals. The load-sharing ratio at MCL failure for the normal joint was 89%, suggesting an MCL-dominated response. For the non-immobilized group, the load-sharing ratio was 24% at 3 weeks of healing, suggesting a capsule-dominated response. At and after 6 weeks of healing, an MCL-dominated response was observed, with the ratio being 68% or greater. Thus, at less than 6 weeks of healing, the structural strength capabilities of the joint may be better represented by the medial structures rather than the isolated MCL. Immobilization delayed the transition from a capsule-dominated response to an MCL-dominated response in this model.
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Affiliation(s)
- G M Thornton
- Division of Orthopaedic Engineering Research, University of British Columbia, Richmond, BC, Canada V7A 4S5.
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Besdine R, Boult C, Brangman S, Coleman EA, Fried LP, Gerety M, Johnson JC, Katz PR, Potter JF, Reuben DB, Sloane PD, Studenski S, Warshaw G. Caring for Older Americans: The Future of Geriatric Medicine. J Am Geriatr Soc 2005; 53:S245-56. [PMID: 15963180 DOI: 10.1111/j.1532-5415.2005.53350.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [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: 11/26/2022]
Abstract
In response to the needs and demands of an aging population, geriatric medicine has grown rapidly during the past 3 decades. The discipline has defined its core values as well as the knowledge base and clinical skills needed to improve the health, functioning, and well-being of older persons and to provide appropriate palliative care. Geriatric medicine has developed new models of care, advanced the treatment of common geriatric conditions, and advocated for the health and health care of older persons. Nevertheless, at the beginning of the 21st century, the health care of older persons is at a crossroads. Despite the substantial progress that geriatric medicine has made, much more remains to be done to meet the healthcare needs of our aging population. The clinical, educational, and research approaches of the 20th century are unable to keep pace and require major revisions. Maintaining the status quo will mean falling further and further behind. The healthcare delivery and financing systems need fundamental redesign to improve quality and eliminate waste. The American Geriatrics Society (AGS) Task Force on the Future of Geriatric Medicine has identified five goals aimed at optimizing the health of older persons: To ensure that every older person receives high-quality, patient-centered health care; To expand the geriatrics knowledge base; To increase the number of healthcare professionals who employ the principles of geriatric medicine in caring for older persons; To recruit physicians and other healthcare professionals into careers in geriatric medicine; To unite professional and lay groups in the effort to influence public policy to continually improve the health and health care of seniors. Geriatric medicine cannot accomplish these goals alone. Accordingly, the Task Force has articulated a set of recommendations primarily aimed at the government, organizations, agencies, foundations, and other partners whose collaboration will be essential in accomplishing these goals. The vision described in this document and the accompanying recommendations are only the broad outline of an agenda for the future. Geriatric medicine, through its professional organizations and its partners, will need to mobilize resources to identify and implement the specific steps that will make the vision a reality. Doing so will require broad participation, consensus building, creativity, and perseverance. The consequences of inaction will be profound. The combination of a burgeoning number of older persons and an inadequately prepared, poorly organized physician workforce is a recipe for expensive, fragmented health care that does not meet the needs of our older population. By virtue of their unique skills and advocacy for the health of older persons, geriatricians can be key leaders of change to achieve the goals of geriatric medicine and optimize the health of our aging population. Nevertheless, the goals of geriatric medicine will be accomplished only if geriatricians and their partners work in a system that is designed to provide high-quality, efficient care and recognizes the value of geriatrics.
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Affiliation(s)
- Richard Besdine
- American Geriatrics Society, 350 Fifth Avenue, Suite 801, New York, NY 10118, USA
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Abstract
Dynamic etching methods for fabricating fibre optic tips are explored and modelled. By vertically translating the fibre during etching by an HF solution under an organic protective layer, a variety of tip shapes were created. The probe taper lengths, cone angles and geometrical probe shapes were measured in order to evaluate the dynamic meniscus etching process. Fibre motion, etching rate, meniscus distortion and etching time were all found to be important variables that can be used to control the final probe shape.
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Affiliation(s)
- L H Haber
- Department of Chemistry, University of California, Berkeley, CA 94720-1460, USA
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Mackenzie ER, Taylor L, Bloom BS, Hufford DJ, Johnson JC. Ethnic minority use of complementary and alternative medicine (CAM): a national probability survey of CAM utilizers. Altern Ther Health Med 2003; 9:50-6. [PMID: 12868252] [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: 03/03/2023]
Abstract
CONTEXT US research results suggest that some sociodemographic characteristics predict use of complementary and alternative medicine (CAM). Specifically, use of CAM has been positively associated with persons from higher socioeconomic status groups and negatively associated with African-Americans. OBJECTIVE To investigate the sociodemographic characteristics of CAM utilizers in a national probability sample, one containing an over-sampling of ethnic minorities. DESIGN We tested the hypothesis that CAM use is prevalent among many different ethnic groups in the US. by analyzing a subset of data from The 1995 National Comparative Survey of Minority Health Care of The Commonwealth Fund, a national probability sample of 3,789 persons with an over-sampling of ethnic minorities. The survey was conducted by telephone in 6 languages. We analyzed use of CAM (defined by 5 items: herbal medicine, acupuncture, chiropractic, traditional healer, home remedy) within the last year. RESULTS Use of 1 or more CAM modalities did not differ by ethnicity. Overall, 43.1% of the respondents reported using 1 or more CAM modality. Predictors of CAM use were female gender, being uninsured, and having a high school education or above. CONCLUSION Use of CAM is equally prevalent among white, African-American/black, Latino, Asian, and Native American populations in the US, but characteristics of utilizers vary considerably by specific CAM modality.
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Lockwood PW, Johnson JC, Katz TL. Clinical efficacy of flunixin, carprofen and ketoprofen as adjuncts to the antibacterial treatment of bovine respiratory disease. Vet Rec 2003; 152:392-4. [PMID: 12696705 DOI: 10.1136/vr.152.13.392] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [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: 11/04/2022]
Abstract
Three non-steroidal anti-inflammatory drugs (NSAIDs), flunixin, ketoprofen and carprofen, were used in conjunction with ceftiofur, in the treatment of naturally occurring bovine respiratory disease. Sixty-six mixed-breed beef cattle weighing on average 197 kg met the inclusion criteria of pyrexia of at least 40 degrees C, an illness score indicating at least moderate illness and at least moderate dyspnoea. They were allocated randomly to four treatment groups. All the groups received ceftiofur for three days at a dose rate of 1.1 mg/kg by intramuscular injection, and three groups received, in addition, a single dose of either flunixin (2.2 mg/kg by intravenous injection) or ketoprofen (3 mg/kg by intravenous injection) or carprofen (1.4 mg/kg by subcutaneous injection). During the first 24 hours of the study, the pyrexia of the three groups treated with a NSAID was reduced significantly more than the pyrexia of the group treated with ceftiofur alone, and two and four hours after treatment the reduction in pyrexia was significantly greater in the groups treated with flunixin and ketoprofen than in the group treated with carprofen. There were no statistically significant differences between the four groups with respect to depression, illness scores, dyspnoea or coughing. There was less lung consolidation in the three groups treated with a NSAID than in the animals treated with ceftiofur alone, but the difference was significant only in the group treated with flunixin.
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Affiliation(s)
- P W Lockwood
- Schering-Plough Animal Health, 2458 Chamberlain Street, Terre Haute, IN 47805, USA
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Fanger GR, Houghton RL, Retter MW, Hendrickson RC, Babcook J, Dillon DC, Durham MD, Reynolds LD, Johnson JC, Carter D, Fleming TP, Roche PC, Persing DH, Reed SG. Detection of mammaglobin in the sera of patients with breast cancer. Tumour Biol 2002; 23:212-21. [PMID: 12499777 DOI: 10.1159/000067251] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Current procedures for the diagnosis of breast cancer are cumbersome and invasive, making detection of this disease difficult. A rapid screening test for early detection of breast cancer would allow for better management of this deadly disease. In this report, we show that, with the exception of the skin, mammaglobin mRNA is specifically expressed in mammary tissue and commonly overexpressed in breast cancer. Mammaglobin is not expressed in other types of cancer including colon, lung, ovarian, and prostate cancer. Breast-specific expression of mammaglobin protein was shown using immunohistochemical methods. Mammaglobin is secreted from both established breast cancer cell lines and primary breast carcinoma cells cultured in vitro. Using a monoclonal antibody-based assay for monitoring the presence of mammaglobin in serum, elevated levels of mammaglobin were detected in sera of patients with breast cancer, but not in healthy women. Thus, mammaglobin, which is overexpressed and secreted from breast carcinoma cells, is detectable in sera of patients with breast cancer and may provide a rapid screening test for the diagnosis and management of breast cancer.
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Affiliation(s)
- G R Fanger
- Corixa Corporation, Department of Antigen Discovery, Seattle, WA 98104, USA.
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Harralson TL, White TM, Regenberg AC, Kallan MJ, Have TT, Parmelee PA, Johnson JC. Similarities and differences in depression among black and white nursing home residents. Am J Geriatr Psychiatry 2002; 10:175-84. [PMID: 11925278] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
The authors examined racial similarities and differences in depressive symptomatology, diagnosis, and the predictors of depression in four independent nursing homes, conducting analyses across all sites and separately for the nursing home with the greatest racial balance (NH4). All-site data indicated that white residents showed more depression than black residents. There were no racial differences in the depression diagnosis derived from a structured interview of DSM-III-R. At NH4, there were no statistically significant racial differences in any of the measures of depression. Across sites, functional disability was the strongest predictor of both Geriatric Depression Scale (GDS) and DSM-III-R diagnosis of depression in both blacks and whites. Cognitive impairment and use of antidepressants were predictive of medical chart diagnosis of depression across sites, but not of depression measured by GDS or DSM-III-R criteria. At NH4, functional disability was predictive of GDS depression, but only among whites. Age was not an important predictor of depression. Results indicate the importance of considering the method used to diagnose depression and the necessity of controlling for the nursing home setting when examining racial differences in depression.
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Affiliation(s)
- Tina L Harralson
- Division of Geriatric Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
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Abstract
OBJECTIVE To assess depressive symptoms, self-concept, and behavior in non-affected siblings of children with severe pediatric traumatic brain injury (TBI). DESIGN Cross-sectional study with case controls. SETTING Children's hospital tertiary care center. PARTICIPANTS Twelve siblings of children consecutively admitted to an inpatient rehabilitation unit after a severe TBI. Case controls were randomly selected from the sibling's classmates. MAIN OUTCOME MEASURES The Child Behavior Checklist (CBCL), the Teacher's Report Form of the CBCL (TRF-CBCL), the Self-Perception Profile for Children and the Children's Depression Inventory (CDI). RESULTS No statistical differences were found in depressive symptoms, self-concept, or behavior between the siblings and their classmates 3 to 18 months after injury. Poorer functional outcomes in the child with a TBI were found to correlate significantly with lower self-concept and more symptoms of depression in the siblings. CONCLUSIONS Further research is needed to evaluate the potential impact on sibling adjustment after pediatric TBI.
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Affiliation(s)
- M A McMahon
- Division of Pediatric Rehabilitation, Department of Pediatric Rehabilitation, Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
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Johnson JC. A potential hole in the safety net. Ann Emerg Med 2001; 38:604-5. [PMID: 11679879 DOI: 10.1067/mem.2001.119275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Longo DR, Johnson JC, Kruse RL, Brownson RC, Hewett JE. A prospective investigation of the impact of smoking bans on tobacco cessation and relapse. Tob Control 2001; 10:267-72. [PMID: 11544392 PMCID: PMC1747578 DOI: 10.1136/tc.10.3.267] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.9] [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: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVES To examine the long term impact of workplace smoking bans on employee smoking cessation and relapse. Over three years we studied a total of 1033 current or former smokers (intervention group) employed in smoke-free hospitals and 816 current or former smokers (comparison group) employed in non-smoke-free workplaces. The design of this natural experiment is a prospective cohort study. We randomly selected both hospitals and employees from 12 strata based on hospital size and state tobacco regulations, and sampled employees in the same communities. Main outcome measures were post-ban quit ratio and relapse rate. RESEARCH DESIGN Between groups comparisons were conducted using the Cochran-Mantel-Haenszel statistic for general association, stratified Cox proportional hazards models, and the CMH analysis of variance statistic based on ranks. McNemar's test and the sign test were used to test for changes over time within each group. RESULTS Differences in the post-ban quit ratio were observed between intervention and comparison groups (p < or = 0.02). For employees whose bans were implemented at least seven years before survey, the post-ban quit ratio was estimated at 0.256, compared with 0.142 for employees in non-smoke-free workplaces (p = 0.02). After controlling for a variety of factors, time to quit smoking was shorter for the hospital employees (p < 0.001), with an overall relative risk of quitting of 2.3. Contrary to expectations, relapse rates were similar between the groups. CONCLUSION Employees in workplaces with smoking bans have higher rates of smoking cessation than employees where smoking is permitted, but relapse is similar between these two groups of employees. The results of this investigation have international applicability for policy makers, clinicians, employers, and employees. Countries should review smoking policies in workplaces in light of their own smoking patterns and efforts to deal with environmental tobacco smoke.
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Affiliation(s)
- D R Longo
- Center for Family Medicine Science in the Department of Family and Community Medicine, School of Medicine, University of Missouri-Columbia, Columbia, Missouri 65212, USA.
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Abstract
Clinically ill feline leukemia virus (FeLV)-infected cats, treated with Staphylococcus protein A (SPA) or oral interferon alpha (IFN), or both, were compared with cats treated with saline (SAL). Nine cats received SPA/SAL, nine received SPA/IFN, 10 received SAL/IFN, and eight received SAL/SAL. Twelve cats survived and completed the 100-week therapy. Significantly more owners of cats treated with SPA/SAL thought their cat's health improved during treatment compared to owners of cats treated with SAL/SAL (P=0.05, pair-wise comparison) or SPA/IFN (P=0.05, pair-wise comparison). No significant differences in body weight, temperature, hematocrit, red blood cell counts, mean corpuscular hemoglobin concentration, reticulocyte counts, white blood cell or neutrophil numbers, lymphocyte concentrations, bone-marrow cytopathology, FeLV status, survival time, activity, or appetite scores were observed. No significant differences in the owners' subjective assessment of their cat's health following treatment with SAL/IFN, SPA/IFN, or SAL/SAL were seen. Therapy with SPA as a single agent results in the owners' subjective impression of improved health of their FeLV-infected cats.
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Affiliation(s)
- D L McCaw
- Department of Veterinary Medicine, College of Veterinary Medicine, University of Missouri, Columbia 65211, USA
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Abstract
OBJECTIVE To determine whether a lumbar support improves trunk repositioning error (RE), an aspect of proprioception. DESIGN RE was measured with and without a lumbar support. SETTING Outpatient clinic. PARTICIPANTS Twenty subjects with chronic low back pain (LBP) and 20 control subjects. INTERVENTIONS Subjects wore the lumbar support for 2 hours and then testing was repeated. MAIN OUTCOME MEASURES Standing with legs and pelvis immobilized, subjects moved to a predetermined target position and then attempted to replicate the position. The 3-dimensional position of the trunk was measured with a 3Space Tracker. RE was calculated as the absolute difference between the actual target position and the subject-perceived target position. Testing was performed with and without a lumbar support both before and after wearing the support for 2 hours. RESULTS In subjects with LBP, RE was significantly lower with a support in flexion, extension, and right lateral bending. In control subjects, RE was significantly lower when wearing the support in left bending only, and RE was significantly higher in control subjects after wearing the support for 2 hours. CONCLUSION A lumbar support improves trunk RE. In subjects with LBP, this result was significant in the sagittal plane and in right lateral bending, whereas in control subjects, it was significant only in left lateral bending.
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Affiliation(s)
- K Newcomer
- Department of Physical Medicine and Rehabilitation, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA
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Johnson JC. Minutes of the Members' Business Meeting. J Am Geriatr Soc 2001. [DOI: 10.1111/j.1525-1497.2004.30240.x-i1] [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: 11/29/2022]
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Markvardsen AJ, David WI, Johnston JC, Johnson JC, Shankland K. A probabilistic approach to space-group determination from powder diffraction data. Acta Crystallogr A 2001; 57:47-54. [PMID: 11124502 DOI: 10.1107/s0108767300012174] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2000] [Accepted: 09/05/2000] [Indexed: 11/10/2022] Open
Abstract
An algorithm for the determination of the space-group symmetry of a crystal from powder diffraction data, based upon probability theory, is described. Specifically, the relative probabilities of different extinction symbols are assessed within a particular crystal system. In general, only a small number of extinction symbols are relatively highly probable and a single extinction symbol is often significantly more probable than any other. Several examples are presented to illustrate this approach.
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Affiliation(s)
- A J Markvardsen
- ISIS Facility, Rutherford Appleton Laboratory, Chilton, Oxon OX11 0QX, England.
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Abstract
OBJECTIVE To report values for percentage coverage of the femoral head (PC) and Norberg angle (NA) in 4 common breeds of dogs and to determine values for each that distinguish between normal and dysplastic hip status on the basis of Orthopedic Foundation for Animals (OFA) hip evaluation. ANIMALS 1,841 dogs 24 to 48 months of age that were Labrador Retrievers (455), Golden Retrievers (423), Rottweilers (545), or German Shepherd Dogs (418). PROCEDURE Retrospective analysis of NA and PC measured from standard OFA ventrodorsal pelvic radiographs from 4 breeds of dog. RESULTS Norberg angle ranged from 67.4 to 124.4 degrees for Labrador Retrievers, 59.7 to 128.6 degrees for Rottweilers, 70.2 to 119.4 degrees for Golden Retrievers, and 55.3 to 121.3 degrees for German Shepherd Dogs. The PC ranged from 6.5 to 79.9% for Labrador Retrievers, 5.7 to 79.5% for Rottweilers, 8.3 to 79.3% for Golden Retrievers, and 5.4 to 83.7% for German Shepherd Dogs. On the basis of logistic regression modeling for determining normal versus abnormal hip status for all 4 breeds, cutoff points for NA were <105 degrees and PC were <50%. CONCLUSIONS AND CLINICAL RELEVANCE Results of our study indicate that cutoff points of NA of 105 degrees and PC of 50% do not differentiate normal versus dysplastic hip status. Each of the 4 breeds had different values for NA and PC that distinguished normal from dysplastic hip status.
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Affiliation(s)
- J L Tomlinson
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia 65211, USA
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Rhee SH, Parker JC, Smarr KL, Petroski GF, Johnson JC, Hewett JE, Wright GE, Multon KD, Walker SE. Stress management in rheumatoid arthritis: what is the underlying mechanism? Arthritis Care Res 2000; 13:435-42. [PMID: 14635321] [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: 04/27/2023]
Abstract
OBJECTIVE To test whether change in cognitive-behavioral variables (such as self-efficacy, coping strategies, and helplessness) is a mediator in the relation between cognitive behavior therapy and reduced pain and depression in persons with rheumatoid arthritis (RA). METHODS A sample of patients with RA who completed a stress management training program (n = 47) was compared to a standard care control group (n = 45). A path analysis testing a model including direct effects of comprehensive stress management training on pain and depression and indirect effects via change in cognitive-behavioral variables was conducted. RESULTS The path coefficients for the indirect effects of stress management training on pain and depression via change in cognitive-behavioral variables were statistically significant, whereas the path coefficients for the direct effects were found not to be statistically significant. CONCLUSION Decreases in pain and depression following stress management training are due to beneficial changes in the arenas of self-efficacy (the belief that one can perform a specific behavior or task in the future), coping strategies (an individual's confidence in his or her ability to manage pain), and helplessness (perceptions of control regarding arthritis). There is little evidence of additional direct effects of stress management training on pain and depression.
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Affiliation(s)
- S H Rhee
- Harry S. Truman Memorial Veterans' Hospital, 800 Hospital Drive, Columbia, MO 65201, USA
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Schaller RD, Johnson JC, Saykally RJ. Nonlinear chemical imaging microscopy: near-field third harmonic generation imaging of human red blood cells. Anal Chem 2000; 72:5361-4. [PMID: 11080888 DOI: 10.1021/ac000699r] [Citation(s) in RCA: 32] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Third harmonic generation (THG) imaging using a near-field scanning optical microscope (NSOM) is demonstrated for the first time. A femtosecond, tunable near-infrared laser was used to generate both nonresonant and resonantly enhanced third harmonic radiation in human red blood cells. We show that resonantly enhanced THG is a chemically specific bulk probe in NSOM imaging by tuning the excitation source onto and off of resonance with the Soret transition of oxyhemoglobin. Additionally, we provide evidence that tightly focused, nonresonant, far-field THG imaging experiments do not produce contrast that is truly surface specific.
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Affiliation(s)
- R D Schaller
- Department of Chemistry, University of California, Berkeley 94720, USA
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Johnson JC, Reynolds SJ, Fuortes LJ, Clarke WR. Lead exposure among workers renovating a previously deleaded bridge: comparison of trades, work tasks. AIHAJ 2000; 61:815-9. [PMID: 11192213 DOI: 10.1080/15298660008984591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Airborne and surface lead exposures were evaluated for construction trade groups at a previously deleaded bridge renovation site in the midwestern United States. Although all lead-based paint should have been removed, old layers of leaded paint were still present on some sections of the bridge. Ironworkers performing metal torch cutting had the highest exposures (188 microg/m3), followed by workers engaged in clean-up operations and paint removal (p < 0.001). Respirators were most frequently worn by workers with the greatest lead exposures; however, laborers performing clean-up operations had exposures to lead dust of 43 microg/m3 and often wore no respiratory protection. Wipe samples revealed that almost all contractor vehicles were contaminated with lead. Heavy equipment operators with low airborne lead exposure had the highest levels of surface contamination in personal vehicles (3,600 microg/m2). Laborers cleaning structural steel with compressed air and ironworkers exposed to lead fumes from cutting had the highest concentrations of lead dust on clothing (mean 4,766 microg/m2). Handwashing facilities were provided, but were infrequently used. No separate clothes changing facility was available at the site. The potential for "take-home" contamination was high, even though this site was thought to be relatively free of lead. Construction contractors and their workers need to be aware that previous deleading of a site may not preclude exposure to significant amounts of lead.
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Affiliation(s)
- J C Johnson
- Department of Preventive Medicine, University of Iowa, Iowa City 52242, USA.
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Abstract
Revision total knee arthroplasty (TKA) using a second-generation modular rotating hinge design was performed on 16 knees in 15 patients over a 5-year period. Follow-up of 2 to 6 years (mean, 51 months) was obtained in 14 knees in 13 patients. Indications for revision were aseptic loosening of a hinged prosthesis (8 knees), loosening and bone loss associated with chronic extensor mechanism disruption (2 knees), component instability with chronic medial collateral ligament disruption (3 knees), and comminuted distal femur fracture (1 knee). Clinical and radiographic results were reviewed and compared with 87 patients who underwent revision TKA using a standard condylar revision design during the same period. Early results showed comparable postoperative knee scores and range of motion between the 2 groups despite the use of the rotating hinge component in more complex revision cases. No patient has exhibited radiographic evidence of definite component loosening. Alignment of 5 degrees to 10 degrees of valgus in the frontal plane and within 2 degrees of neutral in the sagittal plane was achieved consistently. Short-term clinical and radiographic results are encouraging and suggest that a second-generation modular rotating hinge component can be used successfully in selected salvage revision cases.
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Affiliation(s)
- R L Barrack
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA
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