Biomedical subjects

Lisa M Brown

Publications and source records attributed to Lisa M Brown.

11 recordsLinked to original sources

PubMed2006

Establishing and refining hurricane response systems for long-term care facilities.

In February 2006 the John A. Hartford Foundation funded a long-term care "Hurricane Summit," sponsored by the Florida Health Care Association. Representatives from five Gulf Coast states that sustained hurricane damage during 2005 and from Georgia, a receiving state for hurricane evacuees, attended. Summit participants evaluated disaster preparedness, response, and recovery for long-term care provider networks and identified gaps that impeded safe resident evacuation and disaster response. The meeting identified emergency response system issues that require coordination between long-term care providers and state and federal emergency operations centers. Five areas warranting further attention are presented as lessons learned and potential areas for grant making.

Congresses as Topic↗

PubMed2006

Five-factor personality dimensions, mood states, and cognitive performance in older adults.

In this study we examined the impact of personality traits and negative mood state on performance in several cognitive domains in a sample of 398 elderly community-dwelling individuals. Multiple linear regression analyses were used to examine the variance in cognitive measures explained by state depression and anxiety after controlling for the effects of demographic characteristics and five-factor model personality traits. Personality traits were found to contribute significantly to cognitive function, explaining 2-7% of the variance in ability across domains. Examination of the contributions of individual five-factor traits showed that Openness had a significant relationship with all indexes of verbal memory and with general cognitive ability. State anxiety and depression variables were found to play a very small part, however, in contributing to cognitive function.

Affect↗

PubMed2005

Affective reactions to pictures of ingroup and outgroup members.

A pervasive form of social categorization among humans is between us and them. In this study, we assessed emotional reactions when people viewed pictures depicting members of the same or different ethnic group. African American and European American participants viewed a series of pleasant and unpleasant pictures portraying either ingroup or outgroup members, while physiological, behavioral, and evaluative judgments were measured. Two hypotheses were assessed. The outgroup antipathy hypothesis predicts that people will respond to outgroup pictures with more negative affect than to ingroup pictures. In contrast, the ingroup empathy hypothesis predicts that people will show exaggerated (pleasant and unpleasant) affective responses to pictures of ingroup members, due to group identification or personal relevance. The data provided no support for the antipathy hypothesis, whereas facial EMG, skin conductance, rating, and viewing time data lent support to the ingroup empathy hypothesis, in which greater pleasure and displeasure were apparent when viewing ingroup pictures.

Adolescent↗

PubMed2005

Development and initial validation of a 15-item informant version of the Geriatric Depression Scale.

OBJECTIVE: To develop a brief informant version of the Geriatric Depression Scale for use in screening for depression in older adults. DESIGN: A scale development and validation study. SETTING: Internal medicine and geriatric outpatient clinics located at the James A. Haley Veterans' Medical Center and the University of South Florida Medical Center, Tampa, Florida. PARTICIPANTS: A total of 147 patients (81 females and 66 males) and their adult informants. MEASUREMENTS: Self and informant versions of the 30-item Geriatric Depression Scale, NEO-FFI, and a health behaviors questionnaire. RESULTS: The 15-item informant version of the GDS was found to have sufficient internal consistency reliability (alpha = 0.86) and retest reliability (r = 0.81) to support its use as a clinical instrument. Construct validity was demonstrated by a pattern of correlations with external demographic and personality variables consistent with those of other versions of the GDS, as well as substantive correlations with these other versions. Efficacy of the GDSI-15 was found to be as good as that for the full 30-item informant version of the GDS. CONCLUSIONS: The GDSI-15 may be a useful adjunct or alternative to standard screening methods in assessing patients in outpatient settings.

Aged↗

PubMed2005

Blood lead levels and risk factors for lead poisoning in children and caregivers in Chuuk State, Micronesia.

Lead poisoning is a preventable environmental disease. Children and developing fetuses are especially vulnerable; even low blood lead levels (BLLs) are linked with learning and behavioral problems. We assessed children's and their caregivers' BLLs and risk factors for lead exposure in Chuuk State, Federated States of Micronesia. Children aged 2-6 years were randomly selected within 20 randomly selected villages. Children and caregivers provided venous blood, and caregivers offered information about possible risk factors for lead exposure. Mean BLLs were 39 microg/l for children and 16 microg/l for caregivers. Children with BLLs of > or = 100 microg/l (elevated) were 22.9 (95% CI: 4.5-116.0) times more likely to have a caregiver with an elevated BLL, 6.2 (95% CI: 1.4-27.3) times more likely to live on an outer island, and 3.4 (95% CI: 1.7-6.9) times more likely to have a family member who made lead fishing weights than did other children even after controlling for age and sex. For children, 61% of elevated BLLs could be attributed to making fishing weights. Caregivers with elevated BLLs were 5.9 (95% CI: 1.5-23.7) times more likely to live in a household that melted batteries than other caregivers even after controlling for age and education. For caregivers, 37% of the elevated BLLs could be attributed to melting batteries. The association of elevated BLLs in children and their caregiver suggests a common environmental exposure. Melting batteries to make fishing sinkers is a preventable source of lead exposure for children and their caregivers in Chuuk. Published by Elsevier GmbH.

Adult↗

PubMed2005

Disaster mental health training in Florida and the response to the 2004 hurricanes.

The need for mental health interventions in disasters has long been recognized. The Florida Center for Public Health Preparedness (FCPHP) has been providing disaster mental health training to employees of the Florida Department of Health and others since 2001. One of the training programs was Bioterrorism Trauma Intervention Specialist Training (BTIST), offered between May 2003 and January 2004. The FCPHP has also developed three distance learning courses, including one that provides advice to responders who are experiencing compassion fatigue. The BTIST curriculum prepares participants to provide mental health interventions during and following disasters. The four hurricanes that struck Florida in a 7-week period in 2004 created a great demand for mental health services. The FCPHP supported the Florida Department of Health response effort by providing a roster of BTIST trainees and hundreds of copies of the compassion fatigue audio CD. The FCPHP conducted a Web-based survey of the BTIST participants after the hurricanes. A large majority of respondents reported that the training had given them greater knowledge of disaster mental health, provided many disaster mental health skills, and the skills had been valuable in their professional and personal lives. Most of those who had actively responded to the hurricanes indicated that the training had given them confidence for their response and that they had used the acquired skills in their response efforts.

Attitude of Health Personnel↗

PubMed2003

3MS normative data for elderly African Americans.

The Modified Mini-Mental State Examination (3MS) is an expanded and modified version of the Mini-Mental Status Exam (MMSE). Although the MMSE has achieved widespread clinical use as a brief cognitive screen, the utility of the measure to ascertain cognitive impairment is constrained by a limited set of abilities sampled, a narrow range of possible scores, floor and ceiling effects, and by a paucity of normative data for use with older adults from ethnically diverse backgrounds. Research demonstrates that the reliability, validity, and sensitivity of the 3MS are superior to that of the MMSE in detecting cognitive impairment. To date there has been minimal research investigating the usefulness of the 3MS with African American older adults. The current study examined the influence of demographic characteristics on the 3MS in a community-dwelling sample of 238 African American older adults (60-84 years). Age, gender, and education accounted for moderate amounts of variance in 3MS performance. Based on these results, normative tables for 3MS scores, stratified by age and with score adjustments for education and gender, are provided.

Black or African American↗

PubMed2002

Transfer of M2 muscarinic acetylcholine receptors to clathrin-derived early endosomes following clathrin-independent endocytosis.

Upon agonist stimulation, many G protein-coupled receptors such as beta(2)-adrenergic receptors are internalized via beta-arrestin- and clathrin-dependent mechanisms, whereas others, like M(2) muscarinic acetylcholine receptors (mAChRs), are internalized by clathrin- and arrestin-independent mechanisms. To gain further insight into the mechanisms that regulate M(2) mAChR endocytosis, we investigated the post-endocytic trafficking of M(2) mAChRs in HeLa cells and the role of the ADP-ribosylation factor 6 (Arf6) GTPase in regulating M(2) mAChR internalization. Here, we report that M(2) mAChRs are rapidly internalized by a clathrin-independent pathway that is inhibited up to 50% by expression of either GTPase-defective Arf6 Q67L or an upstream Arf6 activator, Galpha(q) Q209L. In contrast, M(2) mAChR internalization was not affected by expression of dominant-negative dynamin 2 K44A, which is a known inhibitor of clathrin-dependent endocytosis. Nevertheless, M(2) mAChRs, which are initially internalized in structures that lack clathrin-dependent endosomal markers, quickly localize to endosomes that contain the clathrin-dependent, early endosomal markers early endosome autoantigen-1, transferrin receptor, and GTPase-defective Rab5 Q79L, which is known to swell early endosomal compartments. These results suggest that M(2) mAChRs initially internalize via an Arf6-associated, clathrin-independent pathway but then quickly merge with the clathrin endocytic pathway at the level of early endosomes.

ADP-Ribosylation Factor 6↗

PubMed2002

The Key Behaviors Change Inventory and executive functioning in an elderly clinic sample.

The Key Behaviors Change Inventory (KBCI) was developed to assess executive, behavioral, and emotional functioning following brain insults and to track the course of recovery. The purpose of this study was to investigate, in an elderly memory disorder clinic sample, the convergent and discriminant validity of the KBCI by examining the relationships between various measures of executive functioning and the KBCI scales that theoretically relate to executive functions. The KBCI was administered to the caregivers of 97 consecutive patients who came to a memory disorders clinic seeking services. The KBCI scales of Inattention, Apathy, Unawareness of Problems, and Communication Problems were significantly correlated with cognitive measures of executive functioning but not with measures of memory, visuospatial abilities or global cognitive functioning. In contrast, KBCI scales of Interpersonal Difficulties, Somatic Difficulties, and Emotional Adjustment were not related to any cognitive measures, either executive or nonexecutive. Contrary to predicted findings, the Impulsivity Scale was not associated with cognitive measures of executive functioning. This lack of relationship most likely reflects the failure to include executive measures of orbitofrontal functioning in this study. Results provide convergent and discriminant validity support for the KBCI. The KBCI may be a useful tool for assessing and tracking the executive, behavioral, and emotional sequelae of neurologic disorders.

Adaptation, Psychological↗

PubMedDate not supplied

The impact of unstable angina guidelines in the triage of emergency department patients with possible acute coronary syndrome.

OBJECTIVE: The primary aim of this study is to determine whether implementing the Agency for Health Care Policy and Research (AHCPR) Unstable Angina Practice Guideline improves emergency physician's decision making in patients with symptoms of possible acute coronary syndrome (ACS), including those for whom the diagnosis of unstable angina is uncertain. METHODS: The authors conducted a prospective guideline implementation trial with pre-post design in the emergency departments of 1 university hospital and 1 university-affiliated community teaching hospital from January 2000 to May 2001. They enrolled 1140 adults who presented with chest pain or other symptoms of possible ACS. The intervention included the following: 1) physician training in use of the AHCPR risk groups, 2) algorithm for risk stratification, and 3) group feedback. To determine how accurately physicians interpreted the guideline algorithm, the authors compared their risk ratings with actual guideline risk groups. RESULTS: No significant difference in physician triage decisions was observed between baseline and intervention periods. Analysis of physician's risk ratings during the intervention period revealed low overall concordance with actual guideline risk groups (kappa = 0.31); however, physician's risk ratings showed superior discrimination in identifying patients with confirmed ACS (receiver operating characteristic [ROC] area .81 v. .74, P = 0.008). Strict adherence to guideline recommendations would have resulted in hospitalizing 9% more non-ACS patients without lowering the rate of missed ACS. CONCLUSION: Implementation of the AHCPR guideline did not improve triage decisions in emergency department patients with possible ACS. Assessing physician triage solely based on concordance with the AHCPR guideline may not accurately reflect the quality of patient care.

Adult↗

PubMedDate not supplied

Evidence for implementing nonpharmacological interventions for wandering.

Wandering is among the most frequent, problematic, and dangerous comorbid behaviors in dementia or head injury. To summarize the emerging literature on nonpharmacological interventions used to control negative consequences of wandering, a systematic review of the literature was performed. The review included searching multiple electronic databases and hand searches of individual articles. The search yielded 31 articles that met established criteria. These articles then were classified into six categories: Subjective barriers, walking/exercise and other activities, specialized environments, behavioral techniques, music, and alarms. The literature varied widely in terms of theoretical soundness, methodological rigor, and clarity. The level of evidence supporting these interventions and implications for future study are discussed.

Behavior Therapy↗