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Biomedical subjects

S Whitman

Publications and source records attributed to S Whitman.

49 records · Page 3Linked to original sources

Psychosis and epilepsy: seizure-type comparisons and high-risk variables.

Compared 153 patients with temporal lobe epilepsy (TLE) and 79 patients with generalized epilepsy on the Goldberg Index, an MMPI-derived measure of psychosis. Analysis of covariance indicated that seizure type was not related to psychosis. Multiple regression analyses indicated that, in TLE, being female was correlated positively with Goldberg Index scores. In the group with generalized epilepsy, none of the variables was associated significantly with psychosis scores.

Adult↗

Aggression and epilepsy: seizure-type comparisons and high-risk variables.

One hundred fifty-three patients with temporal lobe epilepsy and 79 patients with generalized epilepsy were compared on a measure of aggression (derived from the Minnesota Multiphasic Personality Inventory). Analysis of covariance indicated that seizure type was not related to aggression. Multiple-regression analyses for each seizure group indicated that in temporal lobe epilepsy the chronologic age was inversely correlated with aggression scores. In the group with generalized epilepsy, chronologic age and myoclonic seizures were inversely correlated with aggression, while akinetic seizures were directly associated with increased aggression.

Adult↗

Multietiological determinants of psychopathology and social competence in children with epilepsy.

The purpose of this investigation was to inquire into the multietiological determinants of psychopathology and social competence in children with epilepsy. The relationship between behavioral functioning as assessed by the Child Behavior Checklist and a variety of biological, psychosocial, medication and demographic risk factors was investigated in a sample of 183 children with epilepsy aged 6-16. Several risk factors were found to be related to each behavioral measure. The results are discussed both in terms of their implications for models of psychopathology in epilepsy as well as their relationship to previous findings in the epilepsy/psychopathology field.

Adolescent↗

The architecture of research in the epilepsy/psychopathology field.

In order to examine how research about the relationship between epilepsy and psychopathology has proceeded, the literature that has appeared since 1966 was reviewed and 78 relevant studies were located. The variables employed in these studies (510 in all) were tabulated to determine if they examined biological variables, social variables or medication variables as etiology of psychopathology in people with epilepsy. The results indicate an overwhelming tendency to omit social variables when searching for etiological factors. It is concluded that such an omission is of theoretical and practical significance and 3 hypotheses are put forward to account for the current distribution of research efforts. Finally, the implications of such a structure of investigation are considered.

Epilepsy↗

Evaluating Chicago's success in reaching the Healthy People 2000 goal of reducing health disparities.

OBJECTIVE: This study was designed to assess Chicago's progress from 1980 to 1998 in addressing the Healthy People 2000 goal of reducing health disparities. METHODS: Chicago vital statistics and surveillance data were used to calculate black:white rate ratios of mortality and morbidity for 1980-1998. Mortality and morbidity rate ratios were also used to compare people living in areas with the lowest median household income with those living in the highest for 1979-1981, 1991-1993, and 1996-1998. The health measures included mortality associated with leading causes of death; all-cause mortality, incidence rates for two communicable diseases; and two birth outcomes. RESULTS: Both black:white and low-income:high-income rate ratios monotonically increased for virtually all measures of mortality and morbidity. Almost all of the rate ratios and linear trends were statistically significant. From 1980 to 1998, the black:white rate ratio for all-cause mortality increased by 57% to 2.03. From 1979-1981 to 1996-1998, the low-income:high-income rate ratio for all-cause mortality increased by 56% to 2.68. CONCLUSIONS: These findings provide clear evidence that disparities in health did not decrease in Chicago. Instead, racial and economic disparities increased for almost all measures of mortality and morbidity used in this study. The fact that the Healthy People 2000 campaign to reduce and then eliminate health disparities was not effective must serve as a stimulus for improved strategies.

Adolescent↗

The role of the EEG in epilepsy of long duration.

Although the electroencephalogram's (EEG's) relevance in the initial work-up of individuals with epilepsy is well-defined, its role in epilepsy of long duration remains uncertain. A literature survey revealed eight studies that had evaluated epileptiform patterns (EPs) in series of patients but none of these were derived from outpatients presenting for regular follow-up. Such EEG results are crucial for determining disability benefits that are often denied to people with normal records. We therefore randomly surveyed 100 adult outpatients attending the seizure follow-up clinic at Cook County Hospital. An EP was detected in 33 patients, 36 had normal records, and 31 had non-EP abnormalities. The presence of an EP was significantly related to an etiology of head injury, duration of epilepsy, age of onset before age 20 years, and receiving more than one antiepileptic drug (AED). The presence of an EP did not correlate with seizure frequency, seizure type, or presence of a neurological deficit. A prior EEG increased the proportion with an EP only to 41%. The relatively low proportion of people who demonstrated an EP suggests that (a) the presence of an EP on an EEG should not be a factor in deciding about disability benefits for individuals with epilepsy, and (b) that use of an EP as an eligibility criterion for entry into a research series is likely to generate a select group of patients, thus making it difficult to generalize results.

Adolescent↗

Controlled examination of effects of progressive relaxation training on seizure reduction.

We determined the efficacy of progressive muscle relaxation in reducing seizure frequency. Subjects were 24 people with epilepsy attending an urban neurology clinic. The experimental design consisted of an 8-week baseline period, a treatment period of six sessions of progressive relaxation training (PRT, n = 13) or quiet sitting (QS, n = 11) and an 8-week follow up. In the PRT group, 11 subjects reported a decrease in seizure frequency (p less than 0.01), and in the QS group, 7 reported a decrease (p greater than 0.05). The mean decrease in seizure frequency was 29% for the PRT group (p less than 0.01) but only 3% for the QS group (p greater than 0.05). This is the fifth recent report of a controlled study documenting the success of progressive relaxation therapy in seizure reduction. PRT is inexpensive and noninvasive and facilitates patient participation. Such a technique should be incorporated into clinical practice.

Adult↗

An urban community-based cancer prevention screening and health education intervention in Chicago.

Most types of cancer are disproportionately present in black populations. Among all ethnic and racial groups, black people have the highest incidence of all types of cancer combined, experiencing the highest mortality and the worst survival rate. A major intervention effort has begun in Chicago, targeting women living in 10 south side community areas whose populations are almost all black and among the poorest in the city. The purposes of the intervention are to develop and evaluate ways to reduce morbidity and mortality from breast and cervical cancer. Three outcome measures are being used, the proportion of women who receive Papanicolaou smears, breast examinations, and mammograms; the scores derived from a knowledge, attitudes, and practices survey; and the stage of diagnosed cancer. The results are being evaluated in three locations, the 10 target community areas, a Chicago Health Department clinic located in the community, and Fantus Clinic at Cook County Hospital. The intervention consists of reducing barriers to care at both public clinic sites and delivering education and information within the community. Public health outreach workers who are culturally sensitive to the population bring word of the program to places frequented by women, including local businesses (such as beauty shops, grocery stores, pharmacies, and currency exchanges), public housing developments (one being the largest in the country), and facilities belonging to city services programs. The intervention was developed to permit its ready adoption in similar environments should the evaluation results prove its usefulness.

Black or African American↗

A nurse-delivered intervention to reduce barriers to breast and cervical cancer screening in Chicago inner city clinics.

An 18-month intervention was implemented to increase breast and cervical cancer screening among poor African-American women in Chicago. Breast and cervical cancer screening programs were set up in two public clinics, one community-based and the other hospital-based. Nurse clinicians and public health workers were used in these programs to recruit women in the clinics and in targeted community institutions to receive free breast and cervical cancer screening. The following barriers were specifically addressed by the intervention: accessibility of screening, knowledge about breast and cervical cancers, access to followup screening examinations, and access to treatment. A computerized followup system was specifically designed to track patients. During the 18 months of the intervention, 10,829 visits were made by 7,654 low-income women. A total of 84 cases of breast cancer and 9 cases of cervical cancer were detected. Awareness of the program, as measured by a survey after the completion of the intervention, increased in both clinics compared with baseline results. Knowledge about breast and cervical cancers also increased, as measured by scores on tests given before and after a class on breast and cervical cancers. Followup rates were 86 percent for women attending the programs. More than 90 percent of the women referred for evaluation of breast abnormalities kept an appointment. In summary, the intervention was successful in reducing barriers to breast and cervical cancer detection and in attracting a high-risk group of women.

Adult↗