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Scholarly Works (6678 results)

  • Thesis
  • Peer Reviewed
UC San Diego Electronic Theses and Dissertations (2012)
The following three pieces were created between September, 2010 and May, 2012
    Cover page: Folio
    • Thesis
    • Peer Reviewed
    UC Berkeley Electronic Theses and Dissertations (2016)

    Bipolar disorder is a serious mental illness that goes untreated more often among blacks than whites in the U.S. In the current study, I identified and tested a proposed mechanism underlying differential treatment in bipolar disorder, namely how treatment providers’ racial biases contribute to the inadequate care of black patients with bipolar disorder. Findings from research in general and mental healthcare show that providers’ clinical decisions may be related to racial biases based on stereotypes that providers hold. Moreover, general healthcare research has demonstrated the presence of implicit racial biases (defined as unconscious preferences for one race over another) among providers that are linked to the differential treatment of blacks and whites. Unfortunately, much less work has been done to show the presence and effects of implicit racial biases among mental healthcare providers. The hypothesized model in the current study proposes that implicit racial biases held by mental healthcare providers bias diagnostic and prognostic assessments as well as treatment recommendations in bipolar disorder and result in the observed treatment disparities between black and white patients. The Implicit Association Test was used to measure general racial biases in a sample of 82 mental healthcare providers. Clinical decision-making was simulated using clinical vignettes about theoretical black and white patients with psychotic and non-psychotic bipolar disorder. Three-way ANOVAs were used to test for racial disparities in decision-making, and structural equation modeling was used to determine whether providers’ implicit racial biases were associated with decision-making outcomes. Results showed that providers held moderate pro-white/anti-black racial biases and neutral explicit attitudes, also known as an “aversive racism” profile. Racial disparity was observed, but confounded by a mismatch in the severity of symptoms of the hypothetical patients. Composite scores for the vignettes were used to overcome this issue in the SEM analyses. These results revealed that there was no link between racial bias and decision-making. Suggestions for future research are given to improve modeling of the relationship between racial bias and patient care. Despite limitations, findings provide some of the first evidence establishing the presence or implicit racial biases in mental healthcare.

      Cover page: Explaining Racial Disparity in Bipolar Disorder Treatment: How Do Providers Contribute?
      • Article
      • Peer Reviewed
      UC San Francisco Previously Published Works (2016)
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2013)
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2012)
          The Health Care Empowerment Model offers direction for the investigation of patient-controlled engagement and involvement in health care. At the core of the model is the construct of Health Care Empowerment (HCE), for which there exist no validated measure
            • Article
            • Peer Reviewed
            UC Davis Previously Published Works (2020)

            Background

            Idiopathic inflammatory airway disease (IAD) in cats often is described as asthmatic (eosinophilic) or bronchitic (neutrophilic), but this designation requires collection of airway fluid and it fails to consider cats with mixed airway inflammation.

            Objective

            To identify clinical features that would differentiate inflammatory disease types.

            Animals

            Forty-nine cats with nonspecific airway inflammation identified by bronchoscopic bronchoalveolar lavage (BAL) between 2011 and 2018 were evaluated.

            Methods

            This is a retrospective study. Cats were categorized by BAL differential cytology as having eosinophilic (eosinophils >20% with neutrophils <14%, or eosinophils >50%), mixed (eosinophils 20%-50% and neutrophils >14% or discordant inflammation from 2 BAL sites), or neutrophilic (neutrophils >14% and eosinophils <20%) inflammation. Type and duration of presenting complaints, signalment, body condition score, respiratory rate, CBC results, bronchoscopy, BAL results (% recovery, total nucleated cell count, differential cell count), and radiographic findings were compared among groups.

            Results

            Idiopathic IAD was diagnosed in 49 cats, with BAL eosinophilic inflammation in 23, mixed inflammation in 14, and neutrophilic inflammation in 12. Cough was the predominant presenting complaint with no difference in duration of signs among groups (median, 5.5 months). Respiratory rate and effort also did not differ. Cats with eosinophilic inflammation were significantly younger (4.4 ± 3.3 years) than those with neutrophilic (8.0 ±5.6 years) or mixed inflammation (7.5 ± 4.0 years; P = .03). Results of CBC and interpretation of radiographic findings did not differ among groups.

            Conclusions and clinical importance

            Substantial overlap exists in clinical and radiographic findings in cats with various forms of idiopathic airway inflammation.
              Cover page: Clinical features and radiographic findings in cats with eosinophilic, neutrophilic, and mixed airway inflammation (2011‐2018)
              • Article
              • Peer Reviewed
              UC Berkeley Previously Published Works (2014)

              Background

              Across two studies we examined the role of emotion perception as a correlate of quality of life and occupational functioning in bipolar I disorder.

              Method

              In Study 1, we tested a multifactorial model of quality of life and occupational functioning, including the role of emotion perception and other established correlates of functional outcomes, among 42 participants diagnosed with bipolar I disorder. In Study 2, participants diagnosed with bipolar I disorder and age- and gender-matched controls completed an affect recognition task and a quality of life measure.

              Results

              Across both studies, emotion perception related to functional outcomes. In Study 1, self-rated emotion perception explained unique variance in subjective well-being after controlling for illness characteristics, education, and executive function. In Study 2, a behavioral measure of facial affect recognition accuracy was related to quality of life, even after controlling for illness severity.

              Limitations

              Limitations include the use of a cross-sectional design, relatively small sample sizes, and the focus on only one aspect of social cognition.

              Conclusions

              Findings indicate that emotion perception may protect quality of life in bipolar disorder. This dimension may help predict important outcomes and, with further research, could serve as a potential treatment target.
                Cover page: Emotion perception and quality of life in bipolar I disorder
                • Article
                • Peer Reviewed
                UC Davis Previously Published Works (2016)

                Background

                Bronchiectasis is a permanent and debilitating sequel to chronic or severe airway injury, however, diseases associated with this condition are poorly defined.

                Objective

                To evaluate results of diagnostic tests used to document bronchiectasis and to characterize underlying or concurrent disease processes.

                Animals

                Eighty-six dogs that had bronchoscopy performed and a diagnosis of bronchiectasis.

                Methods

                Retrospective case series. Radiographs, computed tomography, and bronchoscopic findings were evaluated for features of bronchiectasis. Clinical diagnoses of pneumonia (aspiration, interstitial, foreign body, other), eosinophilic bronchopneumopathy (EBP), and inflammatory airway disease (IAD) were made based on results of history, physical examination, and diagnostic testing, including bronchoalveolar lavage fluid analysis and microbiology.

                Results

                Bronchiectasis was diagnosed in 14% of dogs (86/621) that had bronchoscopy performed. Dogs ranged in age from 0.5 to 14 years with duration of signs from 3 days to 10 years. Bronchiectasis was documented during bronchoscopy in 79/86 dogs (92%), thoracic radiology in 50/83 dogs (60%), and CT in 34/34 dogs (100%). Concurrent airway collapse was detected during bronchoscopy in 50/86 dogs (58%), and focal or multifocal mucus plugging of segmental or subsegmental bronchi was found in 41/86 dogs (48%). Final diagnoses included pneumonia (45/86 dogs, 52%), EBP (10/86 dogs, 12%) and IAD (31/86 dogs, 36%). Bacteria were isolated in 24/86 cases (28%), with Streptococcus spp, Pasteurella spp, enteric organisms, and Stenotrophomonas isolated most frequently.

                Conclusions and clinical importance

                Bronchiectasis can be anticipated in dogs with infectious or inflammatory respiratory disease. Advanced imaging and bronchoscopy are useful in making the diagnosis and identifying concurrent respiratory disease.
                  Cover page: Bronchoscopy, Imaging, and Concurrent Diseases in Dogs with Bronchiectasis: (2003-2014).
                  • Article
                  • Peer Reviewed
                  UC San Francisco Previously Published Works (2013)
                  Systemic, life-threatening infections in humans are often caused by bacterial or fungal species that normally inhabit a different locale in our body, particularly mucosal surfaces. A hallmark of these opportunistic pathogens, therefore, is their ability to
                    • Article
                    • Peer Reviewed
                    Lucero, Volume 10, Issue 1 (1999)
                      Cover page: Black God, White Devil: wishing, speaking, lying
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