Psychiatric Symptomatology in a Deaf College Population Affecting Diagnosis and Treatment

Abstract

As the mental health needs of the deaf receive increased recognition, issues of diagnosis and treatment become vital. Several characteristic behavioral patterns are frequently encountered which often confuse diagnosis, particularly in clinicians inexperienced with hearing-impaired individuals. These behavioral characteristics of suspiciousness, the use of odd or idiosyncratic language, difficulties in expression of affects, and acting out behaviors may create a tendency to overdiagnose serious mental illness. In addition, an understanding of the impact of deafness on an individual's personality development is crucial to an intelligent choice of treatment approach. These difficult issues of differential diagnosis and treatment are discussed in the context of the psychotherapeutic experiences of a hearing and nonsigning clinician working with deaf college students.     

A Swedish Prevalence Study of Deaf People Using Sign Language: a prerequisite for Deaf studies

A widely used estimate claims that one per thousand individuals is deaf, but few recent studies exist on the actual prevalence. The aim of this study was to investigate the prevalence of deaf people, defined as deaf individuals who use sign language as their main mode of communication, in the county of Scania, Sweden. To achieve high validity, data were collected from a large variety of sources including both public institutions and voluntary associations, working with deaf people. The study demonstrates a prevalence of 0.7 per thousand inhabitants, a figure considerably lower than the traditional estimate. One interpretation of this finding is that the prevalence of deafness is on the decrease. Another interpretation reflects the problem to define deafness. As prevalence figures vary with the definition used, one single estimate valid for the prevalence of deafness is not possible to make. We therefore question the traditional one-per-thousand estimate of deafness.     

Chlamydia Trachomatis Infection in a Female College Student Population

Abstract

“Physical Dependence on Nicotine in Gum: A Placebo Substitution Trial,” JOHN R. HUGHES, et al. To test whether ex-smokers become physically dependent on nicotine in gum, we entered eight ex-smokers who were using nicotine gum into a randomized, double-blind, placebo-substitution trial. When placebo was substituted, seven of the eight subjects were observed to have withdrawal symptoms and two relapsed to smoking or nicotine gum. This result suggests that physical dependence (i.e., withdrawal) may be a cause of behavioral dependence on nicotine gum (i.e., use of gum beyond the recommended period) and physicians should emphasize the need for gradual reduction of nicotine gum. (Journal of the American Medical Association 1986;255:3277–3279.)

“Absence of Therapeutic Benefit From Antacids or Cimetidine in Non-Ulcer Dyspepsia,” OLOF NYREN, et al. We randomly assigned 159 patients with non-ulcer dyspepsia, defined as chronic or recurrent epigastric pain without concomitant symptoms of the irritable bowel syndrome and with no evidence of organic disease, to treatment for three weeks with an antacid suspension one and three hours after meals, 400 mg of cimetidine twice a day, or placebo, according to a double-blind, double-dummy model. The intensity and duration of epigastric pain were recorded by the patients four times daily during a one-week period without therapy and during the three weeks of treatment. The mean reduction in pain intensity after three weeks in the placebo group was 25 percent. Neither antacid nor cimetidine treatment resulted in more than a 4 percent better effect. The reduction of pain was statistically significant (P < 0.01) in all three groups. The time course of the pain scores in the groups receiving active drugs followed closely those in the placebo group, and there were no significant differences between the groups at any stage of the treatment. We conclude that the neutralization or suppression of gastric acid is of no clinical value in patients with this syndrome. (New England Journal of Medicine 1986;314:339–43.)     

Isoniazid Completion Rates for Latent Tuberculosis Infection Among College Students Managed by a Community Pharmacist

Objective: The authors' objective was to document 9-month and previously recommended 6-month treatment completion rates for latent tuberculosis infection (LTBI) in a pharmacistmanaged LTBI clinic in a community pharmacy on a college campus, and to describe patient characteristics. Participants: Participants were university students diagnosed with LTBI. Methods: The authors conducted a retrospective review of pharmacy records from 2000 to 2006. Main outcome measures included 6-month and 9-month LTBI treatment completion rates, total isoniazid (INH) tablets taken, characteristics of completers versus noncompleters, average time to treatment completion, and reported adverse drug events. Results: The 9-month completion rate was 59%, and the 6-month completion rate was 67%. Among those not completing treatment, 15.2% experienced fatigue and 2.2% experienced a rash (p = .04 and p = .03, respectively). Conclusion: LTBI clinics are a unique niche for community pharmacies and can provide individualized patient care to ensure LTBI treatment adherence, monitoring for disease progression, and safety of INH.     

Sleep Patterns of College Students at a Public University

Objective: The authors' purpose in this study was to determine the sleep patterns of college students to identify problem areas and potential solutions. Participants: A total of 313 students returned completed surveys. Methods: A sleep survey was e-mailed to a random sample of students at a North Central university. Questions included individual sleep patterns, problems, and possible influencing factors. Results: Most students reported later bedtimes and rise times on weekends than they did on weekdays. More than 33% of the students took longer than 30 minutes to fall asleep, and 43% woke more than once nightly. More than 33% reported being tired during the day. The authors found no differences between freshmen, sophomores, juniors, seniors, and graduate students for time to fall asleep, number of night wakings, or total time slept each night. Conclusions: Many students have sleep problems that may interfere with daily performance, such as driving and academics. Circadian rhythm management, sleep hygiene, and white noise could ameliorate sleep difficulties.     

Health Risk Appraisal at the College Level

Abstract

This study attempted to determine if health risk appraisals with personalized conferences affected the “health age” of undergraduates at a large, midwestern university. One hundred thirteen (113) students enrolled in four undergraduate health education classes served as subjects. A nonequivalent control group design was employed with two of the classes consisting of students majoring in health-allied disciplines.

On the first and last day of class during the ten week course, all students completed a health risk appraisal questionnaire—“Health Evaluation Learning Program”—used to acquire past and present health history and present lifestyle practices. Data from the questionnaires were analyzed by a computer into a printout known as the “Health Risk Index.” All groups received their instruction from lectures. The control groups followed a popular college text and did not receive any feedback via the index or personalized conference. Each student in the experimental classes received a personalized conference with the instructor at which time their index was interpreted indicating the degree of future mortality risk. Students were informed that their health age reflected their risk compared to the risk of the average person of the same age, sex, and race. The principal hypothesis was based on the difference between one's actual age (chronological) and one's health age (risk). A 4-factor, 2-between, 1-within, repeated measures analysis of variance was used to determine the effect, if any, of the health risk appraisal with the conference on each group's health age and comparisons between/among groups.

Students in the experimental groups increased the difference between actual age and health age from pretest to posttest time significantly more than students in the control groups, with those not majoring in health-allied disciplines displaying the largest pretest to posttest difference (p<.05). Sex status did not significantly influence the age differential.     

Teaching Sociology at a Tribal College: Navajo Philosophy as a Pedagogy

This article begins with a brief history of Dine College, the first tribally controlled college in the nation. I then provide an overview of Dine College’s educational philosophy, called Sa’ah Naaghai Bik’eh Hozhoon, and give examples that demonstrate how I apply this SNBH philosophy in my teaching. I discuss my own Dine identity, and explain how that fosters a greater understanding among the students I teach. I also introduce a concept called “the Navajo time bind” that illuminates the challenges I face in teaching sociology to a Navajo population. Overall, this article provides insights about the unique aspects of teaching sociology in a tribally controlled college.     

Active Commuting Patterns at a Large,Midwestern College Campus

Abstract

Objective: To understand patterns and influences on active commuting (AC) behavior. Participants: Students and faculty/staff at a university campus. Methods: In April–May 2008, respondents answered an online survey about mode of travel to campus and influences on commuting decisions. Hierarchical regression analyses predicted variance in walking and biking using sets of demographic, psychological, and environmental variables. Results: Of 898 respondents, 55.7% were female, 457 were students (50.4%). Students reported more AC than faculty/staff. For students, the models explained 36.2% and 29.1% of the variance in walking and biking, respectively. Among faculty/staff, the models explained 45% and 25.8% of the variance in walking and biking. For all models, the psychological set explained the greatest amount of variance. Conclusions: With current economic and ecological concerns, AC should be considered a behavior to target for campus health promotion.     

The State of Sleep Among College Students at a Large Public University

Abstract

Objective: Data about college student sleep were collected and used to develop an education campaign to improve sleep. Participants: On-campus residents at a large state university were surveyed on 4 occasions, October 2005 to April 2007. Sample size was 675 to 1,823 students. Fall 2005 mean age = 18.5 years, SD = 1.03 (range 18–30) years. Initial survey included 935 males and 1,859 females (2005–2006). Matched pairs data (2006–2007) included 91 males and 107 females. Twenty-six males and 22 females participated in interviews. Methods: A survey administered online included the Pittsburgh Sleep Quality Index, along with an 8-question in-person interview. Results: Poor sleep interacted with academics and mental health, and an education campaign positively affected student sleep. Conclusions: Teaching students how to effectively manage sleep can improve their well-being. Sleep may also be a gateway topic for health care professionals to address sensitive health issues such as depression.     

Social Work Studies at a Haredi Women's College: Difficulties and Dilemmas

This paper examines the challenges faced by female Ultra-Orthodox students in a social work program designed for the Ultra-Orthodox community in Israel. Findings were obtained from four focus groups with a total of 32 students. The participants reported being exposed to contents that were inconsistent with the perspectives of their community, fieldwork expectations and requirements that violated strict rules of gender separation, and inconvenient scheduling of exams and field trips that did not take their religious observances into consideration. Despite the considerable distress that these matters caused, most of the students made determined efforts to cope, to learn the course material, to carry out their fieldwork assignments, and to reconcile the discrepancies between some of the contents they learned and behaviors that were expected of them and their deeply held values and ways. Implications of the findings are discussed and recommendations made.     

AEDs at Your Fingertips: Automated External Defibrillators on College Campuses and a Novel Approach for Increasing Accessibility

Abstract. The use of automated external defibrillators (AEDs) increases survival in cardiac arrest events. Due to the success of previous efforts and free, readily available mobile mapping software, the discussion is to emphasize the importance of the use of AEDs to prevent sudden cardiac arrest–related deaths on college campuses and abroad, while suggesting a novel approach to aiding in access and awareness issues. A user-friendly mobile application (a low-cost iOS map) was developed at Florida State University to decrease AED retrieval distance and time. The development of mobile AED maps is feasible for a variety of universities and other entities, with the potential to save lives. Just having AEDs installed is not enough—they need to be easily locatable. Society increasingly relies on phones to provide information, and there are opportunities to use mobile technology to locate and share information about relevant emergency devices; these should be incorporated into the chain of survival.     

HPV Knowledge and Behaviors of Black College Students at a Historically Black University

College students are at high risk for human papillomavirus (HPV) infection, yet their knowledge and self-protective behaviors appear inadequate. Researchers who have measured HPV-related knowledge and behaviors in evaluating college intervention efforts pay secondary attention to black college students because this group generally represents only a small subset of samples of the broader college population. Objective and Participants The authors' purpose in this study was to examine HPV-related knowledge and behaviors in 351 black undergraduates attending a historically black southeastern university in the spring of 2003. Methods Voluntary and anonymous student participation was solicited in randomly selected undergraduate classes. Results Results indicated that most students lacked HPV awareness (64%), became aware of HPV largely after infection, and gained their HPV knowledge from a health-care provider or college class. The authors performed an analysis by gender and found that women were more knowledgeable about HPV than were men. Observed HPV-related knowledge and behaviors were similar to samples of the broader US college population. Conclusions Findings suggest a greater need for HPV intervention efforts for all college students, including those at black colleges.     

Risk Factors for Chlamydia Trachomatis Infection in a California Collegiate Population

Abstract

Chlamydia trachomatis infection in college students has not undergone a detailed large-scale evaluation. The authors undertook a cross-sectional study of 4,086 students enrolled on the campuses of California State University, Sacramento, and 3 local community colleges from fall 2000 through spring 2002. They used an outreach screening model to determine the presence of infection by testing urine for chlamydial DNA by polymerase chain reaction. Participants completed demographic and behavioral risk questionnaires and a chlamydia knowledge assessment. Overall, 3.4% of participants tested positive for infection. Screening of male and female students was evenly distributed and incidence rates for males (3.03%) and females (3.78%) were similar. Variables associated with significantly increased risk were younger than 25 years, ethnicity other than White, more than one sexual partner in the preceding year or a new partner in the preceding 2 months, and current symptoms. Innovative outreach programs to screen a majority of at-risk college students should be developed.     

Self-reported Barriers to Professional Help Seeking Among College Students at Elevated Risk for Suicide

Abstract

Objectives: This study sought to describe self-reported barriers to professional help seeking among college students who are at elevated suicide risk and determine if these barriers vary by demographic and clinical characteristics. Participants: Participants were 165 non–treatment seekers recruited as part of a Web-based treatment linkage intervention for college students at elevated suicide risk (from September 2010 through December 2011). Methods: Data were collected using Web-based questionnaires. Two coders coded students’ responses to an open-ended question about reasons for not seeking professional help. Results: The most commonly reported barriers included perception that treatment is not needed (66%), lack of time (26.8%), and preference for self-management (18%). Stigma was mentioned by only 12% of students. There were notable differences based on gender, race, and severity of depression and alcohol abuse. Conclusions: Efforts aimed at reaching students at elevated risk for suicidal behavior should be particularly sensitive to these commonly described barriers.     

Development of a Testicular Self-Examination Program for College Men

Abstract

“When to Perform Biopsies of Enlarged Peripheral Lymph Nodes in Young Patients,” GAIL B. SLAP, et al. Identification of young patients with peripheral lymphadenopathy who will benefit from lymph node biopsy often is difficult. A model was developed to differentiate patients whose biopsy results do not lead to treatment (normal, hyperplastic, or benign inflammatory lymph nodes) from those whose biopsy results do lead to treatment (granulomatous or malignant nodes). The medical records and histopathology slides of 123 nine- to 25-year-old patients who underwent biopsies of enlarged peripheral lymph nodes were reviewed for pathological diagnosis and 22 clinical findings. Seventy-two (58%) patients had biopsy results that did not lead to treatment, and 51 (42%) had results that did lead to treatment. Using stepwise discriminant analysis, a predictive model was developed that assigned 95% of the cases to the correct biopsy group based on lymph node size; history of recent ear, nose, and throat symptoms; and chest roentgenogram. When tested prospectively on new patients, the model correctly classified 32 (97%) of 33. We conclude that this simple model can help select adolescents and young adults with peripheral lymphadenopathy for biopsy. (Journal of the American Medical Association 1984;252:1321-1326.)

“The Clinical Information Value of the Glycosylated Hemoglobin Assay,” David M. Nathan, et al. We evaluated the clinical information value of the glycosylated hemoglobin assay by comparing it with practitioners' estimates of glucose control over the preceding 10 weeks in 216 patients with diabetes. Twenty-four percent of the practitioners' estimates, which were based on historical and laboratory data collected during a routine office visit, differed by more than ± 75 mg per deciliter from the actual mean blood glucose levels calculated with the glycosylated hemoglobin assay. One third of the mean blood glucose concentration fell outside the confidence intervals physicians used to bound their estimates. When examined individually or in the aggregate, historical information, such as polyuria, nocturia, or home urine testing for glucose, and laboratory information, such as fasting or random blood glucose levels, were weak predictors of the actual mean concentration of blood glucose.     

Rapid Assessment for Psychopathology in a College Health Clinic: Utility of College Student Specific Questions

Abstract

Objective: The purpose of this study was to determine the utility and unique benefits of employing the College Health Questionnaire (CHQ) in a college health care setting. The CHQ is a newly designed measure to assess psychosocial issues commonly problematic among college students. Participants: One hundred nine patients participated in the study during their medical appointments. Methods: Participants completed the study questionnaires (CHQ and Patient Health Questionnaire) in the waiting room. Their provider had the opportunity to use the responses in treatment decision making. Results: A majority (66.1%) endorsed at least one CHQ item. Patients who indicated traditional mental health problems were more likely to be prescribed psychotropic medications, whereas patients who endorsed psychosocial issues commonly problematic among college students were more likely to be referred for behavioral treatment. Conclusions: Screening for behavioral problems in college primary care settings without the use of college-related questions would result in missing numerous important psychosocial problems.     

Support for Alcohol-Control Policies and Enforcement Strategies Among US College Students at 4-Year Institutions

Objective: The authors examined college student support for policies and enforcement strategies to reduce alcohol problems on campus. Participants: A random sample of students from each of 32 four-year colleges and universities participated. Methods: Students completed an anonymous mail survey. Results: A majority of students supported 5 of the 12 policy proposals. Whatever percentage of students indicated support for a policy, a far smaller percentage reported that other students supported it. The majority at all 32 schools supported using stricter disciplinary sanctions for students who engage in alcohol-related violence and repeatedly violate campus alcohol policy. The majority at more than half of the schools supported applying stricter penalties for the use of false IDs to purchase alcohol illegally and prohibiting kegs on campus. Conclusions: Higher-education administrators should survey students to learn which policies a majority of their students will endorse.     

Reflections of a Group of Deaf Adults on Their Experiences in Mainstream and Residential School Programs in the United States

The purpose of this study was to learn about mainstream and residential school programs for deaf students in the United States from the perspective of the deaf person, and to present the experiences of clients of educational services in their own words. Data for this paper were collected through open-ended, in-depth interviews with 25 graduates from the National Technical Institute for the Deaf at Rochester Institute of Technology (NTID at RIT). The comments of informants suggest that there are advantages and disadvantages inherent in each educational model. For example, the selection of one model over another may involve 'trading' academic for social opportunity. In particular, it is suggested that both kinds of school experiences play a critical role in the socialization of deaf people and the development of deaf community. It is recommended that further research be conducted to learn more about the perspectives of deaf people on educational services and to explore with them the long term as well as the immediate impact of different kinds of school environments.