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Biomedical subjects

C I Cohen

Publications and source records attributed to C I Cohen.

At least 19 recordsLinked to original sources
PubMed1992

Project rescue: serving the homeless and marginally housed elderly.

The authors describe the engagement techniques and service components of a program for homeless and marginally housed elderly. On follow-up evaluation of 132 people, clients averaged three favorable outcomes (maximum = 7). Service delivery was conceptualized as a three-stage process based on the differential effects that variables had at each stage. The strongest predictors of outcome were number of service encounters, type of presenting problem, and perceived level of social support.

Aged↗
PubMed1992

Homeless mentally ill or mentally ill homeless?

Mainstream psychiatry conceptualizes people who are homeless and mentally ill as distinct from other homeless persons because it is thought that their status stems from their mental disorder and the poor implementation of deinstitutionalization. The authors believe this dichotomy is illusory. They present data indicating that recent socioeconomic and political shifts contributed greatly to homelessness among all groups, regardless of mental illness; that those with and without mental illness have similar biographical and demographic profiles; that high levels of mental distress are common to all homeless persons; and that few mentally ill homeless persons require involuntary hospitalization. This perspective suggests novel responses that de-emphasize clinical solutions and focus on empowerment, consumerism, entitlement, community-level interventions, and closer alliances with other advocates for the homeless.

Ill-Housed Persons↗
PubMed1990

Outcome of schizophrenia into later life: an overview.

Studies of schizophrenia into later life may provide many of the keys to understanding the disorder. In this paper, recent developments in the study of aging and schizophrenia are reviewed, with particular emphasis on: the course and outcome of psychopathological symptoms; cognitive, neurological, and other organic factors; and social functioning. Four basic postulates about schizophrenia into later life as well as six themes for future research emerge from the review.

Aged↗
PubMed1990

The use of desmopressin in the management of two patients with von Willebrand's disease undergoing periodontal surgery. 2 case reports.

Von Willebrand's disease is a genetic bleeding disorder characterized by either a reduced plasma concentration of von Willebrand's factor (vWF) or a qualitative deficiency in that vWF which is produced. Previous therapy consisted of injecting concentrates of vWF manufactured from the pooled plasma of multiple donors. With the increased incidence and risk of serum borne transmission of such diseases as hepatitis and AIDS, the advantages of an alternative mode of therapy was obvious. In the course of using 1-desamino-8-D-arginine (desmopressin or DDAVP, a synthetic analogue of 8-arginine vasopressin, a hormone secreted in the posterior pituitary gland) in the treatment of diabetes insipidus, it was discovered that this drug causes the release of bound vWF into the plasma. The elevation lasts for several hours and is effective in producing hemostasis in some types of mild to moderate von Willebrand's disease. In 1984, desmopressin was approved for this usage in the United States. This paper discusses the use of DDAVP in the management of von Willebrand's disease and present two case reports of patients with von Willebrand's disease and in need of periodontal surgery.

Adult↗
PubMed1989

Schizophrenia and social network patterns: a survey of black inner-city outpatients.

An analysis of the social networks of black schizophrenic outpatients living in the inner-city (n = 47) revealed network patterns similar to those found in schizophrenics in other populations, thereby suggesting such patterns may be found cross-culturally. Because of the diminution in network size found among old black schizophrenics, there was a potential for older schizophrenics to overload their remaining linkages, particularly kin. However, with increased age, there was less material dependence on and greater satisfaction with network members. These findings are discussed with respect to the lower readmission rates found among the aging schizophrenics.

Adolescent↗
PubMed1989

The EASI: a self-administered screening test for cognitive impairment in the elderly.

The Early Assessment Self Inventory (EASI), a rapid self-administered screening test for cognitive impairment in the elderly, was constructed to permit individuals to be assessed in a group or singly without examiner intervention. This paper-and-pencil device requires a fourth-grade reading level and makes minimal demands on literacy while assessing orientation, recent and remote memory, language, visual-construction, calculation, and attention. In the present study, the EASI was group-administered to 146 elderly persons attending senior centers and completed individually without examiner intervention by 19 outpatients at a memory disorders clinic. Participants were 60 to 95 years old with 5 to 18 years of education. The EASI demonstrated good internal consistency and test-retest reliability and was significantly correlated with the Mini-Mental State Exam and the Mattis Dementia Rating Scale, both widely used screening instruments. Neuropsychological measures of memory, attention, and verbal fluency correlated as well with the EASI as with the examiner-administered screening instruments, suggesting that the EASI may provide an efficient method of screening for cognitive impairment.

Aged↗
PubMed1988

The physical well-being of old homeless men.

This study addressed a variety of issues related to the etiology, prevalence, and treatment of physical disorders among aging homeless men. The sample consisted of 195 nonstreet dwellers (177 residing in flophouses, 18 in apartments) and 86 street dwellers on the Bowery in New York City. The sample comprised men aged 50 and older. Bowery men scored worse than an aged-matched sample of community men on all physical health scales, with the greatest differences occurring in the respiratory, gastrointestinal, edema, hearing, hypertension, and ambulatory scales. Frequency of visits to doctors by the Bowery men was comparable to that of the community men, and the Bowery men rated their health substantially better than did their counterparts of two decades ago. Poor physical health often appeared to antedate arrival on the Bowery. However, a hierarchical regression analysis identified several variables--stress, unfulfilled needs, being relatively young, institutional/agency contacts--that were associated with current levels of poor health. Identification of these variables pointed to areas that warrant closer attention by clinicians and service providers.

Aged↗
PubMed1988

The mental health of old homeless men.

The recent focus on the young homeless mentally ill has diverted attention from other subgroups of the homeless, particularly the aging, who compose one fourth of the homeless population. A total of 86 street-dwelling and 195 non-street-dwelling (177 flophouse-, 18 apartment-dwelling) men aged 50 and older on the Bowery in New York City were studied. Although 23% evidenced psychosis or had prior psychiatric hospitalization (PPH group), depression was more prevalent with one third of all men categorized as clinically depressed. Only 5% evidenced gross organic mental disease. Several groups were identified for intervention because of their increased susceptibility to depression: alcoholics, relatively younger men, those with organic mental symptoms, street men. With respect to the PPH men, they did not appear to be distinct from the other homeless men on various social and health indices, although they differed substantially from age-matched community men. Thus these men must be viewed as homeless first, and in addition, as having the handicap of mental illness. Contrary to the popular stereotype, there was no evidence of widespread isolation among the PPH men, and despite their disturbances, most showed an adequate capacity for survival.

Aged↗
PubMed1988

Periodontal surgery for a patient with paroxysmal nocturnal hemoglobinuria.

Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon blood stem cell disorder. The acquired defect is in the cell membrane of the precursor of the affected clone, which renders erythrocytes, platelets and granulocytes unusually sensitive to the hemolytic effects of complement. It is characterized by chronic hemolysis, intermittent hemoglobinuria, thrombotic events and bone marrow hypoplasia. Hemolysis is precipitated by infection, strenuous exercise, surgery or menstruation. The dilemma of managing a PNH patient is that both the periodontal infection and the surgical treatment are precipitating factors. Management is further complicated by the fact that the patient is receiving corticosteroids. The treatment of the PNH patient is complex and potentially hazardous. It requires close cooperation between the periodontist and the hematologist. This paper describes the management of one such case.

Adult↗
PubMed1986

Assessment of stress-buffering effects of social networks on psychological symptoms in an inner-city elderly population.

Social network researchers have been divided into two camps: those who propose that social networks have a direct effect on subsequent psychological symptoms and those who posit a stress-buffering effect as well. Previous research has been limited by rudimentary measures of social interaction and the absence of longitudinal data as well as by different approaches to the assessment of possible buffering effects. In the present study, using 19 social network variables, the authors followed 133 elderly residents of mid-Manhattan SRO hotels for 1 year. Three different methods of determining buffering effects were examined: Dividing the sample into high- and low-stress groups and contrasting differences in percentage variance accounted for by social networks between the two groups; Examining the group as a whole to assess if any Network Variable X Stress interactional terms are significant; Examining the group as a whole to assess whether there is a reduction in the beta value of stress with respect to psychological symptoms when network variables are added to the analysis. Method 1 indicated a direct network effect, but none of the methods indicated a buffering effect. Of clinical relevance was the nonlinearity of the network effects, that is, depending upon a person's stressor level, different network dimensions must be emphasized and strengthened.

Adaptation, Psychological↗
PubMed1985

Social networks, stress, and physical health: a longitudinal study of an inner-city elderly population.

Research examining the relationship between social networks, stress, and physical symptoms has been limited by rudimentary network measures and the lack of longitudinal data. Using 19 network variables, the authors followed 133 elderly residents of mid-Manhattan hotels for 1 year. The findings indicated that social networks exert a direct effect on reducing subsequent physical symptoms. Moreover, social networks also act to reduce symptoms by buffering the effect of increased levels of stress. Of clinical relevance was the finding that combining knowledge of patients' social networks with their current health status predicts their future health status with an exceedingly high degree of certainty. Consequently, intervention to reinforce a network can be as clinically significant as implementing a medical procedure.

Aged↗