St Louis Va Medical Center

St. Louis, MO, United States

St Louis Va Medical Center

St. Louis, MO, United States
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Denner D.R.,Washington University in St. Louis | Rauchman M.,Washington University in St. Louis | Rauchman M.,St Louis Va Medical Center
Developmental Biology | Year: 2013

Development of the nephron tubules, the functional units of the kidney, requires the differentiation of a renal progenitor population of mesenchymal cells to epithelial cells. This process requires an intricate balance between self-renewal and differentiation of the renal progenitor pool. Sall1 is a transcription factor necessary for renal development which is expressed in renal progenitor cells (cap mesenchyme). Sall1 recruits the Nucleosome Remodeling and Deacetylase (NuRD) chromatin remodeling complex to regulate gene transcription. We deleted Mi2Β, a component of the NuRD complex, in cap mesenchyme (CM) to examine its role in progenitor cells during kidney development. These mutants displayed significant renal hypoplasia with a marked reduction in nephrons. Markers of renal progenitor cells, Six2 and Cited1 were significantly depleted and progenitor cell proliferation was reduced. We also demonstrated that Sall1 and Mi2Β exhibited a strong in vivo genetic interaction in the developing kidney. Together these findings indicate that Sall1 and NuRD act cooperatively to maintain CM progenitor cells. © 2012.

Crocker L.D.,University of Illinois at Urbana - Champaign | Heller W.,University of Illinois at Urbana - Champaign | Warren S.L.,St Louis Va Medical Center | O'Hare A.J.,University of Massachusetts Dartmouth | And 4 more authors.
Frontiers in Human Neuroscience | Year: 2013

Emotion-cognition and motivation-cognition relationships and related brain mechanisms are receiving increasing attention in the clinical research literature as a means of understanding diverse types of psychopathology and improving biological and psychological treatments. This paper reviews and integrates some of the growing evidence for cognitive biases and deficits in depression and anxiety, how these disruptions interact with emotional and motivational processes, and what brain mechanisms appear to be involved. This integration sets the stage for understanding the role of neuroplasticity in implementing change in cognitive, emotional, and motivational processes in psychopathology as a function of intervention. © 2013 Crocker, Heller, Warren, O_hare, Infantolino and Miller.

Spielberg J.M.,University of Illinois at Urbana - Champaign | Miller G.A.,University of Illinois at Urbana - Champaign | Miller G.A.,University of California at Los Angeles | Warren S.L.,University of Illinois at Urbana - Champaign | And 4 more authors.
Depression and Anxiety | Year: 2014

Conclusions: Findings advance the field toward an integrative model of the neural instantiation of anxiety/depression by identifying specific, distinct dysfunctions associated with anxiety and depression in networks important for maintaining approach and avoidance goals. Specifically, findings shed light on potential neural mechanisms involved in attentional biases in anxiety and valuation biases in depression and underscore the importance of examining transdiagnostic dimensions of anxiety/depression while networks are challenged.Background: Advancing research on the etiology, prevention, and treatment of psychopathology requires the field to move beyond modular conceptualizations of neural dysfunction toward understanding disturbance in key brain networks. Although some studies of anxiety and depression have begun doing so, they typically suffer from several drawbacks, including: (1) a categorical approach ignoring transdiagnostic processes, (2) failure to account for substantial anxiety and depression comorbidity, (3) examination of networks at rest, which overlooks disruption manifesting only when networks are challenged. Accordingly, the present study examined relationships between transdiagnostic dimensions of anxiety/depression and patterns of functional connectivity while goal maintenance was challenged.Methods: Participants (n = 179, unse-lected community members and undergraduates selected to be high/low on anxiety/depression) performed a task in which goal maintenance was challenged (color-word Stroop) while fMRI data were collected. Analyses examined moderation by anxiety/depression of condition-dependent coupling between regions of dorsolateral prefrontal cortex (dlPFC) previously associated with approach and avoidance motivation and amygdala/orbitofrontal cortex (OFC).Results: Anxious arousal was positively associated with amygdala虠bright dlPFC coupling. Depression was positively associated with OFC虠right dlPFC coupling and negatively associated with OFC虠left dlPFC coupling. © 2014 Wiley Periodicals, Inc.

Huncharek M.,St Louis Va Medical Center | Huncharek M.,Meta Analysis Research Group | Sue Haddock K.,Dorn Medical Center | Reid R.,Dorn Medical Center | Kupelnick B.,Meta Analysis Research Group
American Journal of Public Health | Year: 2010

Objectives. We evaluated the relationship between smoking and adenocarcinoma of the prostate. Methods. We pooled data from 24 cohort studies enrolling 21 579 prostate cancer case participants for a general variance-based meta-analysis. Summary relative risks (RRs) and 95% confidence intervals (Cls) were calculated separately for mortality and incidence studies. We tested the robustness of effect measures and evaluated statistical heterogeneity with sensitivity analyses. Results. In the pooled data, current smokers had no increased risk of incident prostate cancer (RR = 1.04; 95% Cl = 0.87, 1.24), but in data stratified by amount smoked they had statistically significant elevated risk (cigarettes per day or years: RR = 1.22; 95% Cl = 1.01, 1.46; pack years of smoking: RR = 1.11; 95% Cl = 1.01, 1.22). Former smokers had an increased risk (RR = 1.09; 95% Cl = 1.02, 1.16). Current smokers had an increased risk of fatal prostate cancer (RR = 1.14; 95% Cl = 1.06, 1.19). The heaviest smokers had a 24% to 30% greater risk, of death from prostate cancer than did nonsmokers. Conclusions. Observational cohort studies show an association of smoking with prostate cancer incidence and mortality. III-defined exposure categories in many cohort studies suggest that pooled data underestimate risk.

O'Connor S.,St Louis Va Medical Center | Vandenberg B.,University of Missouri-St. Louis
Mental Health, Religion and Culture | Year: 2010

Although delusion is a central characteristic of psychosis, problems with the DSM definition make identification difficult, especially when religious content is involved. This study, involving 255 participants, sought to (1) determine if untrained participants' assessment of religious beliefs would be similar to that of trained clinicians in a previous study and (2) determine whether participants' Religious Fundamentalism (RF) influenced assessment. Three sets of religious beliefs, with varying levels of conventionality, were assessed. Results indicate that untrained participants rated religious beliefs in much the same way as did clinicians in a previous study, suggesting that social norms play an important role in the assessment of religious ideation. It was also found that High RF participants rated beliefs similar to their own as less pathological than did Low RF participants. Furthermore, High RF participants did not lower pathology ratings for beliefs from the least conventional religion, even when identified as religious. © 2010 Taylor & Francis.

Mensie L.C.,St Louis Va Medical Center | Steffen A.M.,University of Missouri-St. Louis
Home Health Care Services Quarterly | Year: 2010

This study investigated the relationship between activities during respite time and depressive symptoms in family caregivers (N = 74) of older adults receiving in-home respite services. Contrary to prior research, demographic contextual variables (caregiver gender, household income, and dyad relationship) and care recipient problems (behavioral dysfunction and functional impairment) were not associated with caregiver depressive symptoms, nor was total minutes engaged in discretionary activities during respite. Self-reported depressive symptomatology in family caregivers was significantly and inversely related to both past service usage and total minutes of chore time completed on a typical home-based respite day. Implications for research in this area and service delivery are discussed. © Taylor & Francis Group, LLC.

Nurutdinova D.,St Louis Va Medical Center | Nurutdinova D.,University of Washington | Chrusciel T.,St Louis Va Medical Center | Chrusciel T.,University of Washington | And 8 more authors.
AIDS | Year: 2012

OBJECTIVE:: Mental health comorbidities are common in HIV-infected veterans and can impact clinical outcomes for HIV. We examined the impact of mental health diagnoses on progression to AIDS-defining illness (ADI) and death in a large cohort of HIV-infected veterans who accessed care between 2001 and 2006. DESIGN:: Retrospective cohort study using the national Veterans Health Administration (VHA) HIV Clinical Case Registry. METHODS:: We identified HIV-infected veterans initiating combination antiretroviral therapy (cART) within the VHA between 2000 and 2006. The prevalences of the following mental health diagnoses were examined: schizophrenia, bipolar disorder, depression, anxiety, and substance use disorder. Cox proportional hazards models were constructed to examine the relationship between mental health conditions and two outcomes, all-cause mortality and ADI. Models were computed before and after adjusting for confounding factors including age, race, baseline CD4 cell count, comorbidities and cART adherence. RESULTS:: Among 9003 veterans receiving cART, 31% had no mental health diagnosis. Age, race, baseline comorbidity score, CD4, and cART adherence were associated with shorter time to ADI or death. All-cause mortality was more likely among veterans with schizophrenia, bipolar disorder and substance use, and ADI was more likely to occur among veterans with substance use disorder. CONCLUSIONS:: Our results demonstrate the high prevalence of mental health diagnoses among HIV-infected veterans. In the era of highly active antiretroviral therapy, presence of psychiatric diagnoses impacted survival and development of ADI. More aggressive measures addressing substance abuse and severe mental illness in HIV-infected veterans are necessary. © 2012 Lippincott Williams & Wilkins, Inc.

Corvalan J.C.,St Louis Va Medical Center
Missouri medicine | Year: 2011

The long Iraq and Afghanistan conflicts have thrust Combat Related Post-Traumatic Stress Disorder (CR-PTSD) into the public consciousness and promoted national dialogue on the incidence and results of war related psychological trauma. In the first of a two part series we outline our contemporary understanding of CR-PTSD, the evolution of the diagnosis throughout the history of modern warfare, its impact on the mind and body, and its treatment. PTSD has become the mental health issue of our time.

Schafer R.M.,Saint Louis University | Handal P.J.,Saint Louis University | Brawer P.A.,St Louis Va Medical Center | Ubinger M.,Saint Louis University
Journal of Religion and Health | Year: 2011

This study was a follow up investigation of Brawer et al.'s (Prof Psychol Res Pr 33(2):203-206, 2002) survey of education and training of clinical psychologists in religion/spirituality. Directors of clinical training were surveyed to determine whether changes had occurred in the coverage of religion and spirituality through course work, research, supervision, and in the systematic coverage of the content area. Results indicated an increased coverage in the areas of supervision, dedicated courses, inclusion as part of another course, and research. There was no increase in systematic coverage, but significantly more programs provided at least some coverage. The current study also assesses other areas of incorporation as well as directors' opinions regarding the importance of religion/spirituality in the field of psychology. © 2009 Springer Science+Business Media, LLC.

Mensie L.C.,St Louis Va Medical Center | Steffen A.M.,University of Missouri-St. Louis
Home Health Care Management and Practice | Year: 2011

This longitudinal study applies the behavioral model of health services use (Andersen, 1995) to the prediction of in-home respite utilization within the naturalistic context of ongoing respite services. Participants (N = 74) were family caregivers who provided informal care for a physically and/or cognitively impaired older adult. All participants resided in the Midwest and received in-home respite services managed by an Area Agency on Aging and funded through the National Family Caregiver Support Program. The primary significant predictor of 3-month in-home respite utilization was the caregiving dyad's past in-home respite usage. Contrary to prior research, demographic predisposing variables (relationship type, household income) and objective need variables (behavioral dysfunction, functional impairment) were not associated with hours of respite use over 3 months, nor was level of caregiver depressive symptoms. Implications of these data for case management, the provision of in-home respite services, and future research are discussed. © 2011 SAGE Publications.

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