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Psychosocial concerns reported by Syrian refugees living in Jordan: systematic review of unpublished needs assessments. - The British journal of psychiatry : the journal of mental science
Humanitarian organisations supporting Syrian refugees in Jordan have conducted needs assessments to direct resources appropriately.To present a model of psychosocial concerns reported by Syrian refugees and a peer review of research practices.Academic and grey literature databases, the United Nations Syria Regional Response website, key humanitarian organisation websites and Google were searched for needs assessments with Syrian refugees in Jordan between February 2011 and June 2015. Information directly reporting the views of Syrian refugees regarding psychosocial needs was extracted and a qualitative synthesis was conducted.Respondents reported that psychological distress was exacerbated by both environmental (financial, housing, employment) and psychosocial outcomes (loss of role and social support, inactivity), which are themselves stressors. Need for improvement in research methodology, participatory engagement and ethical reporting was evident.Participatory engagement strategies might help to address identified psychosocial outcomes. More rigorous qualitative methods are required to ensure accuracy of findings.Â© The Royal College of Psychiatrists 2016.
Supported employment for people with severe mental illness: systematic review and meta-analysis of the international evidence. - The British journal of psychiatry : the journal of mental science
Individual placement and support (IPS) is a vocational rehabilitation programme that was developed in the USA to improve employment outcomes for people with severe mental illness. Its ability to be generalised to other countries and its effectiveness in varying economic conditions remains to be ascertained.To investigate whether IPS is effective across international settings and in different economic conditions.A systematic review and meta-analysis of randomised controlled trials comparing IPS with traditional vocational services was undertaken; 17 studies, as well as 2 follow-up studies, were included. Meta-regressions were carried out to examine whether IPS effectiveness varied according to geographic location, unemployment rates or gross domestic product (GDP) growth.The overall pooled risk ratio for competitive employment using IPS compared with traditional vocational rehabilitation was 2.40 (95% CI 1.99-2.90). Meta-regressions indicated that neither geographic area nor unemployment rates affected the overall effectiveness of IPS. Even when a country's GDP growth was less than 2% IPS was significantly more effective than traditional vocational training, and its benefits remained evident over 2 years.Individual placement and support is an effective intervention across a variety of settings and economic conditions and is more than twice as likely to lead to competitive employment when compared with traditional vocational rehabilitation.Â© The Royal College of Psychiatrists 2016.
Staying a smoker or becoming an ex-smoker after hospitalisation for unstable angina or myocardial infarction. - Health (London, England : 1997)
The aim of our study was to better understand processes of ongoing smoking or smoking cessation (quitting) following hospitalisation for myocardial infarction or unstable angina (acute cardiac syndromes). In-depth interviews were used to elicit participants' stories about ongoing smoking and quitting. In total, 18 interviews with smokers and 14 interviews with ex-smokers were analysed. Our findings illustrate the complex social nature of smoking practices including cessation. We found that smoking cessation following hospitalisation for acute cardiac syndromes is to some extent a performative act linked to 'doing health' and claiming a new identity, that of a virtuous ex-smoker in the hope that this will prevent further illness. For some ex-smokers hospitalisation had facilitated this shift, acting as a rite of passage and disrupting un-contemplated habits. Those participants who continued to smoke had often considered quitting or had even stopped smoking for a short period of time after hospitalisation; however, they did not undergo the identity shift described by ex-smokers and smoking remained firmly entrenched in their sense of self and the pattern of their daily lives. The ongoing smokers described feeling ashamed and stigmatised because of their smoking and felt that quitting was impossible for them. Our study provides an entry point into the smokers' world at a time when their smoking has become problematised and highly visible due to their illness and when smoking cessation or continuance carries much higher stakes and more immediate consequences than might ordinarily be the case.Â© The Author(s) 2016.
Translational and emerging clinical applications of metabolomics in cardiovascular disease diagnosis and treatment. - European journal of preventive cardiology
Numerous molecular screening strategies have recently been developed to measure the chemical diversity of a population's biofluids with the ultimate aim to provide clinicians, medical scientists and epidemiologists with a clearer picture of the presence and severity of cardiovascular disease; prognosis; and response to treatment. Current cardiology practice integrates clinical history and examination with state-of-the-art imaging, invasive measures, and electrical interrogation. Biomarkers in common clinical use are relatively limited to troponin and brain natriuretic peptide, dependent on damage to heart muscle, or myocyte 'stretch' respectively. Although they have been recently applied to risk stratification in asymptomatic individuals at higher risk, the development of markers capable of detecting earlier phases of disease development would facilitate targeted strategies to prevent pathological complications in the general community. Metabolomics is the systematic study of small molecules in biological fluids. Profiling strategies aim to comprehensively measure and quantify such biomarkers in a fast, cost-effective and clinically informative manner. Techniques tend to be applied in an unbiased fashion, with advanced statistical methods allowing for identification of signature profiles in particular cohorts. In this manner, metabolomics has the potential to identify new pathophysiological pathways, and thus therapeutic targets, as well as assist in improved risk-stratification and personalized cardiovascular medicine. The latter has great potential in the primary and secondary cardiovascular disease prevention settings, integrating known and as yet unidentified host and environmental factors. The current review discusses applications of metabolomic techniques relevant to both the research and the clinical cardiologist.Â© The European Society of Cardiology 2016.
The Sponge Hologenome. - mBio
A paradigm shift has recently transformed the field of biological science; molecular advances have revealed how fundamentally important microorganisms are to many aspects of a host's phenotype and evolution. In the process, an era of "holobiont" research has emerged to investigate the intricate network of interactions between a host and its symbiotic microbial consortia. Marine sponges are early-diverging metazoa known for hosting dense, specific, and often highly diverse microbial communities. Here we synthesize current thoughts about the environmental and evolutionary forces that influence the diversity, specificity, and distribution of microbial symbionts within the sponge holobiont, explore the physiological pathways that contribute to holobiont function, and describe the molecular mechanisms that underpin the establishment and maintenance of these symbiotic partnerships. The collective genomes of the sponge holobiont form the sponge hologenome, and we highlight how the forces that define a sponge's phenotype in fact act on the genomic interplay between the different components of the holobiont.Â© Crown copyright 2016.
Association of genetic risk factors with cognitive decline: the PATH through life project. - Neurobiology of aging
We examined the association of 28 single nucleotide polymorphisms (SNPs), previously associated with dementia or cognitive performance, with tests assessing episodic memory, working memory, vocabulary, and perceptual speed in 1689 nondemented older Australians of European ancestry. In addition to testing each variant individually, we assessed the collective association of the 12-risk SNPs for late-onset Alzheimer's disease using weighted and unweighted genetic risk scores. Significant associations with cognitive performance were observed for APOE Îµ4 allele, ABCA7-rs3764650, CR1-rs3818361, MS4A4E-rs6109332, BDNF-rs6265, COMT-rs4680, CTNNBL-rs6125962, FRMD4A-rs17314229, FRMD4A-rs17314229, intergenic SNP chrX-rs12007229, PDE7A-rs10808746, SORL1-rs668387, and ZNF224-rs3746319. In addition, the weighted genetic risk score was associated with worse performance on episodic memory. The identification of genetic risk factors, that act individually or collectively, may help in screening for people with elevated risk of cognitive decline and for understanding the biological pathways that underlie cognitive decline.Copyright Â© 2016 Elsevier Inc. All rights reserved.
Syntactic comprehension deficits across the FTD-ALS continuum. - Neurobiology of aging
To establish the frequency, severity, relationship to bulbar symptoms, and neural correlates of syntactic comprehension deficits across the frontotemporal dementia-amyotrophic lateral sclerosis (FTD-ALS) disease spectrum. In total, 85 participants were included in the study; 20 amyotrophic lateral sclerosis (ALS), 15 FTD-ALS, 27 progressive nonfluent aphasia (PNFA), and 23 controls. Syntactic comprehension was evaluated in ALS, FTD-ALS, PNFA, and controls using the Test for Reception of Grammar. Voxel-based morphometry examined neuroanatomical correlates of performance. Syntactic comprehension deficits were detected in 25% of ALS (pÂ = 0.011), 92.9% of FTD-ALS (p < 0.001), and 81.5% of PNFA (p < 0.001) patients. FTD-ALS was disproportionately impaired compared to PNFA. Impaired Test for Reception of Grammar performance was frequent in ALS with early bulbar involvement but did not correlate with bulbar impairment overall. Left peri-insular atrophy correlated with syntactic comprehension deficits. Syntactic comprehension deficits are frequent in FTD-ALS, more severe than in PNFA, and related to left peri-insular atrophy. A significant minority of ALS patients are impaired, but the relationship between bulbar symptoms and syntactic impairment is not understood.Copyright Â© 2016 Elsevier Inc. All rights reserved.
The Physical Activity 4 Everyone Cluster Randomized Trial: 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents. - American journal of preventive medicine
Few interventions have been successful in reducing the physical activity decline typically observed among adolescents. The aim of this paper is to report the 24-month effectiveness of a multicomponent school-based intervention (Physical Activity 4 Everyone) in reducing the decline in moderate to vigorous physical activity (MVPA) among secondary school students in disadvantaged areas of New South Wales, Australia.A cluster RCT was conducted in five intervention and five control schools with follow-up measures taken at 24 months post-randomization.The trial was undertaken within secondary schools located in disadvantaged communities in New South Wales, Australia.A multicomponent school-based intervention based on the Health Promoting Schools Framework was implemented. The intervention consisted of seven physical activity promotion strategies that targeted the curriculum (teaching strategies to increase physical activity in physical education lessons, student physical activity plans, and modification of school sport program); school environment (recess/lunchtime activities, school physical activity policy); parents (parent newsletters); and community (community physical activity provider promotion). Six additional strategies supported school implementation of the physical activity intervention strategies.Minutes per day spent in MVPA, objectively measured by accelerometer.Participants (N=1,150, 49% male) were a cohort of students aged 12 years (Grade 7) at baseline (March-June 2012) and 14 years (Grade 9) at follow-up (March-July 2014). At 24-month follow-up, there were significant effects in favor of the intervention group for daily minutes of MVPA. The adjusted mean difference in change in daily MVPA between groups was 7.0 minutes (95% CI=2.7, 11.4, p<0.002) (analysis conducted December 2014-February 2015). Sensitivity analyses based on multiple imputation were consistent with the main analysis (6.0 minutes, 95% CI=0.6, 11.3, p<0.031).The intervention was effective in increasing adolescents' minutes of MVPA, suggesting that implementation of the intervention by disadvantaged schools has the potential to slow the decline in physical activity.Australian New Zealand Clinical Trials Registry ACTRN12612000382875.Crown Copyright Â© 2016. Published by Elsevier Inc. All rights reserved.
The two-pore domain potassium channel, TWIK-1, has a role in the regulation of heart rate and atrial size. - Journal of molecular and cellular cardiology
The two-pore domain potassium (K(+)) channel TWIK-1 (or K2P1.1) contributes to background K(+) conductance in diverse cell types. TWIK-1, encoded by the KCNK1 gene, is present in the human heart with robust expression in the atria, however its physiological significance is unknown. To evaluate the cardiac effects of TWIK-1 deficiency, we studied zebrafish embryos after knockdown of the two KCNK1 orthologues, kcnk1a and kcnk1b. Knockdown of kcnk1a or kcnk1b individually caused bradycardia and atrial dilation (p<0.001 vs. controls), while ventricular stroke volume was preserved. Combined knockdown of both kcnk1a and kcnk1b resulted in a more severe phenotype, which was partially reversed by co-injection of wild-type human KCNK1 mRNA, but not by a dominant negative variant of human KCNK1 mRNA. To determine whether genetic variants in KCNK1 might cause atrial fibrillation (AF), we sequenced protein-coding regions in two independent cohorts of patients (373 subjects) and identified three non-synonymous variants, p.R171H, p.I198M and p.G236S, that were all located in highly conserved amino acid residues. In transfected mammalian cells, zebrafish and wild-type human TWIK-1 channels had a similar cellular distribution with predominant localization in the endosomal compartment. Two-electrode voltage-clamp experiments using Xenopus oocytes showed that both zebrafish and wild-type human TWIK-1 channels produced K(+) currents that are sensitive to external K(+) concentration as well as acidic pH. There were no effects of the three KCNK1 variants on cellular localization, current amplitude or reversal potential at pH7.4 or pH6. Our data indicate that TWIK-1 has a highly conserved role in cardiac function and is required for normal heart rate and atrial morphology. Despite the functional importance of TWIK-1 in the atrium, genetic variation in KCNK1 is not a common primary cause of human AF.Copyright Â© 2015. Published by Elsevier Ltd.
The Role of Habit and Perceived Control on Health Behavior among Pregnant Women. - American journal of health behavior
Many pregnant women do not adhere to physical activity and dietary recommendations. Research investigating what psychological processes might predict physical activity and healthy eating (fruit and vegetable consumption) during pregnancy is scant. We explored the role of intention, habit, and perceived behavioral control as predictors of physical activity and healthy eating.Pregnant women (N = 195, Mage = 30.17, SDage = 4.46) completed questionnaires at 2 time points. At Time 1, participants completed measures of intention, habit, and perceived behavioral control. At Time 2, participants reported on their behavior (physical activity and healthy eating) within the intervening week. Regression analysis determined whether Time 1 variables predicted behavior at Time 2. Interaction terms also were tested.Final regression models indicated that only intention and habit explained significant variance in physical activity, whereas habit and the interaction between intention and habit explained significant variance in healthy eating. Simple slopes analysis indicated that the relationship between intention and healthy eating behavior was only significant at high levels of habit.Findings highlight the influence of habit on behavior and suggest that automaticity interventions may be useful in changing health behaviors during pregnancy.
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