Marie Dennis - Academia.edu (original) (raw)

Papers by Marie Dennis

Gerontechnology : international journal on the fundamental aspects of technology to serve the ageing society, 2010

Use of assistive devices in caring for individuals with dementia has not been systematically exam... more Use of assistive devices in caring for individuals with dementia has not been systematically examined, particularly as it concerns managing behavioral symptoms. We tested a nonpharmacologic intervention to manage behaviors that involved instructing families in effective communication techniques, simplifying tasks and the home environment and using assistive devices. This paper describes the assistive devices provided to families assigned to intervention, extent of use of issued devices, their perceived helpfulness, and cost. Following each treatment session, occupational therapists (OT) documented time spent training in the use of strategies to manage problem behaviors. For families receiving assistive devices, OTs asked caregivers after 4 months whether they continued to use the device (yes/no), and extent to which it helped manage the targeted problems (not at all, somewhat, very helpful). We also tracked the costs associated with ordering, delivering and installing devices. Of 27...

Clinical interventions in aging, 2007

Project ACT is a randomized controlled trial designed to test the effectiveness of a non-pharmaco... more Project ACT is a randomized controlled trial designed to test the effectiveness of a non-pharmacological home-based intervention to reduce behavioral and psychological symptoms of dementia (BPSD) and caregiver distress. The study targets 272 stressed racially diverse family caregivers providing in-home care to persons with moderate stage dementia with one or more behavioral disturbances. All participants are interviewed at baseline, 4-months (main trial endpoint), and 6-months (maintenance). The four-month intervention involves up to 13 visits from an occupational therapist who works with families to problem-solve potential triggers (communication style, environmental clutter) contributing to behaviors, and instruct in strategies to reduce caregiver stress and manage targeted behaviors. To rule out infection or other potential medical contributors to behaviors, a nurse obtains blood and urine samples from the dementia patient, and conducts a medication review. Participants in the no...

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2008

To test whether the Tailored Activity Program (TAP) reduces dementia-related neuropsychiatric beh... more To test whether the Tailored Activity Program (TAP) reduces dementia-related neuropsychiatric behaviors, promotes activity engagement, and enhances caregiver well-being. Prospective, two-group (treatment, wait-list control), randomized, controlled pilot study with 4 months as main trial endpoint. At 4 months, controls received the TAP intervention and were reassessed 4 months later. Patients' homes. Sixty dementia patients and family caregivers. The eight-session occupational therapy intervention involved neuropsychological and functional testing, selection, and customization of activities to match capabilities identified in testing, and instruction to caregivers in use of activities. Behavioral occurrences, activity engagement, and quality of life in dementia patients; objective and subjective burden and skill enhancement in caregivers. At 4 months, compared with controls, intervention caregivers reported reduced frequency of problem behaviors, and specifically for shadowing an...

The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists, 2008

Water science and technology : a journal of the International Association on Water Pollution Research, 2004

A laboratory study has successfully demonstrated that a nitrogen deficient thermomechanical pulpi... more A laboratory study has successfully demonstrated that a nitrogen deficient thermomechanical pulping wastewater can be effectively treated in a sequencing batch reactor (SBR) operated under conditions of biological nitrogen fixation (the N-ViroTech process). In comparison to continuous stirred tank reactor activated sludge (CSTR-AS) configurations operated under either nitrogen fixing or nitrogen supplemented conditions, slightly lower removals of dissolved organic material were observed in the SBR. However, this was largely offset by significantly better suspended solids removal in the SBR, which contributes to the overall COD discharge. The settleability and dewaterability of sludge produced by the SBR was significantly better than that obtained from the nitrogen fixing CSTR-AS reactors, and comparable to that of a nitrogen supplemented system. Consistently low total and dissolved nitrogen discharges from the N-ViroTech systems demonstrated the advantage of this system over ones re...

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2012

To examine older African American's recognition of and beliefs about depressive symptoms, pre... more To examine older African American's recognition of and beliefs about depressive symptoms, preferred symptom management strategies, and factors associated with willingness to use mental health treatments. Differences between the depressed and nondepressed and men and women were examined. Cross-sectional survey. Home, senior center. A total of 153 senior center members (56 male, 97 female) 55 years and older. Using a depression vignette, participants indicated if the person was depressed and their endorsement of items reflecting beliefs, stigma, symptom management, and willingness to use treatments (yes/no). A 9-item Patient Health Questionnaire assessed current symptomatology. Overall, 24.2% reported depressive symptoms (≥5); 88.2% correctly identified the person in the vignette as depressed. Most (≥75%) endorsed active symptom management strategies, preference for treatment in physician and therapist offices, and willingness to take medications, seek therapy, see doctor, and att...

Water Science & Technology, 2011

A BOD:N:P ratio of 100:5:1 is often used as a benchmark for nutrient addition in nutrient limited... more A BOD:N:P ratio of 100:5:1 is often used as a benchmark for nutrient addition in nutrient limited wastewaters. The impact of varying nitrogen levels, whilst maintaining phosphorus constant, was studied in a simulated aerated lagoon (BOD:N of 100:0; 100:1.3; 100:1.8; 100:2.7 and 100:4.9). A synthetic wastewater was prepared using methanol, glucose and acetate as the combined carbon source, ammonium chloride as the nitrogen source and dipotassium hydrogen phosphate as the phosphorus source. Nitrogen levels did not impact organic carbon removal, but did strongly influence floc structure. With no supplemental nitrogen, growth was dispersed. Increasing the nitrogen level increased filamentous growth, with a marked change in filamentous species occurring between a BOD:N ratio of 100:1.8 and 100:2.7. Nitrogen fixation occurred at a BOD:N ratio of 100:0; 100:1.3 and 100:1.8, with nitrogen loss at BOD:N ratios of 100:2.7 and 100:4.9. At a BOD:N ratio of 100:4.9, ammonium discharge was significantly greater (1.8 mg/L) than at the lower nitrogen levels (0.04 - 0.18 mg/L). Phosphorus behaviour was more variable, however significantly more phosphorus was discharged at the lowest nitrogen level than at the highest (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Based on readily available nitrogen, the BOD:N ratio at which nitrogen fixation no longer occurred was around 100:1.9.

Value in Health, 2010

13th Euro Abstracts A449 despite adequate treatment. About 30% of patients do not achieve remissi... more 13th Euro Abstracts A449 despite adequate treatment. About 30% of patients do not achieve remission after 4 different antidepressant treatment trials (Rush et. Al., 2006). a few studies have examined the economic burden of TRD, but none have investigated the cost associated with more chronic and extensive forms of TRD characterized by non-response to four or more treatment trials. The objective of this study is to compare the direct medical expenditures of TRD patients to chronic MDD patients. METHODS: Patients with chronic MDD (defi ned as 2 or more years of continuous treatment) and patients with very severe TRD (defi ned as switching, augmentation, or addition of at least four qualifying therapies) were identifi ed in the PharMetrics Patient-Centric Database. Medical resource utilization (MRU) and payer costs per patient per year enrolled in the plan were compared. Patients were matched on duration of enrollment, length of depression, medications taken, and age. Statistical signifi cance was assessed using Student's t-tests. RESULTS: The average medical expenditures per TRD (n = 31,803) patient per year enrolled was 12,260comparedto12,260 compared to 12,260comparedto7,619 for non-TRD chronic MDD patients (n = 50,092) (p < 0.001), representing 60.9% higher costs per year. The differences in annual medical expenditures per TRD patient were primarily driven by higher medical and pharmacy MRU (number of services per patient) relative to the chronic MDD group (70.3 vs. 107.6, p < 0.001). CONCLUSIONS: Our results demonstrate that TRD patients accrued signifi cantly higher per patient medical costs than MDD patients due to higher medical resource use. These fi ndings suggest that more effective non-pharmacological alternative interventions are needed.