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Papers by Kathleen Kim, MD, MPH

Research paper thumbnail of Integrating Psychiatric Services Into Primary Care Settings: A Systems Approach

Research paper thumbnail of Psychological Coercion in the Context of Modern-Day Involuntary Labor: Revisiting United States v. Kozminski and Understanding Human Trafficking

U. Tol. L. Rev., 2006

PSYCHOLOGICAL COERCION IN THE CONTEXT OF MODERN-DAY INVOLUNTARY LABOR: REVISITING UNITED STATES V... more PSYCHOLOGICAL COERCION IN THE CONTEXT OF MODERN-DAY INVOLUNTARY LABOR: REVISITING UNITED STATES V. KOZMNSKI AND UNDERSTANDING HUMAN TRAFFICKING Kathleen Kim* I. INTRODUCTION HUMAN trafficking is synonymous with modern-day ...

Research paper thumbnail of From Language to Empire: Walt Whitman in the Context of Nineteenth-Century Popular Anglo-Saxonism

Walt Whitman Quarterly Review, 2006

anglo-SaxoniSm in nineteentH-century america took many forms, ranging from an academic interest i... more anglo-SaxoniSm in nineteentH-century america took many forms, ranging from an academic interest in the anglo-Saxon language to fullout declarations of the supremacy of the modern anglo-Saxon race. Few people, however, had quite as complex a relation to the anglo-Saxon movement as Walt Whitman, whose poetry and other writings manifest contradictory views towards america's claim of pure anglo-Saxonness. Critical description of anglo-Saxonism frequently omits serious discussion of Whitman, fueled no doubt at least in part by his reputation as the democratic poet who sought to unify the cosmos. however, as a journalist and literary figure, it would have been nearly impossible for Whitman not to hear and respond to the intense contemporary interest in anglo-Saxon. While Whitman's goal appears to be to erase racial difference through his project of a unified america, his vocabulary of anglo-Saxonism problematizes the call for equality and universality. his acclamation of american language and the american race complicates his explicit valorization of english hereditary traits, while his poems celebrating universality cannot entirely erase the impression of anglo-Saxon imperial domination. only when he specifically contradicts aspects of common imperialist-anglo-Saxonist claims does he succeed in silencing the ghosts of his own rhetoric. as eric Lott writes, "Whitman is a salutary reminder that there is no simple correspondence between individual racial feeling, cultural predisposition, and political ideology." 1 nor, as Jay grossman adds, is there necessarily any consistency in this correspondence over time. 2 examining Whitman's writings to form a single conclusion about his anglo-Saxonism is futile, but his changing focus from language to racial superiority and then to the postbellum negation of that superiority demonstrates the complexity of Whitman's politics. Whitman's racial and national politics have been the subject of innumerable critical works, which have examined him from many angles. anglo-Saxonism cannot be separated from other movements of the time;

Research paper thumbnail of Imputing observed blood pressure for antihypertensive treatment: impact on population and genetic analyses

American journal of hypertension, 2014

Elevated blood pressure (BP), a heritable risk factor for many age-related disorders, is commonly... more Elevated blood pressure (BP), a heritable risk factor for many age-related disorders, is commonly investigated in population and genetic studies, but antihypertensive use can confound study results. Routine methods to adjust for antihypertensives may not sufficiently account for newer treatment protocols (i.e., combination or multiple drug therapy) found in contemporary cohorts. We refined an existing method to impute unmedicated BP in individuals on antihypertensives by incorporating new treatment trends. We assessed BP and antihypertensive use in male twins (n = 1,237) from the Vietnam Era Twin Study of Aging: 36% reported antihypertensive use; 52% of those treated were on multiple drugs. Estimated heritability was 0.43 (95% confidence interval (CI) = 0.20-0.50) and 0.44 (95% CI = 0.22-0.61) for measured systolic BP (SBP) and diastolic BP (DBP), respectively. We imputed BP for antihypertensives by 3 approaches: (i) addition of a fixed value of 10/5mm Hg to measured SBP/DBP; (ii) i...

Research paper thumbnail of Anxiety disorders in a public mental health system: Clinical characteristics and service use patterns

Journal of Affective Disorders, 2007

Background-Anxiety disorders are among the most common forms of psychiatric disorder, yet few inv... more Background-Anxiety disorders are among the most common forms of psychiatric disorder, yet few investigations have examined the prevalence or service use of clients with anxiety disorders in the public mental health sector.

Research paper thumbnail of A 35-year longitudinal assessment of cognition and midlife depression symptoms: the Vietnam Era Twin Study of Aging

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2011

To determine whether early adult cognitive ability is a risk factor for depressive symptoms in mi... more To determine whether early adult cognitive ability is a risk factor for depressive symptoms in midlife and how genetic and environmental influences explain the association and to examine cross-sectional relationships between depressive symptoms and specific cognitive abilities at midlife.

Research paper thumbnail of Untreated Hypertension Decreases Heritability of Cognition in Late Middle Age

Behavior Genetics, 2012

Hypertension is a risk factor for cognitive decline, but the mechanisms underlying the effects of... more Hypertension is a risk factor for cognitive decline, but the mechanisms underlying the effects of hypertension on cognition, particularly in midlife, are unclear. We examined whether hypertension modifies genetic influences on individual differences in cognition. Nine cognitive domains and general cognitive ability were assessed in a sample of 1,237 male twins aged 51-60 who were divided into three blood pressure groups: nonhypertensive; medicated hypertensive; and unmedicated hypertensive. Heritability was significantly lower among unmedicated hypertensives compared to medicated hypertensives and non-hypertensives for visual-spatial ability (p = 0.013) and episodic memory (p = 0.004). There were no heritability differences between non-hypertensives and medicated hypertensives. In addition, there were no significant differences in mean level cognition across the three blood pressure groups. These results suggest that in middle-aged men, untreated hypertension suppresses normal genetic influences on individual differences in certain domains of cognition prior to the emergence of hypertension-related effects on cognitive performance. These results further suggest that antihypertensive medication may protect against or reverse this effect.

Research paper thumbnail of A New Brief Instrument for Assessing Decisional Capacity for Clinical Research

Archives of General Psychiatry, 2007

There is a critical need for practical measures for screening and documenting decisional capacity... more There is a critical need for practical measures for screening and documenting decisional capacity in people participating in different types of clinical research. However, there are few reliable and validated brief tools that could be used routinely to evaluate individuals' capacity to consent to a research protocol. To describe the development, testing, and proposed use of a new practical instrument to assess decision-making capacity: the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). The UBACC is intended to help investigators identify research participants who warrant more thorough decisional capacity assessment and/or remediation efforts prior to enrollment. We developed the UBACC as a 10-item scale that included questions focusing on understanding and appreciation of the information concerning a research protocol. It was developed and tested among middle-aged and older outpatients with schizophrenia and healthy comparison subjects participating in research on informed consent. In an investigation of reliability and validity, we studied 127 outpatients with schizophrenia or schizoaffective disorder and 30 healthy comparison subjects who received information about a simulated clinical drug trial. Internal consistency, interrater reliability, and concurrent (criterion) validity (including correlations with an established instrument as well as sensitivity and specificity relative to 2 potential "gold standard" criteria) were measured. Reliability and validity of the UBACC. The UBACC was found to have good internal consistency, interrater reliability, concurrent validity, high sensitivity, and acceptable specificity. It typically took less than 5 minutes to administer, was easy to use and reliably score, and could be used to identify subjects with questionable capacity to consent to the specific research project. The UBACC is a potentially useful instrument for screening large numbers of subjects to identify those needing more comprehensive decisional capacity assessment and/or remediation efforts.

Research paper thumbnail of Integrating Psychiatric Services Into Primary Care Settings: A Systems Approach

Research paper thumbnail of Psychological Coercion in the Context of Modern-Day Involuntary Labor: Revisiting United States v. Kozminski and Understanding Human Trafficking

U. Tol. L. Rev., 2006

PSYCHOLOGICAL COERCION IN THE CONTEXT OF MODERN-DAY INVOLUNTARY LABOR: REVISITING UNITED STATES V... more PSYCHOLOGICAL COERCION IN THE CONTEXT OF MODERN-DAY INVOLUNTARY LABOR: REVISITING UNITED STATES V. KOZMNSKI AND UNDERSTANDING HUMAN TRAFFICKING Kathleen Kim* I. INTRODUCTION HUMAN trafficking is synonymous with modern-day ...

Research paper thumbnail of From Language to Empire: Walt Whitman in the Context of Nineteenth-Century Popular Anglo-Saxonism

Walt Whitman Quarterly Review, 2006

anglo-SaxoniSm in nineteentH-century america took many forms, ranging from an academic interest i... more anglo-SaxoniSm in nineteentH-century america took many forms, ranging from an academic interest in the anglo-Saxon language to fullout declarations of the supremacy of the modern anglo-Saxon race. Few people, however, had quite as complex a relation to the anglo-Saxon movement as Walt Whitman, whose poetry and other writings manifest contradictory views towards america's claim of pure anglo-Saxonness. Critical description of anglo-Saxonism frequently omits serious discussion of Whitman, fueled no doubt at least in part by his reputation as the democratic poet who sought to unify the cosmos. however, as a journalist and literary figure, it would have been nearly impossible for Whitman not to hear and respond to the intense contemporary interest in anglo-Saxon. While Whitman's goal appears to be to erase racial difference through his project of a unified america, his vocabulary of anglo-Saxonism problematizes the call for equality and universality. his acclamation of american language and the american race complicates his explicit valorization of english hereditary traits, while his poems celebrating universality cannot entirely erase the impression of anglo-Saxon imperial domination. only when he specifically contradicts aspects of common imperialist-anglo-Saxonist claims does he succeed in silencing the ghosts of his own rhetoric. as eric Lott writes, "Whitman is a salutary reminder that there is no simple correspondence between individual racial feeling, cultural predisposition, and political ideology." 1 nor, as Jay grossman adds, is there necessarily any consistency in this correspondence over time. 2 examining Whitman's writings to form a single conclusion about his anglo-Saxonism is futile, but his changing focus from language to racial superiority and then to the postbellum negation of that superiority demonstrates the complexity of Whitman's politics. Whitman's racial and national politics have been the subject of innumerable critical works, which have examined him from many angles. anglo-Saxonism cannot be separated from other movements of the time;

Research paper thumbnail of Imputing observed blood pressure for antihypertensive treatment: impact on population and genetic analyses

American journal of hypertension, 2014

Elevated blood pressure (BP), a heritable risk factor for many age-related disorders, is commonly... more Elevated blood pressure (BP), a heritable risk factor for many age-related disorders, is commonly investigated in population and genetic studies, but antihypertensive use can confound study results. Routine methods to adjust for antihypertensives may not sufficiently account for newer treatment protocols (i.e., combination or multiple drug therapy) found in contemporary cohorts. We refined an existing method to impute unmedicated BP in individuals on antihypertensives by incorporating new treatment trends. We assessed BP and antihypertensive use in male twins (n = 1,237) from the Vietnam Era Twin Study of Aging: 36% reported antihypertensive use; 52% of those treated were on multiple drugs. Estimated heritability was 0.43 (95% confidence interval (CI) = 0.20-0.50) and 0.44 (95% CI = 0.22-0.61) for measured systolic BP (SBP) and diastolic BP (DBP), respectively. We imputed BP for antihypertensives by 3 approaches: (i) addition of a fixed value of 10/5mm Hg to measured SBP/DBP; (ii) i...

Research paper thumbnail of Anxiety disorders in a public mental health system: Clinical characteristics and service use patterns

Journal of Affective Disorders, 2007

Background-Anxiety disorders are among the most common forms of psychiatric disorder, yet few inv... more Background-Anxiety disorders are among the most common forms of psychiatric disorder, yet few investigations have examined the prevalence or service use of clients with anxiety disorders in the public mental health sector.

Research paper thumbnail of A 35-year longitudinal assessment of cognition and midlife depression symptoms: the Vietnam Era Twin Study of Aging

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2011

To determine whether early adult cognitive ability is a risk factor for depressive symptoms in mi... more To determine whether early adult cognitive ability is a risk factor for depressive symptoms in midlife and how genetic and environmental influences explain the association and to examine cross-sectional relationships between depressive symptoms and specific cognitive abilities at midlife.

Research paper thumbnail of Untreated Hypertension Decreases Heritability of Cognition in Late Middle Age

Behavior Genetics, 2012

Hypertension is a risk factor for cognitive decline, but the mechanisms underlying the effects of... more Hypertension is a risk factor for cognitive decline, but the mechanisms underlying the effects of hypertension on cognition, particularly in midlife, are unclear. We examined whether hypertension modifies genetic influences on individual differences in cognition. Nine cognitive domains and general cognitive ability were assessed in a sample of 1,237 male twins aged 51-60 who were divided into three blood pressure groups: nonhypertensive; medicated hypertensive; and unmedicated hypertensive. Heritability was significantly lower among unmedicated hypertensives compared to medicated hypertensives and non-hypertensives for visual-spatial ability (p = 0.013) and episodic memory (p = 0.004). There were no heritability differences between non-hypertensives and medicated hypertensives. In addition, there were no significant differences in mean level cognition across the three blood pressure groups. These results suggest that in middle-aged men, untreated hypertension suppresses normal genetic influences on individual differences in certain domains of cognition prior to the emergence of hypertension-related effects on cognitive performance. These results further suggest that antihypertensive medication may protect against or reverse this effect.

Research paper thumbnail of A New Brief Instrument for Assessing Decisional Capacity for Clinical Research

Archives of General Psychiatry, 2007

There is a critical need for practical measures for screening and documenting decisional capacity... more There is a critical need for practical measures for screening and documenting decisional capacity in people participating in different types of clinical research. However, there are few reliable and validated brief tools that could be used routinely to evaluate individuals' capacity to consent to a research protocol. To describe the development, testing, and proposed use of a new practical instrument to assess decision-making capacity: the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). The UBACC is intended to help investigators identify research participants who warrant more thorough decisional capacity assessment and/or remediation efforts prior to enrollment. We developed the UBACC as a 10-item scale that included questions focusing on understanding and appreciation of the information concerning a research protocol. It was developed and tested among middle-aged and older outpatients with schizophrenia and healthy comparison subjects participating in research on informed consent. In an investigation of reliability and validity, we studied 127 outpatients with schizophrenia or schizoaffective disorder and 30 healthy comparison subjects who received information about a simulated clinical drug trial. Internal consistency, interrater reliability, and concurrent (criterion) validity (including correlations with an established instrument as well as sensitivity and specificity relative to 2 potential "gold standard" criteria) were measured. Reliability and validity of the UBACC. The UBACC was found to have good internal consistency, interrater reliability, concurrent validity, high sensitivity, and acceptable specificity. It typically took less than 5 minutes to administer, was easy to use and reliably score, and could be used to identify subjects with questionable capacity to consent to the specific research project. The UBACC is a potentially useful instrument for screening large numbers of subjects to identify those needing more comprehensive decisional capacity assessment and/or remediation efforts.