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Braceland Center
for Mental Health and Aging
Director: Karen Blank, M.D.
Assistant Director: Charles Wilber, M.Ed.
Mission and
Activities:
- Alzheimer's Disease Neuroimaging Initiative, a
public-private research partnership organized by the National Institute of
Health. This 60 million dollar, five-year study is developing improved
methods of tracking biomarkers and early changes associated with Alzheimer's
disease and memory decline and has created a tremendous, publicly accessible
database that is available to qualified researchers worldwide.
- Conduct research and education aimed at
improving health care of older persons
- Provide
comprehensive assessment and treatment planning for persons with cognitive
impairments and dementia
- Provide
consultation to physicians and agencies caring for patients and families
with dementia
- Improve
access of persons with memory decline and their families to research trial participation
- Collaborate with federal and state
governments, local service and educational organizations to carry out research and evaluation projects
- Work in close partnership with The Institute
of Living's clinical geriatric services
- Provide training to undergraduate and
graduate physicians, nurses, social workers and other therapists
- Maintain affiliation
with the Center on
Aging at the University of Connecticut School of Medicine
Staff holds faculty
appointments within:
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UConn Department of Psychiatry
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UConn Department of Medicine, Division of Geriatrics
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UConn School of Social Work
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- The larger Hartford Hospital community
- Yale School of Epidemiology and Public Health
- The Connecticut Coalition to Improve End of Life Care
- The Institute for Community Research
- The North Central Area Agency on Aging
- The Connecticut Association of Not-for-Profit Facilities for the Aged
- The Connecticut Association of Health Care Facilities
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Karen Blank, M.D.
Karen Bullock, Ph.D., M.S.W.
Charles Wilber, M.Ed.
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Major areas of research address Alzheimer's Disease and
related dementias, mild cognitive impairment, older drivers, neuroimaging, end-of-life decision-making,
ethics in geriatric care, minority mental illness and dementia, and depression. Projects are
funded through a variety of federal and state sources (NIH's National
Institute of Aging, Administration on Aging, CMS, Connecticut Office of Policy and
Management, Connecticut Department of Social Services) and private foundations
(Robert Wood Johnson Foundation, Alzheimer's Association, Donaghue
Medical Research Foundation).
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Video Intervention Project: Depression
and Anxiety in Older Latino Adults
Principal Investigator:
S. Gaztambide, Collaborators: J. Robison & K. Blank
This project involves developing
two 30-minute Spanish language videotapes about depression and anxiety
aimed at Latino elders and their families. The purpose of these
videotapes is to increase awareness and knowledge of depression and
anxiety as mental health problems that affect not just individual Latino
elders but also their families, to teach skills to help target group
members to cope with these illnesses, and to increase motivation to seek
and adhere to medical care. The videos will be aired in the Connecticut
access program throughout the state (Hartford County census is over 30,000
Hispanic adults). |
Dying Experience Among Racially
Diverse Hospitalized Older Adult Patients
K. Bullock
IOL Research Funds
This study involves a
retrospective analysis of medical records data for patients age 65+ who
died in Hartford Hospital in a two-year period. The goal of the research
is to determine whether racial differences exist in the use of advance
directives and life-sustaining medical treatments for older adults. |
Computer-Based Driving
Assessment in Early Alzheimer’s Disease
G. Pearlson (Olin
Neuropsychiatry Research Center) & K. Blank
Hartford Hospital Research
Funds
This project uses a computer-based driving simulation program which
presents elderly drivers with simulated driving situations known to lead
to crashes for individuals with Alzheimer’s disease. The driving simulator
will be validated using 20 patients with moderate Alzheimer’s’ disease and
20 matched healthy community controls. The simulator will then be used to
evaluate the driving of 40 people with early, mild Alzheimer’s disease.
Driving and cognitive skills will also be assessed using neuropsychiatric
instruments, spatial-visual tests, and driving history. A 12 month
follow-up of the forty subjects with mild Alzheimer’s disease will
determine the predictive value of the various assessments in identifying
motor vehicle accidents in the intervening time period. |
Burden and Morbidity in Families
of People with Psychotic Spectrum Disorders
J. Robison & L. Haber (IOL
Family Resource Center)
Hartford Hospital Research Funds
Through interviews with family members
of patients with psychotic spectrum disorders, this study examines the
effects on family member burden and morbidity of patient characteristics,
illness history and symptomology, as well as the effects of the family’s
own characteristics and experiences. |
Quantification of Factors that
Prolong Length of Stay in the IOL Geriatric Unit
K. Blank
Hartford Hospital Research Funds
Length of stay (LOS) for inpatients is
one of the outcome measures tracked through the quality improvement
process and is reflected in the quality compass under the financial
indicators. Although the LOS for inpatients on the geriatric psychiatry
unit at the IOL has dropped steadily and significantly in recent years,
there continues to be a cohort of patients whose LOS is notably longer
than the rest. This study synthesizes and analyzes retrospective chart
data to determine any contributing factors. This analysis will be used to
develop treatment protocols and revise patient care processes, with the
ultimate goal of improving patient care and shortening length of stay. |
The Institute of Living’s Program
for the Residents of Elderly Housing Facilities
E. Hickey (Institute of Living
Geriatric Programs), K. Bullock (Evaluator) & J. Robison (Evaluator)
Hartford Foundation for Public
Giving
This grant provides mental health
services to residents of Hartford senior housing buildings, in partnership
with the research grant, "Improving Access to Mental Health Services for
Older Hartford Residents." Building staff receive training and education
in identifying and assisting residents in need of psychiatric treatment.
The Braceland Center is conducting the evaluation of this three year
service grant. |
Improving Access to Mental
Health Services for Older Hartford Residents
J. Schensul (Institute for
Community Research), J. Robison, & Carmen Reyes (North Central Area Agency
on Aging)
Patrick and Catherine Weldon
Donaghue Medical Research Foundation
This study conducted depression and
anxiety screenings in 13 senior housing buildings in Hartford, referred
those who screened positive for treatment, and conducted follow-up interviews
with referred participants. Older adults and service providers engaged in
qualitative interviews to identify definitions of depression, help seeking
behaviors, and barriers to treatment. |
Service Use in Depressed Middle-Aged
and Older Puerto Rican Patients: Does a Family-Focused Intervention Make
a Difference?
J. Robison & K. Blank
Hartford Hospital Research Funds
The study assessed middle-aged and older Puerto Rican primary care
patients’ use of Hartford Hospital based medical services and compared the
medical service use of patients with no or few depressive symptoms to
those who screen positive for depression. It also tested the effectiveness
of an intervention for depressed patients, focused on educating close
family members about depression and treatment. |
Depression and Related Psychiatric
Symptoms in Puerto Rican Middle-Aged and Older Adults: Culturally
Sensitive Screening and Obstacles to Treatment
J. Robison, K. Blank,
C. Gruman, & L. Curry
Hartford Hospital Research Funds
The project involved: a)
comprehensive psychiatric evaluations to investigate rates of depression
and other psychiatric symptoms in 300 Puerto Rican middle aged and elderly
individuals in primary care settings, b) determining the utility of brief
depression screening instruments for Puerto Rican individuals age 50 and
older and making specific recommendations as to appropriate screens that
could be readily incorporated for use in primary care settings, and c)
examination of social and cultural factors which impede access to care. |
Screening for Depression in the
Elderly: How Many Questions are Needed?
K. Blank, C. Gruman, L. Curry, & Gerard
Kerins (University of Connecticut Health Center)
Hartford Hospital Research Funds
This study used three
different geriatric populations to determine the optimal depression
screening instruments for elderly patients. The three study populations
examined were: 1) ambulatory medical outpatients, 2) hospitalized medical
patients from Hartford Hospital, and 3) nursing home residents. |
Effects of Depression on Elderly
Patients’ Attitudes About Life Sustaining Treatments and Assisted
Suicide
K. Blank & J. Duffy (Psychiatric
Consultation Liaison Services, Hartford Hospital)
Hartford Hospital Research Funds
This study examined the
influence of depression on patients’ preferences regarding resuscitation
status, other life-sustaining medical decisions, and attitudes about
assisted suicide. It also explored whether the stability of those
preferences over time is affected by the presence of depression. |
Behavioral Symptoms Associated With
Alzheimer’s Disease And Related Dementias: Characteristics And
Predictors Of Effective Management
L. Curry & J. Robison
Donaghue Medical Research Foundation
Patients were followed
after discharge from an inpatient geriatric psychiatry unit to track
status of behavioral symptoms, physical or cognitive changes, community or
nursing home caregiver characteristics, and implementation and maintenance
of the treatment plan. The data allowed investigators to understand
factors that influence effective management of behavioral symptoms in
patients with Alzheimer’s disease over time. From this study, a Discharge
Planning Form was developed which is currently used with any IOL geriatric
patients with a diagnosis of dementia. |
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- Allen PD, Kellett, K, Gruman, C. Elder abuse and neglect in Connecticut’s nursing homes. Journal of Elder Abuse and Neglect,
15(1), 19-4, 2003.
- Allen PD,
Klein WC, Gruman C. Correlates of complaints made to the Connecticut
long-term care ombudsman program: The role of organizational and structural
factors. Research on Aging, 26(6):631-654, 2003.
- Blank K, Hixon L, Gruman C, Robison J, Hickey G, Schwartz
HI. Determinants of geropsychiatric inpatient length of stay. Psychiatric
Quarterly 76:195-212, 2005.
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Blank K. Late-life
depression: Lessons and hope. Lessons learned from geriatric psychiatry.
CD-ROM. American Association of Geriatric Psychiatry, Omni Press, 2004.
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Blank K (Ed.). Late-life
depression: Lessons and hope. Lessons learned from geriatric psychiatry.
American Association of Geriatric Psychiatry, Washington, DC, 2004.
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Blank
K. Legal and ethical issues. In Grossberg G, Sadavoy J, Jarvik LF, Meyers BS
(eds.). Comprehensive Review of Geriatric Psychiatry, 3rd Edition. WW Norton
& Company, New York, 1183-1206, 2004.
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Blank
K. (Section editor)
Medical-legal, ethical, and financial issues. In Grossberg G, Sadavoy J,
Jarvik LF, Meyers BS (eds.). Comprehensive Review of Geriatric Psychiatry,
Third Edition. WW Norton & Company, New York, 1182-1279, 2004.
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Blank K. Medical-legal,
ethical and financial issues. In Cheong J, Blank K, Kirwin PD, Lantz MDS,
Lyness JM, Steffens DC, VanGerpen M. (eds). Geriatric Psychiatry
Self-Assessment Program, 2nd edition. American Association for Geriatric
Psychiatry, Bethesda MD, 251-258, 2004.
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Blank K, Gruman C, Robison,
JT. Case-finding for depression in the elderly: Balancing ease of
administration with validity in varied treatment settings. Journal of
Gerontology: Medical Sciences, 59(4): M378-M384, 2004.
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Blank K, Kennedy G, Lantz M. (Eds.). Progress and hope.
Lessons learned from geriatric psychiatry. Monograph and CD-ROM. American
Association of Geriatric Psychiatry, Washington, DC, 2004.
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Blan
k
K. Virtual testing device determines skills of graying drivers. The New York
Times, 12, October 22, 2003.
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Blank
K, Gruman C, Robison J. Are the ultra-brief
one or two question screening
instruments suitable for late-life depression? The Gerontologist, 43, 301,
2003.
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Blank K. Respectful
decisions at the end of life. American Journal of Geriatric Psychiatry, 10(4),
362-364, 2002.
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Blank K, Cohen CI,
Cohen GD, Gaitz C, Gottlieb GL, Katz IR, Leuchter A, Maletta
G, Margolin R, Sakauye, K, Shamoian C. Failure to adequately
detect suicidal intent in elderly patients in the primary care setting.
Clinical Geriatrics, 9(1), 26-36, 2001.
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Blank K, Robison J, Doherty E, Prigerson H, Duffy J, Schwartz HI.
Life-sustaining treatment
and assisted death choices in depressed older patients. Journal of the
American Geriatrics Society, 49(2), 153-161, 2001.
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Blank K, Robison J, Prigerson H, Schwartz HI. Instability of attitudes about
euthanasia and physician assisted suicide in depressed older hospitalized
patients. General Hospital Psychiatry, 23, 326-332, 2001.
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Bradley EH, Curry LA, McGraw SA, Webster TR,
Kasl SV, Andersen R. Intended use of informal care for long-term care
needs: The role of race/ethnicity. Ethnicity and Health, 9:37-54, 2004.
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Bradley EH, Curry L,
Williams CS, van Doorn C, Fried TR, Fortinsky R, Kasl SV. Social support and social networks in the last year of life.
Journal of Mental Health and Aging, 8(1), 7-18, 2002.
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Bradley EH, McGraw SA, Curry L, Buckser A, King KL, Kasl SV, Andersen R.
Expanding the Andersen Model: The role of psychosocial factors in long-term
care use. Health Services Research, 37(5), 1221-1242, 2002.
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Bullock K. Get thee behind me: African American grandparents
raising grandchildren exposed to domestic violence. In RL Hampton, T
Gullotta (Eds), Interpersonal Violence in the African American Community:
Evidence-Based Prevention and Treatment Practices. New York, Springer,
pp.149-163, 2006.
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Bullock K. Promoting advance
care directives among African Americans: A faith-based model. Journal of
Palliative Medicine 9:183-195, 2006.
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Bullock K. McGraw SA. A community capacity-enhancement
approach to breast and cervical cancer screening among older women of color.
Health & Social Work. 31:16-25, 2006.
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Bullock
K. Ahora le voy a cuidar mis nietos: Rural Latino grandparents raising
grandchildren of substance abusing parents. Reprint in M. Delgado (ED.),
Latinos and alcohol use/abuse revisited: Advances and challenges for
prevention and treatment programs. New York, Haworth Press, pp. 107-130,
2005.
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Bullock, K. Ahora le voy a
cuidar mis nietos: Rural Latino grandparents raising grandchildren of
substance abusing parents. Alcoholism Quarterly, 23: 107-130, 2005.
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Bullock, K. Prevention from the Inside Out.
Journal of Primary Prevention, 26(1), 63-65, 2005.
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Bullock K, McGraw SA, Blank K, Bradley EH. What matters
to older African-Americans facing end-of-life decisions? A focus group
study. Journal for Social Work in End-of-life and Palliative Care, 1(3),
3-19, 2005.
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Bullock K.
The changing role of grandparents in rural families: The results of an
exploratory study in southeastern North Carolina. Families in society. The
Journal of Contemporary Social Services, 85:45-54, 2004.
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Bullock K. Family Social Support. In P. J.
Bomar (3rd Ed.). Promoting health in families: Applying family research and
theory to nursing practice. WB Saunders Publisher, 142-161, 2004.
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Bullock K. Healthy family systems: The
changing role of grandparents in rural areas. The Gerontologist, 43:48, 2003.
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Bullock
K, Crawford SL, Tennstedt SL. Employment and caregiving: An exploration of
African American caregivers. Social Work, 48 (2), 150-162, 2003.
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Carter AL, Wilber C, Sahl R. Motivational interviewing
techniques and the harm-reduction model in a short-term substance-abuse
group for adolescents with psychiatric problems. Connecticut Medicine, 69:
535-541, 2005.
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Cheong JA, Blank K, Kirwin PD, Lantz MS,
Lyness JM, Steffens DC, Van Gerpen M (Eds.). Geriatric Psychiatry
Self-Assessment Program, Question Book and Critique Book, Second Edition.
American Association for Geriatric Psychiatry, Bethesda, MD, 2004.
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Cohen GD, Blank K, Cohen CI, Gaitz C, Liptzin B, Maletta G, Meyers B, Sakauye K. Mental health
problems in assisted living residents. The physician’s role in treatment
and staff education. Geriatrics, 58(2), 44, 54-55, 2003.
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Covington TM, Morphy
M, Conwell Y, Schohn M, Ossip-Klein D, Sprafkin R P, Lantinga LJ. Documentation of suicidal behavior: Is it accurate? Federal
Practitioner,18(1), 10-18, 2001.
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Curry L, Bradley E, Robison J.
Individual decisions regarding financing nursing home care: Psychosocial
considerations. Journal of Aging Studies, 18:337-352, 2004.
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Curry, L, Jackson J. Recruitment and
retention of diverse ethnic and racial groups in health research: An
evolving science. In Curry L, Jackson J (Eds.), The Science of
Inclusion: Recruiting and Retaining Racial and Ethnic Elders in Health
Research. Washington, DC: The Gerontological Society of
America,1-7, 2003.
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Curry L, Jackson, J. The science of
including older ethnic and racial group participants in health-related
research. The Gerontologist, 43(1), 15-17, 2003.
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Curry L, Jackson J. (Eds.). The
Science
of Inclusion: Recruiting and Retaining Racial and Ethnic Elders in Health
Research. Washington, DC: The Gerontological Society of America, 2003.
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Curry L. Ethical
and legal considerations in health services research. In M. B. Kapp (Ed.),
Ethics, Law, and Aging Review. New York, NY: Springer
Publishing Company, 57-75, 2002.
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Curry L, Robison J. Consumer and family caregiver views on assisted living. Southwest
Journal on Aging, 18(1), 43-50, 2002.
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Curry L, Schwartz HI, Gruman C, Blank K. Could adequate palliative care obviate
assisted suicide? Death Studies, 26(9), 757-774, 2002.
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Curry L, Gruman C,
Robison J. Medicaid estate planning: Perceptions of morality and
necessity. The Gerontologist, 41(1), 34-42, 2001.
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Diefenbach GJ, Robison JT, Tolin DF,
Blank K. Late-life anxiety disorders among Puerto Rican primary care
patients: Impact on well-being, functioning, and service utilization. Journal
of Anxiety Disorders, 18:841-858, 2004.
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Disch W, Schensul J, Reyes C, Brockman K,
Robison J. Integrating social network measures in a mixed-methodological
study of urban adults and depression. The Gerontologist, 43:283, 2003.
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Gaztambide S, Baez E, Desmarais K, Schensul J.
Cultural definitions of depression. The Gerontologist, 43:283, 2003.
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Gould BE, Grey MR,
Huntington, CG, Gruman C, Rosen JH, Storey E, Abrahamson L, Conaty AM, Curry L, Ferreira M, Harrington KL, Paturzo D, Van
Hoof TJ. Improving patient care outcomes by teaching quality
improvement to medical students in community-based practices. Academic
Medicine, 77(10), 1011-1018, 2002.
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Gruman C, Kellett K, Allen P. Elder abuse and
neglect in Connecticut’s nursing homes. The Gerontologist, 43:411, 2003.
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Kellett K. (Book Review) Mental wellness in
aging: Strengths-based approaches. Educational Gerontology 30(6):557-558,
2004.
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Kellett K. (Book Review) Personal
control in social and life course contexts. Educational Gerontology,
30(3):257-258, 2004.
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Kellett K. (Book Review) Vital
connections in long-term care: Spiritual resources for staff and residents.
Educational Gerontology, 30(1):73-74, 2004.
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Kellet K, Gruman C, Robison J, Nuss L,
Kerins G. Research issues related to individuals with intellectual
disabilities. Connecticut Medicine, 68:525-529, 2004.
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Kellett K, Gruman C, Porter M, Porter A.
Connecticut’s personal assistance services program: An evaluation of
workforce barriers. The Gerontologist, 43:427, 2003.
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Kenny AM, Rowland H, Gruman C. Understanding the components of publication success: A
survey of academic award recipients. Connecticut Medicine, 67(4),
205-214, 2004.
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Kenny AM, Bellantonio
S, Gruman, CA, Acosta RD, Prestwood KM. Effects of transdermal testosterone on cognitive function and health perception in older
men with low bioavailable testosterone levels. Journal of Gerontology:
Medical Sciences, 57A(5), M321-M325, 2002.
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Kenny AM, Prestwood KM, Gruman CA, Marcello KM, Raisz LG. Effects of transdermal testosterone on bone and muscle in older men with low bioavailable
testosterone levels. Journal of Gerontology: Medical Sciences, 56A(5),
M266-M272, 2001.
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King MB, Whipple RH, Gruman CA, Judge JO, Schmidt JA, Wolfson LI. The
performance enhancement project: Improving physical performance in older
persons. Archives of Physical Medicine and Rehabilitation, 83,
1060-1069, 2002.
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Lyketsos CG, Colenda CC, Beck C, Blank K, Doraiswamy MP,
Kalunian DA, Yaffe K. Position statement of the American Association for
Geriatric Psychiatry regarding principles of care for patients with dementia
resulting from Alzheimer Disease. American J Geriatr Psychiatry, 14:7,
561-572, 2006.
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Pillemer K, Suitor JJ,
Henderson CR, Meador R, Schultz L, Robison J, Hegeman C.
A cooperative communication intervention for nursing home staff and family
members of residents. The Gerontologist, 43(Special Issue 2), 96-106, 2003.
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Radda K, Gaztambide S, Hickey E, Reyes C,
Robison J. Integrating qualitative and quantitative measures of barriers to
mental health care for older adults. The Gerontologist, 43:283, 2003.
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Robison J. Partners in Caregiving in a special
care environment. The Gerontologist 43:587, 2003.
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Robison J, Curry L, Gruman C, Covington T,
Gaztambide S, Blank K. Depression in later-life Puerto Rican primary care
patients: The role of illness, stress, social integration, and religiosity.
International Psychogeriatrics, 15(3):239-251, 2003.
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Robison J, Schensul J, Diefenbach G, Radda K.
Measuring mental health of older residents of senior housing. The
Gerontologist, 43:283, 2003.
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Robison J, Schensul J, Mills T. Measurement
issues in improving access to mental health care for older residents of senior
housing. The Gerontologist, 43:283, 2003.
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Robison J, Gruman C, Gaztambide
S, Blank K. Screening for depression in middle-aged and older
Puerto Rican primary care patients. Journal of Gerontology: Medical
Sciences, 57A(5), M308-M314, 2002.
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Schwartz HI, Curry L. Physician-assisted suicide and palliative care: Beliefs and empiricism
in the policy debate. Connecticut Medicine, 66(11), 699-702, 2002.
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Schwartz HI, Curry L,
Blank K, Gruman C. Physician-assisted suicide or voluntary
euthanasia: A meaningless distinction for practicing physicians? Journal of
Clinical Ethics, 12(1), 51-63, 2001.
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Tolin DF, Robison JT, Gaztambide S, Horowitz S, Blank K.
Ataques de nervios and psychiatric disorders in older Puerto Rican primary
care patients. J of Cross-Cultural Psychology, in press.
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Tolin DF, Robison JT, Gaztambide S, Blank K.
Anxiety disorders in older Puerto Rican primary care patients. American
Journal of Geriatric Psychiatry, 13(2), 150-156, 2005.
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Unson CG, Dunbar N,
Curry L, Kenyon L, Prestwood K. The effects of knowledge,
attitudes, and significant others on decisions to enroll in a clinical trial
on osteoporosis: Implications for recruitment of older African-American women. Journal of the National Medical Association, 93(10),
392-404, 2001.
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Webster T, Curry L, McGraw S, Buckser A,
Bradley E. The role of intended use on actual use of home care: Is race
a factor? Home Health Care Services Quarterly, 23:57-68, 2004.
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Weingartner K, Robison
J, Fogel D, Gruman C. Depression and substance use in a middle
aged and older Puerto Rican population. Journal of Cross-Cultural
Gerontology, 17, 173-193, 2002.
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Wild-Wesley R. Learning narratives of older
adult participants in a community leadership training program. The
Gerontologist, 43:109, 2003.
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