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Growing Organizational Capacity To Facilitate The Streamlining Of Patients With Psychiatric Disorders In A Community Academic Health Network; An Eight Year Review, Edward R. Norris MD, FAPA, FAPM, Michael W. Kaufmann MD, David B. Burmeister DO, Muhamad Aly Rifai MD, Laurence P. Karper MD, Ralph A. Primelo MD 2016 Lehigh Valley Health Network

Growing Organizational Capacity To Facilitate The Streamlining Of Patients With Psychiatric Disorders In A Community Academic Health Network; An Eight Year Review, Edward R. Norris Md, Fapa, Fapm, Michael W. Kaufmann Md, David B. Burmeister Do, Muhamad Aly Rifai Md, Laurence P. Karper Md, Ralph A. Primelo Md

David Burmeister, DO, FACEP, CPE

No abstract provided.


Illness Cognitions And Coping Self-Efficacy In Depression Among Persons With Low Vision., Bonnie A Sturrock, Jing Xie, Edith E Holloway, Mark Hegel, Robin J. Casten, David Mellor, Eva Fenwick, Gwyneth Rees 2016 University of Melbourne

Illness Cognitions And Coping Self-Efficacy In Depression Among Persons With Low Vision., Bonnie A Sturrock, Jing Xie, Edith E Holloway, Mark Hegel, Robin J. Casten, David Mellor, Eva Fenwick, Gwyneth Rees

Department of Psychiatry and Human Behavior Faculty Papers

PURPOSE: To investigate the mediating role of coping self-efficacy (CSE) between two types of illness cognitions (i.e., acceptance and helplessness) and depressive symptoms in persons with low vision.

METHODS: This was a single-group, cross-sectional study. Patients with visual acuity < 6/12 in the better eye and at least minimal depressive symptoms (≥5 on the Patient Health Questionnaire-9 [PHQ-9]) were recruited from vision rehabilitation services and participated in telephone-administered structured interviews at one time point. Measures were the PHQ-9, CSE Scale, and Illness Cognition Questionnaire. Structural equation modeling (SEM) devised the causal flow of illness cognitions and their observed indirect effects on depressive symptoms via the CSE mediators: problem focused, emotion focused, and social support.

RESULTS: The study comprised 163 patients (mean age 62 years; 61% female), most with age-related macular degeneration (26%) and moderate vision impairment (44%, <6/18-6/60). Structural equation modeling indices indicated a perfect fit (χ2 < 0.001, P = 1.00), accounting for 55% of the variance in depressive symptoms. Lower levels of acceptance and higher levels of helplessness illness cognitions were associated with lower self-efficacy in problem-focused coping (β = 0.38, P < 0.001, β = -0.28, P < 0.01, respectively), which in turn was associated with greater depressive symptom severity (β = -0.54, P < 0.001).

CONCLUSIONS: Lack of acceptance and greater helplessness relating to low vision led to a lack of perceived capability to engage in problem-focused coping, which in turn promoted depressive symptoms. Third-wave cognitive-behavioral treatments that focus on acceptance may ...


Collecting Histories Of Education And Employment Activities From Young Adults With Serious Mental Health Conditions, Kathryn Sabella, Peter Bui, Laura Golden, Kathleen Biebel 2016 University of Massachusetts Medical School

Collecting Histories Of Education And Employment Activities From Young Adults With Serious Mental Health Conditions, Kathryn Sabella, Peter Bui, Laura Golden, Kathleen Biebel

UMass Center for Clinical and Translational Science Research Retreat

Young adulthood is a critical time for establishing the foundation of an adult working life. As adolescents mature and explore career interests, they also begin to focus in on particular career pathways. However, lower levels of employment and educational attainment, as well as the demands of parenting, prevent and delay Youth and Young adults (Y&YAs) with serious mental health conditions (SMHCs) from participating in settings where career development and exploration activities typically occur. Of Y&YA parents who do work, the majority will work part-time, at low-level service jobs, and at low salaries (Osgood, et al., 2005). Y&YA ...


Brain Structure In Pediatric Tourette Syndrome, Alton C. Williams, Kevin J. Black 2016 Washington University School of Medicine in St. Louis

Brain Structure In Pediatric Tourette Syndrome, Alton C. Williams, Kevin J. Black

Kevin J. Black, MD

Previous studies of brain structure in Tourette syndrome (TS) have produced mixed results, and most had modest sample sizes. In the present multi-center study, we used structural MRI to compare 103 children and adolescents with TS to a well-matched group of 103 children without tics. We applied voxel-based morphometry methods to test gray matter (GM) and white matter (WM) volume differences between diagnostic groups, accounting for MRI scanner and sequence, age, sex and total GM + WM volume. The TS group demonstrated greater GM volume in posterior thalamus, hypothalamus and midbrain, and lower WM volume bilaterally in orbital and medial prefrontal ...


Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents: An Educational Intervention, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews 2016 Dominican University of California

Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents: An Educational Intervention, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews

Master's Theses and Capstone Projects

PURPOSE. The purpose of this project was to provide first responders with communication strategies for older adults that may help when responding to fall- related calls. General information was also provided to First Responders on working with older adults with a focus on the aging process, fall risk factors, and communications strategies.

METHODS. A series of educational sessions to first responders at a local fire district were developed and presented by occupational therapy students. Materials were developed by presenters from evidence-based resources and tailored to the target population. Each presentation focused on statistics about older adults, the aging process, fall ...


Pay For Performance And Treatment Outcome, Emily Loscalzo, PsyD, A. Levit, Robert Sterling, PhD, Stephen Weinstein, PhD 2016 Thomas Jefferson University

Pay For Performance And Treatment Outcome, Emily Loscalzo, Psyd, A. Levit, Robert Sterling, Phd, Stephen Weinstein, Phd

Department of Psychiatry and Human Behavior Faculty Papers

Introduction:

Pay for Performance (P4P): Models which offer fiscal incentives to medical and behavioral health providers for meeting specific expectations related to patient care have gained popularity over the last decade as a means of improving quality of care (Bremer et al., 2008). Research by McLellan et al. (2008) has supported the feasibility of implementing such programs and the openness of substance abuse treatment facilities to participating in P4P.


Piloting "Signs Of Safety": A Deaf-Accessible Toolkit For Trauma And Addiction, Melissa L. Anderson, Kelly S. Wolf Craig, Amanda Sortwell, Douglas M. Ziedonis 2016 University of Massachusetts Medical School

Piloting "Signs Of Safety": A Deaf-Accessible Toolkit For Trauma And Addiction, Melissa L. Anderson, Kelly S. Wolf Craig, Amanda Sortwell, Douglas M. Ziedonis

Community Engagement and Research Symposia

The Deaf community - a minority group of 500,000 Americans who use American Sign Language (ASL) - experiences trauma and addiction at rates double to the general population. Yet, there are no evidence-based treatments that have been evaluated to treat trauma, addiction, or other behavioral health conditions among Deaf people.

Current evidence-based treatments fail to meet the needs of Deaf clients. One example is Seeking Safety, a well-validated therapy for people recovering from trauma and addiction. Seeking Safety includes a therapist guide and client handouts for 25 therapy sessions, each teaching clients a safe coping skill. When Seeking Safety was used ...


Functional Impairment And Changes In Depression Subtypes For Women In Star*D: A Latent Transition Analysis, Christine Ulbricht, Anthony Rothschild, Kate Lapane 2016 University of Massachusetts Medical School

Functional Impairment And Changes In Depression Subtypes For Women In Star*D: A Latent Transition Analysis, Christine Ulbricht, Anthony Rothschild, Kate Lapane

Anthony J. Rothschild

OBJECTIVE: To characterize the association between functional impairment and major depression subtypes at baseline and to characterize changes in subtypes by functional impairment level in women receiving citalopram in level 1 of the Sequenced Treatment Alternatives to Relieve Depression trial.

METHOD: Women who completed baseline and week 12 study visits were included. Items from the self-reported Quick Inventory of Depressive Symptomatology were used to define the latent depression subtypes. The Work and Social Adjustment Scale was used to classify baseline functional impairment. A latent transition analysis model provided estimates of the prevalence of subtype membership and transition probabilities by functional ...


Memantine Improves Buprenorphine/Naloxone Treatment For Opioid Dependent Young Adults, Gerardo Gonzalez, Gregory DiGirolamo, Mauricio Romero-Gonzalez, David Smelson, Douglas Ziedonis, Monika Kolodziej 2016 University of Massachusetts Medical School

Memantine Improves Buprenorphine/Naloxone Treatment For Opioid Dependent Young Adults, Gerardo Gonzalez, Gregory Digirolamo, Mauricio Romero-Gonzalez, David Smelson, Douglas Ziedonis, Monika Kolodziej

Douglas M. Ziedonis

BACKGROUND: Opioid use disorders are considered a serious public health problem among young adults. Current treatment is limited to long-term opioid substitution therapy, with high relapse rates after discontinuation. This study evaluated the co-administration of memantine to brief buprenorphine pharmacotherapy as a treatment alternative.

METHODS: 13-week double-blind placebo-controlled trial evaluating 80 young adult opioid dependent participants treated with buprenorphine/naloxone 16-4mg/day and randomized to memantine (15mg or 30mg) or placebo. Primary outcomes were a change in the weekly mean proportion of opioid use, and cumulative abstinence rates after rapid buprenorphine discontinuation on week 9.

RESULTS: Treatment retention was not ...


Implementation And Use Of A Crisis Hotline During The Treatment As Usual And Universal Screening Phases Of A Suicide Intervention Study, Sarah Arias, Ashley Sullivan, Ivan Miller, Carlos Camargo, Edwin Boudreaux 2016 Brown University

Implementation And Use Of A Crisis Hotline During The Treatment As Usual And Universal Screening Phases Of A Suicide Intervention Study, Sarah Arias, Ashley Sullivan, Ivan Miller, Carlos Camargo, Edwin Boudreaux

Edwin D. Boudreaux

BACKGROUND: Although research suggests that crisis hotlines are an effective means of mitigating suicide risk, lack of empirical evidence may limit the use of this method as a research safety protocol. PURPOSE: This study describes the use of a crisis hotline to provide clinical backup for research assessments. METHODS: Data were analyzed from participants in the Emergency Department Safety and Follow-up Evaluation (ED-SAFE) study (n=874). Socio-demographics, call completion data, and data available on suicide attempts occurring in relation to the crisis counseling call were analyzed. Pearson chi-squared statistic for differences in proportions were conducted to compare characteristics of patients ...


Prenatal Triptan Exposure And Parent-Reported Early Childhood Neurodevelopmental Outcomes: An Application Of Propensity Score Calibration To Adjust For Unmeasured Confounding By Migraine Severity, Mollie Wood, Jean Frazier, Hedvig Nordeng, Kate Lapane 2016 University of Massachusetts Medical School

Prenatal Triptan Exposure And Parent-Reported Early Childhood Neurodevelopmental Outcomes: An Application Of Propensity Score Calibration To Adjust For Unmeasured Confounding By Migraine Severity, Mollie Wood, Jean Frazier, Hedvig Nordeng, Kate Lapane

Jean A. Frazier

PURPOSE: Triptan medications are serotonin agonists used to treat migraine, a chronic pain condition highly prevalent in women of reproductive age. Data on the safety of triptans during pregnancy are scant. We sought to quantify the association of prenatal triptan exposure on neurodevelopment in 3-year-old children. METHODS: Using data from the Norwegian Mother and Child Cohort Study, we used propensity score matching to examine associations between prenatal triptan exposure and psychomotor function, communication, and temperament. We used an external validation study to perform propensity calibration to adjust effect estimates for confounders unmeasured in the main study (migraine severity, type, and ...


Trauma-Informed Care In The Massachusetts Child Trauma Project, Jessica Bartlett, Beth Barto, Jessica Griffin, Jenifer Fraser, Hilary Hodgdon, Ruth Bodian 2016 University of Massachusetts Medical School

Trauma-Informed Care In The Massachusetts Child Trauma Project, Jessica Bartlett, Beth Barto, Jessica Griffin, Jenifer Fraser, Hilary Hodgdon, Ruth Bodian

Jessica L. Griffin

Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT ...


Health Evaluation And Referral Assistant: A Randomized Controlled Trial To Improve Smoking Cessation Among Emergency Department Patients, Edwin D. Boudreaux, Beau Abar, Brianna Haskins, Brigitte Bauman, Grant Grissom 2016 University of Massachusetts Medical School

Health Evaluation And Referral Assistant: A Randomized Controlled Trial To Improve Smoking Cessation Among Emergency Department Patients, Edwin D. Boudreaux, Beau Abar, Brianna Haskins, Brigitte Bauman, Grant Grissom

Edwin D. Boudreaux

BACKGROUND: Computer technologies hold promise for implementing tobacco screening, brief intervention, and referral to treatment (SBIRT). This study aims to evaluate a computerized tobacco SBIRT system called the Health Evaluation and Referral Assistant (HERA).

METHODS: Smokers (n = 421) presenting to an emergency department were randomly assigned to the HERA or a minimal-treatment Control and were followed for 3 months. Analyses compared smoking cessation treatment provider contact, treatment initiation, treatment completion, and smoking behavior across condition using univariable comparisons, generalized estimating equations (GEE), and post hoc Chi square analyses.

RESULTS: HERA participants were more likely to initiate contact with a treatment ...


Participatory Action Research, Jonathan Delman 2016 University of Massachusetts Medical School

Participatory Action Research, Jonathan Delman

Jonathan Delman

In this brief video, Dr. Jonathan Delman describes Participatory Action Research and its importance.


Integrating Recovery-Oriented Practices For Individuals With Co-Occurring Disorders: With Tobacco & Schizophrenia Case Example, Douglas Ziedonis 2016 University of Massachusetts Medical School

Integrating Recovery-Oriented Practices For Individuals With Co-Occurring Disorders: With Tobacco & Schizophrenia Case Example, Douglas Ziedonis

Douglas M. Ziedonis

This webinar discusses motivation-based, recovery-oriented treatment plans for co-occurring disorders, including community resources. It describes how to integrate recovery practices such as dual recovery therapy, mindfulness-based interventions, and Open Dialogue into mental health and addiction treatment settings.


The First Step In Health Reform For Those With Serious Mental Illness: Integrating The Dis-Integrated Mental Health System, Jeffrey Geller 2016 University of Massachusetts Medical School

The First Step In Health Reform For Those With Serious Mental Illness: Integrating The Dis-Integrated Mental Health System, Jeffrey Geller

Jeffrey L. Geller

Increasing attention is being directed toward meeting the psychiatric and medical needs of persons with persistent or recurrent mental illness through the integration of behavioral and medical healthcare. There are many models being considered or tested to achieve this objective. These models, however, generally ignore the challenge of integrating systems that are themselves dis-integrated. Also ignored is the fact that many persons with persistent or recurrent mental illness operate in the context of an array of entitlements; receive "services" from the criminal justice, as well as the health and behavioral health systems; and all these systems are both siloed and ...


Implementation Of Mindfulness Training For Mental Health Staff: Organizational Context And Stakeholder Perspectives, Jay Bryon, Douglas Ziedonis, Caroline McGrath, Jean Frazier, Fernando de Torrijos, Carl Fulwiler 2016 University of Massachusetts Medical School

Implementation Of Mindfulness Training For Mental Health Staff: Organizational Context And Stakeholder Perspectives, Jay Bryon, Douglas Ziedonis, Caroline Mcgrath, Jean Frazier, Fernando De Torrijos, Carl Fulwiler

Jean A. Frazier

Occupational stress and burnout adversely impacts mental health care staff well-being and patient outcomes. Mindfulness training reduces staff stress and may improve patient care. However, few studies explore mental health setting implementation. This qualitative study used focus groups to evaluate stakeholders' perceptions of organizational factors affecting implementation of an adapted version of Mindfulness-Based Stress Reduction (MBSR) for staff on adolescent mental health units. Common facilitators included leadership securing buy-in with staff, allocating staff time to participate, and quiet space for training and practice. Other facilitators were past staff knowledge of mindfulness, local champions, and acculturating staff with mindfulness through a ...


The Pediatric Imaging, Neurocognition, And Genetics (Ping) Data Repository, Terry Jernigan, David Kennedy, Jean Frazier 2016 University of California, San Diego

The Pediatric Imaging, Neurocognition, And Genetics (Ping) Data Repository, Terry Jernigan, David Kennedy, Jean Frazier

Jean A. Frazier

The main objective of the multi-site Pediatric Imaging, Neurocognition, and Genetics (PING) study was to create a large repository of standardized measurements of behavioral and imaging phenotypes accompanied by whole genome genotyping acquired from typically-developing children varying widely in age (3 to 20 years). This cross-sectional study produced sharable data from 1493 children, and these data have been described in several publications focusing on brain and cognitive development. Researchers may gain access to these data by applying for an account on the PING portal and filing a data use agreement. Here we describe the recruiting and screening of the children ...


Transitioning From First Drug Use To Dependence Onset: Illustration Of A Multiparametric Approach For Comparative Epidemiology, Olga Vsevolozhskaya, James Anthony 2016 Michigan State University

Transitioning From First Drug Use To Dependence Onset: Illustration Of A Multiparametric Approach For Comparative Epidemiology, Olga Vsevolozhskaya, James Anthony

Olga A. Vsevolozhskaya

Studying transitions from first drug use (DU) to drug dependence (DD) onset, we estimate a parsimonious set of parameters based on epidemiological data, with plans for future longitudinal research on newly incident drug users and with tracking of self-administration frequencies and DD clinical features. Our expectation is a distinctive sigmoid pattern with one asymptote for lower DD probability (when DU is insubstantial), upturning slopes of DD risk beyond a middle value (PD50), and eventual higher DD risk asymptotes at higher DU frequencies. We illustrate this novel approach using cross-sectional data from the United States National Surveys on Drug Use and ...


Factors Associated With Suicide Outcomes 12 Months After Screening Positive For Suicide Risk In The Emergency Department, Sarah Arias, Ivan Miller, Carlos Camargo, Ashley Sullivan, Amy Goldstein, Michael Allen, Anne Manton, Edwin Boudreaux 2016 Brown University

Factors Associated With Suicide Outcomes 12 Months After Screening Positive For Suicide Risk In The Emergency Department, Sarah Arias, Ivan Miller, Carlos Camargo, Ashley Sullivan, Amy Goldstein, Michael Allen, Anne Manton, Edwin Boudreaux

Edwin D. Boudreaux

OBJECTIVE: The main objective was to identify which patient characteristics have the strongest association with suicide outcomes in the 12 months after an index emergency department (ED) visit.

METHODS: Data were analyzed from the first two phases of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE). The ED-SAFE study, a quasi-experimental, interrupted time-series design, involved participation from eight general medical EDs across the United States. Participants included adults presenting to the ED with active suicidal ideation or an attempt in the past week. Data collection included baseline interview; six- and 12-month chart reviews; and six-, 12-, 24-, 36-, and ...


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