bluuebunny/crossref_metadata_2025 huggingface dataset:
Distinctive Trajectory Groups of Mental Health Functioning among Assertive Community Treatment Clients: An Application of Growth Mixture Modelling Analysis
Authors: Wilk Piotr , Vingilis Evelyn , Bishop Joan E H , He Wenqing , Braun John , Forchuk Cheryl , Seeley Jane , Mitchell Beth
Published: July 2017

Objective:

Assertive community treatment (ACT) studies that have used conventional, statistical growth modelling methods have not examined different trajectories of outcomes or covariates that could influence different trajectories, even though heterogeneity in outcomes has been established in other research on severe mental illness. The purpose of our study was to examine the general trend in mental health functioning of ACT clients over a 2-year follow-up time period, to discover groups of ACT clients with distinctive longitudinal trajectories of mental health functioning, and to examine if some of the key sociodemographic and illness-related factors influence group membership.

Method:

A 2-year, prospective, within-subjects study of 216 ACT clients within southern Ontario, collected functional outcome data at baseline and 12 and 24 months using the Colorado Client Assessment Record. Baseline covariates included sex, primary diagnosis, number of comorbidities, hospitalization history, and duration of illness. Growth mixture modelling (GMM) was used to examine trajectories.

Results:

Clinical staff assessments of ACT clients showed a statistically significant improvement in functioning and 84% achieved successful community tenure. GMM analysis identified 2 classes of ACT clients: class 1 (79.63% of clients) experienced lower and stable overall functioning, and class 2 (20.37%) showed a better baseline functioning score and improvement in the overall functioning over time. Class membership was predicted by the number of comorbidities and diagnosis.

Conclusions:

Our study suggests general stability in overall functioning for the sampled ACT clients over 2 years, but significant heterogeneity in trajectories of functioning.
Functional Impairment in Patients with Major Depressive Disorder and Comorbid Anxiety Disorder
Authors: Gili Margalida , Toro Mauro García , Armengol Silvia , García-Campayo Javier , Castro Adoración , Roca Miquel
Published: July 2017

Objective:

To analyze the potential for different aspects of anxiety to modify the effect of impaired functioning in major depressive disorder (MDD).

Methods:

Participants ( n = 1226) were psychiatric outpatients with MDD. A cross-sectional, multicentre, nationwide study was designed. The 12-item version of the World Health Organization Disability Assessment Schedule II was used to assess functional limitation. Anxiety was measured using the Hamilton Anxiety Rating Scale and the State-Trait Anxiety Inventory (STAI). Depression severity was measured using the Quick Inventory of Depressive Symptomatology.

Results:

About 43.1% of patients had a comorbid MDD and anxiety disorder. Poorer functioning correlated significantly with severity of depression (Pearson r = 0.78, P = 0.001), severity of anxiety ( r = 0.65, P = 0.001), and higher anxiety trait scores ( r = 0.40, P = 0.001), but not significantly with STAI-State scores ( r = 0.03, P = 0.26). The overall regression model was significant and explained 66 of the functioning variability in patients with MDD, mostly attributable to depression severity. Results indicate that anxiety has a moderate impact on functioning impairment in patients with MDD.

Conclusions:

Our findings suggest that MDD and anxiety severity appear to be associated significantly with impaired functioning in patients with MDD but explains only a moderate proportion of variance.
Neurocognition: Clinical and Functional Outcomes in Schizophrenia
Authors: Lepage Martin , Bodnar Michael , Bowie Christopher R
Published: July 2017

Schizophrenia is characterized by significant heterogeneity in outcome. The last decades have witnessed a significant interest in identifying factors that can moderate or influence clinical and functional outcomes in people with schizophrenia. One factor of particular interest is neurocognition, as performance on various measures of cognitive abilities, such as memory, attention, and executive functions, have been consistently related to functional outcome and, to a lesser extent, clinical outcome. This review aims to provide an up-to-date description of recent studies examining the association between neurocognition and clinical and (or) functional outcomes. In the first section, studies examining neurocognitive performance in relation to clinical outcome are examined. When clinical outcome is defined dichotomously (for example, comparing remitted and nonremitted), verbal memory performance consistently exhibits a strong association with clinical status, with the poor outcome group showing the largest deficits. In the second section, studies exploring the relation between neurocognition and various dimensions of functional outcome are reviewed. These dimensions include independent living, social functioning, and vocational functioning, among others. Again, a strong link between neurocognitive deficits and impairments in several aspects of functioning clearly emerges from this review. Finally, several measurement issues are discussed that pertain to the need to standardize definitions of clinical and (or) functional outcomes, the importance of defining cognitive domains consistently across studies, and distinguishing between one's competence to perform tasks and what one actually does in everyday life. Addressing these measurement issues will be key to studies examining the development of effective interventions targeting neurocognitive functions and their impact on clinical and functional outcomes.
Is the Effect of Compulsory Community Treatment on Preventable Deaths from Physical Disorders Mediated by Better Access to Specialized Medical Procedures?
Authors: Kisely Steve , Xiao Jianguo , Lawrence David , Jian Le
Published: July 2017

Objectives:

Compulsory community treatment has been shown to reduce preventable deaths from physical disorders—these causes being up to 10 times more common than suicide in psychiatric patients. We investigated whether this was mediated by better access to specialized medical procedures.

Method:

All patients on compulsory community treatment for over 11 years were compared with matched control subjects using linked administrative health data from Western Australia (state population of about 2.24 million). Outcomes were access to revascularization and other specialized procedures at 1-, 2-, and 3-year follow-up. Logistic regression was used to adjust for demographics, prior health service use, diagnosis, and length of psychiatric history.

Results:

There were 2757 patients and 2687 control subjects (total n = 5444). Sixty-five per cent were males ( n = 3522), and the average age was 36 years (SD 13.2). Most had schizophrenia or other nonaffective psychoses (74%), followed by affective disorders (26%). At 2-year follow-up, 2% ( n = 53) of patients and 2.6% ( n = 69) of control subjects had undergone a specialized intervention. Compulsory community treatment did not result in greater access to specialized procedures at all 3 time points even after adjusting for potential confounders.

Conclusions:

Greater access to specialized procedures does not explain the reduced mortality from preventable physical illness that had been reported in patients on community treatment orders. There must be other explanations for this finding, such as mental health staff facilitating access to chronic disease management in primary care. This warrants further research.
Suicidal Behaviour in Mood Disorders—Who, When, and Why?
Authors: Isometsä Erkki
Published: July 2017

Objective:

About one-half to two-thirds of all suicides are by people who suffer from mood disorders; preventing suicides among those who suffer from them is thus central for suicide prevention. Understanding factors underlying suicide risk is necessary for rational preventive decisions.

Method:

The literature on risk factors for completed and attempted suicide among subjects with depressive and bipolar disorders (BDs) was reviewed.

Results:

Lifetime risk of completed suicide among psychiatric patients with mood disorders is likely between 5% and 6%, with BDs, and possibly somewhat higher risk than patients with major depressive disorder. Longitudinal and psychological autopsy studies indicate suicidal acts usually take place during major depressive episodes (MDEs) or mixed illness episodes. Incidence of suicide attempts is about 20- to 40-fold, compared with euthymia, during these episodes, and duration of these high-risk states is therefore an important determinant of overall risk. Substance use and cluster B personality disorders also markedly increase risk of suicidal acts during mood episodes. Other major risk factors include hopelessness and presence of impulsive–aggressive traits. Both childhood adversity and recent adverse life events are likely to increase risk of suicide attempts, and suicidal acts are predicted by poor perceived social support. Understanding suicidal thinking and decision making is necessary for advancing treatment and prevention.

Conclusion:

Among subjects with mood disorders, suicidal acts usually occur during MDEs or mixed episodes concurrent with comorbid disorders. Nevertheless, illness factors can only in part explain suicidal behaviour. Illness factors, difficulty controlling impulsive and aggressive responses, plus predisposing early exposures and life situations result in a process of suicidal thinking, planning, and acts.
Preventing Suicide among Inpatients
Authors: Sakinofsky Isaac
Published: July 2017

Objective:

Inpatient suicide comprises a proportionately small but clinically important fraction of suicide. This study is intended as a qualitative analysis of the comprehensive English literature, highlighting what is known and what can be done to prevent inpatient suicide.

Method:

A systematic search was conducted on the Cochrane Library, PubMed, Embase, Web of Knowledge, and a personal database for articles on cohort series, preferably controlled, of inpatient suicide (not deliberate self-harm or attempted suicide, unless they also dealt specifically with suicide data).

Results:

A qualitative discussion is presented, based on the findings of the literature searched.

Conclusions:

The bulk of inpatient suicides actually occur not on the ward but off premises, when the patient was on leave or had absconded. Peaks occur shortly after admission and discharge. It is possible to reduce suicide risk on the ward by having a safe environment, optimizing patient visibility, supervising patients appropriately, careful assessment, awareness of and respect for suicide risk, good teamwork and communication, and adequate clinical treatment.
Suicide: Rationality and Responsibility for Life
Authors: Ho Angela Onkay
Published: July 2017

Objectives:

Death by suicide is widely held as an undesirable outcome. Most Western countries place emphasis on patient autonomy, a concept of controversy in relation to suicide. This paper explores the tensions between patients' rights and many societies' overarching desire to prevent suicide, while clarifying the relations between mental disorders, mental capacity, and rational suicide.

Methods:

A literature search was conducted using search terms of suicide and ethics in the PubMed and LexisNexis Academic databases. Article titles and abstracts were reviewed and deemed relevant if the paper addressed topics of rational suicide, patient autonomy or rights, or responsibility for life. Further articles were found from reference lists and by suggestion from preliminary reviewers of this paper.

Results:

Suicidal behaviour in a person cannot be reliably predicted, yet various associations and organizations have developed standards of care for managing patients exhibiting suicidal behaviour. The responsibility for preventing suicide tends to be placed on the treating clinician. In cases where a person is capable of making treatment decisions—uninfluenced by any mental disorder—there is growing interest in the concept of rational suicide.

Conclusions:

There is much debate about whether suicide can ever be rational. Designating suicide as an undesirable event that should never occur raises the debate of who is responsible for one's life and runs the risk of erroneously attributing blame for suicide. While upholding patient rights of autonomy in psychiatric care is laudable, cases of suicidality warrant a delicate consideration of clinical judgment, duty of care, and legal obligations.
The Mistreatment of Major Depressive Disorder
Authors: Paris Joel
Published: July 2017

Objective:

To examine the effects of classification on treatment in major depressive disorder (MDD).

Method:

This is a narrative review.

Results:

MDD is a highly heterogeneous category, leading to problems in classification and in specificity of treatment. Current models classify all depressions within a single category. However, the construct of MDD obscures important differences between severe disorders that require pharmacotherapy, and mild-to-moderate disorders that can respond to psychotherapy or remit spontaneously. Patients with mild-to-moderate MDD are being treated with routine or overly aggressive pharmacotherapy.

Conclusions:

The current classification fails to address the heterogeneity of depression, leading to mistreatment.
The Mood Disorders Association of British Columbia Psychiatric Urgent Care Program: A Preliminary Evaluation of a Suggested Alternative Model of Outpatient Psychiatric Care
Authors: Remick Ronald A , Araki Yuriko , Bruce Robin , Gorman Chris , Allen Judy , Remick Abigail K , Lear Scott A
Published: July 2017

Objective:

To describe an alternative model of psychiatric outpatient care for patients with mood and anxiety disorders (the Mood Disorders Association of British Columbia Psychiatric Urgent Care Program or the MDA Program) using group medical visits (GMV) and (or) email communications in lieu of individual follow-up appointments.

Method:

Annual costs of the MDA Program were compared with average costs of private psychiatrists offering outpatient care and patients being treated in a mental health centre. In addition, questionnaires as to patient satisfaction with the MDA Program intake, GMV experience, and family physician satisfaction with the MDA Program were administered.

Results:

The MDA Program model of care is significantly more cost effective than individual psychiatric outpatient care or health authority mental health centre care for patients with moderate or severe illness. Patients and family physicians were very satisfied with the model of care and GMVs offered. Conclusions: The MDA Program model of care appears to be efficient and cost-effective, and patients and referring physicians appear satisfied with the care offered in this program.
Recovery and Severe Mental Illness: Description and Analysis
Authors: Drake Robert E , Whitley Rob
Published: July 2017

The notion of recovery has been embraced by key stakeholders across Canada and elsewhere. This has led to a proliferation of definitions, models, and research on recovery, making it vitally important to examine the data to disentangle the evidence from the rhetoric. In this paper, first we ask, what do people living with severe mental illness (SMI) say about recovery in autobiographical accounts? Second, what do they say about recovery in qualitative studies? Third, from what we have uncovered about recovery, can we learn anything from quantitative studies about proportions of people leading lives of recovery? Finally, can we identify interventions and approaches that may be consistent or inconsistent with the grounded notions of recovery unearthed in this paper? We found that people with mental illness frequently state that recovery is a journey, characterized by a growing sense of agency and autonomy, as well as greater participation in normative activities, such as employment, education, and community life. However, the evidence suggests that most people with SMI still live in a manner inconsistent with recovery; for example, their unemployment rate is over 80%, and they are disproportionately vulnerable to homelessness, stigma, and victimization. Research stemming from rehabilitation science suggests that recovery can be enhanced by various evidence-based services, such as supported employment, as well as by clinical approaches, such as shared decision making and peer support. But these are not routinely available. As such, significant systemic changes are necessary to truly create a recovery-oriented mental health system.
Resting-State Neuroimaging Studies: A New Way of Identifying Differences and Similarities among the Anxiety Disorders?
Authors: Peterson Andrew , Thome Janine , Frewen Paul , Lanius Ruth A
Published: July 2017

This review examines recent functional neuroimaging research of resting-state regional connectivity between brain regions in anxiety disorders. Studies compiled in the PubMed–National Center for Biotechnology Information database targeting resting-state functional connectivity in anxiety disorders were reviewed. Diagnoses included posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), obsessive–compulsive disorder (OCD), panic disorder (PD), and specific phobia (SP). Alterations to network connectivity were demonstrated in PTSD, GAD, SAD, OCD, and PD in several resting-state investigations. Differences from control subjects were primarily observed in the default mode network within PTSD, SAD, and OCD. Alterations within the salience network were observed primarily in PTSD, GAD, and SAD. Alterations in corticostriatal networks were uniquely observed in OCD. Finally, alterations within somatosensory networks were observed in SAD and PD investigations. Resting-state studies involving SPs as a primary diagnosis (with or without comorbidities) were not generated during the literature search. The emerging use of resting-state paradigms may be an effective method for understanding associations between anxiety disorders. Targeted studies of PD and SPs, meta-analyses of the studies conducted to date, and studies of the impact of specific comorbid presentations, are recommended future research directions.
Incentives and Disincentives for the Treatment of Depression and Anxiety: A Scoping Review
Authors: Ashcroft Rachelle , Silveira Jose , Rush Brian , McKenzie Kwame
Published: July 2017

Objective:

There is widespread support for primary care to help address growing mental health care demands. Incentives and disincentives are widely used in the design of health care systems to help steer toward desired goals. The absence of a conceptual model to help understand the range of factors that influence the provision of primary mental health care inspired a scoping review of the literature. Understanding the incentives that promote and the disincentives that deter treatment for depression and anxiety in the primary care context will help to achieve goals of greater access to mental health care.

Method:

A review of the literature was conducted to answer the question, how are incentives and disincentives conceptualized in studies investigating the treatment of common mental disorders in primary care? A comprehensive search of MEDLINE, PsycINFO, CINAHL, and Google Scholar was undertaken using Arksey and O'Malley's 5-stage methodological framework for scoping reviews.

Results:

We identified 27 studies. A range of incentives and disincentives influence the success of primary mental health care initiatives to treat depression and anxiety. Six types of incentives and disincentives can encourage or discourage treatment of depression and anxiety in primary care: attitudes and beliefs, training and core competencies, leadership, organizational, financial, and systemic.

Conclusions:

Understanding that there are 6 different types of incentives that influence treatment for anxiety and depression in primary care may help service planners who are trying to promote improved mental health care.
Meta-Cognitions in Tourette Syndrome, Tic Disorders, and Body-Focused Repetitive Disorder
Authors: O'Connor Kieron , St-Pierre-Delorme Marie-Ève , Leclerc Julie , Lavoie Marc , Blais Mélodie T
Published: July 2017

Objective:

To explore if self-reported presence of thinking about tics or body-focused repetitive behaviours (BFRBs; gests) are direct triggers of tic or gest onset in 3 groups: Tourette syndrome (TS; n =18), persistent chronic tic disorders (TDs; n = 42), and a comparison group with BFRB ( n = 36).

Method:

The 3 groups completed a thinking about tics inventory, listing 22 items derived from clinician consensus that asked whether thoughts always, sometimes, or never exclusively triggered tic onset. Other questionnaires measured mood, perfectionism, impulsivity, premonitory urge, and self-rated tension. Sixty-three participants completed the inventory twice, and the inventory was completed pre- and post-behavioural intervention by a further 54.

Results:

The ranking of the thoughts reported as likely to trigger tics or gests was positively correlated across TD and BFRB groups. Exploratory principal components analysis of a reduced 12-item set (the thinking about tics inventory) in TS and TD groups revealed that such thoughts could be grouped into 3 separate subscales: thoughts about the interference of tics or gests, thoughts anticipating tics or gests, and thoughts about whether the person has permission to perform the tic or the gest. The 3 sets of subscales showed good and acceptable internal consistency and overall score showed good test–retest reliability, suggesting thoughts about tics or gests are robust and measurable. The subscales correlated with impulsivity, tic or behaviour severity, and ratings of frequency decreased post-behavioural treatment.

Conclusions:

Thinking about tics or gests is reported as triggering tics or gests in both TD and BFRB, and meta-cognition seems independent of premonitory sensations and relates to distinct clinical characteristics in each clinical group.
Male Inmate Profiles and Their Biological Correlates
Authors: Horn Mathilde , Potvin Stephane , Allaire Jean-François , Côté Gilles , Gobbi Gabriella , Benkirane Karim , Vachon Jeanne , Dumais Alexandre
Published: July 2017

Objective:

Borderline and antisocial personality disorders (PDs) share common clinical features (impulsivity, aggressiveness, substance use disorders [SUDs], and suicidal behaviours) that are greatly overrepresented in prison populations. These disorders have been associated biologically with testosterone and cortisol levels. However, the associations are ambiguous and the subject of controversy, perhaps because these heterogeneous disorders have been addressed as unitary constructs. A consideration of profiles of people, rather than of exclusive diagnoses, might yield clearer relationships.

Methods:

In our study, multiple correspondence analysis and cluster analysis were employed to identify subgroups among 545 newly convicted inmates. The groups were then compared in terms of clinical features and biological markers, including levels of cortisol, testosterone, estradiol, progesterone, and sulfoconjugated dehydroepiandrosterone (DHEA-S).

Results:

Four clusters with differing psychiatric, criminal, and biological profiles emerged. Clinically, one group had intermediate scores for each of the tested clinical features. Another group comprised people with little comorbidity. Two others displayed severe impulsivity, PD, and SUD. Biologically, cortisol levels were lowest in the last 2 groups and highest in the group with less comorbidity. In keeping with previous findings reported in the literature, testosterone was higher in a younger population with severe psychiatric symptoms. However, some apparently comparable behavioural outcomes were found to be related to distinct biological profiles. No differences were observed for estradiol, progesterone, or DHEA-S levels.

Conclusions:

The results not only confirm the importance of biological markers in the study of personality features but also demonstrate the need to consider the role of comorbidities and steroid coregulation.
An Updated Meta-Analysis of Randomized Controlled Evidence for the Effectiveness of Community Treatment Orders
Authors: Kisely Steve , Hall Katharine
Published: July 2017

Objectives:

It is unclear whether community treatment orders (CTOs) for people with severe mental illnesses can reduce health service use, or improve clinical and social outcomes. Randomized controlled trials of CTOs are rare because of ethical and logistical concerns. This meta-analysis updates available evidence.

Method:

A systematic literature search was performed of the Cochrane Schizophrenia Group Register, Science Citation Index, PubMed, MEDLINE, and Embase to November 2013. Inclusion criteria were studies comparing CTOs with standard care including those where control subjects received voluntary care, for most of the trial.

Results:

Three studies provided 749 subjects for the meta-analysis. Two compared compulsory treatment with entirely voluntary care, while the third had control subjects receiving voluntary treatment for the bulk of the time. Compared with control subjects, CTOs did not reduce readmissions (risk ratio 0.98, 95% CI 0.82 to 1.16) or bed days (mean difference [MD] −16.36; 95% CI −40.8 to 8.05) in the subsequent 12 months ( n = 749). Moreover, there were no significant differences in psychiatric symptoms (standardized MD −0.03; 95% CI −0.25 to 0.19; n = 331) or the Global Assessment of Functioning (MD −1.36; 95% CI −4.07 to 1.35; n = 335). Only including the 2 studies that compared compulsory treatment with entirely voluntary care made no difference to the results.

Conclusions:

CTOs may not lead to significant differences in readmission, social functioning, or symptomatology, compared with standard care. Their use should be kept under review.
Expanding and Clarifying the Role of Emotion Regulation in Nonsuicidal Self-Injury
Authors: Andover Margaret S , Morris Blair W
Published: July 2017

Objective:

Deficits in emotion regulation have been implicated in nonsuicidal self-injury (NSSI) by both theory and research. Research indicates that NSSI is commonly performed as an emotion regulation strategy, as it often decreases the experience of negative affect. People who engage in NSSI often report greater emotion dysregulation than those without an NSSI history. Further, interventions that have demonstrated effectiveness in reducing NSSI involve a focus on emotion regulation skills. Given the important role of emotion regulation in NSSI, research should continue to develop our understanding of this construct.

Methods:

We conducted a review of relevant research in emotion regulation and dysregulation and specific emotion regulation strategies in NSSI.

Results:

First, we provide an overview of current research on emotion regulation and dysregulation in NSSI. Second, we discuss the application of a specific emotion regulation model to NSSI research, and review research on NSSI supporting the use of this model.

Conclusion:

NSSI has been associated with an emotion regulation function and trait emotion dysregulation among people who self-injure. Relevant research provides initial support for the applicability of a specific model of emotion regulation to NSSI. We suggest directions for future research to continue to cultivate our understanding of emotion regulation in NSSI.
Treating Nonsuicidal Self-Injury: A Systematic Review of Psychological and Pharmacological Interventions
Authors: Turner Brianna J , Austin Sara B , Chapman Alexander L
Published: July 2017

Objective:

Nonsuicidal self-injury (NSSI), the deliberate, self-inflicted damage of bodily tissue without the intent to die, is associated with various negative outcomes. Although basic and epidemiologic research on NSSI has increased during the last 2 decades, literature on effective interventions targeting NSSI is still emerging. Here, we present a comprehensive, systematic review of existing psychological and pharmacological treatments designed specifically for NSSI, or including outcome assessments examining change in NSSI.

Method:

We conducted a systematic search of PsycINFO, MEDLINE, and ERIC databases to retrieve relevant articles that met inclusion criteria; specifically, uncontrolled and controlled trials that 1) presented quantitative outcome data on NSSI, and 2) clearly differentiated NSSI from suicidal self-injury (SSI). Consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, definition of NSSI, we excluded studies examining populations with developmental or intellectual disabilities, or with psychotic disorders.

Results:

Several interventions appear to hold promise for reducing NSSI, including dialectical behaviour therapy, emotion regulation group therapy, manual-assisted cognitive therapy, dynamic deconstructive psychotherapy, atypical antipsychotics (aripiprazole), naltrexone, and selective serotonin reuptake inhibitors (with or without cognitive-behavioural therapy). Nevertheless, there remains a paucity of well-controlled studies investigating treatment efficacy for NSSI.

Conclusions:

Structured psychotherapeutic approaches focusing on collaborative therapeutic relationships, motivation for change, and directly addressing NSSI behaviours seem to be most effective in reducing NSSI. Medications targeting the serotonergic, dopaminergic and opioid systems also have demonstrated some benefits. Future studies employing controlled designs as well as a clear delineation of NSSI and SSI will improve knowledge regarding treatment effects.
Collaborative Care for Psychiatric Disorders in Older Adults: A Systematic Review
Authors: Dham Pallavi , Colman Sarah , Saperson Karen , McAiney Carrie , Lourenco Lillian , Kates Nick , Rajji Tarek K.
Published: July 2017

Objective:

To evaluate the mode of implementation, clinical outcomes, cost-effectiveness, and the factors influencing uptake and sustainability of collaborative care for psychiatric disorders in older adults.

Design:

Systematic review.

Setting:

Primary care, home health care, seniors’ residence, medical inpatient and outpatient.

Participants:

Studies with a mean sample age of 60 years and older.

Intervention:

Collaborative care for psychiatric disorders.

Methods:

PubMed, MEDLINE, Embase, and Cochrane databases were searched up until October 2016. Individual randomized controlled trials and cohort, case-control, and health service evaluation studies were selected, and relevant data were extracted for qualitative synthesis.

Results:

Of the 552 records identified, 53 records (from 29 studies) were included. Very few studies evaluated psychiatric disorders other than depression. The mode of implementation differed based on the setting, with beneficial use of telemedicine. Clinical outcomes for depression were significantly better compared with usual care across settings. In depression, there is some evidence for cost-effectiveness. There is limited evidence for improved dementia care and outcomes using collaborative care. There is a lack of evidence for benefit in disorders other than depression or in settings such as home health care and general acute inpatients. Attitudes and skill of primary care staff, availability of resources, and organizational support are some of the factors influencing uptake and implementation.

Conclusions:

Collaborative care for depressive disorders is feasible and beneficial among older adults in diverse settings. There is a paucity of studies on collaborative care in conditions other than depression or in settings other than primary care, indicating the need for further evaluation.
The New Principle-policy Gap: How Diversity Ideology Subverts Diversity Initiatives
Authors: Smith Candis Watts , Mayorga-Gallo Sarah
Published: July 2017

Colorblind ideology is a dominant mode of thinking about race matters in the United States, but it is not the only racial ideology that operates today. The United States appears to be shifting toward becoming more race conscious. We add to the critical diversity studies literature, and argue that even though we see a greater appreciation for the presence of nonwhite bodies in various spaces, we are not likely to see real systemic change in the American racial hierarchy because of a reliance on diversity ideology. Through an analysis of semistructured interviews with 43 white Millennials, this article outlines the ways in which diversity ideology’s four tenets—diversity as acceptance, commodity, intent, and liability—help whites maintain power in multiracial spaces. This article pinpoints how whites employ these tenets to subvert policy efforts that aim to incorporate people of color into predominately white institutions, introducing a new principle-policy gap for the twenty-first century.
Evaluating the Psychometric Properties of the Original Grit Scale Using Rasch Analysis in an Arab Adolescent Sample
Authors: Areepattamannil Shaljan , Khine Myint Swe
Published: July 2017

This study examined the psychometric properties of the Original Grit Scale using Rasch analysis in a sample of 777 adolescents hailing from a collectivistic society, one of the Arab states of the Persian Gulf. Results of the Rasch analysis provided support for the appropriateness of the Original Grit Scale as a measure of one of the noncognitive skills, grit, among adolescents in the Arab Gulf State. Implications of the findings are briefly discussed.
Conflict/Proximity Determine Advocacy Group Coverage
Authors: McCluskey Michael , Kim Young Mie
Published: July 2017

In an analysis of stories about advocacy organizations, prominent story placement is linked to the news values of conflict and proximity. Thus, stories about advocacy groups' conflict with local and state governments receive more prominent placement.
Incivility Dominates Online Comments on Immigration
Authors: Santana Arthur D.
Published: July 2017

An analysis of reader comments on the sites of three online newspapers in border states finds a much higher percentage of uncivil comments following stories about immigration than those following stories about the Tea Party.
Non-Scientist Sources Lend Balance, but Create Bias
Authors: Opt Susan , Low Russanne
Published: July 2017

This study finds North Carolina newspaper coverage of sea-level rise tends to reflect the national media trend of emphasizing the scientific consensus that climate change and sea-level rise are real. Bias appears, though, through use of non-scientific sources.
Do Independent Women Participate in Demonstrations More? Empowerment and Politics in Predicting Activism Among Mexican Women
Authors: Albarracin Julia , Munier Nathan , Bail Kristin
Published: July 2017

The influence of Latinos on all aspects of the American political landscape has increased dramatically in recent years. However, research on political participation among Latinas has been scarce. This study examined the factors influencing participation in protests, a type of nonelectoral political behavior, among Mexican women. This research was based on surveys with 290 Mexican women from the Chicago area and explored the role of their levels of economic, social, and household empowerment in explaining participation in protests. After controlling for a number of demographic and political factors, it was found that women with higher levels of social and household empowerment were more likely to participate in protests. More specifically, women who did not need permission from their husbands to leave their house and those who had fewer domestic chores were more active in protests.
Correction of Chin Ptosis by Transposition Technique
Authors: Chong John
Published: July 2017

Chin ptosis occurring as a result of aging is corrected here by fibrous fat transposition technique.

The step-by-step surgical procedure is described and the important landmarks and surgical points are emphasized for the success of this technique.
A Nine-Year Experience with Autologous Fat Transplantation
Authors: Bircoll Mel
Published: July 2017

When I first introduced the concept of autologous fat transplantation (AFT) in 1984, many professionals responded with enthusiasm. Others, far more vocal, responded with skepticism and derision. This latter response was similar to the one received by liposuction when it was first introduced.

Now, nine years later, AFT is used worldwide for a variety of cosmetic and reconstructive procedures. Its use has stimulated the study of injectable autologous materials, and the development of other autologous materials such as injectable collagen. It is indeed a procedure that points a way to the future.
Constricted Breast Deformity in Augmentation Mammoplasty
Authors: Yvorchuk William
Published: July 2017

There has been a resurgence in the demand for elective breast enhancement over the latter portion of this decade. Endoscopic technology has expanded the techniques available for breast augmentation, and treatment programs for a number of breast deformities have been elucidated.

The constricted and tuberous breast deformities have previously been defined, but there appears to be a lack of recognition of minor variations of the constricted breast deformity and, to date, there has been no satisfactory clinical classification of this relatively common entity.

A proposal for the classification of the constricted breast deformity is presented along with a recommendation on the possible treatment for different variations of the deformity.
Rejuvenation of the Acne-Scarred Face
Authors: Silverton Kimball , Fulton James E.
Published: July 2017

Since the 1950s, dermaplaning has been used to improve acne scars. However, global improvement is often limited and remains about 50%. By combining the techniques of subcision, subcutaneous filling, laser shrinkage of collagen, dermabrasion, and excision of acne scars, we hoped to achieve a more pleasing aesthetic result. After preconditioning the skin of 62 patients (ages 17—47, mean age 32; 22 men and 40 women) with vitamin A/glycolic conditioning lotions, a Jessner/TCA peel was performed on the neck and décolletage area. The periorbital areas were also peeled if they were not photoaged. The acne valleys were subcised with a semiblunt needle, and the developed pockets were filled with adipose tissue. Then, the surface skin was vaporized with three passes of a CO2 laser, and the deeper acne scars in the midface region were sanded with a diamond fraise abrasion. Remaining scars were relasered, excised, or both, and sutured or grafted. To facilitate healing, a semiocclusive dressing was used for 5 days, then replaced with an ointment-based moisturizer for another 5 days. After 10 days, a moisturizer–sunscreen was used, followed by a bleaching cream at 15 days, if necessary. Patients were usually back to work in 2 weeks. By combining these multiple modalities of dermal subcision and augmentation, collagen shrinkage, and dermal sanding, dramatic improvement of the acne-scarred face was possible.
Moyamoya Disease in Children: Results From the International Pediatric Stroke Study
Authors: Lee Sarah , Rivkin Michael J. , Kirton Adam , deVeber Gabrielle , Elbers Jorina
Published: July 2017

This study aimed to describe children with moyamoya disease from an international multicenter stroke database, and explore risk factors for stroke recurrence. We reviewed data of children >28-days old with moyamoya disease enrolled in the International Pediatric Stroke Study from January 2003 to March 2013. A total of 174 children from 32 sites and 14 countries had moyamoya disease; median age 7.4 years, 49% male. Of these, 90% presented with ischemic stroke, 7.5% with transient ischemic attack, and 2.5% with hemorrhagic stroke. One-third of patients had moyamoya syndrome. Stroke recurrence was 20% over median follow-up of 13 months; 9% had multiple recurrences. Children treated with surgical revascularization were less likely to have stroke recurrence ( P = .046). Moyamoya disease accounted for 8% of arterial strokes in this international pediatric stroke registry. One-third of pediatric patients with moyamoya disease have an underlying syndromic condition. Surgical revascularization is effective at reducing the incidence of stroke recurrence.
Micronutrient Alterations During Continuous Renal Replacement Therapy in Critically Ill Adults: A Retrospective Study
Authors: Kamel Amir Y. , Dave Nisha J. , Zhao Vivian M. , Griffith Daniel P. , Connor Michael J. , Ziegler Thomas R.
Published: July 2017

Background: Continuous renal replacement therapy (CRRT) is commonly used to provide renal replacement therapy in the intensive care unit. Limited published data suggest that CRRT may lead to depletion of water‐soluble vitamins and trace elements. The goal of this study was to identify the incidence of trace element and vitamin deficiencies in critically ill patients during CRRT. Materials and Methods: This study is based on a retrospective chart review of patients who were referred to Emory University Hospital’s nutrition support services and had at least 1 serum micronutrient level measured during CRRT (thiamin, pyridoxine, ascorbic acid, folate, zinc, and copper) between April 1, 2009, and June 1, 2012. Results: Seventy‐five patients were included in the study. Nine of 56 patients (16%) had below‐normal whole blood thiamin concentrations, and 38 of 57 patients (67%) had below‐normal serum pyridoxine levels. Serum ascorbic acid and folate deficiencies were identified among 87% (13 of 15) and 33% (3 of 9) of the study patients, respectively. Nine of 24 patients had zinc deficiency (38%), and 41 of 68 patients had copper deficiency (60%). Of the 75 total subjects, 60 patients (80%) had below‐normal levels of at least 1 of the micronutrients measured. Conclusions: The incidence of various micronutrient deficiencies in critically ill patients who required CRRT was higher than previously reported. Prospective studies are needed to determine the impact of CRRT on micronutrient status and the potential clinical and metabolic efficacy of supplementation in the intensive care unit setting.
Prevalence of Home Parenteral and Enteral Nutrition in the United States
Authors: Mundi Manpreet S. , Pattinson Adele , McMahon Megan T. , Davidson Jacob , Hurt Ryan T.
Published: July 2017

Background: Malnutrition is highly prevalent and associated with increased morbidity and mortality. Studies continue to reveal significant clinical benefits with nutrition support, including improved wound healing, reduction in complications and length of stay, and mortality. Due to these benefits, the prevalence of home parenteral and enteral nutrition (HPEN) continues to increase worldwide. In the United States, given our healthcare insurance landscape, it has been very difficult to ascertain the true prevalence of HPEN. Methods: Medicare beneficiary data for 2013 were obtained from Centers for Medicare and Medicaid Services. Commonly used Healthcare Common Procedure Coding System codes were used for home enteral nutrition (HEN) and home parenteral nutrition (HPN). Data regarding number of patients and insurance providers were also obtained from 3 of the largest home infusion providers in the United States (Coram CVS, Option Care Enterprises, and BioScrip Inc). Based on the ratio of Medicare to non‐Medicare billing, an estimate of HPEN prevalence was obtained. Results: For 2013, there were 6778 Medicare beneficiaries for HPN and 114,287 for HEN. The ratio of Medicare to non‐Medicare was 0.271 for HPN and 0.261 for HEN, leading to an estimated prevalence of 25,011 patients receiving HPN (79 per million U.S. inhabitants) and 437,882 patients receiving HEN (1385 per million U.S. inhabitants). There are an estimated 4129 pediatric patients and 20,883 adult patients receiving HPN; for HEN, 189,036 pediatric patients and 248,846 adult patients. Conclusion: Compared with results from 1992, the prevalence of HEN has increased dramatically, while the prevalence of HPN has declined.
Diagnostic Yield and Outcomes of Computed Tomography of the Head in Critically Ill Nontrauma Patients
Authors: Finkelmeier Fabian , Walter Sophie , Peiffer Kai-Henrik , Cremer Anjali , Tal Andrea , Vogl Thomas , Zeuzem Stefan , Fichtlscherer Stephan , Friedrich-Rust Mireen , Bojunga Jörg , Farnik Harald
Published: July 2017

Background:

Computed tomography of the head (HCT) is a widely used diagnostic tool, especially for emergency and trauma patients. However, the diagnostic yield and outcomes of HCT for patients on medical intensive care units (MICUs) are largely unknown.

Methods:

We retrospectively evaluated all head CTs from patients admitted to a single-center MICU during a 5-year period for CT indications, diagnostic yield, and therapeutic consequences. Uni- and multivariate analyses for the evaluation of risk factors for positive head CT were conducted.

Results:

Six hundred ninety (18.8%) of all patients during a 5-year period underwent HCT; 78.7% had negative CT results, while 21.3% of all patients had at least 1 new pathological finding. The main indication for acquiring CT scan of the head was an altered mental state (AMS) in 23.5%, followed by a new focal neurology in 20.7% and an inadequate wake up after stopping sedation in 14.9% of all patients. The most common new finding was intracerebral bleeding in 6.4%. In 6.7%, the CT scan itself led to a change of therapy of any kind. Admission after resuscitation or a new focal neurology were independent predictors of a positive CT. Psychic alteration and AMS were both independent predictors of a higher chance of a negative head CT. Positive HCT during MICU is an independent predictor of lower survival.

Conclusions:

New onset of focal neurologic deficit seems to be a good predictor for a positive CT, while AMS and psychic alterations seem to be very poor predictors. A positive head CT is an independent predictor of death for MICU patients.
Do Economic Profit Companies Walk Their Compensation Talk?
Authors: Farris Paul W. , Haskins Mark E. , Pfeifer Phillip E.
Published: July 2017

This article reports the results of an analysis of a matched sample of companies that use economic profit (EP) as part of their criteria for awarding incentive compensation for their Named Executive Officers (NEO) compared with competitor firms that do not (non-EP firms). Companies using EP display stronger relationships between changes in estimated EP and changes in yearly NEO average total compensation. A number of other financial metrics are compared between the two samples. Interestingly, the within sample, cross-firm analyses show weaker relationships between compensation and estimated EP for EP firms than for non-EP firms. This weaker relationship may be due to an unobservable, underlying factor stimulating a company’s adoption of EP as a criterion for the incentive compensation part of yearly NEO average total compensation.