To compare clinical characteristics of older and younger patients with bipolar disorder enrolled in the United States' National Network of Depression Centers (NNDC) Clinical Care Registry (CCR). Multicenter, de-identified naturalistic... more
To compare clinical characteristics of older and younger patients with bipolar disorder enrolled in the United States' National Network of Depression Centers (NNDC) Clinical Care Registry (CCR). Multicenter, de-identified naturalistic data from the National NNDC's CCR for all patients with a diagnosis of bipolar disorder who were enrolled in the registry as of April 25, 2013. Community-dwelling patients (N = 218), ages 18 years or older, with bipolar disorder diagnosis recruited by NNDC-affiliated medical centers to participate in the NNDC CCR. Subjects aged 55 years or older were compared with subjects younger than age 55 years on clinical measures. Patient Health Questionnaire; Quick Inventory of Depressive Symptomatology - Self-Report; Altman Self-Rating Mania Scale; Work and Social Adjustment Scale; Frequency and Intensity of Burden of Side Effects Rating; and the Self-Administered Comorbidity Questionnaire. A greater percentage of older patients were prescribed antidepr...
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Of the many technologies used by the Canadian Salmonid Enhancement Program (SEP, established in 1979), hatcheries have been a major tool used to increase the freshwater survival of selected wild, native stocks of coho, chinook and chum... more
Of the many technologies used by the Canadian Salmonid Enhancement Program (SEP, established in 1979), hatcheries have been a major tool used to increase the freshwater survival of selected wild, native stocks of coho, chinook and chum salmon, both to address conservation concerns and to provide fishing opportunities. SEP hatcheries have contributed substantially to the fisheries for coho and chum
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The objective of this study was to obtain a direct estimate of the prevalence of depression, its associated factors, and rates of treatment among residents of assisted living (AL) facilities in central Maryland. One hundred ninety-six AL... more
The objective of this study was to obtain a direct estimate of the prevalence of depression, its associated factors, and rates of treatment among residents of assisted living (AL) facilities in central Maryland. One hundred ninety-six AL residents were recruited from 22 (10 large and 12 small) randomly selected AL facilities in the city of Baltimore and seven Maryland counties. Chart review, staff and family history, comprehensive in-person resident evaluation, and the Cornell Scale for Depression in Dementia (CSDD) were administered by an experienced team of geriatric psychiatry clinicians. Those scoring >7 on the CSDD, a cut point repeatedly associated with poor outcomes, were considered clinically depressed. Participants had an average age of 86 years, most were female and widowed, and 68% met consensus criteria for dementia. Twenty-four percent (47 of 196) of the sample was depressed. In bivariate analyses, depression was significantly related to medical comorbidity, need for...
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The health care system is a complex and demanding environment requiring an acculturation process for all those who provide services under its aegis. Social workers new to a medical setting, are faced with difficulties relating to all... more
The health care system is a complex and demanding environment requiring an acculturation process for all those who provide services under its aegis. Social workers new to a medical setting, are faced with difficulties relating to all aspects of their role: bureaucratic, professional and clinical. In an attempt to ease their entry into the health care system, five social work administrators, employed by the largest HMO in Israel, structured and facilitated an off-site orientation program for new workers. A core group of 22 social workers participated in the program, and in the final session, the participants evaluated the course verbally and in an anonymous closed questionnaire. Feedback was mixed and included the participants dissatisfaction with the reduction of the experiential component of the sessions.
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Strategies are needed to effectively improve the management of depression in Germany. Can telephone case management (TCM) be a promising strategy to improve depression care in the German health-care system? A systematic literature review... more
Strategies are needed to effectively improve the management of depression in Germany. Can telephone case management (TCM) be a promising strategy to improve depression care in the German health-care system? A systematic literature review in PubMed, Cochrane Library, ISI Web of Science, PsycINFO and PSYNEXplus for randomised controlled trials (RCT) that evaluate TCM was carried out. Ten RCTs that compared TCM to treatment as usual were found. TCM was more effective in reducing depressive symptoms and in increasing satisfaction with care than treatment as usual. Whether TCM was capable of significantly improving pharmacotherapy compliance remained controversial. The effectiveness of TCM seemed to be related to the health-care system structure in which it was implemented. Most studies on TCM were conducted in US-American Health Maintenance Organizations. Thus, it is unclear to what extent these results can be transferred to the German health system. However, in the light of the promising results of these studies it seems to be worthwhile to test TCM also under conditions of the German health-care system.
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A course on the doctor and his feelings was presented as part of a programme for family medicine residents. The course was led by family physicians and behavioural science professionals who taught as an integrated team. Various teaching... more
A course on the doctor and his feelings was presented as part of a programme for family medicine residents. The course was led by family physicians and behavioural science professionals who taught as an integrated team. Various teaching techniques were utilized to highlight emotional aspects of the doctor-patient relationship to inexperienced residents. Pre- and post-course assessments suggested there were benefits in a short intensive course of this nature. Possible explanations for the findings are discussed.
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R eceived wisdom tells us that America's modern welfare state did not start until the Social Security Act of 1935. Although there are many problems with this view (see Skocpol 1992), its most obvious omission has to do with... more
R eceived wisdom tells us that America's modern welfare state did not start until the Social Security Act of 1935. Although there are many problems with this view (see Skocpol 1992), its most obvious omission has to do with "mothers' pen-sions," the forerunner of the Aid to Dependent ...