Comprehensive Treatment Program Research Articles

ENHANCE: Evidence for the efficacy of a comprehensive intervention program to promote subjective well-being.

Building from the growing empirical science of happiness, or subjective well-being (SWB), we have developed a 12-week comprehensive intervention program-Enduring Happiness and Continued Self-Enhancement (ENHANCE)-to increase SWB and enable a thorough examination of the mechanistic processes of program content and administrative structure for SWB change over time. In a randomized controlled trial, participants (N = 155; 55 using the in-person format, 100 online format) were randomly assigned to participate in ENHANCE or to a waitlist control condition. All participants completed assessments of SWB, including non-self-report measures, and process variables at baseline, posttest, and follow-up (3 months). We found evidence supporting the efficacy of ENHANCE for increasing SWB, whether administered in-person or online. Furthermore, development of the skills targeted in the program (e.g., gratitude, mindfulness) accounted for SWB improvements. This study provides initial evidence that ENHANCE can promote SWB and offers insights regarding the processes involved in these changes. To bolster these findings, we present additional data (n = 74) from a fourth assessment showing within-person maintenance of SWB gains over 6 months in the original treatment condition (n = 39) and a replication of the immediate ENHANCE treatment effects in the waitlist condition (n = 36). We discuss potential avenues for the utilization of ENHANCE in basic research and applied disseminations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Can Curricular Intervention Increase Health Awareness and Produce Healthier Outcomes Among University Students?

Abstract Objectives Significance and objectives of this study is to (1) investigate influences of curricular intervention on student lifestyle choices using self reporting assessment tools including CCAPS instrument and (2) determine if a correlation exist between curricular intervention and an increase in healthy self reported evaluations and outcomes. Methods A Health Behavior Study was conducted by Healthy Campus 2020® a campus-wide comprehensive wellness intervention program. IRB approved health behavior surveys were disseminated to students (N = 645) investigating (co-) curricular intervention to assist with increasing health awareness among students. Counselors evaluated students (N = 101) using Counseling Center Assessment of Psychological Symptoms (CCAPS) a high-quality multi-dimensional assessment tool with distinct subscales related to psychological and distress symptoms. Among the 8 subscales measured, responses to eating concerns were highlighted. Correlation between mental wellness and nutrition were observed. Coded responses were obtained and analyzed. Results Descriptive analytics and correlation coefficient are used to analyze data responses. Students enrolled in courses embedded with 8 STANDOUT® health principles (sunlight, temperance, rest, nutrition, water, outdoors, physical activity and trust) increased in the number of positive health behavior responses after one month. Responding to healthy # of steps an increase of 78% students indicated “yes” compared to one month prior and 90% of students achieved 2500 + steps/day. An 11% increase of students reported consuming healthier diets including recommended daily intake of fruits, vegetables and whole grains. CCAPS-62 results showed 44.5% of students reported positive responses to body image. A high % of students reported they do not engage in eating disorders including purging (92%) or refrain from eating (93.1%) to control their weight or feel better about themselves, respectively. Conclusions (Co-) Curricular intervention may have the ability to increase health awareness and produce healthier outcomes among university students. CCAPS can be used to assess students experiencing forms of depression or anxiety that may negatively impact their academic success. Funding Sources Funding for research conducted through HC2020® was provided by The Dept of Education Title III.

Driving Factors of Recent Vegetation Changes in Hexi Region, Northwest China Based on a New Classification Framework

Since other factors (soil properties, topography, etc.) under natural conditions are relatively invariant over one or two decades, climate variables (precipitation and temperature) and human activities are the two fundamental factors driving vegetation changes in global or large-scale areas. However, the combined effects of either single climatic factor and human activities on vegetation changes and the role of human activities itself in a specific region has not been fully discussed. In this study, the Hexi region, a typical dryland consisting of three inland river basins in northwest China was selected as a case area. A new classification framework combining Pearson correlation analysis and residual trend approach was proposed to assess their individual and conjoint contributions of climate variables and human activities in areas of significant vegetation changes. Our results indicated that most of vegetation covered areas in the Hexi region experienced significant changes during the period 2001−2017, and vegetation improvements were widespread except the interior of oases; significant changes in vegetation caused by human activities, precipitation, the interactions of precipitation and human activities, temperature, the interactions of temperature and human activities, the interactions of temperature and precipitation, and the interactions of the three factors accounted for 50.46%, 16.39%, 19.90%, 4.33%, 2.32%, 2.11%, and 4.49% of the total change areas, respectively. Generally, the influence of temperature was relatively weaker than that of precipitation, and the contributions of the interactions of climate variables and human activities on vegetation changes were greater than that of climate contributions alone. Moreover, the results of various investigations, according to the trends and the time of vegetation changes, indicate that decreasing trends of the normalized difference vegetation index (NDVI) in the Hexi region were chiefly attributed to the adjustments of agricultural planting structure while the comprehensive treatment programs implemented in river basins supported a large proportion of vegetation improvements.

Assessment of the Efficacy of a Mobile Phone-Delivered Just-in-Time Planning Intervention to Reduce Alcohol Use in Adolescents: Randomized Controlled Crossover Trial.

BackgroundInterventions to reduce alcohol use typically include several elements, such as information on the risks of alcohol consumption, planning for sensible drinking, and training of protective behavioral strategies. However, the effectiveness of these individual intervention elements within comprehensive programs has not been addressed so far, but it could provide valuable insights for the development of future interventions. Just-in-time interventions provided via mobile devices are intended to help people make healthy decisions in the moment and thus could influence health behavior.ObjectiveThe aim of this study was to test the proximal effects of a mobile phone–delivered, just-in-time planning intervention to reduce alcohol use in adolescents who reported recent binge drinking. The efficacy of this individual intervention element was tested within a comprehensive intervention program to reduce problem drinking in adolescents.MethodsThe study had an AB/BA crossover design, in which participants were randomly allocated to (1) a group receiving the planning intervention (A) in period 1 and assessment only (B) in period 2 or (2) a group receiving assessment only (B) in period 1 and the planning intervention (A) in period 2. The planning intervention included a text message to choose one of two predetermined if-then plans to practice sensible drinking with friends or when going out and a prompt to visualize the chosen plan. There was a washout period of at least 1 week between period 1 and period 2.ResultsOut of 633 program participants who recently binge drank, 136 (21.5%) were receptive in both periods of time and provided data on the proximal outcome, which was the number of alcoholic drinks consumed with friends or when going out. After the planning intervention, the number of alcoholic drinks consumed was approximately one standard drink lower compared with the finding without the intervention (P=.01).ConclusionsA mobile phone–delivered, just-in-time, if-then planning intervention to practice sensible drinking with friends or when going out is effective in reducing alcohol consumption among adolescents who report recent binge drinking. Based on the relatively low percentage of participants with self-reported receptivity for the planning intervention, measures to increase the population impact of similar planning interventions should be implemented and tested in future trials.Trial RegistrationISRCTN Registry ISRCTN52150713; http://www.isrctn.com/ISRCTN52150713

Violence and chronic pain in cancer patients in northeastern Mexico.

e24113 Background: Chronic cancer pain generates fear and anguish in cancer patients. It is suffered by 64% of patients with metastatic or terminal disease, 59% of patients in early and intermediate stages, and 33% of patients cured from cancer. They require a psychosocial support network. This network has been proposed as an essential tool to reduce the negative impact of the symptoms and psychosocial implications of cancer on the quality of life of patients. Patients with dysfunctional family networks can add to the pain of suffering cancer when they suffered or suffer violence. Cancer and pain test all personal resources and the patient's support network where family functioning is capital for quality of life. Methods: Descriptive, comparative and correlational study. A sample was taken for convenience with the prior consent of the patients who attend the outpatient clinic of the Pain Clinic of the Oncology Service, of the University Center Against Cancer of the University Hospital “Dr. José Eleuterio González” in Nuevo León. The questionnaires were applied during a session of 25 to 30 minutes. It was requested to answer the scales to assess the level of intra-family functioning, intra-family violence, quality of life, measuring psychosocial and health variables; as well as for the detection of the type and quality of psychosocial support perceived by the subjects. Results: A total of 207 research subjects were included in the study, the average age was 49 years of age (minimum 12, maximum 81 years of age), 23% men and 77% women. Marital status: married 52%, home-based 63%; monthly income less than $120 USD (n = 75, 37%). The quality of life index and chronic cancer pain had a high linear correlation with the variables of family violence, psychosocial support, family functioning, somatic symptoms, among other variables studied. Fatigue was the symptom most frequently associated with the decrease in the quality of life index. Conclusions: The satisfaction of perceived social support is a factor associated with the quality of life in patients with chronic cancer pain, however, the number of caregivers is not. There was no relationship between the size of the network and satisfaction with it. Also, the symptoms associated with chronic cancer pain affect the quality of life, identity, social functionality and roles, which in turn impact the quality of life perceived by the patient. This study supports our comprehensive intervention programs and new protocols to promote the quality of life of cancer patients.

Interventions for Pedohebephilic Arousal in Men Convicted for Sexual Offenses Against Children: A Meta-Analytic Review

Given the centrality of pedohebephilic interest in understanding sexual offending against children, several interventions have been developed to help men manage or inhibit their sexual arousal to children to reduce the intensity of their experience of such arousal. A meta-analytic review was conducted to examine the effectiveness of interventions for managing pedohebephilic arousal, as measured by phallometric testing. A systematic literature review identified 23 within-group design studies and 18 single-case design studies ( N = 1,071) for analysis. Behavioral and pharmacological interventions showed moderate to large effects for reducing pedohebephilic arousal. Moderator analyses suggest that men with high pretreatment pedohebephilic arousal showed the greatest reductions in arousal. Small effects were found for comprehensive treatment programs; none of the interventions had the effect of increasing sexual arousal to adults. These results support the effectiveness of behavioral and pharmacological interventions for managing pedohebephilic arousal in men convicted of sexual offenses against children.

Effectiveness of a comprehensive post-operative health education program in improving quality of life after gastric cancer surgery.

Patients with gastric cancer often experience postoperative problems such as dumping syndrome, abdominal cramps, and nausea, which have profound effects on their mental health and quality of life. Earlier studies have shown that comprehensive health education can dramatically improve the quality of life of cancer patients after surgery. Thus, in this study, we conducted a health education intervention program in patients who had undergone surgical treatment for gastric cancer and evaluated the effectiveness of this program in improving the postoperative quality of life, with an attempt to offer evidence for better postoperative management of gastric cancer patients. Totally, 80 patients with gastric cancer who underwent surgery at our center from February 2018 to February 2019 were equally divided into an observation group and control group according to the random number table method. The observation group was offered with interventions regarding health education, including disease awareness-raising, instructions on behavior and lifestyle, rehabilitation management, and mental health counseling, and the control group received the routine nursing intervention. The quality of life one month before and after surgery was assessed by using the Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-STO22. The baseline data and quality of life showed no significant differences between the observation group and the control group one month before surgery (both P>0.05). One month after the surgery, the scores of dysphagia, pain/discomfort, reflux symptoms, and emotional issues and overall score in the observation group decreased significantly (34.86±2.170, 38.66±3.08, 32.26±2.76, 49.55±4.20, and 54.26±7.03, respectively), which were also significantly lower than those in the control group (36.33±3.10, 44.29±3.72, 33.64±3.10, 53.56±3.25, and 60.17±7.28, respectively; all P<0.05). The comprehensive health education intervention program can effectively improve the quality of life in patients after gastric cancer surgery and deserves further application in clinical settings.

Effects and follow-up of a multimodal treatment program including intensive physical training for low back pain patients

The results of a comprehensive 4-week treatment program including intensive physical training were evaluated in 65 chronic low back pain patients. Marked increases in measures of spinal mobility, trunk muscle strength and lifting capacity were found during the treatment, but no average increase in pain ratings. At 3-week and 12-month follow-ups a statistically significant decrease in subjective disability and pain was found, but the percentage of patients who were working was unchanged. This points to a need for more work-oriented rehabilitation efforts in the treatment.

Assessing the effectiveness of a comprehensive menstrual health intervention program in Ugandan schools (MENISCUS): process evaluation of a pilot intervention study

BackgroundPoor menstrual health and hygiene (MHH) is a globally recognised public health challenge. A pilot study of an MHH intervention was conducted in two secondary schools in Entebbe, Uganda, over 9 months. The intervention included five components delivered by the implementing partner (WoMena Uganda) and the research team: (i) training teachers to implement government guidelines for puberty education, (ii) a drama skit to reduce stigma about menstruation, (iii) training in use of a menstrual kit (including re-usable pads), (iv) guidance on pain relief methods including provision of analgesics and (v) improvements to school water, sanitation and hygiene (WASH) facilities. The aim of the process evaluation was to examine implementation, context and possible causal pathways.MethodsWe collected information on fidelity, dose, reach, acceptability, context and mechanisms of impact using (i) quantitative survey data collected from female and male students in year 2 of secondary school (ages 13–21; 450 at the baseline and 369 at endline); (ii) qualitative data from 40 in-depth interviews with parents, teachers and female students, and four focus group discussions with students, stratified by gender; (iii) data from unannounced visits checking on WASH facilities throughout the study; and (iv) routine data collected as part of the implementation. Quantitative data were used primarily to assess fidelity, dose and reach. Qualitative data were used primarily to assess acceptability, context and possible mechanisms.ResultsBoth schools received all intervention elements that were delivered by the research team and implementing partner. The drama skit, menstrual kit and pain management intervention components were delivered with fidelity. Intervention components that relied on school ownership (puberty education training and WASH improvements) were not fully delivered. Overall, the intervention was acceptable to participants. Multilevel contextual factors including schools’ social and physical environment, and family, cultural and social factors influenced the acceptability of the intervention in the school setting. The intervention components reinforced one another, as suggested in our theoretical framework.ConclusionThe intervention was feasible to deliver and acceptable to the schools and students. We propose a full-scale cluster-randomised trial to evaluate the intervention, adding a school-based MHH leadership group to address issues with school ownership.Trial registrationClinicalTrials.gov NCT04064736. Registered August 22, 2019, retrospectively registered.

Improvement of Autism Symptoms After Comprehensive Intensive Early Interventions in Community Settings.

Background:Preschool children with autism in southern Sweden participated in a comprehensive Naturalistic Developmental Behavioral Intervention (NDBI) program.Aims:To evaluate the ongoing NDBI program by comparing the pre- and postintervention outcomes in terms of improved autism symptom severity.Method:The improvement of Autism Diagnostic Observation Schedule (ADOS-R) test results between baseline and evaluation among children participating in the NDBI program (n = 67) was compared with the results among children receiving community treatment as usual (n = 27) using analysis of covariance.Results:The study showed that children in the NDBI group improved their ADOS-R total scores between baseline and evaluation (−0.8 scores per year; 95% CI [−1.2, −0.4]), whereas no improvement was detected in the comparison group (+0.1 scores per year; 95% CI [−0.7, +0.9]). The change in the NDBI group versus the change in the comparison group was statistically significant after adjusting for possible confounders as well. Children in the NDBI group also significantly improved their ADOS severity scores, but the scores were not significantly different from those of the comparison group.Conclusions:The results from the current naturalistic study must be interpreted cautiously, but they do support earlier studies reporting on improvement of autism symptoms after early intensive interventions. Results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. The results do indicate that children with autism benefit from participating in early comprehensive intensive programs.

Chronic pelvic pain: from correct diagnosis to adequate therapy

Management of patients with chronic pelvic pain (CPP) is an actual interdisciplinary problem of modern clinical medicine. CPP is chronic or persistent pain lasting more than 6 months, which is located in the structures related to the male or female pelvis and is associated with negative cognitive, behavioral, and emotional consequences, as well as with lower urinary tract, bowel, and pelvic floor symptoms, and reproductive and sexual dysfunction. In accordance with the biopsychosocial model, CPP is the result of a dynamic interaction of biological, psychological and sociocultural factors. When diagnosing CPP, it is most acceptable to phenotype patients according to the UPOINTS classification. To implement the treatment strategy, it is necessary to adhere to a multidisciplinary personalized approach to pain management with active patient participation. Cognitive behavioral therapy (CBT) occupies an important place in the treatment of CPP. There is clinical and neurophysiological evidence of the efficiency of CBT in patients with CPP, a protocol has been developed for the combined use of CBT and physical therapy. CBT is recommended to be included in a comprehensive treatment and rehabilitation program for patients with CPP.

Risk factors for cardiovascular disease from a population-based screening study in Tianjin, China: a cohort study of 36,215 residents.

BackgroundCardiovascular disease (CVD) is a harmful disease that poses a serious threat to human life. By effectively controlling its risk factors, the occurrence and development of CVD can be reduced, and people’s health status and quality of life can be improved.MethodsA total of 36,215 participants were collected from participants of the Early Screening and Comprehensive Intervention Program for High Risk Population of Cardiovascular Disease in Tianjin on July 31, 2017. We analyzed the relationship between CVD risk and personal information, personal and family medical history, biochemical index, and physical fitness index using Pearson’s chi-squared test with and without Yates’s correction for continuity, and Fisher’s exact test. CVD risk-related factors were examined through logistic regression and decision tree analysis.ResultsA personal history of hypertension and apoplexy had a contingency coefficient with CVD risk of more than 0.3. A higher risk of CVD was also found to be associated with biochemical markers of cholesterol, low-density lipoprotein cholesterol, and blood sugar. Logistic regression analysis revealed 12 indicators to be influencing factors of CVD, including age, systolic blood pressure (SBP), diastolic blood pressure (DBP), and the number of people aged >90 in the family. Hypertension, SBP, BMI, cholesterol, and blood glucose were associated with five or more other indicators.ConclusionsThe prevalence of CVD risk factors in Tianjin residents is relatively high. Family disease history and individual physical fitness indicators need to be taken into account during CVD screening and intervention, to reduce the risk of CVD.

Anxiety and Depression among new entrants in a Medical College

Background: Depression is commonly reported by university students due to change in environment, academic demands, developing new relations and more financial freedom. If that professional course happens to be medical education, the transition is even more drastic. Studies have also shown that Quality of Life (QOL) is negatively affected by the presence of anxiety and depression. Aim: Present study aims to find the prevalence of anxiety, depression and stress among students who have recently joined medical college. Materials &amp; Method: This cross-sectional study was undertaken at Private medical college in north India. Depression, Anxiety and Stress Scale (DASS) was used for the data collection. MBBS students who have joined the institution in August 2019 were included in the study. Statistical Analysis Used: Data was entered in excel and analysed using Statistical Package for Social Science (SPSS) Version 21. Result: We found that almost half of the students who participated in the study had scores above 10 (meaning thereby depressed) on the depression scale, with 23.5% of respondents showing moderate or severe depression. Two-third students experienced anxiety, with 20% students having severe to very severe anxiety. Stress levels amongst the students were also high, with 47% of the students reporting stress. 3.4% students experienced severe or very severe stress. Conclusion: Medical students have high prevalence of stress, anxiety and depression. It is recommended that medical colleges should implement appropriate and timely measures to address students’ well-being and offer comprehensive intervention and preventive programs to help students cope with this transition phase.

Комплексный анализ применения фитопрепарата «пародонтоцид» в консервативном лечении больных хроническим генерализованным пародонтитом легкой степени

A comprehensive clinical and laboratory analysis of the use of the phytoremedy «Parodontocide» in the complex treatment of chronic periodontitis was carried out. «Parodontocide» contains sage oil, peppermint oil, sage oil, clove oil, allantoin, phenyl salicylate and it demonstrates a pronounced anti-inflammatory and repairing effect. It was well tolerated by the majority of patients, practically causing no adverse reactions and complications in comparison with other medications. That's precisely why «Parodontocide» can be used in a comprehensive treatment program for mild chronic periodontitis and in patients with intolerance to synthetic antiseptics as a part of monotherapy.

Language therapy outcomes in deaf children with cochlear implant using a new developed program: A pilot study

BackgroundCochlear implanted (CI) children have problems in most aspects of language and in particular with regards to grammar. Considering the lack of studies in the field of grammar treatment in CI children and bearing in the mind that CI children have the potential to develop language, the aim of the present study was to investigate the effect of treating grammar in CI children using a treatment grammar program. Methodologyfirst, the literature related to grammar were reviewed so as to extract different grammatical components for developing grammar treatment program and to make sentences for each element as well as to compile a manual for its implementation. Second, the validity of the sentences was examined using the Delphi method. Third, grammar treatment was performed on five CI children. Persian Developmental Sentence Scoring(PDSS) and Mean Length of Utterance(MLU) were used to evaluate them before and after treatment. ResultsFive grammatical classes were extracted, and the grammatical elements were classified in each category according to age. For all of the grammatical items, 2076 sentences were constructed. After applying the Delphi method, a total of 1936 sentences with Kendall's coefficient of concordance (W) of 71%, remained. Using this program, grammar treatment was effective in all five children. The PDSS and MLU increased in all five children during the treatment phase, which was confirmed by Percentage of Non-overlapping Data (PND), Improvement Rate Difference (IRD). During the follow-up period, the children showed that they were able to maintain the trained components. ConclusionCochlear implants have the potential to learn language skills, and the present study confirms their ability to learn grammar, using a comprehensive grammar treatment program.

1E Improving the Image of Pain Care through Advanced Nursing Practice

Through innovation/transformational leadership, our APRN Pain Management Service (APRNPMS) had a goal of developing a model of care that met the JC 2018 Standards for Pain Mgt & provided patients with a comprehensive treatment program that improved comfort and decreased reliance on opioid medication. The APRNPMS recognized that patients lacked access to evidence based nonpharmacologic strategies in the hospital. Faced with the opioid epidemic & new JC 2018 Pain Standards, the PMS developed an action plan to expand services that improve patient comfort & decrease opioid use. An integrative pain management model empowers APRNs to collaborate with clinical nurses in EBP & research projects that add to the literature in this field. APRN service developed a SWOT analysis of the current service. Identifying strengths, weaknesses, opportunities & threats that enhance/impede the development of a robust team with a skill set to provide the integrative modalities patients may benefit from was necessary for this patient-centric model. Recognizing value of current staff, NP licensed acupuncturist, clinical nurse Homeopath & NP certified in hospice & palliative care, & clinical hypnosis, a vision for the APRNPMS was born. The APRNs have built relationships through collaborative working groups to empower clinical nurses to engage in research & EBP projects providing options to their patients without contributing to the opioid epidemic. Evaluation/Outcomes are measured through compliance w/JC standards of Pain Management. Statistics will b presented. Empowering APRN autonomous practice & encouraging innovation in practice model development allows APRNs to use EBP to guide nursing practice and improves APRN satisfaction. Our model is an example of how to improve outcomes, decreases opioid reliance, promotes safety, & optimize healing & wellness.

Thinking inside the box: have we underestimated cardiac rehabilitation?

Cardiac rehabilitation (CR) is a comprehensive secondary intervention programme offered to select cardiac patients in order to educate them on their condition, modify cardiovascular risk factors and improve functional capacity. There is a large body of evidence demonstrating the extensive benefits

3:27 PM Abstract No. 75 Implementation of an automated patient follow-up system in a low-resource setting

Timely and consistent patient follow-up has been a challenge while establishing a comprehensive interventional radiology (IR) service and training program in Tanzania. Currently, trainees are responsible for personally calling patients at 1 and 3 months postprocedure. This arrangement has become increasingly burdensome as patient volume continues to grow, often requiring trainees to make up to 10 calls a day in addition to daily procedures and clinical duties. With Tanzanian mobile phone use increasing, an automated text-messaging follow-up system has been devised as a possible solution to this challenge. With no functioning electronic medical record in place, the new IR service has relied on REDCap for organizing and tracking procedural and patient data. Twilio, a REDCap compatible web service that can administer automated text-messaging surveys, is now being added to improve follow-up rates. Patients can respond with yes or no and add an explanation. Costs range from $0.04 to $0.09 per text, depending on the patient’s mobile carrier. A survey consisting of six questions was written in English and translated into Swahili. This survey was then built into the Twilio web app. Code was written in Python and PHP to allow for exchange of patient information and survey data between REDCap and Twilio. Tanzanian IR trainees will review survey results weekly and determine which patients require additional follow-up via phone call or clinic appointment. The automated follow-up system is scheduled to be fully operational by October 2019. Response rates and follow-up data for the first five months will be presented. Establishment of a new specialty in a low-resource setting requires creative solutions to ensure care is made available to as many patients as possible. Implementation of an automated text-messaging follow-up system may allow for more efficient allocation of resources and more effective and complete patient follow-up.

Annual Meeting to Offer Sessions on Suicide From Many Dimensions

Back to table of contents Previous article Next article APA & MeetingsFull AccessAnnual Meeting to Offer Sessions on Suicide From Many DimensionsMichael Myers, M.D.Michael MyersSearch for more papers by this author, M.D.Published Online:4 Feb 2020https://doi.org/10.1176/appi.pn.2020.2a34AbstractSuicide will once again be a prominent topic at APA’s Annual Meeting in response to the rising numbers of deaths by suicide.APA’s Annual Meeting is always replete with state-of-the-art updates on psychiatric dimensions of suicide. This year is no exception. What follows is a list of some of the many offerings. It is far from exhaustive, so I urge anyone attending the meeting to keep abreast of the full program. (Please note that attendees must register for courses and pay an additional fee.)“Dissemination and Implementation of an Evidence-Based Care for Suicide Attempters in Japan” with APA President Bruce Schwartz, M.D., and his expert collaborators from Japan. This Presidential Session will have great appeal to many American and international psychiatrists attending the meeting.“Responding to the Impact of Suicide in Clinicians” with Eric Plakun, M.D., and Jane Tillman, Ph.D. This is a popular and annual interactive session by two seasoned clinicians.“Therapeutic Risk Management of the Suicidal Patient” with Hal Wortzel, M.D., and Bridget Matarazzo, Psy.D., and “Evidence-Based Treatment Approaches for Suicidal Adolescents” with Michele Berk, Ph.D., and Stephanie Clarke, Ph.D. These sessions are presented by APA Publishing authors, who always draw a large attendance.“What Do I Do Now? The Development of a Clinical Pathway for Children and Adolescents With Identified Suicide Risk” with Stephen Soffer, Ph.D., Jason Lewis, Ph.D., O’Nisha Lawrence, M.D., Yesenia Marroquin, Ph.D., and Tami D. Benton, M.D. The presenters will describe the rationale and need for a clinical pathway to support a practice with children and adolescents at risk for suicide, review the process for developing a clinical pathway, and guide the audience through the flow of the clinical pathway.“Data Versus Diatribe and the Depiction of Suicide in the News Media” with Mira Zein, M.D., M.P.H., Jessica Gold, M.D., M.S., Diana Robinson, M.D., Abhisek Chandan Khandai, M.D., M.S., and Laura Pientka, D.O. Attendees will meet in small groups to discuss the relationship between psychiatrists and the media, including safe reporting guidelines and reducing contagion.“Firearms and Suicide Prevention: Why We Should Ask About Guns and How to Do It” with Marian Rain, M.D., Meagan Patricia Whitney, M.D., Theresa Raquel De Freitas Nicholson, M.D., and “Suicide and Firearms: What Do We Know and What Do We Do” with Ahmad Hameed, M.D., Kathleen Clare Dougherty, M.D., and Usman Hameed, M.D. Over 22,000 people die by firearm suicide each year in the United States—a public health crisis in which psychiatrists can play a prominent role in the effort to end it.“Dynamic Therapy With Self-Destructive Borderline Patients: An Alliance-Based Intervention for Suicide” with Eric Plakun, M.D., and Samar Habl, M.D. This session will cover nine practical principles to establish and maintain a therapeutic alliance in the psychodynamic psychotherapy of self-destructive borderline patients.“Developing a Suicide-Specific Treatment Program in Your Health Care Setting” with Kathleen Crapanzano, M.D., and Raymond Tucker, Ph.D. They will focus on the importance of integrating a comprehensive suicide-specific treatment program into mental health care settings.“The Suicidal Patient: Principles and Practice of Assessment, Treatment, and Care Management” with Kirk Strosahl, Ph.D., John Chiles, M.D., and Laura Roberts, M.D., M.A. This master course is a comprehensive, day-long course that will appeal to attendees irrespective of career stage. Participants will learn about the difficulties inherent in both predicting and preventing suicide, with the aim of refocusing their clinical attention on aspects of the patient’s presentation that are more amenable to direct intervention.“Imminent Suicide Risk Assessment in High-Risk Individuals Denying Suicidal Ideation or Intent: Introduction and Training” with Igor Galynker, M.D., Ph.D., and his expert faculty. Dr. Galynker is a prominent suicide researcher/clinician and frequent presenter at APA Annual Meetings. The course aims to train clinicians in a novel framework for the assessment of short-term suicide risk: the Modular Assessment of Risk for Imminent Suicide (MARIS) and the Narrative-Crisis Model of suicidal behavior (NCM). ■More information on these and other Annual Meeting sessions can be found using the Session Search tool on APA’s website here.Michael Myers, M.D., is a consultant to APA’s Scientific Program Committee and a professor of clinical psychiatry at SUNY-Downstate Medical Center. He is a specialist in physician health and the author of numerous books including The Physician as Patient: A Clinical Handbook for Mental Health Professionals and Touched by Suicide: Hope and Healing After Loss. ISSUES NewArchived

Comprehensive geriatric intervention in community-dwelling older adults: a cluster-randomized controlled trial.

BackgroundIn longevity societies, one of the most serious social issues is sarcopenia and/or frailty. Preventing them is important for maintaining independence and quality of life in the older population. This study investigated the effect of a self‐monitoring comprehensive geriatric intervention programme (CGIP) on physical function and muscle size in community‐dwelling older adults. We compared the effects of a CGIP using weekly class‐styled (CS) sessions and a home‐based (HB) programme.MethodsThe 526 participants were randomized into one of two groups (CS 251, HB 275) based on their residential districts. We conducted a 12 week CGIP, which consisted of low‐load resistance exercise, physical activity increments, oral function improvements, and a nutritional guide. All participants were encouraged to attend two 90 min lectures that included instructions on the CGIP. They were provided with exercise materials (triaxial‐accelerometers/pedometers, ankle weights, and elastic bands) and diary logs. The CS group attended 90 min weekly sessions and independently executed the programme on other days, whereas the HB group only received instructions on how to execute the programme. Physical functions, such as knee extension strength (KES), normal and maximum walking speed, the timed up‐and‐go test, and anterior thigh muscle thickness (MT), were measured and analysed using intention‐to‐treat analysis before and after the 12 week intervention.ResultsOf the 526 participants identified, 517 (CS 243 age 74.0 ± 5.4 women 57.2%, HB 274 age 74.0 ± 5.6 women 58.8%) were enrolled. Nine (CS 8, HB 1) were excluded from the analysis because they did not participate in the pre‐intervention measurements. Both interventions significantly improved KES (CS 18.5%, HB 10.6%), normal walking speed (CS 3.7%, HB 2.8%), and MT (CS 3.2%, HB 3.5%). Greater improvement of KES was observed in the CS group (P = 0.003). Maximum walking speed (CS 4.7%, HB 1.8%; P = 0.001) and timed up‐and‐go (CS −4.7%, HB −0.2%; P < 0.001) significantly improved in the CS group only.ConclusionsThe intervention was effective in preventing sarcopenia and/or frailty. Most physical functions and MT improved after both interventions. The HB intervention is cost‐effective and may help prevent sarcopenia and/or frailty in the large older population.