Scaling out a Digital-First Behavioral Health Care Model to Primary Care.

There is an established supply/demand problem in addressing behavioral health needs. A proposed solution is to have primary care providers respond to patients' behavioral health challenges directly. The current study describes the adaptation and evaluation process of Precision Behavioral Health (PBH), a digital-first behavioral health care model with provider-referral to an ecosystem of digital interventions.

Identifying predictors of long-term treatment outcomes using narratives from written exposure therapy and cognitive processing therapy for PTSD.

Objective: Cognitive processing therapy (CPT), a 12-session, gold-standard treatment for posttraumatic stress disorder (PTSD), and written exposure therapy (WET), a brief, five-session treatment, have similar treatment efficacy. The aim of the present study was to identify predictors of long-term treatment outcomes of WET and CPT using clients' written narratives.

Method: Narratives from both treatments were coded with the Change and Growth Experiences Scale coding system to identify predictors of long-term PTSD symptom outcomes.

Evaluating the Implementation and Clinical Effectiveness of an Innovative Digital First Care Model for Behavioral Health Using the RE-AIM Framework: Quantitative Evaluation.

Background: In the United States, innovation is needed to address the increasing need for mental health care services and widen the patient-to-provider ratio. Despite the benefits of digital mental health interventions (DMHIs), they have not been effective in addressing patients' behavioral health challenges as stand-alone treatments.

Objective: This study evaluates the implementation and effectiveness of precision behavioral health (PBH), a digital-first behavioral health care model embedded within routine primary care that refers patients to an ecosystem of evidence-based DMHIs with strategically placed human support.

Evaluation of the impact of a digital care navigator on increasing patient registration with digital mental health interventions in routine care.

Background: Less than half of adults with mental health disorders in the United States receive appropriate or timely care. Digital Mental Health Interventions (DMHIs) have the potential to bridge this gap. However, real-world adoption of DMHIs is impeded by patient and provider-level technological barriers.

Widening area-based socioeconomic inequalities in cancer mortality in Germany between 2003 and 2019.

Cancer mortality has declined in recent decades, but-due to a lack of national individual-level data-it remains unclear whether this applies equally to all socioeconomic groups in Germany. Using an area-based approach, this study investigated socioeconomic inequalities in cancer mortality and their secular trends on a German nationwide scale for the first time. Official cause-of-death data from 2003 to 2019 were linked to the district-level German Index of Socioeconomic Deprivation.

Basin-scale reconstruction of euxinia and Late Devonian mass extinctions.

The Devonian-Carboniferous transition marks a fundamental shift in the surface environment primarily related to changes in ocean-atmosphere oxidation states, resulting from the continued proliferation of vascular land plants that stimulated the hydrological cycle and continental weathering, glacioeustasy, eutrophication and anoxic expansion in epicontinental seas, and mass extinction events. Here we present a comprehensive spatial and temporal compilation of geochemical data from 90 cores across the entire Bakken Shale (Williston Basin, North America). Our dataset allows for the detailed documentation of stepwise transgressions of toxic euxinic waters into the shallow oceans that drove a series of Late Devonian extinction events.

Using Client Narratives to Identify Predictors of Outcome in Written Exposure Therapy and Cognitive Processing Therapy.

Written exposure therapy (WET) is a brief, five-session treatment for posttraumatic stress disorder (PTSD) that aims to improve access to care. WET has been demonstrated to be an efficacious PTSD treatment with lower rates of dropout and noninferior PTSD symptom outcome compared to cognitive processing therapy (CPT), a 12-session, gold-standard treatment. To identify predictors of treatment outcome in both WET and CPT, the current study examined the content of participants' written narratives.

A re-examination of the mechanism of whiting events: A new role for diatoms in Fayetteville Green Lake (New York, USA).

Whiting events-the episodic precipitation of fine-grained suspended calcium carbonates in the water column-have been documented across a variety of marine and lacustrine environments. Whitings likely are a major source of carbonate muds, a constituent of limestones, and important archives for geochemical proxies of Earth history. While several biological and physical mechanisms have been proposed to explain the onset of these precipitation events, no consensus has been reached thus far.

Sulfur cycling at natural hydrocarbon and sulfur seeps in Santa Paula Creek, CA.

Biogeochemical cycling of sulfur is relatively understudied in terrestrial environments compared to marine environments. However, the comparative ease of access, observation, and sampling of terrestrial settings can expand our understanding of organisms and processes important in the modern sulfur cycle. Furthermore, these sites may allow for the discovery of useful process analogs for ancient sulfur-metabolizing microbial communities at times in Earth's past when atmospheric O concentrations were lower and sulfide was more prevalent in Earth surface environments.

Associations between psychiatric morbidity and COVID-19 vaccine hesitancy: An analysis of electronic health records and patient survey.

Psychiatric illness confers significant risk for severe COVID-19 morbidity and mortality; identifying psychiatric risk factors for vaccine hesitancy is critical to mitigating risk in this population. This study examined the prevalence of vaccine hesitancy among those with psychiatric illness and the associations between psychiatric morbidity and vaccine hesitancy. Data came from electronic health records and a patient survey obtained from 14,365 patients at a group medical practice between February and May 2021.

The Impact of the Covid-19-Related Transition to Telehealth on Visit Adherence in Mental Health Care: An Interrupted Time Series Study.

Covid-19 has led to an unprecedented shift to telemental health (TMH) in mental healthcare. This study examines the impact of this transition on visit adherence for mental health services in an integrated behavioral health department. Monthly visit data for 12,245 patients from January, 2019 to January, 2021 was extracted from the electronic medical record.

ALSUntangled #60: light therapy.

ALSUntangled reviews alternative and off-label treatments for people with ALS. Here we review light therapy. We show that it has theoretically plausible mechanisms, three flawed pre-clinical data, studies, and one incompletely documented case report supporting its use.

Predictors of Dropout in Cognitive Processing Therapy for PTSD: An Examination of Trauma Narrative Content.

Dropout rates in trauma-focused treatments for adult posttraumatic stress disorder (PTSD) are high. Most research has focused on demographic and pretreatment predictors of dropout, but findings have been inconsistent. We examined predictors of dropout in cognitive processing therapy (CPT) by coding the content of trauma narratives written in early sessions of CPT.

Metformin alleviates muscle wasting post-thermal injury by increasing Pax7-positive muscle progenitor cells.

Background: Profound skeletal muscle wasting and weakness is common after severe burn and persists for years after injury contributing to morbidity and mortality of burn patients. Currently, no ideal treatment exists to inhibit muscle catabolism. Metformin is an anti-diabetic agent that manages hyperglycemia but has also been shown to have a beneficial effect on stem cells after injury.

Common Data Elements in the Assessment of Military-Related PTSD Research Applied in the Consortium to Alleviate PTSD.

Introduction: Driven by the need to share data, sufficiently power studies, and allow for cross-study comparisons of medical and psychiatric diseases, the President's National Research Action Plan issued in 2013 called for the use of state-of-the-art common data elements (CDEs) for research studies. CDEs are variables measured across independent studies that facilitate methodologically sound data aggregation and study replication. Researchers in the field of military-related post-traumatic stress disorder (PTSD) have suggested applicable CDEs; however, to date, these recommendations have been conceptual and not field-tested.

The structure of co-occurring PTSD and depression symptoms in a cohort of Marines pre- and post-deployment.

Symptoms of posttraumatic stress disorder (PTSD) and major depressive disorder are the most frequently co-occurring problems following potentially traumatic events. It is unclear whether these comorbidities represent two correlated but distinct disorders or a common post-event response. We sought to inform this question by examining the distinctiveness of PTSD and depression symptoms at four cross-sectional time points, using data from a parent prospective longitudinal study of 858 Marines evaluated before deployment and approximately 1, 5, and 8 months after returning from the Afghanistan war.

Network destabilization and transition in depression: New methods for studying the dynamics of therapeutic change.

The science of dynamic systems is the study of pattern formation and system change. Dynamic systems theory can provide a useful framework for understanding the chronicity of depression and its treatment. We propose a working model of therapeutic change with potential to organize findings from psychopathology and treatment research, suggest new ways to study change, facilitate comparisons across studies, and stimulate treatment innovation.

The temporal relationship between posttraumatic stress disorder and problem alcohol use following traumatic injury.

Chronic alcohol abuse is a major public health concern following trauma exposure; however, little is known about the temporal association between posttraumatic stress disorder (PTSD) symptoms and problem alcohol use. The current study examined the temporal relationship between PTSD symptom clusters (re-experiencing, effortful avoidance, emotional numbing, and hyperarousal) and problem alcohol use following trauma exposure. This study was a longitudinal survey of randomly selected traumatic injury patients interviewed at baseline, 3 months, 12 months, and 24 months following injury.

Perceived military organizational support and peacekeeper distress: a longitudinal investigation.

Many professions vital to the safety of society require workers to face high magnitude and potentially traumatizing events. Because this routine exposure can cause high levels of stress in workers, it is important to investigate factors that contribute to both risk of posttraumatic stress disorder (PTSD), and healthy responses to stress. Although some research has found social support to mitigate the effects of posttraumatic stress symptoms, scant research has investigated organizational support.

Prospective investigation of mental health following sexual assault.

Background: Comorbidity in psychological disorders is common following exposure to a traumatic event. Relatively little is known about the manner in which changes in the symptoms of a given type of psychological disorder in the acute period following a trauma impact changes in symptoms of another disorder. This study investigated the relationship between changes in posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in the first 12 weeks following sexual assault.

The distinctiveness of prolonged grief and posttraumatic stress disorder in adults bereaved by the attacks of September 11th.

Background: Prolonged Grief Disorder (PGD) is a new diagnosis proposed for inclusion in the DSM-V. Although some studies have shown the distinctiveness of PGD and posttraumatic stress disorder (PTSD), this relationship has yet to be tested within a context of sudden, violent loss.

Method: We conducted an exploratory factor analysis (EFA) using self-report data collected from a sample of 587 bereaved adults who lost friends and relatives in the attacks of September 11th.