A national campaign to finance supported employment.

Medicaid is now the main payment source and financing mechanism for services for adults with serious mental illness. Services formerly paid with state mental health funds have been converted to Medicaid, lightening the burden on state budgets affected by recession and other factors. The change has allowed states to maintain community care and inpatient services (in general hospitals).

Birth is but our death begun: a bioarchaeological assessment of skeletal emaciation in immature human skeletons in the context of environmental, social, and subsistence transition.

The second millennium BC was a period of significant social and environmental changes in prehistoric India. After the disintegration of the Indus civilization, in a phase known as the Early Jorwe (1400-1000 BC), hundreds of agrarian villages flourished in the Deccan region of west-central India. Environmental degradation, combined with unsustainable agricultural practices, contributed to the abandonment of many communities around 1000 BC.

Do not turn out the lights on the public mental health system when the ACA is fully implemented.

When all of the insurance and health care reforms of the ACA are fully implemented, some public financing needs for behavioral health services will remain. This commentary outlines a number of the residual functions of the public mental health system in an ACA world, and it identifies opportunities for expansions of service areas not covered by traditional insurance or the health delivery reforms for behavioral health services within the scope of the ACA.

Bedside upper gastrointestinal series in critically ill low birth weight infants.

Background: The upper gastrointestinal (UGI) series is the preferred method for the diagnosis of malrotation. A bedside UGI technique was developed at our institution for use in low birth weight, critically ill neonates to minimize the risks of transportation from the neonatal intensive care unit (NICU) such as hypothermia and dislodgement of support lines and tubes.

Objective: To determine the ability of a bedside UGI technique to identify the position of the duodenojejunal junction (DJJ) in low birth weight, critically ill infants in the NICU.

The dynamics of psychiatric bed use in general hospitals.

This study examines general hospitals' adjustments in psychiatric bed utilization practices in response to increases in psychiatric inpatient admissions. Using panel data from 439 hospitals, monthly observations (N = 7,831) between 2007 and 2010 on psychiatric admissions, psychiatric bed occupancy rates, and average length-of-stay were created for psychiatric inpatients. In fixed-effects regressions, an increase in psychiatric admissions was associated with an increase in the probability of psychiatric bed use exceeding 100 % occupancy and with a reduction of mean length-of-stay.

Adverse Childhood Experiences (ACEs) questionnaire and Adult Attachment Interview (AAI): implications for parent child relationships.

Although Adverse Childhood Experiences (ACEs) are linked to increased health problems and risk behaviors in adulthood, there are no studies on the association between ACEs and adults' states of mind regarding their early childhood attachments, loss, and trauma experiences. To validate the ACEs questions, we analyzed the association between ACEs and emotional support indicators and Adult Attachment Interview (AAI) classifications in terms of unresolved mourning regarding past loss or trauma and discordant states of mind in cannot classify (U/CC) interviews. Seventy-five urban women (41 clinical and 34 community) completed a questionnaire on ACEs, which included 10 categories of abuse, neglect, and household dysfunction, in addition to emotional support.

Fecal incontinence: the role of the urologist.

Fecal incontinence is the involuntary loss of solid or liquid stool. While the true prevalence of fecal incontinence is difficult to discern, it is estimated that almost 9 % of non-institutionalized women in the US experience this condition. Disorders leading to fecal urgency alone are usually related to rectal storage abnormalities while incontinence is often a result of anatomic or neurologic disruption of the anal sphincter complex.

Evaluation of a case-based urology learning program.

Objective: To address the challenges that today's trainees encounter, such as information overload and reduced immersion in the field, and recognizing their preference for novel educational resources, an electronic case-based urology learning program was developed. Each case was designed to illustrate the basic principles of the disease process and the fundamentals of evaluation and management using the Socratic method, recapitulating a prototypical patient encounter.

Methods: A 21-question survey was developed after review of published reports of classroom and clinical learning environment surveys.

Defining response and non-response to treatment in patients with overactive bladder: a systematic review.

Objective: There is currently a lack of formal guidance for assessing treatment response and non-response in patients with overactive bladder (OAB). Such guidance would be useful for both clinical practice and the design of clinical trials. Our purpose was to review and assess definitions of treatment response and non-response used in patients with OAB.

Simple sling incision for the treatment of iatrogenic bladder outlet obstruction.

Introduction And Hypothesis: Bladder outlet obstruction (BOO) is reported to occur in 15 % of women after anti-incontinence surgery. In the past, iatrogenic BOO from slings was treated with urethrolysis. However, urethrolysis is not without morbidity, including significant bleeding, urethral injury, and recurrent stress urinary incontinence (SUI).

Labhardt's colpoperineocleisis: subjective results of an alternative treatment for genital prolapse in patients who are not sexually active--2-year follow-up.

Introduction And Hypothesis: Genital prolapse affects up to 50 % of multiparous women and has an impact on quality of life (QoL) for many. Vaginal obliterative techniques are relevant in older patients who are not sexually active. We performed Labhardt's colpoperineocleisis in such patients.

Barriers to implementing evidence-based smoking cessation practices in nine community mental health sites.

Objective: Guidelines strongly recommend that smokers with mental illness receive evidence-based smoking cessation interventions similar to those provided to smokers in the general population. The goal of this study was to evaluate the resources, barriers, and willingness to use these evidence-based interventions in mental health settings.

Methods: Clinicians at nine community mental health settings (five psychosocial rehabilitation programs and four community mental health clinics) in four counties in Maryland were surveyed.

Assisting Social Security Disability Insurance beneficiaries with schizophrenia, bipolar disorder, or major depression in returning to work.

Objective: People with psychiatric impairments (primarily schizophrenia or a mood disorder) are the largest and fastest-growing group of Social Security Disability Insurance (SSDI) beneficiaries. The authors investigated whether evidence-based supported employment and mental health treatments can improve vocational and mental health recovery for this population.

Method: Using a randomized controlled trial design, the authors tested a multifaceted intervention: team-based supported employment, systematic medication management, and other behavioral health services, along with elimination of barriers by providing complete health insurance coverage (with no out-of-pocket expenses) and suspending disability reviews.

Rat mesenchymal stem cell secretome promotes elastogenesis and facilitates recovery from simulated childbirth injury.

Vaginal delivery is a risk factor for stress urinary incontinence (SUI). Mesenchymal stem cells (MSCs) home to injured organs and can facilitate repair. The goal of this study was to determine if MSCs home to pelvic organs after simulated childbirth injury and facilitate recovery from SUI via paracrine factors.

The rapidly increasing usefulness of social media in urogynecology.

Objective: We assessed the availability and quality of urinary incontinence and pelvic organ prolapse information in social medias and the growth of such information in the past 13 months.

Methods: We focused on the most popular social medias (Facebook, Twitter, and YouTube) to evaluate the key words "urogynecology," "pelvic organ prolapse," "stress incontinence," "urge incontinence," and "incontinence." Initial evaluation included top 30 search results for key word "incontinence" to compare with our study in 2010, followed by a secondary search using the top 100 items.

Utility of postoperative laboratory studies after female pelvic reconstructive surgery.

Objective: We sought to determine the frequency of laboratory studies after female pelvic reconstructive surgery and the rate of intervention based on the results of these laboratory values at a single institution.

Study Design: We conducted a retrospective review of all patients undergoing female pelvic reconstructive surgery for pelvic organ prolapse by 5 fellowship-trained pelvic reconstructive surgeons at a single institution from Jan. 1, 2010, through Dec.