Addressing clozapine under-prescribing and barriers to initiation: a psychiatrist, advanced practice provider, and trainee survey.

Clozapine use has declined, despite its superior antipsychotic efficacy in treatment-resistant schizophrenia. Implications for clozapine underutilization include suboptimal treatment outcomes and increased hospitalizations. Many barriers preventing the use of clozapine have been described in the literature, including suboptimal knowledge and poor perceptions.

Psychosocial Difficulties in Adolescent Idiopathic Scoliosis: Body Image, Eating Behaviors, and Mood Disorders.

Objective: To examine the recent literature on psychologic comorbidities prevalent in youth living with adolescent idiopathic scoliosis (AIS)-including body image, eating behaviors, and mood disorders-to improve patient outcomes.

Methods: A comprehensive literature review was performed using the PubMed database. Eligible studies were extracted based on defined inclusion criteria, and the effects of AIS on psychologic comorbidities were evaluated.

Clinical Case Vignettes: A Promising Tool to Assess Competence in the Management of Agitation.

Objective: While standardized patients (SPs) remain the gold standard for assessing clinical competence in a standardized setting, clinical case vignettes that allow free-text, open-ended written responses are more resource- and time-efficient assessment tools. It remains unknown, however, whether this is a valid method for assessing competence in the management of agitation.

Methods: Twenty-six psychiatry residents partook in a randomized controlled study evaluating a simulation-based teaching intervention on the management of agitated patients.

Psychiatric aspects of comorbid HIV/AIDS and pain, Part 2.

The high prevalence, underassessment, and undertreatment of pain throughout the course of HIV disease make understanding the barriers and inequalities in HIV/AIDS-related pain care essential. There is a tremendous need for integrated implementation of pharmacological and psychosocial interventions. Part 2 of this review aims to discuss mood, anxiety, and substance abuse assessments; barriers to care; and psychiatric treatments in the context of HIV-AIDS-related pain.

Psychiatric aspects of comorbid HIV/AIDS and pain, Part 1.

HIV/AIDS-related pain remains a clinically challenging condition despite recent advances in treatment modalities. The existing data on pain in HIV-positive persons demonstrate a high prevalence, wide variability in clinical presentation, significant negative impact on health-related quality of life, and alarmingly inadequate assessment and management. Patients with HIV/AIDS have clearly identified physician attention to pain control as extremely important.

Self-triggered functional electrical stimulation during swallowing.

Hyolaryngeal elevation is essential for airway protection during swallowing and is mainly a reflexive response to oropharyngeal sensory stimulation. Targeted intramuscular electrical stimulation can elevate the resting larynx and, if applied during swallowing, may improve airway protection in dysphagic patients with inadequate hyolaryngeal motion. To be beneficial, patients must synchronize functional electrical stimulation (FES) with their reflexive swallowing and not adapt to FES by reducing the amplitude or duration of their own muscle activity.