Quality of Care at the End of Life: Applying the Intersection of Race and Gender.

Background And Objectives: Research on racial and gender disparities in end-of-life care quality has burgeoned over the past few decades, but few studies have incorporated the theory of intersectionality, which posits that membership in 2 or more vulnerable groups may result in increased hardships across the life span. As such, this study aimed to examine the intersectional effect of race and gender on the quality of care received at the end of life among older adults.

Research Design And Methods: Data were derived from the combined Round 3 to Round 10 of the National Health and Aging Trends Study.

Social determinants of willingness to discuss end-of-life care with family and doctors among Korean American immigrants: Findings from a cross-sectional survey in Alabama.

Prior research reported lower engagement in end-of-life discussions and planning among Korean American (KA) immigrants; however, there is a dearth of research investigating factors associated with their willingness to discuss their end-of-life care wishes. This study aimed to examine the willingness to have end-of-life discussions with family and doctors among KA immigrants and social determinants of health (SDH) associated with willingness. A self-administered, cross-sectional survey was conducted with a convenience sample of 259 KA immigrants recruited from two counties in Alabama.

Willingness to Discuss End-of-Life Care Wishes Among Rural Black/African American Residents of the Alabama Black Belt.

Willingness for end-of-life discussion and related factors among rural Blacks/African Americans of the Alabama Black Belt have not been well-studied. This study aims to assess their willingness for the discussion and examine its relationship with social determinants of health (SDH) and demographic factors. A cross-sectional survey was conducted with a convenience sampling of 182 participants.

Awareness of Hospice Care Among Rural African-Americans: Findings From Social Determinants of Health Framework.

Despite the need for hospice care as our society ages, adults in the U.S.'s southern rural region have limited awareness of hospice care.

Child and Adolescent Psychiatry Fellowship Program Participation in the National Resident Matching Program Match: Trends and Implications for Recruitment.

Objective: Recruitment is one of the most important missions for the Child and Adolescent Psychiatry (CAP) Caucus of the American Association of Directors of Psychiatric Residency Training, the American Academy of Child and Adolescent Psychiatry, and the American Association of Directors of Child and Adolescent Psychiatry. A review of the National Resident Matching Program (NRMP) Match data is needed to inform current and future practices.

Methods: The NRMP, Accreditation Council for Graduate Medical Education, and Association of American Medical College databases were queried from 1996 to 2021.

The Use of Simulation in Teaching.

Simulation-based medical education (SBME) provides experiential learning for medical trainees without any risk of harm to patients. Simulation is now included in most medical school and residency curricula. In psychiatric education, simulation programs are rapidly expanding and innovating.

What are the factors associated with neighborhood park visits and health in Alabama? A cross-sectional study using a path model.

This study seeks to examine the effect of the characteristics of park users, park characteristics, and the neighborhood environment on park visits and the resultant perceived health status of residents living in Alabama, US. One hundred and eighty-nine participants, representing residents from 49 counties in Alabama, were recruited via a random-digit dial method to complete a telephone survey related to park visits. Data collection spanned 11 months.

Racial Disparities in Substance Use Treatment Completion Among Older Adults.

Background And Objectives: Racial disparities in substance use among young adults have been well documented in the substance use literature, but little attention has been paid to older adults. While being an older adult is positively associated with substance use treatment completion, racial disparities in treatment completion have yet to be examined. The purpose of this study was to determine to what extent racial disparities exist in substance use treatment completion among older adults (65 and older).

Sexual Health in Child and Adolescent Psychiatry: Multi-Site Implementation Through Synchronized Videoconferencing of an Educational Resource Using Standardized Patients.

Matters of sexuality and sexual health are common in the practice of child and adolescent psychiatry (CAP), yet clinicians can feel ill-equipped to address them with confidence. To address this gap in training and practice, we developed, implemented, and evaluated an educational module enhanced by videotaped depictions of expert clinicians interacting with professional actors performing as standardized patients (SPs). We developed an educational resource highlighting common issues of sexual health relevant to CAP practice, including sexual development, psychotropic-related side effects, and sexuality in children with autism.

Child and adolescent psychiatry training in the USA: current pathways.

This manuscript reviews contemporary training in the field of child and adolescent psychiatry in the USA. There are multiple well-defined pathways to becoming a child and adolescent psychiatrist in the USA. The Accreditation Council of Graduate Medical Education oversees child and adolescent psychiatry training programs and ensures that training programs are meeting the appropriate common and program-specific requirements.

Intermediate Levels of Antibiotics May Increase Diversity of Colony Size Phenotype in Bacteria.

Antibiotics select for resistant bacteria whose existence and emergence is more likely in populations with high phenotypic and genetic diversity. Identifying the mechanisms that generate this diversity can thus have clinical consequences for drug-resistant pathogens. We show here that intermediate levels of antibiotics are associated with higher levels of phenotypic diversity in size of colony forming units (cfus), within a single bacterial population.

Association Between Employment and Mental Health Service Use Among Justice-Involved Individuals.

Using a nationally representative sample of justice-involved persons (N = 1525), the present study examined the extent to which employment status was associated with mental health service use by various service providers. The findings indicate that the rate of mental health service use by general health care providers among the unemployed was higher than that of the employed. Factors associated with mental health service use varied by type of provider.

Adolescent Medication Misuse: Results from the MUSC Inventory of Medication Experiences (MIME).

Objectives: To survey a diverse high school population on current prescription and over-the-counter medication misuse behaviors and attitudes.

Methods: We administered the MUSC Inventory of Medication Experiences (MIME), a newly developed self-report instrument, in demographically diverse high schools in Charleston, SC, to assess the feasibility of its administration and determine characteristics associated with medication misuse among high school students.

Results: A total of 3182 students completed the MIME (93% completion rate).

Does physician continuity within a clinical trial increase retention and compliance among adolescent smokers?

Background: Retention and compliance are hurdles in many clinical trials designed for adolescents. Factors that may improve these issues in a challenging population may lead to increased data and power in much needed adolescent substance abuse research.

Methods: Within a large-scale smoking cessation study for adolescents, physician continuity (PC) was examined to determine its effect on retention, compliance, and cessation.

An analysis of the root causes for opioid-related overdose deaths in the United States.

Objective: A panel of experts in pain medicine and public policy convened to examine root causes and risk factors for opioid-related poisoning deaths and to propose recommendations to reduce death rates.

Methods: Panelists reviewed results from a search of PubMed and state and federal government sources to assess frequency, demographics, and risk factors for opioid-related overdose deaths over the past decade. They also reviewed results from a Utah Department of Health study and a summary of malpractice lawsuits involving opioid-related deaths.

Varenicline versus bupropion XL for smoking cessation in older adolescents: a randomized, double-blind pilot trial.

Introduction: Despite tremendous potential public health impact, little work has focused on development of evidence-based smoking cessation treatments for adolescents, including pharmacotherapies. No prior studies have explored the feasibility and safety of varenicline and bupropion XL, 2 potentially promising pharmacotherapies, as smoking cessation treatments in adolescents.

Methods: Treatment-seeking older adolescent smokers (ages 15-20) were randomized (double-blind) to varenicline (n = 15) or bupropion XL (n = 14), with 1-week titration and active treatment for 7 weeks.

Bupropion SR and contingency management for adolescent smoking cessation.

There is a significant need for evidence-based treatments for adolescent smoking cessation. Prior research, although limited, has suggested potential roles for bupropion sustained-release (SR) and contingency management (CM), but no previous studies have assessed their combined effect. In a double-blind, placebo-controlled design, 134 adolescent smokers were randomized to receive a 6-week course of bupropion SR + CM, bupropion SR + non-CM, placebo + CM, or placebo + non-CM, with final follow-up at 12 weeks.

Attention-deficit/hyperactivity disorder confounds nicotine withdrawal self-report in adolescent smokers.

Individuals with attention-deficit/hyperactivity disorder (ADHD) are more likely than those without ADHD to initiate smoking and develop nicotine dependence. Recent research indicates that adults with ADHD experience more severe nicotine withdrawal symptoms than those without ADHD. However, little is known about nicotine withdrawal in adolescent smokers with history of ADHD.

Malignant catatonia in a patient with bipolar disorder, B12 deficiency, and neuroleptic malignant syndrome: one cause or three?

A Case is presented of a 23-year-old woman with progressive onset of paranoid psychosis and catatonia, who was ultimately found to have both vitamin B12 deficiency and a family history of bipolar disorder. The patient was initially diagnosed with schizophrenia and treated with the antipsychotic medication ziprasidone. Her condition rapidly worsened to a state consistent with either neuroleptic malignant syndrome or malignant catatonia.

In vivo phage display selection in the human/SCID mouse chimera model for defining synovial specific determinants.

Phage display has represented a phenomenal technological advance of the last two decades. This technique is a very effective way of producing large numbers (up to 10(12)) of diverse peptides and proteins (including antibodies), presented as fusion proteins on the viral capsid, that can be used for isolating specific molecules for therapeutic targeting. The increasing realization of the importance of the vascular endothelium in chronic inflammation as well as in neoplastic growth/spreading has prompted the targeting of blood vessels using phage display.

Isolating ligands specific for human vasculature using in vivo phage selection.

The endothelium lining blood vessels expresses molecules that are restricted in their expression to a particular tissue or organ. These molecules are attractive targets for therapy and diagnosis because they allow agents to be delivered specifically to the blood vessels supplying the desired tissue. However, it is difficult to identify these tissue-specific molecules because endothelium loses much of its tissue-specific nature when it is removed from the organ.