Wildland Firefighter Work History and Clinical Indicators of Cardiovascular Health.

Objective: To determine the association between the occupational history as a wildland firefighter (WFF) and clinical indicators of cardiovascular health.

Methods: Among 2862 WFFs, we evaluated associations between the number of total days assigned on fire and high-risk categories of three clinically measured cardiovascular indicators.

Results: Almost one-third (32%) of WFFs had one or more clinical measures that would place them in high-risk categories for body mass index, blood pressure, and total cholesterol.

Subclinical Measures of Cardiovascular Health Among Wildland Firefighters.

Objective: The aim of the study is to compare subclinical measures of cardiovascular health among wildland firefighters (WFFs) to the US general population.

Methods: Our cross-sectional study compared body mass index, total cholesterol, and blood pressure in 11,051 WFFs aged 17 to 64 years using Department of the Interior Medical Screening Program clinical screening examinations between 2014-2018 to National Health and Nutrition Examination Survey of 2015-2016 cycle using adjusted logistic regression analyses.

Results: The logistic regression model shows significantly higher odds of hypertension and prehypertension in WFFs (2.

Comparative feasibility of dobutamine stress echocardiography performed with and without intravenous contrast in patients with class III obesity.

Background: Concern exists regarding adequacy of visualization of stress echocardiograms performed without intravenous contrast in persons with Class III obesity (body mass index ≥ 40 kg/m ).

Methods: Dobutamine stress echocardiography (DSE) was performed on 128 candidates for bariatric surgery with class III obesity without chest pain or pre-existent coronary artery disease (CAD). DSE without intravenous contrast was initially performed on 62 patients with class III obesity, then was subsequently was performed with intravenous contrast on 66 patients with class III obesity.

The Text Effect: Stress Management and Resiliency Training Pilot for Resident Physicians.

Background And Objectives: Burnout is common among resident physicians. Studies show that those who engage in stress management and mindful practice have improved empathy and lower rates of mood disturbance. This study piloted a program entitled Stress Management and Resiliency Training for Residents (SMART-R) with Family Medicine (FM) and Ob-Gyn residents at an academic medical center.

Novel Assessment of Ischemia in Patients With Anomalous Right Coronary Artery.

Anomalous right coronary arteries are usually benign; however, sudden death owing to myocardial ischemia, especially during exertion, have been reported in patients with intramural or interarterial course, which is likely due to dynamic obstruction. We propose a novel method of physiological evaluation with instantaneous wave-free ratio with dobutamine infusion to simulate controlled dynamic obstruction in anomalous right coronary arteries. ().

Computer-Assisted Cognitive-Behavior Therapy in Medical Care Settings.

Purpose Of Review: We reviewed research on computer-assisted cognitive-behavior therapy (CCBT) performed in medical settings with the goals of assessing the effectiveness of this newer method of treatment delivery, evaluating the need for clinician support of therapeutic computer programs, and making suggestions for future research and clinical implementation.

Recent Findings: The overall results of randomized, controlled trials suggest that CCBT can be an effective treatment for depression in primary care patients and health care anxiety. Also, it can be a useful component of treatment for somatic conditions including irritable bowel syndrome, diabetes, fibromyalgia, and chronic pain.

Computer-Assisted Cognitive-Behavior Therapy for Depression in Primary Care: Systematic Review and Meta-Analysis.

Objective: To examine evidence for the effectiveness of computer-assisted cognitive-behavior therapy (CCBT) for depression in primary care and assess the impact of therapist-supported CCBT versus self-guided CCBT.

Methods: A search for randomized studies of CCBT compared to control groups for treating depression in primary care settings was conducted using Ovid MEDLINE, PsycINFO, PubMed, and Scopus. We extracted the following information from the studies that met inclusion criteria: mean depression rating scale scores before and after treatment, number of patients, type of control group and CCBT program, therapist support time and method of support, and treatment completion rate.

Toxicity testing in the 21st century: a vision and a strategy.

With the release of the landmark report Toxicity Testing in the 21st Century: A Vision and a Strategy, the U.S. National Academy of Sciences, in 2007, precipitated a major change in the way toxicity testing is conducted.

Resident physician burnout: is there hope?

Background: Prevalent among resident physicians, burnout has been associated with absenteeism, low job satisfaction, and medical errors. Little is known about the number and quality of interventions used to combat burnout.

Methods: We performed a systematic review of the literature using MEDLINE and PubMed databases.

The role of patient personality in the identification of depression in older primary care patients.

Background: Our aim was to evaluate whether personality factors significantly contribute to the identification of depression in older primary care patients, even after controlling for depressive symptoms.

Methods: We examined the association between personality factors and the identification of depression among 318 older adults who participated in the Spectrum study.

Results: High neuroticism (unadjusted Odds Ratio (OR) 2.

The future of the veterans' health care system.

The probable adoption of a national health insurance system in the near future makes the Veterans Administration's health care program vulnerable to change. The last major turning point in the program occurred at the end of World War II when a decision was made to link VA hospitals to medical schools. This linkage in large measure has been responsible for the program's focus on acute care.