Medical Coders' Use of the ICD-10-CM "Unspecified" Codes for Head and Brain Injury in Emergency Department Settings.

Context: In the emergency department (ED) setting, prioritizing triage and patient care may lead to challenges in capturing detailed documentation necessary for specific International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding in medical records. Consequently, the prevalent use of the "unspecified head injury" code poses concerns about the precision of ED-based administrative billing claims data when analyzed for public health surveillance of nonfatal traumatic brain injuries (TBIs). Understanding the perspective of medical coders can illuminate coding processes and opportunities to enhance coding accuracy for TBI and other head injuries in the ED.

Caregiver Preparedness: A Therapeutic Mechanism and Moderating Factor on Outcomes for the Savvy Caregiver Program.

Objectives: Evidence-based interventions for dementia caregivers, such as the Savvy Caregiver Program (SC), seek to address skills and knowledge deficits, caregiver burden, depressive symptoms, and grief. Little research has examined mechanisms by which these interventions accomplish their goals. Caregiver preparedness may be a possible mechanism by which caregiver interventions may confer benefits.

Fractured families and social networks: Identifying risk and resilience factors for supporting positive mental health in Venezuelan immigrant groups.

Objectives: Language barriers, isolation, and challenges related to social integration, acculturative stress, and systemic discrimination are correlated with poor physical and mental health outcomes among immigrant populations. Emerging literature highlights the importance of social networks for resiliency and well-being. This study explores the experiences of Venezuelan immigrants in central Florida, factors that have promoted resilience, and considerations for mental health providers to meet the needs of this population.

Medicine and Horsemanship: The Effects of Equine-assisted Activities and Therapies on Stress and Depression in Medical Students.

This study examined the use of an equine-assisted brief course module on stress and depression among medical students (n = 28), a demographic known to experience high pressure. Evidence supports that animal-assisted therapies can lead to the improvement of health and quality of life, particularly in terms of cognitive, psychological, and physical benefits. This study used the seven-session Kane Medicine and Horsemanship program; students completed pre- and post-measures one week before and after the course.

National policy actions on dementia in the Americas and Asia-Pacific: Consensus and challenges.

Alzheimer's disease and related dementias (ADRD) affect over 50 million persons globally, and the number is expected to rise. In response, health ministries are developing and implementing policies and programs to systemically address the needs of individuals and families affected by ADRD. While national plans of action on ADRD are advancing among European Member States of World Health Organization (WHO), those in the Asia-Pacific and Americas are lagging behind.

Pilot testing a manualized equine-facilitated cognitive processing therapy (EF-CPT) intervention for PTSD in veterans.

Objective: The objective of this study was to test effectiveness and feasibility of equine-facilitated cognitive processing therapy (EF-CPT), a manualized adaptation of the cognitive processing therapy model for veterans with posttraumatic stress disorder (PTSD) championed by the Department of Veterans Affairs, in which equine-facilitated activities are integrated into face-to-face sessions.

Method: Twenty-seven veterans with a diagnosis of PTSD participated (M = 51; 78% male) in a pretest-posttest design. Veterans were seen by a single psychologist for 12 sessions of individual EF-CPT.

Service dog training programs for veterans with PTSD: results of a pilot controlled study.

Service dog programs are increasingly being explored as complementary or alternative interventions for military veterans with posttraumatic stress disorder (PTSD). This paper details the results of a control group, pre-and-post pilot investigation evaluating the use of a 14-week service dog training program for veterans in central Florida. Thirty veterans diagnosed with PTSD, 15 in the intervention group and 15 in the waitlist controlled group, completed all pretests and posttests measures, consisting of the 136-item Trauma Symptom Inventory-2 and the 36-item World Health Organization-Disability Assessment Schedule 2.

Barriers to healthcare services and supports for signing deaf older adults.

Objective: Although developmental stages and identity have been studied as part of aging, one category of both identity and biological difference that has received little attention in the medical and public health literature is that of older adults who were born deaf and/or who identify as part of the signing Deaf community.

Research Method: Researchers conducted a systematic search of the literature for barriers to care access related to both aging and deafness.

Results: Lack of cultural competence among providers, coupled with inconsistent access to interpreters in medical settings, puts deaf individuals at risk for treatment without adequate consent, or insufficient care due to communication barriers or misperceptions of expression or culture.

Delirium and Antipsychotic Medications at Hospital Intake: Screening to Decrease Likelihood of Aggression in Inpatient Settings Among Unknown Patients With Dementia.

For individuals with dementia, disorientation and both external and internal stimuli may trigger behaviors that are difficult to manage or dangerous to health-care providers. Identification of correlational risk factors to aggressive behavior in patients who are unknown to the hospital can allow providers to adapt patient care quickly. Records for patients aged 60+ who spent at least 24 hours at the hospital other than in the psychiatric unit were used (N = 14 080).

Individual and organizational factors associated with professional quality of life in Florida fire personnel.

Objective: The purpose of this study was to determine a baseline level of compassion satisfaction, burnout, and secondary traumatic stress (STS) in firefighters, as well as to examine how these constructs related to perceived organizational support, perceived coworker support, psychological resilience, and debriefing in the fire personnel.

Design: This was done through a voluntary nonrandom, cross-sectional administration of surveys.

Setting: The study was carried out in the state of Florida.

Examining the Effects of an Otago-Based Home Exercise Program on Falls and Fall Risks in an Assisted Living Facility.

Background And Purpose: The Otago exercise program is a strengthening, balance, and walking program designed to decrease falls among community-dwelling older adults. Few studies have examined the effects of the Otago program in an assisted living environment. The purpose of the current study was to assess the effects of an Otago-based home exercise program in decreasing falls and the risk of falls among older adults living in an assisted living facility.

Perceptions and receptivity of non-spousal family support: A mixed methods study of psychological distress among older, church-going African American men.

The purpose of this study was to explore the role of non-spousal family support on mental health among older, church-going African American men. The mixed methods objective was to employ a design that used existing qualitative and quantitative data to explore the interpretive context within which social and cultural experiences occur. Qualitative data (n=21) were used to build a conceptual model that was tested using quantitative data (n= 401).

Rigor, Transparency, and Reporting Social Science Research: Why Guidelines Don't Have to Kill Your Story.

Dissemination of research is the most challenging aspect of building the evidence base. Despite peer-review, evidence suggests that a substantial proportion of papers leave out details that are necessary to judge bias, consider replication, or initiate meta-analyses and systematic reviews. Reporting guidelines were created to ensure minimally adequate reporting of research and have become increasingly popular since the 1990s.

Relationships Among Caregiving, Income, Gender, and Health: A Cross-Sectional Examination of a Representative Sample of Older Americans.

Although there is substantial evidence to support the impact of burden on caregivers, few studies have compared caregivers to their non-caregiving counterparts on the basis of health and wellbeing outcomes. This study examines the relationship between caregiving and health, and whether other factors may have stronger influence on well-being measures. Using a nationally representative sample of older adults in the United States (=3,005), this study examines relationships between caregiving status, gender, and income, and nine outcomes (self-rated physical and mental health, time since seeing a doctor, time since most recent pap smear or prostate-specific antigen [PSA] test, depression, loneliness, stress, anxiety), using logistic and linear regression models.

Person-Centered Primary Care Strategies for Assessment of and Intervention for Aggressive Behaviors in Dementia.

With an increase in the number of individuals affected by dementia, it is imperative for health care providers to be well versed in the most effective ways to manage neuropsychiatric symptoms, such as aggression. Aggression can be particularly hard to manage because it creates risk of harm for formal and informal caregivers, and options for medical intervention are complex and situation dependent. Although multiple guidelines for management of aggression in dementia are available in the literature, their scope is widespread and suggested treatments often vary, making decision making difficult to navigate for busy clinicians.

A Mixed-Methods Evaluation of Social Work Learning Outcomes in Interprofessional Training with Medicine and Pharmacy Students.

Social work has moved firmly into a need for partnership training models, as our newest EPAS guidelines explicitly call for interprofessional education (IPE). While IPE is not a new model, we have not been consistently involved in training partnerships. Three professional schools partnered to provide IPE events for social work (42), medicine (108), and pharmacy (49) students.

Older, Church-Going African Americans' Attitudes and Expectations About Formal Depression Care.

This phenomenological study involved focus groups with church-affiliated, African American women and men ( N = 50; ages 50 and older) in southeast Michigan to determine their attitudes and expectations around formal mental health care. Data analysis employed a constant comparative approach and yielded themes related to formal mental health care, along with delineating concerns about defining depression, health, and well-being. Health and well-being were defined as inclusive of physical and spiritual aspects of self.

Delirium and mental health history as predictors of aggression in individuals with dementia in inpatient settings.

Objectives: Aggressive behaviors by patients with dementia present risk to health care workers and patients. An information processing model, developed to study aggressive behaviors among children, was applied to study aggression among older hospital patients with dementia. Hypotheses were that delirium and mental health or depression history, would relate to increased risk of aggressive behaviors.

Evidence to Support the Pike's Peak Model: The UA Geropsychology Education Program.

The University of Alabama's Graduate Geropsychology Education program (GGE) was conceived and implemented in the years prior to the design of the Pike's Peak Model (PPM) of geropsychology training. The GGE program provides a unique opportunity to evaluate the PPM, and this paper outlines the GGE program in the framework of the model. Three primary goals defined the GGE program: recruitment and retention of students in the geropsychology program, a doctoral level interdisciplinary class, and a set of clinical rotations in urban and rural sites.

Evaluating a moving target: Using Practical Participatory Evaluation (P-PE) in hospital settings.

This article describes lessons learned about implementing evaluations in hospital settings. In order to overcome the methodological dilemmas inherent in this environment, we used a practical participatory evaluation strategy to engage as many stakeholders as possible in the process of evaluating a clinical demonstration project. Demonstration projects, in this context, push the envelope about what is known about effectiveness in novel settings, and turnover of staff and patient populations can present challenges to gathering optimal data.

What is known about dementia care recipient violence and aggression against caregivers?

Aggression is a known behavior in dementia, but there is little in the literature about risk to home-based caregivers in situations where severe aggression is present. This article examines this issue with a focus on what is known and where further research is needed. Rates of severe aggression by dementia care recipients against caregivers are estimated at greater than 20%, and may be the strongest predictor of nursing home placement.

Enhancing provider knowledge and patient screening for palliative care needs in chronic multimorbid patients receiving home-based primary care.

This article describes a pilot model to increase palliative care (PC) knowledge and collaboration among providers and to systematically identify chronic multimorbid home care patients who would benefit from focused discussion of potential PC needs. Thirty health care providers from a home-based primary care team attended interdisciplinary trainings. The Palliative Performance Scale (PPS) tool was used to trigger discussions of potential palliative needs at team rounds for patients who scored below a cutoff point on the tool.

The economic, public health, and caregiver burden of late-life depression.

This article reviews the burden of late-life depression (LLD) from several perspectives, including costs of depression treatment and treatment of other comorbid psychiatric and medical conditions; the impact of LLD on job functioning, disability, and retirement; and how LLD influences others, such as family members and caregivers.