Three-Year Effects of Motivational Interviewing-Enhanced Behavior Therapy for Adolescents With Attention-Deficit/Hyperactivity Disorder: A Randomized Community-Based Trial.

Objective: This study reports 3-year effects of a parent-teen cognitive/behavioral treatment for adolescent attention-deficit/hyperactivity disorder (ADHD), blended with Motivational Interviewing (Supporting Teens' Autonomy Daily [STAND]), vs Usual Care (UC) in 4 community clinics.

Method: This was a randomized clinical trial with double randomization of adolescents and therapists to STAND vs UC. Participants were 278 culturally diverse adolescents diagnosed with DSM-5 ADHD and 82 community therapists.

Site- and frequency-specific enhancement of visual search performance with online individual alpha frequency (IAF) repetitive transcranial magnetic stimulation (rTMS) to the inferior frontal junction.

In this study, repetitive transcranial magnetic stimulation was applied to either the right inferior frontal junction or the right inferior parietal cortex during a difficult aerial reconnaissance search task to test its capacity to improve search performance. Two stimulation strategies previously found to enhance cognitive performance were tested: The first is called "addition by subtraction," and the second condition utilizes a direct excitatory approach by applying brief trains of high-frequency repetitive transcranial magnetic stimulation immediately before task trials. In a within-subjects design, participants were given active or sham repetitive transcranial magnetic stimulation at either 1 Hz or at 1 Hz above their individual peak alpha frequency (IAF + 1, mean 11.

Modulating microbiome-immune axis in the deployment-related chronic diseases of Veterans: report of an expert meeting.

The present report summarizes the United States Department of Veterans Affairs (VA) field-based meeting titled "Modulating microbiome-immune axis in the deployment-related chronic diseases of Veterans." Our Veteran patient population experiences a high incidence of service-related chronic physical and mental health problems, such as infection, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), various forms of hematological and non-hematological malignancies, neurologic conditions, end-stage organ failure, requiring transplantation, and posttraumatic stress disorder (PTSD). We report the views of a group of scientists who focus on the current state of scientific knowledge elucidating the mechanisms underlying the aforementioned disorders, novel therapeutic targets, and development of new approaches for clinical intervention.

The Impact of Psilocybin on Patients Experiencing Psychiatric Symptoms: A Systematic Review of Randomized Clinical Trials.

Objective: This systematic review aims to evaluate the impact of psilocybin on patients experiencing psychiatric symptoms, with a focus on health-related quality of life (HRQoL) and safety.

Method Of Research: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the PubMed database and identified studies published from January 2011 to December 2021 pertaining to the impact of psilocybin on psychiatric symptoms. Two authors independently conducted a focused analysis and reached a final consensus on five studies meeting the specific selection criteria.

Medical-Surgical Nursing.

This specialty provides fertile ground for professional development.

Effective Holistic Approaches to Reducing Nurse Stress and Burnout During COVID-19.

Background: Prolonged exposure to work-related stress can lead to nurse burnout, potentiating clinical and medication errors and low-quality patient care. Holistic approaches (such as mindfulness training, "zen rooms," and massage chairs, among others) have been shown to reduce nurses' anxiety, stress, and burnout.

Purpose: To evaluate the use of "serenity lounges" (dedicated rooms where nurses can take workday breaks for the purposes of relaxation and rejuvenation) and massage chairs on nurses' anxiety, stress, and burnout.

Integration of Advanced Health Technology Within the Healthcare System to Fight the Global Pandemic: Current Challenges and Future Opportunities.

Unlabelled: The COVID-19 pandemic presents a significant challenge for providing adequate healthcare services in the context of patient isolation.

Discussion: The ability of our current healthcare system to cope with the current situation is mainly dependent on advanced health technology, such as telehealth, chatbots, virtual reality (VR), and artificial intelligence (AI). Telehealth can be a novel tool for improving our current healthcare system and allowing for greater delivery of healthcare services during global crises (i.

How Should Clinicians Respond When Patients' Loved Ones Do Not See "Brain Death" as Death?

Two commentaries respond to a case. Each considers religious or cultural values that sometimes conflict with medical standards of practice or law. These conflicts frequently occur at the end of life when stress and tensions are high and, if not handled carefully, can escalate and cause tremendous pain.

Depression in Heart Failure: A Systematic Review.

: This paper sought to identify the instruments used to measure depression in heart failure (HF) and elucidate the impact of treatment interventions on depression in HF. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. Studies published from 1988 to 2018 covering depression and HF were identified through the review of the PubMed and PsycINFO databases using the keywords: "depres*" AND "heart failure.

Psychiatric Symptoms in Cushing's Syndrome: A Systematic Review.

Psychiatric symptoms are frequently comorbid with Cushing's syndrome (CS), a relatively rare condition that results from chronic hypercortisolism. Psychiatric manifestations might be present in the prodromal phase, during the course of the illness, and even after the resolution of CS. Our goals are to review the prevalence of psychiatric symptoms in CS; to determine the impact of psychiatric symptoms on morbidity, functioning, and quality of life; and to analyze the impact of treatment of CS on psychiatric symptoms.

Improving Depression Management in Patients with Medical Illness Using Collaborative Care: Linking Treatment from the Inpatient to the Outpatient Setting.

: This paper sought to review the impact of depression in patients with comorbid medical problems, the importance of bridging the gap between inpatient and outpatient care for medical inpatients with depression (especially for organizations that treat patients in both settings), and the elements necessary to implement a pilot for an outpatient Collaborative Care Management program for patients with depression following medical admissions. Taken into account is the presence of new billing mechanisms and potential cost offsets. The literature referenced in this paper was identified through a search of online databases, including PubMed and Google Scholar.

A latent class based imputation method under Bayesian quantile regression framework using asymmetric Laplace distribution for longitudinal medication usage data with intermittent missing values.

Evaluating the association between diseases and the longitudinal pattern of pharmacological therapy has become increasingly important. However, in many longitudinal studies, self-reported medication usage data collected at patients' follow-up visits could be missing for various reasons. These pieces of missing or inaccurate/untenable information complicate determining the trajectory of medication use and its complete effects for patients.

Screening for Nonalcoholic Fatty Liver Disease in the Primary Care Clinic.

Nonalcoholic fatty liver disease (NAFLD) is a spectrum of diseases ranging from simple hepatic steatosis to nonalcoholic steatohepatitis (NASH) to advanced fibrosis and cirrhosis as well as liver cancer. Despite the significant morbidity associated with NAFLD, there are no global consensus guidelines to screen for liver fibrosis in patients considered high risk, including patients older than 50 years with type 2 diabetes or metabolic syndrome. Multiple therapies are currently being investigated and may soon receive regulatory approval for use in the clinic.

Panic Attacks in HYPERALDOSTERONISM.

Panic attacks and panic disorders are common in the general population. However, the presence of panic attacks associated with primary hyperaldosteronism has been rarely documented. We describe a patient with new-onset hyperaldosteronism secondary to adrenal adenoma who presented with recurrent panic attacks.

Abdominal Wall Schwannoma.

This rare form of subcutaneous nodule can be identified through the combination of imaging and biopsy, but the definitive diagnosis is made on complete excision of the mass.

No longer failing to treat heart failure: A guideline update review.

Heart failure is a leading cause of hospital admissions and death in the United States and worldwide. In 2016, the American Heart Association, the American College of Cardiology, and the Heart Failure Society of America released a joint focused guideline update for the management of patients with Stage C heart failure with reduced ejection fraction. An additional update released in 2017 reinforces the 2016 update's strong recommendation for substituting angiotensin-converting enzyme inhibitors or angiotensin receptor blockers with an angiotensin receptor-neprilysin inhibitor to reduce morbidity and mortality in selected patients.

Hepatitis B Virus Infection and Organ Transplantation.

Hepatitis B virus (HBV) infection remains an important cause of liver disease and continues to present several unique challenges in organ transplantation despite the availability of an effective vaccine to prevent HBV infection and the introduction of oral therapy to treat HBV infection over 20 years ago. HBV recurrence following liver transplantation can now be prevented with antiviral therapy, although controversy persists as to whether immunoprophylaxis with hepatitis B immunoglobulin is also necessary. HBV reactivation following organ transplantation can occur even in recipients with absent hepatitis B surface antigen at the time of transplantation and remains an important cause of morbidity and mortality.

A multiple imputation method based on weighted quantile regression models for longitudinal censored biomarker data with missing values at early visits.

Background: In patient-based studies, biomarker data are often subject to left censoring due to the detection limits, or to incomplete sample or data collection. In the context of longitudinal regression analysis, inappropriate handling of these issues could lead to biased parameter estimates. We developed a specific multiple imputation (MI) strategy based on weighted censored quantile regression (CQR) that not only accounts for censoring, but also missing data at early visits when longitudinal biomarker data are modeled as a covariate.

Hospital admission volume does not impact the in-hospital mortality of acute pancreatitis.

Background: Multiple factors influence mortality in Acute Pancreatitis (AP).

Methods: To evaluate the association of demographic, clinical, and hospital factors with the in-hospital mortality of AP using a population-based administrative database. The Maryland HSCRC database was queried for adult (≥18 years) admissions with primary diagnosis of AP between 1/94-12/10.

Assessing the Value of High-Quality Care for Work-Associated Carpal Tunnel Syndrome in a Large Integrated Health Care System: Study Design.

Context: Little is known about quality of care for occupational health disorders, although it may affect worker health and workers' compensation costs. Carpal tunnel syndrome (CTS) is a common work-associated condition that causes substantial disability.

Objective: To describe the design of a study that is assessing quality of care for work-associated CTS and associations with clinical outcomes and costs.