MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'assessment'. Sat, 03 Sep 2011 01:53:17 +0100 http://www.medworm.com/index.php?rid=5169576&cid=t_105289_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2F99B5X6YMrKA%2F URL: http://www.get.gg/Cognitive Behavior Therapy (CBT) has been proven to help mental health problems. This website offers CBT self-help information, resources and tools, including therapy worksheets. For: Anyone, Clinicians, ConsumersTopics: Academia, Behaviour Management, Cognitive, Cognitive Behaviour Therapy, Common Factors, Counselling, Depression, Eating Disorders, Emotional Health, General Psychology, Life, Mental Health, Mental Health Promotion, Personality, Personality disorders, Psychology and Technology, Psychology and the Media, Self-helpFeatures: Articles, Assessment Instruments, Clinical Tools, File Sharing, Information, Links, Multimedia, Patient Handouts, Research Tools, Resources, Training, e-learning Cognitive Behavior Therapy (CBT) has been proven to help mental hea... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=5169576 Sat, 27 Aug 2011 17:00:09 +0100 5169576 http://www.medworm.com/index.php?rid=5158855&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fimplementation-of-patient-safety-alerts%2F Scan or click to download 'Implementation of Patient Safety Alerts' Title: Implementation of Patient Safety Alerts The Skinny: Report from Action Against Medical Accidents into the implementation of Patient Safety Alerts by NHS Trusts. These alerts are issued by the National Patient Safety Agency (NPSA) about known problems that have repeatedly caused harm or killed patients, and which can be avoided if the actions in the alerts are implemented. The report finds: 195 NHS trusts had not complied with at least one patient safety alert for which the deadline had already past. This is almost 50% of all NHS trusts. Of the 9 extra-urgent “Rapid Response Report” alerts issued in 2010 and which are already past the deadline for completion, not a single one has been complied ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158855 Tue, 23 Aug 2011 12:01:12 +0100 5158855 http://www.medworm.com/index.php?rid=5158856&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fhow-to-guide-improving-transitions-from-the-hospital-to-the-clinical-office-practice-to-reduce-avoidable-rehospitalizations%2F Scan or click to download 'How-to Guide: Improving Transitions from the Hospital to the Clinical Office Practice to Reduce Avoidable Rehospitalizations' Title: How-to Guide Improving Transitions from the Hospital to the Clinical Office Practice to Reduce Avoidable Rehospitalizations The Skinny: Guide from Institute for Health Improvement on avoiding avoidable rehospitalisations as a result of poor co-ordination of care settings. Avoiding this is a key step toward achieving broader delivery system transformation. Based on the healthcare system of the USA this guide is of use to those looking at primary care and community settings. Publisher: Institute for Health Improvement Published: August 2011 Filed under: Ooops Missed Category! Tagged: Clinical Governance, Collaboration, Coord... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158856 Tue, 23 Aug 2011 09:53:48 +0100 5158856 http://www.medworm.com/index.php?rid=5158858&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fhow-to-guide-improving-transitions-from-the-hospital-to-home-health-care-to-reduce-avoidable-rehospitalizations%2F Scan or click to download 'How-to Guide: Improving Transitions from the Hospital to Home Health Care to Reduce Avoidable Rehospitalizations' Title: How-to Guide: Improving Transitions from the Hospital to Home Health Care to Reduce Avoidable Rehospitalizations The Skinny: Guide from Institute for Health Improvement on avoiding avoidable rehospitalisations as a result of poor co-ordination of care settings. Avoiding this is a key step toward achieving broader delivery system transformation. Based on the healthcare system of the USA this guide is of use to those looking to aviod rehospitalisation on return to the community detailing initial steps to create an enhanced transition to home health care in the first 48 hours after the patient is discharged from the hospital, a post-acut... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158858 Tue, 23 Aug 2011 07:59:04 +0100 5158858 http://www.medworm.com/index.php?rid=5159453&cid=t_105289_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2011%2F08%2Fbible-on-intellectual-assessment-has.html Just in time for your XMAS shopping!!!! One of the best texts on intellectual assessment and theories related to the practice of intellectual assessment.The publisher has given me permission to post this information. The text below does not show all the formatting in the original document sent to me, so if you want a nicer PDF version to share with others, click here.Conflict of interest disclosure: I have coauthored a chapter in the book and will be splitting an honorarium check (not big, trust me) and will be receiving a free copy. But, I get no royalties (I wish I did).Kudos to Dr. Flanagan and Harrison for revising what I consider one of the best texts on intellectual assessment.NEW FROM THE GUILFORD PRESS (​Revised and Expanded!)Contemporary Intellectual Assessment, Third EditionThe... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=5159453 Fri, 19 Aug 2011 15:09:00 +0100 5159453 http://www.medworm.com/index.php?rid=5139623&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F18%2Ftaking-stock-a-rapid-review-of-the-national-child-measurement-programme%2F Title: Taking Stock: A rapid review of the National Child Measurement Programme Scan or click to download ‘Taking Stock: A rapid review of the National Child Measurement Programme’ The Skinny: The National Child Measurement Programme (NCMP) is a monitoring programme launched in 2005 which collects annual data on the height and weight of all children in English state primary and middle schools, in reception class and Year 6. This six week review was commissioned by the Department of Health to draw together existing and new data on the delivery of the programme, and to suggest any changes that would help the programme to make an effective transition into the new public health system proposed for England. Publisher: Institute of Education, University of London Published: August... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5139623 Thu, 18 Aug 2011 12:46:40 +0100 5139623 http://www.medworm.com/index.php?rid=5139626&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F18%2Fsafe-and-sustainable-review-of-childrens-congenital-heart-services-in-england-interim-health-impact-assessment%2F Title: Safe and sustainable: Review of Children’s Congenital Heart Services in England Interim Health Impact Assessment Scan or click to download ‘Safe and sustainable: Safe and sustainable: Review of Children’s Congenital Heart Services in England Interim Health Impact Assessment’ The Skinny: Looks at the impact of moving to Congenital heart networks as the new model of care to ensure that in future care for children and young people with congenital heart disease are better coordinated. Within the new model of care, each network would include a Specialist Surgical Centre, a Children’s Cardiology Centre and District Children’s Cardiology Services. It states that concentrating surgical expertise onto fewer sites and bringing non-surgical care closer to home wi... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5139626 Thu, 18 Aug 2011 12:38:06 +0100 5139626 http://www.medworm.com/index.php?rid=5069530&cid=t_105289_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F07%2F27%2Flunch-wars-win-the-battle-for-our-childrens-health%2F Oh how happy I was to see the new book Lunch Wars: How to Start a School Food Revolution and Win the Battle for Our Children’s Heath by Amy Kalafa, producer of the award-winning documentary “Two Angry Moms.” I get on my soapbox all too often about this very issue, because I have one child who is so sensitive to food that teachers can tell if he ate a cookie at lunch, and the other possesses about as much will power as I have when it comes to saying no to cinnamon-flavored soft pretzels. Why, in the world, would they offer seven-year-olds the option to buy Klondike bars, cinnamon-flavored soft-pretzels, Doritos, and Gatorade? I think the answer has to do with budgets. But in the process we are raising fat kids whose academic progress is compromised by all the crap they shove in their ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=5069530 Wed, 27 Jul 2011 16:56:50 +0100 5069530 http://www.medworm.com/index.php?rid=5069843&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F07%2F26%2Fmanaging-migraines-without-medication%2F Ahhh, migraine – psychedelia without the high… nausea without the alcohol… The diagnostic criteria: A) At least 5 attacks fulfilling B-D; B) lasting untreated 4-74 hours; C) two of the following: unilateral, pulsating, moderate or severe pain intensity, worsening with physical activity; D) one of the following: nausea and/or vomiting, photophobia or phonophobia; E) not attributed to another disorder. (International Classification of headache disorders, 2004) (go here for one of the most comprehensive sites on migraine) The main treatment for migraine is to use medication – best evidence to date suggests:  “Only two pharmacological treatments have been shown to be effective in placebo-controlled randomized trials: topiramate and local injection of botulinum to... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=5069843 Tue, 26 Jul 2011 01:42:59 +0100 5069843 http://www.medworm.com/index.php?rid=5062519&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F07%2F25%2Fusing-the-chronic-pain-acceptance-questionnaire%2F Over the past few months I’ve been using the Chronic Pain Acceptance Questionnaire (CPAQ-8) as part of a battery of questionnaires used at intake and outcome measures.  Along with the CPAQ-8, we use the Tampa Scale for Kinesiophobia, the Depression Anxiety Stress Scale, the Pain Anxiety Symptoms Scale, the Pain  Catastrophising Scale, Pain Self Efficacy Questionnaire, and Pain Disability Index. The CPAQ-8 consists of two subscales: Pain Willingness and Activity Engagement.  Together they measure “acceptance” or psychological flexibility associated with chronic pain. Let me pull this apart a bit.  Pain Willingness refers to how prepared a person might be to experience an increase in pain so they can get something important done.  For example, I love to dance and I&#82... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=5062519 Sun, 24 Jul 2011 19:15:16 +0100 5062519 http://www.medworm.com/index.php?rid=5050526&cid=t_105289_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FkEln6-tme7A%2F Stories in DoD Buzz and the Christian Science Monitor this week cover a new Center for Strategic and Budgetary Assessment report on the Pentagon’s 2012 budget request. Both articles focus on the insightful section of the report explaining how the post 9-11 defense spending explosion has barely increased our war-fighting capacity. Unfortunately, both echo the report’s claim that all money spent on cancelled programs is money wasted and an indictment of the Pentagon acquisition system (page 36 and 37). Here’s how the Monitor put it: The new spending involves considerable waste, the report says. The Pentagon has spent nearly $50 billion since the 9/11 attacks on weapons systems that it never used due to technological failures or cost overruns, according to the study. “These are weapon... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5050526 Thu, 21 Jul 2011 12:57:56 +0100 5050526 http://www.medworm.com/index.php?rid=5036612&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F07%2F18%2Fwhat-matters-patient-determined-outcomes-and-clinicianresearcher-outcomes%2F It’s easy to forget, sometimes, that when we choose an outcome measure, we need to seriously consider who will use the measures in the end.  Of course, I am assuming that we’re all using outcome measures – we are, aren’t we?  If anyone isn’t, shame on you – how on earth will you establish whether what you’re doing is having an effect? And don’t come at me with “oh but I just ask them” because I don’t want to have to list all the response bias, demand characteristics, and lack of consistency problems again. kthx. Anyway, where was I? That’s right, the end-user in outcome measures.  Over the past few years, interest has risen in identifying the range of outcome measures that can be/should be used in research of treatm... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=5036612 Sun, 17 Jul 2011 19:30:31 +0100 5036612 http://www.medworm.com/index.php?rid=5029273&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F07%2F12%2Fself-efficacy-and-fear-of-movement-mediate-pain-intensity-and-disability-in-acute-pain%2F Most clinicians working in chronic pain management are well aware that the time it takes for people to finally be referred for management of their pain is far too long and some of the readers of this blog who work with people who have acute pain may wonder whether anything I write about applies to them and the people they treat.  To both groups of readers – today’s post should apply! Arguably the most common reason for people seeing a doctor is because of a musculoskeletal pain.  Treatment is usually quite simple: diagnosis, pain relief, anti-inflammatories and gradual return to function.  It’s this last part of treatment that seems to cause the most trouble for people - what if the pain doesn’t settle, what if I’m damaging my body, how long should I &#8220... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=5029273 Mon, 11 Jul 2011 19:29:01 +0100 5029273 http://www.medworm.com/index.php?rid=5028462&cid=t_105289_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F07%2F10%2Fbetty-ford-dies-at-age-93%2F Betty Ford, the former First Lady of the United States died Friday at the age of 93. Dr. William Van Ornum gives this succinct summary of her life in a tribute on the website of the American Mental Health Foundation (AMHF): Mrs. Ford was born in Chicago, grew up in modest circumstances, became a dancer, and married Mr. Ford shortly after he returned from the Navy in World War II. She thought she was signing up for a life with a mid-western lawyer; instead he chose politics and she was thrust into the role of a political wife, all the while raising 4 children and trying to keep her own interests as well. Political life became difficult for her and she felt an emptiness inside from which she sought solace in alcohol and prescription pills. She was open about her addiction at a time when othe... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=5028462 Sun, 10 Jul 2011 10:23:09 +0100 5028462 http://www.medworm.com/index.php?rid=4997843&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F07%2F04%2F%25e2%2580%259coh-wad-some-power-the-giftie-gie-us-to-see-oursels-as-others-see-us-it-wad-frae-monie-a-blunder-free-us-and-foolish-notion%25e2%2580%259d%2F That quote from Robbie Burns. For such a long time it seems that pain research has focused only on the person having pain and less on the social context where the person is experiencing it. Pain is subjective, personal and private, and the only way I can determine whether someone is in pain is if they’re exhibiting pain behaviours. Some of these behaviours, it’s true, are automatic reflex-driven responses (nocifensive, to be pedantic) – but usually only once the brain determines that the input received is a threat.  And what the brain determines to be threatening depends on a whole lot of things, including what else is going on in the environment. We have numerous pen and paper measures of pain behaviour, but far fewer tools to capture what is one of the most important e... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4997843 Mon, 04 Jul 2011 04:41:12 +0100 4997843 http://www.medworm.com/index.php?rid=4953371&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FhXi3b_bpH4s%2F CONCLUSIONS: S/R promotes the use of post-treatment self-regulation skills that, in turn, directly contribute to ongoing 12-step self-help group involvement.Authors: Carrico AW, Gifford EV, Moos RH. Spirituality/religiosity promotes acceptance-based responding and 12-step involvement. Drug Alcohol Depend. 2007 Jun 15;89(1):66-73Regular news feed free subscription.NEWYou Can Help an Alcoholic (Source: Twelve Step Facilitation.com) Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4953371 Thu, 16 Jun 2011 03:49:24 +0100 4953371 http://www.medworm.com/index.php?rid=4893948&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F06%2F02%2Fcatastrophising-and-pain-ii%2F What are some of the indications that someone tends to catastrophise about their pain? How do we know? Do we have to use a questionnaire? Is it really my job to know about this if I’m not a psychologist – and what do I do about it? These are the kinds of questions that have been posed to me as I’ve explored the topic of catastrophising, and I propose to answer the last question in my next post (sorry to keep stringing you along like this – I think many may know my take on that already!). I work in a wonderful interdisciplinary team setting, in a centre where everyone who attends the Centre gets to complete a set of psychometrically sound questionnaires that all of the team are encouraged to use and interpret, so any of the team can be confident about identifying and... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4893948 Thu, 02 Jun 2011 08:26:50 +0100 4893948 http://www.medworm.com/index.php?rid=4893949&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F06%2F01%2Fpain-behaviours-persist%2F In this study by Martel, Thibault and Sullivan (2010), people with back pain were recorded on two separate occasions (on averge 22 days apart) while carrying out two lifting tasks designed to elicit pain behaviours.  These recordings were reviewed by trained observers who recorded the number of pain behaviours in each segment of film using a standardised coding scheme (developed by Keefe and Block, 1982).  Participants in the lifting tasks also completed a range of questionnaires – the Tampa Scale for Kinesiophobia, the McGill Pain Questionnaire, and the Pain Catastrophising Scale. Before I describe the findings, in this study two different forms of pain behaviour were identified – communicative behaviours are things like grimacing, speaking, sighing, moaning and so on; while... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4893949 Wed, 01 Jun 2011 05:26:00 +0100 4893949 http://www.medworm.com/index.php?rid=4883925&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F05%2F31%2Fcatastrophising-and-pain-i%2F One reason I love blogging is the discussion between me and readers. I wrote about the language of pain recently, and out of that discussion I’ve spent a few days digging around the literature to look at what is known about the relationship between language, pain and catastrophising. I’d argued in my post that metaphoric language can reflect distress both in the communicator and the listener, and that this is supported by fMRI studies in which various parts of the brain are activated when emotion-laden communication about pain is being carried out, while one of my readers thought I might be taking this interpretation too far. Pain behaviour My reason for being interested in how we communicate about pain is that talking about pain (including describing it) is a pain behaviour. P... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4883925 Mon, 30 May 2011 19:15:07 +0100 4883925 http://www.medworm.com/index.php?rid=4876420&cid=t_105289_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F05%2F28%2Fatypical-antipsychotic-medications-not-a-good-choice-for-alzheimers%2F People with Alzheimer’s disease often suffer not only from the debilitating effects of the disease itself, but also from the secondary psychological effects. Delusions and hallucinations appear in up to 50 percent of those with Alzheimer’s, and as many as 70 percent demonstrate aggressive behaviors and agitation. Both caregivers and family members are distressed by these symptoms, and so everyone is motivated to treat the person with Alzheimer’s with antipsychotic medications. The problem? Antipsychotic medications haven’t always been well-researched on older populations, and fewer still on people with a disease like Alzheimer’s. And when the research has been done, the results are often underwhelming. Take the latest research, for instance, by Vigen and coll... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4876420 Sat, 28 May 2011 19:52:09 +0100 4876420 http://www.medworm.com/index.php?rid=4813690&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F05%2F11%2Fthe-language-of-pain%2F Have you ever wondered about the ways we communicate our pain? Pain behaviour doesn’t just include nonverbal communication – one of the main ways we communicate our pain is through speech. Words are an incredibly powerful aspect of pain behaviour that strikes me as something we haven’t really studied much. When I was searching for the article to refer to in this post, I looked in PsychInfo under the terms “linguistics” and “pain” – and out of the tens of thousands of articles under each term, and total of 16 included both words. Sixteen! The stimulus for this post comes from someone who said the term “catastrophising” is a misnomer – a way for health professionals to dismiss or minimise the suffering and distress someone who... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4813690 Wed, 11 May 2011 00:57:33 +0100 4813690 http://www.medworm.com/index.php?rid=4803558&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F05%2F10%2Fcatastrophising-and-maybe-what-to-do-about-it-for-subacutechronic-pain%2F This study is also an excellent one for looking at process, or how people change over time using a daily diary method. The finding in this paper suggests that one way for helping people be more resilient and modify their tendency towards catastrophising might be to help them identify and then pursue positive experiences during each day.  Scheduling pleasant or enjoyable events as part of a daily routine is certainly something any clinician can do, and often those pleasant events can be physical, such as going for a walk, playing with the kids, or even doing some stretches. Finally (but not the final word!), a study by McKnight and colleagues looked at the mediating effect of self efficacy on the relationship between catastrophising and disability.  In this study, participants with early ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4803558 Tue, 10 May 2011 02:18:40 +0100 4803558 http://www.medworm.com/index.php?rid=4803330&cid=t_105289_129_f&fid=27216&url=http%3A%2F%2Flifewithadhd.com%2Fadhd-medication%2Fadhd-assessment-and-diagnosis-getting-it-right.php Your absolute first step with Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD) before considering medication and ADHD treatment is to ensure a proper assessment and diagnosis. Why is this so important? There are a number of variances within ADHD and other medical conditions that share symptoms. It is extremely important to know exactly what you’re dealing with before you seek treatment. It’s like treating the common cold with antibiotics – they don’t have any effect and the cold won’t go away, likewise you’ll be putting things in your body that you simply don’t need. However, with ADHD an inaccurate diagnosis and mistreatment has much more significant risks because ADHD doesn’t go away like the common cold. ... Life With ADHD blogs http://www.medworm.com/rss/comments.php?id=4803330 Sun, 08 May 2011 23:00:00 +0100 4803330 http://www.medworm.com/index.php?rid=4803531&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FCnXzG-32TH4%2F Image via WikipediaAlcohol abuse and dependence, referred to as alcohol-use disorders (AUDs), affect 76.3 million people worldwide and account for 1.8 million deaths per year. AUDs affect 18.3 million Americans (7.3% of the population), and up to 40% of hospitalized patients have AUDs.This review discusses the development and progression of critical illness in patients with AUDs.In contrast to acute intoxication, AUDs have been linked to increased severity of illness in a number of studies.In particular, surgical patients with AUDs experience higher rates ofpostoperative hemorrhage,cardiac complications,sepsis, andneed for repeat surgery.Outcomes from trauma are worse for patients with chronic alcohol abuse, whereas burn patients who are acutely intoxicated may not have worse outcomes.AUDs... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4803531 Fri, 06 May 2011 21:53:47 +0100 4803531 http://www.medworm.com/index.php?rid=4794816&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F05%2F06%2Fjournal-of-the-american-medical-association-2011%2F This article reports on a systematic review and meta-analysis of randomised controlled clinical trials (RCTs) assessing associations of structured exercise training regimens (aerobic, resistance, or both) and physical activity advice with or without dietary cointervention on change in haemoglobin A1c (HbA1c) in type 2 diabetes patients. The article concludes that structured exercise training that consists of aerobic exercise, resistance training, or both combined is associated with HbA1c reduction in patients with type 2 diabetes. Structured exercise training of more than 150 minutes per week is associated with greater HbA1c declines than that of 150 minutes or less per week. Physical activity advice is associated with lower HbA1c, but only when combined with dietary advice. Filed under: A... Fade Library blogs http://www.medworm.com/rss/comments.php?id=4794816 Fri, 06 May 2011 12:53:30 +0100 4794816 http://www.medworm.com/index.php?rid=4794817&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F05%2F06%2Fjournal-of-the-american-medical-association-2011-vol-305-no-16%2F This article aims to  evaluate the association between low health literacy and all-cause mortality and hospitalisation among outpatients with heart failure. The article concludes that among patients with heart failure in an integrated managed care organisation, low health literacy was significantly associated with higher all-cause mortality. An NHS Athens password is required to access this article online, alternatively contact the Library for a copy of the article. Filed under: Athens Password, E-Journals, Journals Tagged: Health Care Assessment, Heart Failure, Mortality, Outcome, Patient Education (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4794817 Fri, 06 May 2011 12:14:05 +0100 4794817 http://www.medworm.com/index.php?rid=4794818&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F05%2F06%2Fjournal-of-the-american-medical-association-2011-vol-305-no-15%2F The objective of this study was to  develop and validate predictive models for progression of Chronic Kidney Disease (CKD). The article concludes that a model using routinely obtained laboratory tests can accurately predict progression to kidney failure in patients with CKD stages 3 to 5. An NHS Athens password is required to access this article online, alternatively contact the Library to obtain a copy. Filed under: Athens Password, E-Journals, Journals Tagged: Albuminuria, Chronic Kidney Failure, Creatinine, Disease Progression, Glomerular Filtration Rate, Kidney Diseases, Laboratory Techniques and Procedures, Models, Prognosis, Risk Assessment, Statistical (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4794818 Fri, 06 May 2011 11:24:24 +0100 4794818 http://www.medworm.com/index.php?rid=4780495&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F05%2F04%2Fmore-psychological-stuff-isnt-in-my-scope-of-practice-so-what-can-i-do%2F I promised there would be more on this topic – it’s a popular one and full of vexing questions.  I left off yesterday, after making four points that IMHO might help incorporate some of the psychosocial management to a nonpsychological practice.  They were: Give precise advice about what to do. Give reasons for your advice. Ask the person about their understanding of their pain. Make sure you give clear timeframes for any activity restrictions. The underlying rationale for each of these is to counter two main problems that appear to underpin the development of longterm disability associated with pain: catastrophising, or ‘thinking the worst’, and avoidance. This point is really important, so listen up! It’s not the presence of pain alone that is the problem.�... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4780495 Tue, 03 May 2011 19:32:40 +0100 4780495 http://www.medworm.com/index.php?rid=4775617&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F05%2F03%2Fpsychological-stuff-isnt-in-my-scope-of-practice-so-what-can-i-do%2F A common cry from various clinicians who work in the field of pain management but who are not psychologists is “but now what?” when they recognise that a key factor in recovery is something psychosocial. The answer is not, I suspect, heading off to become a psychologist! For several reasons, I think it’s critical for non-psychologists to get comfortable with psychosocial language and principles. All clinicians use psychological principles in their interactions with patients.  Like it or not, when we give advice or encouragement we’re using knowledge gleaned from psychological study.  We might call it something like “developing rapport”, but no matter what we call it, these interpersonal skills are psychosocial in nature.  If we use these approaches, ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4775617 Tue, 03 May 2011 00:22:24 +0100 4775617 http://www.medworm.com/index.php?rid=4734699&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F04%2F20%2Festablishing-routines-and-baselines-recording-daily-schedules%2F I don’t know about you, but I’m not the world’s best at noting down every activity I do during a day.  I get engrossed in the thing I’m doing and I often get interrupted, so it’s not very easy to record my activity moment-by-moment.  Yet, for many of us, this is something we ask for from the people we’re working with. Luckily, there is some research on daily diary methods.  Unluckily for most of us, the best ones (ie most accurate and least intrusive) are electronic!  Useful if you’re funded for some research, less helpful if you’re trying to do this in your everyday clinical setting!  Basically, the research findings show that an electronic, automated and usually random alarm that reminds the participant to record their activity (and us... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4734699 Tue, 19 Apr 2011 19:23:47 +0100 4734699 http://www.medworm.com/index.php?rid=4723947&cid=t_105289_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2FNpwwY8tAoEA%2F URL: http://psych.ucsc.edu/dreams/This web site contains everything needed to conduct scientific studies of dream meaning using a system of content analysis. This web site does NOT interpret dreams for the layperson, this is more for research and the understanding of the “entirety” and the “wholeness” of dreams. For: Clinicians, ResearchersTopics: Common Factors, Emotional Health, General PsychologyFeatures: Articles, Assessment Instruments, Author Lists, Clinical Tools, Information, Journaling, Links, e-learning This web site contains everything needed to conduct scientific studies of dream meaning using a system of content analysis.  This web site does NOT interpret dreams for the layperson, this is more for research and the understanding of the “entirety&#... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=4723947 Mon, 18 Apr 2011 08:32:29 +0100 4723947 http://www.medworm.com/index.php?rid=4720083&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Falcohol-withdrawal-during-hospitalization-ajn-the-american-journal-of-nursing%2F This article discusses the effects on the body of chronic alcohol intake, the potential symptoms of alcohol withdrawal, and ways to recognize and treat these symptoms through early assessment and consistent intervention.Alcohol Detox During Hospitalisation - Free downloadRelated articlesHelp an Alcoholic 8 (recoveryissexy.com)Alcohol use by healthcare professionals. (twelvestepfacilitation.com)Alcoholic Liver Disease (twelvestepfacilitation.com)Physical Effects of Alcohol on Women (recoveryissexy.com)Enabling of Alcoholism / Addiction Questionnaire (recoveryissexy.com)NEWYou Can Help an AlcoholicRandom ArticlesGender and Alcohol Rehabilitation over 8 yearsAlcohol Misuse Among the ElderlyDepression in Former DrinkersAlcohol Reduces Breast MilkPainkiller abuse (Source: Twelve Step Facilitati... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4720083 Fri, 15 Apr 2011 18:20:27 +0100 4720083 http://www.medworm.com/index.php?rid=4719932&cid=t_105289_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2FvA8fH867OTY%2F Search by alphabetic or category listings of a myriad of test titles. You will find included in Buros’s Institute of Mental Measurements free information on 3,500 commercially available assessments. For: Clinicians, ResearchersTopics: Academia, Behaviour Management, Clinical Decision Making, Clinical Psychology, Clinical Tool Development, Psycho-education, PsychometricsFeatures: Assessment Instruments, Databases, Information, e-learningSearch by alphabetic or category listings of a myriad of test titles.  You will find included in Buros’s Institute of Mental Measurements free information on 3,500 commercially available assessments. Over 2,500 of these same assessments have been critically reviewed by the Buros Institute.  The reviews can be purchased for 15 $ a review. (Sourc... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=4719932 Fri, 15 Apr 2011 17:00:56 +0100 4719932 http://www.medworm.com/index.php?rid=4696659&cid=t_105289_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2011%2F04%2F09%2Fusing-aeioutips-for-altered-mental-states%2F The AEIOUTIPS acronym holds a special place in my paramedic heart. It stands alongside OPQRST and SOAP as one of the three most useful acronyms I ever learned in medicine. I’m a believer in AEIOUTIPS for several reasons. Unlike mnemonics like my first cardiac arrest algorithm, (Shock, shock, shock. Everybody shock. Little shock, big shock, big shock, little shock.) AEIOUTIPS has remained relevant. That helpful cardiac arrest rhyme may have helped me through my first ACLS class, but it barely lasted through my first year as a paramedic. Once someone thought up high dose Epinephrine, things got complicated. And, unlike more well known acronyms such as DCAP-BTLS-TIC, AEIOUTIPS has actual clinical application. That means I actually run through it in my head while I’m in the middle ... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=4696659 Sat, 09 Apr 2011 21:25:13 +0100 4696659 http://www.medworm.com/index.php?rid=4664176&cid=t_105289_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbureaucrats-propose-to-discontinue-home-glucose-monitoring-coverage%2F2011.04.01 The larger the bureaucracy the more inefficient a system becomes. Several things can happen in the decision making process. 1. The decision making process can become opaque rather than transparent. 2. Decisions are made by a committee by consensus. 3. Consensus committee decisions might not sharply define the original goals. 4. Blame for errors gets dissipated. 5. Decisions are only as good as the information that is gathered. 6. Changing a wrong decision can be difficult and costly. President Obama’s healthcare reform law is creating 256 new agencies to gather information and recommend decisions for other agencies to write regulations. The following decision is being made by an agency in Washington state. It is not only the wrong decision, but is a decision that will set back the care o... Better Health blogs http://www.medworm.com/rss/comments.php?id=4664176 Fri, 01 Apr 2011 11:00:24 +0100 4664176 http://www.medworm.com/index.php?rid=4653616&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F03%2F30%2Fwhat-do-people-expect-when-they-get-referred-to-a-pain-management-centre%2F This study also found that many people didn’t feel they had been heard, or taken seriously prior to being referred. Participants in their study “needed to feel legitimated in the sick role, and part of the reason for wanting to know the cause of the pain was a desire to seek legitimacy in the eyes of others.” They made an interesting observation in that participants ranked the statement “I would like to have a better understanding of my pain” fifth on the list of 10 statements, and in the focus group discussion, identified having a diagnostic label as something different from having a better understanding. Allcock, Elkan and Williams suggest that “It was not so much personal understanding of their pain that they needed to legitimise it, as a diagnostic l... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4653616 Tue, 29 Mar 2011 18:25:34 +0100 4653616 http://www.medworm.com/index.php?rid=4566344&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2F10-things-known-about-addiction-2%2F Image via WikipediaThe 10 Most Important Things Known About AddictionIf you were asked: ‘What are the most important things we know about addiction?’ what would you say? This paper brings together a body of knowledge across multiple domains and arranged as a list of 10 things known about addiction, as a response to such a question.The 10 things are: (1) addiction is fundamentally about compulsive behaviour;(2) compulsive drug seeking is initiated outside of consciousness;(3) addiction is about 50% heritable and complexity abounds;(4) most people with addictions who present for help have other psychiatric problems as well;(5) addiction is a chronic relapsing disorder in the majority of people who present for help;(6) different psychotherapies appear to produce similar treatment outc... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4566344 Thu, 10 Mar 2011 01:15:34 +0100 4566344 http://www.medworm.com/index.php?rid=4560245&cid=t_105289_87_f&fid=36438&url=http%3A%2F%2Fedwork.edgeboss.net%2Fwmedia%2Fedwork%2Ffc%2Ffc021011.wvx By Andrew J. CoulsonLast month, I testified before the House Education & the Workforce Committee. The most startling part of that experience was the response to my testimony offered by ranking Democrat George Miller (who had chaired the committee in the previous Congress.) The archived web-cast is now available, and Rep. Miller's response begins at 42:29. To set things up: I reported that the federal government has spent $2 trillion dollars on k-12 schooling over the past two generations, and failed to achieve either of its avowed goals (raising overall achievement, and narrowing the gaps by family income and minority status). To this, Rep. Miller replied: I think when you look at student performance and you look at money and you want to say that somehow there should be some correlati... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4560245 Mon, 07 Mar 2011 17:18:03 +0100 4560245 http://www.medworm.com/index.php?rid=4552149&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Fyouth-alcohol-use-disorders%2F Diagnosis, assessment and management of harmful drinking and alcohol dependence in youthsDescriptionThis clinical guideline offers evidence-based advice on the diagnosis, assessment and management of harmful drinking and alcohol dependence in adults and in young people aged 10–17 years.This is one of three pieces of UK NICE guidance addressing alcohol-related problems and should be read along with:Alcohol-use disorders: preventing the development of hazardous and harmful drinking. NICE public health guidance 24 (2010) – public health guidance on the price, advertising and availability of alcohol, how best to detect alcohol misuse in and outside primary care, and brief interventions to manage it in these settings.Alcohol-use disorders: diagnosis and clinical management of alcohol-re... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4552149 Sat, 05 Mar 2011 17:18:00 +0100 4552149 http://www.medworm.com/index.php?rid=4532258&cid=t_105289_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2FU1vFhQFwRHs%2F URL: http://www.newselfesteem.com/The SCC is an online resource using the latest research on the psychology of self esteem. The SCC offers information on the most relevant topics in psychology relating to self esteem as well as an self esteem building e-course that provides exercises and tools that implement the topics on the website. For: AnyoneTopics: Anxiety, Behaviour Management, Emotional Health, General Psychology, Lifestyle, Personality disorders, Social PsychologyFeatures: Articles, Assessment Instruments, Commentary and Blogs, Community and Social Networking, Information, Links, Resources, e-learning, ebook The SCC is an online resource using the latest research on the psychology of self esteem. The SCC offers information on the most relevant topics in psychology relating to s... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=4532258 Tue, 01 Mar 2011 00:31:22 +0100 4532258 http://www.medworm.com/index.php?rid=4512619&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Ffacilitating-mutual-support-group-participation%2F If a healthcare or social service provider suspects that a patient or client has a substance use disorder (SUD), the provider should ensure that the client receives formal treatment. Once the client receives formal treatment—or if he or she refuses or cannot afford treatment— the provider’s next step is to facilitate involvement in a mutual support group.Matching clients to treatment based solely on gender, motivation, cognitive impairment, or other such characteristics has not been proved to be effective.Clients who are “philosophically well matched” to a mutual support group are more likely to actively participate in that group. Thus, the best way to help a client benefit from mutual support groups is to encourage increased participation in his or her chosen group.Professional ... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4512619 Wed, 23 Feb 2011 16:43:00 +0100 4512619 http://www.medworm.com/index.php?rid=4477761&cid=t_105289_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmeasuring-the-patient-experience%2F2011.02.15 There’s a growing recognition within the medical-industrial complex that the patient is a key element of the enterprise, and that patient satisfaction, patient experience, patient engagement, patient activation, and patient-centeredness are very important. Some research shows that patient activation yields better patient outcomes, and that patient activation can be measured. Patient-centeredness and patient engagement are two of the key metrics to be used by the feds in describing Accountable Care Organizations (ACOs), if the internecine battles within government are resolved soon enough to actually release draft ACO regulations in time to allow for sufficient advance planning for the January 2012 go-live date. (Wearing one of my many hats, I’ve had the opportunity to submit ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4477761 Tue, 15 Feb 2011 14:00:44 +0100 4477761 http://www.medworm.com/index.php?rid=4464454&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F02%2F11%2Fmental-health-in-family-medicine-vol-5-no-4%2F This article investigates the view that general practitioners ought to detect early signs of suicidal tendencies in their patients (Print subscription held at Fade Library) Filed under: Depression, General Practice, Primary Care, Suicide Tagged: Depression, General Practitioners, Patients, Primary Care, Risk Assessment, Suicide (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4464454 Fri, 11 Feb 2011 14:37:35 +0100 4464454 http://www.medworm.com/index.php?rid=4455498&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F02%2F09%2Fmore-on-choosing-chronic-pain-questionnaires%2F Mood and anxiety - depression, anxiety and pain-specific anxiety were chosen because of their importance to outcomes, and the need to treat psychopathology Catastrophising – because this is thought to be one of the most important aspects of cognition that needs to be addressed Pain-related anxiety and avoidance – because this appears to be one of the strongest predictors of ongoing disability Acceptance – this domain has been emerging as an increasingly important treatment process variable, and may be a target for intervention Pain location and intensity - yes, we do ask, just in case you wondered! Pain self efficacy – again, this seems to be an important process variable, and a target for treatment.  It’s also associated with higher levels of disability. Pain-related disability... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4455498 Wed, 09 Feb 2011 08:56:40 +0100 4455498 http://www.medworm.com/index.php?rid=4450530&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F02%2F09%2Fchoosing-chronic-pain-questionnaires-2%2F In my last post I started to discuss the questionnaire domains that can be used in a battery of questionnaires for chronic pain.  Today it’s time to turn to the specific measures that we’ve chosen as part of a set that a group working across the public health system in New Zealand have selected.  It’s hoped that eventually the responses from these questionnaires will be as available within the national DHB patient information system as the results from radiology and lab tests.  Imagine that! Below are the domains as I indicated yesterday. Mood and anxiety - depression, anxiety and pain-specific anxiety were chosen because of their importance to outcomes, and the need to treat psychopathology Catastrophising – because this is thought to be one of the most important as... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4450530 Tue, 08 Feb 2011 18:31:33 +0100 4450530 http://www.medworm.com/index.php?rid=4446048&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F02%2F07%2Fchoosing-chronic-pain-questionnaires%2F Choosing a set of questionnaires for an assessment battery can be a task fraught with all kinds of traps, because if there is one thing bound to get clinical tongues flapping, it’s the idea that their favourite questionnaire will be left out of the mix! And to complicate matters for us Southern Hemispherians, most of the research into normative data for questionnaires is North American, so it can be a long, quite tedious and epic job to arrive at a set that covers all the basic domains, doesn’t give the client questionnaire-fatigue, and uses psychometrically-sound  instruments. At the Centre where I work, the set of questionnaires has just been reviewed and, working with a number of clinicians from around the country, we have arrived at a set that seems to be a reasonably work... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4446048 Mon, 07 Feb 2011 05:53:13 +0100 4446048 http://www.medworm.com/index.php?rid=4399841&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F01%2F26%2Fpulling-it-all-together-biopsychosocial-assessment%2F Over the past little while I’ve been writing about how a comprehensive pain assessment can be carried out.  Today it’s time to pull that information together to develop a formulation, or set of possible explanations for why this person presents in this way at this time – at least for one or two aspects of his presentation. For example, if the person’s pain is low back pain, where surgery has failed to improve the person’s pain, but he has maintained working in a teaching job where physical demands are reasonably light, but is having trouble with sleep, feels irritable, can’t manage things like mowing lawns, and is very careful not to bend because he was advised after surgery to avoid bending because it may affect healing.   Limited forward flexion, si... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4399841 Wed, 26 Jan 2011 01:00:45 +0100 4399841 http://www.medworm.com/index.php?rid=4399506&cid=t_105289_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FqpvPLv4QH9o%2F By Andrew J. CoulsonNew science test scores on the National Assessment of Educational Progress were released today, and they’re not comparable to the scores for earlier years. You may want to know whether our schools are getting better or worse over time in this subject, but apparently the federal government is more ambivalent. There are actually two different flavors of the NAEP tests: the Long Term Trends (which stay the same over time so that we can see, well, trends), and the “Nation’s Report Card,” which can be redesigned whenever it is absolutely… convenient. But here’s the thing: the NAEP Long Term Trends science test has not been administered since 1999, when it showed that a statistically significant decline in achievement had taken place at the... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4399506 Tue, 25 Jan 2011 18:50:41 +0100 4399506 http://www.medworm.com/index.php?rid=4389378&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F01%2F24%2Fpulling-the-biopsychosocial-assessment-together%2F Over the past couple of posts I’ve described one way to assess a person’s chronic pain presentation from a medical, psychosocial and functional perspective.  I don’t think there is much difficulty in seeing how these three perspectives can help us develop a biopsychosocial explanation, or formulation, for why this person is presenting in this way at this time – and that’s what assessment is about, when it comes to chronic pain. A quick note on why explanations or formulations are useful when working in chronic pain.  Acute pain is, as most people know, usually directly related to some sort of tissue damage, potential or actual.  The usual rule for helping someone with acute pain is to diagnose the underlying cause of the pain, remediate that causal factor,... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4389378 Mon, 24 Jan 2011 01:25:20 +0100 4389378 http://www.medworm.com/index.php?rid=4377571&cid=t_105289_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpersonal-genetic-testing-psychological-and-behavioral-effects%2F2011.01.20 In conclusion, personal genetic testing does not seem to generate a lot of distress, although the study was clearly limited by a high dropout percentage of 44 percent and the self-selection of participants who opted to do the test. Article in New England Journal of Medicine: Effect of Direct-to-Consumer Genomewide Profiling to Assess Disease Risk Flashback: An Interview with Navigenics… *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4377571 Thu, 20 Jan 2011 16:00:21 +0100 4377571 http://www.medworm.com/index.php?rid=4372260&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F01%2F20%2Fa-comprehensive-pain-assessment-continued%2F One of the hallmarks of chronic pain is the effect on functional performance.  It’s for this reason alone that an assessment of function needs to be a major part of any comprehensive pain assessment.  This, however, is probably where agreement begins – and ends. Function is all about doing, and in this kind of pain assessment, what I’m interested in is how the person with pain goes about engaging in activities that are important and necessary to him or her.  Like any measure, the sum weight a person can shift in a manual handling task means very little without some sort of context.  I’m more interested in how the person planned the movements; the quality of his or her movements; the pace the person moved; the thoughts or images that went through the person&#8217... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4372260 Wed, 19 Jan 2011 18:41:54 +0100 4372260 http://www.medworm.com/index.php?rid=4360955&cid=t_105289_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FAlknYS0uFx4%2F By Neal McCluskeyRumor has it that President Obama, no doubt because it is always a warm and fuzzy subject, will feature education prominently in his upcoming State of the Union address. If so, he will almost certainly stress his goal of having the United States lead the world in the percentage of its citizens with a college degree by 2020. Unfortunately, doing what feels good often isn’t the same as doing what’s smart. Today, we get more evidence that simplistic, rhetoric-driven education policymaking — more degrees equals more learning equals economic bonanza! — is ultimately counterproductive.  It turns out, students generally learn very little in at least their first couple years of college, and many learn little over four years. According to Inside Hi... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4360955 Tue, 18 Jan 2011 18:33:34 +0100 4360955 http://www.medworm.com/index.php?rid=4361321&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F01%2F19%2Fa-comprehensive-pain-assessment%2F What makes up a comprehensive pain assessment?  I could begin and never end this particular topic, I know, so I’ll try to confine myself to some of the major themes as I see it.  While this is my opinion, and readers should always remember this, there are some very good researchers and clinicians who hold this view as well – and I’ll cite one or two at least! The first aspect to determine in any assessment is its purpose.  I’ll explore this much further in future posts – the process I’ll describe is to guide initial case formulation and broad direction for pain management.  That is, it’s to identify any medical strategies required, to ascertain the basic coping ability (and thus the need for self management), and finally, to gauge the general f... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4361321 Tue, 18 Jan 2011 18:15:38 +0100 4361321 http://www.medworm.com/index.php?rid=4313961&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F01%2F05%2Fjournal-of-the-american-medical-association-2011-vol-305-no-1%2F This article aims to evaluate the relationship between gait speed and survival in geriatric patients. Pooled analysis of 9 cohort studies (collected between 1986 and 2000) measured the survival rates and life expectancy in geriatric patients. Predicted survival based on age, sex, and gait speed was as accurate as predicted based on age, sex, use of mobility aids, and self-reported function or as age, sex, chronic conditions, smoking history, blood pressure, body mass index, and hospitalisation. The article concludes that in this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in older adults. An NHS Athens password is required to access this article online alternatively contact the Library for a copy of the article. Fi... Fade Library blogs http://www.medworm.com/rss/comments.php?id=4313961 Wed, 05 Jan 2011 09:45:28 +0100 4313961 http://www.medworm.com/index.php?rid=4313959&cid=t_105289_85_f&fid=34798&url=http%3A%2F%2Fcommitmenttoliving.com%2F2011%2F01%2F04%2Fhelping-at-risk-patients-who-rarely-show-up%2F From early on in my quest to understand the unique challenges mental health professionals face in working with patients at risk for suicide, I’ve wondered aloud about the things that make us the most nervous. I’m still working my way through a  list of questions I posted based on my notes from a series of trainings I delivered across New York State. One that has kept coming up since that time is this one: How do we handle individuals at risk who are only marginally involved in treatment-they miss more appointments than they make, but still come enough that they remain on our caseloads? Mental health care was not organized to fit the way many people at risk utilize services. Much of outpatient mental health is organized around a fantasy that most patients will (1) Make an appoi... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=4313959 Wed, 05 Jan 2011 02:21:31 +0100 4313959 http://www.medworm.com/index.php?rid=4309639&cid=t_105289_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2011%2F01%2F04%2Fheart-attack-symptoms-and-women%2F I rarely create posts that point directly to another post, but I’m making an exception. Every once in a while I come across a post so phenomenally useful that I just have to point it out and share it. Recently Kevin Pho, M.D. of the KevinMD blog (pictured left) posted just that type of post on his blog. The post, written by Carolyn Thomas, shares the first person descriptions of dozens of women who have had heart attacks. Why is this so useful to my EMT and paramedic readership? Right now, 43% of your female patients who are experiencing heart attacks will present with no chest pain. Chest pain may be the “classic sign” of a heart attack in men, but women are a different story. Female patients are twice as likely to have their heart attacks misdiagnosed by a physician. Ho... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=4309639 Tue, 04 Jan 2011 17:58:21 +0100 4309639 http://www.medworm.com/index.php?rid=4309857&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2F4YPra4KSVlk%2F This article discusses the effects on the body of chronic alcohol intake, the potential symptoms of alcohol withdrawal, and ways to recognize and treat these symptoms through early assessment and consistent intervention.Alcohol Detox During Hospitalisation - Free downloadRelated articlesHelp an Alcoholic 8 (recoveryissexy.com)Alcohol use by healthcare professionals. (twelvestepfacilitation.com)Alcoholic Liver Disease (twelvestepfacilitation.com)Physical Effects of Alcohol on Women (recoveryissexy.com)Enabling of Alcoholism / Addiction Questionnaire (recoveryissexy.com)Random ArticlesDoes AA Lower Alcohol use by Reducing Depression?Reductions in Drinking for Hep C PatientsAbstinence Seekers More Ready to ChangeAlcoholics can benefit from Al-AnonThank You for Visiting My Blogs (Source: Twelv... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4309857 Sat, 01 Jan 2011 04:10:43 +0100 4309857 http://www.medworm.com/index.php?rid=4287578&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2F4PG0SywWPO8%2F Lifetime exposure to potentially traumatic events in a sample of alcoholic patients in Poland. Recent studies show a high prevalence of traumatic events in samples of patients with a substance use disorder.In the present study, the lifetime exposure to potentially traumatic events (PTE’s) was estimated in a sample of 458 patients recruited at 17 randomly chosen alcohol-dependence treatment units in the public healthcare sector in Poland.Eighty percent of the patients reported a history of at least one potentially traumatic event.Sixty percent of them reported experiencing more than one probable trauma.However, only the patients who experienced physical assault reported worse clinical severity in posttraumatic stress (PTSD) and alcohol-use related symptomatology.The findings confirm t... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4287578 Sat, 18 Dec 2010 02:29:17 +0100 4287578 http://www.medworm.com/index.php?rid=4287583&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2F652viuRP4ug%2F Postural sway among abstinent alcoholics can be improved up to a pointExcessive sway during quiet standing is a common and significant consequence of chronic alcoholism, even after prolonged sobriety, and can lead to fall-related injury and even death.A new study of residual postural instability in alcohol-abstinent men and women shows that alcoholics improve with prolonged sobriety, but the improvement may not fully erase the problem of instability.Results will be published in the March 2010 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.“Caricatures depict acutely intoxicated individuals with a stumbling, weaving, wobbly gait,” said Edith V. Sullivan, professor in the department of psychiatry and behavioural sciences at Sta... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4287583 Sat, 11 Dec 2010 01:15:03 +0100 4287583 http://www.medworm.com/index.php?rid=4249089&cid=t_105289_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2FtCwACAFMSQ8%2F URL: http://www.phwa.org/The Psychologically Healthy Workplace Program (PHWP) is a collaborative effort between the American Psychological Association and the APA Practice Organization, designed to educate the employer community about the link between employee health and well-being and organizational performance. For: AnyoneTopics: Behaviour Management, Common Factors, Depression, General Psychology, Life, Lifestyle, Mental Health Promotion, Self-help, Social Psychology, Social SupportFeatures: Articles, Assessment Instruments, Clinical Tools, Collaborative News, Information, Research, Resources The Psychologically Healthy Workplace Program (PHWP) is a collaborative effort between the American Psychological Association and the APA Practice Organization, designed to educate the employer... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=4249089 Fri, 10 Dec 2010 17:00:22 +0100 4249089 http://www.medworm.com/index.php?rid=4241678&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F12%2F08%2Fnursing-times-2010-vol-106-no-47%2F This article examines strategies for toilet training using a five step appraoch to achieve bladder and bowel control. Contact the Library for a copy of this article. Filed under: Ooops Missed Category! Tagged: Assessment, Continence, Learning Disabilities (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4241678 Wed, 08 Dec 2010 13:14:17 +0100 4241678 http://www.medworm.com/index.php?rid=4241681&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F12%2F08%2Fjournal-of-the-american-medical-association-2010-vol-304-no-21%2F Contents Page Fade Fave: Toward an Outcomes-Based Health Care System: A View From the United Kingdom Fade Skinny: In a comprehensive, publicly funded system like the United Kingdom’s National Health Service (NHS) there is an overriding imperative to deliver maximum health benefit per pound spent. Quality, effectiveness, and efficiency are the goals. Following a decade of above-inflation increases in NHS funding, the urgent need to reduce the United Kingdom’s national debt means the NHS is entering a sustained period of flat or declining funding, while demand for services continues to increase (from technological progress, an aging population, increasing expectations, and population growth). Striving for value therefore becomes an ethical imp... Fade Library blogs http://www.medworm.com/rss/comments.php?id=4241681 Wed, 08 Dec 2010 12:14:42 +0100 4241681 http://www.medworm.com/index.php?rid=4245608&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FCU2QcXFcum0%2F in Primary Care Settings Michael F. Fleming, M.D., M.P.H. Primary care practitioners are in a unique position to identify patients with potential alcohol problems and intervene when appropriate. Screening, the process by which practitioners can identify at-risk drinkers, can be followed by one-time or repeated short counseling sessions, known as brief interventions, which are designed to help the patient reduce drinking and minimize related problems. Varied levels of screening and brief intervention can be implemented in the primary care setting, depending on patient and physician factors. Although screening and brief intervention are valuable tools, they are underutilized in primary care practices. Strategies that may help increase physicians’ use of these techniques in the primary... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4245608 Wed, 08 Dec 2010 00:54:29 +0100 4245608 http://www.medworm.com/index.php?rid=4245609&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FStQOf6irHMM%2F Alcoholism is a diagnosable disease similar to other chronic, relapsing conditions such as asthma, diabetes and high blood pressure. All of these illnesses: Have strong genetic and behavioral components Can be identified with reliable diagnostic methods Can be effectively managed with behavior change and medication Show similar patterns of symptom control and relapse Yet we continue to deal with alcoholism as a social problem more often than as a health issue, primarily because of the stigma, or social disapproval, that accompanies addiction to any drug. As a result, too few people get the treatment they need. This drives up alcohol-related health care costs, disrupts families, cuts productivity in the workplace and threatens the safety of our communities. Recent advances in neuroscienc... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4245609 Mon, 06 Dec 2010 21:10:38 +0100 4245609 http://www.medworm.com/index.php?rid=4233128&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F12%2F06%2Fimpact-assessment-visualised%2F Overall Impact We saw a great feedback wordle from a training session the other day so we thought it would be interesting to run the Impact Assessment feedback forms through it as a really quick and lazy piece of content analysis. This is particularly useful for the comment boxes on our feedback forms which we’ve been mor than a little gratified people have completed. Mediated Search Feedback Document Supply Impact Feedback Information Handling Training Impact Feedback   Filed under: Fade, Fade Comms, Librarianship, Library Services, Literature Searching, Searching, Study Skills Tagged: Content Analysis, Data, Impact Assessment, Visualisation (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4233128 Mon, 06 Dec 2010 11:34:35 +0100 4233128 http://www.medworm.com/index.php?rid=4220462&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FAkreI4Vn5yg%2F Phases of Alcoholism RecoveryThe recovery process in Alcoholics Anonymous includes several general phases that people may pass through. These are not time related but are usually dependent on the persons particular circumstances.Initial SobrietySurrenders to alcohol – accepts alcoholismBegins humble search for selfRestoration of physical health beginsRestoration of memory beginsRestoration of mental functions beginsBegins to practice self-honestyIs pre-occupied with sobrietyGrowth of open-mindednessLessening of needless guiltFreely discusses alcohol and its problemsMild depression and anxiety lessensMental functions are more alertLearning SobrietyAccepts and owns their alcoholismLoss of freedom acknowledged and acceptedAlibis replaced by sound reasons for sobrietySocial pressures to ... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4220462 Mon, 29 Nov 2010 19:56:20 +0100 4220462 http://www.medworm.com/index.php?rid=4207517&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F11%2F29%2Fcan-psychological-management-of-fibromyalgia-affect-pain%2F When I’m working with someone who has chronic pain, from the outset I’m pretty straight-up that the treatments I offer don’t directly affect pain intensity.  It’s not my focus, and very often after the first session, I don’t even discuss pain – I’m more interested in what the person is doing! And for this focus, I sometimes get some reasonably snippy comments, none more so than a doctor (who shall remain nameless) who said to some of my students that psychological and functional approaches to pain management are, in effect, useless because they ‘can’t directly address the pain’. Well, I beg to differ, kind sir. While pain intensity isn’t the focus of treatment, it very often is affected by the treatments offered using a cog... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4207517 Sun, 28 Nov 2010 21:06:30 +0100 4207517 http://www.medworm.com/index.php?rid=4220464&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FY6OqkALBvcs%2F What They Want: Motivation and Treatment Choice in Non-treatment-Seeking Substance AbusersAlthough a variety of therapies exist for the treatment of substance use disorders, little emphasis is placed on allowing individuals to choose their own treatment trajectories. Considering the preference of a person for the type of substance abuse treatment; he or she would want to be made to feel important and in allowing the person to feel autonomous, which may impact the overall motivation for substance abuse behavior change.The investigators assessed 51 country detention facility inmates recently arrested on drug-related or alcohol-related charges, examining the motivational factors and treatment preference when presented with 2 hypothetical treatments.The findings showed that the group was relat... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4220464 Thu, 25 Nov 2010 23:55:00 +0100 4220464 http://www.medworm.com/index.php?rid=4179310&cid=t_105289_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FTfZilzWQDTM%2F By Neal McCluskeyThe recent elections made one thing very clear: Americans want a cheaper, smaller, more effective federal government. Today we have powerful evidence that a terrific place to start giving them that is education. New National Assessment of Educational Progress — so-called “Nation’s Report Card” — scores are out, and despite years of massive increases in federal education spending, as well as nearly a decade of No Child Left Behind “accountability,” stagnation is what we’ve gotten. Reading scores for 12th graders — our schools’ final products — are lower than they were in 1998 and 1992. In math all we have is a slight bump between 2005 and 2009, and no data before that because NAEP changed its math framework, ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4179310 Thu, 18 Nov 2010 16:55:40 +0100 4179310 http://www.medworm.com/index.php?rid=4151687&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F11%2F09%2Fnursing-times-2010-vol-106-no-42%2F Fade Fave: How to compile a professional portfolio of practice 2: structure and building evidence Fade Skinny: This is the second in a two-part unit on developing a professional portfolio and what is meant by quality evidence and how to develop it. Contact the Library for a copy of this article. Filed under: Journals Tagged: Nursing, Portfolio. Assessment, Structure, Work-based Learning (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4151687 Tue, 09 Nov 2010 09:10:02 +0100 4151687 http://www.medworm.com/index.php?rid=4133755&cid=t_105289_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F11%2F03%2Fthe-three-collision-rule%2F I imagine it was probably my first Prehospital Trauma Life Support class back in 1990 that I first heard of the three collision rule. Since then, it has remained a useful tool in examining the mechanism of injury after auto accidents. If you haven’t heard of it, please allow me to elaborate. The three collision rule states that, in any auto accident, there are three collisions that occur and the keen EMT needs to be aware of all three. The next time you walk up to a vehicle accident, instead of imagining two large objects colliding with each other, imagine three separate collisions occurring with each respective vehicle. All of them have implications for the alert EMT. Collision Number One: The Exterior of The Vehicle Strikes Something Take a quick walk around the vehicle and conside... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=4133755 Thu, 04 Nov 2010 02:26:24 +0100 4133755 http://www.medworm.com/index.php?rid=4125302&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F11%2F01%2Fwords-on-the-value-of-data%2F I’m not known for my immaculate office or my attention to detail – I’m the sort of big picture or conceptual person in a team.  I care about values and finding a way to achieve an end result, but I’m less fascinated by detail.  There is, however, a time when record-keeping and data comes into its own, and I am very grateful to those people who do look after the nuts and bolts.  And today’s post is about why. I work in a tertiary pain management centre in a teaching hospital in a large health organisation with multiple layers of administration and management all wanting a piece of the fiscal pie allocated to us from central government.  Throughout my years in health care, I can’t ever recall being told ‘we have lots of money, let’s go shop... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4125302 Mon, 01 Nov 2010 07:31:47 +0100 4125302 http://www.medworm.com/index.php?rid=4139487&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FK1pXSga4XFg%2F Researchers Identify Five Alcoholism Subtypes Analyses of a national sample of individuals with alcohol dependence (alcoholism) reveal five distinct subtypes of the disease, according to a new study by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH). “Our findings should help dispel the popular notion of the typical alcoholic, notes first author Howard B. Moss, M.D., NIAAA Associate Director for Clinical and Translational Research. “We find that young adults comprise the largest group of alcoholics in this country, and nearly 20 percent of alcoholics are highly functional and well-educated with good incomes. More than half of the alcoholics in the United States have no multigenerational family history... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4139487 Sat, 30 Oct 2010 15:02:30 +0100 4139487 http://www.medworm.com/index.php?rid=4119760&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F10%2F28%2Fwhats-missing-from-pain-assessment%2F I am stumped. Here is a common clinical quandary – one of the most important outcomes from pain management is to increase participation in daily activity (occupation), yet the measures we use just don’t quite cut it for me. Here’s a couple of examples: in the IMMPACT recommendations from 2008 (in the paper I’ve cited below and from the one I cited earlier this week) two ‘disability’ measures are suggested as a way to assess disability.  One is the ‘Interference’ subscale from the Multidimensional Pain Inventory, and the other is the Pain Disability Index.  Both of these have sound psychometric properties, have been used for a long time in pain management research and clinical use – but both of them have problems. The problems are abou... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4119760 Wed, 27 Oct 2010 18:39:19 +0100 4119760 http://www.medworm.com/index.php?rid=4106087&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F10%2F26%2Fwhat-matters-to-people-with-persistent-pain%2F I’ve read many written expectations of people coming for pain management – and without a doubt, the majority of people want to get on with life, go back to doing what they enjoy, and feel better in themselves. The only problem with that? Most of them preface their goals with ‘reduce my pain so I can…’, or words to that effect. And the reality is that for many of them, that particular goal is frustratingly difficult to achieve. I would think that most clinicians working in pain management want to practice patient-centred care – but what is it that patients really want when pain can’t be completely eliminated? Luckily for us (maybe), the team developing the IMMPACT (Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials) recommend... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4106087 Mon, 25 Oct 2010 18:29:08 +0100 4106087 http://www.medworm.com/index.php?rid=4106088&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F10%2F25%2Fessential-skills-for-pain-clinicians%2F Strangely enough I don’t have a specific reading or paper for my post today – only my experience over a long time working in pain management. Now I know anecdotes are not strong evidence, yet at the same time there are some things that have yet to be well researched, so this is an attempt maybe to put something out there that someone will pick up and run with! What are some of the essential skills for pain clinicians? Whether they’re working in acute pain or chronic pain, I think the first and sot essential skill is the ability to listen and be empathic towards the peson with pain. To me, listening with the whole mind and heart is a clinical imperative. It means really hearing what the person is saying with words and body. Why would I put this skill at the top of the list... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4106088 Sun, 24 Oct 2010 21:01:05 +0100 4106088 http://www.medworm.com/index.php?rid=4074453&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Falcohol-use-disorders-in-the-critically-ill-patient%2F Image via Wikipedia Alcohol abuse and dependence, referred to as alcohol-use disorders (AUDs), affect 76.3 million people worldwide and account for 1.8 million deaths per year. AUDs affect 18.3 million Americans (7.3% of the population), and up to 40% of hospitalized patients have AUDs. This review discusses the development and progression of critical illness in patients with AUDs. In contrast to acute intoxication, AUDs have been linked to increased severity of illness in a number of studies. In particular, surgical patients with AUDs experience higher rates of postoperative hemorrhage, cardiac complications, sepsis, and need for repeat surgery. Outcomes from trauma are worse for patients with chronic alcohol abuse, whereas burn patients who are acutely intoxicated may not have... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4074453 Thu, 14 Oct 2010 16:16:00 +0100 4074453 http://www.medworm.com/index.php?rid=4031176&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F10%2F05%2Fageing-and-society-2010-vol-30-no-7%2F This article looks at the concerns of policy makers, practitioners, older people and carers with regards to the quality of assessment of older people with health and social care needs. (Print subscription held at Fade Library) Filed under: Current Awareness, Journals Tagged: Adult Services, Assessment, Local Authorities, Multidisciplinary Teams, Older People (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4031176 Tue, 05 Oct 2010 06:56:00 +0100 4031176 http://www.medworm.com/index.php?rid=4027357&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FScUSn2l5j_o%2F Which to treat first; Comorbid anxiety or alcohol disorder? Therapies that target just one problem are in sufficient for patients who have both. Men and women with anxiety disorders are at three times the general population’s risk of being alcohol-dependent, and those who seek treatment for an anxiety disorder are at even higher risk of alcohol disorder. This comorbidity can complicate treatment attempts if either disorder remains unaddressed, leading to increased relapse risk and multiple treatment episodes. Based on our research and clinical work in helping patients with comorbid alcohol dependence and anxiety disorders, this article describes: potential relationships between anxiety disorders and alcohol disorder pros and cons of 3 approaches to treating this comorbidity how... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4027357 Sat, 02 Oct 2010 07:29:38 +0100 4027357 http://www.medworm.com/index.php?rid=4025782&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FQK6H7gd2PM0%2F The relation between alcohol problems and the anxiety disorders. The idea that people suffering from anxiety have a proclivity to consume alcohol to relieve their symptoms is supported by reports showing high comorbidity rates of alcohol and anxiety problems. The authors reviewed relevant epidemiologic surveys, family studies, and field studies and conclude that the relationship between alcohol problems and anxiety appears to be variable among the anxiety disorders. In agoraphobia and social phobia, alcohol problems appear more likely to follow from attempts at self-medication of anxiety symptoms, but panic disorder and generalized anxiety disorder may be more likely to follow from pathological alcohol consumption. Simple phobia does not appear to be related to alcohol problems in any mean... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4025782 Wed, 29 Sep 2010 06:42:51 +0100 4025782 http://www.medworm.com/index.php?rid=4025783&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2F8ZVc_aHzUf8%2F : Prevalence, predictors, and counteracting treatment influences The prevalence, predictors, and treatment-related factors affecting dropout from 12-step self-help groups in the first year following professional substance abuse treatment were assessed in 2,778 male patients. The patients were asked to complete an inventory at baseline, at discharge, and 1 year after discharge. Attendance at 12-step groups either in the 90 days before treatment or during treatment was reported by 91% (2,518). Forty percent had dropped out at the 1-year follow-up. Logistic regression analysis revealed that the odds of having used substances by the time of the 1-year follow-up were almost three times higher for those who had dropped out of 12-step self-help groups than for those who had continued attendance (... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4025783 Tue, 28 Sep 2010 06:16:06 +0100 4025783 http://www.medworm.com/index.php?rid=4003454&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F09%2F28%2Ffearanxietyavoidance-%25e2%2580%2593-treatments-review%2F For years, clinicians working in pain management have mixed together a rich assortment of strategies to help people function better.  But to identify the ‘active ingredients’ of multidisciplinary pain management using a cognitive behavioural approach, it’s been important to tease each element apart.  One size does not fit all – and just as a physician chooses the most effective medication for a disorder, in time I hope we will be able to choose the most effective strategy for the problems each individual experiences rather than applying our current ‘scatter-gun’ approach. Yesterday I gave a brief overview of the three main treatments to helping people who are fearful/anxious of their pain (or harm) and avoid activities as a result. They are: Graded ex... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4003454 Mon, 27 Sep 2010 18:25:26 +0100 4003454 http://www.medworm.com/index.php?rid=4003294&cid=t_105289_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2FPwmILitKMD8%2F URL: http://www.additudemag.com/What will you find on ADDitude’s site? There’s so much! For: Anyone, ConsumersTopics: ADHD, Behaviour Management, Child and Adolescent, Clinical Psychology, Life, Mental Health, Mental Health Promotion, Self-help, Treatment PlanningFeatures: Advertising, Articles, Assessment Instruments, Collaborative News, Commentary and Blogs, Community and Social Networking, Forums, Information, Interviews, Links, NewsletterWhat will you find on ADDitude’s site? There’s so much: Practical information about raising children with ADD/ADHD, including behavior and discipline strategies, help making and keeping friends, and organizing for success. Hundred of answers from ADDitude’s expert panel to difficult questions asked by real people living with A... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=4003294 Mon, 27 Sep 2010 17:00:58 +0100 4003294 http://www.medworm.com/index.php?rid=3994369&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F09%2F23%2Fworking-with-thoughts-habits-take-time-to-change%2F If only there was a magic wand. I could make millions out of a ‘quick fix’ to changing habits! Unfortunately my magic wand is red and glittery – and plastic. I call it my ‘self management’ wand because it reminds me that self management is no quick fix, and a good deal of the work we need to do is about helping people recognize unhelpful thoughts and behaviors that might work in the short term, but not so in the long term. Changing patterns for sleeping well despite chronic pain is no different – what might have been going on for years isn’t likely to change overnight. Some of the thoughts that people have when embarking on cognitive behavioral therapy for insomnia can be quite unhelpful. One woman I worked with became despondent and eventually gav... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3994369 Wed, 22 Sep 2010 18:35:51 +0100 3994369 http://www.medworm.com/index.php?rid=3987247&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F09%2F21%2Fthinking-about-sleep-or-not%2F It’s 3.00 in the morning.  You haven’t slept since you got into bed at 11.00, and the last time you had a full night’s sleep was some months ago.  Every morning you wake up feeling as though you haven’t really slept yet – and every day is just the same. I can understand why people who have sleeping problems (and yes, I’m one of them!) often have quite strong reactions when they’re introduced to some of the concepts that are most successful for restoring a normal sleep pattern.  While the basic principles of sleep hygiene are well-known and reasonably simple, putting them – and other more challenging strategies in place – can be quite a difficult process. It’s what goes through a person’s mind that makes it difficult &#821... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3987247 Tue, 21 Sep 2010 09:06:04 +0100 3987247 http://www.medworm.com/index.php?rid=3983559&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F09%2F20%2Fsleep-problems-in-chronic-pain-what-helps%2F I have written about sleep problems in people with chronic pain several times. It is one of those aspects of dealing with pain that inevitably arise as I talk with people about energy, their activity through the day, and their mood. Many people blame the pain for their sleep problems, which is unsurprising really – once you’re awake in the middle of the night, there’s not a lot else to think about! But it seems like while pain might be associated with a sense of poorer quality sleep, and could well have been a factor influencing the onset of insomnia, it’s often other factors that maintain unsatisfying sleep. What are those factors? Well, one of the first ones is ‘general affective disturbance’ - in other words, feeling low or flat, whether frankly depre... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3983559 Mon, 20 Sep 2010 08:02:29 +0100 3983559 http://www.medworm.com/index.php?rid=3999300&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FooBa0LA0VSU%2F Is emergency department based brief intervention worthwhile in adults presenting with alcohol related events? BEST EVIDENCE TOPIC REPORTS A short cut review was carried out to establish whether emergency department (ED) based brief intervention is worthwhile in adults presenting with alcohol related events. A total of 590 papers were found using the reported search, of which eight represented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are presented in table 1. The clinical bottom line is that brief psychotherapeutic intervention is worthwhile in adults who attend the emergency department after an alcohol related event. Emergency Medic... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3999300 Sun, 19 Sep 2010 04:38:02 +0100 3999300 http://www.medworm.com/index.php?rid=3982013&cid=t_105289_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftranscontinental-anesthesia%2F2010.09.18 Just two weeks after we reported on teleanesthesia in the form of remotely-performed nerve blocks, the first report of transcontinental anesthesia comes in. On August 30, anesthesiologists of McGill-McGill University Health Centre in Montreal, kept watch over a patient in Pisa, Italy, undergoing thyroid gland surgery. Basically they used a teleconferencing setup with four cameras, with two cameras streaming the anesthesia data (ventilation parameters and vital signs), one camera aimed at the operating field, and the last one for any special purposes. (more…) *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3982013 Sat, 18 Sep 2010 22:00:01 +0100 3982013 http://www.medworm.com/index.php?rid=3921093&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F09%2F01%2Fmeasuring-changes-during-graded-exposure-acceptance-treatment%2F I have been pondering about the best way to monitor ‘Matt’s progress during graded exposure therapy for his avoidance of activities involving back movement. I introduced you to Matt yesterday. He’s a ‘man’s man’, a real bloke who, for the past four years since he had surgery for a prolapsed disc, has avoided things like mowing the lawns, making the bed, fishing and whitebaiting and even golf. Yesterday I described how we went through 100 photographs of activities of daily living, and of these, Matt identified 67 of the photographs as things he wouldn’t do because of his concern about both the impact on his pain and the ‘strain’ on his back. I have used a simple count of the number of photographs a person decides is in the ‘avoided... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3921093 Tue, 31 Aug 2010 19:35:59 +0100 3921093 http://www.medworm.com/index.php?rid=3920782&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F08%2F31%2Fnursing-times-2010-vol-106-no-29%2F This article examines the assessment of acute pain in olde rpeople, as well as different approaches to and challenges in pain management. Contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: Acute Pain Management, Older People, Pain, Pain Assessment (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3920782 Tue, 31 Aug 2010 09:57:06 +0100 3920782 http://www.medworm.com/index.php?rid=3915309&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F30%2Fexposure-in-vivo-for-kinesiophobia%2F In this study, the authors firstly looked at outcomes of graded exposure and whether anxiety, depression and catastrophising moderated these.  While anxiety was found to influence outcome generally (leading to poorer outcomes for those who were more anxious), catastrophising was found to have a more complex relationship.  Graded exposure was effective for low and moderate catastrophising, but for those with high catastrophising the results were far less spectacular.  And depression? Made little difference to outcome at all. After finding that high levels of catastrophising influenced outcome, the next step in this study was to examine those people who made a good deal of changein disability  and compare them with those who made much less change in disability.   For this part of the s... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3915309 Sun, 29 Aug 2010 19:33:53 +0100 3915309 http://www.medworm.com/index.php?rid=3899658&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F25%2Fdrawing-pain%2F The pain drawing has to be one of the more ubiquitous assessment tools around. There are many versions of outlines of naked bodies on which a person can scribble, colour, and write to indicate to treatment providers exactly where they feel their pain, and to a certain extent, some of the sensory features of that pain. But – how many of us use that drawing for anything other than ‘Oh so that’s where you feel it?’ Schott, in this truly interesting paper, discusses pain maps – not a term I’d come across before – and traces the history of pain maps as well as discussing some of the problems with it – and concludes that pain maps can contribute something quite unique to our understanding of the person’s experience, but at the same time, ackn... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3899658 Wed, 25 Aug 2010 03:05:42 +0100 3899658 http://www.medworm.com/index.php?rid=3921085&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2Fa6lHYSy2j5Y%2F , Skills in Discussing Alcohol Use Often, primary care clinicians inadequately address alcohol use with their patients. To describe alcohol-related discussions in primary care, investigators audiotaped and performed qualitative analysis of outpatient visits involving 14 primary care clinicians (physicians and nurse practitioners) and 29 of their patients. All patients were male veterans who screened positive for unhealthy alcohol use.* Three themes emerged: Patients often disclosed that they consumed large amounts of alcohol and/or experienced negative health consequences from drinking. Clinicians commonly responded by changing the subject, minimizing the significance of their patients’ drinking, or pursuing a nonalcohol-related issue. Hesitation, stuttering, inappropriate laughter,... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3921085 Tue, 24 Aug 2010 21:39:13 +0100 3921085 http://www.medworm.com/index.php?rid=3891826&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F23%2Fwho-drops-out-of-cbt-for-chronic-pain%2F Wouldn’t it be wonderful if everyone we saw was ready for self management and committed to putting everything in place? Wouldn’t it be even better if we could tell who was and who wasn’t going to drop out? Then we could focus treatment on people who were ready for treatment, and help those who are not ready prepare to get ready (or manage their situation differently). Unfortunately, it’s one of those areas that is not well-researched, even though it’s a very important part of our clinical planning and can affect up to 60% of people initially enrolled in a cognitive behavioural approach to pain management. Over the years I’ve worked in pain management, I’ve seen several different approaches for establishing whether people should be included or not. ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3891826 Mon, 23 Aug 2010 09:14:55 +0100 3891826 http://www.medworm.com/index.php?rid=3868760&cid=t_105289_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F08%2F15%2Fpatients-define-their-emergencies-part-2%2F True Story… The dispatch information was updated before we had even rolled our rig out onto the pad. Eye injury, no serious symptoms. Jodie shut down the lights and I informed dispatch that we’d be responding non-emergent. Up stairs and inside the small two bedroom apartment, Samantha, our patient, was waiting on the couch, holding a hot compress to her swollen right eyelid. Mom worked calmly in the kitchen finishing diner for her other two children. Alan, Samantha’s father sat on the edge of his seat next to his daughter in a state of barely containable anxiety. He had recently arrived home from work and his wife had informed him of the apparent infection in Samantha’s right eye. One look and he was on the phone to us. Now he breathed rapidly as he fumbled throug... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3868760 Sun, 15 Aug 2010 22:10:06 +0100 3868760 http://www.medworm.com/index.php?rid=3899646&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2Fxz8xbe6QJxs%2F Women Physicians and Addiction. Doctors get addicted just like other people and female doctors have earlier addiction and develop worse medical conditions. Researchers compared case histories of 969 male and female (13%) substance dependent doctors. Their conclusions; “These findings suggest different characteristics between male and female impaired physicians which may have implications for identification and treatment of this population.” The comparison revealed that females; Were younger by 4 years (mean 40 years) Had 15% more medical problems (49%), and 13% more psychiatric issues (76%) More past suicidal ideation (52% v 30%), and Current suicidal ideation (11% v 5%) Had attempted more suicides (20% v 5%) while intoxicated, and Had attempted more suicides (14% v 2%... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3899646 Sat, 14 Aug 2010 19:19:21 +0100 3899646 http://www.medworm.com/index.php?rid=3858433&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F12%2Fwhat-do-people-with-chronic-pain-health-anxiety-worry-about%2F This study by Tang and colleagues took a group of 60 patients with chronic pain attending a pain management centre, half of whom had high health anxiety and half with low health anxiety.  They conducted in-depth semi-structured interviews with these patients, and looked at how much the cognitive, affective, physiological and behavioural responses described by the participants were consistent with the predictions of the health anxiety model. The groups were distinguished in terms of health anxiety by their responses on the Short Health Anxiety Inventory, a popular tool for assessing clinically significant health anxiety.  The high health anxiety group all scored well above 18, the cut-off score for Health Anxiety, while the low health anxious group didn’t reach this cut-off at all. ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3858433 Wed, 11 Aug 2010 19:31:20 +0100 3858433 http://www.medworm.com/index.php?rid=3858203&cid=t_105289_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2F3hjmV_oYWdU%2F URL: http://www.ulifeline.com/main/Home.htmlULifeline is an anonymous, confidential, online resource center, where college students can be comfortable searching for the information they need and want regarding mental health and suicide prevention. ULifeline is available where college students seek information the most - at their fingertips on the Internet. For: StudentsTopics: Clinical Psychology, Cognitive Behaviour Therapy, Counselling, Depression, Emotional Health, LifeFeatures: Assessment Instruments, Clinical Tools, Community and Social Networking, Information, Self MonitoringULifeline is an anonymous, confidential, online resource center, where college students can be comfortable searching for the information they need and want regarding mental health and suicide prevention. ULifelin... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=3858203 Wed, 11 Aug 2010 17:00:49 +0100 3858203 http://www.medworm.com/index.php?rid=3854774&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F11%2Fis-reassurance-reassuring%2F Having started yesterday’s post by discussing health anxiety, and pointing out that one of the things people do to cope with their anxiety about their pain is to seek reassurance, I thought it might be useful to go back to a paper published a couple of years ago by Linton, McCracken & Vlaeyen (2008).  In this paper, the authors reviewed the concept of reassurance and see whether it is, in fact, reassuring. What is reassurance anyway? We talk about it as if we know what we mean, and it’s even part of most guidelines for managing acute low back pain – but what is it? In this paper, the authors refer to the Oxford dictionary definition where reassurance is defined as ‘‘. . .removes the fears or doubts of (pain/illness); to comfort’’. As they point out, “Re... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3854774 Tue, 10 Aug 2010 18:43:41 +0100 3854774 http://www.medworm.com/index.php?rid=3808857&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F02%2Fmeasuring-the-total-impact-of-a-health-condition%2F When I think of the ‘cost’ of having a disability, I have to say I usually think about the effect of the disorder alone on the ability to do valued activities – I haven’t usually thought about the impact of the treatment itself on how people live their lives. I came across this paper by Gerald Devins while searching for ways to measure the effectiveness of interventions on the lives of people attending the Pain Management Centre in which I work.  (I had been looking for something that could measure ‘interference’ of pain on activity and found a couple of good measures such as the Interference subscale from the Westhaven Yale Multidimensional Pain Inventory and the Interference bank of statements from the PROMIS bank.) Anyway, Devins introduced me to the... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3808857 Mon, 02 Aug 2010 08:25:40 +0100 3808857 http://www.medworm.com/index.php?rid=3790939&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F07%2F27%2Fassessment-as-intervention%2F When you start to put together all the elements that people want from a health interaction, it’s not surprising that simply having an assessment can be an incredibly powerful experience. So much so that an assessment can be counted as an intervention in its own right. Does that make you think about the investment you put into the process? Poston and Hanson in a very recent meta-analytic study of psychological assessment found an effect size of d=0.423 (CI [0.321, 0.525]) in a sample of 1, 496 participants over 17 studies. That’s a whole lot of effect – about 66% of participants who went through a psychological assessment changed significantly compared with the control or comparison group. What that means to me is that what we do during the assessment process is just as im... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3790939 Mon, 26 Jul 2010 19:44:59 +0100 3790939 http://www.medworm.com/index.php?rid=3772345&cid=t_105289_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FjLsVNwDrhXw%2F This study established the methodologies that made possible the effective scientific study of the efficacy of psychotherapies. The evidence base and of such treatments as CBT, DBT, Motivational Enhancement Treatment and other evidence-based psychotherapies derives directly from this study and its seminal influence. This was a contribution to the science of Clinical Treatment Development research. I would say that my major interest, however, has been in the next step, the science of knowledge transfer. There has been and remains a long and costly (in terms particularly of unnecessary suffering) lag between the development of new knowledge and its common and effective use in practice. In order the help the field moved forward, I have worked for the last 20 years in the development and implem... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=3772345 Tue, 20 Jul 2010 10:07:21 +0100 3772345 http://www.medworm.com/index.php?rid=3764303&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F07%2F19%2Fintuition-and-other-failings-in-clinical-reasoning%2F Einstein is accredited with saying “The important thing is not to stop questioning” while Euripedes apparently said “Question everything. Learn something. Answer nothing.” I’m sure of the origins of neither quote – but I think I must have inhaled both of them when I was a toddler because I have never stopped asking ‘why’! In clinical reasoning, there is a real risk of having our very human cognitive reasoning biases kick in before we can even draw a breath. This isn’t surprising – but it is very, very subtle and we can fail to identify our biases until well after we’ve made decisions based on hunches, intuition or other incomplete information – if we pick them up at all. And if we think that years of experience make us immune ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3764303 Sun, 18 Jul 2010 19:29:11 +0100 3764303 http://www.medworm.com/index.php?rid=3761633&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Falcohol-screening-and-brief-intervention%2F in Primary Care Settings Michael F. Fleming, M.D., M.P.H. Primary care practitioners are in a unique position to identify patients with potential alcohol problems and intervene when appropriate. Screening, the process by which practitioners can identify at-risk drinkers, can be followed by one-time or repeated short counseling sessions, known as brief interventions, which are designed to help the patient reduce drinking and minimize related problems. Varied levels of screening and brief intervention can be implemented in the primary care setting, depending on patient and physician factors. Although screening and brief intervention are valuable tools, they are underutilized in primary care practices. Strategies that may help increase physicians’ use of these techniques in the primary... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3761633 Fri, 16 Jul 2010 12:01:05 +0100 3761633 http://www.medworm.com/index.php?rid=3750314&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F07%2F14%2Fways-to-ask-about-sensitive-topics%2F I teach postgraduate courses in pain and pain management.  Many of my students are experienced general practitioners who often ask me “how do I talk to people with pain about psychosocial issues without them thinking I’m telling them their pain is ‘all in the head’?” It can be a pretty sensitive topic for the person with unexplained pain that doesn’t go away because to somehow suggest (a) they’re not coping with their situation or (b) they have some psychological problem can seem uncaring or even that the person’s pain is ‘imaginary’. The psychosocial ‘yellow flags’ are widely known, but even after a decade or more of exposure to what the ‘yellow flags’ are, there is much confusion and misconception.  Tod... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3750314 Tue, 13 Jul 2010 19:32:03 +0100 3750314 http://www.medworm.com/index.php?rid=3743735&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F07%2F12%2Fself-report-or-really-doing-it-or-both%2F In this study, a group of women with widespread pain, some reaching threshold for fibromyalgia, who had been referred for a pain management programme had their activities of daily living performance assessed in two ways: one was the typical pen and paper questionnaire, this time the Fibromyalgia Impact Questionnaire (Burckhardt, Clark, and Bennett, 1991); and the other an occupational therapy specific measure AMPS, or Assessment of Motor and Process Skills (Fisher, 1993). All participants were assessed prior to participating in the outpatient interdisciplinary pain management programme, and once a completion of the programme and again at follow-up. AMPS requires that the person carry out two of 85 standardised personal ADL and domestic ADL tasks, calibrated to be at the level appropriate f... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3743735 Sun, 11 Jul 2010 19:36:56 +0100 3743735 http://www.medworm.com/index.php?rid=3740831&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FBEp_28lOq1E%2F A Study of Readiness to Change Profiles in Alcohol and Other Drug Abusers. The purpose of the study was to measure readiness to change profiles of alcohol and other drug abusers, information which is needed in the individual tailoring of treatment. The subjects (N = 780) were Finnish alcoholics and polydrug users receiving inpatient treatment. The instrument used to measure readiness to change was the University of Rhode Island Change Assessment Scale (URICA). In the cluster analysis the subjects were placed in groups. The results revealed wide differences in readiness to change profiles, yet not between alcoholics and polydrug users. Higher education, female gender, living with minor children and marital state were consistently associated with better readiness to change. Those coming on ... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3740831 Mon, 05 Jul 2010 09:47:56 +0100 3740831 http://www.medworm.com/index.php?rid=3726570&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F07%2F05%2Fquality-in-primary-care-2010-vol-18-no-3%2F This article aims to assess whether there is any value or effect of patient care planning on the quality of home care. It concludes that care plans in home care lead to significant differences in process, but they have no effect on outcomes for patient and informal caregivers. Contact the Library for a copy of this article Filed under: Current Awareness, Journals, Primary Care Tagged: Access, Evaluation, Healthcare, Outcomes, Patient Care Planning, Primary Health Care, Process Assessment, Quality (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3726570 Mon, 05 Jul 2010 09:41:58 +0100 3726570 http://www.medworm.com/index.php?rid=3721970&cid=t_105289_151_f&fid=35818&url=http%3A%2F%2Frecoveryissexy.com%2Fwhat-is-problem-gambling-2%2F Problem gambling is gambling to the extent that it causes emotional, family, legal, financial or other problems for the gambler and the people around the gambler. Problem gambling can get worse over time, and gambling problems can range from mild to severe. “What are some signs of problem gambling?” When people have a problem with gambling, many times they feel like they need to bet more money more frequently, feel irritated when they try to stop, and think that they can “chase” their losses to recover money. This can lead to more gambling, despite financial loss and the trust of friends and loved ones. In general, people with gambling problems usually spend a large portion of their income on gambling. “Do a lot of people have problems with gambling?” If gambling is b... Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=3721970 Fri, 02 Jul 2010 16:08:00 +0100 3721970 http://www.medworm.com/index.php?rid=3714311&cid=t_105289_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FiGhbnYRh3c8%2F Karolinska Development to divest portfolio company (press release) “Today, Karolinska Development has divested Cogmed, one of Karolinska Development’s portfolio companies, to Pearson where it will become part of Pearson’s Clinical Assessment business.” Why does it make all the sense in the world for a large publisher with heavy educational and clinical operations to acquire a computerized cognitive training company like Cogmed? and, why Pearson? Read more (Source: SharpBrains) SharpBrains blogs http://www.medworm.com/rss/comments.php?id=3714311 Wed, 30 Jun 2010 16:51:38 +0100 3714311 http://www.medworm.com/index.php?rid=3695817&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FUUeQOwQ1cyQ%2F New Findings on Asian Alcohol-Protection Gene Only certain East Asian populations have a high prevalence of a gene that protects against alcohol over-consumption, and researchers speculate that some event must have occurred over the past few thousand years to make this genetic protection advantageous, Reuters reported. Yale University researchers said that unknown environmental factors are the likely cause for the prevalence of the ADH1B*47His gene variant among some Asian populations, but not others. The gene causes rapid metabolism of alcohol into acetaldehyde, a chemical that produces hangovers, flushing, nausea and other unpleasant symptoms that make even moderate drinking a poor experience. Researchers found that the gene variant was very prevalent in East Asia, fairly common in West ... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3695817 Sun, 20 Jun 2010 06:18:17 +0100 3695817 http://www.medworm.com/index.php?rid=3671840&cid=t_105289_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fthree-things-you-may-not-know-about-hitech-act-should There has been much discussion around the HITECH Act and what it means since the enactment of ARRA last year.  It is now widely known that the Department of Health and Human Services has issued regulations for breach notification by covered entities under HIPAA. Yet unlike the poor enforcement record of HIPAA regulations, the new HITECH Act provides for substantial financial penalties for failing to comply with these rules.  And we are seeing these penalties are actually starting to be enforced. (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=3671840 Wed, 16 Jun 2010 17:21:49 +0100 3671840 http://www.medworm.com/index.php?rid=3666248&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F06%2F16%2Fsemi-structured-screening-interview-for-participants-in-group-pain-management%2F It’s not always easy to work out who will make the most of a pain management programme.  While some clinicians have a ‘take it or leave it’ approach, others spend a long time ‘preparing’ people for inclusion in a programme – or is there another way?  We do know that not everyone who attends a programme will ‘fit in’ – some people have difficult communication skills (or lack of), some are not able to focus for the time needed for a 9 – 4 daily programme, some have ‘other issues’ that interfere with participation (like chaotic lifestyles or alcohol/drug problems), and some are simply not looking for what a programme is intended to address. While there is no guaranteed way to accurately select who is ‘in’ an... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3666248 Tue, 15 Jun 2010 22:08:32 +0100 3666248 http://www.medworm.com/index.php?rid=3672047&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FFPkp6XSEoVo%2F Brief-TSF manual; How to help an alcoholic find freedom from alcohol. You will be automatically redirected to a download page once payment is confirmed. US$9.95 – using Paypal, Visa or Mastercard —————————————————- Help set the ghosts of alcoholism free Medical students’ knowledge about alcohol and drug problemsAlcohol Brief Intervention in Primary PracticeElderly Tend to Drink Too MuchAA and SpiritualityAA and Professional Treatment (Source: Twelve Step Facilitation.com) Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3672047 Fri, 11 Jun 2010 14:13:27 +0100 3672047 http://www.medworm.com/index.php?rid=3648600&cid=t_105289_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2Fxj9kjb1Hkpk%2F URL: http://health.discovery.com/centers/mental/mental.htmlChock full of links, pertaining to mental health issues (and some not), with features and ask the expert. Includes quizzes, blogs, podcasts and more. Also includes videos about certain mental health issues and subjects. For: AnyoneTopics: ADHD, Abnormal, Addiction, Behaviour Management, Bipolar, Clinical Psychology, Depression, Eating Disorders, Educational Psychology, Emotional Health, General Psychology, General Science, Mental Health, Mental Health Promotion, Obsessive Compulsive Disorder, Personality, Personality disorders, Self-help, VariedFeatures: Articles, Assessment Instruments, Collaborative News, Commentary and Blogs, Information, Links, Multimedia, Podcasts, RSS Aggregator, RSS Feeds, Resources, e-learningChock full of ... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=3648600 Wed, 09 Jun 2010 17:00:57 +0100 3648600 http://www.medworm.com/index.php?rid=3644784&cid=t_105289_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F06%2F08%2Fthe-ultimate-guide-to-emt-vital-signs%2F Part 3: The First Rule of Vital Signs This is probably a good time to bring up the number one rule of vital signs. Remember the movie Fight Club? Everyone knew the first rule of fight club was to never talk about fight club. Now let me give you the first rule of vital signs. Burn it into your memory. Never lie about vital signs. Oh, I know. You think you’d never lie about vital signs. You’re an honest person right? Why would you lie about something as silly as vital signs? And yet, it happens…a bunch. There you are deflating that blood pressure cuff. Everyone’s looking at you, waiting for your report, and you hear . . . . (wait for it) . . . (wait for it) . . . nothing! everyone is waiting. And you did see the needle bounce right around 120 and stop bouncing right a... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3644784 Tue, 08 Jun 2010 20:32:12 +0100 3644784 http://www.medworm.com/index.php?rid=3625589&cid=t_105289_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F06%2F02%2Fdid-you-think-that-apa-mandatory-fee-was-mandatory%2F You would think psychologists would have a unique understanding and appreciation of the power of human language and the meaning of words. Words shape perception, and psychologists not only study human perception, but also work to help change it when people are in need. So in what world does a “mandatory assessment” fee not actually mean “mandatory” (as in, required)? Apparently, in the world of the American Psychological Association. Since its inception, many, if not most, APA members have thought it was a required payment if you were a practicing clinical psychologist. It’s no wonder — the APA has referred to the fee as a “mandatory assessment” for the majority of that time. For most of us, that means it is required and obligatory. (If you h... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3625589 Wed, 02 Jun 2010 17:40:05 +0100 3625589 http://www.medworm.com/index.php?rid=3603652&cid=t_105289_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F26%2Femail-not-that-effective-with-college-depression%2F I’m always on the lookout for how technology can better help people with mental health issues. But some uses of technology leave me scratching my head. Take, for instance, this one: If you email a depression assessment quiz to college students, some will take it. Some of those who take it will have depression. Those are the astounding findings from a research study presented the other day at the annual meeting of the American Psychiatric Association. But few of the students who received the email at four different colleges bothered taking the quiz — only 691 students — suggesting that it remains an ineffective way of reaching students (except those who may already believe they have or may be at risk for depression). Worse yet, the email quiz did nothing to encourage stude... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3603652 Wed, 26 May 2010 16:35:24 +0100 3603652 http://www.medworm.com/index.php?rid=3599745&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FpviUKCyysFQ%2F Detoxification from alcohol abuse. The alcohol withdrawal syndrome (AWS) is a common management problem in hospital practice for neurologists, psychiatrists and general physicians alike. Although some patients have mild symptoms and may even be managed in the outpatient setting, others have more severe symptoms or a history of adverse outcomes that requires close inpatient supervision and benzodiazepine therapy. Many patients with AWS have multiple management issues; withdrawal symptoms, delirium tremens (DT’s), the Wernicke–Korsakoff syndrome, seizures, depression, polysubstance abuse, electrolyte disturbances and liver disease, These require a coordinated, multidisciplinary approach. Although AWS may be complex, careful evaluation and available treatments should en... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3599745 Wed, 26 May 2010 11:01:05 +0100 3599745 http://www.medworm.com/index.php?rid=3599746&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FgmaEiInPPRc%2F Conclusions; These findings provide compelling evidence that adult children of parents with substance use disorders are more likely to have relapses of social phobia and panic disorders. Clinicians who treat adults with anxiety disorders should assess parental substance use disorders and dependence histories. Such information may facilitate treatment planning with regards to their patients’ level of vulnerability to perceive scrutiny by others in social situations, and ability to maintain a long-term panic-free state. Research; Impact of parental history of substance use disorders on the clinical course of anxiety disorders. Maria E. Pagano, Richard Rende, Benjamin F. Rodriguez, Eric L. Hargraves, Amanda T. Moskowitz, & Martin B. Keller. Substance Abuse Treatment, Prevention, and... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3599746 Tue, 25 May 2010 10:57:13 +0100 3599746 http://www.medworm.com/index.php?rid=3599748&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FEIb7U9ucaQE%2F , Pediatricians Say The American Academy of Pediatricians has recommended that doctors screen all of their young patients for alcohol use starting in middle school, the Wausau Daily Herald reported May 15. The group’s Committee on Substance Abuse released a revised policy statement on youth alcohol use on May 1. "A remarkable amount of brain development is still occurring for young people through their 20s," said report lead author Patricia Kokotailo of the University of Wisconsin School of Medicine and Public Health. "This policy statement provides better evidence about how alcohol affects the brains of young people and why it is important to screen children." Committee chair Janet Williams of the University of Texas Health Science Center at San Antonio said tha... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3599748 Sun, 23 May 2010 11:26:46 +0100 3599748 http://www.medworm.com/index.php?rid=3577635&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FUCwbm-UN8wE%2F Understanding Stress: Characteristics and Caveats By Hymie Anisman, Ph.D. and Zul Merali, Ph.D. Exposure to stressful situations is among the most common human experiences. These types of situations can range from unexpected calamities to routine daily annoyances. In response to stressors, a series of behavioral, neurochemical, and immunological changes occur that ought to serve in an adaptive capacity. However, if those systems become overly taxed, the organism may become vulnerable to pathology. Likewise, the biological changes, if sufficiently sustained, may themselves adversely affect the organism’s well-being. Several factors may dictate an individual’s response to environmental stressors, including characteristics of the stressor (i.e., type of stressor and its controlla... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3577635 Sun, 16 May 2010 09:17:13 +0100 3577635 http://www.medworm.com/index.php?rid=3567943&cid=t_105289_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2FYmBrQTxSCc0%2F URL: http://www.dsm5.org/pages/default.aspxPublication of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013 will mark one the most anticipated events in the mental health field. As part of the development process, the preliminary draft revisions to the current diagnostic criteria for psychiatric diagnoses are now available for public review. For: Clinicians, ResearchersTopics: Academia, Clinical Decision Making, Clinical Psychology, Clinical Tool Development, Common Factors, Diagnosis, General Psychology, General ScienceFeatures: Assessment Instruments, Clinical Tools, Databases, Information, Research, Research Tools, Resources Publication of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013 will ... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=3567943 Sat, 15 May 2010 17:00:44 +0100 3567943 http://www.medworm.com/index.php?rid=3547016&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2Fb7X1u2eY_Xo%2F Alcohol consumption and the CAGE questionnaire in Korean adults: results from the Second Korea National Health and Nutrition Examination Survey. J Korean Med Sci. 2008 Apr;23(2):199-206. Park JT, Kim BG, Jhun HJ. We evaluated alcohol consumption and alcohol-related problems in Korean adults by evaluating alcohol consumption and responses to the CAGE questionnaire obtained from the second Korea National Health and Nutrition Examination Survey. The age-adjusted prevalence of males who consumed 0, 0.1-20, 20.1-40, or >40 g/day of alcohol were 28.0, 51.5, 12.5, and 8.0%, respectively; 26.9% of male drinkers were CAGE-positive (> or =2 affirmative responses to the CAGE). The age-adjusted prevalence of females who consumed 0, 0.1-10, 10.1-20, or >20 g/day of alcohol were 67.7, 26.6, ... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3547016 Sun, 02 May 2010 07:07:05 +0100 3547016 http://www.medworm.com/index.php?rid=3547017&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2F0ONUy3rDOqg%2F Characteristics of Students with Fetal Alcohol Syndrome and Fetal Alcohol Effect Students with FAS/E are as different from each other as any group of children. They come from all socioeconomic backgrounds. Each child presents a complex individual portrait of competencies and delays. Students with FAS/E must be recognized as individuals rather than as members of a homogeneous group. FAS/E can affect individuals in varying degrees, from mild to severe in the following areas: Cognitive Functioning. The intellectual abilities of students with FAS/E can vary greatly. Many students with FAS/E have graduated from high school with minimal extra support and adaptations. To date, a wide range of IQ has been documented: 29 to 120 for FAS and 42 to 142 for FAE. Other conditions commonly observed in ch... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3547017 Sat, 01 May 2010 07:02:29 +0100 3547017 http://www.medworm.com/index.php?rid=3502877&cid=t_105289_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F04%2Fjournal-of-psych-assessment-new-editor.html Kudos to Cecil Reynolds.  I like the new emphasis on basic measurement for the journal.Reynolds, C. (2010).  Measurement and Assessment:  An Editorial View.  Psychological Assessment, 22(1), 1-4If a thing exists, it can be measured. Measurement is a central component of assessment if we believe that fear, anxiety, intelligence, self-esteem, attention, and similar latent variables exist and are useful to us in developing an understanding of the human condition and leading us to ways to improve it. Much of what is published in Psychological Assessment deals with the development and the application of measurement devices of various sorts with the end goal of applications in assessment practice. What is submitted but not published largely deals with the same topics. As the new Editor writi... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3502877 Sat, 24 Apr 2010 19:24:00 +0100 3502877 http://www.medworm.com/index.php?rid=3522831&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FgDG0Cy-PGuQ%2F AA & 12-Step Treatment AA Assists Alcoholics Avoid Alcohol AA Can Help Most Alcoholics AA Fact File AA’s 12-Step Recovery Program Al-Anon offers new life Alcohol and Anxiety Alcohol Problems Database Alcoholic Defense Mechanisms Alcoholics Anonymous and Nursing Alcoholics Anonymous Program in India Alcoholics can benefit from Al-Anon Alcoholics Have Trouble Identifying Emotions Alcoholism / Addiction Treatment Saves Money Alcoholism in women Alcoholism Treatment in a Nursing Home Altruism helps AA members stay sober An Introduction to Medication for Alcohol Dependence Anti-craving Drugs Attendance at Narcotics Anonymous and Alcoholics Anonymous Meetings Binge Drinking & Brain Damage Brain Damage & Cirrhosis Brief Intervention in Emergency Room Effective Brief-TSF Descrip... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3522831 Sat, 24 Apr 2010 05:54:31 +0100 3522831 http://www.medworm.com/index.php?rid=3499189&cid=t_105289_125_f&fid=34820&url=http%3A%2F%2Fwww.dentalblogs.com%2Farchives%2Fadministrator%2Fdentists-spread-disease%25e2%2580%25a6awareness-with-preventive-tests%2F As research and science continue to develop, we’re learning the importance of oral health to the health of the body as a whole. Dentistry is gaining higher regard as a necessity of good health; oral healthcare is getting off the bench and getting in the game. To further the importance of dental care, dentist-administered tests can reveal a person’s proclivity for dental decay, as well as serious conditions, like severe gum disease and HPV. Some of the tests provide early detection of conditions, like oral cancer, which allows for proactive treatment that literally saves lives. Periodontal Disease Risk Assessment: MyPerioID® PST & MyPerioPath® HPV Assessment: OraRisk SM HPV Diabetes Test: If a patient has bleeding gums, you may conduct a finger-stick blood test to check glucose le... dental blog for dentists about dentistry blogs http://www.medworm.com/rss/comments.php?id=3499189 Fri, 23 Apr 2010 14:28:21 +0100 3499189 http://www.medworm.com/index.php?rid=3490742&cid=t_105289_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FWV_7K2JURAU%2F You may already have read the hundreds of media articles today titled “brain training doesn’t work” and similar, based on the BBC “Brain Test Britain” experiment. Once more, claims seem to go beyond the science backing them up … except that in this case it is the researchers, not the developers, who are responsible. Let’s recap what we learned today. The Good Science The study showed that putting together a variety of brain games in one website and asking people who happen to show up to play around for a grand total of 3-4 hours over 6 weeks (10 minutes 3 times a week for 6 weeks) didn’t result in meaningful improvements in cognitive functioning. This is useful information for consumers to know, because in fact there are websites and compani... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=3490742 Wed, 21 Apr 2010 05:50:29 +0100 3490742 http://www.medworm.com/index.php?rid=3479902&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FFEZTHei8aho%2F This article examines the history of Alcoholics Anonymous (AA), the goals of the 12 steps, research on AA, and common issues reported by clients about this approach and offers suggestions for addressing these issues. AA was developed by two severe alcoholics in the 1930s in an effort to provide holistic treatment of addictive disorders. Twelve-step programs and the related disease concept of addiction have heavily influenced inpatient and outpatient treatment. The 12-step approach emphasizes a comprehensive approach for the disease of addiction, addressing mental, physical, and spiritual components, and participation in each other’s treatment is critical to sustained sobriety. With intensive work in the program, the 12-step approach offers management of the addictive behavior as well... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3479902 Mon, 12 Apr 2010 03:51:05 +0100 3479902 http://www.medworm.com/index.php?rid=3479903&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FTi-Xqdf_Jq8%2F in biomedicine The recent surge of interest in links between spirituality and health has generated many assessment approaches that seek to identify spiritual need and suggest strategic responses for health care practitioners. The interpretations of spirituality made within health frameworks do not do justice to the way spirituality is understood in society in general. Spiritual assessment should not impose a view or definition of spirituality, but should seek to elicit the thoughts, memories and experiences that give coherence to a person’s life. Spiritual assessment tools should not be used without adequate exploration of the assumptions made. Assessment processes need to be adequately conceptualised and practically relevant. In agencies organised according to biomedical priorities... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3479903 Sun, 11 Apr 2010 03:48:01 +0100 3479903 http://www.medworm.com/index.php?rid=3479904&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FVugu1V14kDo%2F Do Doctors’ Drinking Habits Affect Management of Patients’ Alcohol Problems? Two different studies explored whether a physician’s approach to his patients’ alcohol use is complicated by his own drinking habits. Kaner et al interviewed 29 general practitioners (GPs) in Northern England and found the following: Some GPs felt that their own alcohol use provided them insight into their patients’ use and helped facilitate discussion with patients. Others, however, separated their drinking from their patients’ drinking. Some GPs recognized and addressed risk only in patients who drank more or differently from them. Aalto et al surveyed all Finnish primary care physicians (n=3193), 60% of whom completed all survey questions (63% women; mean age 42 years). Of th... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3479904 Sat, 10 Apr 2010 03:39:02 +0100 3479904 http://www.medworm.com/index.php?rid=3479905&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FbxdbGPWJjCw%2F Conclusions: For dually-diagnosed individuals, continued participation in dual recovery self-help groups plays a significant role in the recovery process, particularly in the area of substance use. Implications for Policy, Delivery or Practice: Participation in dual-recovery self-help groups, both during and after formal treatment, should be encouraged as part of an integrated lifelong recovery plan for dually-diagnosed individuals. Research; One-Year Outcomes among Members of a Dual-Recovery Self-Help Program. Laudet A, Magura S, Vogel H, Knight E, Staines G; Abstr Acad Health Serv Res Health Policy Meet. 2000; 17. More at; Double Trouble in Recovery See also; 12-Step Treatment More Effective than Alternative AA and Treatment Work Better Together Subscribe to Twelve Step Facilitation by ... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3479905 Fri, 09 Apr 2010 03:28:24 +0100 3479905 http://www.medworm.com/index.php?rid=3479906&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FkW3taFhU3Fo%2F Conclusions: Greater awareness of this resource for mental health and substance misuse fields could enhance practice. Mutual aid groups in psychiatry and substance misuse. Alex Baldacchino;  Woody Caan; Carol Munn-Giddings. Mental Health and Substance Use: dual diagnosis, Volume 1, Issue 2 June 2008 , pages 104 – 117 See also; 12-Step Treatment More Effective than Alternative AA Offers Recovery Not Religion Brief-TSF can assist patients cease alcohol consumption. Subscribe to Twelve Step Facilitation by e-Mail           The Self-Help Sourcebook: Finding & Forming Mutual Aid Self-Help Groups Amazon Books; Read more about this title… Share/SaveDouble Trouble in RecoveryAlcohol Brief Intervention in Primary Pr... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3479906 Thu, 08 Apr 2010 03:13:12 +0100 3479906 http://www.medworm.com/index.php?rid=3437931&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FshbplyUaF-E%2F (MET) is a systematic intervention approach for evoking change in problem drinkers. It is based on principles of motivational psychology and is designed to produce rapid, internally motivated change. This treatment employs motivational strategies to mobilize the client’s own change resources. MET consists of four carefully planned and individualized treatment sessions. The first two focus on structured feedback from the initial assessment, future plans, and motivation for change, The final two sessions at the midpoint and end of treatment provide opportunities for the therapist to reinforce progress, encourage reassessment, and provide an objective perspective on the process of change. The counselor seeks to develop a discrepancy in the client’s perceptions between current b... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3437931 Sun, 04 Apr 2010 02:43:54 +0100 3437931 http://www.medworm.com/index.php?rid=3435058&cid=t_105289_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F04%2F03%2Fthe-c-spine-helmet-issue%2F The good news in the world of head trauma and brain injury is that we’re seeing a lot more folks putting on helmets before they go out and do potentially dangerous, head crushing stuff. The good/bad news is that we’re encountering more patients who are wearing helmets and need to be placed in full spinal immobilization. This brings up a controversial decision. Should we remove the helmet or leave it in place? The leave it or remove it controversy has been around for as long as I’ve been in EMS and, like most controversies that remain unresolved for years, there are merits to both options. In these instances, it’s easy to create blanket rules and then follow them mindlessly. “Always leave the helmet in place, unless it obstructs the airway.” “Alway... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3435058 Sat, 03 Apr 2010 12:00:23 +0100 3435058 http://www.medworm.com/index.php?rid=3437933&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FJPZlTeEt01s%2F Conclusions; The strong, specific association between prior alcohol dependence and current or recent major depression in a nationally representative sample of former drinkers indicates that the association is not entirely an artifact of misdiagnosed intoxication and withdrawal effects. A better understanding of the nature of the relationship between the 2 disorders should be sought and will have important public health significance. Research report; Deborah S. Hasin; Bridget F. Grant.Major Depression in 6050 Former Drinkers; Association With Past Alcohol Dependence. Arch Gen Psychiatry. 2002;59:794-800. Alcoholics Have Trouble Identifying Emotions Cognitive Behavioral Therapy Depressed Men Who Drink More Likely to Commit Suicide Depression & 12-Step Programs Share/SaveRando... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3437933 Fri, 02 Apr 2010 02:17:01 +0100 3437933 http://www.medworm.com/index.php?rid=3420441&cid=t_105289_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F4XM3Iy_0f0M%2F By Neal McCluskeyCongratulations Delaware and Tennessee — you’ve won the Race to the Top beauty contest! Of course, the grading was subjective and will be disputed by lots of states that haven’t won. Well, haven’t won yet — there’s a second round to this, remember. So what do the victories for Delaware and Tennessee mean? The edu-pundits will no doubt be reading deep into the results over the coming days, trying to determine what they portend for the future of RttT, federal education policy generally, and politicians across the country.  And there are some juicy political leads worth following, including the possibility that the winning states were chosen because they have Republican congress members who could be pivotal in getting bipartisan support for the ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3420441 Mon, 29 Mar 2010 17:58:47 +0100 3420441 http://www.medworm.com/index.php?rid=3415982&cid=t_105289_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F29%2Fbmj-2010-vol-340-no-7748%2F Contents page Fade Fave: Sunbed use in children aged 11-17 in England: face to face quota sampling surveys in the National Prevalence Study and Six Cities Study Fade Skinny: Sunbed use by children is widespread in England, is often inadequately supervised, and is a health risk. National legislation is needed to control sunbed outlets. (NHS Athens is required to access this article online) Filed under: Athens Password, Current Awareness, E-Journals, Journals Tagged: Athens Password, Children, Current Awareness, E-Journals, Health Risk Assessment, Sunbeds (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3415982 Mon, 29 Mar 2010 12:56:32 +0100 3415982 http://www.medworm.com/index.php?rid=3403870&cid=t_105289_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FRxWGAQcwSlI%2F By Neal McCluskeyDespite nearly two decades of state and federal standards-and-testing, as well as big increases in spending, today’s reading results from the National Assessment of Educational Progress – the so-called “Nation’s Report Card” — continue to tell a tale of stagnation.  Nationally, the average fourth-grade score was 217 (out of 500) in 1992. In 2009 it was only 221. For eighth grade, the average score in 1992 was 260. In 2009 it was just 264. Oh, and eighth-graders had hit 264 by 1998, which means there hasn’t been even a smidgen of improvement since then. “But,” will say the standardizers, “the problem is that we just haven’t set really high standards and been unrelenting in forcing schools to meet them.&#... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3403870 Wed, 24 Mar 2010 17:16:39 +0100 3403870 http://www.medworm.com/index.php?rid=3391016&cid=t_105289_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F03%2F22%2Faccepting-chronic-pain%2F How willing are you to have persistent pain? Can you accept pain without fighting against it? If you were told your pain was going to be there forever, would you avoid important activities or would you start to get back into life again? Recently I reviewed about 200 questionnaires completed by people attending the Pain Management Centre where I work. I was looking especially at what they’d written down as goals for coming to the Centre, and unsurprisingly, most of them were to ‘reduce my pain’ – to tolerable levels, to manageable levels, or so the person could begin ‘living a normal life’. I hate to break it to you – even the most effective medication seems to only reduce pain by about 30%, and most people wanting pain reduction are after at least ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3391016 Sun, 21 Mar 2010 18:21:45 +0100 3391016 http://www.medworm.com/index.php?rid=3386911&cid=t_105289_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2FqcvW5tRG_zg%2F URL: http://www.asdreams.org/The International Association for the Study of Dreams is a non-profit, international, multidisciplinary organization dedicated to the pure and applied investigation of dreams and dreaming. Its purposes are to promote an awareness and appreciation of dreams in both professional and public arenas; to encourage research into the nature, function, and significance of dreaming; to advance the application of the study of dreams; and to provide a forum for the eclectic and interdisciplinary exchange of ideas and information. For: Anyone, Clinicians, ResearchersTopics: Behaviour Management, Emotional Health, General Psychology, General Science, Insomnia, Life, LifestyleFeatures: Advertising, Articles, Assessment Instruments, CE Activities, Clinical Tools, Collaborative... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=3386911 Sat, 20 Mar 2010 22:24:34 +0100 3386911 http://www.medworm.com/index.php?rid=3382756&cid=t_105289_85_f&fid=34798&url=http%3A%2F%2Fcommitmenttoliving.com%2F2010%2F03%2F18%2Fpreparing-presentation-aa-2010%2F I’m preparing my presentation for the April 2010 American Association of Suicidology annual conference, which will be held in Orlando, Florida.   My presentation is titled “Evaluation of Commitment to Living: a brief training to address suicide risk assessment and management.”  I’m enjoying the preparations because I’m planning to present entirely using mindmaps on my curriculum which relies heavily on mindmaps!  There’s a very pleasing symmetry about it.   And I’m impressed all over again with how much the maps aid the conceptual organization of the material I want to present.  I’m sure it’s not for everybody, but I find it so helpful. If you’re going to be in Orlando on April 24, please come by and say hello. Related post... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=3382756 Thu, 18 Mar 2010 20:04:01 +0100 3382756 http://www.medworm.com/index.php?rid=3385556&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2F4krst9RF1eM%2F facilitates patients’ active participation in the fellowship of Alcoholics Anonymous. TSF regards such active involvement as the primary factor responsible for sustained sobriety (recovery) and therefore as the desired outcome of participation in this treatment program. This therapy is grounded in the concept of alcoholism as a spiritual and medical disease. TSF consists of a brief, structured, and manual-driven approach to facilitating early recovery from alcohol abuse/alcoholism and other drug abuse/addiction. It is intended to be implemented on an individual basis in 12 to 15 sessions and is based in behavioral, spiritual, and cognitive principles that form the core of 12-step fellowships such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). It is suitable for problem ... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3385556 Tue, 16 Mar 2010 23:21:14 +0100 3385556 http://www.medworm.com/index.php?rid=3385558&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FzZiUr-l-Z4c%2F The Role of Uncontrollable Trauma in the Development of PTSD and Alcohol Addiction By Joseph Volpicelli, M.D., Ph.D.; Geetha Balaraman; Julie Hahn; Heather Wallace, M.A.; and Donald Bux, Ph.D. After a traumatic event, people often report using alcohol to relieve their symptoms of anxiety, irritability, and depression. Alcohol may relieve these symptoms because drinking compensates for deficiencies in endorphin activity following a traumatic experience. Within minutes of exposure to a traumatic event there is an increase in the level of endorphins in the brain. During the time of the trauma, endorphin levels remain elevated and help numb the emotional and physical pain of the trauma. However, after the trauma is over, endorphin levels gradually decrease and this may lead to a period of endo... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3385558 Mon, 15 Mar 2010 23:09:52 +0100 3385558 http://www.medworm.com/index.php?rid=3366315&cid=t_105289_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2010%2F03%2Fneuropsychology-abstract-of-day_14.html CONCLUSIONS: A simple, calculated progression rate at the initial visit gives reliable information regarding performance over time on cognition, global performance and activities of daily living. The slowest progression group also survives longer. This baseline measure should be considered in the design of long duration Alzheimer's disease clinical trials.PMID: 20178566 [PubMed - as supplied by publisher] (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=3366315 Sun, 14 Mar 2010 23:01:00 +0100 3366315 http://www.medworm.com/index.php?rid=3370676&cid=t_105289_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2F9SLUf7UAC08%2F CONCLUSIONS: in the long-term TSF may be the treatment of choice for alcohol-dependent clients with networks supportive of drinking; involvement in AA should be given special consideration for clients with networks supportive of drinking, irrespective of the therapy they will receive. Research; Longabaugh R, Wirtz PW, Zweben A, Stout RL. Network support for drinking, Alcoholics Anonymous and long-term matching effects.Addiction. 1998 Sep;93(9):1313-33. Subscribe to regular RSS feeds. Related Reading: Share/SaveRandom ArticlesRole of Self Help ProgramsAbstinence rates in AAMore AA meetingsEarly outpatient alcohol rehabilitation worksBrief-TSF ASSESSMENT (Source: Twelve Step Facilitation.com) Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3370676 Sat, 13 Mar 2010 22:40:12 +0100 3370676