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 'care delivery'. Sat, 03 Sep 2011 02:39:31 +0100 http://www.medworm.com/index.php?rid=5028052&cid=t_320163_85_f&fid=34798&url=http%3A%2F%2Fcommitmenttoliving.com%2F2011%2F07%2F11%2Fmental-health-during-deployment-study%2F A group of US and UK colleagues have published an interesting qualitative study about the challenges and resiliency of military mental health professionals (MMHPs). They had a small non-representative sample of British MMHPs who had completed a period of deployment in Iraq between 2003-2005. For the study, they participated in detailed interviews about their experiences practicing in a deployment setting. The authors did a nice job pulling together themes from the interviews in order to develop a conceptual model for the goals, challenges, and resources, and to draw out some recommendations about training and planning. Recommended: McCauley, M., Liebling-Kalifani, H., & Hughes, J. H. (2011). Military Mental Health Professionals On Operational Deployment: An Exploratory Study. Community... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=5028052 Mon, 11 Jul 2011 16:17:18 +0100 5028052 http://www.medworm.com/index.php?rid=4540544&cid=t_320163_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F17%2Ffoundation-blogs-round-up-health-reform-disparities-global-health-obesity-and-more%2F%3Fcat%3Dgrantwatch As my work week draws to a close, I have put together a quick listing of some foundation-related posts that I think you might want to check out. If your foundation has a blog about health care and it is not listed on GrantWatch Blog’s Blogroll, let me know about it! Disparities in Health: “Poll [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4540544 Fri, 18 Feb 2011 00:56:06 +0100 4540544 http://www.medworm.com/index.php?rid=3122106&cid=t_320163_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F12%2F26%2Fdemystifying-psychiatry-an-interview-with-charles-f-zorumski-and-eugene-h-rubin%2F Today I have the honor of interviewing Eugene (Gene) and Charles (Church) Zorumski, authors of “Demystifying Psychiatry: A Resource for Patients and Families.” It is a fascinating and comprehensive resource to explain one of the most misunderstood sciences of our time. Question: In your book, you chart the various trends of psychiatry. In your view what are the most substantial trends and why? Answer: Thank you for asking us about our thoughts concerning the most substantial trends in psychiatry and about why we are optimistic about the future of psychiatry. We believe that three of the most substantial trends in psychiatry today are: Increasing collaboration between primary care and mental health teams in the delivery of psychiatric care Increasing use of and greater avai... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3122106 Sat, 26 Dec 2009 13:37:46 +0100 3122106 http://www.medworm.com/index.php?rid=2879682&cid=t_320163_123_f&fid=39041&url=http%3A%2F%2Fdrnabong.blogspot.com%2F2009%2F04%2Fwhat-to-prepare-for-birth-of-your.html Things to think about before delivery:If you have a boy, Should we circumcise or not? The American Academy of Pediatrics is not recommending this across the board. but parents can decide to have this done. It decreased the incidence of a urinary tract infection and penile carcinoma 1% of the time. It prevents incidence of infection of the foreskin. The most common reason for this is the resemblance to the majority of the males in the United States.Breastfeed or Bottle feed? Both methods are safe for the baby but the American Academy of Pediatrics advocates nursing up to 1 year of age.Should I store My Newborn's cord blood?Some genetic diseases can be cured by stem cell transplant. The storage of cord blood is not recommended at this point unless there is a member of the family that would n... Dr Nabong's Pediatric Blogs blogs http://www.medworm.com/rss/comments.php?id=2879682 Mon, 20 Apr 2009 16:31:00 +0100 2879682 http://www.medworm.com/index.php?rid=1815300&cid=t_320163_85_f&fid=34798&url=http%3A%2F%2Fcommitmenttoliving.com%2F2008%2F09%2F22%2Fmeans-restrict-resource%2F I’ve had a nice response to the brief commentary I posted in conjunction with a link to the NY Times article about means restriction.  In light of that, I thought I’d post a link to the a site called Means Matter, which is published by the Harvard Injury Control Research Center.   The site has summary pages called “Taking Action” for families, communities, and clinicians. The talking action page for clinicians is worth reading for any clinician, and could be especially useful to primary care providers.  I’m thinking a lot about primary care right now because (a) primary care psychology has beeen a focus of my career and I have a deep respect for the breadth of responsibility primary care providers carry, including in suicide prevention (b) I’m still ... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=1815300 Mon, 22 Sep 2008 15:17:25 +0100 1815300 http://www.medworm.com/index.php?rid=947321&cid=t_320163_85_f&fid=34798&url=http%3A%2F%2Friskassessment.wordpress.com%2F2007%2F10%2F12%2Fwarning-non-family-tx-may-be-hazardous-to-your-family%25e2%2580%2599s-health%2F A clever article in the September 2007 issue of the Journal of Family Psychology by Jose Szapocznik and Guillermo Prado suggests that “psychosocial treatments with vulnerable populations have the potential to produce negative side effects on families.” The authors reported unexpected findings from three separate studies that compared the efficacy of a family and non-family treatment. In brief, they found that family-level outcomes measured after applying non-family treatments didn’t just remain static (as they had expected), they actually declined. This relationship is correlational and does not necessarily mean that the treatments in question caused the decline, but the authors argue that the findings are striking enough to raise the question about whether unintended s... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=947321 Fri, 12 Oct 2007 14:08:42 +0100 947321 http://www.medworm.com/index.php?rid=824657&cid=t_320163_85_f&fid=34798&url=http%3A%2F%2Friskassessment.wordpress.com%2F2007%2F08%2F27%2Fthoughts-about-sad-persons-screen%2F I’ve gotten a few questions from colleagues and trainees lately about using the SADPERSONS screen. Most recently, a colleague pointed me to an article in Psychiatric Times titled, “APA: Simple Screen Improves Suicide Risk Assessment.” The topic seems worthy of a post to think through both the appeal and risks of the SADPERSONS scale. For those who are not aware of SAD PERSONS, it is a 10-item scale to purports to screen for suicide risk. An individual is given one point for each item for which he or she screens positive: Sex (male) Age less than 19 or greater than 45 years Depression (patient admits to depression or decreased concentration, sleep, appetite and/or libido Previous suicide attempt or psychiatric care Excessive alcohol or drug use Rational thinking loss... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=824657 Mon, 27 Aug 2007 18:27:45 +0100 824657 http://www.medworm.com/index.php?rid=788175&cid=t_320163_123_f&fid=34883&url=http%3A%2F%2Fdenverpickles.blogspot.com%2F2007%2F08%2Fmaybe-they-should-call-it-sick.html Much in the same way that life insurance isn't really life insurance--it's death insurance (but who wants to buy something called that?)--what we call health insurance is really sick insurance.Case in point:This morning I was reading an article in the AAP (American Academy of Pediatrics) News describing new obesity guidelines to be published later this year. Truthfully, there was little groundbreaking in this article: treat obesity as a chronic disease condition, assess if the family perceives a problem, encourage a sensible diet and one hour of exercise daily (that last one is a little surprising, and potentially problematic: yes, it's recommended, but how many obese kids will do that much? I fear many will hear of such a lofty goal and fuggedabudit. I know I don't have time to exercise a... Just Practicing blogs http://www.medworm.com/rss/comments.php?id=788175 Thu, 09 Aug 2007 00:44:50 +0100 788175 http://www.medworm.com/index.php?rid=637990&cid=t_320163_123_f&fid=34883&url=http%3A%2F%2Fdenverpickles.blogspot.com%2F2007%2F05%2Feasy-or-hard.html Let's play "easy or hard." What would you do?1. Mom brings in a 2-year old girl. The girl has been having a green runny nose for three days. She has been running a low grade fever (under 100). She is eating (though not as much as usual), sleeping, and still playing. She also attends daycare. Physical exam reveals mild nasal congestion; lungs are clear, eardrums look normal. Do you:a) (Easy) prescribe amoxicillin for "sinusitis" so she can go back to day care and prevent mom from calling you in 3 days to say, "she's still not better!"b) (Hard) let mom know that green rhinorrhea does not necessarily mean a bacterial infection, particularly in an upper respiratory infection of a few days with no other significant symptoms (e.g., fever, lethargy, findings on physical exam); explain that antibi... Just Practicing blogs http://www.medworm.com/rss/comments.php?id=637990 Thu, 24 May 2007 17:40:00 +0100 637990 http://www.medworm.com/index.php?rid=520149&cid=t_320163_85_f&fid=34798&url=http%3A%2F%2Friskassessment.wordpress.com%2F2007%2F04%2F04%2Ftreatment-teams-as-communities-of-practice%2F Still thinking about the intersection of clinical practice, risk assessment, knowledge management (KM), and Dave Snowden, which I blogged about yesterday. In KM world, what mental health clinicians call a “treatment team” could be considered a Community of Practice. There are many definitions of this term and treatment teams fit some more than others. But Dave Snowden is clear in the videotaped discussion I pointed to yesterday that one of the failures of contemporary knowledge management is the inability to promote fruitful communities of practice. Snowden argues that organizations make the mistake of trying to organize communities of learning and practice using language, structures, and concepts that are not “naturalistic.” That is, we ignore the processes by ... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=520149 Wed, 04 Apr 2007 11:37:46 +0100 520149 http://www.medworm.com/index.php?rid=518737&cid=t_320163_123_f&fid=34883&url=http%3A%2F%2Fdenverpickles.blogspot.com%2F2007%2F04%2Faaugh.html Just like Lucy pulling the football away from Charlie Brown, Medicaid loves to play games with the pediatrician.For the uninformed, a primer: Medicaid is the government's "safety net" insurance program for the poor. Many children are covered by Medicaid (in fact, here in Mississippi, about 3 out of 4 are). The federal government provides much of the funding, with the rest coming from each state, and each state also administers the program. Each state provides benefits as it sees fit--within certain broad federal guidelines--and can also set provider reimbursement in a similar way.Medicaid represents government at its best and worst. The concept is wonderful, and enables patients to receive care at any willing provider. But the bureaucracy can be inscrutable, bizarre, and sometimes downrigh... Just Practicing blogs http://www.medworm.com/rss/comments.php?id=518737 Wed, 04 Apr 2007 00:09:00 +0100 518737 http://www.medworm.com/index.php?rid=508346&cid=t_320163_85_f&fid=34798&url=http%3A%2F%2Friskassessment.wordpress.com%2F2007%2F03%2F28%2Fwheres-the-family%2F I was just looking at the post counts on my categories and seeing few posts I have (only 2) family therapy category.   I think that reflects the state of the field right now, as well as my own internal conceptual development which is not yet entirely integrated.  Two things for sure: 1.  Almost everything I’ve read in the clinical suicide assessment literature assumes a one-on-one context.   Family therapy is usually not mentioned.  Families are sometimes mentioned, usually as potential sources of information when things get really risky, but without much attention to how to do that. 2. Family therapists tend to get pretty individualistic when they teach or write about suicide prevention.   This tendency was unmistakable in a recent Family Therapy Magazine, a publication of... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=508346 Wed, 28 Mar 2007 22:32:37 +0100 508346 http://www.medworm.com/index.php?rid=490003&cid=t_320163_123_f&fid=34883&url=http%3A%2F%2Fdenverpickles.blogspot.com%2F2007%2F03%2Fwe-dont-care-how-they-do-it-in-new-york.html I caught a glimpse of the NBC Nightly News last week and was surprised to see a feature story about Dr. Persharon Dixon, a pediatrician who left Atlanta to work with the local community health center here after the storm. The health center has her riding around in a mobile van, a rather ingenious setup. The van and her work is sponsored by the Children's Health Fund out of New Yawk.The broadcast gave me a peculiar feeling of pride, revulsion, and anger.Only the first emotion is directed at Dr. Dixon. I've met her, and she's a wonderful woman and pediatrician, very sincere and caring. I have nothing but good things to say about her.The latter two emotions I reserve for the Children's Health Fund.A mobile health van is a good thing. A community health center is also a good thing. But so are ... Just Practicing blogs http://www.medworm.com/rss/comments.php?id=490003 Wed, 21 Mar 2007 15:31:00 +0100 490003 http://www.medworm.com/index.php?rid=472332&cid=t_320163_85_f&fid=34798&url=http%3A%2F%2Friskassessment.wordpress.com%2F2007%2F03%2F07%2Forganizational-factors-that-support-care-of-suicidal-person%2F Wendi Cross, a gifted and innovative colleague in our department, presented at our Family Research Roundtable yesterday. One of the ways she is contributing to the field is to raise awareness about, and develop methodology to study, the factors surrounding implementation of an evidence-based intervention (be it training, prevention, or therapeutic intervention) that influence its ultimate impact. Right now her focus is on implementers of an intervention, but in the course of discussion she mentioned that there are other extra-intervention factors, such as institutional and organizational factors that influence how, how much, and how well evidence-based interventions are put into practice after someone is trained. This got me thinking about what might be the institutional factors that ena... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=472332 Wed, 07 Mar 2007 21:01:13 +0100 472332 http://www.medworm.com/index.php?rid=478831&cid=t_320163_123_f&fid=34883&url=http%3A%2F%2Fdenverpickles.blogspot.com%2F2007%2F02%2Fpandemic-panic.html Amidst the hoopla over the Gardasil (HPV/cervical cancer) vaccine this week, one news item largely overlooked concerned OSHA and the CDC issuing more pandemic flu guidelines. In the event of a severe pandemic, children would be largely quarantined; no school, no daycare, no spreading the nasty little hobbitses...er, I mean, flu viruses...until the pandemic started to abate.By itself, that sounds prudent. Past studies have shown children to be the principal "vectors" for spreading the flu. Interrupt transmission by keeping them away from each other.I'm curious if anyone on the federal level has considered the economic consequences of this. As a med school professor used to say, "if this is true, what does this imply?"No school or day care means teachers and day care workers out of work, pos... Just Practicing blogs http://www.medworm.com/rss/comments.php?id=478831 Fri, 09 Feb 2007 16:40:00 +0100 478831 http://www.medworm.com/index.php?rid=472339&cid=t_320163_85_f&fid=34798&url=http%3A%2F%2Friskassessment.wordpress.com%2F2007%2F01%2F30%2Fstandardizing-risk-assessment-documentation%2F There are no established formats for documenting a formulation of suicide risk. I have taken some steps to standardize this documentation in the clinical service I direct, but it needs further development. I’ll be helping our department arrive at a common format. Thankfully, I’ll be working with some really bright people who can view this documentation need from a variety of perspectives (compliance/QA, acute services, research). Here are some working principles: 1. Check boxes will not do. We can prompt clinicians with keywords, but like it or not, suicide risk formulation will always need narrative. 2. Our format needs to feel friendly and familiar to clinicians with a wide range of education and clinical experience. 3. The following elements should be present: specific risk... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=472339 Tue, 30 Jan 2007 12:18:46 +0100 472339 http://www.medworm.com/index.php?rid=472340&cid=t_320163_85_f&fid=34798&url=http%3A%2F%2Friskassessment.wordpress.com%2F2007%2F01%2F27%2Fhow-we-think-about-primary-care-gatekeepers%2F Primary care physicians are often grouped in as “gatekeepers,” who need to be able to ask about suicide, know warning signs, and refer. The tend not to get in-depth training about formulating or documenting risk assessments. The problem with this “gatekeeper” view is that we don’t have the kind of seamless system that allows the primary care professional the luxury to leave the judgment call to a mental health professional. It’s not like they are standing at a gate, able to wave a patient on to a mental health professional on the other side. There are barriers to access, patients who refuse evaluations, and the need to make decisions about who warrants intrusive involvement and who does not. These are sophisticated clinical judgments that go beyond &#822... Commitment to Living blogs http://www.medworm.com/rss/comments.php?id=472340 Sat, 27 Jan 2007 21:28:28 +0100 472340