Who Benefits the Most from Cognitive Stimulation Therapy for Dementia?

Posted on May 14, 2012 by rkennedy

A study in the International Journal of Geriatric Psychiatry reports that the efficacy of cognitive stimulation therapy (CST) has been demonstrated, but little is known about the characteristics of people with dementia, who may respond to this therapy. This study sought to investigate which factors may predict a more positive response to CST.

Subjects diagnosed with dementia (n-272) took part in a 7-week CST intervention. Assessments were carried out pre-treatment and post-treatment. The results were compared with those of a previous comparable CST randomized control trial. A comparison of mean scores pre-CST and post-CST groups was undertaken, and contributing factors that predicted change in outcomes were examined.

Results demonstrated

  • CST improved cognition and quality of life, and the results showed that the benefits of CST were independent of whether people were taking acetylcholinesterase inhibitors (AChEI) or not.
  • Increasing age was associated with cognitive benefits, as was female gender.
  • Care home residents improved more than community residents on quality of life, but the community sample seemed to benefit more in relation to behavior problems.

International Journal of Geriatric Psychiatry
May 2012

 

 

 

Posted in Alzheimer's Disease, Cognition, Cognitive Behavior Therapy, Cognitive Stimulation, Dementia, Women | Comments Off

May is Mental Health Awareness Month

Posted on May 9, 2012 by rkennedy

For more than 50 years, Mental Health America and hundreds of affiliates from around the country have led the observance of May is Mental Health Month by reaching millions of people through the media, local events and screenings. This unified effort includes educational messages about mental health and substance use conditions and the importance of mental health.

Two important themes are being highlighted for 2012:
Do More for 1 in 4 is a call to action to help the 1 in 4 American adults who live with a diagnosable, treatable mental health condition and the fact that they can go on to live full and productive lives.

The second theme, Healing Trauma’s Invisible Wounds, focuses on the impact of traumatic events on individuals and communities.  Until recently, trauma survivors were largely unrecognized by the formal treatment system. The costs of trauma and its aftermath to victims and society were not well documented. Inadvertently, treatment systems may have frequently re-traumatized individuals and failed to understand the impact of traumatic experiences on general and mental health.

Today, the causes of trauma—sexual abuse, violence in families and neighborhoods, and the impact of war, for example—are matters of public concern.

Download the Do More For 1in4 Toolkit.

Download the Healing Trauma’s Invisible Wounds Toolkit.

Posted in Education, Mental health | Comments Off

New AAN Guidelines on Migraine Prevention

Posted on April 30, 2012 by rkennedy

The American Academy of Neurology (AAN) and the American Headache Society (AHA) have published new guidelines for the prevention of episodic migraine. The goal was to provide updated evidence-based recommendations for the preventive treatment of migraine headache. The clinical question addressed was: What pharmacologic therapies are proven effective for migraine prevention?

The authors analyzed published studies from June 1999 to May 2009 using a structured review process to classify the evidence relative to the efficacy of various medications available in the United States for migraine prevention.

New Level A changes include the addition of  topiramate, but gabapentin and verapamil and other calcium-channel blockers are now considered Level U, or without sufficient evidence for or against their usefulness.

Another evidence-based review evaluated the role of nonsteroidal anti-inflammatory drugs (NSAIDs) and complementary treatments for migraine prevention. They did find sufficient evidence to allow recommendation of some of these treatments.

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults
Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults

Posted in Guideline, Headache, Migraine | Comments Off

CME Outfitters Demonstrates Best in Class at the 37th Annual Alliance for Continuing Education in the Health Professions Conference

Posted on April 25, 2012 by rkennedy

CME Outfitters (CMEO) receives outstanding responses from two CMEO poster presentations, and two interactive breakout sessions at the Alliance for Continuing Education in the Health Professions Annual Conference

CME Outfitters (CMEO), a leading international provider for continuing medical education, is proud to announce findings of demonstrated excellence in a feedback survey among many stakeholders at the annual meeting of the Alliance for Continuing Education in the Health Professions (ACEHP). CME Outfitters authored and produced two poster presentations for this four-day conference. These posters were displayed in the halls of the conference center, allowing conference participants to browse during session breaks.

A compelling poster presented an in-depth look at outcomes data from a recent CMEO activity and the resultant outcomes article entitled “A Simplified Model for Educational Outcomes Measurements (EOMs): Change in Serum Lipid Monitoring Rates in Patients with Bipolar Disorder.” These data demonstrated direct level five performance-based outcomes; the results rose to statistical significance regarding change in clinicians’ behavior for serum lipid monitoring in a population at risk for cardiometabolic syndrome. For example, the percentages of patients monitored by clinicians nationwide (in U.S.) who participated in the CME activity increased by 17.8% over 1 year from baseline (p = .00001). Gross, median monitoring rates in the national study group increased from 30% to 80%, and all clinicians at or above the 75th percentile of monitoring rates monitored 100% of their patients after participating. Monitoring rate increases for clinicians in the nationwide learner group were greater among clinicians with higher patient counts. The local study group at the Lindner Center of HOPE increased gross monitoring by 28.0% (from 27.5% to 55.5%), or a 102% increase over baseline rates. The co-sponsors, USF Health and CME Outfitters gratefully acknowledge support from Janssen Pharmaceuticals, Inc., administered by Janssen Scientific Affairs, LLC, and Lilly USA, LLC, for the “Change in Serum Lipid Monitoring Rates in Patients with Bipolar Disorder” educational research study and the foundational educational activities upon which the article was based.

CMEO displayed another poster that detailed educational effectiveness and advanced outcomes data. This poster demonstrated that the CME Outfitters 2010 Annual Chair Summit meeting had a statistically significant impact on positive patient health outcomes. The poster was entitled “Ask the Expert Meets Peer-to-Peer: Outcomes from the 3rd Annual Chair Summit – Master Class for Neuroscience Professional Development. During the outcomes studies, participants were asked if they changed their clinical decision-making processes or any direct patient care as a result of participating in the 3.5-day Chair Summit conference. The responses were overwhelming, with 62% of respondents saying, “Yes.” USF Health and CME Outfitters also acknowledges support from AstraZeneca, Cephalon, Inc., Janssen Pharmaceuticals, Inc., administered by Janssen Scientific Affairs, LLC, Lilly USA, LLC, Pfizer, Inc. and Sepracor, Inc. for the “Outcomes from the 3rd Annual Chair Summit – Master Class for Neuroscience Professional Development” educational research study and the educational activity upon which it was based.

CMEO received an overwhelmingly positive response from the meeting’s attendees. Participants enjoyed the informative display and congratulated CMEO on their exceptional outcomes analyses, a core competence at the company. Joy Bartnett Leffler, CMEO’s Senior Medical Program Director and Director of Educational Research & Outcomes remarked, “It is exciting to share such compelling data with our colleagues in the CME community. At CMEO, we work every day to demonstrate that well-designed and thoughtfully executed educational activities can make a difference in the lives of patients. Our collaborators helped us to achieve these significant results. CMEO continues to set the pace for educational outcomes that improve clinical practice…one change at a time.”

CME Outfitters was proud to be accepted as a presenter at the ACEHP this year as well. CMEO Managing Partner, Shari Tordoff, CCMEP, presented during a breakout session on day two of the conference. Ms. Tordoff worked alongside Karen Roy and Dr. Thomas Roth, from University of Michigan on an educational session detailing: Publications in CME: Disseminating the Data to Multiple Audiences. Objectives of this presentation were to allow learners to identify publications opportunities for their own CME program, implement a strategic publications plan targeting both education and medical literature, engage faculty in publications development and harness CME publications for internal CME advocacy. Positive buzz was created around this session as participants were tweeting their approval of Dr. Thomas Roth joining the live presentation via Skype. Participants were impressed not only by the content of the session, but also by the successful fluidity of the presentation with use of modern technology.

CMEO’s leadership in the CME community continued to be highly visible at the annual meeting of the National Association of Medical Education Companies (NAMEC). In addition to receiving the award for Best Practices in Collaboration Among CME Stakeholders and the 2012 Brian P. Russell Exemplary CME Professional, CMEO Managing Partner, Jan Perez, CCMEP who serves as the Chair of the NAMEC Program Committee, facilitated a highly interactive session entitled Developing a Funding Strategy When Multisupport Falls Short. The town hall style discussion was very unique bringing together competitors to share ideas and brainstorm strategies related to managing funding shortfalls for multisupport grants, which is a universal challenge facing medical education companies today. “We were a little hesitant about the session and concerned that no one would want to give away their secrets, but were overwhelmed by the group’s willingness to share and work together to tackle one of our biggest challenges”, stated Perez.

PRWeb press release

Posted in CME, Education, Research | Tagged | Comments Off

Computerized 3D Self-help Intervention for Adolescent Depression

Posted on April 24, 2012 by rkennedy

According to a study published in BMJ, adolescents suffering from depression can benefit just as much from specialized computer therapy as they do from one-to-one therapy with a clinician.

Using SPARX, an interactive 3D fantasy game, researchers from the University of Auckland, New Zealand, set out to assess whether a new innovative computerized cognitive behavioral therapy intervention could reduce depressive symptoms as much as usual care can in adolescents who may be reluctant to seek professional help.

In SPARX a single user undertakes a series of challenges to restore balance in a virtual world dominated by GNATs (Gloomy Negative Automatic Thoughts). It contains seven modules designed to be completed over a four to seven week period. Usual care mostly involved face-to-face counseling by trained clinicians.

The research team carried out a randomized controlled trial in 24 primary healthcare sites across New Zealand. All 187 adolescents were between the ages of 12 and 19, were seeking help for mild to moderate depression and were deemed in need of treatment by primary healthcare clinicians. One group underwent face-to-face treatment as usual and the other took part in SPARX. Participants were followed up for three months and results were based on several widely used mental health and quality of life scales.

Results showed that SPARX was as effective as usual care in reducing symptoms of depression and anxiety by at least a third. In addition significantly more people recovered completely in the SPARX group (31/69 (44%) of those who completed at least four homework modules in the SPARX group compared with 19/83 (26%) in usual care).

The authors conclude that SPARX is an “effective resource for help seeking adolescents with depression at primary healthcare sites. Use of the program resulted in a clinically significant reduction in depression, anxiety, and hopelessness and an improvement in quality of life.” They suggest that it is a potential alternative to usual care and could be used to address unmet demand for treatment. It may also be a cheaper alternative to usual care and be potentially more easily accessible to young people with depression in primary healthcare settings.

Source: BMJ
SPARX link

Posted in Adolescents, Cognitive Behavior Therapy, Depression, Technology, Treatment | Comments Off

Linking Mental Illness To Chronic Physical Illness Risk

Posted on April 16, 2012 by rkennedy

Results from a study by Substance Abuse and Mental Health Services Administration (SAMHSA) demonstrated that individuals aged 18 and older who had any mental illness, major depressive episodes or serious mental illness in the past year, are more likely to have a strke or develop diabetes, high blood pressure, asthma, cardiovascular disease, than those who have not had any mental illness.

Comparing adults who have not experienced any mental illness in the past year, 18.3% had high blood pressure in the last year,compared to 21.9% of those who experienced mental illness. In addition, 10.6% of adults without mental illness in the past year also had asthma, compared to 15.7% of adults who had any mental illness.

The researchers also found that individuals who suffered from a serious mental illness (i.e. a mental illness resulting in severe functional impairment substantially interfering with one or more major life activities) in the past year were more likely to develop cardiovascular disease, high blood pressure, asthma, diabetes, and stroke than adults without serious mental illnesses.

Individuals who had major depressive episodes lasting 2+ weeks were more likely (24.1%) to develop high blood pressure than adults without experiencing major depressive episodes in the past year (19.8%), 8.9% to develop diabetes vs. 7.1%, 6.5% to develop cardiovascular disease vs. 4.6%, 17.0% asthma vs. 11.4%, and 2.5% stoke vs. 1.1%.

The study also found that individual who experienced serious mental illness in the past year were more likely to to use emergency departments (47.6%) than adults without serious mental illness (30.5%). In addition, adults who experienced serious mental illness were more likely to have been hospitalized (20.4%) than those without serious mental illness (11.6%).

The SAMHSA report is an annual nationally representative survey of the U.S. civilian, non-institutionalized population aged 12 or older.

SAMHSA study

 

Posted in Depression, Diabetes, Heart health, Mental health, Metabolic screening, Risk | Comments Off

Paraskevidekatriaphobia

Posted on April 13, 2012 by rkennedy

Some people take fear of Friday the 13th or paraskevidekatriaphobia very seriously. The year 2012 is an especially bad year for those who fear this day. Most years have one or two Friday the 13ths, but this year, there are three. And, they are 13 weeks apart. (January 13th, April 13th, July 13th).

It is estimated that many millions of dollars are lost in business on this day. Symptoms range from mild anxiety to full-blown panic attacks. The latter may cause people to reshuffle schedules or miss an entire day’s work. Some refuse to fly, or conduct business as usual.

A study published in the British Medical Journal examined the relation between health, behavior, and superstition surrounding Friday 13th in the United Kingdom by comparing Friday the 13th with another Friday in these 3 areas. Results demonstrated that there were consistently and significantly fewer vehicles on the road on Friday the 13th compared with Friday the 6th. The numbers of shoppers were not significantly different on the two days. However, hospital admissions due to transport accidents were significantly increased on Friday 13th (total 65 v 45; p < 0.05), an increase of 52%.(1)

Separate from the day of the week, the number 13 has a reputation all its own. Fear of the number 13 is a condition called triskaidekaphobia. Many notable figures throughout history have had issues with the number 13 including President Franklin D. Roosevelt, who would not travel on the 13th day of any month and would never host 13 guests at a meal. According to Thomas Fernsler, an associate policy scientist in the Mathematics and Science Education Resource Center at the University of Delaware in Newark, the number 13 suffers because of its position after 12. Numerologists consider 12 a “complete” number. There are 12 months in a year, 12 signs of the zodiac, 12 gods of Olympus, 12 labors of Hercules, 12 tribes of Israel, and 12 apostles of Jesus.(2)

More than 80 percent of high-rise buildings lack a 13th floor. Many airports skip the 13th gate. Hospitals and hotels regularly have no room number 13. On streets in Florence, Italy, the house between number 12 and 14 is addressed as 12 and a half. (3)

According to DSM-IV. a phobia is a marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, seeing blood).Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed panic attack. The phobic situation is avoided or else is endured with intense anxiety or distress.The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person’s normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.(4)

Take a Poll

Sources:
(1) Scanlon TJ. BMJ
(2) Fernsler T. Univ Delaware
(3) Dossey DE. Holiday Folklore, Phobias and Fun: Mythical Origins, Scientific Treatments and Superstitious “Cures”
(4) DSM-IV-TR

 

Posted in Anxiety Disorders, Phobia | Comments Off

Alzheimer’s Biomarker and Major Depression

Posted on April 10, 2012 by rkennedy

Research published in the American Journal of Psychiatry demonstrates that elderly patients who are cognitively intact and diagnosed with major depression may have low levels of amyloid beta 42 (Aß-42) in cerebral spinal fluid (CSF).

Aß-42 has been implicated in Alzheimer’s disease as the main component of plaques. According to the authors, amyloid beta peptides also induce a depressive state in rodents and disrupt major neurotransmitter systems linked to depression. The authors assessed whether major depression was associated with CSF levels of amyloid beta, tau protein, and F2-isoprostanes in elderly individuals with major depressive disorder and age-matched nondepressed comparison subjects.

Results revealed that amyloid beta 42 levels were significantly lower in the major depression group (n=28) relative to the comparison group (n=19), and amyloid beta 40 levels were lower but only approaching statistical significance. In contrast, isoprostane levels were higher in the major depression group. No differences were observed in total and phosphorylated tau proteins across conditions. Antidepressant use was not associated with differences in amyloid beta 42 levels.

The study concluded that reduction in CSF levels of amyloid beta 42 may be related to increased brain amyloid beta plaques or decreased soluble amyloid beta production in elderly individuals with major depression relative to nondepressed comparison subjects. The researchers point out that “these results may have implications for our understanding of the pathophysiology of major depression and for the development of treatment strategies.”

Am J Psychiatry 2012

Posted in Alzheimer's Disease, Biomarker, Cognition, Dementia, Depression, Uncategorized | Comments Off

New IOM Report on Epilepsy

Posted on April 5, 2012 by rkennedy

A new report from the Institute of Medicine (IOM) highlights gaps in the knowledge and management of epilepsy. The report recommends specific actions to promote a better understanding of the disorder and improve the lives of patients with epilepsy and their families.

According to the IOM, “although epilepsy is one of the nation’s most common neurological disorders, public understanding of it is limited. Many people do not know the causes of epilepsy or what they should do if they see someone having a seizure. Epilepsy is a complex spectrum of disorders that affects an estimated 2.2 million Americans in a variety of ways, and is characterized by unpredictable seizures that differ in type, cause, and severity. Yet living with epilepsy is about much more than just seizures; the disorder is often defined in practical terms, such as challenges in school, uncertainties about social situations and employment, limitations on driving, and questions about independent living.”

Epilepsy Across the Spectrum: Promoting Health and Understanding

 

Posted in Uncategorized | Comments Off

CME Outfitters Awarded Accreditation with Commendation

Posted on April 2, 2012 by rkennedy

CME Outfitters (CMEO), a leading provider for continuing medical education, is proud to announce that it has been awarded Accreditation with Commendation, the highest recognition an organization can merit.  This is a second time award for CMEO since it first opened its doors in 2002 as a CME provider.   CMEO has held Accreditation with Commendation status since 2006 and is proud to continue providing best-in-class medical education at the highest level through 2018.

Read the press release for more details

Posted in CME, Medical Education, Uncategorized | Comments Off