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Smoking cessation in pregnancy: why, how, and what next…

Clin Obstet Gynecol. 2008 Jun;51(2):419-35

Authors: Crawford JT, Tolosa JE, Goldenberg RL

Smoking cessation in pregnancy has been shown to reduce low birth weight, preterm birth, and infant morbidities. The effectiveness and safety profile of current cessation approaches in pregnancy are presented. The highest cessation rates are associated with counseling and behavioral interventions. Further studies are needed to evaluate the safety and efficacy of pharmacotherapy in pregnancy including nicotine replacement therapy, bupropion and the recently approved drug Varenicline. The risks and benefits of nicotine replacement therapy in heavy smokers and bupropion are discussed. Data on fetal risk are not yet available for Varenicline.

PMID: 18463471 [PubMed - indexed for MEDLINE]

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Impact of Patient Empathy Modeling on pharmacy students caring for the underserved.

Am J Pharm Educ. 2008 Apr 15;72(2):40

Authors: Chen JT, LaLopa J, Dang DK

OBJECTIVE: To determine the impact of the Patient Empathy Modeling pedagogy on students’ empathy towards caring for the underserved during an advanced pharmacy practice experience (APPE). DESIGN: Pharmacy students completing an APPE at 2 primary care clinics participated in a Patient Empathy Modeling assignment for 10 days. Each student “became the patient,” simulating the life of an actual patient with multiple chronic diseases who was coping with an economic, cultural, or communication barrier to optimal healthcare. Students completed the Jefferson Scale of Physician Empathy (JSPE) before and after completing the assignment, and wrote daily journal entries and a reflection paper. ASSESSMENT: Twenty-six students completed the PEM exercises from 2005-2006. Scores on the JSPE improved. Students’ comments in journals and reflection papers revealed 3 major themes: greater appreciation of the difficulty patients have with adherence to medication and treatment regimens, increased empathy for patients from different backgrounds and patients with medical and psychosocial challenges, and improved ability to apply the lessons learned in the course to their patient care roles. CONCLUSION: A Patient Empathy Modeling assignment improved pharmacy students’ empathy toward underserved populations. Integrating the assignment within an APPE allowed students to immediately begin applying the knowledge and insight gained from the exercise.

PMID: 18483606 [PubMed - indexed for MEDLINE]

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False memory for associated word lists in individuals and collaborating groups.

Mem Cognit. 2008 Apr;36(3):598-603

Authors: Maki RH, Weigold A, Arellano A

Using the Deese/Roediger-McDermott (DRM) paradigm, we investigated recall of presented and nonpresented associated words by collaborating groups, nominal groups, and individuals. In Experiment 1, participants recalled individually and then recalled in collaborating groups. Nominal groups made up of individual recall produced more presented and nonpresented associated words than did collaborating groups. Collaborating groups recalled more presented words than did individuals, but not more nonpresented words. In Experiment 2, collaborating groups versus individuals was a between-subjects variable, and everyone made two recall attempts. For recall, the pattern was the same as that in Experiment 1, in that collaborating groups recalled more presented words than did individuals but about the same number of nonpresented words. In a DRM paradigm, collaborating groups were able to produce more presented words than were individuals, without increasing their false recall.

PMID: 18491499 [PubMed - indexed for MEDLINE]

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The COGNITION study rationale and design: influence of closed loop stimulation on cognitive performance in pacemaker patients.

Pacing Clin Electrophysiol. 2008 Jun;31(6):709-13

Authors: Wiegand U, Nuernberg M, Maier SK, Weiss C, Sancho-Tello MJ, Hartmann A, Schuchert A, Maier P, Chan NY

BACKGROUND: Several studies showed the beneficial effect of pacemaker implantation on cognitive performance in patients with bradycardia. But it has never been investigated if patients with chronotropic incompetence may improve their cognitive performance if treated by a rate-adaptive system reacting to mental stress in comparison to the most frequently used accelerometer-driven pacing. METHODS: The randomized, single-blind, multicenter COGNITION study evaluates if closed loop stimulation (CLS) offers incremental benefit in the speed of cognitive performance and the overall well-being of elderly patients with bradycardia compared with accelerometer-based pacing. Four hundred chronotropically incompetent patients older than 55 years will be randomized 3-6 weeks after implantation to CLS or accelerometer sensor. Follow-up visits are performed after 12 and 24 months. The speed of cognitive performance, which is the underlying function influencing all other aspects of cognitive performance, will be assessed by the number connection test, a standardized psychometric test for the elderly. Secondary endpoints include patient self-assessment of different aspects of health (by visual analogue scales), quality of life (by SF-8 health survey), the incidence of atrial fibrillation (episodes lasting for longer than 24 hours), and the frequency of serious adverse events. CONCLUSION: In the ongoing COGNITION study, we aim at long-term comparison of two rate-adaptive systems, focusing on the cognitive performance of the patients, which was neglected in the past evaluation of pacemaker sensors.

PMID: 18507543 [PubMed - indexed for MEDLINE]

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[The combined DAK therapy of obesity for children and adolescents. Evaluation after 1 year]

MMW Fortschr Med. 2008 Apr 10;150 Suppl 1:7-15

Authors: Adam S, Westenhöfer J, Rudolphi B, Kraaibeek HK

In 2003, the program “The combined DAK therapy of obesity for children and adolescents”, funded and conducted by the Deutsche Angestellten Krankenkasse (DAK) (A German Health Insurance Company), has started. The whole treatment lasts for 1 year including an initial inpatient therapy for 6 weeks followed by an outpatient treatment at home that adresses the overweight patients and their families. The therapy contents are developed according to the recommendations of the “Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter (AGA)”. In a prospective cohort study a sample of 604 subjects was studied in order to examine the achievement of the treatment goals weight reduction, behaviour modification and improvement of quality of life. The development of weight was evaluated using BMI-SDS. 44,1% of children and adolescents had a successful weight reduction, they reduced their weight at least by 0,3 BMI-SDS. Furthermore, significant changes of health behaviour, physical fitness and quality of life were observed. However, during the outpatient treatment an impairment of some behaviour changes were observed. Nevertheless, the study has identified significant, positive effects in weight loss, behaviour modifications, changes in physical fitness and in the development of quality of life as a result of the therapy. It is demonstrated that a relapse in “old behaviour” followed by an increase of weight after the inpatient treatment can be avoided bythe subsequent outpatient therapy.

PMID: 18540326 [PubMed - indexed for MEDLINE]

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Pharmacotherapy for patients with fibromyalgia.

J Clin Psychiatry. 2008;69 Suppl 2:25-9

Authors: Clauw DJ

Fibromyalgia is a common and disabling syndrome. Despite research detailing the efficacy of a variety of medicinal treatments, most notably, tricyclic antidepressants, serotonin-norepinephrine re-uptake inhibitors, and alpha(2)delta ligands, there is still widespread, routine use of agents that are mostly ineffective in treating the central nature of fibromyalgic pain. This article discusses pharmacotherapeutic options for fibromyalgia, including those with high-level evidence for efficacy, moderate-level evidence, and little or no evidence for efficacy. The importance of an integrated treatment approach that includes pharmacotherapy and at least one, but preferably more, of the most effective nonmedicinal treatment options available (e.g., education, aerobic exercise, and cognitive-behavioral therapy) is also discussed.

PMID: 18537460 [PubMed - indexed for MEDLINE]

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Multidisciplinary modalities in the treatment of fibromyalgia.

J Clin Psychiatry. 2008;69 Suppl 2:30-4

Authors: Goldenberg DL

Fibromyalgia is a common musculoskeletal pain condition associated with chronic widespread pain, tenderness at various points on the body, fatigue, and sleep abnormalities. Individuals with fibromyalgia often have comorbid anxiety, depression, and/or other pain syndromes. Research into pharmacologic remedies for fibromyalgia has demonstrated efficacy for a variety of agents, but pharmacology is only one piece of the puzzle when it comes to successful management of fibromyalgia. Sensitive and appropriate methods of diagnosis and an integrated treatment plan including proper patient education, aerobic exercise, and cognitive-behavioral therapy have been shown to be effective in alleviating fibromyalgic symptoms.

PMID: 18537461 [PubMed - indexed for MEDLINE]

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Effects of multiple maltreatment experiences among psychiatrically hospitalized youth.

Child Abuse Negl. 2008 Jun 24;

Authors: Boxer P, Terranova AM

OBJECTIVE: Relying on indicators coded from information collected routinely during intake assessments at a secure inpatient psychiatric facility, this study examined the extent to which different forms of maltreatment accounted for variations in youths’ emotional and behavioral problems. METHODS: Clinical information was reviewed for a large (N=401) and diverse sample (mean age=13.9 years; 53% male; 54.6% racial/ethnic minority) of youth admitted to a publicly funded psychiatric hospital. Data were drawn from intake narratives, standardized psychopathology rating scales, and psychiatric diagnostic ratings. RESULTS: Findings provide some support for a hierarchical classification of multiple maltreatment experiences with sexual abuse identified as the specific form of maltreatment most reliably associated with poor adjustment. Support also was obtained for a cumulative classification approach, as the number of different types of maltreatment experiences was linked positively to elevated psychopathology ratings. CONCLUSIONS: Even in this high-risk, atypical sample, maltreatment experiences account for variation in levels of psychopathology. These results have implications for classifying multiple maltreatment and enhancing clinical care for atypical youth who have been maltreated. PRACTICE IMPLICATIONS: Clinicians working in youth psychiatric populations should implement maltreatment-specific psychotherapy approaches for maltreated youth, even as adjunctive treatments in a therapeutic milieu.

PMID: 18582936 [PubMed - as supplied by publisher]

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A roadmap to disentangle the molecular etiology of schizophrenia.

Eur Psychiatry. 2008 Jun 24;

Authors: Falkai P, Mike O, Inez MG, Paul H, Andras BG, Sophia F, Meos Consortium

Schizophrenia is a severe mental disorder striking mainly young adults and leading to life-long disability in a substantial portion of the sufferers. On the other hand, substantial knowledge about its etiology and pathogenesis is still lacking. Therefore the European Science Foundation (ESF) sponsored a meeting of a panel of European experts on schizophrenia research to discuss the state of art and future perspectives of key topics in this area. The fields covered genetics, epidemiology, animal models, molecular neuropathology and imaging. This was a first step to establish a network of European groups dedicated to Schizophrenia research. The coming calls of the frame work program will be used to strengthen this network in order to achieve substantial progress in understanding and treating this devastating illness.

PMID: 18583106 [PubMed - as supplied by publisher]

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How should Alcohol Dependence be Treated? The Public View.

Alcohol Alcohol. 2008 Jun 26;

Authors: de Toledo Piza Peluso E, Blay SL

AIMS: The aim of this study was to assess public preferences on sources of help and treatment, and perception of prognosis for alcohol dependence. METHOD: A household survey was administered in 2002 to a probabilistic sample of 500 individuals, all residents of the city of São Paulo, Brazil, with ages ranging from 18 to 65. A vignette in colloquial language describing an individual with alcohol dependence (according to DSM-IV and ICD-10 criteria) was presented together with a structured questionnaire with questions about the vignette. RESULTS: The public considered the help of lay people, self-help groups and psychologists the most useful. Medical professionals were viewed less favourably. The treatments and activities most recommended were psychotherapy and general activities, such as physical activities, keeping the mind busy and attending church services. Medical treatments were seen as more harmful than helpful. The more important determinants were identification of alcohol dependence as mental illness, religion and number of years of school completed. Prognosis with treatment was viewed as favourable. CONCLUSION: These results may indicate that the public needs to receive more information on the full range of treatments options, especially those related to professional or formal treatment.

PMID: 18583544 [PubMed - as supplied by publisher]

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