Verve Student Program

The Verve Student Program\u27s purpose is to aid students in the problems they may face, such as bullying, depression, and lack of responsibility.https://digitalscholarship.unlv.edu/educ_sys_202/1042/thumbnail.jp

Characterizing primary care for patients with major depressive disorder using electronic health records of a US-based healthcare provider

Background: Major depressive disorder (MDD) is predominantly managed in primary care. However, primary care providers (PCPs) may not consistently follow evidence-based treatment algorithms, leading to variable patient management that can impact outcomes. Methods: We retrospectively analyzed adult patients with MDD seen at Geisinger, an integrated health system. Utilizing electronic health record (EHR) data, we classified patients as having MDD based on International Classification of Disease (ICD)-9/10 codes or a Patient Health Questionnaire (PHQ)-9 score ≥5. Outcomes assessed included time to first visit with a PCP or behavioral health specialist following diagnosis, antidepressant medication switching, persistence, healthcare resource utilization (HRU), and treatment costs. Results: Among the 38,321 patients with MDD managed in primary care in this study, significant delays between diagnosis with antidepressant prescribing and follow-up PCP visits were observed. There was also considerable variation in care following diagnosis. Overall, 34.9% of patients with an ICD-9/10 diagnosis of MDD and 41.3% with a PHQ-9 score ≥15 switched antidepressants. An ICD-9/10 diagnosis, but not moderately severe to severe depression, was associated with higher costs and HRU. More than 75% of patients with MDD discontinued antidepressant medication within 6 months. Limitations: The study population was comparable with other real-world studies of MDD, but study limitations include its retrospective nature and reliance on the accuracy of EHRs. Conclusions: Management of patients with MDD in a primary care setting is variable. Addressing these gaps will have important implications for ensuring optimal patient management, which may reduce HRU and treatment medication costs, and improve treatment persistence

The Romantic Triangle: A Study In Expanding Consciousness. (volumes I And Ii).

PhDLiteratureUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/188967/2/7529293.pd

Infusing Military Culture in Multicultural Counseling Frameworks: A Phenomenological Study

This descriptive phenomenological study focused on counselor educators’ (CESs) experiences infusing military culture into counseling curriculum. Specifically, this study sought to learn what counseling programs can do to best prepare counselors-in-training to work with military families. The researchers used the McCracken (1988) method to interview ten participants who had terminal degrees in counselor education or a highly related field, experience providing services to military-connected clients, and were aware of military cultural facets (e.g., implicit and explicit expectations, rules, and ways of being). The findings support the need to redefine multiculturalism and intentional infusion of military culture in counseling curriculum to increase counselors’ awareness of military culture to provide more effective services

The safety and tolerability of vortioxetine: analysis of data from randomised placebo-controlled trials and open-label extension studies

The safety and tolerability of vortioxetine in adults with major depressive disorder (MDD) was assessed. Tolerability was based on the nature, incidence and severity of treatment-emergent adverse events (TEAEs) during acute (6/8) week treatment in 11 randomised, double-blind placebo-controlled short-term studies in MDD: 6 with an active reference. Symptoms following discontinuation were assessed through the Discontinuation-Emergent Signs and Symptoms (DESS) checklist in 3 studies. Long-term (?52 weeks) tolerability was evaluated in 5 open-label extension studies. 5701 patients were acutely treated with either placebo (n=1817), vortioxetine (5-20mg/day) (n=3018), venlafaxine XR (225mg/day) (n=113), or duloxetine (60mg/day) (n=753). The withdrawal rate due to TEAEs during treatment with vortioxetine (5-20mg/day) was 4.5-7.8%, compared to placebo (3.6%), venlafaxine XR (14.2%) or duloxetine (8.8%). Common TEAEs (incidence ?5% and >2x placebo) with vortioxetine (5-20mg/day) were nausea (20.9-31.2%) and vomiting (2.9-6.5%). For vortioxetine (5-20mg/day), the incidence of TEAEs associated with insomnia was 2.0-5.1% versus 4.0% for placebo, and with sexual dysfunction 1.6-1.8% versus 1.0% for placebo. Discontinuation symptoms as assessed by the mean DESS total score after abrupt discontinuation were comparable to placebo in the first and second week. Vortioxetine had no effect relative to placebo on clinical laboratory parameters, body weight, heart rate, or blood pressure. Vortioxetine showed no clinically relevant effect on ECG parameters, including the QTcF interval. In long-term treatment, no new types of TEAEs were seen; the mean weight gain was 0.7-0.8kg. Thus, vortioxetine (5-20mg/day) appears safe and generally well tolerated in the treatment of MDD