Improving Depression Screening and Diagnosis in a Diverse Urban University Health Service

Background: Twenty percent of the United States (U.S.) adult population is affected by mental illness each year of which depression is the most common cause of disability and suicide. Each year, one in four young adults between the ages of 18 – 25 will experience at least one depressive episode. This demographic propensity for young adults to suffer depression has implications for college campuses where young adults congregate and high rates of depression have been noted. In addition to the impact of depression on health and quality of life, depression has been linked to a decrease in students’ academic performance. Thus from a health perspective as well as its potential impact on academic success, depression is a major health concern on college campuses. Objectives: The purpose of this quality improvement project is to evaluate whether integrating a brief depression screening tool into an electronic health record (EHR) and providing decision support increases the proportion of students screened and diagnosed for depression. Participants: Data were drawn from a convenience sample of 130 student patient scheduled visit notes in the Department of General Medicine at a diverse urban University over a 4 year period. Methods: Using the Plan-Do-Study-Act method of quality improvement, the brief depression screening tool was integrated into the EHR. Evaluation consisted of a pre/post implementation comparison of measures for screening for depressive symptoms and depression diagnosis. Results: Integration of the PHQ-2 and decision support into the EHR increased the proportion of students: screened for depressive symptoms (7.7%:86.2%); and diagnosed with Major Depressive Disorder (30%:45.5%). Conclusions: The integration of a valid and reliable tool to screen and diagnose depression can increase the number of students treated for depression. This has implications for academic success and quality of life

Voices from the Past

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Regando o jardim com a psicomotricidade relacional : corpo e afetividade florescendo nas aulas de educação física

Trabalho de Conclusão de Curso (graduação)—Universidade de Brasília, Faculdade de Educação Física, 2017.A presente pesquisa teve como objetivo analisar a influência da psicomotricidade relacional nas relações afetivas entre crianças durante aulas de educação física na Educação Infantil. Vários teóricos subsidiaram a construção desse trabalho, tais como Lapierre, Aucouturier, Le Boulch, Negrine, dentre outros. Tais autores fundamentam a ideia de que o jogo simbólico e espontâneo contribui para as interações entre as crianças e destas com o professor, a partir das quais emergem os conflitos inconscientes que poderão ser trabalhados na mediação pedagógica. Tal investigação, de cunho qualitativo, teve como participantes alunos de uma turma de segundo período da Educação Infantil em uma escola da rede pública de ensino do Distrito Federal. Foi utilizada como instrumento de pesquisa a observação participante. Os resultados indicam que a utilização de objetos dispostos durante as sessões e a mediação pedagógica relacional do professor nas situações de jogo entre os alunos contribuem com o desenvolvimento da criança quanto à manifestação de sentimentos e pulsões reprimidas, a utilização da própria linguagem do corpo como meio de comunicação e a socialização no que concerne às relações afetivas. Conclui-se que a prática de intervenções psicomotoras propulsoras de relações afetivas é importante na etapa da Educação Infantil e é uma grande colaboradora nos processos de desenvolvimento sócio-emocional da criança

HER-2 Expression in Immunohistochemistry Has No Prognostic Significance in Gastric Cancer Patients

The role of HER-2 expression as a prognostic factor in gastric cancer (GC) is still controversial. The aim of the study was to asses HER-2 status, its correlations with clinicopathological parameters, and prognostic impact in GC patients. Tumor samples were collected from 78 patients who had undergone curative surgery. In order to evaluate the intensity of immunohistochemical (IHC) reactions two scales were applied: the immunoreactive score according to Remmele modified by the authors and standardised Hercep test score modified for GC by Hofmann et al. The HER-2 overexpression was detected by IHC in 23 (29.5%) tumors in Hercep test (score 2+/3+) and in 24 (30.7%) in IRS scale (IRS 4–12). The overexpression of HER-2 was associated with poorly differentiated tumors, but this correlation was not significant (P = 0.064). No relationship was found between HER-2 expression and primary tumor size and degree of spread to regional lymph nodes. Both univariate and multivariate analyses revealed that TNM stage and patient's age were the crucial negative prognostic factors. No correlation was observed between patient survival and expression of HER-2 estimated using both scales. This research did not confirm HER-2 expression (evaluated with immunohistochemistry) value as a prognostic tool in GC

Alice in recidivism land: The Queens logic and child protection workers\u27 assessment of sexual dangerousness

This article is based on a case that highlights the dearth of cogent and pertinent risk assessment information in the reports and testimonies of many involved in assessing risks to children in real life problematic circumstances. In the case, the decision to exclude an intrafamilial sexual offender from the family home was made in large measure on the basis that the offender\u27s wife accepted the offender\u27s "denial of guilt" to accusations previously made against him. Keeping families apart should not be entertained without reliable and valid evidence pointing to that decision. However, as will be seen, the evidence often relied upon by child protection workers, albeit in good faith, is neither. The assessment processes described in the case point directly to what appears to be a wider lack of knowledge specific to assessment of recidivism, to misrepresentation of risk assessment information, and to overarching epistemological issues that appear to be widely ignored and/or misunderstood within the overall field of risk assessment and threat management. The purpose of this article is to describe how the information used to decide upon exclusion in the case cannot be considered probative and to iterate the methodological processes that must be considered in such cases if miscarriages of justice are to be avoided