Suicidal Ideation and Self-injury Prevalence and Impairment in an Urban Integrated Primary Care Clinic

Introduction: Suicide is the second leading cause of death for adolescents (Rosenbaum & Ougrin, 2019). Pediatric primary care staff are often the first line of intervention for youth presenting with suicidal thoughts and NSSI (Taliaferro et al., 2013). The primary aim of the current study was to describe reported suicidal ideation, attempts, and NSSI in youth presenting to an urban integrated primary care setting. Methods: Within an outpatient pediatric primary care clinic, patients were referred by medical staff and introduced to behavioral health services. Patients were asked about their history of suicidal thoughts/attempts and NSSI (Mage = 12.63; SD = 4.51; 66.3% female, 66.3% Black; 69.6% Medicaid). Patients were also screened using the Pediatric Symptom Checklist-17 (PSC17; Gardner et al., 2007) and Top Problems (Weisz et al., 2001). Results: Seventeen percent of patients endorsed a history of either suicidal ideation/attempts or NSSI. Chi-square analyses identified a significant association between patient race and suicidal ideation/attempts [χ2(6) = 13.56, p = .035]. The sample’s mean internalizing score on the PSC17 fell within the clinical range (M = 6.13, SD = 2.49). Further results reflecting findings, interventions used, and top problem areas will be presented. Conclusion: Results highlight a demand for establishing and sustaining effective screening and engagement in mental health treatment for youth suicidality and self-injury in integrated care settings. Future directions will be discussed.https://scholarscompass.vcu.edu/gradposters/1111/thumbnail.jp

Annual Survey of Virginia Law: Damages for Medical Malpractice in Virginia

As a general rule, a plaintiff in actions for personal injury and wrongful death in Virginia, regardless ofwhether the cause derives from medical malpractice, may state a claim for any medical expenses incurred as a result of the alleged injury or death. By definition, an expense is incurred when it has been paid or one become[s] legally obligated to pay it. A tortfeasor is bound and obligated to make the plaintiff whole, which means the injured party or his estate must be reasonably compensated for the fair and reasonable value of incurred medical expenses

Social and Psychological Factors Associated with Health Care Transition for Young Adults Living with Sickle Cell Disease

Introduction: Due to advances in disease management, mortality rates in children with sickle cell disease (SCD) have decreased. However, mortality rates for young adults (YA) increased, and understanding of social and psychological factors is critical. The aim of this study was to explore factors associated with health care transition experiences for YA with SCD. Method: This was a qualitative descriptive study. A 45-minute semistructured interview was conducted with 13 YA (M = 21.5 years, SD = 1.73). Results: Results suggest that social and psychological factors and self-management experiences influence health care transition. Eight themes emerged: “need for accessible support”; “early assistance with goal setting”; “incongruence among expectations, experiences, and preparation”; “spiritual distress”; “stigma”; “need for collaboration”; “appreciation for caring providers”; and “feeling isolated.” Discussion: Consideration of cultural contexts will guide nurses in supporting health care transition. Designing culturally relevant interventions that address unique needs for YA living with SCD is warranted

Co-Occurrence and Characteristics of Patients With Axial Spondyloarthritis Who Meet Criteria for Fibromyalgia : Results From a UK National Register

The British Society for Rheumatology (BSR) Biologics Register in Ankylosing Spondylitis is funded by the BSR and they have receive funds for this from Pfizer, AbbVie and UCB. These companies receive advance copies of manuscripts and can provide comments but have no input into determining the topics for analysis, publication and no input into the work involved in this analysis. This analysis is part-funded by Arthritis Research UK (Grant No: 21378)Peer reviewedPublisher PD

The management of behavioural and psychological symptoms of dementia in the acute general medical hospital: A longitudinal cohort study

yesBackground: The acute hospital is a challenging place for a person with dementia. Behavioural and psychological symptoms of dementia (BPSD) are common and may be exacerbated by the hospital environment. Concerns have been raised about how BPSD are managed in this setting and about over reliance on neuroleptic medication. This study aimed to investigate how BPSD are managed in UK acute hospitals. Method(s): A longitudinal cohort of 230 patients with dementia admitted to two acute NHS hospitals. BPSD were measured every four days (Behave-AD scale), as well as documentation of pharmacological prescriptions and non-pharmacological management. Results: The overall prevalence of BPSD was 75%, with aggression and activity disturbance being the most common. Antipsychotics were prescribed for 28 (12%) patients; 70% of these prescriptions were new on admission. Benzodiazepines were prescribed for 27 (12%) patients, antidepressants were prescribed for 37 (16%) patients, and sedatives were prescribed for 14 (3%) patients. Patients who were prescribed antipsychotics, after adjusting for end of life medication, age and dementia severity, were significantly more likely to die (adjusted hazard ratio 5.78, 95% CI 1.57, 21.26, p= 0.008). Nonpharmacological management was used in 55% of participants, most commonly psychosocial interventions (36%) with little evidence of monitoring their effectiveness. A form of restraint was used during 50 (22%) patients’ admissions. Conclusions: Antipsychotic medications and psychosocial interventions were the main methods used to manage BPSD; however, these were not implemented or monitored in a systematic fashion.Alzheimer's Society; BUPA Foundatio

Phosphonopeptides Revisited, in an Era of Increasing Antimicrobial Resistance

Given the increase in resistance to antibacterial agents, there is an urgent need for the development of new agents with novel modes of action. As an interim solution, it is also prudent to reinvestigate old or abandoned antibacterial compounds to assess their efficacy in the context of widespread resistance to conventional agents. In the 1970s, much work was performed on the development of peptide mimetics, exemplified by the phosphonopeptide, alafosfalin. We investigated the activity of alafosfalin, di-alanyl fosfalin and β-chloro-L-alanyl-β-chloro-L-alanine against 297 bacterial isolates, including carbapenemase-producing Enterobacterales (CPE) (n = 128), methicillin-resistant Staphylococcus aureus (MRSA) (n = 37) and glycopeptide-resistant enterococci (GRE) (n = 43). The interaction of alafosfalin with meropenem was also examined against 20 isolates of CPE. The MIC50 and MIC90 of alafosfalin for CPE were 1 mg/L and 4 mg/L, respectively and alafosfalin acted synergistically when combined with meropenem against 16 of 20 isolates of CPE. Di-alanyl fosfalin showed potent activity against glycopeptide-resistant isolates of Enterococcus faecalis (MIC90; 0.5 mg/L) and Enterococcus faecium (MIC90; 2 mg/L). Alafosfalin was only moderately active against MRSA (MIC90; 8 mg/L), whereas β-chloro-L-alanyl-β-chloro-L-alanine was slightly more active (MIC90; 4 mg/L). This study shows that phosphonopeptides, including alafosfalin, may have a therapeutic role to play in an era of increasing antibacterial resistance