Addressing Electroconvulsive Therapy Knowledge Gaps and Stigmatized Views Among Nursing Students Through a Psychiatrist-APRN Didactic Partnership

BACKGROUND:Knowledge gaps and stigmatized perceptions regarding electroconvulsive therapy (ECT) among patients and health providers contribute to the underutilization of an important therapeutic modality. The proactive education of future advanced practice registered nurses (APRNs) provides an opportunity to optimize the use of this evidence-based clinical practice.AIMS:As part of a general course in psychiatry during the first year of nursing school, we dedicated 1 hour to treatment-refractory depression, including ECT, and a second hour to a summary discussion of mood disorders. We evaluated the efficacy of this didactic offering, which was co-taught by a psychiatrist and a psychiatric APRN.METHOD:At baseline, consenting students (n= 94) provided three words they associated with ECT and then completed three validated instruments: (a) Questionnaire on Attitudes and Knowledge of ECT, (b) Opening Minds Stigma Scale for Health Care Providers, and (c) Self-Stigma of Seeking Help. Among the 67 students who repeated the assessment at endpoint, 39 attended the ECT didactic (Intervention group, 58%) and 28 did not (Control, 42%).RESULTS:After completion of the 3-month course, students showed improvement across all measures (p<.001). The only outcomes that improved differentially between the Intervention and Control groups were the Questionnaire on Attitudes and Knowledge of ECT Attitudes and Knowledge scales (p= .01). Word choice valence associated with ECT shifted favorably by endpoint (p<.001).CONCLUSIONS:An educational intervention co-led by a psychiatric-mental health APRN had a significant impact on nursing students' knowledge and perceptions of ECT. This approach can be readily implemented at other institutions. Future refinements will include the videotaped depiction of a simulated patient undergoing the consent, treatment, and recovery phases of ECT

Radar climatology of the COPS region

A climatology of convection initiation (CI) and convective enhancements (CE) has been developed using radar reflectivity data in southwestern Germany and eastern France over the period of May�August of 2000�2006 and 2008. The study region included the Vosges Mountains of France, the Rhine Valley which straddles France and Germany, the Black ForestMountains and the SwabianMountains of Germany. Convection occurred frequently during the summer months throughout the study region. The CI density (number of initiations per square km) illustrates preferential formation in the mountain regions while the CE events spanned both mountains and valleys nearly equally. There is a strongmid-day peak of the CI events suggesting that diurnal heating is critical for CI in the region. The very strong thunderstorms (>46 dBZ) first occurred in the mountains and �2 h later in the Rhine Valley. During the summer of 2007, the Convective and Orographically-induced Precipitation Study (COPS) field campaign was conducted with the objective of obtaining improved understanding of convective processes and short-term quantitative precipitation forecasting in low-mountain regions. Comparisons were made between the radar climatology results and the COPS summer. The COPS summer exhibited preferential CI density in the mountainous regions but not as pronounced as the climatology. The COPS summer had a similar diurnal peak of CI events as climatology but the ratio of daytime to nighttime CI (1.7), or amplitude of the diurnal cycle, was less than that of climatology (3.0). While both the 8-year climatology and COPS summer were dominated by daytime, locally-forced CI occurrences, the broad distribution of daytime CI events and increase in nighttime events observed during COPS indicate a more active synoptic pattern in 2007

Differences in IV alcohol-induced dopamine release in the ventral striatum of social drinkers and nontreatment-seeking alcoholics

Background Striatal dopamine (DA) has been implicated in alcohol use disorders, but it is still unclear whether or not alcohol can induce dopamine release in social drinkers. Furthermore, no data exist on dopamine responses to alcohol in dependent drinkers. We sought to characterize the DA responses to alcohol intoxication in moderately large samples of social drinkers (SD) and nontreatment-seeking alcoholics (NTS). Methods Twenty-four SD and twenty-one NTS received two [11C]raclopride (RAC) PET scans; one at rest, and one during an intravenous alcohol infusion, with a prescribed ascent to a target breath alcohol concentration (BrAC), at which it was then “clamped.” The alcohol clamp was started 5 min after scan start, with a linear increase in BrAC over 15 min to the target of 80 mg%, the legal threshold for intoxication. Target BrAC was maintained for 30 min. Voxel-wise binding potential (BPND) was estimated with MRTM2. Results IV EtOH induced significant increases in DA in the right ventral striatum in NTS, but not SD. No decreases in DA were observed in either group. Conclusions Alcohol intoxication results in distinct anatomic profiles of DA responses in SD and NTS, suggesting that in NTS, the striatal DA system may process effects of alcohol intoxication differently than in SD

Clinico-Neuropathological Findings in the Oldest Old from the Georgia Centenarian Study

Background: Centenarian studies are important sources for understanding of factors that contribute to longevity and healthy aging. Clinico-neuropathological finding is a key in identifying pathology and factors contributing to age-related cognitive decline and dementia in the oldest old. Objective: To characterize the cross-sectional relationship between neuropathologies and measures of premortem cognitive performance in centenarians. Methods: Data were acquired from 49 centenarians (≥98 years) from the Georgia Centenarian Study. Cognitive assessment from the time point closest to mortality was used (\u3c1 year for all subjects) and scores for cognitive domains were established. Neuropathologies [cerebral atrophy, ventricular dilation, atherosclerosis, cerebral amyloid angiopathy (CAA), Lewy bodies, hippocampal sclerosis (HS), hippocampal TDP-43 proteinopathy, neuritic plaque (NP) and neurofibrillary tangle (NFT) counts, Braak staging, and National Institute on Aging-Reagan Institute (NIARI) criteria for the neuropathological diagnosis of Alzheimer’s disease (AD)] were compared among subjects with different ratings of dementia. Linear regression was applied to evaluate the association between cognitive domain scores and neuropathologies. Results: Wide ranges of AD-type neuropathological changes were observed in both non-demented and demented subjects. Neocortical NFT and Braak staging were related to clinical dementia rating. Neocortical NFT and NP, Braak and NIARI staging, cerebral and ventricular atrophy, HS, CAA, and TDP-43 proteinopathy were differentially associated with poor performance in multiple cognitive domains and activities of daily living. Conclusion: AD-type pathology was associated with severe dementia and poor cognition but was not the only variable that explained cognitive impairment, indicating the complexity and heterogeneity of pathophysiology of dementia in the oldest old

Genetic Variants Associated With Vincristine‐Induced Peripheral Neuropathy in Two Populations of Children With Acute Lymphoblastic Leukemia

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149215/1/cpt1324_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149215/2/cpt1324.pd