PTSD – an update for general practitioners

Provides up-to-date guidance for general practitioners (GPs) in the recognition of PTSD and the current best practice recommendations for pharmacological and psychological treatment. Background Australians are commonly exposed to traumatic events, which can lead to the development of post-traumatic stress disorder (PTSD). Several recent developments in the trauma field have led to significant changes in how PTSD is diagnosed and treated. Objective This article provides up-to-date guidance for general practitioners (GPs) in the recognition of PTSD and the current best practice recommendations for pharmacological and psychological treatment. Discussion Often the first port-of-call, GPs are well placed to help patients who have recently experienced a potentially traumatic event and are at risk of developing PTSD. The role of the GP can include initial support, assessment, treatment and, where indicated, appropriate spe-cialist referral. There are recent clinical practice guidelines that GPs can use to assess and determine appropriate treatment for their patients with PTSD. &nbsp

Recognition and responses to intimate partner violence (IPV) in gambler's help services : A qualitative study

Accumulating evidence shows a strong association between gambling problems and reports of intimate partner violence (IPV) but provides limited guidance about how to respond to these issues in specialised gambling services. The aim of this study was thus to improve understanding of the potential role of gambling help providers in identifying and responding to IPV. This was addressed via 20 semistructured interviews with gambling help service staff in Australia (15 female and 5 male). Data were analysed in the context of a social constructivist approach to thematic analysis, which produced four themes: (1) “It's loaded with complexity,” which highlights the clinical complexity of clients who disclosed both gambling problems and IPV; (2) “The hidden nature of gambling and IPV,” describing stigma, shame and secrecy attached to both gambling and IPV; (3) “The big thing is putting it on the radar,” which outlined factors in the service context that either enabled client disclosures of IPV or kept it hidden; and (4) “It's everyone's business,” which described current approaches to interagency collaboration, with reference to factors that either limited or facilitated such responses to addressing IPV

Compassion, stigma, and professionalism among emergency personnel responding to the opioid crisis: An exploratory study in New Hampshire, USA.

OBJECTIVE: Drug overdoses are the leading cause of death in the United States for those under 50 years of age, and New Hampshire has been disproportionately affected, resulting in increased encounters with the emergency response system. The ensuing impact on emergency personnel has received little attention. The present study aimed to explore the experiences and perspectives of emergency personnel responding to the opioid crisis in NH, with a focus on their views toward people who use opioids. METHODS: Thirty-six emergency personnel (emergency department clinicians, n = 18; emergency medical service providers, n = 6; firefighters, n = 6; and police officers, n = 6) in 6 New Hampshire counties were interviewed about their experiences responding to overdoses and their perspectives on individuals who use opioids. Directed content analysis was used to identify themes in the transcribed, semistructured interviews. The results were reviewed for consensus. RESULTS: Several categories of themes were identified among emergency personnel's accounts of their overdose response experiences and perspectives, including varied degrees of compassion and stigma toward people who use opioids; associations between compassion or stigma and policy- and practice-related themes, such as prehospital emergency care and the role of emergency departments (EDs); and primarily among personnel expressing compassion, a sense of professional responsibility that outweighed personal biases. CONCLUSIONS: Despite the magnitude of the ongoing opioid crisis, some emergency personnel in New Hampshire have sustained or increased their compassion for people who use opioids. Others' perspectives remain or have become increasingly stigmatizing. The associations of compassion and stigma with various policy- and practice-related themes warrant further investigation

“It’s way more than just writing a prescription”: A qualitative study of preferences for integrated versus non-integrated treatment models among individuals with opioid use disorder

Background: Increasingly, treatment for opioid use disorder (OUD) is offered in integrated treatment models addressing both substance use and other health conditions within the same system. This often includes offering medications for OUD in general medical settings. It remains uncertain whether integrated OUD treatment models are preferred to non-integrated models, where treatment is provided within a distinct treatment system. This study aimed to explore preferences for integrated versus non-integrated treatment models among people with OUD and examine what factors may influence preferences. Methods: This qualitative study recruited participants (n = 40) through Craigslist advertisements and flyers posted in treatment programs across the United States. Participants were 18 years of age or older and scored a two or higher on the heroin or opioid pain reliever sections of the Tobacco, Alcohol, Prescription Medications, and Other Substances (TAPS) Tool. Each participant completed a demographic survey and a telephone interview. The interviews were coded and content analyzed. Results: While some participants preferred receiving OUD treatment from an integrated model in a general medical setting, the majority preferred non-integrated models. Some participants preferred integrated models in theory but expressed concerns about stigma and a lack of psychosocial services. Tradeoffs between integrated and non-integrated models were centered around patient values (desire for anonymity and personalization, fear of consequences), the characteristics of the provider and setting (convenience, perceived treatment effectiveness, access to services), and the patient-provider relationship (disclosure, trust, comfort, stigma). Conclusions: Among this sample of primarily White adults, preferences for non-integrated versus integrated OUD treatment were mixed. Perceived benefits of integrated models included convenience, potential for treatment personalization, and opportunity to extend established relationships with medical providers. Recommendations to make integrated treatment more patient-centered include facilitating access to psychosocial services, educating patients on privacy, individualizing treatment, and prioritizing the patient-provider relationship. This sample included very few minorities and thus findings may not be fully generalizable to the larger population of persons with OUD. Nonetheless, results suggest a need for expansion of both OUD treatment in specialty and general medical settings to ensure access to preferred treatment for all

It\u27s way more than just writing a prescription : A qualitative study of preferences for integrated versus non-integrated treatment models among individuals with opioid use disorder

BACKGROUND: Increasingly, treatment for opioid use disorder (OUD) is offered in integrated treatment models addressing both substance use and other health conditions within the same system. This often includes offering medications for OUD in general medical settings. It remains uncertain whether integrated OUD treatment models are preferred to non-integrated models, where treatment is provided within a distinct treatment system. This study aimed to explore preferences for integrated versus non-integrated treatment models among people with OUD and examine what factors may influence preferences. METHODS: This qualitative study recruited participants (n = 40) through Craigslist advertisements and flyers posted in treatment programs across the United States. Participants were 18 years of age or older and scored a two or higher on the heroin or opioid pain reliever sections of the Tobacco, Alcohol, Prescription Medications, and Other Substances (TAPS) Tool. Each participant completed a demographic survey and a telephone interview. The interviews were coded and content analyzed. RESULTS: While some participants preferred receiving OUD treatment from an integrated model in a general medical setting, the majority preferred non-integrated models. Some participants preferred integrated models in theory but expressed concerns about stigma and a lack of psychosocial services. Tradeoffs between integrated and non-integrated models were centered around patient values (desire for anonymity and personalization, fear of consequences), the characteristics of the provider and setting (convenience, perceived treatment effectiveness, access to services), and the patient-provider relationship (disclosure, trust, comfort, stigma). CONCLUSIONS: Among this sample of primarily White adults, preferences for non-integrated versus integrated OUD treatment were mixed. Perceived benefits of integrated models included convenience, potential for treatment personalization, and opportunity to extend established relationships with medical providers. Recommendations to make integrated treatment more patient-centered include facilitating access to psychosocial services, educating patients on privacy, individualizing treatment, and prioritizing the patient-provider relationship. This sample included very few minorities and thus findings may not be fully generalizable to the larger population of persons with OUD. Nonetheless, results suggest a need for expansion of both OUD treatment in specialty and general medical settings to ensure access to preferred treatment for all

Developing a victorious strategy to the second strong gravitational lensing data challenge

Strong lensing is a powerful probe of the matter distribution in galaxies and clusters and a relevant tool for cosmography. Analyses of strong gravitational lenses with deep learning have become a popular approach due to these astronomical objects’ rarity and image complexity. Next-generation surveys will provide more opportunities to derive science from these objects and an increasing data volume to be analysed. However, finding strong lenses is challenging, as their number densities are orders of magnitude below those of galaxies. Therefore, specific strong lensing search algorithms are required to discover the highest number of systems possible with high purity and low false alarm rate. The need for better algorithms has prompted the development of an open community data science competition named strong gravitational lensing challenge (SGLC). This work presents the deep learning strategies and methodology used to design the highest scoring algorithm in the second SGLC (II SGLC). We discuss the approach used for this data set, the choice of a suitable architecture, particularly the use of a network with two branches to work with images in different resolutions, and its optimization. We also discuss the detectability limit, the lessons learned, and prospects for defining a tailor-made architecture in a survey in contrast to a general one. Finally, we release the models and discuss the best choice to easily adapt the model to a data set representing a survey with a different instrument. This work helps to take a step towards efficient, adaptable, and accurate analyses of strong lenses with deep learning frameworks

Factors associated with objectively assessed physical activity levels of heart failure patients

Aim: To determine the level of objectively measured moderate-to-vigorous physical activity (MVPA) in patients with heart failure (HF), and to assess the association between MVPA and patient sociodemographic, exercise capacity, and health status factors. Methods: Baseline MVPA data was available in 247 HF patients with 7-day wrist-worn accelerometry from two randomized controlled trials. Associations between MVPA and patient sociodemographic, exercise capacity, and health status factors were assessed using univariate and multivariable linear regression models. Results: 247 patients (28% female, mean age 71 ± 10 years) with HF with reduced ejection fraction (n=198) and preserved ejection fraction (n=49) were included in the analysis. Average MVPA was 283. 3 min/week and ranged widely from a minimum of 0 mins/week to maximum of 2626. 7 mins/week (standard deviation: 404. 1 mins/week). 111 (45%) of patients had a level of PA that met current guidelines of at least 150 minutes/week of MVPA. Multivariable regression showed patient’s age, body mass index, employment status, smoking status, New York Heart Association class, NT-proBNP and exercise capacity to be strongly associated (p<0. 001) with the level of MVPA (p<0. 001). Conclusion: Whilst 45% of HF patients had objectively measured levels of MVPA that met current PA recommendations, we observed a wide range in the level of MVPA across this patient sample. As a number of factors were found to be associated with MVPA our findings provide important information for future interventions aiming to increase MVPA in HF patients

The Lantern, 2012-2013

• How They Run • What Was Said in Boston • On the Last Day of the Month • An Angel Tries to Surprise Humans • I Wonder if God Modeled Boys After Books • Marred with Modern Scars • Feather Bed • Ode to a Pen • Objet Petit A • Breaking News: Grownups Fear Return of Disco • Neuroscience • New Document • We Were Stars, and the Sky was Our Grass • About a Man • Trojan • An Ode • Yr Body Sour • That Lake in Jamaica • Live While Chiefs are Still Fighting • Lament for Mathematics • The Robert Frost House • People Fell in Love on Me • Sunday Review • Looks Silly in Tiny Desk Chairs • Two Years Later • Better Than Nothing • Istanbul • Packs of Cigarettes • Sonnet • Outside King of Steaks • Obstinance • Coffee Grinds • Autumn Equinox • Homecoming • Oh, San Francisco • Slide: A Beginning • Slowly Last Summer • Of Dogs and Men • Letters Not Sent • Before the Race • The Little Things • Tarpon Springs • Payment for Rebellion • Wednesday • When is President\u27s Day? • Heartless Parallels and Perpendiculars • Railway • Presto Agitato • Easier Said Than Done • Waves • Four White Women • Rope • Alter Ego Self Portrait • Pebbles • Coney Island • Guanjuanto • Growth • Evolve • Winter Blackout • Honeybee • Frames • Wanderlust • Guiding Light 1 • Frick\u27s Lock • The Ones That Never Leave • In Memoriam: Rachel Blunthttps://digitalcommons.ursinus.edu/lantern/1179/thumbnail.jp