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APA 2015

APA 2015

New research was presented at APA 2015, the American Psychiatric Association’s annual meeting, from May 16 to 20 in Toronto. The features below highlight some of the studies that emerged from the conference. Anxiety & Suicide in Hospitalized Psychiatric Patients The Particulars: Studies have shown that suicide risk is highest in the first 2 months after a psychiatric hospitalization. However, few studies have explored factors that may raise risks for return psychiatric visits. Data Breakdown: For a study, patients hospitalized for suicidality were assessed for state and trait anxiety at admission and discharge. Patients who returned to the psychiatric emergency room within 2 months had significantly lower self-assessment scores on state and anxiety from admission to discharge. Those with a lifetime history of suicide attempts requiring major medical care had significantly greater decreases in self-assessed trait anxiety. Take Home Pearl: Acute anxiety reactivity appears to predict returns to the emergency room following psychiatric hospitalization. Delirium Poorly Detected The Particulars: Delirium affects 10% to 30% of hospitalized patients, but the prognosis for these patients tends to be poor. Research shows that delirium detection rates are low among primary treating physicians. Data Breakdown: Study investigators reviewed the charts of hospitalized patients diagnosed with delirium following a psychiatry consult for reasons other than delirium, confusion, or disorientation. Several delirium symptoms were not detected or misidentified by the primary treating physician but were later detected during the psychiatry consult. These included a reduced ability to focus or shifting attention, memory deficits, fluctuating symptoms during the course of the day, and psychomotor retardation. Take Home Pearls: Subtle signs and symptoms of delirium appear to...
An Update for Preventing MRSA

An Update for Preventing MRSA

In 2008, the Society for Healthcare Epidemiology of America and Infectious Diseases Society of America—partnering with the American Hospital Association, Association for Professionals in Infection Control and Epidemiology, and the Joint Commission—published the “Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals,” a collection of recommendations focused on common hospital-acquired infections. With new research emerging and the need for up-to-date information, the organizations recently released an update to the compendium. As part of the compendium, updated recommendations were made on the prevention of MRSA infection and transmission. Getting to the Basics Published in Infection Control and Hospital Epidemi-ology, the recently updated compendium recommendations provide a roadmap for prioritizing and implementing strategies to help prevent MRSA infection and transmission. These strategies are broken down into basic practices (Table 1) and special practices. “Based on evidence, expert opinion, and experience, the basic practices are recommended for all hospitals, regardless of the burden of MRSA,” explains lead author David P. Calfee, MD, MS. “These are good, basic infection control practices. Many would be useful in preventing a wide variety of healthcare-associated infections (HAIs) and preventing transmission of various pathogens, including MRSA.” When considering MRSA control practices, conducting a risk assessment is important. This should include an analysis of infection rates, the basic practices that have and have not been implemented already, and whether implemented practices are adhered to consistently, according to Dr. Calfee. “Writing a policy and making sure it’s actually being followed are two different things,” he adds. “A good understanding of the epidemiology of MRSA within your facility is really the first step.” He notes that all providers...
Journal Publishers’ Exorbitant Profit Margins

Journal Publishers’ Exorbitant Profit Margins

Many have written about who is making money in healthcare. Sure doctors do very well, but not as well as hospitals, hospital administrators, insurance companies and their corporate officers, drug companies, device manufacturers, and others. Another lucrative area is medical journal publication, especially if you are the publisher. A researcher gets an idea, plans and carries out a study, writes a manuscript, and submits it to a journal. The research may have been funded by the government, ie, you and me. An associate editor or a member of the journal’s editorial board looks at the manuscript, and if it is deemed worthy, it is sent out to two or more people in the same field for peer review. This process may be repeated for papers that require revision. All of the players in the above scenario—the researchers, most of the editorial board members except maybe the editor, and the peer reviewers—are paid nothing for their work. Factor in that the cost of producing a journal has plummeted in the computer era. How much money do journal publishers make? Here are some impressive numbers from an article that appeared on a French website called “Rue89.” The figures are for the year 2011 and are in euros. They include revenue from all science publishing, not just medicine. As you can see profit margins range from 32% to nearly 42%. Elsevier’s profit of over €878 million converts to just over $1 billion. To put that into perspective, the most recent figures for Apple Inc., arguably the most successful company in the world currently, show a profit margin of 20%. The Rue89 piece...
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