“Mad or Bad?”: Burden on Caregivers of Patients With Personality Disorders.
“Mad or Bad?”: Burden on Caregivers of Patients with Personality Disorders.
Filed under: Rehab Centers
J Pers Disord. 2012 Aug 1;
Bauer R, Döring A, Schmidt T, Spießl H
The burden on caregivers of patients with personality disorders is often greatly underestimated or completely disregarded. Possibilities for caregiver support have rarely been assessed. Thirty interviews were conducted with caregivers of such patients to assess illness-related burden. Responses were analyzed with a mixed method of qualitative and quantitative analysis in a sequential design. Patient and caregiver data, including sociodemographic and disease-related variables, were evaluated with regression analysis and regression trees. Caregiver statements (n = 404) were summarized into 44 global statements. The most frequent global statements were worries about the burden on other family members (70.0%), poor cooperation with clinical centers and other institutions (60.0%), financial burden (56.7%), worry about the patient’s future (53.3%), and dissatisfaction with the patient’s treatment and rehabilitation (53.3%). Linear regression and regression tree analysis identified predictors for more burdened caregivers. Caregivers of patients with personality disorders experience a variety of burdens, some disorder specific. Yet these caregivers often receive little attention or support.
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Pain And Posttraumatic Stress Disorder Symptoms During Inpatient Rehabilitation Among Operation Enduring Freedom/Operation Iraqi Freedom Veterans With Spinal Cord Injury.
Filed under: Rehab Centers
Arch Phys Med Rehabil. 2012 Aug 1;
Ullrich PM, Smith BM, Poggensee L, Evans CT, Stroupe KT, Weaver FM, Burns SP
OBJECTIVE: Tp examine the frequency of PTSD symptoms and pain, and how PTSD symptoms were associated with pain severity ratings and the longitudinal course of pain during inpatient rehabilitation for spinal cord injury (SCI) among veterans of the Operation Enduring Freedom/Operating Iraqi Freedom (OEF/OIF) conflicts. DESIGN: Longitudinal analysis of data gathered from electronic medical records. SETTING: SCI specialty care centers within the Department of Veterans Affairs (VA). PARTICIPANTS: 87 veterans of the OEF/OIF conflicts who received inpatient rehabilitation for SCI/D at VA SCI centers between May 2003 and October 2009. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): PTSD screening at start of rehabilitation and pain numeric rating scale measurements completed throughout rehabilitation. Cut-scores were used to categorize participants into one of four groups based on scores at the start of rehabilitation: Pain and PTSD, Pain Alone, PTSD Alone, Neither Condition. RESULTS: Co-morbid pain and PTSD symptoms were more common than either condition alone, and nearly as common as not having either condition. Participants with pain at start of rehabilitation (Pain and PTSD, Pain Alone groups) showed declines in pain ratings over the course of rehabilitation. In contrast, participants in the PTSD Alone group showed increasing pain over the course of rehabilitation. CONCLUSION(S): Pain and PTSD symptoms may be more likely to manifest as comorbidities than as isolated conditions during inpatient rehabilitation. Assessment routines and care plans should be prepared with comorbidities as a foremost concern. It is advisable to screen for pain and PTSD at multiple time-points during inpatient rehabilitation to detect new or emerging concerns.
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Serologic evidence of exposure of raptors to influenza A virus.
Filed under: Rehab Centers
Avian Dis. 2012 Jun; 56(2): 411-3
Redig PT, Goyal SM
Serum or plasma samples from raptors that prey or scavenge upon aquatic birds were tested by a commercially available blocking enzyme-linked immunosorbent assay for the evidence of antibodies to influenza A virus. Samples were taken from birds (n = 616) admitted to two rehabilitation centers in the United States. In addition, samples from 472 migrating peregrine falcons (Falco peregrinus) trapped on autumnal and vernal migrations for banding purposes were also tested. Only bald eagles were notably seropositive (22/406). One each of peregrine falcon, great horned owl (Bubo virginianus), and Cooper’s hawk (Accipiter cooperi) from a total of 472, 81, and 100, respectively, were also positive. None of the turkey vultures (n = 21) or black vultures (n = 8) was positive. No clinical signs referable to avian influenza were seen in any bird at the time of capture. These data indicate that, among raptors, bald eagles do have exposure to influenza A viruses.
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Effects of exercise training on depressive symptoms in patients with chronic heart failure: the HF-ACTION randomized trial.
Filed under: Rehab Centers
JAMA. 2012 Aug 1; 308(5): 465-74
Blumenthal JA, Babyak MA, O’Connor C, Keteyian S, Landzberg J, Howlett J, Kraus W, Gottlieb S, Blackburn G, Swank A, Whellan DJ
Depression is common in patients with cardiac disease, especially in patients with heart failure, and is associated with increased risk of adverse health outcomes. Some evidence suggests that aerobic exercise may reduce depressive symptoms, but to our knowledge the effects of exercise on depression in patients with heart failure have not been evaluated.To determine whether exercise training will result in greater improvements in depressive symptoms compared with usual care among patients with heart failure.Multicenter, randomized controlled trial involving 2322 stable patients treated for heart failure at 82 medical clinical centers in the United States, Canada, and France. Patients who had a left ventricular ejection fraction of 35% or lower, had New York Heart Association class I to IV heart failure, and had completed the Beck Depression Inventory II (BDI-II) score were randomized (1:1) between April 2003 and February 2007. Depressive scores ranged from 0 to 59; scores of 14 or higher are considered clinically significant.Participants were randomized either to supervised aerobic exercise (goal of 90 min/wk for months 1-3 followed by home exercise with a goal of ?120 min/wk for months 4-12) or to education and usual guideline-based heart failure care.Composite of death or hospitalization due to any cause and scores on the BDI-II at months 3 and 12.Over a median follow-up period of 30 months, 789 patients (68%) died or were hospitalized in the usual care group compared with 759 (66%) in the aerobic exercise group (hazard ratio [HR], 0.89; 95% CI, 0.81 to 0.99; P = .03). The median BDI-II score at study entry was 8, with 28% of the sample having BDI-II scores of 14 or higher. Compared with usual care, aerobic exercise resulted in lower mean BDI-II scores at 3 months (aerobic exercise, 8.95; 95% CI, 8.61 to 9.29 vs usual care, 9.70; 95% CI, 9.34 to 10.06; difference, -0.76; 95% CI,-1.22 to -0.29; P = .002) and at 12 months (aerobic exercise, 8.86; 95% CI, 8.67 to 9.24 vs usual care, 9.54; 95% CI, 9.15 to 9.92; difference, -0.68; 95% CI, -1.20 to -0.16; P = .01).Compared with guideline-based usual care, exercise training resulted in a modest reduction in depressive symptoms, although the clinical significance of this improvement is unknown.clinicaltrials.gov Identifier: NCT00047437.
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Gate House Academy On Rehab Centers – Gatehouse Academy is an extended care treatment center for young men and women in need of long term alcohol or drug rehabilitation. We offer the opportunity for young adults from the ages of 17-25 to learn life skills, continue formalized education,
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