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The Veterans Health Administration's system for documenting self-directed violence (SDV) requires that clinicians make a determination of the suicidal intent of the behavior (ie, "undetermined" intent vs. "suicide attempt") which contributes to the enhanced care offered. Past studies suggest clinicians' judgment of suicide risk is impacted by patient demographics regardless of clinical presentation. As women are less likely to die by suicide than men, women's SDV may be taken less seriously; they may be more likely to have their SDV classified as "undetermined" than men, which may impact the care received.
This study examines whether women veterans' SDV is disproportionately classified as "undetermined" suicidal intent versus "suicide attempt" as compared with men veterans, and how one's classification and gender modifies the care received.
This was an observational, retrospective study of data from Veterans Health Administration administrative databases. We included all veterans with documented nonfatasification and enhanced care.
Suicide rates for women veterans are increasing faster than for nonveterans. The 2017 suicide rate for women veterans was more than double that for women nonveterans. However, research to inform improved suicide prevention for women veterans is scant.
To accelerate research on women veterans' unique risks and resiliencies for suicide, the Department of Veterans Affairs (VA) Women's Health Research Network launched a Women Veterans Suicide Prevention Research Work Group to target technical support for researchers, promote collaboration with national VA program offices, and ultimately increase dissemination and translation of research into clinical practice, public health strategies, and policies. The objective of this paper is to report on the process and outcomes of the Work Group's strategic planning efforts to identify and fill gaps in suicide prevention research among women veterans.
An in-person meeting of 20 researchers and operational leaders was convened to summarize existing research evidence an a suicide prevention research agenda for women veterans requires is ongoing focus.This case report details the multidisciplinary management of a frequent attender in his early 50s with no fixed abode who presented with pyrexia of unknown origin, complicated by his noncooperation with intervention and treatment because of the development of psychotic symptoms. The case required the involvement of liaison psychiatry, anesthesia, cardiology, radiology, gastroenterology, rheumatology, respiratory, hematology, and social services, highlighting not just multidisciplinary intervention but the benefits of working with a multispeciality team. The patient had previously presented to the emergency department 47 times over an 18-month period. The management during his most recent inpatient stay resulted in the patient living independently and presenting to the hospital only once over the ensuing 7 months.Tamoxifen is a synthetic, nonsteroidal antiestrogen widely used in the treatment of hormone-sensitive breast cancer that has also been shown to inhibit the enzyme protein kinase C (PKC). Upregulation of PKC is associated with disruption of prefrontal cortical regulation of thinking and behavior, which can lead to mania-like symptoms in animal models. Lithium and valproate, 2 mood stabilizers that are widely used in the treatment of bipolar disorder, have also been shown to inhibit PKC. We describe the case of a 48-year-old woman who entered a hypomanic state after discontinuation of tamoxifen while remaining on unopposed venlafaxine prescribed for depression. This case highlights the risk of misdiagnosing unipolar depression in breast cancer patients with undiagnosed bipolar disorder who are being treated with tamoxifen and subsequently started on antidepressants. The use of antidepressants in this population should be carefully monitored to avoid the development of manic, hypomanic, or mixed symptoms in patients with underlying bipolar disorder once tamoxifen is discontinued.Reentry courts facilitate successful offender reintegration into the community following release from incarceration, and many justice-involved veterans may benefit from such services given their elevated risk for deleterious outcomes postrelease. However, effectively engaging court participants is a crucial foundation to achieve the goals of recidivism reduction and global psychosocial improvement. This conceptual article presents an overview of factors that may interfere with a veteran's engagement in reentry court through the lens of both veteran and offender identity. Recommendations for reentry court personnel based on justice-involved veterans' experiences, identity, and unique needs are presented. Careful consideration of these factors and associated practice adaptations may facilitate rapport between reentry court personnel and veteran participants, foster engagement, and ultimately improve outcomes among this unique, at-risk population.The coronavirus disease 2019 (COVID-19) pandemic thrust health care professionals around the globe to the frontlines to care for those affected by this medical crisis. While many surgical and procedural medical subspecialties experienced drastic declines in patient visits during this time, the demand for psychiatric services was more stable. In response to statewide stay at home orders, third-year residents in the psychiatry outpatient clinic described in this article quickly transitioned to telepsychiatry to continue providing care to their patients. https://www.selleckchem.com/products/bi-d1870.html While providing care from home, these residents experienced a number of challenges that serve as important lessons for enhancing competence in telepsychiatry services.The coronavirus disease 2019 (COVID-19) pandemic thrust health care professionals around the globe to the frontlines to care for those affected by this medical crisis. While many surgical and procedural medical subspecialties experienced drastic declines in patient visits during this time, the demand for psychiatric services was more stable. In response to statewide stay at home orders, third-year residents in the psychiatry outpatient clinic described in this article quickly transitioned to telepsychiatry to continue providing care to their patients. While providing care from home, these residents experienced a number of challenges that serve as important lessons for enhancing competence in telepsychiatry services.
Read More: https://www.selleckchem.com/products/bi-d1870.html
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