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Optimizing Interventions for Major Depressive Disorder and Provider Burnout: Self-speak Exercise Dosing (SED)
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Major Depressive Disorder (MDD) is ranked highest among mental illnesses in the United States (US) and significantly contributes to the mental health care crisis. Patients experience resistance to pharmacologic interventions, side effects, co-morbidities, and mental health provider shortages. Subsequently, 33 % of Serious Mental Illnesses (SMIs) are being redirected to Primary Care Providers (PCPs). Concurrently, prescriber mental health is in crisis. Growing workloads for physicians and Advanced Practice Providers (APPs) have increased provider burnout syndrome (BOS). Major Depressive Disorder and BOS are positively affected by exercise, Cognitive Restructuring (CR), and Behavioral Activation (BA). Sports medicine and psychology research shows that movement performance, learning, self-regulation, cognition, and focus are improved via a self-directed and self-referential technique called self-speak. Pairing exercise with self-speak, neuroplasticity, and BA can increase patient engagement. Improving non-pharmacologic, autonomous techniques that effectively treat MDD and burnout syndrome could decrease the need for patient visits, minimize provider demand, and reduce prescriber burnout
Stop the Bleed! Acute Epistaxis Management
Get PDFEpistaxis, the most common Otolaryngology-related emergency, is responsible for one in 200 emergency department (ED) visits in the United States (US) and one-third of otolaryngology visits.1,11 Up to 60% of the population will experience epistaxis during their lifetime, and 6% -10 % will require medical intervention.2,3 Epistaxis occurs in children and adults and has a seasonal variation. Although 85% of nosebleeds are idiopathic, they are more frequent in those on supplemental oxygen, anticoagulation, antiplatelet therapy, and in those with other conditions that may predispose them to bleeding. Most clinicians will encounter patients with acute epistaxis; therefore, it is vital to be educated on the etiology, prevention, and acute management. This CME article will review the new Clinical Practice Guidelines4 from the American Academy of Otolaryngology-Head and Neck Surgery regarding epistaxis and discuss newer therapies that have emerged
Health Literacy: Impact and Interventions
Get PDFThe objectives of this paper are to examine the connection between health literacy level and patient outcome, identify contributing factors of low health literacy, and identify ways in which providers and health literacy programs can promote health literacy on an individual and community level. I conducted a literature search using PubMed and Google Scholar in order to lend evidence to these objectives.
The results demonstrated a clear correlation between low health literacy levels and poor patient outcomes. Low health literacy is also correlated with reduced medication adherence, improper use of medication, more emergency department visits, and unhealthy habits during pregnancy among others. Some contributing factors to low health literacy are lack of patient education, inadequate provider communication training, poor social support, slow acculturation, lack of health literacy intervention by providers, and scant health literacy intervention programs. Health literacy intervention has improved medication adherence and overall patient outcomes in type II diabetes, asthma, obesity, cardiovascular disease, and hypertension, and has also improved the quality of life for some patients. Health literacy intervention in the form of provider communication training, universal health literacy precautions, and various community programs have shown promising results.
This literature review demonstrates that health literacy is a health-related social need that can be targeted for improvement. Provider intervention and public health programs are powerful tools that can be used to promote health literacy and consequently improve patient outcomes. With this knowledge, future research needs to be done to decide on how these resources can be made more widely accessible for underserved populations and for those disproportionately impacted by low health literacy. With the advancement of technology and a general transition to eHealth, we continue to see new obstacles in the promotion of health literacy and improvement of patient outcomes
Health Implications for Combat Veterans’ Exposure to Airborne Hazards and Open Burn Pits
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