Brent Nelson

Antipsychotic-associated #weight gain in #children and #adolescents is a major adverse event of second-generation #antipsychotic therapy. This risk can be predicted using patient characteristics collected before #SGA initiation and the initial type of SGA. https://lnkd.in/ejWpPxtA

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Dr. Ted Kyle at ConscienHealth reports on ‘Two updated analyses from the Global Burden of Disease (GBD) Study…’ in The Lancet encompassing data across 204 countries and territories, from 1990 to 2021, for 88 risk factors. The authors state ‘…Troubling increases in high fasting glucose, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions.’ BMI and dietary behavior are framed as both the problem and the solution, influenced by lifestyle factors and an ageing population, focused upon dietary behaviors. https://lnkd.in/ein7XnBB

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A new study evaluated the effectiveness of a provider reminder tool with decision support in prescribing for outpatients #NP#research#reminder#tool https://ow.ly/64Rm50RLGn3

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Articles on Late Adulthood Here is the second in my series of articles on Late Adulthood published by "Excellent Care, Decency and Optimal Living" (ECDOL.org): "Late Adulthood: Options and Guides for Choosing Where to Live (Part 1)" Please see the link below: https://lnkd.in/e2VVTT9m #AgeInPlace, #Boomers, #Retirement, #eldercare, #seniorliving, #caregiving

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Social determinants of health such as inequity in care access and systemic bias are associated with operative and longitudinal mortality after congenital heart surgery, new research suggests. Read more on #CRTonline. https://ow.ly/6KqF50Sk2C2 #cardiacnurse #cardiologists #cardiology #cardiologyfellow #cardiologyfellows #cardiologynurse #cardiologynurses #cathlab #cathlabnurse #cathlabtech #interventionalcardiologists #interventionalcardiology #interventionalcardiologyfellow #interventionalcardiologyfellows #MCRN #medicalequity

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Pediatricians are likely to be the first, and often only, professionals who encounter the nearly two-thirds of children who have experienced trauma. In my latest piece for the American Academy of Pediatrics, I write about how I approach these situations by practicing HOPE. #TIC #traumainformedpediatrics #positivechildhoodexperiences #buildingbuffering https://lnkd.in/gZtCzbCM

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🌟 A huge shout-out to all my fellow Research Administrators today. The recent $7.6 million settlement by the Cleveland Clinic Foundation is a powerful reminder of why what we do is so vital, so I wanted to take a moment to highlight all of our awesome! It's so easy to get caught up in the paperwork of this job, but our role is vital in maintaining the integrity of our research and ensuring the trust of our sponsors, like the NIH. 💪 I feel like this settlement(and others like it) underscore the critical role we play in the research ecosystem. Every day, we're the ones making sure all funding sources are disclosed, we're checking on effort/salary and so much more. https://lnkd.in/dvX3jAee Our diligence keeps the whole operation smooth and above board. I take immense pride in our work because I don't think we're the compliance police — we're the conduit through which groundbreaking research that can change the world is conducted. Though I am sorry for Cleveland Clinic, and any other organization that has to deal with this kind of consequence - I can't help but think that it serves as a reminder of what it is that we really do. We save organizations money. #ResearchAdministration #PrideInOurWork #NIH #HealthcareLeadership

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"A 17-year-old Black male is brought in by the police to the emergency room restrained and agitated...." This statement is a classic example of how (mental) healthcare providers frequently use racial identifiers as a standard clinical practice that few question. What is less standard, however, is examining how using racial identifiers in the chart is a non-consenting practice that opens the door to racist clinical practices that harm the person's well-being in ways their providers never recognize much less explain. I take this practice to task and break down this risk in Lecture 5 of the Antiracism in Mental Health Fellowship, "Racism, not Race"--an excerpt from which is featured below. Here are some of the main takeaways from this lecture, which details why healthcare's very typical practice of invoking race as a part of clinical care must be supplanted by a deeper understanding of how racism impacts clinical care--and how this distinction is foundational to an antiracist clinical practice: 💡 To paraphrase Ta-Nehisi Coates, "race is the child of racism not the father"--meaning the social construction of race is itself a racist practice, and race-based mental healthcare (including using racial demographics in notes) can perpetuate biases and stereotypes. 💡 Using a racial identifier in a chart can perpetuate racist tropes about criminalization and deficiency which can feed into mental healthcare’s interfacing with policing/juvenile detention and child welfare, which are known to target Black and Brown people. It can lead to drug testing, restraints, and accusations of malingering. 💡 The need to cultivate a reflective practice whereby anytime a racial identifier is used, this immediately triggers a critical conscious response of why and what impact. 💡 The imperative for healthcare providers to talk to people about using racial identifiers in the chart as part of a thorough informed consent process, noting the risks involved. As part of this process, healthcare providers MUST ask people what--if any--identifier THEY want listed. To randomly assign one based on phenotype is careless. 💡 That discussing race/”racial differences”/racial disparities (as opposed to racism) can advance scientific racism by suggesting that race confers biological qualities. It can lead to the sloppy reliance on race as a proxy for genetics, ancestry, and geography. Some of the most egregious examples of racist documentation practices I've witnessed include referring to someone as "clowning" or "a crack baby." Sometimes they are blatant, sometimes they are more subtle; but now whatter what form they take, they are always damaging to care. Sign up for my youtube channel (https://lnkd.in/gQ7tEuy2), which will continue to feature free excerpts from the Antiracism in Mental Health Fellowship. Consider signing up for the fellowship itself at edu.rupileghamd.com. Huge Ty to Luis Enrique Chochón for producing this clip! #antiracism #mentalhealth #psychiatry #meded

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💡 A new theory article published in the latest May/June 2024 issue presents a case example from the University of Minnesota Medical School, where the Department of Family Medicine and Community Health created a shared vision of harmonized missions. The article highlights the department’s specific strategies for harmonizing the academic missions of care, education, and research, such as creating a harmonization group and applying simple rules for mission alignment. This approach improved faculty well-being and increased scholarly output, providing a model for a learning and adaptive health system. ➡ Read the full theory article here: https://lnkd.in/eKQSPWwa 👥 Authors: C. J. Peek, PhD, Michele Allen, MD, MS, Katie Loth, PhD, MPH, Peter G. Harper, MD, MPH, Casey Martin, MD, James Pacala, MD, MS, Angela Buffington-Johnson, PhD, MA, and Jerica M. Berge, PhD, MPH, LMFT

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📢New article alert from the Journal of Comparative Effectiveness Research:   Healthcare resource utilization among nursing home residents with Parkinson's disease psychosis: an analysis of Medicare beneficiaries treated with pimavanserin or other atypical antipsychotics   This study examines healthcare resource use among nursing home residents with Parkinson's disease psychosis treated with pimavanserin versus other atypical antipsychotics, including quetiapine. Findings show significantly lower hospitalization and emergency room visit rates for pimavanserin users compared to those on quetiapine or other atypical antipsychotics.   Authors: Krithika Rajagopalan, Nazia Rashid, Daksha Gopal & Dilesh Doshi Anlitiks Inc., Acadia Pharmaceuticals Inc.   #heor #HealthEconomics #ParkinsonsDisease #Psychosis #OpenAccess   https://lnkd.in/eUTjZwVh

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Artificial Intelligence in the Provision of Health Care: An American College of Physicians Policy Position Paper These Recommendations/Position Statements from the ACP caught my attention: 1. ACP firmly believes that AI-enabled technologies should complement and not supplant the logic and decision-making of physicians and other clinicians. 8. ACP recommends that in all stages of development and use, AI tools should be designed to reduce physician and other clinician burden in support of patient care. 9. ACP recommends that training be provided at all levels of medical education to ensure that physicians have the knowledge and understanding necessary to practice in AI-enabled healthcare systems https://lnkd.in/eTGC59q9 AI and ML has the potential to "augment" the physician's practice of medicine, assisting the physician synthesize large amounts of patient data and strengthening the clinician's clinical judgment and medical decision making #AI, #ML, #augmentingpatientcare, #patientcare, #patientoutcomes

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Narrative Review summarizes current evidence and explores emerging science on the prevention and treatment of dementia to inform clinical decision-making. https://ja.ma/3yfuLe0

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Washington created this. It was evident to me and many others, a decade ago, this would be the result: driving out private practice and only a few big systems dominating. Banning physician ownership to be replaced by Wall St, massive increase in administrative burden and reporting requirements, reimbursement cuts, etc all contributed. Deep pocketed lobbyists got written what they wanted in the ACA/ObamaCare. What is obvious now, is that given the U.S. is a profit-driven capitalistic system, consolidation means a near monopoly. Scale and economics of scale attract private equity, who will drive up prices, sell assets, extract value for investors, then leave. That is exactly what Stewart Health Care did in Massachusetts and across the nation. https://lnkd.in/eydQQjCs It is what an investor did in Philadelphia. https://lnkd.in/eQcFPEns Capitol Hill’s handwringing now demonstrates how irresponsible and unreliable these “public servants” are who get elected to public office, ostensibly to serve the people, but really to serve corporate interests and the lobbyists who fund their campaigns. This was my biggest source of frustration when I worked in government. Those of us service oriented get our time wasted by special interests who have no interest in fairness.

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A new Annals supplement highlights important evidence from all 8 internal medicine disciplines that clinicians may have missed in 2023. Read this editorial from Christine Laine to learn about the selection process and vision for this new annual feature: https://ow.ly/8HHk50RheZB

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Physicians and other health care professionals must be engaged about the use of AI. We can't have a "wait and see" approach. Please check out the recent position paper by American College of Physicians (ACP) on how we should use AI in clinical practice. Honored to be part of the committee putting out this report. https://lnkd.in/eUKWY6xm #artificalintelligence #aihealth #ai #augmentedintelligence

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As a cardiologist and aspiring economist focused on healthcare policy, I'm deeply concerned by the rise of Medicare Advantage plans. On the surface, these plans promise to deliver Medicare benefits more efficiently through private insurers. But a closer look reveals how prior authorization requirements in Medicare Advantage often restrict medically necessary care, to the detriment of patients and the healthcare system. The numbers tell a very scary story: In 2021, Medicare Advantage plans denied 6% of over 35 million prior authorization requests, frequently overruled on appeal. 82% of prior auth denials are overturned when appealed, suggesting many should not have been denied to begin with. Only 11% of patients appeal denials, often unaware of their rights or daunted by the complex process. The economics are clear - plans have a financial incentive to restrict expensive care via prior authorization, as they are paid a fixed amount per patient. Denying care boosts their bottom line. The human costs are also apparent, as patients face delayed or foregone treatment, worse health outcomes, and surprise bills for denied services. Doctors and hospitals must divert resources to fighting denials. Medicare Advantage has strayed from its promise, prioritizing profits over patients. Healthcare leaders and policymakers must scrutinize these practices and enact reforms. Protecting access to care should be the priority. Our system fails when it rewards insurers for saying "no" to patients in need. The new rules are a start, but robust enforcement will be key. Patients deserve a system that provides fair, timely access to quality care - not one that rations it to pad corporate profits. It's time we rethink the trajectory of Medicare Advantage, before it does irrevocable damage to Medicare and the patients it serves.

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A Four-Letter Solution for Managing Uncomfortable Sensations: RAIN Transdiagnostic treatments address cognitive, emotional, and behavioral processes that are common across different mental health conditions. This method helps address anxiety, depression, and addictions simultaneously. Dr. Judson Brewer developed the RAIN method to manage cravings. This mindfulness-based approach helps observe and reduce cravings' power, making it easier to respond non-reactively. Here's what RAIN stands for: - Recognize - Acknowledge the craving or emotions as they arise. - Accept - Accept the cravings or emotions with or without judgment or brain chatter. Investigate—Explore the cravings, emotions, and brain chatter with curiosity, noticing where they manifest in the body and what sensations are associated with them. - Note - Identify and label the thoughts, feelings, and sensations as they occur. The beauty of the RAIN method lies in its versatility. It can be applied to any uncomfortable sensation, whether fatigue, anxiety, or discouragement! Moreover, it can be seamlessly integrated with the Act Opposite technique from Dialectical Behavior Therapy (DBT), which involves deliberately performing a behavior opposite to the emotional urge. This integration fosters self-autonomy and reduces impulsive actions. At Empathy MindCare, we practice the RAIN method and combine it with accelerated TMS treatments and other cognitive behavioral therapies to enhance brain health. If you would like to learn more about this innovative approach, please review these resources. 🌱 1) www.empathymindcare.com 2) www.empathyminded.com 3) Witkiewitz, K., Bowen, S., Douglas, H., & Hsu, S. (2013). Mindfulness-based relapse prevention for substance craving. Addictive behaviors, 38 2, 1563-71 . https://lnkd.in/ggRe-PYX. 4) Rogg, M., Braakmann, D., Schaich, A., Ambrosch, J., Meine, C., Assmann, N., Schweiger, U., & Fassbinder, E. (2021). How patients with borderline personality disorder experience the skill opposite action in the context of dialectical behavior therapy-A qualitative study.. Psychotherapy, 58 4, 544-556. https://lnkd.in/gsajnZ2Z. 5). Reinholt, N., Hvenegaard, M., Christensen, A., Eskildsen, A., Hjorthøj, C., Poulsen, S., Arendt, M., Rosenberg, N., Gryesten, J., Aharoni, R., Alrø, A., Christensen, C., & Arnfred, S. (2021). Transdiagnostic versus Diagnosis-Specific Group Cognitive Behavioral Therapy for Anxiety Disorders and Depression: A Randomized Controlled Trial.. Psychotherapy and psychosomatics, 1-14. https://lnkd.in/g6bRxeBx. #Mindfulness #MentalHealth #CravingControl #Anxiety #Depression #AddictionRecovery #TransdiagnosticApproach #WellBeing #TMS #EmpathyMindCare #EmpathymindEd

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