Patient Satisfaction with a Psychology Consultation-Liaison Service at an Academic Medical Center.

One to two-thirds of all medically admitted patients have comorbid psychiatric concerns. To address the cognitive, behavioral, and emotional factors that affect medical hospitalization, psychological or psychiatric consultation-liaison (CL) services are consulted. The current study was designed to understand patient satisfaction with a CL psychology service and how it was associated with satisfaction with overall hospitalization, taking into consideration relevant factors. Adults medically admitted to an academic teaching hospital (N = 220), who were seen at least once by the CL psychology service, completed satisfaction and demographic questionnaires. Most patients reported being satisfied with the CL psychology service, with women reporting higher satisfaction than men. Satisfaction with the CL psychology service was associated with satisfaction with overall hospitalization, but did not differ based on age, race/ethnicity, education, income, length of stay, number of visits, or presence of psychiatric diagnosis. The results suggest that CL psychology services may contribute to improving overall patient experience.

The potential positive epigenetic effects of various mind-body therapies (MBTs): a narrative review.

Mind-body therapies (MBTs), such as mindfulness, meditation, yoga, and tai-chi, are said to improve quality of life by contributing to positive thinking and reducing overall distress. MBTs not only play a role in reducing stress and anxiety, but they are also found to epigenetically affect genes and other areas in our genomes that are implicated in inflammation, stress, and distress. This review analyzes the role of MBTs in reducing the epigenetic changes as reported in five previously conducted controlled studies found in the NCBI PubMed database. The methylation of the tumor necrosis factor gene, implicated in psychological distress, was shown to significantly decrease for the women who performed yoga. For people who took part in mindfulness meditation, there was a significant alteration in a variety of modifications of histone deacetylase enzymes as well as their expression patterns when compared to the control group. Other studies found that long-term meditators had slower biomarkers of aging, known as epigenetic clocks, and methylation in genes associated with immune cell metabolism and inflammation. Different genomic regions known as CpG dinucleotide sites ("CpG islands") were also found to be epigenetically altered in participants of tai-chi. These controlled studies were promising evidence on the potential of MBTs to affect the epigenetics of an individual. This information will be useful in diagnostic, therapeutic, and preventative measures, and can be an addition to western medicine, in a way that is more holistic and beneficial to the individual.

Team Approach: Rehabilitation Strategies for Patients After Osteosarcoma Reconstructive Surgery.

The multimodal treatment of osteosarcoma with chemotherapy, surgical resection, and reconstruction has improved outcomes after a limb-salvage surgical procedure. Physical rehabilitation considerations after surgical resection vary, depending on the location of the tumor. Physical medicine and rehabilitation physicians incorporate lymphedema specialists, orthotists, and prosthetists to help to improve limb function. Beyond physical rehabilitation, psychological or behavioral interventions and nutritional rehabilitation are necessary to maximize a patient's return to function.

Implementing and Evaluating SBIRT for Alcohol Use at a Level 1 Trauma Center: A Behavioral Medicine Approach.

To facilitate the early identification and treatment of alcohol misuse among trauma patients, the American College of Surgeons (ACS) requires ACS-accredited level 1 trauma centers to have an active alcohol screening and brief intervention program. The development, implementation, and evaluation of a screening, brief intervention, and referral to treatment as a new institutional standard of care for alcohol misuse at a level 1 trauma center is described. The Division of Behavioral Medicine, a health psychology-based service, was nominated to manage this initiative as a result of clinical training and expertise in assessment, evidence-based psychological interventions, and case management. Trauma patients with elevated blood alcohol concentrations were screened at the time of admission and several months post-hospitalization. Clinical data suggest that screening for alcohol misuse can help identify patients at risk for, and struggling with, alcohol use disorders, encourage positive changes in alcohol consumption patterns, and increase access to treatment. Recommendations for enhancing the effectiveness of this process, associated challenges and limitations, and considerations for future clinical and research endeavors are discussed.