Provider Satisfaction from a New Telepsychiatry Inpatient Consultation Service.

Background:Telepsychiatry is a well-studied modality that has been shown to perform as well as, if not better than, in-person mental health services. However, acceptability of this modality to practitioners, especially as it relates to the type of consult, has not been well studied. To address barriers to implementing a new telepsychiatry consultation-liaison (CL) service at a rural campus of a large tertiary care health network, authors designed a survey to assess consultee attitudes before and after the service launch. A secondary objective was to examine the consult data.Materials and Methods:The new telepsychiatry CL service at the rural hospital was delivered by providers at the main campus of the health network. Authors surveyed all consultees before the launch and every 3 months for 12 months thereafter. Consult data was also tracked in that same period.Results:Over a 12-month period, 442 initial and follow-up consults were completed. Consultees were most concerned with assessing delirium, agitation, and neurocognitive disorder over live video. Consultees generally held their belief that telepsychiatry consults are not as enjoyable as in-person consults, but they recognized its value, specifically regarding improved access for patients.Discussion:The service was successfully launched and was well received as evidenced by the continued use of the service.Conclusions:The project revealed valuable insight which has been used to improve the service and to replicate it at another campus within the health network.

Autophagy linked FYVE (Alfy/WDFY3) is required for establishing neuronal connectivity in the mammalian brain.

The regulation of protein degradation is essential for maintaining the appropriate environment to coordinate complex cell signaling events and to promote cellular remodeling. The Autophagy linked FYVE protein (Alfy), previously identified as a molecular scaffold between the ubiquitinated cargo and the autophagic machinery, is highly expressed in the developing central nervous system, indicating that this pathway may have yet unexplored roles in neurodevelopment. To examine this possibility, we used mouse genetics to eliminate Alfy expression. We report that this evolutionarily conserved protein is required for the formation of axonal tracts throughout the brain and spinal cord, including the formation of the major forebrain commissures. Consistent with a phenotype reflecting a failure in axon guidance, the loss of Alfy in mice disrupts localization of glial guidepost cells, and attenuates axon outgrowth in response to Netrin-1. These findings further support the growing indication that macroautophagy plays a key role in the developing CNS.

Vocal tremor reduction with deep brain stimulation: a preliminary report.

Vocal tremor has been a challenging problem for patients and their physicians. In some cases, it has been possible to lesson the symptom's tremor through medications and/or voice therapy. However, in most cases no good treatment has been available. Chronic stimulation of the thalamus has been successful in controlling tremors of the upper limb and other portions of the body. Our preliminary experience suggests that it may also be helpful in controlling vocal tremor.