The Recovery-Based Interprofessional Distance Education (RIDE) Rotation: Content and Rationale.

A faculty team of two psychiatric nurse practitioners, an exercise physiologist, a registered dietician and a pharmacist developed the 8-week Recovery-Based Interprofessional Distance Education (RIDE) rotation for graduate students in the four disciplines. Organizing the RIDE rotation around the recovery model ensured an emphasis upon optimal health and quality of life. RIDE faculty engaged in project planning for several months before the RIDE rotation was offered to students. In this paper, we describe details of the 8-week program. Our next step will be to analyze student feedback and de-identified evaluation data from the first student cohort.

Vortioxetine (Brintellix®) and levomilnacipran (Fetzima®): the two newest additions to the antidepressant formulary.

In the final months of 2013, the US Food and Drug Administration approved two new antidepressant formulations. This column presents a review of the pertinent literature on both: vortioxetine (Brintellix(®)) and levomilnacipran (Fetzima(®)).

Accessibility versus quality of care plus retention: the formula for service delivery in Australian opioid replacement therapy?

The aim of this paper is to investigate how Australian Opioid Replacement Therapy (ORT) policy influences access to ORT treatment, including the resources required for implementation. In doing so, we also compare the accessibility of ORT treatment in Australia (AU) with ORT in the United Kingdom (UK) and United States (US). A review of government data and policy that influence service delivery was undertaken. When comparing across AU, the UK, and the US, we found several differences. To improve access to treatment in Australia more general practitioners need to provide ORT. Additionally, criteria for quality care, a centralised intake system, a national ORT treatment outcome measure, and a shift towards a recovery focus are recommended.

The Motivation-Facilitation Theory of Prenatal Care Access.

Despite the availability of services, accessing health care remains a problem in the United States and other developed countries. Prenatal care has the potential to improve perinatal outcomes and decrease health disparities, yet many women struggle with access to care. Current theories addressing access to prenatal care focus on barriers, although such knowledge is minimally useful for clinicians. We propose a middle-range theory, the motivation-facilitation theory of prenatal care access, which condenses the prenatal care access process into 2 interacting components: motivation and facilitation. Maternal motivation is the mother's desire to begin and maintain care. Facilitation represents the goal of the clinic to create easy, open access to person-centered beneficial care. This simple model directs the focus of research and change to the interface of the woman and the clinic and encourages practice-level interventions that facilitate women entering and maintaining prenatal care.

A pilot study describing physical activity in persons with schizophrenia spectrum disorders (SSDS) after an exercise program.

Despite the well known mental and physical health benefits of exercise, persons with schizophrenia spectrum disorders remain sedentary. While the exercise barriers (i.e., lack of motivation, poor concentration, sedative effects of medication, poverty, and lack of access to exercise education/programs) of persons with SSDs are numerous, lack of motivation is considered foremost among them. Exercise interventions have been shown to improve exercise behavior, but there is a need for longitudinal documentation of physical activity after interventions conclude. This pilot study describes the physical activity level of 22 persons with SSDs 14 to 34 (mean 22) months after the conclusion of an exercise intervention provided in a randomized controlled trial (RCT). Eighteen months after the RCT, 22 participants wore pedometers daily for one week without altering their activity. Experimental participants walked more steps and covered more distance on average than control participants on six of the seven days. This pilot study is among the first to document the physical activity level of persons with SSDs after exercise intervention. While our findings confirm the low activity level of persons with SSDs reported by others, experimental participants demonstrated higher activity levels than controls on most days. Future studies should increase the sample size and recruit participants from multiple sites to enhance power and generalizability.

Full circle-old drugs prove more beneficial than newer agents for schizophrenia: a case report.

A 55-year-old female with a diagnosis of schizophrenia currently resides in an assisted living facility in a large metropolitan suburb. For approximately 25 years, the patient was relegated to a life of poor symptom control and social adjustment, largely due to nonadherence, relapse, and rehospitalization. The patient experienced a trial-and-error approach to drug therapy, which resulted in reliance on the older or first generation agents for symptom improvement. This case supports the assertion that the second-generation or atypical antipsychotics used to treat schizophrenia are no better than older drugs in terms of efficacy or tolerability.

Lurasidone (latuda®): an atypical antipsychotic.

Lurasidone is a new atypical antipsychotic that has demonstrated positive effects on psychosis, mood, and cognition. This improved efficacy and safety profile for the treatment of schizophrenia. Its overall tolerability profile seems to be comparable to the other atypical antipsychotics. Perhaps its more potent blockade on the 5HT7 receptor will give it more of an advantage in treating the negative symptoms as well as improve cognitive and depressive symptoms associated with schizophrenia. Additionally, it does not appear to have any significant adverse impact on the metabolic profile, such as weight, glucose, or lipid metabolism. Lurasidone is also associated with good cardiovascular tolerability without widening of the QT interval. The use of this medication may be of particular interest in patients presenting with endocrine or cardiovascular abnormalities. The average price for a 30-day supply of lurasidone is $475.98.