Psychotherapy Patients of Psychiatry Residents: A Descriptive Study.

OBJECTIVE: Psychiatry residents learn psychodynamic psychotherapy for generalizable skills and as a transdiagnostic, long-term treatment indicated for patients with chronic mood, anxiety, or personality disorders. It is unknown how these indications align with actual patients of trainees. The aim of this descriptive study was to define characteristics of outpatients receiving psychodynamic psychotherapy from psychiatry residents. METHODS: Case reports (N=204) from 184 psychiatry residents were analyzed for patients' diagnoses and past treatments. RESULTS: Eighty-six percent of patients had prior psychiatric medication or treatment, 31% had three or more past courses of psychotherapy, and 48% had two or more diagnoses, including depression (62%), anxiety (46%), and personality disorders or traits (27%). CONCLUSIONS: Patients receiving psychodynamic psychotherapy from psychiatry residents had multiple psychiatric illnesses and a history of prior treatments that had not achieved or sustained recovery, suggesting complex and chronic illness. Consistent with community-based findings, these patient characteristics correspond with psychodynamic psychotherapy treatment indications.

Proactive Psychiatry Intervention Using a Nurse-Led Behavioral Response Model for Hospitalized Patients With Behavioral Disturbances.

BACKGROUND: The health care sector has one of the highest rates of workplace violence, putting staff at risk and impeding care. To deliver quality health care, staff need targeted resources. This article describes a program to improve staff safety and reduce barriers to care for patients with behavioral disturbances. PROGRAM DESCRIPTION: A nurse-led behavioral response team was created to identify high-risk patients and offer prompt targeted interventions. The Behavioral Optimization and Outcomes Support Team (BOOST) was implemented in November 2012, in conjunction with a proactive model of care, enabling psychiatric intervention. Advanced practice nurses in psychiatry respond to requests from staff on medical/surgical units to assist with management of behavioral disturbances. METHODS: Consultation and intervention data were reviewed, and staff satisfaction surveys were completed to evaluate the program. RESULTS: The program has contributed to staff feeling more supported and safer at work. There has also been a reduction in staff's experience of perceived burden in the care of patients with behavioral disturbances although they are caring for more of these patients. CONCLUSIONS: Although violence risk in health care continues to be a significant issue, programs to intervene early can be effective in supporting staff to minimize these risks.

In vitro Evaluation of Small Molecule Inhibitors and Probiotic Byproducts on Growth and Viability of Vaginal Microorganisms.

Background: Interest in avoidance of antibiotic resistance development through nonantibiotic therapeutics prompts development of topical vaginal preparations that may inhibit vaginal microorganisms. Prior data on boric acid, zinc salts and probiotic microorganisms suggests a potential role in female genital tract infections. Aims: Determine antimicrobial effects of boric acid, zinc sulfate and metabolites of probiotic lactobacilli alone or in combination on Candida albicans, Gardnerella vaginalis and Streptococcus agalactiae. Methodology: Absolute counts of test organisms cultivated with or without inhibitory compounds were determined by a flow cytometric method and compromise of microbial cell integrity was demonstrated by propidium iodide staining, also determined by flow cytometry. All microbial count growth experiments were conducted in triplicate and averages were reported. Results: The three microbial species challenged with boric acid, zinc sulfate or spent medium from probiotic lactobacilli showed varying degrees of susceptibility to these inhibitors, with boric acid showing consistent activity against C. albicans and also showing yeast cell damage demonstrated by propidium iodide uptake. Boric acid showed greater antibacterial activity against S. agalactiae than against G. vaginalis and neither of the bacterial organisms showed propidium iodide staining. Zinc sulfate inhibition was greatest for Candida and least for Gardnerella. Probiotic Lactobacillus spent media was also inhibitory toward the three test organisms with Gardnerella being slightly less susceptible than the other two test organisms. When binary combinations were tested, the combination of boric acid and Lactobacillus spent medium was the most effective in vitro against all three organisms. Conclusion: Zinc sulfate did not prove any more effective in vitro against the three test organisms than did boric acid or Lactobacillus spent media. The most potent binary combination against the three test microorganisms was boric acid plus spent media from probiotic Lactobacilli.