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Biomedical subjects

M F Ward

Publications and source records attributed to M F Ward.

25 records · Page 2Linked to original sources
PubMed1979

Behavioral treatment for depression: an evaluation of therapeutic components.

Designed study to determine the "active ingredients" in Lewinsohn's behavioral treatment for depression. Fifty-six men and women were screened for significant depression and were assigned to four experimental treatment groups: (1) an activities-increase group instructed to increment participation in reinforcing activities; (2) an expectancy-control group that participated in a fitness program; (3) a self-monitoring control that simply recorded activities and mood daily; and (4) an attention-control group. Consistent with an operant model of depression, the resulted indicated that increases in activities that Ss had rated as pleasureable alleviated depressed mood over a 30--day time period. While all Ss evidenced some improvement in mood, the activities-increase group showed significantly greater improvement than Ss in groups that did not increase their activity levels. Correlational analyses of daily activity and Depression Adjective Check List Scores proved additional support for the behavioral model of depression. The outcome for the four experimental groups was not different on a measure of belief in internal vs. external control of reinforcement.

Activities of Daily Living↗
PubMedDate not supplied

Lyme carditis: complete AV dissociation with episodic asystole presenting as syncope in the emergency department.

We report a case of Lyme carditis in an otherwise-healthy young male who presented to the Emergency Department (ED) with syncope and a possible seizure. This patient, without documented history of Lyme disease, acutely developed third-degree atrioventricular (AV) block with episodic asystole, which required placement of a transvenous pacemaker in the ED and resolved only after the patient had been placed on ceftriaxone. We discuss the significance of Lyme carditis and its increasing prevalence, and review the current literature. We also recommend appropriate screening modalities for patients with known Lyme disease, or an atypical profile for cardiac abnormalities.

Adult↗
PubMedDate not supplied

Evaluating expressed emotion and schizophrenia.

This article presents another review from the Network for Psychiatric Nursing Research (NPNR) National Journal Club (see Vol 8(15): 1010-12). The article reviewed was Willets and Leff's (1997) 'Expressed emotion and schizophrenia: the efficacy of a staff training programme'. The collated feedback comments from the regional journal clubs is based on the format proposed by Cormack (1991). The views expressed in this article are those of the journal club members and not necessarily those of the NPNR.

Attitude of Health Personnel↗
PubMedDate not supplied

Effectiveness of an intervention to improve primary care provider recognition of depression.

CONTEXT: Depression remains under-recognized and undertreated by primary care providers. While systematic screening has the potential to improve recognition, providers may overlook screening results because of barriers to accessing the information and the need to address multiple health care issues. OBJECTIVE: To determine whether limited follow-up of positive findings on depression screening improves provider recognition and initial management of depression. DESIGN: Before-after study. PATIENTS: Consecutive patients with positive findings on depression screening in a Veterans Affairs primary care clinic in Oregon during the 3 months before (n = 160) and the 3 months after (n = 97) the intervention began. INTERVENTION: Patients with positive findings on depression screening completed a self-administered questionnaire (Patient Health Questionnaire), which they turned in to their provider. A mental health nurse subsequently reviewed the records of patients who completed questionnaires and contacted providers when depression was not mentioned in the visit note. OUTCOME MEASURES: Documentation of depression or suicidal ideation and actions taken for depression (prescription of antidepressant medication, mental health referral, watchful waiting) at the clinic visit. RESULTS: The mental health nurse received questionnaires for only 39 (40%) postintervention patients. Documentation of depression symptoms (72% vs. 48%; P < 0.001) and suicidal ideation (36% vs. 14%; P < 0.001) significantly improved in the postintervention group compared with the preintervention group. Postintervention patients were also more likely to begin receiving antidepressants (23% vs. 12%; P < 0.05) and to be referred for mental health services (28% vs. 9%; P < 0.001). CONCLUSION: A limited intervention can improve provider recognition and initial management of depression in a Veterans Affairs primary care setting.

Depressive Disorder↗