Search

Abstract Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is an evidence-informed treatment utilizing Cognitive Behavioural Therapy (CBT) treatment principles. UP has demonstrated promising treatment effects comparable to single disorder protocol across several mental disorders. Its impact on personal recovery in anxiety and depression has not been examined. This study compares clinical and personal recovery outcomes of UP treatment for depression and anxiety disorders when delivered in a group vs. individual format. Retrospective chart review of outcomes was conducted for outpatients receiving 12-week individual (n = 65) and group (n = 62) UP treatment in a specialized psychiatric hospital. Descriptive and repeated measures ANOVA analyses were conducted on outcomes on Overall Depression Severity and Impairment Scale, Overall Anxiety Severity and Impairment Scale, Recovery Assessment Scale administered pre and post treatment. On average, participants in both group and individual UP treatment showed improvements in anxiety, depression, and recovery scores. Greater proportion of group participants showed improvements on two interpersonal-focused domains of personal recovery. Results indicate group UP treatment is comparably effective compared to individual UP in improving clinical and recovery outcomes, and treatment modality affects the degree of personal recovery. Overall findings offer important clinical promise of UP treatment as a transdiagnostic treatment option for individuals with anxiety and depression.

Wearable global position system (GPS) technology can help those working with older populations and people living with movement disorders monitor and maintain their mobility level. Health research using GPS often employs inconsistent recording lengths due to the lack of a standard minimum GPS recording length for a clinical context. Our work aimed to recommend a GPS recording length for an older clinical population. Over 14 days, 70 older adults with Parkinson’s disease wore the wireless inertial motion unit with GPS (WIMU-GPS) during waking hours to capture daily “time outside”, “trip count”, “hotspots count” and “area size travelled”. The longest recording length accounting for weekend and weekdays was ≥7 days of ≥800 daily minutes of data (14 participants with 156, 483.9 min recorded). We compared the error rate generated when using data based on recording lengths shorter than this sample. The smallest percentage errors were observed across all outcomes, except “hotspots count”, with daily recordings ≥500 min (8.3 h). Eight recording days will capture mobility variability throughout days of the week. This study adds empirical evidence to the sensor literature on the required minimum duration of GPS recording.

IMPORTANCE:Subtle but important differences have been described in the way that male and female physicians care for their patients, with some evidence suggesting women are more likely to adhere to best practice recommendations. OBJECTIVE:To determine if male and female physicians differ in their prescribing practices as measured by the initiation of lower-than-recommended dose cholinesterase inhibitor (ChEI) drug therapy for dementia management. DESIGN, SETTING, AND PARTICIPANTS:All community-dwelling Ontario residents aged 66 years and older with dementia and newly dispensed an oral ChEI drug (donepezil, galantamine, or rivastigmine) between April 1, 2010 and June 30, 2016 were included. MAIN OUTCOME AND MEASURES:The association between physician sex and the initiation of a lower than recommended-dose ChEI was examined using generalized linear mixed regression models, adjusting for patient and physician characteristics. Data were stratified by specialty. Secondary analyses explored the association between physician sex and cardiac screening as well as shorter duration of the initial prescription. RESULTS:The analysis included 3,443 female and 5,811 male physicians and the majority (83%) were family physicians, Female physicians were more likely to initiate ChEI therapy at a lower-than-recommended dose (Adjusted odds ratio = 1.43,95% confidence interval = 1.17 to 1.74). Compared to their male counterparts, female physicians were also more likely to follow other conservative prescribing practices including cardiac screening (55.1% vs. 49.2%, P-value