AMDIS Case Conference

This is the first of a series of columns on using computers in the mental health field. It is obvious both that computers are being used increasingly and that their uses in psychiatry are lagging behind the enormous increases in computer power and availability. The greatest market growth recently has been in smaller computcr5. Whatever one writes about decreased cost and greater capabilities is almost certain to be out of date if the periodical is not a daily newspaper. More and more mental health professionals have their own computers, and virtually everyone has access to one. The difference between having a small computer of one’s own and sharing a larger one is very much like the difference between having a small private practice and treating patients in an organized setting. While we are often impressed by the helpfulness of the many treatment modalities a facility can bring to bear, more frequently we ask why things can’t work as smoothly as in a private practice. That many of the problems are human organizational rather than technical will become increasingly clear as small clinics and agencies begin to use the same machines for management information systems

Patients are increasingly using online rating websites to obtain information about physicians and to provide feedback. We performed an analysis of urologist online ratings, with specific focus on the relationship between overall rating and urologist subspecialty. We conducted an analysis of urologist ratings on Healthgrades.com. Ratings were sampled across 4 US geographical regions, with focus across 3 practice types (large and small private practice, academic) and 7 urologic subspecialties. Statistical analysis was performed to assess for differences among subgroup ratings. Data were analyzed for 954 urologists with a mean age of 53 (±10) years. The median overall urologist rating was 4.0 [3.4-4.7]. Providers in an academic practice type or robotics/oncology subspecialty had statistically significantly higher ratings when compared to other practice settings or subspecialties (P < 0.001). All other comparisons between practice types, specialties, regions, and sexes failed to demonstrate statistically significant differences. In our study of online urologist ratings, robotics/oncology subspecialty and academic practice setting were associated with higher overall ratings. Further study is needed to assess reasons underlying this difference.

The purpose of this research study is to explore current Telehealth geriatric social work by describing its most recent job market characteristics. As part of a larger longitudinal research, data for this cross- sectional study was collected in January 2021. Three top job search engines, Google, ZipRecruiter, and Indeed, were used to collect data on Telehealth social work job openings. On each search engine, five searches were completed with the five key words: "social work" Telehealth jobs, LCSW Telehealth jobs, remote LCSW jobs, Telehealth "social work" jobs, and Telehealth "social worker" jobs. It analyzed 112 Telehealth geriatric social work job ads, 12.8% of total 873 ads from these fifteen searches. Results from descriptive and thematic data analysis show large, for-profit organizations are dominating the Telehealth geriatric social work field while small private practices are emerging during the pandemic. The study found Telehealth geriatric social work is providing vital continuum services to older people in communities, hospitals, and long-term care facilities at individual, family, and group levels. The results document innovative technological tools present new methods to engage, assess, and intervene, particularly with mental health needs. The Telehealth organizations are making the pitch to attract competitive professionals. While nearly 1/3 of the sampled organizations stated they intended to make Telehealth/remote positions temporary, the study concludes Telehealth has built its infrastructure and workforce to become an indispensable and ongoing part of gerontological and geriatric social work. Social work education, research, and practice must pay close attention to its implications in skill building.

An early woman’s pioneer in medicine, Agnes Thomson Kennie (“Nan”) was initially junior physician (unpaid in those days—it was considered an honour) at Glasgow Royal Infirmary and Muirhead research scholar,...

To (1) identify and quantify the types of treatment that dentists use to manage defective dental restorations and (2) identify characteristics that are associated with these dentists' decisions to replace existing restorations. The Dental Practice-Based Research Network (DPBRN) consists of dentists in outpatient practices from five regions: AL/MS: Alabama/Mississippi; FL/GA: Florida/Georgia; MN: dentists employed by HealthPartners and private practitioners in Minnesota; PDA: Permanente Dental Associates in cooperation with Kaiser Permanente's Center for Health Research and SK: Denmark, Norway and Sweden. A questionnaire was sent to all DPBRN practitioner-investigators who reported doing some restorative dentistry (n = 901). Questions included clinical case scenarios that used text and clinical photographs of defective restorations. Dentists were asked what type of treatment, if any, they would use in each scenario. Treatment options ranged from no treatment to full replacement of the restoration with or without different preventive treatment options. The authors of the current study used logistic regression to analyze associations between the decision to intervene surgically (repair or replace) and the specific dentist, practice and patient characteristics. A total of 65% of dentists would replace a composite restoration when the defective margin was located on dentin and 49% would repair it when the defective margin was located on enamel. Most (52%) dentists would not intervene surgically when the restoration in the scenario was amalgam. Dentists participating in a solo or small private practice (SPP) chose surgical intervention more often than dentists participating in large group practices (LGP) or in public health practices (PHP) (p < .0001). Dentists who do not routinely assess caries risk during treatment planning were more likely to intervene surgically and less likely to choose prevention treatment (p < .05). Dentists from the SK region chose the "no treatment" option more often than dentists in the other regions. Dentists were more likely to intervene surgically when the restoration was an existing composite, compared to an amalgam restoration. Treatment options chosen by dentists varied significantly by specific clinical case scenario, whether the dentist routinely performs caries risk assessment, type of practice and DPBRN region.

Large Corporations As Small Communities and Private Practice Implications

e18553 Background: Neutropenic fever (NF) can result in significant mortality if not managed properly and in swift fashion. There has been a recent shift from small oncology private practices commonly affiliated with non-teaching hospitals (NTH) to large teaching hospitals (TH) with an abundance of specialized faculty and financial resources. We sought to analyze admissions for NF comparing TH versus NHT institutions’ mortality in breast (BC), lung (LC), renal (RC), prostate (PC) and multiple myeloma (MM) from 2006-2014. Methods: We analyzed data from the Healthcare Cost and Utilization Project’s National Inpatient Sample between 2006-2014 using ICD 9 codes for a primary diagnosis of BC, LC, MM, RC and PC. NF was used as a secondary diagnosis. TH and NTH mortality was compared using hazard ratios (HR) which were controlled for confounding factors of age, race, sex, income, insurance status, & comorbidities. Results: There were 77,215 admissions (weighted [w] 383,225) to TH vs 42,860 to NTH (w: 208,430). NTH accounted for 35.21% admissions, 0.031% related to NF. TH accounted for 64.72% with 0.076% related to NF (p = 0.0033). HR of death related to NF during during hospitalization within 30 days were compared for TH vs NTH. Results are listed below. Conclusions: Most admissions for NF occurred at TH. This could be related to resource requirements, higher acuity patients or more intensive regimens used in TH. Hospital mortality of NF at NTH was increased for RC and MM. This may be due to delays in implementing appropriate antimicrobial therapy. However, there was no significant difference in outcomes for BC, LC and PC, possibly due to the routine use of growth factor support or shorter duration of neutropenia in the chemotherapy regimens used in these cancers. With the continual shift in health care delivery to consolidate, it remains important for small NTH to be able to manage oncologic emergencies such as a NF resulting in the same hospital mortality outcomes. TH vs NTH Hazard Ratio 95% Cl P value BC 1.033 0.83 - 1.285 0.7743 LC 1.031 0.955 - 1.113 0.4355 MM 3.662 3.253 - 4.121 < .0001 PC 1.52 0.61-2.16 0.65 RC 2.85 1.71-4.75 < .0001

In the past two decades, sustainability has gained significant attention, influencing global agendas. This paper examines the relationship between Governance for Sustainability (GfS) and organizational dynamics through the lens of Work and Organizational Psychology (WOP). While existing literature predominantly focuses on macro-level governance, this study addresses the overlooked micro and meso levels. By exploring dimensions such as culture and leadership, it sheds light on critical issues for organizations navigating sustainable change. Emphasis is placed on the "human factor" and its connection to WOP. Implications for research and practice are discussed, with a focus on advancing the GfS field through WOP themes.

Promoting Culture Change Within Organizations.

Employees can play a decisive role in combatting climate change by engaging in green behavior at work. Research on employee green behavior has recently gained traction, with research results pointing to the considerable influence of positive variables (e.g., personal values, positive affect) on employee green behavior. While such positive variables lie at the heart of the scholarly discipline positive organizational psychology, there is scant research at the intersection of positive organizational psychology and employee green behavior. The current manuscript aims to give impetus to such research. To this end, the manuscript presents a systematic review of the literature on positive predictors of employee green behavior and identified 94 articles that investigate such predictors. We explicitly map these investigated predictors onto a positive (organizational) psychology frame of reference. Subsequently, we use the findings of the review to identify gaps and outline concrete suggestions for future research at the intersection of positive organizational psychology and employee green behavior, addressing both theoretical and methodological suggestions.

A comprehensive, retrospective chart review of a small private practice, comparing psoriasis treatment patterns wtih national trends

Otto Deiters, for whom the lateral vestibular nucleus and the supporting cells of the outer auditory hair cells were named, died in 1863 aged 29. He taught in the Bonn Anatomy Department, had an appointment in the University Clinic, and ran a small private practice. He published articles on the cell theory, the structure and development of muscle fibers, the inner ear, leukaemia, and scarlet fever. He was the second of five surviving children in an academic family whose private correspondence revealed him to be a young man with limited social skills and high ambitions to complete a deeply original study of the brainstem and spinal cord. However, first his father and then his younger brother died, leaving him and his older brother responsible for a suddenly impecunious family as he failed to gain academic promotion. Otto died of typhus two years after his younger brother's death, leaving his greatest scientific achievement to be published posthumously. He showed that most nerve cells have a single axon and several dendrites; he recognized the possibility that nerve cells might be functionally polarized and produced the first illustrations of synaptic inputs to dendrites from what he termed a second system of nerve fibers.

Behavioral Health Data in the Electronic Health Record: Privacy Concerns Slow Sharing

This study explored how technical factors influence Electronic Health Records (EHR) adoption by nurses at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. Descriptive cross-sectional research design was used. Data were collated through a questionnaire. Simple random sampling method was deployed to select 279 out of 926 nurses from the various Directorates. All the filled surveys were coded into IBM SPSS 21.0 statistical software. Descriptive statistics, including means, standard deviation, skewness and kurtosis were employed to analyze the various variables. Correlation and linear regression analysis were utilized to determine how Information and Communication Technology (ICT) infrastructure, internet access and physical security influence the adoption of EHRs. The significance level was at p < 0.05 for every statistical set. The findings were presented using tables and figures. The findings reveal that nurses agreed that MTRH premises are highly secured (M = 4.219, SD = 0.7386). The study found a positive, strong and statistically meaningful link between the technical factors and EHR adoption (correlation analysis, r (279) = 0.543, p < 0.05; linear regression analysis, F (1,277) = 116.036, p < 0.01). Therefore, to overcome the technical barriers, public-private partnerships should be encouraged for more investments in ICT infrastructure development at MTRH.

Artificial intelligence is reshaping organizational operations in ways that extend far beyond technical implementation. While 85% of IT leaders report that CIOs are becoming organizational changemakers, most continue to focus primarily on operational functions rather than the cultural and organizational transformations AI demands. This gap creates significant risks, as evidenced by high-profile failures at companies like Zillow and Air Canada. Research indicates that 91% of data leaders identify cultural challenges—not technology—as the primary barrier to data-driven transformation. This article examines why traditional technology leadership roles often lack the bandwidth and mandate to address AI's human and organizational implications, proposes an expanded leadership model combining technical expertise with organizational psychology and change management, and explores early examples of organizations successfully implementing this approach through roles that bridge innovation, transformation, and cultural change.