BACKGROUND After publication of the Clostridioides difficile infection (CDI) guidelines by the Infectious Disease Society of America (IDSA) in early 2018, we identified that many prescribers at our institution continued to practice using the older guidelines. OBJECTIVE This study aimed to determine whether the implementation of an electronic order set for CDI would increase prescriber compliance to current IDSA recommendations for CDI management. METHODS This was a single-center, prospective cohort study of adult inpatients with a confirmed CDI. The study was conducted between March 1, 2018, and April 1, 2019. Patients were stratified into a preintervention and postintervention group before and after order set implementation. The primary outcome was a composite of appropriate CDI therapy selection and discontinuation of nonessential antimicrobials and acid-suppressive agents. The secondary outcome evaluated appropriate CDI therapy medications prescribed at hospital discharge. RESULTS Of the 149 patients included in this study, 96 were included in a preintervention group and 53 included in a postintervention group. The primary outcome was met in 45% of patients in the preintervention group and 66% of patients in the postintervention group (P = .01). The secondary outcome occurred in 86% of patients in the preintervention group and 100% of patients in the postintervention group (P = .02). CONCLUSION Implementation of a CDI electronic order set and alert bundle was associated with enhanced prescriber adherence to guideline-directed therapy. Our results suggest that order sets not only improve inpatient compliance to guidelines but may also improve medication-related adherence to guideline recommendations upon discharge.Sexual abuse is a cross-cultural phenomenon related to multiple cultural contexts including religious affiliation. The Haredi, or Orthodox Jewish community (OJC), constitutes a significant minority group of the worldwide Jewish population, characterized by cultural conservatism, steadfast loyalty to the community, and strict religious behavioral codes. To date, only few empirical studies (as opposed to multiple media reports) have dealt with the issue of sexual abuse within the OJC. https://www.selleckchem.com/products/taurochenodeoxycholic-acid.html Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review of the literature on sexual abuse within the OJC and its subgroups that addresses experiences and reports of victims, perpetrators, the Jewish and general community, and professionals in the North America, Israel, and Australia. Articles were collected from peer-reviewed databases and bibliographies; 13 quantitative and qualitative articles were included in the final sample. Three themes emerged disclosure of sexual abuse, perceptions and attitudes toward the abuse, and its implications. Results indicated that alongside several findings that were specifically grounded in the context of closed collective or religious societies and the OJC in particular, most essentially reflected universal aspects of sexual abuse. The results suggest promoting context-informed interventions based on community knowledge and resilience, together with appropriate training in order to better understand the needs of the OJC and of closed communities in general.OBJECTIVE The authors compared baseline characteristics and reporting of psychosocial measures among veterans with seizures who were evaluated in-clinic or remotely via computer video telehealth (CVT). It was hypothesized that the CVT group would report less trauma history, drug use, and comorbid symptoms compared with veterans seen in-clinic. METHODS A cross-sectional design was used to compare 72 veterans diagnosed with psychogenic nonepileptic seizures (PNES) or concurrent mixed epilepsy and PNES who were consecutively evaluated by a single clinician at the Providence Veterans Affairs Medical Center (PVAMC) Neuropsychiatric Clinic. In-clinic evaluations of veterans were performed at the PVAMC Neuropsychiatric Clinic (N=16), and remote evaluations of veterans referred to the VA National TeleMental Health Center were performed via CVT (N=56). All 72 patients were given comprehensive neuropsychiatric evaluations by direct interview, medical examination, and medical record review. Veterans' reporting of trauma and abuse history, drug use, and psychiatric comorbidities was assessed, along with neurologic and psychiatric variables. RESULTS No significant differences were found between veterans evaluated in-clinic or remotely with regard to baseline characteristics and reporting of potentially sensitive information, including trauma and abuse history, substance use, and comorbid symptoms. CONCLUSIONS Veterans with PNES evaluated via telehealth did not appear to withhold sensitive or personal information compared with those evaluated in-clinic, suggesting that CVT may be a comparable alternative for conducting evaluations. Baseline evaluations are used to determine treatment suitability, and telehealth allows clinicians to gain access to important information that may improve or inform care.OBJECTIVE Persistent cognitive, somatic, and neuropsychiatric symptoms following mild traumatic brain injury (TBI) are influenced by posttraumatic stress disorder (PTSD), particularly in military patients. The authors evaluated the degree to which military service members with a history of mild TBI attributed posttraumatic symptoms to TBI versus PTSD. METHODS Service members (N=372) with mild TBI were surveyed about the severity of posttraumatic symptoms across four symptom clusters (cognitive, affective, somatosensory, and vestibular) with the Neurobehavioral Symptom Inventory (NSI). Participants rated the degree to which they believed TBI, PTSD, or other conditions contributed to their symptoms. Differences in cognitive, affective, somatosensory, and vestibular symptom severity were evaluated across participants with TBI, PTSD, or combined TBI-PTSD attribution. Logistic regression was used to evaluate the association between symptom profiles and attribution. RESULTS Participants attributed symptoms mostly to TBI, followed by insufficient sleep, PTSD, chronic pain, depression, and deployment-readjustment stress.