Colonel B.K. Ashford, A Brief Military Medicine Historical Review.

Colonel (Col.) Bailey K. Ashford was a turn of the 19th century Army medical corps officer who made great contributions to military medicine in the areas of infectious disease, public health, and education. His service period spans from the Spanish American War to the early 1920s. Although not as well-known as some of his contemporaries, he is an important figure, contributing to the diagnosis and treatment of "new world hookworm" in the tropics, training medical units in World War I, and the creation of the Institute of Tropical Medicine.

A case of post-traumatic stress disorder presenting with anorexia nervosa restrictive type.

We present a case of combat-related post-traumatic stress disorder that made and unusual initial clinical presentation with anorexia nervosa restrictive type.

Videophones for intensive case management of psychiatric outpatients.

When visiting patients with serious mental illness at their homes, case managers carried a portable videophone. This was used to access the hospital clinical team via the home telephone line, when an acute clinical need arose in addressing questions related to medication management and treatment planning; travel was therefore avoided. In an acceptability study lasting 12 months, 24 patients received the supplemental videophone mental health service and 19 of them completed a satisfaction survey. Only one patient was not satisfied with the videophone treatment, while 74% of them were very satisfied. Specific areas of satisfaction concerned the savings of time and travel, assistance with medication questions and increased involvement in treatment. No patient reported any difficulty in using the equipment. Staff members were enthusiastic about the decrease in travel time and there were no complaints about the videophone process or encounters. During the study, 135 h of the case manager's time was saved by using the videophone for urgent access visits, equivalent to a saving of $4000 in salary costs. In addition, the patients saved 135 h in travel time. We believe that there are other potential uses of videophones for seriously mentally ill patients, including discharge planning, intensive post-discharge monitoring and transition to community life.

Antismoking interventions in residential substance abuse treatment.

OBJECTIVE: : To develop and evaluate an educational strategy to increase motivation to quit smoking and improve attendance at antismoking classes in a residential substance abuse treatment program. METHODS: : The 241 patients admitted in 2004 who smoked reported the number of cigarettes smoked daily at the time of admission. Attendance at the antismoking classes was noted to determine if there was a relationship between attending the classes and a change in the number of cigarettes smoked at discharge. The 193 patients admitted in 2005 additionally attended four 1-hour motivational classes to encourage quitting smoking. Rates of attendance at the antismoking classes and smoking rates at discharge were again noted. RESULTS: : Smoking rates in 2004 (n = 194; 81%) and 2005 (n = 161, 83%), P = 0.43, were similar. Voluntary participation in antismoking classes increased from 40% to 64% (P < 0.001). There was a greater reduction in the number of cigarettes smoked between admission and discharge in the quality improvement period compared with the reference period (P = 0.025). In both years, attendance at antismoking classes was strongly associated with quitting, P < 0.001. Of those who attended antismoking classes, 133 (74%) reported a reduction in smoking compared with only 27 (15%) of those who declined to attend, P < 0.001. Among smokers, nonattendance of antismoking classes was associated with increased likelihood of having an irregular discharge, P < 0.001. CONCLUSION: : This study suggests the benefit of relatively brief, specific educational efforts to increase motivation to quit smoking in this high-use population.