A caregiver training intervention focused on the work of caregiving and targeted at knowledge, skills, and beliefs benefits caregivers in important outcome dimensions. The results suggest the benefits of providing information, linkage, and role coaching to dementia family caregivers.

PURPOSE Postpartum depression affects up to 22% of women who have recently given birth. Most mothers are not screened for this condition, and an ideal screening tool has not been identifi ed. This study investigated (1) the validity of a 2-question screen and the 9-item Patient Health Questionnaire (PHQ-9) for identifying postpartum depression and (2) the feasibility of screening for postpartum depression during well-child visits.METHODS Study participants were English-literate mothers registering their 0-to 1-month-old infants for well-child visits at 7 family medicine or pediatric clinics. They were asked to complete questionnaires during well-child visits at 0 to 1, 2, 4, 6, and 9 months postpartum. Each questionnaire included 2 depression screens: the 2-question screen and the PHQ-9. The mothers also completed the depression component of the Structured Clinical Interview for DSM-IV (SCID) initially, and again at a subsequent interval if either screening result was positive for depression. RESULTSThe response rate was 33%. Of the 506 women who participated, 45 (8.9%) had major depression (ie, they had a positive result on the SCID). The screen sensitivities/specifi cities over the course of the study were 100%/44% with the 2-question screen, 82%/84% with the PHQ-9 using simple scoring, and 67%/92% with the PHQ-9 using complex scoring. In addition, the corresponding values for the fi rst 2 items of the PHQ-9 (ie, the 2-item Patient Health Questionnaire or PHQ-2) were 84%/79%. Some 38% of women completed their 2-to 6-month questionnaires during well-child visits; the rest completed them by mail (29%) or telephone (33%). CONCLUSIONSThe 2-question screen was highly sensitive and the PHQ-9 was highly specifi c for identifying postpartum depression. These results suggest the value of a 2-stage procedure for screening for postpartum depression, whereby a 2-question screen that is positive for depression is followed by a PHQ-9. These screens can be easily administered in primary care clinics; feasibility of screening during well-child visits was moderate but may be better in clinics using a massscreening approach. INTRODUCTIONP ostpartum depression is increasingly recognized as a unique and serious complication of childbirth, with an estimated prevalence in the 12-month postpartum period of up to 21.9%.1 Mothers' depressive symptoms-diminished mood, pleasure, energy, concentration, and self-worth; psychomotor retardation; changes in appetite and sleep; and suicidal ideation-can markedly impair their sense of well-being, marital and other key relationships, 2 work performance and productivity, 3 relationships with their infants, 4 and infants' behavioral and cognitive development. 5 Recognizing the seriousness of this disorder, the US Preventive S CR EENING F OR P OS T PA R T U M DEPR ES SIONServices Task Force has recommended routine depression screening for adults in practices that have systems in place to ensure accurate diagnosis, effective treatment, and follow-up. 6 Most primary care practices do not h...

The authors report how one medical school took an evidence-based, collaborative approach to assessing and improving faculty vitality by building on previous research and including important shareholders (e.g., faculty and administrators). In 1999, the dean and faculty senate asked all full-time faculty (615) at the University of Minnesota Medical School-Twin Cities to complete a survey to (1) identify vitality areas (individual, institutional, or leadership) in which the school was strong and ones that needed improvement, (2) identify strategies for addressing weak areas, and (3) provide a baseline against which to measure the impact of any vitality efforts initiated. The survey was based on features that research studies have found to be associated with academic productivity. Seventy-six percent responded. Summaries of the survey findings were prepared for use at the school level, department level, and special group level (e.g., women, clinical-scholar-track faculty). Three key school-level findings were that (1) there is a disconnect between the stated vision of the school and the departments' visions and actions, (2) there is not enough time for scholarly activity, particularly in the clinical departments, and (3) faculty lack the support of a collegial atmosphere and appreciation for the work they do. In response to the survey's findings every department identified priority faculty needs and initiated tailored development strategies. School-wide strategies were also initiated to address faculty needs common across departments and needs unique to special groups. Together these strategies provide a multi-level, systematic approach to maintaining faculty vitality.

Purpose To investigate changes in mothers’ body dissatisfaction from delivery to 9 months postpartum, and the relationship of postpartum body dissatisfaction to weight, other health, and social characteristics. Methods In this prospective longitudinal study, 506 mothers completed surveys at 0-1 and 9 months postpartum. Postpartum changes in body dissatisfaction and weight were evaluated by paired t-tests, and predictors of postpartum body dissatisfaction were identified by stepwise multiple regression analysis. Results Mothers’ body dissatisfaction increased significantly from 0-1 to 9 months postpartum (mean scores of 15.2 and 18.2, respectively, p < .001). Although women lost an average of 10.1 pounds (sd = 16.3) or 4.6 kg. (sd = 7.4) between 0-1 and 9 months postpartum (p < .001), their weight at 9 months postpartum remained an average of 5.4 pounds (sd = 15.6) or 2.5 kg (sd = 7.1) above their pre-pregnancy weights (p < .001). Body dissatisfaction at 9 months postpartum was associated with overeating or poor appetite, higher current weight, worse mental health (SF-36 Mental Health scale), race other than black, bottle-feeding (vs. breastfeeding), being single (vs. married), and having fewer children,. Conclusions Mothers’ body satisfaction worsened from 1 to 9 months postpartum, and 9-month body dissatisfaction was associated with eating/appetite abnormalities, greater weight, worse mental health, non-black race, non-breastfeeding status, and fewer immediate family relationships. Given these relationships, it is important to educate women about expected postpartum weight and body changes, and to find ways to enhance mothers’ postpartum self-esteem and body satisfaction.

The results emphasize the importance of having both formal and informal mentors who perform mentoring behaviors associated with satisfaction and productivity. The results provide a preliminary indication that mentor types and specific mentoring behaviors may have different effects on satisfaction and productivity. Despite the differences found for some behaviors, it seems that it is more essential that mentoring behaviors be performed by any mentor than by a specific type of mentor.