Clinical Psychiatry News articles from June 2008

Clinical Psychiatry News archives from June 2008

Ask patients about use of the Internet.
June 1, 2008... WASHINGTON -- Psychiatrists might be surprised by just how easy it is for their patients to access very detailed information about suicide methods on the Internet, a study using five Internet search engines shows. "The bottom line for us...

Results support early screening of all trauma patients; PTSD is prevalent 1 year after injury.
June 1, 2008... NEW YORK--Posttraumatic stress disorder and depression are extremely common a full year after hospitalization for injury and are associated with up to a nearly sixfold increased likelihood of failure to return to work, according to the...

Look for comorbidities with problem gambling.
June 1, 2008... WASHINGTON -- Pathological gambling is significantly associated with substance abuse, posttraumatic stress disorder, adjustment disorders, and dependent and narcissistic personality disorders, according to the results of a study of 772...

Atomoxetine OK'd for ADHD maintenance.(News)
June 1, 2008... "The Pink Sheet" The Food and Drug Administration has approved nonstimulant atomoxetine as a maintenance treatment in children and adolescents who have attention deficit/hyperactivity disorder, according to the manufacturer, Eli Lilly &...

New morphine product may block euphoria.(News)
June 1, 2008... TORONTO -- A new formulation of extended release morphine that contains sequestered naltrexone does not provide a sense of euphoria when crushed and taken orally, a study has found. This limits its appeal for recreational use, as the rapid...

Slashing research money won't help, may hurt.(GUEST EDITORIAL)
June 1, 2008... Times are tough... belts must be tightened... everyone should sacrifice. These are the messages Congress conveys as it debates the next year's federal budget. But indiscriminate across the board cuts harm areas that promote the general...

Torture: in the abstract vs. reality.(LETTERS)(Letter to the editor)
June 1, 2008... I have been enjoying Dr. H. Steven Moffic's articles for a long time. I appreciate the mixture of everyday mundane medical issues intermixed with philosophical interpretation of them, which makes The Ethical Way a real pleasure to read....

Finding power within the APA.(LETTERS)(Letter to the editor)
June 1, 2008... The column by Dr. H. Steven Moffic about the American Psychiatric Association made me think about where the real power lies in the organization ("If I Were President [of Our APA]"), The Ethical Way, December 2007, p. 38). For many people,...

Drug companies falsely indicted.(LETTERS)(Letter to the editor)
June 1, 2008... Dr. Daniel Carlat's argument--that cooperation with pharmaceutical companies corrupts the values and missions of physicians--is flawed ("Physicians, Big Pharma, and Deception," Guest Editorial, April 2008, p. 9). Dr. Carlat's line of...

A different view on autism.(LETTERS)(Letter to the editor)
June 1, 2008... I am writing in response to an editorial by Lawrence Scahill, Ph.D., about autism ("Autism Is Not An Epidemic," Guest Editorial, March 2008, p. 14). I am not an epidemiologist or a neuropsychologist and have no formal training in autism...

Should primary care physicians provide dementia screening? Too many patients go undiagnosed.(POINT/COUNTERPOINT)
June 1, 2008... Alzheimer's disease affects more than 5 million Americans and is the fourth-leading cause of death in the United States. Yet by many accounts, only 50% of the cases are diagnosed, and only 25% of patients receive the medication they need. In 40...

Should primary care physicians provide dementia screening? The evidence for screening is weak.(POINT/COUNTERPOINT)
June 1, 2008... At first glance, dementia screening appears likely to be beneficial. But advocates of population-based dementia screening fail to take into account medicine's prime directive: First, do no harm. Screening would indeed identify more...

Options limited in resistant schizophrenia: trial of clozapine is considered standard approach, but optimal results could take more than 6 weeks.(PRACTICAL PHSYCHOPHARMACOLOGY)
June 1, 2008... Progress in the treatment of schizophrenia over the last decades has been dramatic, with the development of new antipsychotics and accelerating research into the disorder's diverse symptom domains. But a substantial proportion of...

Stress in early pregnancy may raise schizophrenia risk.(PRACTICAL PSYCHOPHARMACOLOGY)
June 1, 2008... Severe stress in the first trimester was linked in a population-based study to an increased risk of a woman's offspring developing schizophrenia as an adolescent or adult. "This effect is independent of a range of factors known to...

Variations in gene may predict risk of PTSD.(Adult Psychiatry)
June 1, 2008... Among people who experienced severe trauma as children, variations in the FKBP5 gene appear to predict who will develop posttraumatic stress disorder when exposed to further trauma as adults, investigators reported. Some polymorphisms in...

FDA adds new indications for aripiprazole.(Adult Psychiatry)
June 1, 2008... The Food and Drug Administration added maintenance and treatment of additional bipolar disorders in pediatric and adolescent patients to the indications for the atypical antipsychotic aripiprazole. The drug, a dopamine partial agonist, is...

Peruse e-mails, records of online sex offenders.(Adult Psychiatry)
June 1, 2008... SAN FRANCISCO -- When assessing defendants charged with online sex offenses, a forensic psychiatrist cannot rely entirely on a face-to-face interview, Dr. Clarence Watson said at the annual meeting of the American College of Forensic...

Allergies may be associated with depression, suicide.(Adult Psychiatry)
June 1, 2008... PHILADELPHIA -- Seasonal allergies might be associated with fatigue and mood disorders, including depression, in certain patients, Dr. Tedor T. Postolache reported at the annual meeting of the American Academy of Allergy, Asthma, and...

Dyslipidemia poses threat in bipolar disorder.(Adult Psychiatry)(Clinical report)
June 1, 2008... WASHINGTON -- Many patients with bipolar disorder appear to have dangerous levels of dyslipidemia, based on a retrospective study of more than 200 patients. Researchers found that almost two-thirds of patients with bipolar disorder (61%)...

Tamoxifen may improve mania in bipolar disorder.(Adult Psychiatry)
June 1, 2008... Tamoxifen improved mania symptoms in a preliminary trial involving 66 patients hospitalized with bipolar I disorder. The antimanic effects were "similar in magnitude and timing" to those reported for lithium and divalproex, and tamoxifen...

CBT approaches valuable for developmentally disabled.(Adult Psychiatry)(Cognitive-behavioral treatment )
June 1, 2008... SAN DIEGO -- Cognitive-behavioral treatment can help developmentally disabled persons with sexual behavior problems learn self-regulation skills, but don't expect one approach to work in all cases. "Treatment has to be very concrete and...

Screening for metabolic syndrome encouraged.(APA MEETING NEWS)
June 1, 2008... WASHINGTON -- Risk factors for metabolic syndrome appear to be common among patients on antipsychotics, making the screening for metabolic abnormalities a potentially important component of care for this population, a study of 92 patients...

Modafinil may keep weight gain from olanzapine to minimum.(APA MEETING NEWS)
June 1, 2008... WASHINGTON -- The wakefulness drug modafinil appears to reduce weight gain associated with the use of the atypical antipsychotic olanzapine, based on a study of healthy subjects presented at the annual meeting of the American Psychiatric...

New atypical shows efficacy for inpatients in early trial.(APA MEETING NEWS)
June 1, 2008... WASHINGTON -- The novel atypical antipsychotic iloperidone is just as effective as ziprasidone for the short-term treatment of acute exacerbation of schizophrenia, a 4-week, double-blind study of 593 psychiatric inpatients shows. In...

Working memory low in children with ADHD.(Child/Adolescent Psychiatry)
June 1, 2008... PHILADELPHIA -- Children with attention-deficit/hyperactivity disorder performed worse than children without the disorder on tests of working memory--an important factor in learning and academic success, according to the results of a...

Exposure to lead, tobacco linked to ADHD.(Child/Adolescent Psychiatry)
June 1, 2008... HONOLULU -- More than 800,000 cases of attention-deficit/hyperactivity disorder in the United States may be linked to childhood exposure to lead and intrauterine exposure to tobacco smoke, Dr. Tanya E. Froehlich said at the joint meeting of the...

Avoid potential mistakes in managing ADHD: watch out for comorbidities such as learning disabilities, ODD, conduct disorder, depression.(Child/Adolescent Psychiatry)(Disease/Disorder overview)
June 1, 2008... MIAMI BEACH -- TO avoid mistakes in the management of a child with attention-deficit/hyperactivity disorder, consider the patient's receptive language age, comorbidities such as depression, and medication to protect a young child when a parent...

Ask 10 questions before prescribing stimulants for ADHD.(Child/Adolescent Psychiatry)
June 1, 2008... New York -- Before starting a child on stimulants to treat attention-deficit/hyperactivity disorder, consider asking some extra questions to confirm the diagnosis and family history, Dr. Laurence L. Greenhill said at a psychopharmacology update...

Complex factors drive underage alcohol use.(Child/Adolescent Psychiatry)
June 1, 2008... A complex mixture of biologic, psychological, and social evidence suggests that alcohol consumption in children and adolescents is a developmental issue, based on data from several studies published in a supplement in the journal Pediatrics....

Dysregulated eating may be linked to cortisol.(Child/Adolescent Psychiatry)
June 1, 2008... BALTIMORE -- Children with greater food intake in the absence of hunger might have abnormal cortisol levels after stressful situations--a finding that could have implications for the development of obesity--data presented at the annual meeting...

Genes may make some vulnerable to weight gain.(Child/Adolescent Psychiatry)
June 1, 2008... BALTIMORE -- Genes appear to play a role not only in a child's vulnerability to weight gain but also in behaviors that can lead to weight gain, data presented at the annual meeting of the American Psychosomatic Society show. Jane Wardle,...

Early adversity linked to risk of adult obesity.(Child/Adolescent Psychiatry)(Clinical report)
June 1, 2008... Some stressful childhood emotional experiences are associated with an increased likelihood of adult obesity and, therefore, a greater risk for type 2 diabetes, according to findings of a British population-based study of more than 9,000...

Psychosocial competence may affect diabetes control.(Child/Adolescent Psychiatry)
June 1, 2008... WASHINGTON -- Total social competence and externalizing behavior may play a role in how well children and adolescents control their diabetes, according the results of a study involving 78 patients. "Lower total psychosocial competence is a...

Intellectual impairment: use developmental lens.(Child/Adolescent Psychiatry)(Disease/Disorder overview)
June 1, 2008... BOSTON -- Failure to use a developmental framework when assessing mental illness in children and adolescents with intellectual disabilities can hinder the accurate diagnosis of psychiatric disorders, and lead to inappropriate and possibly...

Early family-based intervention might help prevent antisocial behavior.(Child/Adolescent Psychiatry)
June 1, 2008... KAUI, HAWAN -- Preschoolers at genetic risk for antisocial behavior may benefit from family-based preventive intervention, Dr. Glen O. Gabbard said at the annual meeting of the American College of Psychiatrists. "I worked in the prison...

Factors identified for earlier Dx of ASD.(Child/Adolescent Psychiatry)
June 1, 2008... PHILADELPHIA -- Children are likely to be diagnosed with autism spectrum disorders at a younger age if there is a shorter period between referral and evaluation, Dr. Ginger Janow said. Early diagnosis of autism spectrum disorders can make a...

A Texas appeals court ruled recently that the state illegally seized hundreds of children from a polygamists' compound. A few days later, the state's Supreme Court upheld that ruling. As facts about the sect unfold, does it appear that taking the children was in the children's best interests?(FINK! STILL AT LARGE)
June 1, 2008... The complexity of this case makes it difficult to determine what is in the best interests of the children. As of this writing, it is unclear where the children might end up. However, our job as clinicians who make decisions based on facts and...

Questionnaire tops other mood evaluations.(Geriatric Psychiatry)
June 1, 2008... WASHINGTON -- A nine-item questionnaire of self-reported symptoms was more reliable and efficient than the widely used Geriatric Depression Scale and the Minimum Data Set 2.0 scale at assessing mood disorders in nursing home patients, according...

Depression tied to high vitamin D, low parathyroid hormone levels.(Geriatric Psychiatry)
June 1, 2008... Both the presence and severity of depression are associated with decreased serum levels of 25-hydroxyvitamin D and increased levels of parathyroid hormone in older patients, researchers reported. It is not yet known whether abnormal levels...

'Use it or lose it' strategy can prevent cognitive decline.(Geriatric Psychiatry)
June 1, 2008... CHICAGO -- Older adults with normal cognition who engaged in a mental fitness program for 1 hour a day, 5 days a week for 8 weeks demonstrated significant improvements in memory and nonmemory tasks, according to data presented at the annual...

NSAID pair fails Alzheimer's prevention test.(Geriatric Psychiatry)
June 1, 2008... Naproxen and celecoxib failed to prevent Alzheimer's disease in the first clinical trial to test the agents as preventives in older subjects who had no cognitive impairment, wrote Barbara K. Martin, Ph.D., of Johns Hopkins Bloomberg School of...

Older Ca patients have greater risk of suicide.(Geriatric Psychiatry)
June 1, 2008... BOSTON -- The risk of suicide in older adults is higher among patients with cancer than among those with other medical illnesses, even after controlling for psychiatric illness and the risk of dying within 1 year, Dr. Matthew Miller reported at...

Personality disorder subtype predicts relapse.(Addiction Psychiatry)(Clinical report)
June 1, 2008... TORONTO -- The impact of stressful life events on alcohol relapse varied depending on personality disorder subtype and history of alcohol use in an analysis of data from the Collaborative Longitudinal Study of Personality Disorders, Dr....

Three-drug combo aids quit rates in ill smokers: patients used patch, inhaler, and bupropion until they were able to go 14 days without cravings.(Addiction Psychiatry)
June 1, 2008... PITTSBURGH -- Among medically ill smokers, a combination of the nicotine patch, a nicotine inhaler, and bupropion significantly increased smoking cessation rates at 26 weeks compared with the nicotine patch alone and did not result in serious...

Payments from employers promote smoking cessation.(Addiction Psychiatry)
June 1, 2008... PITTSBURCH -- Financial incentives for smoking cessation offered by employees in large workplace settings succeed in getting employees to quit, the findings from a government-funded study suggest. The subject is controversial. Two 2005...

Smoothing the road for teens with mental illness.(PREVENTION IN ACTION)
June 1, 2008... For most teenagers, 18 is a magic number. High school graduation, admission into college, entrance into the "working world," and independent living are among the milestone transitions that happen at or around 18 years. But for teenagers...

Psychiatry and chronic pain patterns.(THE PSYCHIATRIST'S TOOLBOX)
June 1, 2008... As a psychiatrist known for using behavioral techniques as well as a variety of relaxation therapies, I was not surprised when, a number of years ago, orthopedic surgeons and neurosurgeons started referring their chronic pain patients to me....

Workplace program lowers headache frequency, analgesic use.(THE PSYCHIATRIST'S TOOLBOX)
June 1, 2008... A workplace exercise and relaxation program can significantly reduce the frequency of headaches and shoulder pain as well as employees' use of analgesics, according to an Italian study of 384 workers. Researchers from the University of...

Methadone is complex choice for managing pain.(THE PSYCHIATRIST'S TOOLBOX)
June 1, 2008... TAMPA -- Methadone is an excellent choice for pain management when the prescribing complexities are understood, said two experts at the annual meeting of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative...

Ten minutes a day walking on treadmill eases mood, pain.(THE PSYCHIATRIST'S TOOLBOX)(Clinical report)
June 1, 2008... ORLANDO -- A physical conditioning program that consisted of just 10 minutes a day of walking on a treadmill at a moderate pace for 3 weeks significantly improved measures of pain perception, aerobic capacity, depression, and anxiety, in...

Assess and treat apnea in diabetes patients.(Psychosomatic Medicine)
June 1, 2008... ST. LOUIS -- Sleep apnea assessment and treatment should be considered an integral part of diabetes management, Susan M. LaRue, R.D., said at the annual meeting of the American Association of Diabetes Educators. "Sleep apnea is highly...

Too much, too little sleep doubles risk of death.(Psychosomatic Medicine)(Clinical report)
June 1, 2008... COLORADO SPRINGS -- Change in sleep duration during midlife is associated in a U-shaped fashion with risk for death more than a decade later, Dr. Francesco Cappuccio reported at a conference of the American Heart Association. The major...

Hypnotics and sleep apnea.(EVIDENCE-BASED PSYCHIATRIC MEDICINE)
June 1, 2008... The Problem You have a patient with obstructive sleep apnea who requests a hypnotic. Knowing that benzodiazepines can worsen the condition, you consider prescribing one of the common hypnotics. The Question Which of the commonly...

Sodium, potassium ratio affects cardiac risk.(Across Specialties)
June 1, 2008... COLORADO SPRINGS -- The intake ratio of sodium to potassium bears a much stronger association with subsequent development of cardiovascular disease than does consumption of either alone, according to new findings from the Trials of Hypertension...

Dexmedetomidine reduces postsurgery delirium.(Across Specialties)(Clinical report)
June 1, 2008... BALTIMORE -- The use of dexmedetomidine for sedation after cardiac surgery significantly reduces the incidence of inhospital delirium, compared with midazolam and propofol, two commonly used postoperative sedation drugs. In an open-label...

Migraine frequency, aura tied to CV disease risk.(Across Specialties)
June 1, 2008... CHICAGO -- Migraine frequency appears to be an indicator of increased risk of cardiovascular disease in migraineurs with aura, according to findings from a large cohort analysis presented at the annual meeting of the American Academy of...

Partner history raises gay women's vaginosis risk.(Across Specialties)
June 1, 2008... CHICAGO -- The biggest risk factor for bacterial vaginosis among gay or bisexual women is having a sex partner with a history of the disorder--an association that increases the chances of bacterial vaginosis by more than 400%, Dr. Jeanne...

Low vitamin D tied to high risk in breast Ca.(Across Specialties)
June 1, 2008... Vitamin D deficiency at the time of breast cancer diagnosis is common and is associated with a significantly increased risk of metastasis and mortality, according to data from a study to be presented at the annual meeting of the American...

Nerve block reduces hot flushes, sleep disturbances.(Across Specialties)
June 1, 2008... A stellate-ganglion nerve block significantly reduced the frequency and intensity of hot flushes and sleep disruption in breast-cancer survivors, according to a study. This finding may lead to a new therapy that could boost medication...

Mammography plus ultrasound detects more cancers.(Across Specialties)(Clinical report)
June 1, 2008... Adding a single screening ultrasound exam to routine mammography significantly improves breast cancer detection in women who are at high risk for the disease, investigators reported. Supplementing mammography with ultrasound raised the rate...

Obesity, sleep duration associated across groups.(Across Specialties)
June 1, 2008... Obesity was associated with poor sleep across a range of populations, and people who didn't get enough sleep were more likely to develop metabolic syndrome, based on data from a pair of studies. Previous research has shown an association...

Obesity/CVD risk spans ethnicities.(Across Specialties)
June 1, 2008... Obesity is epidemic in most but not all racial and ethnic groups, and the incidence of cardiovascular disease risk factors and subclinical vascular disease is directly related to obesity, regardless of race or ethnicity, according to recent...

Inflammation may connect obesity with heart failure.(Across Specialties)
June 1, 2008... The inflammatory markers interleukin-6 and C-reactive protein as well as macroalbuminuria are independently predictive of heart failure, according to a study that followed nearly 7,000 Americans for a median of 4 years. Each standard...

Use of triglyceride oil promotes weight loss.(Across Specialties)
June 1, 2008... Colorado Springs -- Substituting moderate amounts of medium-chain triglycerides for other fats in a weight-loss program results in enhanced weight loss and a greater reduction in fat mass with no adverse impact on cardiovascular risk factors,...

Dyslipidemia improves after teen bariatric surgery.(Across Specialties)
June 1, 2008... COLORADO SPRINGS -- Dyslipidemia improves markedly after bariatric surgery in extremely obese adolescents, Dr. Holly M. Ippisch reported at a conference of the American Heart Association. The improvement in lipid abnormalities is apparent...

Teens with type 2 diabetes often misjudge their weight.(Across Specialties)
June 1, 2008... More than half of adolescents with type 2 diabetes underestimate their weight, and so do their parents, according to results from interviews with 104 child-parent pairs. "Clinicians should recognize that even extremely overweight children...

Reducing salt intake could help combat childhood obesity.(Across Specialties)
June 1, 2008... Dietary salt intake significantly drives consumption of sugar-sweetened soft drinks in children and adolescents, an analysis of British survey data has shown. This is the first time such a link has been described in young people, Dr. Feng...

Asthma outreach program poised to expand; New York city-based initiative estimates cost per underserved pediatric patient is down by $4,490.(Across Specialties)
June 1, 2008... MIAMI BEACH -- Physicians who run a successful outreach and treatment program for underserved, inner-city children and adults with asthma plan to expand nationwide once they determine the essential and cost-effective components. The...

Youths overestimate asthma control.(Across Specialties)
June 1, 2008... HONOLULU -- Nearly three-quarters of adolescents with asthma overestimate their level of asthma control, according to a study of more than 200 teens. Their degree of overestimation is often large as well, said Dr. Maria Britto of...

Influenza may affect kids' asthma outcome.(Across Specialties)
June 1, 2008... HONOLULU -- Consider influenza testing in children hospitalized for asthma because those with both conditions have almost five times the chance of intubation or death, compared with asthmatic children without a comorbid condition, according to...

Medicare panel alarmed by sharply rising hospice costs.(Practice Trends)
June 1, 2008... WASHINGTON -- Staggering growth in the popularity of hospice services--and in the rise of for-profit hospice providers--has caught the attention of the Medicare Payment Assessment Commission. At their recent meeting, MedPAC commissioners...

MedPAC gives final backing to bundled pay for hospitalization.(Practice Trends)
June 1, 2008... WASHINGTON -- The Medicare Payment Advisory Commission has given its backing to bundling payment for hospitalization, which would essentially give hospitals and physicians an incentive to control costs and avoid readmissions. At its April...

IAN registers nearly 24,000.(POLICY & PRACTICE)
June 1, 2008... Kennedy Krieger Institute's Interactive Autism Network (IAN), the first U.S. autism registry, has registered nearly 24,000 individuals in its first year and is helping to facilitate approximately 75 research projects across the United States,...

Hurricanes' mental health impact.(POLICY & PRACTICE)
June 1, 2008... Fifty-three percent of Louisiana residents said that the 2005 Hurricanes Katrina and Rita had an impact on the mental health of people living in their community, according to an April 2008 survey of 800 randomly selected adults that was...

Disorders cause billions in losses.(POLICY & PRACTICE)
June 1, 2008... A new study suggests that major mental disorders cost $193 billion a year in lost earnings. Ronald Kessler, Ph.D., a professor of health care policy at Harvard University, Boston, and his colleagues analyzed data from 4,982 respondents to the...

Half of America on drugs.(POLICY & PRACTICE)(Report)(Brief article)
June 1, 2008... Medco Health Solutions has determined that 51% of insured Americans--children and adults--were taking prescription medications for at least one chronic condition in 2007. The pharmacy benefit management company analyzed a representative sample...

Direct-to-consumer genetic testing.(POLICY & PRACTICE)
June 1, 2008... Patients should be fully informed about how to interpret direct-to-consumer genetic tests, which provide only the probability of developing a disease, according to a new policy statement from the American College of Medical Genetics. The...

Working with psychotherapists now important in physician.(Practice Trends)
June 1, 2008... SAN FRANCISCO -- In psychiatry, the thinking has changed on working with psychotherapists who lack medical degrees, according to Dr. John Q. Young. Dr. Young, a psychiatrist with the University of California, San Francisco, said knowing...

Charter sets rules for physician ratings.(Practice Trends)
June 1, 2008... Under an agreement among physicians, consumers, employers, and large insurers, some health plans have agreed to have their physician rating systems audited by independent experts. The announcement comes after physicians across the country...

Medical home concept now closer to reality.(Practice Trends)
June 1, 2008... WASHINGTON -- The concept of a medical home is one step closer to reality for Medicare patients, after it received strong backing from the Medicare Payment Advisory Commission. All 17 commissioners present at the meeting in April voted to...

McCain plan relies on tax changes, cost control.(Practice Trends)
June 1, 2008... While the Democrats continue to debate the need for individual mandates for health coverage, Sen. John McCain recently unveiled a starkly different plan for reforming the health care system. At the heart of Sen. McCain's health proposal is...

Massachusetts plan is doing well.(Practice Trends)
June 1, 2008... WASHINGTON -- Don't believe what you read in the national media: The Massachusetts health coverage plan enacted in 2006 is actually doing quite well, thank you very much. That was the message from John McDonough, D.P.H., executive director...

PTSD increases hospitalizations in primary care.(Practice Trends)
June 1, 2008... Posttraumatic stress disorder is associated with a doubling of the number of hospitalizations and more than twice the use of mental health resources for urban primary care patients, according to a cross-sectional study published in the journal...

Quality of care initiative.(FYI)
June 1, 2008... The Centers for Medicare and Medicaid has released "The Hospital-Acquired Conditions in Acute Inpatient Prospective Payment System Hospitals Fact Sheet" and "The Present on Admission Indicator Reporting by Acute Inpatient Prospective Payment...