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Adequately prepared educators are critical to the success of children in rural settings, but many educators receive little training on how to support students with disabilities. Professional development for educators is challenging in rural areas due to the lack of opportunities and travel requirements. Project ECHO™ was originally developed to overcome similar challenges facing physicians. The ECHO Model overcomes these challenges by creating a hub and spoke network that connects local providers with experts. These networks meet regularly over teleconferencing technology to conduct a short professional development workshop, followed by a case-study from one of the local sites. We adapted the ECHO Model for use in education and since 2014 implemented four networks: autism, assistive technology, secondary transitions, and behavioral supports. Educators found ECHO highly acceptable and reported improved skills and knowledge. ECHO for Education is effective and has the potential to improve capacity of education systems in rural settings.

Objectives: Research demonstrates consistent relations between posttrauma symptoms and interpersonal dysfunction. The current study examined the extent to which perceptions of community rejection account for the relation between posttraumatic stress disorder (PTSD) and interpersonal outcomes in students exposed to assaultive and nonassaultive trauma. Method: Participants (N = 137; 66.4% female; M = 20 years) completed a trauma history interview, questionnaires assessing symptom severity, social disapproval, and interpersonal outcomes. Results: Assault survivors (n = 83) reported greater symptoms (d = 0.57), disapproval (d = 0.80), and social impairment (d = 0.51) relative to the nonassault group (n = 54). However, regression analyses indicated stronger associations between PTSD and community disapproval in survivors of nonassaultive (β = 0.69; p < 0.001) versus assaultive (β = 0.34; p < 0.001) events. Indirect effects of PTSD on perceived support and interpersonal functioning through social disapproval were also larger for nonassaultive versus assaultive groups (p < 0.05). Conclusion: Despite greater dysfunction among assault survivors, perceptions of disapproval may be a more salient factor for interpersonal dynamics following nonassaultive trauma. [ABSTRACT FROM AUTHOR]

Chronic hepatitis C virus (HCV) viral infection is the most common blood-borne viral infection and approximately 2%-3% of the world's population or 170-200 million people are infected. In the United States as many as 3-5 million people may have HCV. Psychiatric and substance use disorders (SUDs) are common co-morbid conditions found in people with HCV and are factors in predisposing people to HCV infection. Also, these co-morbidities are reasons that clinicians exclude people from antiviral therapy in spite of evidence that people with HCV and co-morbid psychiatric and SUD can be safely and effectively treated. Furthermore, the neuropsychiatric side effects of interferon (IFN), until recently the mainstay of antiviral therapy, have necessitated an appreciation and assessment of psychiatric co-morbidities present in people with HCV. The availability of new medications and IFN-free antiviral therapy medication combinations will shorten the duration of treatment and exposure to IFN and thus decrease the risk of neuropsychiatric side effects. This will have the consequence of dramatically altering the clinical landscape of HCV care and will increase the number of eligible treatment candidates as treatment of people with HCV and co-morbid psychiatric and SUDs will become increasingly viable. While economically developed countries will rely on expensive IFN-free antiviral therapy, less developed countries will likely continue to use IFN-based therapies at least until such time as IFN-free antiviral medications become generic. The current manuscript discusses the efficacy and viability of treating HCV in people with psychiatric and SUDs comorbidities, the treatment of the neuropsychiatric side effects of IFN -based therapies and the impact of new medications and new treatment options for HCV that offer the promise of increasing the availability of antiviral therapy in this vulnerable population.

A pilot program that delivers telemental health care for posttraumatic stress disorder provides best practices for facilities looking to expand in-home and remote care to veterans., Competing Interests: Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.