Residential alternatives to hospitalization for patients with severe and persistent mental illness: should patients with comorbid substance abuse be excluded?

Residential alternatives to hospitalization for adults with severe mental illness in crisis were not designed for, and often exclude, persons with coexisting substance abuse disorders. Given high comorbidity rates, however, it is important to know whether residential alternatives can be effective for patients with dual diagnoses. To explore the impact of comorbidity on treatment outcomes, structured interviews were conducted at admission and discharge with 92 consecutive admissions to a residential alternative. Using the Structured Clinical Interview for DSM-III-R, two groups were identified: 24 patients with and 68 patients without comorbid substance abuse disorders. At admission, the two groups were similar in demographic and clinical characteristics. The treatment was effective independent of comorbidity; at discharge, treatment success, symptom improvement, and patient satisfaction were similar for both groups. Persons with coexisting substance abuse disorders remained in residence a week longer, but the difference was not statistically significant. Residential alternatives appear suitable for patients with dual diagnoses.     

Childlessness in the United States: estimates from the National Survey of Family Growth

Using a representative sample of about 17,000 ever married women 15 to 44 years of age, this article presents national estimates of the prevalence and correlates of voluntary, involuntary, and temporary childlessness in the United States. These three groups of childless couples are compared with the parents of small planned families and other parents on a number of social, economic, marital, and family characteristics. When viewed cross sectionally, voluntarily childless couples constitute between 1.3% and 1.8% of currently married couples, depending on the definitions used. They are a distinctive but rare population. Their future prevalence depends primarily on the decisions of the large group of temporarily childless couples.     

Prophylactic Peritoneal Dialysis After the Arterial Switch Operation: A Retrospective Cohort Study

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The Art of Supporting Families Faced with Neonatal Transport

When newborns and their families are separated due to neonatal transport, it's critical to support families to ensure emotional and physical well‐being of both babies and parents. Care providers at both sending and receiving facilities play an equally important role in providing education, information and support to families separated from newborns. A family‐centered care approach in neonatal transport is truly a multidisciplinary, multiunit and multisystem approach.