Prevention of Mental and Substance Use and Abuse Disorders and Comorbidity in African Americans

Regrettably for African Americans, research has rarely addressed issues that affect their health and well-being. This lack of attention manifests itself in the dearth of literature available while doing literature reviews on prevention of comorbid mental illness and substance abuse (MISA) and substance use and abuse disorders in African Americans. However, there are a few studies on the prevention of substance use and abuse disorders alone and the prevention of relapse in African Americans with MISA problems. These articles form the basis of our proposal to prevent co-morbidity of mental and substance use and abuse disorders in African Americans.     

Training police trainees about ways to manage trauma and loss

For the second year we were invited to be trainers at a training seminar for senior police educators, held in the German Federal Police University and sponsored by the European Police College, hence, having the opportunity to build on their previous applications. We applied exercises (psychoeducation, mindfulness/awareness, journaling, processing in dyads) that introduced in this training and designed to teach officers how to handle exposure to adversities and minimize potential negative consequences. Police officers expect exposure to potentially traumatic incidents, yet, often suffer deeply because of unresolved trauma related to handling horrific events. Our work aimed to open discussion in order to formulate a standard component in training curricula related to teaching police trainees ways to effectively handle and process trauma.     

Nitric oxide in patients with schizophrenia: the relationship with the severity of illness and the antipsychotic treatment

Objectives: Past studies regarding the relationship between nitric oxide and schizophrenia have reported controversial results. Consequently, the aims of this study are i) to analyze the differences in nitric oxide concentration between patients with schizophrenia and healthy controls, ii) to investigate the influence of antipsychotic treatment on nitric oxide, iii) to correlate nitric oxide concentration with severity of illness, and iv) to investigate the relationship between nitric oxide and any personality disorder.

Research design and methods: We recruited 24 patients and 24 controls; the sample was divided into three groups of 8 patients, each according to the pharmacological treatment (haloperidol, olanzapine, or risperidone). The severity of illness was assessed by PANSS and personality traits were evaluated by SCID II. A blood sample was taken to assess the plasma concentration of nitrites and nitrates.

Results: Patients presented higher nitrate levels than controls (p < 0.05); subjects under olanzapine reported lower nitrate levels than those treated with risperidone (p < 0.05) or haloperidol (p < 0.001). Nitrate levels were correlated with PANSS total score (rho = 0.748; p < 0.001), but not with SCID II scores.

Conclusions: Despite the fact that this study found a correlation between PANSS score and nitrate levels, it is unclear whether nitric oxide is related to the severity of schizophrenia, because nitrate levels are also affected by antipsychotic treatment.     

Violence among comorbid and noncomorbid severely mentally ill adults: A pilot study

This pilot study examined the relationship between substance dependence and violence in a sample of severely mentally ill adults. Subjects were 42 psychiatric outpatients enrolled in a clinical case management program in San Francisco, California. Almost 40% of the participants reported perpetrating at least one violent act in the past 12 months. Comorbid participants were over 4% times more likely to commit a violent act in the past 12 months than noncomorbid participants. Substance dependence was also more frequently associated with perpetration of a violent act by female than by male participants and by Caucasian than by African American participants. Comorbid mentally ill participants appear more likely to perpetrate violent acts than those with mental illness alone. The dangers of substance dependence in terms of the perpetration of violence may not be in mental illness or substance dependence alone but in their co‐occurrence. Further investigation is needed to assess risk factors for violence and victimization in multiple environmental and situational domains. It will be important to explore the moderating effects of gender and race on the co‐occurrence of mental illness, substance dependence, and the perpetration of violent acts.     

STAFFING PATTERNS

Unsolved staffing pattern issues are viewed in the current context of funding pressures, third party payment, and management necessity for program and cost projections. Relevant factors are mustered for consideration with their implications. Use of differentiated skill levels and response as well as development of departmental services mandate are considered. The author also shares his experientially derived throughts on staff ratio to certain institutional assignments.     

The Use of a Rehabilitation Team for Stroke Patients

A multidisciplinary team affiliated with a large urban hospital is described and evaluated with respect to its effects on stroke patients. Twenty-six patients who had been referred to the team in a 7-month period were compared with a group of 32 patients who had not been referred to the team. Patients were evaluated on the basis of their scores on a functional health scale mailed to them 3 months after their discharge from the hospital. The results of this project indicate that the patients seen by this team scored higher on functional health than those not seen by this team.     

专科护士培训体验式教学理论模型的构建

目的 构建重症医学专科护士培训体验式教学理论模型.方法 以贵州省重症医学专科护士培训教学活动为基础,采用文献分析法、问卷调查法、实证研究法、经验总结法,研究重症医学专科护士培训体验式教学理论模型.结果 构建了包括四内容(教学目标、教学内容、教学形式、教学评价),四环节(危重患者护理体验、反思与分享、感悟内化、实践与应用)、三过程(基础、提高、升华)的循环上升式重症医学专科护士培训体验式教学理论模型.结论该理论模型展现了重症医学专科护士培训体验式教学的规律,为专科护士培养提供优化的教学途径.     

Increasing Older Adults’ Use of Positive Reappraisal Coping for Chronic Physical Illness

Positive reappraisal, a cognitive emotion regulation strategy of identifying personally relevant positive meaning following a stressor, has been demonstrated to be particularly relevant for older adults. However, research has not examined whether this strategy can be taught to older adults to facilitate coping. We examined whether we could increase chronically ill older adults’ use of positive reappraisal and whether it was associated with increased positive emotion and reduced distress. Twenty-six community-dwelling older adults with a current medically diagnosed chronic physical illness perceived to be at least moderately stressful were taught to use positive reappraisal. Participants reported increased positive reappraisal use and emotional well-being, indicating that positive reappraisal can be taught to chronically ill older adults to facilitate coping.