Alexithymia and Pathological Gambling

ABSTRACT

The purpose of this study was to study the relationship between alexithymia and gambling in a community sample of pathological gamblers. Pathological, problem and non-problem gamblers were recruited from the community via advertisements and completed an assessment of their gambling behavior and the Toronto Alexithymia Scale. Alexithymia was higher among male pathological gamblers who identified slot machines, cards, and lotteries as their primary gambling problem. High alexithymics scored higher on Diagnostic and Statistical Manual symptoms related to poor self-regulation, communication, and problem-solving skills. Although a correlational study, the evidence suggests that further investigation of the clinical significance of alexithymia in individuals with severe gambling pathology is indicated.     

Planning and evaluating innovations in nursing practice by measuring the ward atmosphere

A controlled evaluation of nurses' and patients' perceptions of the hospital ward atmosphere served to both define problems and evaluate the corrective changes that were implemented in a psychiatric day hospital. The results indicated that nurses and patients held similarly unfavourable views of the ward at a baseline assessment, including low levels of support, involvement, spontaneity and programme clarity. This finding then served as the basis for systematic changes, including staff training, the regrouping of patients, and revising the therapeutic programme. A repeat evaluation then indicated that these changes had significantly improved the ward atmosphere from the perspective of both nurses and patients. It is concluded that this approach holds considerable promise for the implementation of changes in nursing practice.     

Setting performance goals In geriatric nursing

Behavioural techniques are increasingly being applied in the geriatric field as part of a broader emphasis on psychological and social treatments in the care of the elderly. The nurse is in the best position to analyse a patient's performance and manage an intervention programme; however, some nurses have had little experience of autonomously diagnosing problems and setting performance goals.
The authors argue that it is important to set such goals and give examples of how performance may be objectively specified, prerequisites made explicit, criteria for success defined and the consequences of goal attainment or non-attainment discussed with those most concerned.
A complex situation drawn from the geriatric setting which was used as part of a teaching workshop to help nurses define suitable targets for intervention is described in the Appendix.     

Intralipid Prolongs Survival in a Rat Model of Verapamil Toxicity

Objectives: Verapamil is a lipid-soluble calcium channel blocker with significant mortality in overdose. Previous investigators have demonstrated the benefit of lipid emulsion therapy in ameliorating toxicity from lipid-soluble agents. The authors investigated the effect of Intralipid treatment in a rat model of verapamil toxicity.
Methods: Thirty sedated Wistar rats were infused with verapamil at 37.5 mg/kg/h. Five minutes after the start of infusion, animals were treated with a bolus of either 12.4 mL/kg 20% Intralipid or 12.4 mL/kg 0.9% saline. Verapamil infusion was continued until the animals were killed. Respiratory rate, heart rate, and electrocardiography were sampled every 2.5 minutes throughout.
Results: Survival was prolonged in the Intralipid-treated group (44 ± 21 vs. 24 ± 9 minutes; p = 0.003). The median lethal dose was increased in the Intralipid group (25.7 mg/kg [95% confidence interval {CI} = 24.7 to 26.7] vs. 13.6 mg/kg [95% CI = 12.2 to 15.0]). A less marked decrease in heart rate was observed during verapamil infusion in the Intralipid-treated group (6.8 beats/min [95% CI = 8.3 to 5.2] for Intralipid vs. 10.7 beats/min [95% CI = 12.6 to 8.9] for saline; p = 0.001).
Conclusions: Intralipid treatment prolongs survival and doubles median lethal dose in a rat model of verapamil toxicity. The mechanism of action remains to be elucidated.     

Pathological Spending as a Form of Psychological Dependence

A case report is presented of A. B., a 24-year-old woman with a 6-year history of over-spending, which continued despite the considerable psycho-social damage to herself and her family. Features of this case are presented which demonstrate a type of‘psychological dependence’upon spending and which suggest that‘pathological spending’should be recognized as a previously undescribed syndrome.