Goal Setting Among People Living with Mental Illness: A Qualitative Analysis of Recovery Camp

People living with mental illness (consumers) often experience difficulty in achieving life goals, particularly those important for their recovery. An innovative approach to address consumers' goals for recovery can be found in the form of therapeutic recreation (TR) initiatives. Recovery Camp is a five-day TR program, bringing together people with a serious mental illness, undergraduate health students, and staff members. This article aims to examine the types of goals set by consumers in the context of Recovery Camp, and to what extent the self-identified goals were attained. The consumers (n = 27) were invited to set goals that they wished to achieve during the week. On the final day of Recovery Camp, each participant rated the degree to which they felt that each of their goals was achieved or not. The goals were themed using content analysis, revealing four key themes: connectedness, developing healthy habits, challenging oneself, and recovery. All goals were, to some extent, attained. The results suggest people with a mental illness are able to both set and evaluate the self-identified goals in the context of a TR initiative. A collaborative recovery approach indicates that goal planning should be undertaken in direct consultation with the consumer.     

Preparing Nursing Students for Mental Health Care: The Impact of a Recovery-oriented Clinical Placement

The provision of mental health care has recently focused on the concept of recovery-oriented care. Clinical placements are important for imparting recovery-oriented knowledge and skills to students. However, it has been determined that not all clinical placements are beneficial for future nursing professionals. The aim of this study was to examine what elements of professional learning were facilitated by engagement in a recovery- and recreation-based clinical placement for pre-registration nursing students called Recovery Camp. Qualitative data were collected through individual interviews and reflective journals of pre-registration nurses. Findings from this study indicate that Recovery Camp enhanced students' understanding of stigma, developed their professional knowledge and applied skills, and helped them gain insight into the role a consumer plays in his/her own recovery journey. Placements that allow pre-registration nurses the opportunity to authentically engage with people with a lived experience of mental illness may assist in the effective development of future professionals in meeting their diverse needs.     

Meaning of resilience as described by people with schizophrenia

The aim of the present study was to understand the meaning of resilience, as described by people with schizophrenia. Building resilience is a component of recovery‐oriented mental health care, and yet almost no research has been conducted into the resilience of people who live with schizophrenia and who are routinely considered vulnerable. Establishing the meaning of resilience in the context of schizophrenia is an important first step in building understanding. van Kaam's psychophenomenological method was used to interpret 14 interviews with people with schizophrenia who are currently well and living in the community. Resilience is invoked in the tension between opposing forces of challenge and support and in the act of ‘striving’ to take control of schizophrenia. Striving includes repeated, seemingly backwards steps, and during this, the person takes risks and seeks out and uses supportive people and resources. Those same supportive people and resources can also be challenging. Resilience is an energy embedded in the process of recovery from schizophrenia, and is manifest in an attitude of striving. Taking on challenges and engaging in risk is important within treatment and recovery from schizophrenia.     

膈肌疲劳对呼吸中枢驱动的影响

膈肌是主要的呼吸肌，我们设想膈肌疲劳可能会导致呼吸中枢驱动增高以维持正常的通气功能。为验证这一假说，我们在6名健康人身上记录膈肌疲劳前后所进行的二氧化碳重复呼吸时的食道膈肌肌电压。采用具有4个电极对的多导食道电极导管记录膈肌电压，同时用胃食道球管法记录磁刺激下的食道、胃和跨膈肌电压。     

Sniff nasal inspiratory pressure in children

Maximal static inspiratory pressure (P(IMAX)) generated at the mouth is one of the tests of inspiratory muscle strength in children. In adults, inspiratory muscle strength has also been assessed using sniff nasal inspiratory pressure (SNIP). This test is easier to perform than P(IMAX) and might therefore be applicable to children. To test this hypothesis, we measured P(IMAX) and SNIP in 116 children aged 4 to 11 years (54 girls, 62 boys). P(IMAX) was measured using a tube mouthpiece and SNIP using a tightly fitting plug in one nostril, while a sniff was performed through the other nostril. Both tests were performed from functional residual capacity (FRC). Pressure was measured with a differential pressure transducer and displayed in real time on a computer screen. Weight, standing height, sitting height, gender, and age were recorded. There was a significant difference (P < 0.01) in group mean (SD) data between SNIP (81.3 (27.4) cmH(2)O) and P(IMAX) (67.9 (28.1) cmH(2)O). Bland/Altman analysis demonstrated a mean difference of -13.5 cmH(2)O (SD 21.4) between the techniques. Regression analysis indicated highly significant relations (P < 0.01) between SNIP and P(IMAX), and between weight, standing and sitting height, and age for SNIP, and between weight, standing height, and age for P(IMAX). SNIP and P(IMAX) were greater in boys than girls (83.2 vs. 79.2 cmH(2)O SNIP; 72.9 vs. 62.0 cmH(2)O P(IMAX)), but this difference was only significant for P(IMAX) (P < 0.05). SNIP was significantly greater than P(IMAX) (P < 0.01) in both boys and girls. These data suggest that SNIP provides a simple, noninvasive additional test to P(IMAX) for assessing inspiratory muscle strength in children.     

Adductor pollicis twitch tension assessed by magnetic stimulation of the ulnar nerve

Many critically ill patients develop significant skeletal muscle weakness in the Intensive Care Unit (ICU), which ultimately may cause difficulties in weaning from mechanical ventilation and a protracted, expensive ICU stay. Reliable monitoring of muscle strength in this environment is difficult. The purpose of this study was to develop a reproducible, nonvolitional method of measuring adductor pollicis (AP) muscle function by magnetic stimulation of the ulnar nerve (MSUN) that could be applied to patients in the ICU and operating theater (OT). Fifty subjects (32 healthy control subjects [12 of whom were elderly], 12 ICU patients with critical illness [mean APACHE II score 20], and six otherwise healthy patients requiring minor surgery in the OT) received MSUN. In 12 of the normal subjects electrical stimulation of the ulnar nerve (ESUN) and MSUN were compared and AP twitch tension (Tw AP) and surface electromyogram (EMG) were measured. Close agreement was found between supramaximal Tw AP (median [95% CI] for MSUN 6.3 N [5-7.2 N] and ESUN 6.9 N [5.2-7.8 N] [p = NS]). Median (95% CI) values with MSUN for the 20 young and 12 elderly control subjects were 6.9 N (5. 3-7.4 N) and 7.1 N (4.4-9.8 N). Median (95% CI) Tw AP for the ICU group was 4.2 (2.2-6.7 N) and for the OT group was 5.8 (4-9.1 N). Tw AP was significantly reduced in ICU patients compared with age-matched controls (p = 0.01). MSUN can be used to measure neuromuscular function in both the laboratory and clinical settings including the ICU.     

Interactions in the aetiology,presentation and management of synchronous and metachronous adenocarcinoma of the prostate and rectum

Adenocarcinoma of the prostate and rectum are common male pelvic cancers and may present synchronously or metachronously and, due to their anatomic proximity. The treatment of rectal or prostate cancer (in particular surgery and/or radiotherapy) may alter the presentation, incidence and management should a metachronous tumour develop. This review focuses on the interaction between prostatic and rectal cancer diagnosis and management. We have restricted the scope of this large topic to general considerations, management of rectal cancer after prostate cancer treatment and vice versa, management of synchronous disease and cancer follow-up issues.     

Stigma in the media: Investigating journalism students attitudes towards mental illness

Given the profound role that media play in public opinion, there exists an ongoing necessity to understand the portrayal of mental illness by journalists. There is a plethora of studies that have examined how mental illness is portrayed in the media, but few studies have sought to understand what journalist opinions about mental illness are, and none could be found regarding journalism students’ opinions. This study aimed to bridge this gap by examining journalism student’s attitudes towards mental illness using the Social Distance Scale (SDS). This study adheres to STROBE guidelines for cross-sectional studies. One hundred and seventy-two undergraduate journalism students (n = 172) completed the SDS with findings suggesting that students had moderate stigmatizing attitudes, with varying degrees of stigma present depending on the social context. Positively framed reporting and constructive media coverage surrounding mental illness may be improved by shared communication and education with health professionals who specialize in mental health: mental health nurses.