Process and Outcome of Rehabilitation of Homeless Veterans and Their Relationship with Personality Style

Abstract

Treatment process and outcome data for 225 consecutive admissions to a rehabilitation program for the homeless were reviewed. The Northeast Program Evaluation Center's criteria were employed to evaluate participation and outcome (e.g., general, employment, and housing) for participants. Significant relationships were found between predominant personality features and degree of participation in program and living arrangements at discharge.     

Influenza-associated global amnesia and hippocampal imaging abnormality

The acute phase of influenza infection is rarely associated with significant cognitive dysfunction. We describe a case of a 24 year-old man who developed global amnesia in the acute phase of influenza A infection. His deficits resolved over the course of several weeks. Transient abnormalities of diffusion and T2-weighted imaging were seen in the bilateral hippocampi. We review cerebral complications of influenza and discuss the possible role of previously proposed mechanisms in our patient’s case.     

Taking the pressure off in the Emergency Department: evaluation of the prophylactic application of a low shear,soft silicon sacral dressing on high risk medical patients

Pressure injuries are key clinical indicators of care standard. In Australia, pressure injuries increase length of hospital stay by 4·31 and cost $285 million annually. This pilot study examined the effectiveness of sacral dressing in reducing the prevalence of pressure injuries in older, high‐risk patients. A non randomised one‐sample experimental design was used in this study comprising of four phases. Of the 51 patients recruited to the study, one patient developed a sacral pressure injury compared to six patients identified in a known group with similar demographics who were not approached to participate in the study. The results indicated that patients in the known group were 5·4 times more likely to develop a pressure injury than the intervention group. Findings suggest that applying a protective sacral dressing with a low shear backing as part of a simple standardised prevention injury prevention regime commencing in the Emergency Department was beneficial in the prevention of pressure injury in older ‘at high risk’ medical patients.     

Repeated episodes of chronic intermittent ethanol promote insensitivity to devaluation of the reinforcing effect of ethanol

Studies in animal models have shown that repeated episodes of alcohol dependence and withdrawal promote escalation of drinking that is presumably associated with alterations in the addiction neurocircuitry. Using a lithium chloride-ethanol pairing procedure to devalue the reinforcing properties of ethanol, the present study determined whether multiple cycles of chronic intermittent ethanol (CIE) exposure by vapor inhalation also alters the sensitivity of drinking behavior to the devaluation of ethanol's reinforcing effects. The effect of devaluation on operant ethanol self-administration and extinction was examined in mice prior to initiation of CIE (short drinking history) and after repeated cycles of CIE or air control exposure (long drinking history). Devaluation significantly attenuated the recovery of baseline ethanol self-administration when tested either prior to CIE or in the air-exposed controls that had experienced repeated bouts of drinking but no CIE. In contrast, in mice that had undergone repeated cycles of CIE exposure that promoted escalation of ethanol drinking, self-administration was completely resistant to the effect of devaluation. Devaluation had no effect on the time course of extinction training in either pre-CIE or post-CIE mice. Taken together, these results are consistent with the suggestion that repeated cycles of ethanol dependence and withdrawal produce escalation of ethanol self-administration that is associated with a change in sensitivity to devaluation of the reinforcing properties of ethanol.     

Sexuality among Spanish adults with diabetes: A population-based case control study

ObjectivesTo describe and compare sexuality between subjects with diabetes with matched non-diabetic controls.MethodsPopulation based case control study using individual data from the Spanish National Sexual Health Survey. Diabetes status was self reported, we selected type 2 patients. We identified 461 diabetes sufferers. Two controls were matched by age, sex and sexual partner for each diabetic case.Sexuality measures included: sexual activity, importance of sex, satisfaction with partner, bothersome with one's sexual life and self-rated sexual health. Independent variables included: socio-demographics, physical health, chronic diseases and medications use.ResultsNo differences were found in “Sexually activity”, “Importance of sex” or “Bothersome” between those with and without diabetes. Dissatisfaction with partner was 25% in women with diabetes and 12.9% in non-diabetic controls (Adjusted-OR 1.82 95%CI 1.02–4.85).Diabetes sufferers reported sexual health as “fair/poor/very poor” more than their non-diabetic control, 58.1% vs. 45.1% for women (Adjusted-OR 1.74 95%CI 1.15–2.63) and 54.3% vs. 38% for men (Adjusted-OR 1.88 95%CI 1.29–2.75).Among diabetes sufferers “fair/poor/very poor” sexual health was associated with poorer physical health, not having a sexual partner and among men taking heart medications.ConclusionsWomen and men with diabetes have significantly worse sexuality measures than non diabetic controls.     

Exploring predictors of medication adherence among inpatients with schizophrenia in Singapore's mental health settings: A non-experimental study

Schizophrenia is a mental disorder, which is marked by frequent relapses. The main reason for relapse is nonadherence to antipsychotics. A cross-sectional, correlational research study was conducted with a convenience sample of 92 participants. The primary aim of this study was to explore the predictors of medication adherence among inpatients with schizophrenia hospitalised at tertiary hospitals in Singapore. Post-hoc analysis revealed that insight, religion, side effects, types of antipsychotics, social support from significant others, nurse-client relationship, were significant predictive factors. Results from this study added knowledge to the nursing literature about medication adherence of schizophrenia patients and in Singapore setting.