From the Editor—“Beat ‘Em Up,Lock ‘Em Up,or Give ‘Em Up”: The Disgraceful Routes to Mental Health Services for American Children

A theoretical framework explaining how survivors of sexual violence use spirituality to respond to or recover from sexual violence is presented. Data were drawn from open-ended interviews of 27 women and 23 men who participated in a larger, ongoing study of women's and men's responses to sexual violence. Grounded theory methodology was used to develop the core category of Being Delivered, reflecting the participants' experiences of being rescued, saved, or set free from the effects of sexual violence by a spiritual being or power. The theoretical framework describing Being Delivered is composed of three dimensions: Spiritual Connection, Spiritual Journey, and Spiritual Transformation. The framework can be used by clinicians to guide discussions of spirituality and healing with survivors of sexual violence.     

From the Editor—Inadequate Treatment of Adolescent Mental Disorders

Relationships are critical to a woman's growth and development, yet when living with serious mental illness, developing and nurturing connections can be challenging. This qualitative study explored the nature and quality of support provided within relationships for 14 women with schizophrenia. Families were key supporters. Female friends with mental illness often provided a meaningful source of connection for participants. Problematic relationships, losses over time, and living in poverty were among the barriers to receiving needed support. Participants conveyed a sense of wanting relational reciprocity as they talked about their relationships and place within the community.     

Distribution of prenatal and postnatal risk factors for sudden infant death in Budapest

Mortality from coronary heart disease has decreased by 60% in Finland during the past 25 years. The prevalence of coronary heart disease decreased during the 1990s among the elderly. Silent myocardial infarction was common, especially in elderly women. The number of coronary angioplasty or bypass operations has increased considerably, especially in men. Objective &;#114 - &;#114 To characterise the prevalence of, and changes in, coronary heart disease (CHD) among men and women aged between 64 and 71 years in the 1990s. Design &;#114 - &;#114 A study of clinical epidemiology involving two cohorts of elderly persons in 1990 - 1991 and 1998 - 1999. Setting &;#114 - &;#114 Primary health care in the municipality of Lieto in southwestern Finland. Subjects &;#114 - &;#114 Persons between 64 and 71 years of age in the southwest of Finland in 1990-1991 and 1998-1999. Main outcome measures &;#114 - &;#114 The occurrences of CHD were estimated using the history of a previous myocardial infarction or coronary revascularisation procedure evident in the medical records and with ischaemia or infarction as established on ECG according to the Whitehall criteria. Results &;#114 - &;#114 The prevalence of 'probable' CHD decreased among men and women aged between 64 and 71 years, whereas the prevalence of 'possible' CHD decreased among women alone. Silent myocardial infarctions were common among women of both cohorts. Many more men of the second cohort, compared to the first one, had undergone a coronary angioplasty or bypass operation. Conclusion &;#114 - &;#114 The prevalence of CHD decreased among elderly women more clearly than among young elderly men. The favourable development illustrating a decrease in the prevalence of CHD among women should be sustained, while health promotion activities will need to be directed more actively towards men.     

The EPICS Family Bundle and its effects on stress and coping of families of critically Ill trauma patients

AimThe aim of this study was to evaluate impact of the EPICS Family Bundle on stress and coping.BackgroundCritical care nurses frequently deal with family stress, but may be without knowledge and skills needed to assist families to cope.MethodsA non-equivalent control group design was used, with a convenience sample of 84 family members of critically ill patients. During the control phase, participants completed tools measuring stress and coping. The intervention included use of the EPICS Family Bundle. After implementation, participants completed the same tools as those administered during the control phase. Outcomes were analyzed using independent-sample t-tests.ResultsThe experimental group had a significantly higher coping score on two subscales; and although not statistically significant, it was also improved on an additional four.ConclusionAfter implementation of the intervention, families experienced improved coping. The study may have lacked sufficient power to detect all differences.