Community service utilization by youths hospitalized in a state psychiatric facility

A majority of a cohort of 62 children and adolescents who had been hospitalized in a state psychiatric facility was found to have received less restrictive services such as outpatient mental health services prior to their index admission. Also, a number had been involved with the juvenile justice system and almost two-thirds had been placed out-of-home. Ninety percent had at least one prior psychiatric hospitalization. Just over half of the cohort received case management and individual counseling post release. About a third received family counseling, and a few received other types of services. At least a third were rehospitalized within a year of release. Although 90% of the cohort received some type of service post release, a higher proportion of non service receivers were rehospitalized than service receivers. Even those who received services had a high rate of rehospitalization. These findings raise questions as to the appropriateness of service provision during and following hospitalization.This study was funded by a grant from the Office of Program Evaluation and Research, Ohio Department of Mental Health.     

Effect of family role on response to disaster

This study hypothesized that family role (marital and parental status) would moderate the effect of disaster exposure on the mental health of victims. The study included St. Louis residents exposed to floods and dioxin, as well as Puerto Rican respondents exposed to floods and mudslides. In St. Louis, worst outcomes were found for single and married parents exposed to disaster, substantially exceeding the symptomatology of all unexposed respondents except non-victim single parents. In Puerto Rico, victims without families had higher levels of alcohol abuse symptoms than did any other subgroup. Perceived emotional support was found to be an important moderator of disaster's effect on psychiatric distress in this site, generally overriding the effect of family role. Single parents in both sites who were exposed to disaster had substantially reduced levels of emotional support available to them, as compared to unexposed single parents, suggesting that single parents are at particularly high risk for losing access to emotional support following a disaster. This study suggests that both single and married parents constitute important high-risk victim groups. The findings also suggest that those perceiving they lack adequate emotional support, regardless of family role, may be in special need of services.     

Effects of MK-801 and Phenytoin on Flurothyl-Induced Seizures During Development

Summary We determined the effects of the N-methyl-Daspartate (NMDA) receptor blocker MK-801 (0.05, 0.1, and 0.5 mg/kg intraperitoneally, i.p.) and phenytoin (PHT, 5, 10, and 20 mg/kg i.p.) on flurothyl-induced clonic and tonic-clonic seizures in 9-, 1 5, 30-, and 60-day-old male rats. Both agents had seizure-, age-, and dose-specific effects. The highest dose of MK-801 was anticonvulsant against clonic flurothyl-induced seizures only in 9- and 60-day-old rats, but suppressed tonic-clonic seizures in all ages. The lowest dose of MK-801 (0.05 mg/kg) produced significant anticonvulsant effects only in 15 day old rats. PHT did not have any effect on clonic seizures throughout development. Both doses of PHT (10 and 20 mg/kg) were anticonvulsant against tonic-clonic seizures in adult rats but not in any other age group. The results indicate that NMDA receptors play an important role in tonic-clonic flurothyl-induced seizures throughout development (especially in 15-day-old rats) and that the anticonvulsant effects of PHT may vary at different stages of brain development.     

Age-Specific Effects of Baclofen on Pentylenetetrazol-Induced Seizures in Developing Rats

Summary: Purpose : To determine whether seizures have age-specific features, we studied the role of γ-aminobutyric acid, (GABAB) transmission in rats of various ages (9, 15, 30, and 60 postnatal days). Methods: We used a GABA, receptor agonist baclofen (2 or 5 mg/kg intraperitoneally, i.p.) and a GABA_B receptor antagonist CGP 35348 (100 or 600 mg/kg i.p.) in the pentylenetetrazol (PTZ)-induced model of clonic and tonic-clonic seizures (100 mg/kg subcutaneously, s.c.).
Results : Whereas baclofen was anticonvulsant and CGP 35348 proconvulsant in most animals, there were distinct age-related differences in the effectiveness of these drugs and the antagonist had some anticonvulsant activity in adults. Furthermore, the two drugs acting at GABA_B receptors had a different profile of action in clonic seizures as compared with tonic-clonic seizures.
Conclusions : The differences in the age-specific action of the GABA_B agonist and antagonist suggest that different GABA_B receptor subsets may mediate the drug effects. The results indicate that putative antiepileptic drugs (AEDs) must be tested during development because it may not be possible to extrapolate age-specific anticonvulsant effects from studies in adult animals.     

Impact of Social Confrontation on Rat CD4 T Cells Bearing Different CD45R Isoforms

The impact of social defeat on lymphocyte subpopulations and T helper subsets was investigated in Long Evans rats. CD4 T helper cell subsets with distinct functional properties and different cytokine profiles can be distinguished by using the mAbs OX-22 (anti-CD45RC) and OX-7 (anti-CD90, Thy1.1). Male intruders were exposed for 2, 6, or 48 h to aggressive resident pairs. All intruders were attacked upon introduction and were defeated as indicated by frequent display of full submissive postures. After 2 and 48 h of confrontation, drastic but differential effects on blood leukocyte numbers, CD4 and CD8a cells, and CD4 subsets were evident. However, after 6 h of confrontation most lymphocyte subset numbers corresponded to baseline levels. Focusing on CD4 subsets after 2 h of confrontation, we demonstrated that only the number of the CD45RC⁻CD90⁻subset declines, whereas neither the number of the CD45RC⁺CD90⁻subset nor the number of the CD45RC⁻CD90⁺subset (recent thymic emigrants) was influenced. Con A stimulation of sorted subsets identified the CD45RC⁻CD90⁻as a poor producer of IFN-γ. The data clearly demonstrate that social factors might differentially influence not only T cell subsets but also T helper cell subsets with distinct cytokine profiles in a possibly time-dependent manner. Such a stress-induced shift toward a CD45RC⁺CD90⁻-dominated milieu may have important consequences in interpreting results obtained from mitogenic stimulation of blood lymphocytes and cytokine production profiles measured after such a stimulation. In addition, a shift toward a CD45RC⁺CD90⁻dominance may modify the type and magnitude of immune response, at least temporarily.     

Combat-related posttraumatic stress disorder among second-generation Holocaust survivors: preliminary findings

The authors assessed the impact of the Nazi Holocaust on the course and symptoms of posttraumatic stress disorder (PTSD) among Israeli combat stress reaction casualties. They examined a sample of 96 such casualties of the 1982 Lebanon War whose parents had gone through the Nazi Holocaust and compared them to casualties who did not have such family history for 3 consecutive years beginning 1 year after their participation in the war. Results showed that 2 and 3 years after their participation in the 1982 Lebanon War, the children of Holocaust survivors, i.e., "second-generation" casualties, had higher rates of PTSD than did the control subjects, as well as a somewhat different clinical picture. Clinical and methodological implications of the findings are discussed.     

Primary Health Care through a community based smoking-cessation program

The International Conference on Primary Health Care, meeting in Alma-Ata, in the Soviet Union, September 12, 1978, expressed the need for urgent action by all governments, all health and development workers and the world community, to protect and promote the health of all people of the world. The world was caught by the phrase which emerged from this conference, Health For All by the Year 2000 and many have examined the articles of the Alma-Ata declaration and tried to implement them in their corner of the world. This paper describes a community-based smoking-cessation program which was implemented in the province of Nova Scotia, Canada, during the years 1980–1984. Primary to this project was the belief that people have the right and the duty to participate individually and collectively in planning and implementing their health care. This paper describes one community's effort in putting this belief into practice.Carol Smillie, B.N. BE.d. M.S.c. is an Assistant Professor at the School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada B3H 3J5, Katherine Coffin, BA, MEd is the Program Officer, Nova Scotia Office, Health Promotion Directorate Health and Welfare Canada, 5251 Duke Street, Halifax, Nova Scotia. Canada B3J 1P3. Kathryn Porter, B.A. (Gen)., is the Information and Education Coordinator, Nova Scotia Division Canadian Cancer Society. Brenda Ryan, B.A., M.B.A. is Program Evaluation Analysist, Nova Scotia Department of Health, 6088 Hollis Street, Halifax. Nova Scotia, Canada. This Project was funded by Health and Welfare Canada, Nova Scotia Department of Health, Nova Scotia Division Canadian Cancer Society, Requests for reprints should be addressed to: Professor Carol Smillie.     

Malignant pleural effusions: pleurodesis using a small-bore percutaneous catheter

This study describes our experience using a percutaneously placed small-bore catheter for drainage of malignant pleural effusions and subsequent instillation of a sclerosing agent to obliterate the pleural space. We treated 15 consecutive patients with known metastatic cancer and a symptomatic pleural effusion. Twelve patients survived for more than four weeks after the procedure; 11 of these 12 patients had a successful objective clinical response. The procedure was well tolerated, with little or no discomfort during catheter placement and the maintenance period. No serious complications were encountered. We conclude that the use of a small-bore percutaneously placed "pneumothorax" catheter in the management of malignant pleural effusions is an effective and more comfortable alternative to large-bore closed-tube thoracostomy.