The relationship of intimate partner aggression to head injury, executive functioning, and intelligence

Measures of head injury, executive functioning, and intelligence were given to a community sample composed of 102 male perpetrators of intimate partner aggression (IPA) and 62 nonaggressive men. A history of head injury and lower mean score on a measure of verbal intelligence were associated with the frequency of male-perpetrated physical IPA as reported by male perpetrators and their female partners. Lower mean scores on a measure of verbal intelligence also predicted frequency of psychological IPA perpetration. Using the perpetrator subtypes outlined by Holtzworth-Munroe et al. (2000), analyses revealed that compared with other groups, the most severely aggressive subtypes (i.e., borderline-dysphoric and generally violent-antisocial) were the most likely to report a history of head injury and to have significantly lower mean scores on a neuropsychological test of verbal intelligence. The possible role of neuropsychological factors in IPA perpetration and implications for prevention and intervention programs are discussed.     

The Effects of First Occupation on Long Term Health Status: Evidence from the Wisconsin Longitudinal Study

In this paper, we use a longitudinal survey that has collected information for 50 years on a large cohort of Wisconsin high school graduates and their siblings to examine the long term impact of early occupational choice on health status. We find evidence that beginning a career in a blue collar occupation is correlated with several measures of poor health outcomes at ages 50–65. Since our dataset includes usually unobserved pre-labor market characteristics, including IQ and childhood health status, we can show that controlling for these variables is important for many results and suggests a high level of selection into occupation based on health and ability. We also provide evidence of gender differentials in the association between first occupation and later health. Then, we replace our basic measure of occupational categories with summary measures of job characteristics and find that employment at “bad jobs” at the beginning of an individual’s career predicts later health outcomes. Finally, we use sibling information in the dataset to show that unmeasured family background factors explain a large share of the effects of occupation on later health. Overall, the evidence points to limited, though heterogeneous, long term effects of health from blue collar employment.     

The Efron dice voting system

About 50?years ago, Efron noted some counterintuitive properties of the long-term behavior of contests involving dice. For instance, consider the 6-sided dice whose sides are labeled (4,4,4,4,0,0), (3,3,3,3,3,3), (6,6,2,2,2,2), and (5,5,5,1,1,1). Each die has a 2/3 probability of rolling a higher number than the next one in the list and the last has the same 2/3 probability of rolling a higher number than the first. The non-transitivity of games involving non-identical dice was popularized by Gardner (Sci Am, 223:110–114, 1970). Although Gardner and other authors have observed that non-transitive dice serve to illustrate the complexities of the theory of voting, it does not seem that much attention has been paid to the corresponding voting system. Our purpose in this article is to present this voting system and compare its properties with those of other voting systems. One of the most interesting properties is the fact that cancellation with respect to the Efron dice voting system can replace cancellation with respect to pairwise preferences in Young’s characterization of the social choice function associated with the Borda Count.     

Predictors of treatment outcome in a child and adolescent psychiatry clinic: A naturalistic exploration

We present data on predictors of treatment outcome for 3200 consecutive referrals to a child and adolescent psychiatry clinic. Using Reliable Change Index (RCI) methodology, we divided children into those who, between intake and discharge, improved, stayed the same, or got worse according to clinician-rated impairment. Most predictors of improvement were related to parent variables (marital status, maternal anxiety, and ethnicity), while those associated with deterioration were tied to child status (extent of psychiatric comorbidity, history of placement in a self-contained classroom, and a prior trial of psychotropic medications). The implications of these findings for data-driven program development, clinic management, treatment planning, and systems of care are discussed.     

Enclosed versus open nursing stations in adult acute care psychiatric settings: does the design affect the therapeutic milieu?

Specific efforts by hospital accreditation organizations encourage renovation of nursing stations, so nurses can better see, attend, and care for their patients. The purpose of this study was to examine the effect of nursing station design on the therapeutic milieu in an adult acute care psychiatric unit. A repeated cross-sectional, pretest-posttest design was used. Data were collected from a convenience sample of 81 patients and 25 nursing staff members who completed the Ward Atmosphere Scale. Pretest data were collected when the unit had an enclosed nursing station, and posttest data were collected after renovations to the unit created an open nursing station. No statistically significant differences were found in patient or staff perceptions of the therapeutic milieu. No increase in aggression toward staff was found, given patients' ease of access to the nursing station. More research is needed about the impact of unit design in acute care psychiatric settings.     

Delirium: a very common problem you may not recognize

Older adults with multiple pre-existing conditions are admitted to hospitals with acute illnesses and injuries every day. Delirium is not recognized by clinicians across health care settings. With awareness of risk factors and knowledge of delirium, nurses can play a pivotal role in the early identification, treatment, and, most important, prevention of delirium in older adults. Nurses often display a lack of knowledge related to delirium and the complex symptoms that appear differently in the presence of other complicating co-morbid conditions in aging adults. Nurses play a crucial role in keeping patients safe and ensuring optimal outcomes, regardless of the setting. With the growing population of older adults and the expected increases in chronic illness and dementia, delirium is a problem nurses are likely to experience in all practice settings. Knowing what to look for facilitates recognizing the risk and acting early to minimize (or even prevent) delirium.     

Risky recreation: synthetic cannabinoids have dangerous effects

Use of synthetic marijuana (also known as spice, K2, aroma, and eclipse) is often viewed by young people as harmless recreation. Until recently, the substance was freely available in U.S. convenience stores and head shops, and it is still available via the Internet. Emerging evidence shows a wide range of responses to the drug, including paranoia, aggressive behavior, anxiety, and short-term memory deficits. Synthetic cannabinoids are not currently detectable via standard toxicology tests. Recognition and management of synthetic cannabinoid use are discussed.     

Off-label medication use

Prescribing medications for off-label uses is not illegal. Off-label prescribing includes using medications for unapproved indications; using a drug outside of the recommended dosage range or duration of use; using a drug in certain unapproved patient populations, such as those defined by age, sex, or particular clinical parameters; or intentionally using a medication in a patient who has a known contraindication. Medications would be considered appropriate for off-label use based on their known clinical pharmacology, evidence from clinical studies, and sometimes from the personal experience of the prescriber. The decision to use a drug off label should be based on a careful assessment of the patient's treatment history and the drug's potential risks and benefits. Patients should be given adequate informed consent about how the drug is being used off label and why, along with appropriate information about known risks and side effects.