Challenges faced by inpatient child/adolescent psychiatric nurses

Inpatient nurses work to engineer an environment in which patients and staff are physically and psychologically safe. A recent research study on an adult psychiatric unit examined the dimensions involved in keeping the unit safe. The four dimensions included ideology, people (staff and patients), space, and time. In this article, we discuss how these dimensions apply to real-world efforts to keep child and adolescent inpatient units safe. We also discuss the challenges nurses face within each of these safety dimensions, including those arising from fluctuating acuity, staffing formulas, surveillance of physical space, and entrenched unit cultures.     

Where do underage college students get alcohol?

Alcohol consumption and related problems are common among underage college students, yet qualitative, in-depth information on how/where these students obtain alcohol is limited. We conducted focus groups pertaining to access to alcohol and related issues with 19 underage college students. They reported that alcohol is easy to obtain from a variety of sources, with friends/acquaintances who are of legal age or those with a false ID being the most common. Parties were also common sources, but "shoulder tapping" (i.e., asking a stranger to purchase alcohol) was not common. Disagreement arose over whether underage fraternity/sorority members have greater access to alcohol than non-Greeks. Our results provide updated information on the various sources of alcohol and associated issues among underage college students.     

The relationship between childhood abuse and suicidality in adult bipolar disorder

This study evaluates the effect of childhood sexual and physical abuse on suicidality in adults with bipolar disorder. We conducted a retrospective chart review of adult outpatients (N= 381) with DSM-IV-TR-defined bipolar disorder seeking evaluation and treatment at an academic specialty research program (i.e., Mood Disorders Pharmacology Unit, University Health Network, University of Toronto) between October 2002 and November 2005. Eighteen percent (n = 68) of adult patients with bipolar disorder had a recorded history of childhood abuse (p = 0.009). Sixty-three percent (n = 43) of bipolar patients with a history of childhood abuse reported lifetime suicidality (chi2 = 6.885, df= 1, p = 0.009). Logistic regression analysis indicated that Childhood abuse was a significant predictor of lifetime suicidality in adult bipolar patients (OR = 2.05, CI = 1.19-3.510). Childhood abuse is associated with suicidal ideation and suicide attempts in adults with bipolar disorder. Anamnestic inquiry regarding childhood maltreatment is salient to risk assessment, illness management planning, preventative strategies, and treatment interventions in bipolar disorder.     

Is the Gene-Environment Interaction Paradigm Relevant to Genome-Wide Studies? The Case of Education and Body Mass Index

This study uses data from the Framingham Heart Study to examine the relevance of the gene-environment interaction paradigm for genome-wide association studies (GWAS). We use completed college education as our environmental measure and estimate the interactive effect of genotype and education on body mass index (BMI) using 260,402 single-nucleotide polymorphisms (SNPs). Our results highlight the sensitivity of parameter estimates obtained from GWAS models and the difficulty of framing genome-wide results using the existing gene-environment interaction typology. We argue that SNP-environment interactions across the human genome are not likely to provide consistent evidence regarding genetic influences on health that differ by environment. Nevertheless, genome-wide data contain rich information about individual respondents, and we demonstrate the utility of this type of data. We highlight the fact that GWAS is just one use of genome-wide data, and we encourage demographers to develop methods that incorporate this vast amount of information from respondents into their analyses.     

Private Polls and Presidential Policymaking: Reagan as a Facilitator of Change

Did the Reagan administration disregard majority will when craftingits policy initiatives? Did it cater to a narrow partisan constituencyinstead? The answers to these questions will help with an assessmentof Jacobs and Shapiro’s (2000b) hypothesis that presidentssince the late 1970s have used private White House survey researchas a tool to manipulate or assuage centrist public opinion whilemeeting the policy demands of their partisan core supporters,resulting in a decline in presidential responsiveness to majoritywill. Using the actual surveys administered by Richard Wirthlin(Reagan’s pollster) between 1981 and 1983, this articlewill demonstrate the level of consistency between majority opinionon 129 policy issues and Reagan’s behavior through 1984,and it will explore the conditions under which the presidentwas more or less likely to respond to public preferences. Thedata reveal that the Reagan administration was constrained bythe popular will in predicable ways: if the policy issues wereabout domestic concerns, highly popular, and visible in themedia, then the administration acted in line with public preferencesmore than 70 percent of the time. Further, Reagan and his adviserswere selective in responding to party activists: they championedissues drawn from their conservative ideological agenda thatfit with the current tide in public opinion, while sidesteppingother issues dear to party activists that encountered strongmajority resistance. While I do not contest Jacobs and Shapiro’s(2000b) important observation that presidents often use surveyresearch to "craft talk" in an attempt to channel the publicdebate, the evidence here highlights how the president nonethelessremains constrained by the popular will, at least on domesticissues.