Overcoming medication refusal using a patient-centered approach

The refusal of psychotropic medication is a challenge faced by many healthcare providers when treating patients with mental illness. Controversy surrounds medication refusal because some mental health professionals believe that psychiatric patients should be forced to take medications for the safety of the general public, while patients are often acutely aware of potential lifelong adverse side effects and are sometimes reluctant to comply. The proposed alternative to this problem begins with developing the patient-provider relationship through a patient-centered approach. This approach emphasizes the individual needs of patients and creates opportunities for input from patients about their care, which helps form relationships of mutual trust and respect between patients and providers. This article explores the literature to: (1) understand some of the challenges and controversies involved in patient medication refusal from a clinical and societal level; (2) identify some issues in a patient-centered approach; and (3) make some brief clinical and policy recommendations that might help to bring about an increase in the use of patient-centered care. Hopefully, as efforts are made toward a patient-centered approach, increased psychotropic medication adherence and decreased medication coercion will result as providers listen and act upon the needs of their patients.     

Couples’ Communication About Financial Uncertainty Following the Great Recession and its Association with Stress,Mental Health and Divorce Proneness

Economic uncertainty is typically stressful and conflict-inducing for couples. The findings from the current study, however, suggest that economic uncertainty can also strengthen marriages. The sample included 82 Latino and Caucasian married couples. The couples engaged in a stressful conversation about their economic uncertainty in the wake of the Great Recession. Many of the couples were resilient and even grew from their experiences with the recession. The couples’ resilience and risk when talking about financial uncertainty and stress were revealed in four communicative pathways: unifying, thriving, pragmatic and at-risk. These communicative patterns predicted self-reported and physiological stress, mental health indices and divorce proneness. In general, unified/thriving couples had higher levels of psychological well-being and less self-reported stress, anxiety, and divorce proneness compared to pragmatic and at-risk couples.     

Crawling Predicts Infants’ Understanding of Agents’ Navigation of Obstacles

We investigated whether crawling versus noncrawling infants interpret an agent's movements around an obstacle as goal‐directed. Infants (6–9 months) were habituated to a self‐propelled circle jumping over an obstacle to reach a goal. When the obstacle was removed, infants who crawled (n = 13) showed longer looking time to the familiar but now nonrational jumping path versus a novel but rational straight‐line path. Noncrawlers (n = 17) did not discriminate. Looking preference was independent of age and speed of habituation. These findings support the claim that infants’ processing of agency emerges early and applies to all agents, but stress the role of experience in the development of action interpretation.     

Sexuality and the dual‐earner couple,part II: Beyond the baby years

This article reports results from two data sets testing predictions that a couple's sexual relationship suffers if the wife is employed, particularly if she is employed full time or high full time. A multiple‐theory framework was used, fusing the scarcity hypothesis, the enhancement hypothesis, and identity theory. The last suggests that an important individual difference variable, spouse role salience, should be related to a couples sexual functioning. In Study 1, data from the National Health and Social Life Survey were analyzed, focusing on 1,744 married persons. No significant differences in sexuality were found between women employed part, full, or high full time, nor between men employed full or high full time. In Study 2, data from the Wisconsin Maternity Leave and Health project were analyzed, focusing on 261 couples when they had a 4.5‐year‐old child. There were no differences between homemakers and women employed part, full, or high full time for several measures of sexual functioning. Neither were there differences between husbands employed full and high full time. More important were individual differences in spouse role salience.     

Do “Clicker” Educational Sessions Enhance the Effectiveness of a Social Norms Marketing Campaign?

Abstract

Objective: Social norms campaigns are a cost-effective way to reduce high-risk drinking on college campuses. This study compares effectiveness of a “standard” social norms media (SNM) campaign for those with and without exposure to additional educational sessions using audience response technology (“clickers”). Methods: American College Health Association's National College Health Assessment questions are used to evaluate actual and perceived use. Additional survey questions assess individual exposure to the interventions. Results: The authors find “clicker” technology to be more effective than social norms poster media alone in reducing misperceptions of normative alcohol use for those students who attended clicker sessions. Conclusion: Poster SNM campaigns may be most effective when supported by group “clicker” heath-related sessions.     

Infusing Career Development to Strengthen Middle School English Language Arts Curricula

An approach is presented for strengthening middle school standards‐based English language arts (ELA) classroom instruction by infusing theory‐ and research‐supported career development constructs and practices. Over an 8‐week period, 90 urban 7th graders participated in an integrated ELA–career development curriculum. Career agency emerged as an important construct for students. It was related to key markers of ELA achievement (i.e., standardized test scores, grades, and positive change in 6th‐ to 7th‐grade test scores) and elaborated on in nuanced ways by students in their written narratives. Four themes related to career agency were identified in student writings: time perspective, challenges of self‐direction, career development, and social and emotional development. Advantages for students and schools related to synergy, scale, and sustainability are discussed.     

Testofen,a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease,increases testosterone levels and improves sexual function in healthy aging males in a double-blind randomised clinical study

This study examined the effect of Testofen, a specialised Trigonella foenum-graecum seed extract on the symptoms of possible androgen deficiency, sexual function and serum androgen concentrations in healthy aging males. This was a double-blind, randomised, placebo-controlled trial involving 120 healthy men aged between 43 and 70 years of age. The active treatment was standardised Trigonella foenum-graecum seed extract at a dose of 600?mg/day for 12 weeks. The primary outcome measure was the change in the Aging Male Symptom questionnaire (AMS), a measure of possible androgen deficiency symptoms; secondary outcome measures were sexual function and serum testosterone. There was a significant decrease in AMS score over time and between the active and placebo groups. Sexual function improved, including number of morning erections and frequency of sexual activity. Both total serum testosterone and free testosterone increased compared to placebo after 12 weeks of active treatment. Trigonella foenum-graecum seed extract is a safe and effective treatment for reducing symptoms of possible androgen deficiency, improves sexual function and increases serum testosterone in healthy middle-aged and older men.     

Employee perceptions of reputation: An ethnographic study

The ability of organizational members to identify and analyse stakeholder opinion is critical to the management of corporate reputation. In spite of the significance of these abilities to corporate reputation management, there has been little effort to document and describe internal organizational influences on such capacities. This ethnographic study conducted in Red Cross Queensland explores how cultural knowledge structures derived from shared values and assumptions among organizational members influence their conceptualisations of organizational reputation. Specifically, this study explores how a central attribute of organizational culture – the property of cultural selection – influences perceptions of organizational reputation held by organizational members. We argue that these perceptions are the result of collective processes that synthesise (with varying degrees of consensus) member conceptualisations, interpretations, and representations of environmental realities in which their organization operates. Findings and implications for organizational action suggest that while external indicators of organizational reputation are acknowledged by members as significant, the internal influence of organizational culture is a far stronger influence on organizational action.     

Brief Emotion Focused Family Therapy: An Intervention for Parents of Children and Adolescents with Mental Health Issues

This study evaluated the 2‐day intensive modality of Emotion Focused Family Therapy (EFFT). The intervention attempts to prepare parents to take a primary role in their child's recovery from a range of mental health issues. One hundred and twenty‐four parents completed the intervention and provided data a week prior to intervention, post‐intervention and at 4‐month follow‐up. Results include significantly reduced parent blocks and increased parental self‐efficacy in relation to involvement in their child's recovery, as well as significant improvement in child symptomatology. The findings confirm positive results from an earlier pilot study involving eating disorders and demonstrate the potential for EFFT as an intervention for a range of clinical problems in children and youth.