A nursing tool for adherence and recovery in psychosis: a pilot study

Clients with psychotic disorders are at great risk for relapse and rehospitalization. This risk is magnified by poor adherence to medications, as well as refusal to accept optimal treatment planning, including more beneficial atypical medications. Adherence can be even more compromised because of clients' poor insight into these illnesses and their inability to recognize the potential for recovery that exists when taking medications as prescribed. This poor insight makes effective collaboration in treatment more difficult and is an exceptionally troubling impediment to successful treatment. Currently, there are few effective strategies to improve insight into psychosis. We have developed the Levels of Recovery from Psychotic Disorders Scale (LORS) as a teaching tool. It is designed to identify strengths and weaknesses in insight in order to provide the basis for an intervention to enhance and promote change. This article reviews the relevant literature on adherence and insight in this population of clients with psychotic disorders. It also reviews a pilot study comparing the LORS to the BASIS-32. The findings provide the basis for future studies using the LORS to enhance insight, adherence, and recovery.     

The impact of seating and positioning on the development of repetitive strain injuries of the upper extremity in wheelchair athletes

The population of people who use wheelchairs has been increasing due to technological advances. With this increase, there has also been an increase in participation in wheelchair sports. The incidence of upper extremity injury in wheelchair users has been reported to be between 31 and 73% [2,13,23,26,29]. Wheelchair athletes may be at an increased risk for upper extremity injury due to increased upper extremity use with sport. The purpose of this paper is to ascertain whether proper seating and positioning have an impact on the prevention of repetitive strain injuries (RSI) of the soft tissues, including peripheral nerve entrapments and muscle injury, of the upper extremity in wheelchair athletes. A review of current research on wheelchair propulsion and RSI revealed several hazards for wheelchair athletes to develop RSI's. These include duration of impairment, muscle imbalance, awkward positioning, inadequate rest breaks, repetition of muscle use in daily activities and in sport participation, the degree of force needed for propulsion, and fatigue. Current research does not provide conclusive information on optimal seating. Suggestions of preventative measures are given including suggestions with regard to positioning in the wheelchair.     

Does the impact of anti-drinking and driving Public Service Announcements differ based on message type and viewer characteristics?

The purpose of this study was to inform future Public Service Announcement (PSA) development by examining the potential effectiveness of different types of anti-driving under the influence (DUI) PSAs for persons with different characteristics. PSAs utilizing empathy, fear, and informational approaches were shown to persons recruited from psychology courses (n = 137) and individuals that were mandated to treatment following a DUI offense (n = 17). The empathy approach was perceived to be the most effective and evoked the most negative affect, followed by fear and informational approaches. Less experience with DUI, lower sensation seeking, higher motivation to change, and higher perception of dangerousness of DUI all emerged as good predictors of higher perceived effectiveness of anti-DUI PSAs. Gender differences in perceived effectiveness were examined for fear and empathy PSAs, with inconclusive findings.     

Mental health among college students: do those who need services know about and use them?

OBJECTIVE: The objective of this study was to examine connections between university students' mental health and their knowledge and use of campus mental health services. PARTICIPANTS AND METHODS: In March 2001, a sample of undergraduate students (N = 266) completed a Web-based questionnaire, providing information related to their mental health, knowledge of mental health services, and use of those services. RESULTS: Students who were mentally distressed were more likely to know about and use services; however, some students who reported to be mentally distressed either did not know about services or knew about services but did not use them. Living off campus, identifying as male, and having fewer years in college were related to less knowledge of campus mental health services. In addition, female sex and number of years in college were predictive of higher service use. CONCLUSIONS: With the high prevalence rates and severity of mental health problems, university mental health providers must continue to make strategic efforts to disseminate knowledge about mental health services to all students.     

Reflections on citizen-state child welfare partnerships: Listening to citizen review panel volunteers and agency liaisons

Objective

Previous research pertaining to the citizen review panel (CRP) initiative indicates that discrepancies exist between panel member and state agency liaison perceptions of CRP effectiveness in fulfilling the CAPTA CRP mandate. This study explores the impressions of both CRP members and liaisons involving barriers to effective CRP-state child welfare partnerships and recommendations to improve the relationship, provided through narrative survey responses from CRP liaisons from 30 states and D.C. and panel members from 32 states and D.C. Thematic categories which emerged from analyses of these responses are discussed, and a conceptual model and substantive-level theory of the CRP-child protective services (CPS) relationship developed from the results are presented.

Results

The complex nature of CRP-CPS relationships emerged as the central theme among CRP members' and liaisons' responses. Liaisons and CRP members identified a need for CRP members to become more educated globally on child welfare despite the relatively high level of education and experience of much of the sample. Difficulties encountered by panel members in the effort to partner surfaced in themes of mistrust and skepticism about the worth of citizen participation in child protection. Negative agency attitudes, lack of role clarity, and lack of commitment to authentic partnership were cited as negative influences upon the relationship by both liaisons and CRP members. The most important preferred outcome of the partnership was that citizen volunteers would become more knowledgeable partners who could meaningfully contribute to child welfare efforts. A second desired outcome important to CRP members was to form a shared vision with CPS.

Conclusions

Findings imply that when key components of mutual respect, legitimacy, CPS knowledge, shared vision, authenticity, citizen engagement, honest communication, and a serious, deliberative process are in any way impeded, the partnership is vulnerable to breakdown, and intended outcomes may be compromised.

Implications

Important relational difficulties that have formed barriers between volunteers and CPS agencies have been identified, and results suggest specific issues to target for improvement. These findings can prompt a more informed discourse about the challenges and opportunities presented when attempting to engage citizens in child welfare practice and policy-making, and can lead to new research paths. Suggestions for such efforts are offered.     

Make Your Work Matter: development and pilot evaluation of a purpose-centered career education intervention

Developing a sense of purpose is both salient and desirable for adolescents, and purpose in people's lives and careers is associated with both general and work-related well-being. However, little is known about whether purpose can be encouraged through school-based interventions. This article reports the results of a quasi-experimental pilot study and follow-up focus group that evaluated Make Your Work Matter, a three-module, school-based intervention designed to help adolescent youth explore, discover, and enact a sense of purpose in their early career development. Participants were eighth-grade students. Compared to the control group, the intervention group reported increases in several outcomes related to purpose-centered career development, such as a clearer sense of career direction; a greater understanding of their interests, strengths, and weaknesses; and a greater sense of preparedness for the future. However, no significant differences were found on items directly related to purpose, calling, and prosocial attitudes. These results inform the ongoing development of Make Your Work Matter and other school-based career interventions and pave the way for larger-scale trials of such purpose-promoting intervention strategies.     

It’s not only for the money: an analysis of adolescent versus adult entry into street prostitution

Numerous studies examine the causal factors of entrance into prostitution and find economic marginalization, substance addiction, and interpersonal networks are common reasons women enter the trade. However, we know less about the role that age of onset plays in shaping female pathways into prostitution. Here, we build from insights into previous research by analyzing not only entry pathways but also how age categories are linked to time spent in the trade and whether the length of time in prostitution exacts a greater “toll” on women. Drawing from the feminist and age of onset literatures, we analyze 40 in-depth interviews with female street prostitutes from five U.S. cities. Our results underscore the importance of age as an organizing feature of women’s pathways into prostitution and the potential associated consequences of working in this trade.     

Online surveys for BGLT research: issues and techniques

Online surveys are becoming increasingly popular for accessing less visible and decentralized populations, including bisexual, gay, lesbian and transgender (BGLT) populations. Advances in technology and convenience for the both the researcher and the participant have facilitated this trend. In this paper, we explore issues related to conducting BGLT survey research online, such as making decisions about survey formats, target populations and recruitment, compensation, access.     

Global generations: social change in the twentieth century

The concept of generation within sociology has until recently been a marginal area of interest. However, various demographic, cultural and intellectual developments have re-awakened an interest in generations that started with the classic essay by Karl Mannheim. To date, the sociological literature has generally conceptualized generations as nationally bounded entities. In this paper we suggest that the sociology of generations should develop the concept of global generations. This conceptual enhancement is important because the growth of global communications technology has enabled traumatic events, in an unparalleled way, to be experienced globally. The late nineteenth and early twentieth century was the era of international generations, united through print media, and the mid-twentieth century saw the emergence of transnational generations, facilitated by new broadcast communications. However, the latter part of the twentieth century is the period of global generations, defined by electronic communications technology, which is characterized, uniquely, by increasing interactivity. The 1960s generation was the first global generation, the emergence of which had world-wide consequences; today with major developments in new electronic communications, there is even more potential for the emergence of global generations that can communicate across national boundaries and through time. If in the past historical traumas combined with available opportunities to create national generations, now globally experienced traumas, facilitated by new media technologies, have the potential for creating global generational consciousness. The media have become increasingly implicated in the formation of generational movements. Because we are talking about generations in the making rather than an historical generation, this article is necessarily speculative; it aims to provoke discussion and establish a new research agenda for work on generations.