Resilience,mental health and Assertive Community Treatment

Clinicians try to promote resilience by building an effective therapeutic relationship with their clients. Assertive Community Treatment (ACT) is an established approach for providing services to individuals with severe mental illness who have not fared well in the regular mental health system. This work underscores the importance of a resilient therapeutic relationship in preventing relapse and assuring adherence to therapeutic outcomes. Persistent psychiatric illness takes a toll on the resilience of the client, while the relationship work takes a toll on the resilience of the clinician. This article explores the concept of relational resilience between clinician and client as a dynamic process of shared success and failure, progress and regression through cycles of crisis, stabilization, relapse, and partial recovery. This is a qualitative study exploring how ACT clinicians promote and sustain resilience and is based on interviews with social workers, nurses, occupational and recreational therapists, coordinators, and psychiatrists.     

Cognitive therapy: a training model for advanced practice nurses

1. Mental health needs exist in medically underserved areas and can be addressed in nurse-managed, community-based health centers. 2. Cognitive therapy techniques can be used in community-based health centers to intervene and alleviate patients' distress and improve their adherence to treatment. 3. A training program in cognitive therapy can help advanced practice nurses and other health care providers implement the techniques needed to address many behavioral and mental health problems.     

不确定性在团队授权与新产品开发业绩关系中的作用

一个最新的理论研究表明授权的作用取决于环境中不确定性的程度。在对212个新产品开发项目的定量研究中,发现了团队授权与创新速度之间显著性相关关系。对由技术新颖性和技术动态性这两个不同因素引起的技术不确定性作了区分。结果发现,团队授权和创新速度之间的关系被技术动态性所调节,而技术新颖性则不能。通过进一步的研究发现,在不确定性较低的情况下,无论来源于技术新颖性或技术动态性,团队授权和创新速度均呈U形函数关系。这说明在不确定性较低的情况下,要么完全授权,要么完全不授权或高层介入,都有利于提高创新速度。与之形成对应,在不确定性高的情况下,团队授权和创新速度之间的关系受技术新颖性和技术动态性的影响是不同的。当技术新颖性高时,团队授权和创新速度之间呈线性关系,而当技术动态性高时,二者呈反U形函数关系。对于后者,极高程度的团队授权并不加快创新速度。这些结果说明,应该根据研发项目的不确定性的不同来源与水平选择不同的团队授权策略。这些发现或许也表明,技术动态性比技术新颖性对不确定性有更重要的影响。     

The cognitive model. Interventions for improved patient-provider communication.

1. Improving patient-provider interactions mandates an understanding on the part of health care providers of patients' situations, thoughts, feelings, and behaviors. 2. The cognitive model, a cornerstone of cognitive therapy, provides a framework to understand the patient's perspective of his or her situation or illness, which is a necessary component of effective patient-provider interactions. 3. Distance learning formats provide flexibility in meeting continuing education needs and allow learners and presenters to interact in a virtual mode.     

Young Men as Victims and Perpetrators of Violence in Northern Ireland: A Qualitative Analysis

This article explores issues of masculinity and violence in the lives of young men in disadvantaged areas in Northern Ireland. Qualitative data were collected in four focus groups, one group of young men from the Catholic community, one group of young men from the Protestant community, one group of community representatives, and one group of Young Offenders ( N = 28). Themes were extracted from the data using a grounded approach. Results indicate that social disadvantage is fundamental to experiences of violence and that young men understand the costs and benefits of a masculine identity that incorporates a capacity for violence. Discussion suggests that initiatives to reduce violent behavior should be compatible with socially and culturally acceptable constructions of masculinity.     

The impact of routine assessment of past or current mental health on help-seeking in the perinatal period

BackgroundClinical practice guidelines now recommend that women be asked about their past or current mental health as a routine component of maternity care. However, the value of this line of enquiry in increasing engagement with support services, as required, remains controversial.AimThe current study aimed to examine whether assessment of past or current mental health, received with or without referral for additional support, is associated with help-seeking during pregnancy and the postpartum.MethodsA subsample of women drawn from the Australian Longitudinal Study on Women's Health (young cohort) who reported experiencing significant emotional distress during pregnancy (N = 398) or in the 12 months following birth (N = 380) participated in the study.ResultsMultivariate analysis showed that women who were not asked about their emotional health were less likely to seek any formal help during both pregnancy (adjOR = 0.09, 95%CI: 0.04–0.24) and the postpartum (adjOR = 0.07, 95%CI: 0.02–0.13), as were women who were asked about these issues but who were not referred for additional support (antenatal: adjOR = 0.26, 95%CI: 0.15–0.45; postnatal: adjOR = 0.14, 95%CI: 0.07–0.27). However, considerable levels of consultation with general practitioners, midwives and child health nurses, even in the absence of referral, were evident.ConclusionThis study demonstrates that enquiry by a health professional about women's past or current mental health is associated with help-seeking throughout the perinatal period. The clinical and resource implications of these findings for the primary health care sector should be considered prior to the implementation of future routine perinatal depression screening or psychosocial assessment programmes.     

Patterns of Compensatory Behaviors and Disordered Eating in College Students

Abstract. Objective: The current study investigated rates of endorsement of eating-related compensatory behaviors within a college sample. Participants: This sample included male and female students (N = 1,158). Methods: Participants completed the Eating Disorder Examination Questionnaire (EDE-Q). The study defined 3 groups of students: those who did not endorse purging behaviors, those who endorsed only exercise, and those who endorsed laxative use or vomiting. Rates of related eating disorder risk variables were compared across the 3 groups. Results: Almost half of college students reported utilizing exercise as a compensatory strategy over the past 28 days. Those reporting compensatory exercise did not differ from other community and college samples on EDE-Q subscales. Conclusions: Findings suggest that college students report significant rates of compensatory exercise, and those who report exercise as their only compensatory behavior also report relatively low levels of eating disorder risk.     

Estimation of a multivariate normal covariance matrix under a certain structure

We consider the estimation of Σ of the p-dimensional normal distribution N_p (0, Σ) when Σ?=?θ₀ I_p ?+?θ₁ aa′, where a is an unknown p-dimensional normalized vector and θ₀?>?0, θ₁?≥?0 are also unknown. First, we derive the restricted maximum likelihood (REML) estimator. Second, we propose a new estimator, which dominates the REML estimator with respect to Stein's loss function. Finally, we carry out Monte Carlo simulation to investigate the magnitude of the new estimator's superiority.