The Four Es 1-Year Later: A Tool for Predicting the Development of Gambling Problems

The Four Es is a 40-item scale measuring psychological risk for the development of problem gambling behavior. One-year follow-up interviews (n = 395) from a previously reported phone survey in Queensland, Australia (n = 2,577) (Rockloff & Dyer, 2006) tested the ability of the Four Es instrument to prospectively identify persons who would later develop gambling problems. Two groups of participants were selected for the 1-year follow-up interviews, including (1) persons who had gambling problems, high-risk alcohol abuse problems, and/or substance abuse problems (abuse group); and (2) a random selection of other persons from the original survey (random group). The results indicated that the “Excess” trait, which measures impulsive behavior, was predictive of relative increases in gambling problems for both groups over the 1-year period. Additionally, the Four Es questionnaire showed good psychometric properties in the surveys, with a test-retest reliability of r = .70 and a Cronbach’s alpha reliability of α = .90 and .92 in the original and follow-up interviews, respectively.     

Effects of at-work exercises on computer operators

At-work exercises are commonly recommended for computer operators. This randomized control trial assessed adherence, pain and satisfaction after 4 weeks of at-work exercise. Subjects (n=72) were randomized into 3 groups: resistance exercise, stretching, and control. Outcomes included a satisfaction survey, a visual analogue pain scale (VAS), a pain drawing, and the Neck Disability Index (NDI). The VAS, the drawing, and NDI were analyzed together as a composite variate referred to as Pain Impact. Exercise frequency was similar across the 3 groups (median=1.5 times per day). No differences were found between groups on Pain Impact p=0.714) or individual pain variables. Most satisfaction survey item scores did not differ between groups. However, a significant difference between groups on the survey item related to discomfort. The resistance and stretching group differed from the control group with regard to their perception that the exercises were helpful in reducing discomfort in the back and neck (p<0.001). We conclude that most subjects found the resistance and the stretching exercises easy to do, performed them 1 to 2 times daily, and said they reduced discomfort. To determine optimal type and frequency of at-work exercises, further study is needed.     

Psychological well-being and general health of Jordanian university students

Assessment of individuals' psychological well-being and mental health is an important aspect of health promotion. The purpose of this study was to examine the relationship between perception of psychological well-being and general health report among Jordanian university students. A total of 1108 students from six universities in Jordan were surveyed regarding psychological well-being and general health. The results showed that students perceived their psychological well-being as moderate. Psychological wellbeing subscales were negatively correlated with reports of physical pain, chronic infections, and previous or current treatment of a psychiatric illness. Male and female university students were similar in their perceptions of psychological well-being; however, they differed in their general health report. Perception of psychological well-being is an important component of university students' health. The importance of psychological well-being is highlighted, and implications for mental health nurses are presented.     

Mindfulness: an intervention for anxiety in schizophrenia

Despite evidence that individuals with schizophrenia spectrum disorders experience significant and persistent symptoms of anxiety, there are few reports of the use of empirically supported treatments for anxiety in this population. This article describes how we have tried to adapt mindfulness interventions to help individuals with schizophrenia who experience significant anxiety symptoms. Although mindfulness has been widely used to help individuals without psychosis, to our knowledge, this is the first study adapting it to help those with schizophrenia manage worry and stress. We provide an overview of the intervention and use an individual example to describe how our treatment development group responded. We also explore directions for future research of mindfulness interventions for schizophrenia.     

Well balanced: 8 steps to wellness for adults with mental illness and diabetes

Serious mental illness places a tremendous burden on clients, their families, and behavioral and medical health care providers. The co-occurrence of diabetes with mental illness may further compromise daily functioning. Psychiatric nurses can make a significant difference in improving the health and medical outcomes of this client population. A partnership was developed between the University of Rochester School of Nursing and the Western New York Care Coordination Program to evaluate a novel nursing model for adults with both serious mental illness and diabetes mellitus. The Well Balanced program incorporated health promotion, disease management, nursing care management, and evidence-based practice guidelines into 8 Steps to Wellness for a community-based mental health population. During a 16-visit intervention period, psychiatric nurses interacted with 74 clients. As a result of the program, clients experienced improvements in health risk status and in their hemoglobin A1C and reported high satisfaction with the Well Balanced program.     

Caring for the caregivers

National Family Caregivers month is a reminder of the invaluable contributions of family caregivers--contributions that are too often unrecognized when addressing the costs of health care. Unpaid caregivers spend a substantial percentage of each week "helping out," often with older relatives, which requires major changes in their work patterns. It is clear that these caregivers may need help balancing their work and caregiving responsibilities, and it is tempting to want to help them by "taking over" some of the seemingly overwhelming tasks they face daily. Yet, it is also important to recognize the ways in which these tasks may enrich caregivers' own quality of life. Through listening to caregivers, nurses and other health care professionals can better understand the embedded values, goals, joys, and disappointments that connect their lives with those for whom they care.     

Relationship of interpersonal behaviors and health-related control appraisals to patient satisfaction and compliance in a university health center

OBJECTIVE: The authors' aim was to evaluate patient-provider relationships in a college health center. PARTICIPANTS: Eighty student patients and their health-care providers. METHODS: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before and after the consultation. They evaluated their satisfaction with care and compliance after the consultation and again 2 weeks later. Providers completed measures of their participatory behavior and patients' interpersonal behavior after the consultation. RESULTS: Patients preferred to be well informed and to have their preferences taken into account, and generally felt competent at managing their own health affairs. They indicated they obtained the high level of participation they desired. Patients desired and actually experienced friendly and submissive providers. Degree of match between patients' desired and actual level of involvement in their care was associated with greater satisfaction. A greater match between the extent to which they desired the provider to be affiliative and the provider's actual affiliative behavior was associated with more satisfaction. No variables were predictive of patient compliance. CONCLUSION: The authors discuss results in terms of the influence of situational factors characteristic of a college health center.     

College and university compliance with a required meningococcal vaccination law

OBJECTIVE: Maryland became the first state to pass a vaccination law requiring college and university students living on campus to obtain a meningococcal vaccination or to sign a waiver refusing vaccination because college students are at increased risk for disease. The authors sought to identify how Maryland colleges addressed the law and determine whether schools were in full compliance. PARTICIPANTS: The authors surveyed 32 college/university administrators via a self-administered questionnaire. METHODS: The authors calculated vaccination and waiver rates and assessed compliance with the law overall and with specific law components. RESULTS: Among 28 participating schools, annual vaccination rates and waiver rates among students during 2000-2004 ranged from 66%-76% and 12%-17%, respectively. Two (7%) schools were compliant with all components of the law. CONCLUSIONS: Mandatory vaccination laws do not ensure compliance at the college and university level. Mandatory reporting, increased education, and collaboration between colleges and universities and public health agencies are needed.