Medicine and Health Sciences Commons^™

Screening Mammograms In Alzheimer’S Disease Patients, George M. Yousef, Piyush Sovani, Sirisha Devabhaktuni, Lynne J. Goebel

George M. Yousef

Very little guidance exists to help clinicians and families decide whether mammograms are useful in elderly women with Alzheimer’s Disease (AD). We present a case of a patient with moderate AD who had a positive mammogram and discuss the dilemma faced by the family and clinician in deciding what was best to do for the patient. In this case, the family opted for breast conserving surgery (BCS) followed by palliative care which brought up the question of whether screening was appropriate with this treatment goal in mind. We reviewed the literature on AD and breast cancer screening and summarize these …

Targets Of Therapeutic Intervention For Prevention Of Repeated Hospitalization: Need For Developing ‘Personalised Care Model’, Amresh Srivastava

Amresh Srivastava

Targets of therapeutic intervention for prevention of repeated hospitalization: need for developing ‘personalised care model’

Amresh Srivastava1, Coralee Belmont 2, Miky Kaushal 3, Avinash DeSouza 4 Robbie Campbell 5 and Larry Stitt 6 1. Associate Professor of Psychiatry, The Western University, Associate Scientist, and Lawson Health research Institute. Consultant psychiatrist Adult Ambulatory and Psychosis Program. Parkwood Institute Wellington Road. London. ON, N6C 0A7 2. Psychiatric Social worker southwest forensic mental health. St. Thomas 3. Research Fellow, Regional mental health St. Thomas 4. Research Fellow, LTMG Medical College and mental Health Resource Foundation, Mumbai, India 5. Emeritus Professor of Psychiatry. The …

Targets Of Therapeutic Intervention For Prevention Of Repeated Hospitalization: Need For Developing ‘Personalised Care Model’, Amresh Srivastava

Amresh Srivastava

Amresh Srivastava1, Coralee Belmont 2, Miky Kaushal 3, Avinash DeSouza 4 Robbie Campbell 5 and Larry Stitt 6 1. Associate Professor of Psychiatry, The Western University, Associate Scientist, and Lawson Health research Institute. Consultant psychiatrist Adult Ambulatory and Psychosis Program. Parkwood Institute Wellington Road. London. ON, N6C 0A7 2. Psychiatric Social worker southwest forensic mental health. St. Thomas 3. Research Fellow, Regional mental health St. Thomas 4. Research Fellow, LTMG Medical College and mental Health Resource Foundation, Mumbai, India 5. Emeritus Professor of Psychiatry. The Schulich School of medicine and dentistry. 6. Consultant, Statistical services, London. ON Canada Background Strategies …

Transforming The Managerial Class: Binary And Dialectical Thinking In Counseling, Thomas Harrison, Troyann I. Gentile, Terianne Harrison

Troyann I. Gentile

Many counselor conceptualizations of client issues as well as interventions with clients are replete with binary thinking. The subtle result can be a type of management of clients which serves to both create change on some levels and to thwart change on other levels. Clearly, this is in direct opposition to the fundamental tenets of professional counseling. Dialectical thought is defined as the "developmental movement through forms." Dialectical thought is a type of "both/and" thinking that includes binary thought as a subset of advanced systems theory. In essence, dialectical thought puts motion into the binary thought process. This article will …

Video Applications For Online Counseling: Design And Practice, Leping Liu, Troyann I. Gentile

Troyann I. Gentile

Online counseling has been one important portion in our counseling skill training courses. In online counseling, video applications (such as video-conferences, storytelling, interactive information materials, screen-capture video, and counseling video session evaluation) are used for client assessment, online communications, counseling education and evaluation. This paper will present the analysis, design, implementation, and evaluation of integrating these applications into online counseling. Methods, procedures, activities, and issues will be described.

Counselor Education Beyond Our Borders: Promoting Mental Health Counseling In Romania Through A Service–Learning Project, Troyann I. Gentile, Laura M. Schmuldt, Barry Stephens

Troyann I. Gentile

The purpose of this article is to provide readers an account of the challenges and opportunities presented in a multi-faceted service-learning program in Romania. Developed in 2010, this endeavor involved an exploratory visit to assess the needs of social service agencies in Romania, and partnership with an American non-profit agency providing services to at-risk children. The mission of this program was to expose students to counseling as an emerging field in a developing post-communist community. In collaboration with the National Board of Certified Counselors-International (NBCC-I) Mental Health Facilitator (MHF) program, the authors were trained as Master Trainers in order to …

Positive Psychiatry, Amresh Srivastava

Amresh Srivastava

Revolutionary advances in understanding mental disorders and in providing novel treatments have enhanced the expectations of patients and relatives. There is a growing demand on newer research in providing interventions that allow patients to live a normal life. Of late, concept of the illness itself has undergone significant change. It is now proposed that expected outcome from treatment of mental disorder is to achieve a state of ‚ ‘wellness.’ Positive psychiatry is a newer branch of psychological medicine that seeks to promote understanding of wellness and examines its application in intervention and prevention of mental disorders. The concept of positive …

Behavioural Charactertics Of Patients Vulnerable For Repeated Hospitalisation, Amresh Srivastava, Coralee Berlmont, Miky Kaushal, Avinash Desouza, Robbie Campbell, Larry Stitt

Amresh Srivastava

Background

Re-hospitalization which takes place in about 30 to 50% postdischarge patienst, leads to poor outcome, increased rate of mortality and consumes more than 2/3 of budgetary allocations. Inability to identify vulnerable candidates for repeated admissions limits our options for strategic treatment.

Methods

In this prospective study conducted at Regional Mental Health Care ( Presently Parkwood Institute) 101 patienst ( 51 feamles, mean age 43 years), were examined using standard psychometric tools on parameters of clinical, psychopathological, suicide behaviour and resiliency for their risk and preventive characerstics.

Results

We assessed 101 subjects (51 females) with mean age of 42 years. …

Increased Number Of Circulating Exosomes And Their Microrna Cargos Are Potential Novel Biomarkers In Alcoholic Hepatitis, Fatemeh Momen-Heravi, Banishree Saha, Karen Kodys, Donna Catalano, Abhishek Satishchandran, Gyongyi Szabo

Gyongyi Szabo

BACKGROUND: It has been well documented that alcohol and its metabolites induce injury and inflammation in the liver. However, there is no potential biomarker to monitor the extent of liver injury in alcoholic hepatitis patients. MicroRNAs (miRNAs) are a class of non-coding RNAs that are involved in various physiologic and pathologic processes. In the circulation, a great proportion of miRNAs is associated with extracellular vesicles (EVs)/exosomes. Here, we hypothesized that the exosome-associated miRNAs can be used as potential biomarkers in alcoholic hepatitis (AH).

METHODS: Exosomes were isolated from sera of alcohol-fed mice or pair-fed mice, and plasma of alcoholic hepatitis …

Should Suicide Behaviour Be An Outcome Parameter For Mental Disorder, Amresh Srivastava

Amresh Srivastava

Suicide and mental illness are closely related to each other. A high number of people who commit suicide suffer from a mental illness, and a high number of mentally ill patients exhibit suicide behavior. Suicide behavior is a significant aspect of mental illness. It is consistently observed throughout the course of illness, seen in the prodromal stage, during acute phase of remission, in residual phase and whenever illness relapses. A number of times, mental disorder improves but suicide behavior persists. 10-15% patients attempt suicide in the initial phase of an illness. More than half of the patients get hospitalized due …

Should Educators Be ‘Wrapping School Playgrounds In Cotton Wool’ To Encourage Physical Activity? Exploring Primary And Secondary Students’ Voices From The School Playground, Brendon P. Hyndman, Amanda Telford

Dr Brendon P Hyndman

Physical activity in school playgrounds has changed considerably over recent decades to reflect a climate of ‘surplus safety’. A growing culture of surplus safety can be attributed to a desire of parents and teachers responsible for children to protect school students from danger. The aim of this research was to examine students’ perceptions of playground safety influences on physical activity during school breaks from the perspectives of the ‘users’ of school playgrounds. Data collection consisted of seven focus groups (4 primary school & 3 secondary school) conducted across four schools (2 primary & 2 secondary). During this study, the focus …

Should Educators Be ‘Wrapping School Playgrounds In Cotton Wool’ To Encourage Physical Activity? Exploring Primary And Secondary Students’ Voices From The School Playground, Brendon P. Hyndman, Amanda Telford

Dr Brendon P Hyndman

Physical activity in school playgrounds has changed considerably over recent decades to reflect a climate of ‘surplus safety’. A growing culture of surplus safety can be attributed to a desire of parents and teachers responsible for children to protect school students from danger. The aim of this research was to examine students’ perceptions of playground safety influences on physical activity during school breaks from the perspectives of the ‘users’ of school playgrounds. Data collection consisted of seven focus groups (4 primary school & 3 secondary school) conducted across four schools (2 primary & 2 secondary). During this study, the focus …

Abc Of Severe Mental Illnesses, Amresh Srivastava

Amresh Srivastava

Amresh Srivastava MD,MRCPsych,FRCPC Associate Professore of Psychiatry Western University London.ON Severe Mental Illnesses: Training and Education - About 4% patients in the community suffer from severe mental illness and about 16% from ‘any mental disorder’ Maximum financial and human resource allocations for mental health is consumed in managing severe mental disorders, leaving very little for treatment of early phase of illness and for developing preventive program. All of us, psychiatrists, family physicians, other mental health professionals like, nurse, psychologists, socal workers, occupational therapists, counsellors, and members of advocacy groups and mental health organisations, face the challenge for managing patients who …

Co-Parenting Factors That Lead To Academic Success, Julia M. Bernard, David P. Nalbone, Lorna L. Hecker, Suzanne E. Degges-White

Julia M. Bernard

Family Camp Impacts On Family Functioning, Barry A. Garst, Sarah Baughman, Nancy K. Franz Dr., Richard W. Seidel

Barry A Garst

Families are a foundational structure of society that play a critical role in the health and well-being of communities. Every aspect of the American family is experiencing change, including the number of adults who marry, the number of households that are formed by married people, the number of children that are conceived, and the number of non-family households (Nock, 2005). Considering these trends, programming to strengthen family relationships is particularly relevant and urgent. Research suggests that family camps — typically a residential multi-day camp experience designed for children and family members — can play a role in enhancing family functioning …

Identification Of Risk Factors For Suicide Amongst Psychiatric Patients: Can Structured Measurement Tools Be More Specific?, Amresh Shrivastava, Robbie Campbell, Megan Johnston, Coralee Berlmont, Miky Kaushal, Avinash Desousa, Larry Stitt, Charles Nelson

Amresh Srivastava

Background One of the main challenges in suicide prevention is that it cannot be predicted. Significant number of patients attempt suicide while being under psychiatric treatment. Lethality and intent of each risk factor varies and remains inconsistent. Though structured instruments have also been useful with limited success search for newer methods remains an urgent clinical need. We believe risk is multifactorial and a scale based upon fundamental domains of biological, psychological, social, environmental, spiritual and clinical origin can elucidate more specific factors. Scale for impact of suicidality- Management, Assessment & Planning of care-brief screener (SISMAP-bcs) is 23 item scale which …

Construct Validity Of Animal-Assisted Therapy And Activities: How Important Is The Animal In Aat?, Lori Marino

Lori Marino, PhD

Animal-assisted therapy and animal-assisted activities involve a nonhuman animal as a key therapeutic agent in some kind of intervention that may range from highly specified, as in AAT, to more casual, as in AAA. In this review I address the question: How important is the animal in animal therapy? In other words, does the recent literature strongly support the notion that a live animal, as opposed to another novel stimulating component, is specifically necessary for therapeutic success. Two meta-analyses and 28 single empirical studies were reviewed in order to address this issue. I conclude that the effects of AAT and …

The Flip-Side To Readmission: Focused After-Care, Amresh Srivastava

Amresh Srivastava

paper 1. Suicidality in hospitalized early psychosis patients at time of discharge

The purpose of this study was to investigate the presence and nature of suicidal risk among early psychosis patients at the time of discharge from hospital. Is it only related to the involvement of a suicidal attempt at admission? Thirty such patients, who were admitted after a suicide attempt were compared with 30 patients similarly diagnosed, but admitted for clinical reasons not involving a suicide attempt. Dependent measures of psychopathology, adjustment and suicidality were used. It was found that the two groups did not differ in suicidality, which …

Animals As Lifechangers And Lifesavers: Pets In The Redemption Narratives Of Homeless People, Leslie Irvine

Leslie Irvine, PhD

This paper examines personal narratives in which homeless and formerly homeless people construct their companion animals as having changed or saved their lives. The analysis considers selfhood a narrative accomplishment, the strategic outcome rather than the source of the stories people tell. These particular stories employ the theme of redemption, in which tellers describe overcoming adversity to face a better future, with animals playing key roles. The analysis reveals the narrative elements through which animals become vehicles for redemption. As dependent others, animals encourage a sense of responsibility. As the providers of unconditional love, they reward the fulfillment of responsibility. …

The Promise Of Healthcare Reform In Transforming Services For Jail Detainees, Maureen Mcdonnell, Laura Brookes, Arthur J. Lurigio

Arthur J. Lurigio

Chronic behavioral health conditions, such as psychiatric and substance use disorders, affect at least half of all arrestees, with two-thirds suffering from at least one chronic medical disorder. These conditions contribute to their criminal behaviors and propensities to recycle through the criminal justice system (Binswanger et al. Journal of Urban Health 89:183-190, 2012). Despite their limited resources, jails have nonetheless become de facto settings for the delivery of healthcare services. With the passage of the Affordable Care Act (ACA) of 2010, jail releasees will become eligible for government-subsidized healthcare coverage in 2014. The widespread availability of integrated healthcare services for …

Introduction: A Changing Indonesia, Maribeth Erb, Kathleen M. Adams

Kathleen M. Adams

No abstract provided.

A Critical Discourse Analysis Of The Response Of Aamft Approved Supervisors To A Case Vignette Describing The Perpetration Of Violence In A Family , Kathleen Murphy Adams

Kathleen M. Adams

Concerns about how family therapists respond to violence in families have been discussed in the literature for more than two decades (e.g., Bograd, 1984; Cook & Franz-Cook, 1984; Crnkovic, Del Campo, & Steiner, 2000; Goldner, 1985; Hansen, 1993; Harway, Hansen, & Cervantes, 1991, 1997; James & McIntyre, 1983; Pressman, 1989; Shamai, 1996,).;This study was designed to determine to what extent clinical supervisors' awareness of violence in families reflects or contradicts the poor awareness of family therapists as reported in the literature. Feminist informed critical discourse analysis was used, with a particular emphasis on exploring how the language that supervisors used …

Use And Perceived Effectiveness Of Coping Skills Among Police Officer Spouses, Andrea L. Dinsmore

Andrea L. Dinsmore

Discusses her research on the types of psychological stressors faced by the spouses of police officers and their methods of coping.

Assessment Of Competence Restoration: Determining The Threshold, Andrea L. Dinsmore

Andrea L. Dinsmore

Discusses the legal precedent and research basis of evaluating a defendant's mental competency to stand trial, the variables that contribute to non-restorable incompetence to stand trial, and the differences between patients who are restorable to competency versus those who are not restorable to competency.

Theorizing Mental Health Courts, E. Lea Johnston

E. Lea Johnston

To date, no scholarly article has analyzed the theoretical basis of mental health courts, which currently exist in forty-three states. This Article examines the two utilitarian justifications proposed by mental health court advocates—therapeutic jurisprudence and therapeutic rehabilitation—and finds both insufficient. Therapeutic jurisprudence is inadequate to justify mental health courts because of its inability, by definition, to resolve significant normative conflict. In essence, mental health courts express values fundamentally at odds with those underlying the traditional criminal justice system. Furthermore, the sufficiency of rehabilitation, as this concept appears to be defined by mental health court advocates, depends on the validity of …

Association Of Antipsychotic Use With Hospital Events And Mortality Among Medicare Beneficiaries Residing In Long-Term Care Facilities, Linda Simoni-Wastila, Priscilla T. Ryder, Jingjing Qian, Ilene H. Zuckermann, Thomas Shaffer, Lirong Zhao

Priscilla T. Ryder

Objective—Antipsychotic (AP) utilization has grown significantly in long-term care (LTC) settings. Although a growing literature associates AP use with higher mortality in elderly with dementia, the association of APs with hospital events is unclear. The authors examine prevalence and trends in AP use by Medicare beneficiaries residing in LTC and the association of APs and other drug use variables with hospital events and mortality. Design—Retrospective analysis using sequential multivariate Cox proportional hazards models. Setting—Medicare Current Beneficiary Survey linked to Institutional Drug Administration and Minimum Data Set files. Participants—A total of 2,363 LTC Medicare beneficiaries, 1999–2002. Measurements—Trends in LTC AP use …

Ptsd/Sud In Individuals With Physical Disabilities: Identifying Problems And Promising Interventions, Melissa L. Anderson, Douglas M. Ziedonis, Lisa M. Najavits

Melissa L. Anderson

Co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) is common, affects multiple domains of functioning, and presents complex challenges to recovery. Initial research indicates that individuals with physical disabilities experience higher rates of lifetime trauma and PTSD, and exhibit more severe SUD compared to non-disabled individuals. To expand upon these initial findings, we conducted a series of two studies on PTSD and SUD among individuals with physical disabilities.

Morphological Knowledge And Decoding Skills Of Deaf Readers, M. Diane Clark, Gizelle L. Gilbert, Melissa L. Anderson

Melissa L. Anderson

Many studies have reported the necessity of phonological awareness to become a skilled reader, citing barriers to phonological information as the cause for reading difficulties experienced by deaf individuals. In contrast, other research suggests that phonological awareness is not necessary for reading acquisition, citing the importance of higher levels of syntactic and semantic knowledge. To determine if deaf students with higher language skills have better word decoding strategies, students responded to a morphological test, where monomorphemic words and multimorphemic words were matched to their definitions. Two studies are reported, one focusing on English placement levels and a second with formal …

Supporting Recovery In The Deaf Community: Creating Continuum Of Behavioral Health Care In Central Massachusetts, Melissa L. Anderson, Neil S. Glickman, Lisa Mistler, Susan Jones, Monika E. Kolodziej, Douglas M. Ziedonis

Melissa L. Anderson

Across the U.S., there is a paucity of mental health and substance abuse services for Deaf individuals. Without the availability of communication accommodations and specialized clinical expertise, Deaf individuals seeking behavioral health services contend with access limitations, misdiagnoses, and superficial treatments. Moreover, while the assessment and treatment of co-occurring disorders and the infusion of trauma-informed care are key components of effective treatment in the mainstream literature, the investigation and application of these initiatives to the Deaf population has not yet occurred. The proposed poster will outline the current state of specialized behavioral health services for Deaf individuals in Central Massachusetts, …

Resilience: A Psychobiological Construct For Pathway Of Suicidality, Amresh Srivastava, Corelee Berlmont, Miky Kaushal, Avinash Desouza, Robbie Campbell, Larry Stitt

Amresh Srivastava

Absttract: Background and objective Resilience which is a neurobiological and behavioral construct may modulate psychopathological trajectory as a ‘final common pathway’ for suicide behavior. Since it allows people to adapt to adversity and bounce back to normalcy, treatments based upon modifcation of resilience may be a possibility. Objective of this prospective, cross-sectional study was to examine association of resilience and suicidality in individuals with psychiatric disorders attending Regional RMHC, St. Thomas and London. Method We measured level of resilience by using Connor-Davidson scale (CD-RISC, cut-off 60), suicidality by Scale for Impact of Suicidality Management, Assessment and Planning of Care brief …