Wednesday, December 24, 2008

Journal; Hypertension in Relation to Posttraumatic Stress Disorder and journal; Depression in the US National Comorbidity Survey

The clinical literature increasingly indicates that cardiovascular risk factors and cardiovascular disease (CVD) are more common among individuals with posttraumatic stress disorder (PTSD). Depression also poses a risk for CVD and is often comorbid with PTSD. Research to date has not established whether PTSD is associated with additional CVD risk beyond the risks associated with comorbid depression. The authors examined relationships of lifetime PTSD and depression with high blood pressure in data from the US National Comorbidity Survey. They divided participants into 4 mutually exclusive diagnostic groups: (1) PTSD history and no depression history, (2) PTSD and depression history, (3) depression history and no PTSD history, and (4) no history of mental disorder. Hypertension prevalence was higher for the PTSD, no depression and PTSD plus depression groups compared with the depression only and no mental disorder groups. PTSD appears to be related to hypertension independent of depression. This may partially explain elevated rates of CVD in PTSD patients.Jeffrey L Kibler, Kavita Joshi, Mindy Ma. Behavioral Medicine. Washington: Winter 2009. Vol. 34, Iss. 4; pg. 125, 7 pgs.
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Helping Partnerships that Facilitate Recovery from Severe Mental Illness

The intent of this study was to learn how consumers experience helping partnerships that assist them in recovery to inform families, professionals, and peers about meaningful actions and strategies that promote the healing process. In-depth interviews were conducted with a purposeful sample of 10 individuals who had a self-reported diagnosis of severe mental illness. Using the phenomenological research process, helping partnerships and how they develop were described. Six key themes emerged from the data and included Networks of Helping Partnerships, Teaching-Learning, Spirituality, Creative Drive, Time, and Medication Adherence. Characteristics and behaviors of helping partners were identified, as well as structures that promoted their development. Educating the public, consumers, and mental health professionals about how to promote recovery, the role of spirituality and creativity, the benefits of medication and therapy, and the impact of learning on progressing through recovery can go a long way toward eliminating the mystery and fear associated with mental illness.Kathleen Hope Anthony. Journal of Psychosocial Nursing & Mental Health Services. Thorofare: Jul 2008. Vol. 46, Iss. 7; pg. 24, 10 pgs.
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PRAYER AND MARITAL INTERVENTION: CAN IT BE LONG AND STRONG ENOUGH TO MATTER?

Namely, the therapist sees prayer as a way of helping partners gain perspective, break negative thought cycles, promote the relaxation response, or engage in dialogue with a supportive other (namely God or the Deity). The authors discuss how "time out" procedures generally provide some explicit or implicit way of reducing conflict and experiencing a positive break from conflict. The authors suggest that colloquial prayer may provide a behavior that couples are likely to remember to execute when experiencing strong emotions.\n They observe that there are potential gender dynamics that need to be investigated.Everett L Worthington Jr. Journal of Social and Clinical Psychology. New York: Sep 2008. Vol. 27, Iss. 7; pg. 686, 7 pgs.
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Monday, December 22, 2008

All-Cause and Cause-Specific Mortality Among Men Released From State Prison, 1980-2005

We compared mortality of ex-prisoners and other state residents to identify unmet health care needs among former prisoners. We linked North Carolina prison records with state death records for 1980 to 2005 to estimate the number of overall and cause-specific deaths among male ex-prisoners aged 20 to 69 years and used standardized mortality ratios (SMRs) to compare these observed deaths with the number of expected deaths had they experienced the same age-, race-, and cause-specific death rates as other state residents. All-cause mortality among White (SMR=2.08; 95% confidence interval [CI]=2.04, 2.13) and Black (SMR=1.03; 95% CI=1.01, 1.05) ex-prisoners was greater than for other male NC residents. Ex-prisoners' deaths from homicide, accidents, substance use, HIV, liver disease, and liver cancer were greater than the expected number of deaths estimated using death rates among other NC residents. Deaths from cardiovascular disease, lung cancer, respiratory diseases, and diabetes were at least 30% greater than expected for White ex-prisoners, but less than expected for Black ex-prisoners. Ex-prisoners experienced more deaths than would have been expected among other NC residents. Excess deaths from injuries and medical conditions common to prison populations highlight ex-prisoners' medical vulnerability and the need to improve correctional and community preventive health services.David L Rosen, Victor J Schoenbach, David A Wohl. American Journal of Public Health. Washington: Dec 2008. Vol. 98, Iss. 12; pg. 2278, 7 pgs.
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journal Of Treatment Options for Insomnia

The frequency of sleep disruption and the degree to which insomnia significantly affects daytime function determine the need for evaluation and treatment. Physicians may initiate treatment of insomnia at an initial visit; for patients with clear acute stressor such as grief, no further evaluation may be indicated. However, if insomnia is severe or long-lasting, a thorough evaluation to uncover coexisting medical, neurologic, or psychiatric illness is warranted. Treatment should begin with nonpharmacologic therapy, addressing sleep hygiene issues and exercise. There is good evidence supporting the effectiveness of cognitive behavior therapy. Exercise improves sleep as effectively as benzodiazepines in some studies and, given its other health benefits, is recommended for patients with insomnia. Hypnotics generally should be prescribed for short periods only, with the frequency and duration of use customized to each patient's circumstances. Routine use of over-the-counter drugs containing antihistamines should be discouraged. Alcohol has the potential for abuse and should not be used as a sleep aid. Opiates are valuable in pain-associated insomnia. Benzodiazepines are most useful for short-term treatment; however, long-term use may lead to adverse effects and withdrawal phenomena. The better safety profile of the newer-generation nonbenzodiazepines (i.e., zolpidem, zaleplon, eszopiclone, and ramelteon) makes them better first-line choices for long-term treatment of chronic insomnia.
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Toilet Training

Toilet training is a developmental task that impacts families with small children. All healthy children are eventually toilet trained, and most complete the task without medical intervention. Most research on toilet training is descriptive, although some is evidence based. In the United States, the average age at which training begins has increased over the past four decades from earlier than 18 months of age to between 21 and 36 months of age. Newer studies suggest no benefit of intensive training before 27 months of age. Mastery of the developmental skills required for toilet training occurs after 24 months of age. Girls usually complete training earlier than boys. Numerous toilet-training methods are available. The Brazelton child-oriented approach uses physiologic maturity, ability to understand and respond to external feedback, and internal motivation to assess readiness. Dr. Spock's toilet-training approach is another popular method used by parents. The American Academy of Pediatrics incorporates components of the child-oriented approach into its guidelines for toilet training. "Toilet training in a day," a method by Azrin and Foxx, emphasizes operant conditioning and teaches specific toileting components. Because each family and child are unique, recommendations about the ideal time or optimal method must be customized. Family physicians should provide guidance about toilet-training methods and identify children who have difficulty reaching developmental milestones.
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Thursday, December 11, 2008

Psychological Testing For Safety: The Neglected Work Of Hug

Hugo Munsterberg is recognized today as the father of industrial psychology, yet he has made many contributions to the field of occupational safety. A review of his life and accomplishments indicates that he pioneered the use of psychological tests to select people less prone to have accidents and developed the concept that it is the responsibility of management to prevent job-related accidents. Although his work began in Germany, Munsterberg came to the US and worked at Harvard. He then became the president of the American Psychological Association and conducted meaningful research on the use of psychology in industrial settings. However, his popularity waned due to outspoken sympathies toward Germany prior to World War I. Much of Munsterberg's pioneering work in safety was carried out at the Boston Elevated Railway Co., where he evaluated the fitness of the company's motormen for their work. His discoveries indicate that many accidents are caused by diminished attention, due to distraction or fatigue. Munsterberg's activities have inspired increased business interest in psychological testing, and other psychologists have expanded on his theories.
Professional Safety. Des Plaines: Nov 1988. Vol. 33, Iss. 11; pg. 13, 6 pgs

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Using statistical smoothing to estimate the psycholinguistic acceptability of novel phrases

The statistical technique of smoothing, which interpolates unknown values in a distribution, at once addresses twin problems faced by natural language processing (NLP) engineers and psycholinguists as a result of sparse data. The primary purpose of these data is to facilitate the exploration of smoothing as a psycholinguistic process responsible for the differential acceptability of nonoccurring phrases and to facilitate the comparison of smoothing algorithms in ways that will shed light on the aspects of their operation that are germane to the explanation of psycholinguistic acceptability. second, therefore, to illustrate the potential of the data set hi these respects, we present a short series of experiments that utilize a novel methodology for comparing several smoothing algorithms' capacity to predict acceptability judgments.
Matthew A J Roberts, Nick Chater. Behavior Research Methods. Austin: Feb 2008. Vol. 40, Iss. 1; pg. 84, 10 pgs
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Creating the contrast: The influence of silence and background music on recall and attribute importance

The ways in which advertisers can use silence in radio commercials to increase attention to, and subsequent retention of, information in an advertisement are investigated. It is argued that, when music is used in an advertisement, listener attention can be focused on specific pieces of information by cutting to silence just before presenting the crucial information and by continuing the underlying silence as the information is presented. An experiment is reported in which silence effectively increases the listener retention of ad information, in comparison with the use of either background music or background silence throughout. The effect was greatest when the highlighted information was the last items of a series. However, counter to expectations, advertisements with no background music whatsoever did not induce greater overall recall than ads with background music throughout

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Journal Smoking Cessation Intervention for Female Prisoners: Addressing an Urgent Public Health Need

We tested the efficacy of a combined pharmacologic and behavioral smoking cessation intervention among women in a state prison in the southern United States. The study design was a randomized controlled trial with a 6-month waitlist control group. The intervention was a 10-week group intervention combined with nicotine replacement therapy. Two hundred and fifty participants received the intervention, and 289 were in the control group. Assessments occurred at baseline; end of treatment; 3, 6, and 12 months after treatment; and at weekly sessions for participants in the intervention group. The intervention was efficacious compared with the waitlist control group. Point prevalence quit rates for the intervention group were 18% at end of treatment, 17% at 3-month follow-up, 14% at 6-month follow-up, and 12% at 12-month follow-up, quit rates that are consistent with outcomes from community smoking-cessation interventions. Female prisoners are interested in smoking cessation interventions and achieved point-prevalence quit rates similar to community samples. Augmenting tobacco control policies in prison with smoking cessation interventions has the potential to address a significant public health need.
Karen Cropsey, Gloria Eldridge, Michael Weaver, Gabriela Villalobos, et al. American Journal of Public Health. Washington: Oct 2008. Vol. 98, Iss. 10; pg. 1894, 8 pgs

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Journal Perceptions of Turkish Psychiatric Inpatients about Therapeutic Factors of Group Psychotherapy

Many studies on therapeutic factors in group psychotherapy were done during the 1970s and 1980s, primarily with Western samples. The present study was carried out in a psychiatric inpatient clinic in Turkey. Using Yalom's (1975) therapeutic factor questionnaire administered at discharge, patients rated existential factor, instillation of hope and self-understanding as the most helpful factors and identification as the least helpful. There were significant differences among patients with regard to gender, age, education, and comorbid personality disorder, but not with Axis I diagnosis or number of attended sessions. Patients' and psychiatrist's ratings showed significant differences. Differences between this Turkish sample and those reported in common Western literature are discussed under the light of relatedness psychology, which is an important concept of cross-cultural psychology.
Aslhian Sayin, Ersin Hatice Karslioglu, Armagang Sürgit, Selda Sahin, et al. International Journal of Group Psychotherapy. New York: Apr 2008. Vol. 58, Iss. 2; pg. 253, 11 pgs
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Saturday, December 6, 2008

Safeguarding the Rights of Sexual Minorities: The Incremental and Legal Approaches to Enforcing International Human Rights Obligations

The stark contrast between the aspirational, lofty language of international human rights treaties and the domestic laws of their signatories-not to mention official statements made by those signatory nations' leaders-is truly astounding. To note just one example of this disparity, Zimbabwe signed the International Covenant on Civil and Political Rights ("ICCPR"), pledging that its own "law shall prohibit any discrimination and guarantee to all persons equal and effective protection against discrimination."1 But in 2006, Zimbabwe passed legislation that makes it a crime for two people of the same sex to kiss, hug, or hold hands2-and Zimbabwe's current leader, President Robert Mugabe, has publicly stated that gays are "worse than dogs and pigs"3 and has urged members of his party to tie up homosexuals and bring them to the police to be arrested.4
Even in nations where both international treaties and domestic laws protect the rights of sexual minorities,5 violent hate crimes and other forms of discrimination still occur with shocking regularity. South Africa provides a particularly graphic example; it was the first African nation to adopt a constitution providing for, among other things, sexual minority rights6 and the first African nation to legalize same-sex marriage.7 Despite these measures-or perhaps, as this Comment will suggest, as a result of these measures-violent attacks against openly lesbian, gay, bisexual, and transgender ("LGBT") South Africans continue, with "corrective rape" occurring with some frequency.8 Certainly, antigay laws and state-supported discrimination can, and do, increase violence toward gays by legitimizing homophobia and by inciting the public, which previously might not have paid much attention to the LGBT community.9 Laws that protect sexual minorities are clearly a necessary condition-but not necessarily a sufficient one. The presence of domestic and international laws protecting gay rights is not enough to change a population's attitudes and actions toward the LGBT community.10

The international human rights community, though, generally sees changing laws as the necessary first step toward changing attitudes. Where treatment of, and attitudes toward, sexual minorities violate international human rights obligations, international human rights organizations have moved aggressively to advocate for change in domestic laws, with an eye to ultimately transforming attitudes and beliefs toward the LGBT community.11 Given the atrocities that have occurred in recent years,12 it would be unreasonable to expect that human rights organizations would refrain from taking immediate action. But why do international human rights organizations focus their efforts on changing laws, rather than changing attitudes, which could in turn lead to changing laws?

First, this "changing laws" approach has, on the surface, wrought many successes. Over the past two decades, international recognition of LGBT rights has improved dramatically under consistent pressure from human rights activists. The United Nations has, beginning with the ICCPR and the UN Human Rights Committee's ("UNHRC") decision in Toonen v Australia,13 taken a number of affirmative steps to advance the rights of sexual minorities. In the wake of those UN landmarks, LGBT rights organizations have generally agreed that the best way to advance their cause in domestic contexts is to pressure nations to adopt legislation or to alter their constitutions in favor of compliance with international treaties that promote privacy and equality.14

Second, were it equally difficult to change laws and attitudes, there is a strong argument that changing laws would be preferable. Laws that criminalize handholding or prevent human rights groups from organizing15 are detrimental not only to the LGBT movement, but also directly threaten individual privacy and autonomy norms. Most human rights organizations do not address this disparity, possibly due to the dearth of empirical data on the topic. Also, this hypothetical choice between changing laws and changing attitudes might not reflect an actual decision facing organizations, as most international human rights groups have broad scopes and thus attempt to use both strategies simultaneously.16 Whatever the reason, attacking laws certainly garners more attention.17 As a result, most commentators have agreed that at least this much action is required; some commentators go so far as to complain that not enough action is being taken to confront nations over laws that fail to conform to international human rights obligations.18 Working to change law is the clearest and most dramatic way for international human rights groups to advance the goal of safeguarding the rights of sexual minorities.

Third, and perhaps most importantly, LGBT rights groups can devise much stronger arguments for challenging discriminatory domestic laws than they can for complaining about attitudes. In the former case, the groups can appeal to international legal principles and ground their complaints in plain terms-for example, by stating that a nation is violating the terms of the agreement it signed in a specified treaty. This approach appears to have the benefits of simplicity and rationality that the latter approach-attempting to change the deeply held sentiments of a nation and its people-lacks. Thus, it is easy to see why groups have chosen to advocate for changing laws, rather than changing people's attitudes.

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Disorders of Arousal in Children

The disorders of arousal occur when a person fails to arouse fully from non-rapid eye movement (NREM) sleep to wakefulness and instead remains in a mixed state with features of both states.2 It is hypothesized that the centers in the brain and cervical spinal cord that are responsible for movement become dissociated from the parts of the brain that mediate sleep and wakefulness. This is thought to result in the loss of inhibition of motor activity during sleep. Electroencephalographic studies show that the slow wave sleep of individuals with sleep terrors or sleepwalking tend to have small interruptions indicative of sleep instability. Failure to awaken fully from sleep, loss of motor inhibition, and unstable sleep contribute to the features common to the disorders of arousal.
The evaluation of disorders of arousal involves a careful detailed description of the episodes as well as a developmental and neurological examination. Specific information about the number of hours of sleep obtained in a 24-hour period is important to determine if the child suffers from chronic sleep deprivation. The patient should be screened for primary sleep disorders, such as sleep-disordered breathing, periodic limb movement disorder, and restless leg syndrome. Disorders of arousal are more likely if there is a positive family history of confusional arousals, sleep terrors, or sleepwalking. A thorough medication
history is also helpful. Polysomnography typically is not necessary for the diagnosis of arousal disorders. However, it is useful if sleep disordered breathing, periodic limb movement disorder, REM sleep behavior disorder, or seizures are suggested. In the latter case, the polysomnogram should be performed with an
expanded EEG montage with coverage in the frontal and temporal regions. Neuroimaging is not usually indicated unless the neurological examination is abnormal or the diagnosis of epilepsy is considered. Laboratory evaluation including a urine drug screen may be considered on a case by case basis.
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