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Mental health promotion in the upper level of comprehensive school from the viewpoint of school personnel and mental health workers.

https://arctichealth.org/en/permalink/ahliterature144277
Source
Scand J Caring Sci. 2011 Mar;25(1):37-44
Publication Type
Article
Date
Mar-2011
Author
Kristiina Puolakka
Irma Kiikkala
Kirsi-Maria Haapasalo-Pesu
Eija Paavilainen
Author Affiliation
Universtiy of Tampere, Tampere, Finland. kristiina.puolakka@uta.fi
Source
Scand J Caring Sci. 2011 Mar;25(1):37-44
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Finland
Health promotion
Humans
Mental health
Mental Health Services - manpower - organization & administration
Schools - manpower
Abstract
Prevalence of mental health problems among adolescents varies from 10 to 30%. Therefore, mental health promotion in school has risen as a very important developing area in public health services. The need is international. Despite the large number of projects and recommendations on the promotion of schoolchildren's mental health, the literature does not offer a comprehensive theoretical description of what mental health work with people of this particular age really is as a whole. The theory can be constructed by combining and comparing the viewpoints of the different parties--the employees, the schoolchildren and their families--as well as previous knowledge of the subject. The purpose of this research was to produce a description of the concepts used by employees when addressing the subject of promoting mental health in the upper level of comprehensive schools (grades 7-9). The description has been produced by analysing interviews with nine people who work with schoolchildren, as well as workgroup memos related to the development work. The respondents work in the fields of primary healthcare, specialised healthcare, the education authority and social services. The analysis was conducted by applying the grounded theory method. The research target was a Finnish upper-level comprehensive school with 446 pupils. Four key concepts were found: The concept of a school environment comprises the physical and social conditions in the school, the curricula and other instructions. Human resources comprise representatives of various organisations, their competencies and time-consumption opportunities. The schoolchildren and their families and also their friends are key operators and partners. The concept of work to promote mental health is related to enhancing the school's conditions, recognising problems and offering help, co-operation and joint agreement. The produced description clarifies the overall picture of mental health work in schools and facilitates the finding of key development areas.
PubMed ID
20384976 View in PubMed
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British Columbia's provincial nursing workload project: evidence to empowerment.

https://arctichealth.org/en/permalink/ahliterature144303
Source
Nurs Leadersh (Tor Ont). 2010 Mar;23(1):54-63
Publication Type
Article
Date
Mar-2010
Author
Maura MacPhee
Karen Jewell
Andrea Wardrop
Ashifa Ahmed
Barbara Mildon
Author Affiliation
University of British Columbia School of Nursing, 2211 Wesbrook Mall, Vancouver, BC. Maura.macphee@nursing.ubc.ca
Source
Nurs Leadersh (Tor Ont). 2010 Mar;23(1):54-63
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
British Columbia
Community-Based Participatory Research
Decision Making, Organizational
Humans
Leadership
Nurse Administrators - organization & administration - psychology
Nurse's Role
Nursing Administration Research
Nursing Methodology Research
Nursing Staff - organization & administration - psychology
Personnel Staffing and Scheduling - organization & administration
Power (Psychology)
Professional Autonomy
Qualitative Research
Quality Assurance, Health Care
Workload - statistics & numerical data
Abstract
This case study describes an ongoing demonstration project that engages nurses and nurse leaders in decision-making with respect to workload management issues at eight practice sites within British Columbia (two per healthcare sector: acute care, long-term care, community health and community mental health). The primary goal of this project is to promote high-quality practice environments by empowering front-line nurses and their leaders: giving them the means to systematically examine and act upon factors that influence their workloads. Examples from practice sites illustrate tangible benefits from the project.
PubMed ID
20383080 View in PubMed
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The impact of nursing curricula on clinical practice anxiety.

https://arctichealth.org/en/permalink/ahliterature144317
Source
Nurse Educ Today. 2010 Nov;30(8):773-8
Publication Type
Article
Date
Nov-2010
Author
Katherine Melo
Bev Williams
Carolyn Ross
Author Affiliation
Faculty of Nursing, University of Alberta, 3rd Floor Clinical Sciences Building, University of Alberta, Edmonton, AB, Canada. katherine.melo@nurs.ualberta.ca
Source
Nurse Educ Today. 2010 Nov;30(8):773-8
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anxiety - etiology - prevention & control
Canada
Education, Nursing, Baccalaureate
Female
Humans
Male
Problem-Based Learning
Risk factors
Students, Nursing - psychology
Abstract
High levels of anxiety during clinical practice in nursing education may interfere with learning and contribute to poor mental health. The relationship between undergraduate curriculum design and clinical practice anxiety is unknown.
A descriptive, comparative research design was used to compare levels of clinical practice anxiety in third year baccalaureate nursing students in a problem-based learning (PBLP) curriculum (n=53) with those in a traditional, lecture-based (TNP) curriculum (n=42). A secondary aim of this study was to explore relationships between some of the demographic characteristics of the student sample, students' predisposition to anxiety, clinical learning experiences, and clinical practice anxiety. Students anonymously completed three electronic questionnaires including: a demographic questionnaire, the Spielberger State-Trait Anxiety Inventory (STAI), and the Clinical Experience Assessment Form (CEAF).
The PBL and the traditional group did not significantly differ on clinical practice anxiety. The mean scores on the STAI for this sample of nursing students were higher than those previously reported for the general population of university students. Implications for nursing education: strategies aimed at reducing nursing students' clinical practice anxiety are explored.
PubMed ID
20381219 View in PubMed
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Psychological distress among immigrants and visible minorities in Canada: a contextual analysis.

https://arctichealth.org/en/permalink/ahliterature144338
Source
Int J Soc Psychiatry. 2011 Jul;57(4):428-41
Publication Type
Article
Date
Jul-2011
Author
Mai Stafford
Bruce K Newbold
Nancy A Ross
Author Affiliation
Department of Epidemiology and Public Health, UCL, London, UK. m.stafford@ucl.ac.uk
Source
Int J Soc Psychiatry. 2011 Jul;57(4):428-41
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada - epidemiology
Child
Depression - epidemiology
Emigrants and Immigrants - psychology
Female
Health Surveys
Humans
Male
Middle Aged
Odds Ratio
Social Class
Stress, Psychological - epidemiology
Young Adult
Abstract
Immigrants to Canada are less likely to report depression compared with the non-immigrant population. This healthy migrant effect has not so far been explained by demographic and socioeconomic determinants of health.
The present study examined whether the psychological health advantage of immigrants varied across Canadian health regions and investigated the hypothesis of immigrant density as a determinant of immigrant mental health advantage.
Data from the 2000-2001 Canadian Community Health Survey were used to build multi-level models estimating variation in depression within and between health regions by immigrant/visible minority status.
Immigrant and visible minority residents were less likely to experience depression compared with the general population. Depression varied across health regions and the extent of variation was greater for visible minorities. The likelihood of depression decreased with increasing percentage of immigrants in the region among visible minority participants but not among whites.
The protection against depression afforded by immigrant and visible minority status in Canada appears to depend on contextual factors, notably the percentage of immigrants in the region. Future work should seek to better characterize the experiences of visible minorities in different settings.
PubMed ID
20378661 View in PubMed
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Social anxiety disorder and social fears in the Canadian military: prevalence, comorbidity, impairment, and treatment-seeking.

https://arctichealth.org/en/permalink/ahliterature144343
Source
J Psychiatr Res. 2010 Oct;44(14):887-93
Publication Type
Article
Date
Oct-2010
Author
Amber A Mather
Murray B Stein
Jitender Sareen
Author Affiliation
Department of Psychology, University of Manitoba, Winnipeg, MB, Canada.
Source
J Psychiatr Res. 2010 Oct;44(14):887-93
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anxiety Disorders - diagnosis - epidemiology - psychology
Canada - epidemiology
Comorbidity
Depression - diagnosis - epidemiology - psychology
Fear - psychology
Female
Health Surveys
Humans
Male
Marital status
Mental health
Mental Health Services - utilization
Middle Aged
Military Personnel - psychology
Panic Disorder - epidemiology - psychology
Patient Acceptance of Health Care - psychology
Phobic Disorders - epidemiology - psychology
Prevalence
Risk factors
Sex Factors
Social Behavior
Stress Disorders, Post-Traumatic - epidemiology - psychology
Young Adult
Abstract
Military mental health research has rarely investigated social anxiety disorder, despite its known serious consequences in the general population, and what work has been conducted has used specialized samples (e.g., veterans) not representative of all military personnel.
Data were from the 2002 Canadian Community Health Survey-Canadian Forces Supplement, a representative survey of 8441 active regular and reserve military personnel.
Social anxiety disorder has a high lifetime (8.2%) and past-year (3.2%) prevalence in the military. It is associated with increased odds of depression, panic attacks/disorder, generalized anxiety disorder, and post-traumatic stress disorder (AOR range 4.16-16.29). Being female, ages 35-44, or separated/divorced/widowed increases the odds of having social anxiety disorder, while being an officer or a reservist decreases the odds. Treatment-seeking, as in the general population, is relatively rare. Overall, military personnel with social anxiety disorder experience significant rates of role impairment in all domains (53.1-88.3% report some impairment), with the rate of role impairment increasing with the number of social fears. Notably, many (70.6%) report at least some impairment at work (i.e., in their job with the military).
Social anxiety disorder is an important disorder to take into account when considering military mental health. Observing low rates of treatment-seeking for social anxiety disorder among military personnel highlights the importance of initiatives to allow its identification and treatment.
PubMed ID
20378128 View in PubMed
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The 'DAWBA bands' as an ordered-categorical measure of child mental health: description and validation in British and Norwegian samples.

https://arctichealth.org/en/permalink/ahliterature144360
Source
Soc Psychiatry Psychiatr Epidemiol. 2011 Jun;46(6):521-32
Publication Type
Article
Date
Jun-2011
Author
Anna Goodman
Einar Heiervang
Stephan Collishaw
Robert Goodman
Author Affiliation
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. anna.goodman@lshtm.ac.uk
Source
Soc Psychiatry Psychiatr Epidemiol. 2011 Jun;46(6):521-32
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Algorithms
Child
Diagnosis, Computer-Assisted
Female
Great Britain - epidemiology
Humans
Interview, Psychological - methods
Male
Mental Disorders - diagnosis - epidemiology
Mental health
Norway - epidemiology
Prevalence
Risk factors
Young Adult
Abstract
To describe and validate the 'DAWBA bands'. These are novel ordered-categorical measures of child mental health, based on the structured sections of the Development and Well-Being Assessment (DAWBA).
We developed computer algorithms to generate parent, teacher, child and multi-informant DAWBA bands for individual disorders and for groups of disorder (e.g. 'any emotional disorder'). The top two (out of 6) levels of the DAWBA bands were used as computer-generated DAWBA diagnoses. We validated these DAWBA bands in 7,912 British children (7-19 years) and 1,364 Norwegian children (11-13 years), using clinician-rated DAWBA diagnoses as a gold standard.
In general, the prevalence of clinician-rated diagnosis increased monotonically across all levels of the DAWBA bands, and also showed a dose-response association with service use and risk factors. The prevalence estimates of the computer-generated DAWBA diagnoses were of roughly comparable magnitude to the prevalence estimates from the clinician-generated diagnoses, but the estimates were not always very close. In contrast, the estimated effect sizes, significance levels and substantive conclusions regarding risk factor associations were very similar or identical. The multi-informant and parent DAWBA bands performed especially well in these regards.
Computer-generated DAWBA bands avoid the cost and delay occasioned by clinical rating. They may, therefore, sometimes provide a useful alternative to clinician-rated diagnoses, when studying associations with risk factors, generating rough prevalence estimates or implementing routine mental health screening.
PubMed ID
20376427 View in PubMed
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Rates of depression and anxiety in urban and rural Canada.

https://arctichealth.org/en/permalink/ahliterature144361
Source
Soc Psychiatry Psychiatr Epidemiol. 2011 Jul;46(7):567-75
Publication Type
Article
Date
Jul-2011
Author
Sarah Romans
Marsha Cohen
Tonia Forte
Author Affiliation
sarahr4@gmail.com
Source
Soc Psychiatry Psychiatr Epidemiol. 2011 Jul;46(7):567-75
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Anxiety Disorders - epidemiology
Canada - epidemiology
Depressive Disorder - epidemiology
Female
Humans
Male
Mental Health Services - utilization
Middle Aged
Prevalence
Rural Health - statistics & numerical data
Sex Factors
Socioeconomic Factors
Urban Health - statistics & numerical data
Young Adult
Abstract
Studies of urban-rural differences in rates of non-psychotic psychiatric disorders have produced contradictory results, with some finding higher urban rates and others no difference.
This study aimed to compare geographic variability of rates of depression and three anxiety disorders in a large, random community sample of Canadian residents.
Data from the 2002 Canadian Community Health Survey 1.2 were analyzed, using a four-category classification of urban-rurality.
Significant bivariate urban-rural differences were found for age, marital status, country of birth, ethnicity, education, household income, income adequacy, employment, home ownership, physical activity, perceived stress, and physical health. In addition, participants in the urban core and urban fringe had a weaker sense of belonging to their community and reported lower social support. There was a modest urban excess of depression in the previous 12 months but no difference in rates of agoraphobia, panic disorder or social phobia across the geographical areas. The multivariate modeling showed a lower prevalence of depression for people living in the most rural environment only (odds ratio = 0.76, 95% confidence interval = 0.59, 0.98). Factors associated with an increased rate of depression in the model were female gender, younger age, being not married, being born in Canada, white ethnicity, higher education, unemployment, not owning one's home, and poor physical health. Also, participants with a stronger sense of belonging to their community and higher social support reported lower rates of depression.
These results confirmed a lower risk of depression amongst rural dwellers, which was associated with a stronger sense of community belonging. Further research on this topic could usefully include community-level variables, usually subsumed under the rubric of social capital.
PubMed ID
20376426 View in PubMed
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Self-reported collision risk associated with cannabis use and driving after cannabis use among Ontario adults.

https://arctichealth.org/en/permalink/ahliterature144392
Source
Traffic Inj Prev. 2010 Apr;11(2):115-22
Publication Type
Article
Date
Apr-2010
Author
Robert E Mann
Gina Stoduto
Anca Ialomiteanu
Mark Asbridge
Reginald G Smart
Christine M Wickens
Author Affiliation
Social, Prevention and Health Policy Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. robert_mann@camh.net
Source
Traffic Inj Prev. 2010 Apr;11(2):115-22
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - statistics & numerical data
Adolescent
Adult
Alcohol drinking - epidemiology
Automobile Driving - psychology
Cannabis - adverse effects
Cross-Sectional Studies
Female
Health Surveys
Humans
Logistic Models
Male
Marijuana Abuse - epidemiology
Middle Aged
Odds Ratio
Ontario - epidemiology
Risk factors
Socioeconomic Factors
Young Adult
Abstract
This study examined the effects of cannabis use and driving after cannabis use on self-reported collision involvement within the previous 12 months while controlling for demographics, driving exposure, binge drinking, and driving after drinking based on a large representative sample of adults in Ontario.
Data are based on the CAMH Monitor, an ongoing cross-sectional telephone survey of Ontario adults aged 18 and older, conducted by the Centre for Addiction and Mental Health. Data on drivers who reported driving at least one kilometer per week and who responded to the collision item from 2002 to 2007 were merged into one data set (n = 8481). Logistic regression analysis of self-reported collision risk posed by cannabis use (lifetime and past 12 months), driving after cannabis use (past 12 months), and driving after drinking among drinkers (past 12 months) was implemented, controlling for the effects of gender, age, region, income, education, marital status, kilometers driven in a typical week, and consuming five or more drinks of alcohol on one occasion (past 12 months). Due to list-wise deletion of cases the logistic regression sample was reduced (n = 6907).
Several demographic factors were found to be significantly associated with self-reported collision involvement. The logistic regression model revealed that age, region, income, marital status, and number of kilometers driven in a typical week, were all significantly related to collision involvement, after adjusting for other factors. Respondents who reported having driven after cannabis use within the past 12 months had increased risk of collision involvement (odds ratio [OR] = 1.84) compared to those who never drove after using cannabis, a greater risk than that associated with having reported driving after drinking within the past 12 months (OR = 1.34).
Further investigation of the impact of driving after cannabis use on collision risk and factors that may modify that relationship is warranted.
PubMed ID
20373229 View in PubMed
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The work ability index and single-item question: associations with sick leave, symptoms, and health--a prospective study of women on long-term sick leave.

https://arctichealth.org/en/permalink/ahliterature144395
Source
Scand J Work Environ Health. 2010 Sep;36(5):404-12
Publication Type
Article
Date
Sep-2010
Author
Linda Ahlstrom
Anna Grimby-Ekman
Mats Hagberg
Lotta Dellve
Author Affiliation
Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, S-40530 Gothenburg, Sweden. linda.ahlstrom@amm.gu.se
Source
Scand J Work Environ Health. 2010 Sep;36(5):404-12
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Confidence Intervals
Disability Evaluation
Employment - psychology - statistics & numerical data
Female
Health Status Indicators
Humans
Linear Models
Middle Aged
Occupational Diseases - epidemiology - psychology - rehabilitation
Occupational Health - statistics & numerical data
Pain Measurement
Predictive value of tests
Prospective Studies
Quality of Life - psychology
Questionnaires
Sick Leave - statistics & numerical data
Statistics, nonparametric
Sweden
Time Factors
Workplace - psychology - statistics & numerical data
Abstract
This study investigated the association between the work ability index (WAI) and the single-item question on work ability among women working in human service organizations (HSO) currently on long-term sick leave. It also examined the association between the WAI and the single-item question in relation to sick leave, symptoms, and health. Predictive values of the WAI, the changed WAI, the single-item question and the changed single-item question were investigated for degree of sick leave, symptoms, and health.
This cohort study comprised 324 HSO female workers on long-term (>60 days) sick leave, with follow-ups at 6 and 12 months. Participants responded to questionnaires. Data on work ability, sick leave, health, and symptoms were analyzed with regard to associations and predictability. Spearman correlation and mixed-model analysis were performed for repeated measurements over time.
The study showed a very strong association between the WAI and the single-item question among all participants. Both the WAI and the single-item question showed similar patterns of associations with sick leave, health, and symptoms. The predictive value for the degree of sick leave and health-related quality of life (HRQoL) was strong for both the WAI and the single-item question, and slightly less strong for vitality, neck pain, both self-rated general and mental health, and behavioral and current stress.
This study suggests that the single-item question on work ability could be used as a simple indicator for assessing the status and progress of work ability among women on long-term sick leave.
PubMed ID
20372766 View in PubMed
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Gender, hospitalization and mental disorders among homeless people compared with the general population in Stockholm.

https://arctichealth.org/en/permalink/ahliterature144404
Source
Eur J Public Health. 2010 Oct;20(5):511-6
Publication Type
Article
Date
Oct-2010
Author
Ulla Beijer
Sven Andréasson
Author Affiliation
Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden. u.beijer@telia.com
Source
Eur J Public Health. 2010 Oct;20(5):511-6
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Alcoholism - epidemiology
Case-Control Studies
Cohort Studies
Female
Homeless Persons - statistics & numerical data
Hospitalization - statistics & numerical data
Hospitals, Psychiatric - utilization
Humans
Male
Mental Disorders - classification - epidemiology
Middle Aged
Risk factors
Sex Factors
Substance-Related Disorders - epidemiology
Sweden - epidemiology
Abstract
The aim was to study the prevalence of mental disorders among homeless men and women admitted for inpatient treatment in hospitals.
Hospital care utilization of homeless people, 1364 men and 340 women, was compared with a control group consisting of 3750 men and 1250 women from the general population, 1996-2002.
Homeless women ran a higher risk for mental disorders than women in the population [risk ratio (RR) 20.88]; their risk was also higher than the risk for homeless men (RR 1.20). Younger homeless women had the highest risk (RR 2.17). Alcohol use disorders were equally common among homeless men and women, but women had more drug use disorders (RR 1.32). Women had higher risk of schizophrenia (RR 2.79), and personality disorders (RR 2.73). When adjustment was made for substance use disorders, no increased risk for mental disorder was found in the homeless group.
The elevated risk for mental disorders among the homeless was mainly related to substance use problems. Younger homeless women had the highest risk of mental disorder.
PubMed ID
20371499 View in PubMed
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Mental health care use in later life: results from a national survey of Canadians.

https://arctichealth.org/en/permalink/ahliterature144410
Source
Can J Psychiatry. 2010 Mar;55(3):157-64
Publication Type
Article
Date
Mar-2010
Author
John Cairney
Laurie M Corna
David L Streiner
Author Affiliation
Department of Family Medicine, McMaster University, Hamilton, Ontario. cairnej@mcmaster.ca
Source
Can J Psychiatry. 2010 Mar;55(3):157-64
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada
Demography
Diagnostic and Statistical Manual of Mental Disorders
Female
Health Care Surveys
Humans
Logistic Models
Male
Mental Disorders - epidemiology - therapy
Mental Health Services - utilization
Middle Aged
Physicians - utilization
Abstract
To estimate the proportion of older adults who have used mental health services in the past 12 months among those who meet the criteria for one or more Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, 12-month psychiatric disorders. We also examine the factors associated with mental health care use in this population.
We used secondary data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). We first estimated the proportion of adults aged 55 years and older who used a range of mental health services. Next, using logistic regression, we examined the relative contribution of predisposing, enabling, and need characteristics in predicting any service use in this population.
Among the 12 792 adults aged 55 years and older in the CCHS 1.2, 513 (4.23%, 95% CI 3.89% to 4.95%) met the criteria for at least one 12-month DSM-IV disorder. Among these respondents, 37% (95% CI 31% to 43%) saw at least one type of mental health care provider in the past 12 months. Visits to a general health care provider for mental health reasons were most common, followed by specialist care. Only psychological distress was significantly and positively associated with using mental health care services.
Over 60% of the older adults who met the criteria for a DSM-IV disorder were not using mental health care services. Social and demographic factors did not predict service use in this population.
PubMed ID
20370966 View in PubMed
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A cross-sectional prospective study of seclusion, restraint and involuntary medication in acute psychiatric wards: patient, staff and ward characteristics.

https://arctichealth.org/en/permalink/ahliterature144411
Source
BMC Health Serv Res. 2010;10:89
Publication Type
Article
Date
2010
Author
Tonje Lossius Husum
Johan Håkon Bjørngaard
Arnstein Finset
Torleif Ruud
Author Affiliation
SINTEF Health Services Research, PB 124, 0314 Oslo, Norway. tonje.l.husum@sintef.no
Source
BMC Health Serv Res. 2010;10:89
Date
2010
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Coercion
Cross-Sectional Studies
Delayed-Action Preparations
Humans
Medical Staff, Hospital - psychology
Mental Disorders - drug therapy - therapy
Norway
Patient Admission - statistics & numerical data
Patient Isolation
Prospective Studies
Psychiatric Department, Hospital - standards - statistics & numerical data
Regression Analysis
Restraint, Physical
Abstract
Previous research on mental health care has shown considerable differences in use of seclusion, restraint and involuntary medication among different wards and geographical areas. This study investigates to what extent use of seclusion, restraint and involuntary medication for involuntary admitted patients in Norwegian acute psychiatric wards is associated with patient, staff and ward characteristics. The study includes data from 32 acute psychiatric wards.
Multilevel logistic regression using Stata was applied with data from 1016 involuntary admitted patients that were linked to data about wards. The sample comprised two hierarchical levels (patients and wards) and the dependent variables had two values (0 = no use and 1 = use). Coercive measures were defined as use of seclusion, restraint and involuntary depot medication during hospitalization.
The total number of involuntary admitted patients was 1214 (35% of total sample). The percentage of patients who were exposed to coercive measures ranged from 0-88% across wards. Of the involuntary admitted patients, 424 (35%) had been secluded, 117 (10%) had been restrained and 113 (9%) had received involuntary depot medication at discharge. Data from 1016 patients could be linked in the multilevel analysis. There was a substantial between-ward variance in the use of coercive measures; however, this was influenced to some extent by compositional differences across wards, especially for the use of restraint.
The substantial between-ward variance, even when adjusting for patients' individual psychopathology, indicates that ward factors influence the use of seclusion, restraint and involuntary medication and that some wards have the potential for quality improvement. Hence, interventions to reduce the use of seclusion, restraint and involuntary medication should take into account organizational and environmental factors.
Notes
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PubMed ID
20370928 View in PubMed
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Who comes back? Characteristics and predictors of return to emergency department services for pediatric mental health care.

https://arctichealth.org/en/permalink/ahliterature144414
Source
Acad Emerg Med. 2010 Feb;17(2):177-86
Publication Type
Article
Date
Feb-2010
Author
Amanda S Newton
Samina Ali
David W Johnson
Christina Haines
Rhonda J Rosychuk
Rachel A Keaschuk
Philip Jacobs
Mario Cappelli
Terry P Klassen
Author Affiliation
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. mandi.newton@ualberta.ca
Source
Acad Emerg Med. 2010 Feb;17(2):177-86
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta
Child
Child, Preschool
Emergency Service, Hospital - utilization
Female
Hospitals, General - statistics & numerical data
Hospitals, Pediatric
Humans
Infant
Logistic Models
Male
Mental Health Services - organization & administration - statistics & numerical data
Mood Disorders
Multivariate Analysis
Retrospective Studies
Triage
Abstract
The objective of this study was to investigate predictors of emergency department (ED) return visits for pediatric mental health care. The authors hypothesized that through the identification of clinical and health system variables that predict return ED visits, which children and adolescents would benefit from targeted interventions for persistent mental health needs could be determined.
Data on 16,154 presentations by 12,589 pediatric patients (
PubMed ID
20370747 View in PubMed
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ARNTL (BMAL1) and NPAS2 gene variants contribute to fertility and seasonality.

https://arctichealth.org/en/permalink/ahliterature144427
Source
PLoS One. 2010;5(4):e10007
Publication Type
Article
Date
2010
Author
Leena Kovanen
Sirkku T Saarikoski
Arpo Aromaa
Jouko Lönnqvist
Timo Partonen
Author Affiliation
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
Source
PLoS One. 2010;5(4):e10007
Date
2010
Language
English
Publication Type
Article
Keywords
ARNTL Transcription Factors - genetics
Basic Helix-Loop-Helix Transcription Factors - genetics
Circadian Rhythm
Energy Metabolism
Female
Fertility - genetics
Finland
Genotype
Humans
Male
Nerve Tissue Proteins - genetics
Polymorphism, Single Nucleotide
Reproduction - genetics
Seasons
Abstract
Circadian clocks guide the metabolic, cell-division, sleep-wake, circadian and seasonal cycles. Abnormalities in these clocks may be a health hazard. Circadian clock gene polymorphisms have been linked to sleep, mood and metabolic disorders. Our study aimed to examine polymorphisms in four key circadian clock genes in relation to seasonal variation, reproduction and well-being in a sample that was representative of the general population, aged 30 and over, living in Finland.
Single-nucleotide polymorphisms in the ARNTL, ARNTL2, CLOCK and NPAS2 genes were genotyped in 511 individuals. 19 variants were analyzed in relation to 31 phenotypes that were assessed in a health interview and examination study. With respect to reproduction, women with ARNTL rs2278749 TT genotype had more miscarriages and pregnancies, while NPAS2 rs11673746 T carriers had fewer miscarriages. NPAS2 rs2305160 A allele carriers had lower Global Seasonality Scores, a sum score of six items i.e. seasonal variation of sleep length, social activity, mood, weight, appetite and energy level. Furthermore, carriers of A allele at NPAS2 rs6725296 had greater loadings on the metabolic factor (weight and appetite) of the global seasonality score, whereas individuals with ARNTL rs6290035 TT genotype experienced less seasonal variation of energy level.
ARNTL and NPAS2 gene variants were associated with reproduction and with seasonal variation. Earlier findings have linked ARNTL to infertility in mice, but this is the first time when any polymorphism of these genes is linked to fertility in humans.
Notes
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PubMed ID
20368993 View in PubMed
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Are Canadian women achieving a fit pregnancy? A pilot study.

https://arctichealth.org/en/permalink/ahliterature144465
Source
Can J Public Health. 2010 Jan-Feb;101(1):87-91
Publication Type
Article
Author
Tamara R Cohen
Hugues Plourde
Kristine G Koski
Author Affiliation
School of Dietetics and Human Nutrition, McGill University (Macdonald Campus), Ste Anne de Bellevue, QC.
Source
Can J Public Health. 2010 Jan-Feb;101(1):87-91
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Body mass index
Canada
Energy intake
Energy Metabolism
Female
Food Habits
Health Status Indicators
Health Surveys
Humans
Logistic Models
Mental Recall
Odds Ratio
Perinatal care
Physical Fitness
Pilot Projects
Pregnancy
Questionnaires
Weight Gain
Abstract
Canadian recommendations exist for energy intake (EI), physical activity (PA) and gestational weight gain (GWG) to help pregnant women avoid excessive GWG and attain "fit pregnancies". Our objectives were: 1) to measure daily EI, PA and GWG to observe whether pregnant women were meeting recommendations, 2) to explore the impact of health care provider advice on PA and GWG, and 3) to determine behaviours associated with recommended weekly GWG.
Women (n = 81) were recruited from prenatal classes. Current weight and self-reported pre-pregnancy weight were documented. Current PA levels and provider advice for PA and GWG were surveyed using questionnaires. Dietary recalls and pedometer steps were recorded for three and seven days respectively.
The majority of our women were classified as having average pre-pregnancy body mass indices (BMI) of 23.3 +/- 4 kg/m2, average EI of 2237 kcal/d and energy expenditure (EE) of 2328 kcal/d, but with weekly rates of GWG in excess of current recommendations despite having received advice about GWG (74%) and PA (73%). Most were classified as sedentary ( 8.5 MET-hr/wk.
Health care providers need to provide appropriate PA and GWG guidelines to pregnant women. Development of pregnancy step and MET-hr/wk recommendations are warranted in order to promote greater PA during pregnancy.
PubMed ID
20364546 View in PubMed
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Persistent antipsychotic polypharmacy and excessive dosing in the community psychiatric treatment setting: a review of medication profiles in 435 Canadian outpatients.

https://arctichealth.org/en/permalink/ahliterature144502
Source
J Clin Psychiatry. 2010 May;71(5):566-73
Publication Type
Article
Date
May-2010
Author
Ric M Procyshyn
William G Honer
Tony K Y Wu
Rebecca W Y Ko
Sean A McIsaac
Allan H Young
Joy L Johnson
Alasdair M Barr
Author Affiliation
British Columbia Mental Health & Addictions Research Institute, A3-113, 938 W 28th Ave, Vancouver, British Columbia, Canada, V5Z 4H4. rprocyshyn@bcmhs.bc.ca
Source
J Clin Psychiatry. 2010 May;71(5):566-73
Date
May-2010
Language
English
Publication Type
Article
Keywords
Antipsychotic Agents - administration & dosage - therapeutic use
Bipolar Disorder - drug therapy
British Columbia
Depressive Disorder, Major - drug therapy
Female
Humans
Male
Medical Audit
Medication Errors - statistics & numerical data
Mental Disorders - drug therapy
Middle Aged
Outpatients
Polypharmacy
Prevalence
Psychotic Disorders - drug therapy
Schizophrenia - drug therapy
Abstract
The present study aimed (1) to determine the proportion of patients treated with persistent antipsychotic polypharmacy in an outpatient population and (2) to determine if persistent antipsychotic polypharmacy is associated with excessive dosing.
Using a province-wide network that links all pharmacies in British Columbia, Canada, to a central set of data systems, we identified community mental health outpatients who had been treated with the same pharmacologic regimen for at least 90 days. Apart from antipsychotics, data collection included anticholinergics, antidepressants, mood stabilizers, benzodiazepines, lipid-lowering agents, and antidiabetic agents. Demographic data including sex, age, and diagnosis were obtained from the patient's chart. In order to compare dosages of the various antipsychotics we used a fixed unit of measurement based on dividing the prescribed daily dose (PDD) by the defined daily dose (DDD). A PDD/DDD ratio greater than 1.5 was defined as excessive dosing.
Four hundred thirty-five patients met the inclusion criteria and were included in the analysis. Overall, the prevalence of persistent antipsychotic polypharmacy was 25.7% for the entire cohort. The prevalence of persistent antipsychotic polypharmacy was highest for patients with schizoaffective disorder (33.7%), followed by schizophrenia (31.7%), psychosis not otherwise specified (20.0%), bipolar disorder (16.9%), and major depression (14.3%). The mean +/- SD PDD/DDD ratio for all patients prescribed persistent antipsychotic polypharmacy was not only excessive, it was significantly greater compared to that of patients receiving antipsychotic monotherapy (1.94 +/- 0.12 vs 0.94 +/- 0.04, P
PubMed ID
20361903 View in PubMed
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[The Projet PIE: a promising strategy to reach elders with a mental health problem].

https://arctichealth.org/en/permalink/ahliterature144519
Source
Sante Ment Que. 2009;34(2):217-35
Publication Type
Article
Date
2009
Author
Kareen Nour
Brita Brown
Nona Moscovitz
Marijo Hébert
Alan Regenstreif
Author Affiliation
CREGES-CSSS Cavendish-CAU, Canada.
Source
Sante Ment Que. 2009;34(2):217-35
Date
2009
Language
French
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Community Mental Health Services
Female
Humans
Male
Mass Screening
Mental Disorders - diagnosis - epidemiology - therapy
Middle Aged
Program Evaluation
Quebec
Referral and Consultation
Abstract
Approximately fifty percent of older adults with a mental health problem do not receive services. A proactive outreach strategy, Project PIE (Prevention-Intervention-Education) relies upon the assistance of non-traditional referral sources, namely community liaisons, to identify and refer to the CSSS vulnerable or isolated elders with a mental health problem. An evaluation of this project reveals encouraging results. The project appears useful, relevant and efficient to detect elders with a mental health problem and offer the required assistance. This project also appears to be a means to foster social solidarity.
PubMed ID
20361116 View in PubMed
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[Canadian Mental Health Law: accelerating the redirection of the Ship of State].

https://arctichealth.org/en/permalink/ahliterature144522
Source
Sante Ment Que. 2009;34(2):93-121
Publication Type
Article
Date
2009
Author
H Archibald Kaiser
Author Affiliation
Département de Psychiatrie, Université Dalhousie, Canada.
Source
Sante Ment Que. 2009;34(2):93-121
Date
2009
Language
French
Publication Type
Article
Keywords
Canada
Humans
International Cooperation - legislation & jurisprudence
Mental Disorders - therapy
Mental Health Services - legislation & jurisprudence
Mentally Ill Persons - legislation & jurisprudence
Patient Rights - legislation & jurisprudence
United Nations
Abstract
In this article, some hopeful outlooks on the evolution of the law are identified and ways of assessing the state and progress of legislation are advanced, drawing from international organizations and some inspiring efforts in other countries. Potential contributors to the evolution of Canadian mental health law are surveyed. The author concludes that there are coherent ways of changing tack, although in this fraught legislative field, no one can make confident predictions about the future.
PubMed ID
20361111 View in PubMed
Less detail

[Canadian Mental Health Law: recognizing and rectifying a problematic situation].

https://arctichealth.org/en/permalink/ahliterature144523
Source
Sante Ment Que. 2009;34(2):75-91
Publication Type
Article
Date
2009
Author
H Archibald Kaiser
Author Affiliation
Département de Psychiatrie de l'Université Dalhousie, Canada.
Source
Sante Ment Que. 2009;34(2):75-91
Date
2009
Language
French
Publication Type
Article
Keywords
Canada
Humans
Mental Disorders - therapy
Mental Health Services - legislation & jurisprudence
Mentally Ill Persons - legislation & jurisprudence
Patient Rights - legislation & jurisprudence
Abstract
This article explores several conundrums and attempts to identify ways of redirecting the Canadian ship of state. It first presents an overview of some of the salient features of the array of mainly coercive provincial and territorial mental health statutes. The failure in the main of the Charter to deliver on its early ostensible promises for people with mental health problems is assessed. Next, the author argues that extant legislation remains anchored in the medical model, when other human rights promoting paradigms transforms the statutory agenda.
PubMed ID
20361110 View in PubMed
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[Between the legal system and medical and psychosocial intervention: the reality of family members of individuals with mental illness].

https://arctichealth.org/en/permalink/ahliterature144524
Source
Sante Ment Que. 2009;34(2):31-8
Publication Type
Article
Date
2009
Author
Hélène Fradet
Author Affiliation
FFAPAMM, Canada.
Source
Sante Ment Que. 2009;34(2):31-8
Date
2009
Language
French
Publication Type
Article
Keywords
Commitment of Mentally Ill - legislation & jurisprudence
Family
Humans
Mental Disorders - therapy
Mental health services
Mentally Ill Persons
Quebec
Abstract
In this article, the author examines the impact of judicial intervention of individuals with mental illness on family members. The author subunits the hypothesis that an offer of more diversified services could reduce legal intervention of these individuals and consequently attenuate the devastating effects on family members. According to the families' equation, the more services will be developed and adapted, the less frequent family will have to call upon the legal system to intervene and fewer individuals with mental illness will find themselves behind bars.
PubMed ID
20361107 View in PubMed
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