Drug use in the year after prison

With poor health and widespread drug problems in the U.S. prison population, post-prison drug use provides an important measure of both public health and social integration following incarceration. We study the correlates of drug use with data from the Boston Reentry Study (BRS), a survey of men and women interviewed four times over the year after prison release. The BRS data allow an analysis of legal and illegal drug use, and the correlation between them. We find that illegal drug use is associated with histories of drug problems and childhood trauma. Use of medications is associated with poor physical health and a history of mental illness. Legal and illegal drug use are not strongly correlated. Results suggest that in a Medicaid expansion state where health coverage is widely provided to people leaving prison, formerly-incarcerated men and women use medications, not illegal drugs, to address their health needs.Accepted manuscrip

Healing Emotions Through Philosophical Thinking

Manifesting in diverse forms, mental and emotional health problems within the contemporary society have proven challenging to current biomedical healing practice and thereby remain a significant threat to individuals’ welfare. Considering the complexity of human emotions, ailing members of the society remain susceptible to adverse health implications accountable to poor emotional wellbeing. Spawning across diverse cultures with further support from narrative and explorative philosophies, the presence of body, spirit, and mind remains acknowledged as a fundamental foundation of human beings. The study adopts a theoretical approach to research and subjects base eligible base literature to the Creswell data spiral for addressing the primary research problems. Through a concrete inclusion criterion, a total of 46 studies and corporate reports are explicitly explored within the exploration. The organization of information under themes indicates the imperative role of a myriad of holistic healing approaches in appraising the emotional and psychological welfare of individuals. Findings indicate that the adoption of philosophical reasoning remains critical in capacitating of hurt individuals to use their natural body resources in healing. Philosophical perspective allows for inner integration, balance and synchrony with nature such that the healing process emanates from within and further accentuates to natural healing. In essence, the integration of the mind, body and spirit holds the capacity to appraise the natural healing process in the quest to improve an individual’s welfare. Future explorations should concern with the integration of the holistic approaches within the contemporary medical practice for proximal health benefits

Effects and side-effects of integrating care: the case of mental health care in the Netherlands

Contains fulltext : 56200.pdf ( ) (Open Access)Purpose: Description and analysis of the effects and side-effects of integrated mental health care in the Netherlands. Context of case: Due to a number of large-scale mergers, Dutch mental health care has become an illustration of integration and coherence of care services. This process of integration, however, has not only brought a better organisation of care but apparently has also resulted in a number of serious side-effects. This has raised the question whether integration is still the best way of reorganising mental health care. Data sources: Literature, data books, patients and professionals, the advice of the Dutch Commission for Mental Health Care, and policy papers. Case description: Despite its organisational and patient-centred integration, the problems in the Dutch mental health care system have not diminished: long waiting lists, insufficient fine tuning of care, public order problems with chronic psychiatric patients, etc. These problems are related to a sharp rise in the number of mental health care registrations in contrast with a decrease of registered patients in first-level services. This indicates that care for people with mental health problems has become solely a task for the mental health care services (monopolisation). At the same time, integrated institutions have developed in the direction of specialised medical care (homogenisation). Monopolisation and homogenisation together have put the integrated institutions into an impossible divided position. Conclusions and discussion: Integration of care within the institutions in the Netherlands has resulted in withdrawal of other care providers. These side-effects lead to a new discussion on the real nature and benefits of an integrated mental health care system. Integration requires also a broadly shared vision on good care for the various target groups. This would require a radicalisation of the distinction between care providers as well as a recognition of the different goals of mental health care.11 p

Can Prevention Programs Work Together? An Example of School-based Mental Health with Prevention Initiatives

Personnel addressing mental health in schools are required to provide supports in settings that have decreasing resources and multiple initiatives. While competing initiatives in schools can pose problems, integration of prevention systems and data may lead to more efficient supports and effective outcomes. Mental health service providers must consider how the integration of schoolwide initiatives such as positive behavior interventions and supports (PBIS), response to intervention (RtI), and social and emotional learning (SEL) can improve their work. This article will provide an example showing varying levels of integration of schoolwide models in one state. This example will include (a) the level of integration of schoolwide supports with school-based mental health (SBMH), (b) the relationship between integration of schoolwide practices and reported implementation, and (c) the relationship between schoolwide practices and outcome data related to SBMH. Suggestions for integrating models effectively and using data to improve collaboration will be provided

Mental Health and Integration: A Qualitative Study on the Struggles of Recently Arrived Refugees in Germany

Introduction: Forcibly displaced people are at particular risk of mental health problems and also face specific integration challenges upon resettlement. Existing literature suggests that there may be a bidirectional relationship between mental health and integration. The present study seeks to understand the relationship between integration processes and mental health problems or significant negative emotional experiences among adult refugees in Germany. Method: Applying a qualitative approach, we conducted 54 semi-structured interviews with refugees and asylum seekers who arrived in Germany between 2013 and 2018 currently residing in Berlin, Leipzig, or the Duisburg area in North Rhine-Westphalia. Data was collected between December 2018 and September 2019. We analyzed transcripts inductively using thematic analysis. Results: Five themes covering the various links between integration and mental health problems or significant negative emotional experiences were identified. First, we found that the mental health consequences of past adverse experiences, as well as ongoing worries about those left behind in the homeland, can seriously impede refugees' ability to pursue activities key to integration. Second, the process of applying for and securing asylum can result in uncertainty and fear, which, in turn, burden the individual and may impact motivation for integration. Third, many of our participants described mental health ramifications related to feeling stuck and thwarted in the pursuit of building a life, especially in securing employment. Fourth, some participants described feeling so overwhelmed by fundamental tasks throughout the integration process, namely, language learning and bureaucratic processes, that these take a psychological toll. Fifth, we identified several forms of social disconnection between refugees and members of the host community due to xenophobia, social and cultural differences, physical and emotional isolation in refugee camps, as well as with co-nationals and fellow refugees. Negative emotions, mistrust, and socio-cultural differences that emerge throughout the integration processes seem to erode social cohesion among refugee communities, potentially further threatening mental health. Conclusion: Mental health problems and integration processes appear to be closely related across different areas of integration. Innovative solutions to challenges identified by members of the refugee community in Germany stand to benefit mental health and integration outcomes simultaneously

Formative exploration of students’ perception about Community Medicine teaching at Mahatma Gandhi Institute of Medical Sciences, Sewagram, India

Objective: The objectives of the present formative research were to explore the medical undergraduates’ study problems and their perceptions about various teaching approaches in currently practiced teaching curriculum of Community Medicine. Material and Methods: The present formative research was undertaken at Dr. Sushila Nayar School of Public Health incorporating Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram. The respondents were 17 (26.5%) conveniently selected final year exam appearing medical undergraduates from 2004 regular batch of 64 students. A triangulation of qualitative research methods like free listing, pile sort exercise and a Focus Group Discussion (FGD) were used. A two dimensional scaling and hierarchical cluster analysis was completed with the pile sort data. The data was analyzed by using software Anthropac 4.98.1/X software. Results: The medical undergraduates could understand the topics like Integrated Management of Neonatal and Childhood (IMNCI), Primary Health Care (PHC), cold chain system for vaccines, immunization and health education, dietary survey and cluster survey method taught in the community based camp approaches. Students found it difficult to comprehend the core of subject from the scattered lecture series over a long teaching period, especially using lengthy over head projector/liquid crystal display presentations. The major problems encountered in studying the subject of Community Medicine were difficulty in understanding the concepts of biostatistics, confusions due to apparently similar text in National Health Programs and difficulty to recall disease statistics due to vast syllabus. Conclusions: Students perceived the community based camp approach of teaching as a best method to understand the subject, which is an integration of task oriented assignments, integration of social sciences within medical domain and active community involvement. Hence, the community based camp approach can be scaled up as a best Community Medicine teaching approach. The active learning methods could be used to improve the lectures and the clinics which should be more concentrated in final year of teachin

The Impact of Grid on Health Care Digital Repositories

Grid computing has attracted worldwide attention in a variety of applications like Health Care. In this paper we identified the Grid services that could facilitate the integration and interoperation of Health Care data and frameworks world-wide. While many of the current Health Care Grid projects address issues such as data location and description on the Grid and the security aspects, the problems connected to data storage, integrity, preservation and distribution have been neglected. We describe the currently available Grid storage services and protocols that can come in handy when dealing with those problems. We further describe a Grid infrastructure to build a cooperative Health Care environment based on currently available Grid services and a service able to validate it

The influence of therapeutic horticulture on social integration

Study Purpose: The purpose of the pilot study was to qualitatively evaluate the impact of therapeutic horticulture on social integration for people who have mental health problems. Method: A qualitative grounded theory approach captured the perceptions about therapeutic horticulture from people with mental health problems. Data were collected using semi-structured focus group and interviews from a purposive sample (n= 7) and were analysed using a constant comparative approach. Findings: Four key themes emerged from the analysis: ‘A Space to Grow’, ‘Seeing the Person’, ‘Learning about Each Other through Nature’ and ‘Connecting to Nature and Others’. The findings suggest that therapeutic horticulture enabled participants to integrate socially, engage with nature and develop confidence. Social Implications: Therapeutic horticulture embodies the principles of empowerment, person centeredness and can support people with mental health problems to integrate socially. Originality: There is limited evidence about the influence that therapeutic horticulture have on mental health and social integration. The use of therapeutic horticulture is an area that is gathering evidence and this small study highlights the perceived potential benefits of this approach

Nonlinear State-Space Models for Microeconometric Panel Data

In applied microeconometric panel data analyses, time-constant random effects and first-order Markov chains are the most prevalent structures to account for intertemporal correlations in limited dependent variable models. An example from health economics shows that the addition of a simple autoregressive error terms leads to a more plausible and parsimonious model which also captures the dynamic features better. The computational problems encountered in the estimation of such models - and a broader class formulated in the framework of nonlinear state space models - hampers their widespread use. This paper discusses the application of different nonlinear filtering approaches developed in the time-series literature to these models and suggests that a straightforward algorithm based on sequential Gaussian quadrature can be expected to perform well in this setting. This conjecture is impressively confirmed by an extensive analysis of the example application.LDV models; panel data; state space; numerical integration; health