Advancing Nutritional Psychiatry: Cultivating Knowledge and Confidence in Psychiatric Mental Health Nurse Practitioners

Research on the relationship between nutrition and mental health is growing. Mental health professionals, including Psychiatric Mental Health Nurse Practitioners (PMHNPs), may lack the knowledge and confidence to endorse nutrition to benefit mental health outcomes. This quality improvement project sought to increase PMHNPs’ knowledge of nutritional psychiatry, build confidence in discussing nutritional interventions, and increase the nutritional education of patients. The project aims were to evaluate PMHNPs’ current knowledge and attitudes about nutritional psychiatry; assess if PMHNPs’ current practice includes nutritional psychiatry; analyze the effect of a training tool to increase knowledge of nutritional psychiatry and confidence in nutritional counseling; and identify gaps for nursing education stakeholders. A quasi-experimental design was implemented, with an educational intervention and pre- and post-training and follow-up surveys to assess PMHNPs’ knowledge and attitudes toward nutrition and mental health. Forty responses were analyzed for the pre-training survey, six for the posttraining survey, and six for the follow-up survey. Interest in nutrition among PMHNPs was high, but knowledge and confidence were not as significant. The intervention did not have a statistically significant influence on the knowledge or confidence of the participants who opted-in for follow-up. Many respondents believed nutrition did not receive adequate attention in graduate-level education despite its importance. PMHNPs are interested in learning about nutrition in relation to mental health. Training content on nutritional psychiatry and how to effectively engage with patients should be developed both for graduate school curriculum and continuing education

Patterns of local mobility in an Iban community of West Kalimantan, Indonesia

The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file.Title from PDF of title page (University of Missouri--Columbia, viewed on October 2, 2009).Thesis advisor: Dr. Reed Wadley.M.A. University of Missouri--Columbia 2008.This study examines the concept of mobility in relation to small-scale, subsistence-oriented societies, in which groups and individuals create complex resource networks in order to satisfy physical and social needs. Mobility is multi-dimensional and is defined as the capacity or ability to move over a landscape. The purpose of this study was to examine the mobility patterns of the West Kalimantan Iban community of Sungai Sedik, answering the following questions: (1) Where and how often did people travel? (2) At what time during the observed year did people travel? (3) Are there differences in travel patterns, dependent upon gender and age? (4) What are the relationships between the visited and the visitor, and how do the relationships affect the frequency and purpose of travel episodes? (5) How do social relationships affect travel for exchange? Dr. Reed Wadley of the University of Missouri-Columbia, detailed the movement of one Iban longhouse community by conducting a local mobility study among the thirteen households between April/May of 1993 and February/March of 1994. The observations in this study answer these questions and illustrate the importance of the interrelationship between the multi-dimensional mobility patterns of the Sungai Sedik community and their network of natural, economic, and social resources.Includes bibliographical references

Reducing racial and ethnic disparities in the Juenile Justice System: A blueprint for community engagement and action

Presentation made at Latinos in the Heartland (10th : 2012 : Kansas City, Mo.) and published in the annual conference proceedings.This presentation will discuss the approach we have taken as part of a statewide initiative to reduce Disproportionate Minority Contact (DMC) in the Missouri Juvenile Justice System. DMC looks at the experiences of minority youth compared to Caucasian youth at all stages of the Juvenile Justice System (referrals, detention, petitions, probation, transfers to adult courts, etc.). African American and Latino youth in Missouri are almost twice as likely to be referred to the juvenile office as Caucasian youth. By working intensively in three counties, we have built community teams to analyze local policies, practices, and procedures that produce these disparities. We will discuss how and why we formed local teams, the data analysis process, and lessons learned through our experiences working with these communities. Finally, we will discuss the solutions proposed by the three communities, the successes those communities have experienced, and the challenges they face in striving to reduce disparities

The demographics of forced marriage of people with learning disabilities: findings from a national database

Purpose: To compare the UK demographics of forced marriage of people with learning disabilities and people without learning disabilities in order to inform effective safeguarding practice. Design: An analysis of all cases of forced marriage reported to the UK Government’s Forced Marriage Unit (FMU) between 2009 and 2015. Findings: People with learning disabilities are at five times greater risk of forced marriage than people without learning disabilities. Men and women with learning disabilities are equally likely to be forced to marry, whereas amongst the general population women are more likely than men to be forced to marry. Patterns of ethnicity, geographic location within the UK and reporters are the same for people with and without learning disabilities. Research limitations: The analysis is based on cases reported to the FMU, and for some cases the data held was incomplete. More importantly, many cases go unreported and so the FMU data does not necessarily reflect all cases of forced marriage in the UK. Practical implications: Forced marriage of people with learning disabilities is a safeguarding issue. Practitioners across health, education, criminal justice and social care need to better understand the risk of forced marriage for people with learning disabilities. Links to practice resources developed as part of the wider project are provided. Originality: This is the first time that researchers have been given access to FMU data and the first time that a statistical analysis of cases of forced marriage involving someone with a learning disability have been analysed

Spatiotemporal analysis of socioeconomic exposure to assess flood policy effectiveness

After nearly a century of flood policies in the U.S., losses have continued to increase. This thesis examined the potential increase in losses related to the 100-yr floodplain, which is the minimum standard for implementing policies. Despite this core role, as much as 1.5 vertical meters of uncertainty exists when delineating the boundray. However, no uncertainty is provided on flood maps, which could result in increased socioeconomic exposure adjacent to the boundary when a larger flood occurs. This thesis quantified the effectiveness of mitigation from 1990 to 2000 for five North Carolina counties by examining changes in exposure inside and adjacent to the 100-yr floodplain. Findings indicated mitigation efforts have been effective inside the 100-yr floodplain; however, there was a significant increase in exposure adjacent to this floodplain. Stream scale analyses indicated mitigation effectiveness was influenced by stream size, distance from the stream, and location in urban versus rural areas

STREAMFLOW TRENDS AND DROUGHT IN THE SOUTH ATLANTIC, U.S.: IMPLICATIONS FOR WATER MANAGEMENT AND WATER TRANSFERS

The South Atlantic has recently experienced region-wide droughts. There is concern that water scarcity may become more common or prevalent due to a warming climate. Problems associated with water scarcity are compounded by under-developed water allocation policy in the historically water abundant South Atlantic. This dissertation examined the potential causes of water scarcity related to changes in average streamflow from 1934-2005, 1934-1969 (Mid-20th Century) and 1970-2005 (Late-20th Century). Second, the contribution of climate versus anthropogenic drivers of change in mean annual streamflow in the Late 20th Century was evaluated using Budyko curves. Third, hydrologic drought was characterized in the South Atlantic and changes in drought characteristics were assessed over multiple time periods. Fourth, water interconnections, which form an important component of water infrastructure and water management, were assessed for the potential to transfer water from a drought free to a drought stricken area. Results showed that streamflow abruptly shifted from a drier regime in the Mid-20th Century to a wetter regime in the Late-20th Century with trends of significantly decreasing streamflow since 1970. Climate contributed to increased streamflow during the Late-20th Century throughout the South Atlantic; whereas human factors varied between basins and either amplified or decreased the climate change effect on streamflow. Human impacts were equivalent to or exceeded climate impacts in some basins. Seventy-one percent of drought events were shorter than 6 months with a recurrence interval of 6 years. Less than 7% of droughts were longer than one year, yet these longer duration droughts resulted in region-wide water scarcity. There were few significant temporal trends in drought characteristics over the studied time periods. The short interconnection distances (median=11.6 km) rarely extended beyond the spatial extent of multi-year droughts; interconnected water systems were simultaneously in drought 98±3% of the time from 2000-2008. Water managers face many challenges with a steadily growing demand and fluctuating long-term and short-term water supply needs that can be partially met through interconnections. Decision-making will benefit from monitoring changes in climate, human activities, and streamflow, as well as continually assessing the ability of current water infrastructure to perform under normal and adverse conditions.Doctor of Philosoph

Sea Ice and Migration of the Dolphin and Union Caribou Herd in the Canadian Arctic: An Uncertain Future

Caribou (Rangifer tarandus groenlandicus × pearyi) of the Dolphin and Union herd migrate across the sea ice between Victoria Island and the adjacent Canadian Arctic mainland twice each year, southward in fall–early winter and northward in late winter–spring. As a result of warmer temperatures, sea ice between Victoria Island and the mainland now forms 8–10 days later than it did in 1982, raising questions about the impact of delayed ice formation on the ecology of the herd. We examined movements of female Dolphin and Union caribou as they relate to sea-ice crossings using four satellite collar datasets (46 caribou) obtained between 1987 and 2006. Since the late 1980s, Dolphin and Union caribou have been moving by early October to the southern coast of Victoria Island, where they stage until sea-ice formation allows migration across the sea ice to winter range on the mainland. Caribou spending the summer farther north on Victoria Island arrive later at the coast, which shortens their time spent on the staging area. During the study period, the collared caribou began crossings as soon as sea-ice formation allowed. Most caribou departed from just a few areas and tended to use the same departure areas each year. Highest mortality occurred during the fall–early winter ice crossing and in mid to late winter. Our research raises the question of how the Dolphin and Union caribou will persist in supporting harvesting if the crossing becomes riskier for them or if the seasonal migrations between Victoria Island and the mainland are interrupted.Les caribous (Rangifer tarandus groenlandicus × pearyi) du troupeau Dolphin-et-Union migrent en passant sur la glace de mer entre l’île Victoria et la partie continentale adjacente de l’Arctique canadien deux fois par année, se dirigeant vers le sud à l’automne et au début de l’hiver, et vers le nord à la fin de l’hiver et au printemps. En raison des températures plus chaudes, la glace de mer entre l’île Victoria et la partie continentale se forme maintenant de huit à dix jours plus tard qu’en 1982, ce qui a pour effet de soulever des questions sur les incidences de la formation tardive de la glace sur l’écologie du troupeau. Nous avons examiné les mouvements des caribous femelles de Dolphin-et-Union pendant qu’elles traversaient la glace de mer à l’aide de quatre ensembles de données obtenus par colliers-satellites (46 caribous) entre 1987 et 2006. Depuis la fin des années 1980, les caribous de Dolphin-et-Union se déplacent vers le début d’octobre vers la côte sud de l’île Victoria, où ils transitent jusqu’à ce que la formation de la glace permette la migration pour passer l’hiver sur la partie continentale. Les caribous qui passent l’été plus au nord sur l’île Victoria arrivent à la côte plus tard, ce qui a pour effet de raccourcir le temps qu’ils passent en halte migratoire. Au cours de la période visée par l’étude, les caribous dotés d’un collier commençaient à traverser dès que la formation de la glace le permettait. La plupart des caribous partaient de quelques endroits et avaient tendance à partir des mêmes endroits d’une année à l’autre. Le taux de mortalité était le plus élevé pendant les traversées de l’automne et du début de l’hiver, ainsi que vers le milieu et la fin de l’hiver. Notre étude soulève la question à savoir comment les caribous de Dolphin-et-Union vont réussir à soutenir la chasse si les traversées deviennent de plus en plus risquées pour eux ou si les migrations saisonnières entre l’île Victoria et la partie continentale sont interrompues