Factors that Affect Treatment Compliance among Individuals with Mental Illness

Approximately 6% of the American population suffers from a severe mental illness such as Schizophrenia, Bipolar Disorder, Major Depressive Disorder, Post-Traumatic Stress Disorder, and Obsessive-Compulsive Disorder. Treatment compliance in individuals with severe mental illness is imperative as without treatment these individuals may experience homelessness, unemployment, and a decreased life expectancy of up to 34 years. Consequently, researchers have increasingly examined factors that may affect overall compliance among these individuals, such as insight, social support, symptom severity, and substance abuse. However, many of these studies focus on compliance with prescribed medications and few examine compliance with recommended psychological treatment. The current study examined the effects of the aforementioned factors on treatment compliance among individuals with severe mental illness and substance use diagnoses. Defendants in an alternative-to-jail program were asked to complete a brief clinical interview and several self-report measures examining insight, perceived social support, psychiatric symptom severity, and substance use. Each individual\u27s record was then examined at 3- and 6-month follow-up periods to determine the number of re-arrests, re-hospitalizations, and program removals they had experienced. Alcohol addiction severity and social support at intake were found to be significant predictors of treatment adherence at six-month follow-up. These findings will be discussed as they pertain to the implications for identifying and understanding the nature of the relationship between the client-centered factors that most directly impact treatment compliance among individuals with severe and persistent mental illness

Influence of weaning age, restraint stress, and cortisol addition in vitro on immune function in swine

This research attempted to examine the influence of restraint stress in confinement housing in gilts and age of weaning on cellular immune function in the pig. Peripheral blood mononuclear cell (PBMC) blastogenic response to mitogen, neutrophil elastase degranulation, and neutrophil phagocytic ability were examined as indicators of cell mediated immunity. Traditional measures of stress including total and percent free cortisol, total leukocyte number, and leukocyte differential counts were used as another measure of stress. In vitro examinations were made to establish a culture system using cortisol concentrations that were suppressive and those that were not for PBMC blastogenic response to mitogens. Using this system the effects of vitamin C were tested to determine if coincubation of PBMC with cortisol, at suppressive levels, and vitamin C would decrease the suppressive effects seen in blastogenic response to mitogens. The results indicated that restraint stress causes suppression of PBMC blastogenic response for at least 14 d indicating that the animal is still experiencing stress. The other measures of stress, i. e. total and percent free cortisol only indicated a stress response for 4 d. Weaning before 5 wk of age causes a suppression of PBMC blastogenic response to mitogens. However, weaning age did not appear to affect neutrophil function. Based on these results it would appear that several measures of physiological response to stressors need to be used if the effects of stress are to be reported. Cortisol addition in vitro can cause suppression of PBMC blastogenic response at various concentrations. Vitamin C did not appear to have any stimulatory effects on PBMC response to mitogens regardless of the presence or concentration of cortisol. Cortisol can be added at various concentrations to PBMC cultures and not suppress blastogenic response to mitogens

The Effectiveness of A Teen Pregnancy Prevention Program That Offer Special Benefits For Pregnant and Parenting Teens: A Qualitative Study

Teen pregnancy continues to be a problem for families, educators, health care professionals, and the government. Teenagers are not afforded the opportunity to learn or receive reinforcement on God\u27s laws on abstaining from premarital sex because religious education is not allowed in the public school system. This increase has led to the creation of the Teenage Parenting Center (TAPP), located in southwest Georgia. TAPP is one of 64 schools in a school district that offers special benefits for pregnant and parenting teens. This qualitative case study used a phenomenological approach to explore the experience of eight former attendees of the TAPP program. Participants (N = 8) completed interviews, wrote a personal reflection, and completed a survey to determine their beliefs regarding the program\u27s effectiveness. Results showed that participants were satisfied with the practical help the program gave them. Being able to attend school where day care was available enabled participants to remain in school and, with one exception, to graduate from high school. Participants reported satisfaction with program components that helped them learn to plan ahead, think about their futures, and obtain further education and paid employment. All participants but one were gainfully employed, and six had attended or were attending an institution of higher education. The program was successful in encouraging participants to practice safer sex, but was unsuccessful in preventing additional pregnancies out of wedlock or improving moral values, as all but one participant had gone on to have more children and were living with a man to whom they were not married

Should liver enzymes be checked in a patient taking niacin?

No randomized trials directly address the question of frequency of liver enzyme monitoring with niacin use. Niacin use is associated with early and late hepatotoxicity (strength of recommendation [SOR]: B, based on incidence data from randomized controlled trials and systematic reviews of cohort studies). Long-acting forms of niacin (Slo-Niacin) are more frequently associated with hepatotoxicity than the immediate-release (Niacor, Nicolar) or extended-release (Niaspan) forms (SOR: B, based on 1 randomized controlled trial and systematic reviews of cohort studies)

The effects of household assets inequality and conflict on population health in Sudan

We explored the effects on health of both household asset inequality and political armed conflict in Sudan. Using the 2010 Sudan household survey, we evaluated the role of both household asset distribution (measured by the Gini coefficient) and armed conflict status at the state level. We measured associations with six health-related outcomes: life expectancy, infant mortality, height-for-age (stunting), adequacy of food consumption, teenage birth rates and vaccination coverage for young children. For each of six measures of health in Sudan, outcomes were significantly worse in the states with more unequal asset distribution, with correlation coefficients ranging between -0.56 (stunting) and -0.80 (life expectancy). Conflict status predicted worse outcomes. Wealth redistribution in the more unequal states, as well as a political resolution of conflict, may improve population health

Social and Environmental Factors Associated with Preschoolers' Non-sedentary Physical Activity

The two-fold purpose of the investigation was (1) to describe with direct observation data the physical activity behaviors and the accompanying social and environmental events of those behaviors for children in preschools; and (2) to determine which contextual conditions were predictors of moderate-to-vigorous physical activity (MVPA) and non-sedentary physical activity (i.e., light activity + MVPA) for 3-, 4-, and 5-year-old children during their outdoor play. The results indicate that preschoolers' physical activity is characterized as sedentary in nature throughout their preschool day (i.e., 89% sedentary, 8% light activity, 3% MVPA). During outdoor play periods, when children are most likely to be physically active, some contextual and social circumstances better predict their physical activity. Implications for policymakers, practitioners, and researchers are discussed. Originally published Child Development, Vol. 80, No. 1, Jan/Feb 200

Treaties in Collision: The Biosafety Protocol and the World Trade Organization Agreements

In the event of a conflict between the requirements of the Biosafety Protocol, a multilateral agreement governing the trade in genetically modified organisms, and the requirements of the General Agreement on Tariffs and Trade and associated agreements (collectively WTO Agreements), which treaty\u27s requirements prevail? This question lies as the legal heart of the perceived conflict between trade globalization and environmental protection. This issue is particularly timely given the present trade dispute between the United States and European Union over the European Union’s restrictions on the importation of genetically modified agricultural commodities. In this piece, I analyze the relationship between these agreements. I conclude that while the “savings clause” language ultimately included in the Biosafety Protocol preserves countries’ rights and obligations under the WTO Agreements, the Protocol and the WTO Agreements are less on a collision course than some may fear

Study of Health and Activity in Preschool Environments (SHAPES): Study Protocol for a Randomized Trial Evaluating a Multi-Component Physical Activity Intervention in Preschool Children

Background: Physical inactivity is a recognized public health concern. Inadequate proportions of children in the U.S, including those of preschool age, are meeting physical activity recommendations. In response to low numbers of preschool children attaining appropriate physical activity levels, combined with the large number of young children who attend preschool, researchers have identified the need to devise interventions to increase physical activity at preschools. However, few multi-component interventions to increase physical activity in preschool children exist. The aims of this study were to observe the effects of a multi-component intervention on physical activity, sedentary behavior, and physical activity energy expenditure in 3-5 year-old children; identify factors that associate with change in those variables; and evaluate the process of implementing the multi-component intervention. The purpose of this manuscript is to describe the study design and intervention protocol. Methods/design: The overall design of the Study of Health and Activity in Preschool Environments (SHAPES) was a two-year randomized trial (nested cohort design), with two conditions, two measurement occasions, and preschool serving as the unit of analysis. Sixteen schools (eight intervention and eight control) were enrolled. The intervention protocol was based on the social ecological model and included four main components: (a) indoor physical activity (“move inside”), (b) recess (“move outside”), (c) daily lessons (“move to learn”), and (d) social environment. Components were implemented using teacher and administrator trainings and workshops, site support visits, newsletters, and self-monitoring methods. Outcomes included accelerometer assessment of physical activity, sedentary behavior, and physical activity energy expenditure; weight status; and demographic factors; family/home social and physical environment; and parental characteristics. An extensive process evaluation battery was also used to monitor dose delivered by interventionists, completeness of intervention component delivery by teachers, and fidelity of teachers’ implementation. Discussion: The study will address important gaps relative to increasing physical activity in preschool children. Few studies to date have incorporated a multi-component approach, rigorous measurement protocol, and thorough evaluation of intervention implementation. Trial registration: NCT0188532