Behavioral and Mental Health in Nevada

The Nevada Division of Public and Behavioral Health is responsible for providing public and mental health services to people living in or visiting the State. The Division is organized into four branches: Community Services Branch, Regulatory and Planning Services Branch, Clinical Services Branch and Administrative Services Branch. The Clinical Services Branch provides statewide inpatient, outpatient, and community-based public and mental health services. State employees provide mental health services, and contract providers deliver substance use services. Mental health services are additionally organized by age and geography. Adults with mental disorders are treated statewide through the Division of Public and Behavioral Health. Children with mental disorders are served through the Division of Child and Family Services within the populous urban counties (Washoe, Clark and Carson City) and the Division of Public and Behavioral Health across the 14 rural and frontier counties. Services are supported through Medicaid, the Nevada General Fund, and Federal grants. The Division of Public and Behavioral Health is located within the Nevada Department of Health and Human Services, under the Executive Branch of the State, and serves as its Public Health Authority and Mental Health Commissioner. By statute, the Commission on Behavioral Health is responsible for the following: establishing policies to ensure development and administration of services for persons with mental illness, persons with intellectual disabilities and related conditions, and persons with substance use conditions; reviewing programs and finances of the Division; and providing reports to the Governor and Legislature regarding the quality of care and treatment provided to individuals with mental illness, intellectual disabilities, and substance use disorders [Nevada Revised Statutes (NRS) 433.314]. Historically, the governance structure of Nevada’s behavioral and mental health system has been centralized at the state level with limited involvement at regional and local levels. A policy study conducted during 2014 identified Nevada as one of only four states in the country that directly operates community-based mental health services (Kenny C. Guinn Center for Policy Priorities, Mental Health Governance: A Review of State Models & Guide for Nevada Decisions Makers, December, 2014). During that same year, the State began to consider ways to move from its centralized governance structure to a more localized model involving regional, county and city entities. A key consideration was a growing recognition that increasing the State’s responsiveness to the unique needs of individual communities is crucial. Nevada’s plan to restructure the governance of its state mental health system is not without challenges. For example, the numbers of Nevada residents covered by Medicaid benefits almost doubled when Medicaid coverage was expanded by Governor Brian Sandoval under the Affordable Care Act (ACA) during 2014, increasing from 351,315 persons in 2013 to 654,442 individuals in 2015 (Woodard and Nevada Division of Health Care Financing and Policy, 2016). On its face, the increase in numbers of residents covered by Medicaid benefits is a positive outcome. However, the existing mental health provider network was not adequate to serve the increase in numbers of individuals covered. As detailed in later sections in this chapter, the increase in health care coverage appears to have impacted the frequency with which Nevada residents used health care services, most notably hospital emergency departments and inpatient facilities. Thus, the dual influences of increased health care coverage, and limited access to appropriate and optimal mental health services are reflected in the dramatic increase in residents’ utilization of emergency department services for a wide range of mental health-related conditions during 2015, after the expansion of Medicaid during 2014. Also discussed in later sections is the fact that almost all of the State qualifies as a mental health professional shortage area (Health Resources and Services Administration, HRSA). Therefore, moving from a primarily centralized or state control model to a local control model will require accommodation for the shortages in mental health professionals within communities that lie outside the State’s urban centers

Cheris Kramarae 1989 Visit

Communications and information material, Cheris Kramarae 1989 visit., Lectures & lecturin

An Assessment of Two Behavioral Group Strands (Self Help Skills and Communication Skills) of the Behavior Characteristic Progression System

The Behavioral Characteristic Progression (BCP) System consists of a matrix of over 2,500 behavioral areas or strands. Each strand is composed of up to 100 progressive steps or characteristics, ranging from minimal performance to normally accepted adult behavior in that area. This study reports on a reassessment of five profoundly retarded, eight severely retarded and six moderately retarded subjects randomly selected from the population\u27 of a Behavior Modification Unit of Big Spring State Hospital. Each subject was assessed initially with-the BCP in late Fall, 1974, or Summer, 1975. Eight self help skills strands and five communication skills strands were selected for reassessment since improvement in these two areas would enhance the dignity of the subjects and free the staff for other program activities. The change scores were treated with a one-way analysis of variance. The results were not significant although change was noted in the expected direction. In the communication skills strands the moderately retarded demonstrated more change than the severely retarded and the severely retarded more than the profoundly retarded. It was concluded that a more consistent population might be found in a residential program for the mentally retarded who do not have a concomitant emotional or psychiatric problem. The instrument is one way of evaluating even profoundly retarded subjects when used in concert with other tools

Emergence of velvetleaf, Abutilon theophrasti, and of wild cane, Sorghum bicolor, from different seed depths and site of uptake of various chemicals

Call number: LD2668 .T4 1968 C655Master of Scienc

Speechwriting in Rhetorical Criticism: an Extension of Theory as Applied to the Johnson Administration.

Speechwriting practices have long been associated with rhetorical history. American presidents have employed the speechwriter\u27s assistance since the beginning of this nation. From the dawn of radio, presidential speechwriting practices have grown to the extent that most presidents rely heavily on the writer to prepare the bulk of their messages. While many political speakers have grown to depend on the speechwriter to assist him in preparing the ideas or language of his message, rhetorical critics have largely ignored the writer\u27s influence on the message and his impact on the preparation process. The purpose of this study is fourfold. First of all, this critic examines the speechwriter\u27s role in the preparation process and his contributions to presidential discourse since the days of Franklin D. Roosevelt. Secondly, she attempts to point out the strengths and weaknesses of present rhetorical theory and criticism in considering speechwriting practices. Thirdly, the critic proposes her own theoretical postulates for extending critical methodologies, and finally, she applies her postulates to two speeches in Lyndon B. Johnson\u27s administration. The writer discusses how speechwriters have played various roles in preparing presidential discourse. Some participants are responsible for preparing only the language of the address, while others assist in policy decision-making which results in the speechwriter playing a significant role in preparing the ideas of the speech. The organization of writers vary, with some presidents relying primarily on individual efforts and others preferring committee writing efforts. Regardless of their roles and organization, the speechwriter\u27s presence proposes an interactional setting, in which the speaker and his writer or writers participate. The critic must examine the speechwriting effort as an interactional process and therefore consider the effect of the interaction between writers and the speaker on the drafting process and final product. This writer suggests guidelines whereby the critic may explore the triadic relationship between the speaker, the writers, and the ideas of the message; the triadic relationship between the speaker, the writers, and the language of the discourse; and the triadic relationship between the speaker, the writers, and the perception and response to a rhetorical situation. The critic then examines the 1964 State of the Union speech and Johnson\u27s March 31, 1968 speech, to determine the speechwriter\u27s role in the drafting process and their effect on the final product. She describes the interaction between the participants in each drafting process and then examines each of the triadic relationships in both speeches. Finally, the critic evaluates the writer\u27s contribution and interaction in each situation. She evaluates the writer\u27s ability to assist the speaker in realizing his fullest potential inventionally, linguistically, and in response to the rhetorical situation; to assist in producing a superior text technically as well as artistically; and to assist in producing a desired response by making the speech a persuasive instrument

The relationship between membrane pathology and language disorder

Abstract Receptive language disorder in schizophrenia has been hypothesized to involve a fundamental deficit in the temporal (time-based) dynamics of brain function that includes disruptions to patterns of activation and synchronization. In this paper, candidate mechanisms and pathways that could account for this basic deficit are discussed. Parallels are identified between the patterns of language dysfunction observed for schizophrenia and dyslexia, two separate clinical disorders that may share a common abnormality in cell membrane phospholipids. A heuristic is proposed which details a trajectory involving an interaction of brain fatty acids and second-messenger function that modulates synaptic efficacy, and, in turn, influences language processing in schizophrenia patients. It is additionally hypothesized that a primary deficit of functional excitation originating in the cerebellum, in combination with a compensatory decrease of functional inhibition in the prefrontal cortex, influences receptive language dysfunction in schizophrenia.

Associations between purine metabolites and clinical symptoms in schizophrenia

Background: The antioxidant defense system, which is known to be dysregulated in schizophrenia, is closely linked to the dynamics of purine pathway. Thus, alterations in the homeostatic balance in the purine pathway may be involved in the pathophysiology of schizophrenia. Methodology/Principal Findings: Breakdown products in purine pathway were measured using high-pressure liquid chromatography coupled with a coulometric multi-electrode array system for 25 first-episode neuroleptic-naïve patients with schizophrenia at baseline and at 4-weeks following initiation of treatment with antipsychotic medication. Associations between these metabolites and clinical and neurological symptoms were examined at both time points. The ratio of uric acid and guanine measured at baseline predicted clinical improvement following four weeks of treatment with antipsychotic medication. Baseline levels of purine metabolites also predicted clinical and neurological symtpoms recorded at baseline; level of guanosine was associated with degree of clinical thought disturbance, and the ratio of xanthosine to guanosine at baseline predicted degree of impairment in the repetition and sequencing of actions. Conclusions/Significance: Findings suggest an association between optimal levels of purine byproducts and dynamics in clinical symptoms and adjustment, as well as in the integrity of sensory and motor processing. Taken together, alterations in purine catabolism may have clinical relevance in schizophrenia pathology