To Stay at Home: Analysis of Rights and Recommendations on Procedures for Persons Receiving Mental Health Services in the Community

Before the pendulum swings back to the use of institutions as the primary treatment modality for persons with severe mental illness, there should be a re-examination of the alternatives available to community care providers to ensure compliance with treatment outside of the hospital. This article will focus on the alternatives available in the Ohio mental health system, which is fundamentally oriented towards community-based treatment, and the effects of this orientation

Liver transplant recipients’ experiences and perspectives of a telehealth-delivered lifestyle programme A qualitative study

Introduction Dietary modification and exercise are encouraged to address cardiometabolic risk factors after solid organ transplantation. However, the lived experience of attempting positive lifestyle changes for liver transplant recipients is not known. The aim of this study was to explore the experiences of liver transplant recipients and their perspectives of a 12-week telehealth lifestyle programme and assess the feasibility of this innovative health service. Methods Focus groups and one-on-one interviews were conducted with participants who had completed a 12-week, group-based, telehealth-delivered diet and exercise programme and thematic qualitative analysis was used to code and theme the data. Results In total, 19 liver transplant recipients participated in the study (25-68 years, median time since transplant 4.4 years, 63% male). Overarching themes included: (a) 'broad telehealth advantages' which highlighted that telehealth reduced the perceived burdens of face-to-face care; (b) 'impact of employment' which identified employment as a competing priority and appeared to effect involvement with the programme; (c) 'adapting Mediterranean eating pattern to meet individual needs' which identified the adaptability of the Mediterranean diet supported by sessions with the dietitian; (d) 'increasing exercise confidence' which recognised that a tailored approach facilitated confidence and acceptability of the exercise component of the programme. Discussion A telehealth lifestyle programme delivered by dietitians and exercise physiologists is an acceptable alternative to face-to-face care that can meet the needs of liver transplant recipients. There is a need to further innovate and broaden the scope of routine service delivery beyond face-to-face consultations

Cyclic Perimenstrual Pain and Discomfort and Australian Women's Associated Use of Complementary and Alternative Medicine: A Longitudinal Study

© Copyright 2018, Mary Ann Liebert, Inc. 2018. Objective: To examine the longitudinal change in Australian women's prevalence of cyclic perimenstrual pain and discomfort and the association between their symptoms and use of complementary and alternative medicine (CAM). Method: Data on endometriosis, premenstrual syndrome (PMS), irregular periods, heavy periods, and severe period pain were collected over a 7-year period from the Australian Longitudinal Study on Women's Health, for women aged 28 to 33 years in 2006, and at 3-year follow-ups. Changes in symptoms and patterns of CAM practitioner and therapy/product use associated with these symptoms were analyzed using longitudinal regression modeling. Results: Over the 7-year period, prevalence rates of PMS and heavy periods increased, while prevalence rates of endometriosis, irregular periods, and severe period pain remained stable. The most common use of CAM longitudinally associated with the perimenstrual symptoms was use of vitamins/minerals, yoga/meditation, massage therapy, herbal medicine, and aromatherapy. Excluding consultation with a naturopath/herbalist, over the 7-year survey women's use of all other CAM practitioners increased as did their use of vitamin/minerals, yoga/meditation, and Chinese medicines, while aromatherapy use declined. Conclusion: Only the prevalence of PMS and heavy periods increased with aging in this sample of women. While overall use of CAM practitioner and self-prescribed products/therapies increased over time, CAM was chosen by women mainly to treat endometriosis and PMS. The extent to which this use reflects treatment efficacy is uncertain

Use of the Physician Orders for Scope of Treatment Program in Indiana Nursing Homes

OBJECTIVES: To assess the use of the Indiana Physician Orders for Scope of Treatment (POST) form to record nursing home (NH) resident treatment preferences and associated practices. DESIGN: Survey. SETTING: Indiana NHs. PARTICIPANTS: Staff responsible for advance care planning in 535 NHs. MEASUREMENTS: Survey about use of the Indiana POST, related policies, and educational activities. METHODS: NHs were contacted by telephone or email. Nonresponders were sent a brief postcard survey. RESULTS: Ninety-one percent (n=486) of Indiana NHs participated, and 79% had experience with POST. Of the 65% of NHs that complete POST with residents, 46% reported that half or more residents had a POST form. POST was most often completed at the time of admission (68%). Only 52% of participants were aware of an existing facility policy regarding use of POST; 80% reported general staff education on POST. In the 172 NHs not using POST, reasons for not using it included unfamiliarity with the tool (23%) and lack of facility policies (21%). CONCLUSION: Almost 3 years after a grassroots campaign to introduce the voluntary Indiana POST program, a majority of NHs were using POST to support resident care. Areas for improvement include creating policies on POST for all NHs, training staff on POST conversations, and considering processes that may enhance the POST conversation, such as finding an optimal time to engage in conversations about treatment preferences other than a potentially rushed admission process

The 50 Ah NiH2 CPV qualification tests

In 1992, the Naval Research Laboratory (NRL) started a program to qualify a large diameter common pressure vessel (CPV) nickel-hydrogen (NiH2) batteries for use on future Navy/NRL spacecraft electrical power subsystems. NRL's involvement with the qualification of CPV NiH2 batteries dates back to 1988 when COMSAT and Johnson Controls, Inc. initiated a joint effort to fly the first ever NiH2 CPV in space. A later NRL-JCI cooperative research and development agreement led to the launch of a space experiment in 1993 and to the use of a single NiH2 CPV battery on the BMDO Clementine spacecraft in 1994. NRL initiated procurement of two, 50 Ah CPV NiH2 batteries in the Fall of 1992. The two batteries were delivered to NRL in June 1994. NiH2 CPV batteries have almost 2x the specific energy (Wh/kg) of nickel cadium batteries and 2x the energy density (Wh/l) of individual pressure vessel NiH2 CPV's. This presentation discusses the results of electrical and mechanical qualification tests conducted at NRL. The tests included electrical characterization, standard capacity, random vibration, peak load, and thermal vacuum. The last slides of the presentation show initial results from the life cycle tests of the second NiH2 CPV battery at 40% depth of discharge and a temperature of 10 C

Meditation and secondary prevention of depression and anxiety in heart disease: A systematic review

Heart disease is the leading cause of global mortality, accounting for 13.7 million deaths annually. Optimising depression and anxiety symptoms in adults with heart disease is an international priority. Heart disease secondary prevention is best achieved through implementation of sustainable pharmacological and non-pharmacological interventions, including meditation. Meditation is a means of generating self-awareness and has implications for enhanced self-management of depression and anxiety symptoms. This review aims to identify high-level quantitative evidence for meditation interventions designed to improve depression and/or anxiety symptoms among adults with heart disease and ascertain the most important elements of meditation interventions that facilitate positive depression and/or anxiety outcomes. This systematic review and narrative synthesis was completed in accordance with the PRISMA Statement and has adhered to the Cochrane Risk of Bias guideline. Six databases were searched between 1975 and 2017. Statistically significant outcomes were demonstrated in over half (5/9) of phase II meditation studies for depression and/or anxiety and involved 477 participants. Meditation interventions that generated positive outcomes for depression and/or anxiety included elements such as focused attention to body parts (or body scan) (3/4 studies) and/or group meetings (4/5 studies). Meditation is a means of reframing heart disease outpatient services towards an integrated model of care. Future adequately powered phase III studies are needed to confirm which meditation elements are associated with reductions in depression and anxiety; and the differential effects between concentrative and mindfulness-based meditation types among adults with heart disease

On biosignatures for Mars

In this work, we address the difficulty of reliably identifying traces of life on Mars. Several independent lines of evidence are required to build a compelling body of proof. In particular, we underline the importance of correctly interpreting the geological and mineralogical context of the sites to be explored for the presence of biosignatures. We use as examples to illustrate this, ALH84001 (where knowledge of the geological context was very limited) and other terrestrial deposits, for which this could be properly established. We also discuss promising locations and formations to be explored by ongoing and future rover missions, including Oxia Planum, which, dated at 4.0 Ga, is the most ancient Mars location targeted for investigation yet