Behavioral Management of Command Hallucinations to Harm in Schizophrenia

The study objective was to evaluate changes in prevalence of command hallucinations to harm self or others, characteristics and intensity of auditory hallucinations, and levels of anxiety and depression after attendance at a 10-session course teaching behavioral strategies for managing persistent auditory hallucinations to adult outpatients with schizophrenia. Prevalence of command hallucinations to harm self or others was measured at baseline, end of course, and 1-year post-course. Pre-course scores on the Characteristics of Auditory Hallucinations Questionnaire, Unpleasant Voices Scale, tension-anxiety subscale of Profile of Mood States, and Beck Depression Inventory-II were compared with scores immediately post-course and 1 year later. The prevalence rate of command hallucinations to harm self of 44% at baseline decreased to 24% immediately after attending the 10-session course and remained at 24% 1-year post-course. The prevalence rate for command hallucinations to harm others of 21% at baseline decreased to 16% at end of course and 17% 1-year post-course. People who attended the course perceived it as helpful, and improvement was seen in all seven characteristics of auditory hallucinations, intensity of auditory hallucinations, and anxiety and depression immediately after the course and 1-year post-course

Comprehensive Evidence-Based Program Teaching Self-Management of Auditory Hallucinations on Inpatient Psychiatric Units

Patients hearing command hallucinations to harm whose only self-management strategies are to obey these commands, can represent serious safety concerns on inpatient psychiatric units. A comprehensive evidence-based program teaching self-management of auditory hallucinations on inpatient psychiatric units is described that includes five components: suggestions for staff education; patient self-assessment tools; an interview guide and safety protocol; a course to teach strategies for managing distressing voices and commands to harm; suggestions to improve staff communication; and a plan to extend the program from inpatient care settings into the community by sharing materials with community case managers and caregivers when patients are discharged

Behavioral Management of Auditory Hallucinations: Implementation and Evaluation of a 10-Week Course

A 10-session behavioral course for self-management of auditory hallucinations in patients with schizophrenia has demonstrated positive outcomes. This article evaluates both the course’s implementation and benefits to patients attending the course. Teleconferencing, electronic media, and 26 monthly conference calls were used to educate six advanced practice nurses (APNs) at six sites about the course implementation. Thirty-two patients within the U.S. Department of Veterans Affairs participated in the course. All of the APNs reported course helpfulness, improved communication with patients about voices, and improved harm assessment. Of the patients, 96% found the course helpful: 67% no longer heard voices to harm self or others, and 60% had improved auditory hallucination intensity scores. The project demonstrated successful implementation and practice integration with APNs’ activities corresponding to Rogers’ stages of innovation adoption. Facilitators and barriers to implementation are also described

Economic evaluation of pharmacist-led medication reviews in residential aged care facilities

Introduction: Medication reviews is a widely accepted approach known to have a substantial impact on patients’ pharmacotherapy and safety. Numerous options to optimise pharmacotherapy in older people have been reported in literature and they include medication reviews, computerised decision support systems, management teams, and educational approaches. Pharmacist-led medication reviews are increasingly being conducted, aimed at attaining patient safety and medication optimisation. Cost effectiveness is an essential aspect of a medication review evaluation. Areas covered: A systematic searching of articles that examined the cost-effectiveness of medication reviews conducted in aged care facilities was performed using the relevant databases. Pharmacist-led medication reviews confer many benefits such as attainment of biomarker targets for improved clinical outcomes, and other clinical parameters, as well as depict concrete financial advantages in terms of decrement in total medication costs and associated cost savings. Expert commentary: The cost-effectiveness of medication reviews are more consequential than ever before. A critical evaluation of pharmacist-led medication reviews in residential aged care facilities from an economical aspect is crucial in determining if the time, effort, and direct and indirect costs involved in the review rationalise the significance of conducting medication reviews for older people in aged care facilities

The effect of professional development on elementary science teachers’ understanding, confidence, and classroom implementation of reform‐based science instruction

Through a randomized controlled trial, this mixed‐methods study evaluated changes in elementary science teachers’ understandings, confidence, and classroom implementation of problem‐based learning (PBL), inquiry, and nature of science (NOS) instruction following participation in a professional development (PD) as well as the components of the PD that teachers perceived facilitated these changes. Results indicated that following the PD, treatment teacher (n = 139) understandings of and confidence for teaching inquiry, NOS, and PBL were significantly greater than control teachers (n = 98) after controlling for preunderstandings and confidence. The effect sizes were large. Treatment teachers also incorporated significantly more PBL, inquiry, and NOS into their instruction. Modeling, microteaching with feedback and reflection, and in‐classroom coaching facilitated teachers’ confidence, understanding, and intention to implement the reform‐based practices they learned. Implications for the understanding of the relationship between knowledge, confidence, and practice as well as elementary science teacher PD design are discussed

Dungeons and Dragons and Data

Research on the demographics of Dungeons and Dragons players and the influence on character creation has been sparse. The current study focused on collecting demographic data on a large scale and collect information about the respondents preferences in character creation for a Dungeons and Dragons campaign, or game. The survey was sent to various tabletop roleplaying (TRPGs) groups and posted on pages associated with the game. At the end of the data collection the results were put through data visualization software, so the results could be shown easily and effectively. The results show the association between demographics and character creation and the impact of certain demographics on game choices.B.S. (Bachelor of Science