Adjunct extended-release valproate semisodium in late life schizophrenia

Objective Adjunctive anticonvulsant medications may benefit some individuals with schizophrenia, however data on adjunct anticonvulsants in older adults with schizophrenia is limited. This prospective, 12-week open label study evaluated adjunct extended-release valproate semisodium (divalproex) in 20 older adults with schizophrenia. Methods The study was conducted at an academic psychiatry clinic in the mid-western United States. Participants were self-referred from posted advertisements or referred by clinic practitioners. Extended-release valproate semisodium was added onto antipsychotic treatment. Individuals with active substance use disorders or active significant medical comorbidity were excluded. Primary outcome measures included the Positive and Negative Syndrome Scale (PANSS), Geriatric Depression Scale (GDS) and Global Assessment Scale (GAS). Tolerability was evaluated via patient self-reported side effects, change from baseline in body weight and change on abnormal movement scales. Results Patients (mean age 61 years, range 49.8–79.2 years) had significant reductions in psychosis scores as measured by the Positive and Negative Syndrome Scale (PANSS) p  < 0.01, as well as in global functioning as measured by the Global Assessment Scale (GAS) p  < 0.01 and depression as measured by the Geriatric Depression Scale (GDS) p  < 0.05. Mean dose of extended-release valproate semisodium was 587.50 mg/day SD ± 247.02. Extended-release valproate semisodium was well tolerated in this older adult population. The primary adverse effect was sedation, which appeared to be relatively dose and titration-speed dependent. Weight change was not significant. Conclusion While extended-release valproate semisodium appears efficacious and well tolerated in older adults with schizophrenia, data from larger, controlled trials is needed. Copyright © 2007 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/58029/1/1854_ftp.pd

A Golden Age of Security and Education? Adult Education for Civil Defence in the United States 1950–1970

A number of authors consider that the early period of US security and education (1950–1970) was in some way a ‘golden age’ where there was a prevailing societal orientation towards civil defence. This is supported, to some extent, through ‘Duck and Cover’ type activities in schools and in community preparedness efforts. This article considers whether this portrayal is necessarily correct in the case of adult education. From an analysis of previously classified historical archives in the US National Archives II at the University of Maryland, I consider the success of the civil defense adult education programme (CDAE), and earlier adult education courses, from 1950 to 1970. Rather than being a ‘bottom-up’ process, CDAE was imposed on educators directly through an executive order. There was considerable resistance to the CDAE from other areas of government, from states and from students. CDAE had limited success only so much as the Department of Health and Welfare (DHEW) was able to reconcile it with their own educational objectives. The article concludes by considering the implications of these findings for contemporary adult education for emergencies

A school-based resilience intervention to decrease tobacco, alcohol and marijuana use in high school students

<p>Abstract</p> <p>Background</p> <p>Despite schools theoretically being an ideal setting for accessing adolescents and preventing initiation of substance use, there is limited evidence of effective interventions in this setting. Resilience theory provides one approach to achieving such an outcome through improving adolescent mental well-being and resilience. A study was undertaken to examine the potential effectiveness of such an intervention approach in improving adolescent resilience and protective factor scores; and reducing the prevalence of adolescent tobacco, alcohol and marijuana use in three high schools.</p> <p>Methods</p> <p>A non-controlled before and after study was undertaken. Data regarding student resilience and protective factors, and measures of tobacco, alcohol and marijuana use were collected from grade 7 to 10 students at baseline (n = 1449) and one year following a three year intervention (n = 1205).</p> <p>Results</p> <p>Significantly higher resilience and protective factors scores, and significantly lower prevalence of substance use were evident at follow up.</p> <p>Conclusions</p> <p>The results suggest that the intervention has the potential to increase resilience and protective factors, and to decrease the use of tobacco, alcohol and marijuana by adolescents. Further more rigorous research is required to confirm this potential.</p

Sociological and Human Developmental Explanations of Crime: Conflict or Consensus

This paper examines multidisciplinary correlates of delinquency in an attempt to integrate sociological and environmental theories of crime with human developmental and biological explanations of crime. Structural equation models are applied to assess links among biological, psychological, and environmental variables collected prospectively from birth through age 17 on a sample of 800 black children at high risk for learning and behavioral disorders. Results show that for both males and females, aggression and disciplinary problems in school during adolescence are the strongest predictors of repeat offense behavior. Whereas school achievement and family income and stability are also significant predictors of delinquency for males, early physical development is the next strongest predictor for females. Results indicate that some effects on delinquency also vary during different ages. It is suggested that behavioral and learning disorders have both sociological and developmental correlates and that adequate educational resources are necessary to ensure channels of legitimate opportunities for high-risk youths

Global public policy: Does the new venue for transnational tobacco control challenge the old way of doing things?

The World Health Organization has fostered a new global public policy-the Framework Convention for Tobacco Control (FCTC). Until the 1980s, tobacco control was the sole preserve of states. Now, most countries accept the transnational nature of policy. We explain this shift by identifying mutually reinforcing changes in key policy process elements: transnational actors became a source of policy learning; an international venue &lsquo;institutionalized' new policies; networks began to include tobacco control groups and exclude tobacco companies; socioeconomic shifts undermined public support, and the economic case, for tobacco; and the dissemination of scientific evidence helped actors reframe the image of tobacco, from an economic good to a health crisis. These elements combined to produce an environment conducive to &lsquo;comprehensive' tobacco control. Yet the implementation of the FCTC has been slow and uneven, reflecting the continued importance of domestic policy environments, most of which are not conducive to major policy change

Familial factors in early deaths: Twins followed 30 years to ages 51–61 in 1978

Subjects in the National Academy of Sciences-National Research Council Twin Registry of 31,848 male twin veterans were followed for mortality from 1 January 1946, or from the date of entry into military service if that was later, to 31 December 1978. During this time 3,573 deaths occurred among them, 837 due to trauma and 2,712 due to disease.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47612/1/439_2004_Article_BF00278852.pd

African-American health: the role of the social environment

Cooper and colleagues have noted that the forces affecting the health of minority populations are the same forces, on a less intensive scale, that affect the health of the overall population. 90 That is, we can view the health of the African-American population as the visible tip of an iceberg. This tip of the iceberg is a function of the average health of the entire population. Thus, an effective strategy must address not only the tip, but also should attack the entire iceberg and reduce the risk that it is creating throughout the population. Similarly, Wallace and Wallace have shown how the mechanisms of hierarchical diffusion, spatial contagion, and network diffusion lead to the spread of health and social problems initially confined in inner cities to suburban areas and smaller cities. 91 That is, because of the economic links typing various communities together, there are mechanisms that will ensure the diffusion of disease and disorder from one area to another. If unaddressed, the problems of stigmatized and marginalized urban populations will have adverse impacts on the health, well-being, and quality of life of the more affluent. Thus, investments that will improve the social conditions of a marginalized population can have long-term positive health and social consequences for the entire society.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45781/1/11524_2006_Article_BF02345099.pd