Matching Items (13)

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Not Just Welfare Over Justice: Ethics in Forensic Consultation.

Description

The ethics of forensic professionalism is often couched in terms of competing individual and societal values. Indeed, the welfare of individuals is often secondary to the requirements of society, especially

The ethics of forensic professionalism is often couched in terms of competing individual and societal values. Indeed, the welfare of individuals is often secondary to the requirements of society, especially given the public nature of courts of law, forensic hospitals, jails, and prisons. We explore the weaknesses of this dichotomous approach to forensic ethics, offering an analysis of Psychology's historical narrative especially relevant to the national security and correctional settings. We contend that a richer, more robust ethical analysis is available if practitioners consider the multiple perspectives in the forensic encounter, and acknowledge the multiple influences of personal, professional, and social values. The setting, context, or role is not sufficient to determine the ethics of forensic practice.

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Created

Date Created
  • 2013-12-28

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Improving Outpatient Psychiatric Appointment Attendance

Description

Mental health issues are a growing concern for individuals and the public. When patients do not attend their mental health appointments they place themselves at risk for poor health outcomes

Mental health issues are a growing concern for individuals and the public. When patients do not attend their mental health appointments they place themselves at risk for poor health outcomes including worsening of symptoms, relapse, hospitalization, or danger to self and other behaviors. The breadth, background, and significance of this issue were investigated to determine a clinically relevant PICOT question. These elements of the PICOT question were investigated and high-quality evidence was gathered, analyzed, and synthesized in order to develop recommendations for an evidence-based project to help with no-shows at a non-profit integrated healthcare organization that is experiencing a high incidence of no-shows. The Quality Health Outcomes Model and Ottawa Model of Research Use guide the implementation and monitoring of the project.

A chart review was completed in order to understand the impact of a novel automated reminder system on the no-show rate for all psychiatric appointments for 18 months. Additionally, demographic and appointment information was gathered to identify trends in the data and factors related to appointment status. The no-show rate significantly increased in 2019 with the new reminder system. No-shows occurred significantly more in males, tele-medicine appointments, and hospital discharge appointments. There were significant differences in no-show rates observed between reported races, with different providers, and at different practice locations. This gap analysis has provided insight into further projects and work to be completed in order to decrease no-shows, improve treatment compliance, produce better health outcomes, and increase revenue for this organization.

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Created

Date Created
  • 2020-04-30

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Stress and Biological Pathways of Schizophrenia: EGR3 Dependent HTR2A Expression in Response to Sleep Deprivation

Description

Environmental and genetic factors contribute to schizophrenia etiology, yet few studies have demonstrated how environmental stimuli impact genes associated with the disorder. Immediate early genes (IEGs) are of great interest

Environmental and genetic factors contribute to schizophrenia etiology, yet few studies have demonstrated how environmental stimuli impact genes associated with the disorder. Immediate early genes (IEGs) are of great interest to schizophrenia research because they are activated in response to physiological stress from the environment, and subsequently regulate the expression of downstream genes that are essential to neuropsychiatric function. An IEG, early growth response 3 (EGR3) has been identified as a main gene involved in a network of transcription factors implicated in schizophrenia susceptibility. The serotonin 2A receptor (5-HT2AR) seems to play an important role in schizophrenia and the dysfunction of the 5-HT2AR encoding gene, HTR2A, within the prefrontal cortex (PFC) contributes to multiple psychiatric illnesses including schizophrenia. EGR3's role as a transcription factor that is activated by environmental stimuli suggests it may regulate Htr2a transcription in response to physiological stress, thus affecting 5-HT2AR function in the prefrontal cortex (PFC). The aim of this study was to examine the relationship between Egr3 activation and Htr2a expression after an environmental stimulus. Sleep deprivation is an acute physiological stressor that activates Egr3. Therefore to examine the relationship between Egr3 and Htr2a expression after an acute stress, wild type and Egr3 knockout mice that express EGFP under the control of the Htr2a promoter were sleep deprived for 8 hours. We used immunohistochemistry to determine the location and density of Htr2a-EGFP expression after sleep deprivation and found that Htr2a-EGFP expression was not affected by sex or subregions of the PFC. Additionally, Htr2a-EGFP expression was not affected by the loss of Egr3 or sleep deprivation within the PFC. The LPFC subregions, layers V and VI showed significantly more Htr2a-EGFP expression than layers I-III in all animals for both sleep deprivation and control conditions. Possible explanations for the lack of significant effects in this study may be the limited sample size or possible biological abnormalities in the Htr2a-EGFP mice. Nonetheless, we did successfully visualize the anatomical distribution of Htr2a in the prefrontal cortex via immunohistochemical staining. This study and future studies will provide insight into how Egr3 activation affects Htr2a expression in the PFC and how physiological stress from the environment can alter candidate schizophrenia gene function.

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Date Created
  • 2014-05

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Parental Stress in Raising a Child with ADHD

Description

This paper investigates how stress in parents is affected by their child's Attention-Deficit/Hyperactivity Disorder (ADHD). The purpose of this paper is to identify common stressors for parents of children with

This paper investigates how stress in parents is affected by their child's Attention-Deficit/Hyperactivity Disorder (ADHD). The purpose of this paper is to identify common stressors for parents of children with ADHD, as well as to determine what parents need from healthcare providers to mediate this stress. A survey was developed to identify sources of stress, consequences of parental stress, parental coping methods, resources provided by their healthcare provider that have been helpful, along with what they feel that they need from their healthcare providers in order to better support themselves and their family. Participants were composed of members of Facebook support groups for parents of children with ADHD. Major findings of this study include: parents experience the most stress when dealing with their child's oppositional and aggressive behaviors; parents frequently experience disruption in their marital relationship; and parents perceive that they receive little health care resources that are helpful for themselves, their child, and their family overall.

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Created

Date Created
  • 2018-05

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The Arizona Psychiatric System: Structure, Defect, & Reform

Description

The Arizona healthcare system is changing and although its effects can be seen in almost every realm of the medical field, psychiatry is a specialty that is still experiencing hardship.

The Arizona healthcare system is changing and although its effects can be seen in almost every realm of the medical field, psychiatry is a specialty that is still experiencing hardship. There are scarce resources available for the ever-growing and struggling patient pool, especially in rural areas and minority populations. A comorbid cycle of untreated psychiatric illness contributes to the burden on emergency department and primary care medicine, as well as homelessness, crime, and suicide within the state. Arizona currently has a dismal spot in the rankings for American states with appropriate access to psychiatric resources, leaving many who need treatment without it. Compared to states with similar populations who are at the top of these rankings, Arizona spends more government money for behavioral health services, indicating a disparity in productivity and questioning monetary waste. Demographic statistics and other relevant scientific literature reveals that Arizona's psychiatric system lacks appropriate structure, and is failing the mental health care system both in monetary and societal constructs. These issues highlight the need for remedies and identify areas for future reform. Recommendations on such reform include permanent change in legislation and department models to improve crisis ward work, communication and networking during transition of care, integration of and access to continuum of care, and community education. They also include creating incentive and certification programs within the state in order to increase the number of available providers, especially in rural areas. These recommendations are directed to specifically reduce the burden of mental illness on emergency medical services, increase productivity, and decrease chronic untreated mental disease and monetary waste.

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Created

Date Created
  • 2018-05

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Adverse Side Effects of Pharmacological Agents for Pediatric Anxiety Disorders: A Critical Review

Description

Pediatric anxiety disorders are highly prevalent and while pharmacological intervention seems to be an effective treatment, the validity of reported adverse side effects remains unclear. <br/><br/>Objective: To analyze the nature

Pediatric anxiety disorders are highly prevalent and while pharmacological intervention seems to be an effective treatment, the validity of reported adverse side effects remains unclear. <br/><br/>Objective: To analyze the nature of evidence regarding adverse side effects in the pharmacological treatment of pediatric anxiety disorders. <br/><br/>Approach: A search using Google Scholar, PubMed, and PsychInfo was conducted for meta-analyses of pharmacological treatment of pediatric anxiety disorders as well as randomized controlled trials. The focus was on adverse events.<br/><br/>Results and Conclusion: Reportings of a limited number of adverse events were found among resources available to clinician and patient informed sources to inform pharmacological treatment of pediatric anxiety disorders. Only a small fraction of adverse side effects were found in the research literature. This finding raises concerns about making informed decisions to treat pediatric anxiety disorders with pharmacotherapy.

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Created

Date Created
  • 2021-05

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Retinal Vessel Diameter and Symptoms of Depression and Anxiety in Young Adults

Description

Previous studies suggest an association between depression and anxiety in childhood and adolescence and increased risk for cardiovascular disease later in life. The aim of the present study was to

Previous studies suggest an association between depression and anxiety in childhood and adolescence and increased risk for cardiovascular disease later in life. The aim of the present study was to test whether depression and anxiety symptoms in young adulthood were associated with retinal vessel diameter, a subclinical marker of cardiovascular disease. We further tested whether associations for depression were similar to associations for anxiety. Participants completed questionnaires about their depression and anxiety symptoms and underwent retinal imaging. Retinal vessel diameter was assessed using computer software. Results showed no association between depression or anxiety symptoms and retinal vessel diameter, suggesting that retinal vessel diameter may not signal subclinical cardiovascular risk in young adults with symptoms of depression and anxiety.

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Created

Date Created
  • 2016-05

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The Insanity Defense: Defending Its Necessary Place in Law

Description

It is not necessarily concerning that it is harder for some to conform to the law until it brings up the issue of insanity. The insanity defense, though controversial, is

It is not necessarily concerning that it is harder for some to conform to the law until it brings up the issue of insanity. The insanity defense, though controversial, is inherently retributive in that punishing the mentally ill is not blameworthy. As ill-suited subjects for blame, mentally ill persons lack the cognitive reasoning skills necessary to be held legally accountable. Exculpating the mentally ill is not only retributive, but also deeply intuitive, evidenced by how many mentally ill persons seem "odd or crazy" to the average person. Finally, of all the tests used to determined insanity, the Federal Test of 1984 most successfully renders the insanity defense narrow enough to minimize abuse, allows for expert testimony, and calls for a cognitive interpretation of insanity.

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Created

Date Created
  • 2013-05

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Improving Therapeutic Communication in a Psychiatric Mental Health Clinic

Description

Purpose: The purpose of this project is to demonstrate the benefits of therapeutic communication in a mental health clinic with an outcome to increase patient satisfaction of their care and

Purpose: The purpose of this project is to demonstrate the benefits of therapeutic communication in a mental health clinic with an outcome to increase patient satisfaction of their care and improve patient-caregiver communication and relationship.

Background: The consequences of poor communication or non-therapeutic communication cannot be overemphasized; these can include non-adherence to treatment plan, reduced treatment compliance, higher psychological morbidity, dissatisfaction with care and poor patient-caregiver relationship. Patients’ perception of how they are being treated affects how they respond to treatment plans and medication regimens

Method: The project consisted of providing education on the principles of therapeutic communication to healthcare workers in an outpatient psychiatric clinic. Follow up materials on therapeutic communication principles were provided on a weekly basis for one month. A pre-survey questionnaire was given to patients before intervention and a post-survey questionnaire after intervention to determine patient satisfaction with care and degree of communication with healthcare workers. The Short Assessment of Patient Satisfaction (SAPS) and the Communication Assessment Tool-Team (CAT-T) were the instruments utilized in this project.

Finding: Patient satisfaction and communication with staff were statistically and significantly improved after education on therapeutic communication was given to staff.

Conclusion: Education on therapeutic communication is an effective intervention tool in improving patient’s satisfaction and communication with staff and health care team members in a psychiatric outpatient clinic.

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Created

Date Created
  • 2017-05-01

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Decreasing Stigma and Improving Therapeutic Interventions for Psychiatric Patients in the Emergency Department

Description

Findings suggest that stigma associated with mental health may be as strong in healthcare providers as it is in the general public. Research involving non-behavioral health nurses, and medical and

Findings suggest that stigma associated with mental health may be as strong in healthcare providers as it is in the general public. Research involving non-behavioral health nurses, and medical and nursing students, sought to identify bias and negative attitudes directed towards psychiatric patients in a non-psychiatric setting. Studies were reviewed to determine the effects of educational interventions to teach empathy and increase knowledge related to the pathology of, and treatment modalities for, psychiatric patients. Several scales were used to measure bias and rate interventions to minimize it.

Studies found that healthcare personnel, including nurses, are considered by mental health consumers to be primary contributors to stigma and discrimination against those with mental illness. The studies also discovered that participation in an educational intervention to learn empathy and acquire knowledge about psychiatric patients directly decreased bias. The project utilized the evidence-based practice PRECEDE-PROCEED model (PPM) supported by Bandura’s Social Cognitive Theory (SCT). Combining the PPM with the SCT is supported in the literature as they both rely on learned behavior.

Moving forward, the presentation was completed and participation sought. It was at this point the project shifted its perspective. Out of 80 nurses asked to attend 1 of the 2 presentations, a total of 3 nurses participated. The search for statistical significance was not possible. We were left to formulate descriptive statistics to interpret the outcomes and reflect on their meaning.

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Created

Date Created
  • 2016-04-24