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Background and Objectives: The Centers for Medicare and Medicaid Services (CMS) requires reporting of specific tobacco treatment (TT) measures. We examined compliance to these measures before and after initiation of a specialized TT service in a state-psychiatric hospital.Methods: Using a retrospective analysis, patient records (N = 3669) were examined, using one-way ANOVAs, for changes in rates of tobacco use screening and treatment between September-December 2015 (pre-implementation of CMS requirements), and January-April, May-August, and September-December 2016 (post-implementation of the CMS requirements).Results: We found significant increases, between Sep-Dec 2015 and Sep-Dec 2016, in the rates of tobacco use screening (93.4-95.3%, F [3, 12] = 7.39, p = .005), offering TT counseling (68.1-76.5%, F [1] = 18.59, p = .001) and medications (71.7-76.5%, F [1] = 5.86, p = .032).Conclusions and Significance: Our findings can provide guidance to enhance compliance with TT measures in psychiatric settings. (Am J Addict 2018;XX:1-4). [ABSTRACT FROM AUTHOR]

This study examined the person-environment interaction effects of environmental design on ward climate, safety, job satisfaction, and treatment outcomes within a new high security forensic psychiatric facility. Participants included male and female adult psychiatric inpatients and staff members at different security stages. Data were collected once before and twice after the experimental group moved into the new building. The control group remained in the same facilities. Contrary to expectations, the new building had limited effects on the measured variables. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective To determine whether, following implementation of California's minimum nurse staffing legislation, changes in acuity-adjusted nurse staffing and quality of care in California hospitals outpaced similar changes in hospitals in comparison states without such regulations. Data Sources/Study Setting Data from the American Hospital Association Annual Survey of Hospitals, the California Office of Statewide Health Planning and Development, the Hospital Cost Report Information System, and the Agency for Healthcare Research and Quality's Health Care Cost and Utilization Project's State Inpatient Databases from 2000 to 2006. Study Design We grouped hospitals into quartiles based on their preregulation staffing levels and used a difference-in-difference approach to compare changes in staffing and in quality of care in California hospitals to changes over the same time period in hospitals in 12 comparison states without minimum staffing legislation. Data Collection/Extraction Methods We merged data from the above data sources to obtain measures of nurse staffing and quality of care. We used Agency for Healthcare Research and Quality's Patient Safety Indicators to measure quality. Principal Findings With few exceptions, California hospitals increased nurse staffing levels over time significantly more than did comparison state hospitals. Failure to rescue decreased significantly more in some California hospitals, and infections due to medical care increased significantly more in some California hospitals than in comparison state hospitals. There were no statistically significant changes in either respiratory failure or postoperative sepsis. Conclusions Following implementation of California's minimum nurse staffing legislation, nurse staffing in California increased significantly more than it did in comparison states' hospitals, but the extent of the increases depended upon preregulation staffing levels; there were mixed effects on quality. [ABSTRACT FROM AUTHOR]

Objective: To achieve Millennium Development Goals 4 and 5 in Nigeria, a quality assurance project in obstetrics in 10 hospitals in northern Nigeria was established to improve maternal and fetal outcome.Methods: The project commenced in January 2008 with assessment and improvement of the structure of the 10 hospitals. Continuous maternal and fetal data collection and analysis were conducted from 2008 to 2009 by means of a maternity record book and structured monthly summary form. The quality of hospital infrastructure and equipment was also assessed.Results: The mean maternal mortality ratio (MMR) was reduced from 1790 per 100000 births in the first half of 2008 to 940 per 100000 births in the second half of 2009. The average fetal mortality ratio (FMR) decreased slightly from 84.9 to 83.5 per 1000 births. There was an inversely proportional relationship between the total number of deliveries in a hospital and MMR and FMR. There was a close correlation between the MMR and the equipment status and hygiene conditions of the hospitals.Conclusion: Continuous monitoring of quality assurance in maternity units raised the awareness of the quality of obstetric performance and improved the quality of care provided, thereby improving MMR. [ABSTRACT FROM AUTHOR]

Over one hundred children and some of their parents were infected with HIV in state hospitals in the Chimkent region in Southern Kazakhstan. After this tragedy, the Regional Department of Public Health organized social services for these families and asked the American Jewish Joint Distribution Committee (JDC) to provide them with training and supervision. Twelve seminars were conducted for the social workers in Chimkent over an 18-month period. The JDC team also met with the local medical staff as well as with governmental and nongovernmental organizations to assess their needs and provide organizational support for the social services. This article presents an analysis of the psychosocial challenges associated with the mass HIV infection episode in Kazakhstan. The analysis is based on Hofstede's () theory of cultural values, theories on cross-cultural interaction (Cushner & Brislin, ), and principles of multicultural social work (Potocky-Tripodi, ). The training program is described, and its results are discussed. General principles and practical recommendations for planning and implementing cross-cultural international humanitarian programs in the field of HIV are suggested. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Context. Patients with mental disorders show higher burden of coronary heart disease, and may face special safety issues during in-hospital cardiac care. Objectives. To compare the postoperative complication rate between patients with and without mental disorders undergoing isolated coronary artery bypass graft (CABG) surgery. Design, Setting, and Patients. Retrospective analyses of New York state hospital claims between 1997 and 2004 ( N=135,701). Complications were defined using the Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ PSI). Principal Findings. Mental disorders were significantly associated with higher anesthesia complications (adjusted odds ratio [AOR]=6.44, p<.001), decubitus ulcer (AOR=1.42, p=.006), postoperative hip fracture (AOR=3.29, p<.001), and overall complication rate representing nine PSIs (AOR=1.27, p<.001). Conclusions. Mentally ill patients undergoing CABG surgery are more likely to experience potentially preventable complications and injuries. The mechanism underlying this observation warrants further study. [ABSTRACT FROM AUTHOR]

Focuses on the characterization of the functions and design prerequisites of a clinical decision support system (CDSS) in state hospitals. Necessity of CDSS in state hospitals; Details of the categories of the design considerations of a CDSS; Description of a CDSS prototype.

Focuses on the formulation of the future roles and functions of state psychiatric hospitals in the 21st century. Capability of a comprehensive mental health system to provide high-intensity psychiatric rehabilitation; Potential of state hospitals to provide various kinds of services with optimal cost-effectiveness; Problem concerning the interference of the locus of specific services with the focus of treatment and rehabilitation in all domains of function needing improvement.

Focuses on changes in a mental health system. Inauguration of the Community Transition Program (CTP) in 1982 within a state hospital; Provision by the CTP of psychiatric rehabilitation to people with serious and persistent mental disorders; Emergence of administrative obstacles as the program evolved.

Discusses the various factors affecting the nature of state hospital-based forensic mental health services. Evolution of the conceptualization of forensic services; Suspicion concerning the shift of cost and people into the correctional system due to mental health system reform; Explanations regarding cost containment activities in the public mental health sector.

Focuses on the concept of making state psychiatric hospitals rehabilitation-ready for mentally ill individuals in the U.S. Doubt of community practitioners that rehabilitation can occur in inpatient settings; Reason why all clients cannot be treated in the community considering the advances in community-based rehabilitation technology; Changes made by the Fulton State Hospital in Missouri to turn the hospital rehabilitation-ready.

Discusses the state of the state mental hospital in the U.S. Description by the author in a 1976 monograph of functions that state mental hospitals had even as community-based services were being rapidly developed; Partiality of the necessary transfer of state mental hospital functions to community agencies; Examination of interrelated questions in connection with the state of state mental hospitals.

A job club conducted at a state hospital placed 78% of job seekers in competitive employment. Referrals included inpatient, halfway house, and outpatient clients. The results indicate that while client demographics and treatment histories are associated with different success rates, a majority of all client groups found work. [ABSTRACT FROM AUTHOR]

Present the results of a job analysis of psychologists working in state hospitals. Objective of the study; Methodology used to conduct study; Results of study; What graduate training of psychologists should prepare them for.

An objective, semi-structured interview questionnaire (QOLIS) was designed and tested with 201 severely mentally ill people who were living in a state hospital and in community residential facilities. Factor analysis resulted in eight factors with face validity and acceptable coefficient alphas. The factors were found to be related meaningfully to overall level of functioning, total symptom scores, self-reported life satisfaction, and an established objective measure of quality of life. Criterion validity was established and the QOLIS factors significantly differentiated people who were living in the community vs. living in a state hospital. These results suggest that the QOLIS has potential as a valid outcome measure and program evaluation tool. [ABSTRACT FROM AUTHOR]

The article determines the relationship between the Ohio Literacy Test (OLT) and Wonderlic and provides norms for the OLT on a normal adult sample. The sample consisted of 631 adults who were examined during the years 1965-1968 with both the Revised Ohio Literacy Test (ROLT) and Wonderlic Personnel Test (WPT), Form A, prior to employment at Glenwood State Hospital-School. The OLT was found to be concurrently valid to predict the WPT scores of normal adults, and appeared promising to determine the ability level of older persons who do poorly on the WPT.

Objective . This study examined the clinical characteristics of elderly inpatients associated with retention in a large state hospital during a period of rapid reduction in the inpatient census. Design . During the first year of the study all inpatients age 65 or greater were individually evaluated. Patients remaining in the hospital during the second year were reevaluated and followed for an additional year. Separate statistical analysis of the data allowed for replication of findings. Setting . The study was conducted at Pilgrim Psychiatric Center, the largest state hospital in New York State. Participants . The entire inpatient population over the age of 65 were included in the study (N=806). The average age of the sample was 76 years and 70% were assigned a lifetime research diagnosis of schizophrenia. The majority of patients were hospitalized for long periods (mean=33.9 years) and had significant cognitive impairment. Main outcome measures . Cognitive functioning was assessed on the Clinical Dementia Rating Scale. Severity of psychiatric symptoms was evaluated on the PANSS. Occurrence of dangerous behavior and medical and psychiatric treatment were obtained from the patients' medical histories. Main results . The findings, replicated across assessments, were that patients retained had more severe symptoms of excitement, hostility and impulsive behavior than those discharged, while uncooperativeness, delusions, grandiosity and suspiciousness were also more severe in those retained than those discharged. Conclusions . Elderly patients who are very difficult to place are so characterized because of behavior disorders that are difficult to manage rather than psychotic symptoms, cognitive impairment or medical disorders. © 1997 by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Psychiatric inpatients in special units designed for the treatment management of violence (secure care) are compared with inpatients in three forensic programs. Although program designers anticipated that secure care and forensic patients would be similar, they were not. Principally, secure care patients were lower functioning in the psychiatric areas and were more likely to have engaged in a physical assault in the last 30 days. [ABSTRACT FROM AUTHOR]

An instrument was designed to assist mental health professionals in objectively assessing competence to stand trial. Items were empirically derived based on input from multidisciplinary teams of mental health professionals experienced in working with forensic patients in a state hospital. Procedures were adapted from Goldfried and D'Zurella's five-stage behavioral-analytic model for the assessment of social competence. The resulting 15-item audiotaped scale assessed both legal and social competence based on reported responding in jail, in interactions with lawyers, and in the courtroom. Interrater reliability on scoring of responses ranged from .68-.96. High correlations between social and legal competence (.56-.82) demonstrated the likelihood of overlap of these constructs and the importance of directly addressing both. A pilot intervention program was designed from the instrument and implemented with three forensic patients. Failure to demonstrate change in these subjects is briefly discussed, and recommendations for future efforts in this area are made. [ABSTRACT FROM AUTHOR]

This study compares the knowledge and attitudes of 60 patients in a state hospital about medication, before and after structured and unstructured medication education. The purpose was to determine which type of education has more positive effects. A pre- and post-test two-group experimental design was used. The results of this study were not statistically significant in supporting the literature that education has some effect on knowledge or on attitude about taking medication. The study showed similar effects of the method (structured versus unstructured) on increasing knowledge and attitude toward medication. Demographic data from the study suggest a variety of other factors may relate to attitudes and knowledge about medication in the hospital. This study suggests medication education should address demographic factors, incorporate multi-dimensional approaches, include more active patient participation, and utilize one-to-one teaching whenever possible. [ABSTRACT FROM AUTHOR]

Interactive staff training (IST) uses principles of organization psychology to help line-level staff members design and implement social learning programs for severely mentally ill inpatients. IST is a training package that includes assessment of staff perceptions regarding programmatic needs, selection of appropriate social learning strategies to meet these needs, appointment of a program committee from within the ward to champion development of the social learning strategy, and participative decision making about aspects of the social learning strategy. Staff on an extended care ward at a state hospital participated in IST for 15 months as part of a pilot study of its effects. Ongoing examination of ward programming showed that IST significantly increased staff and patient participation in rehabilitation programming and decreased the rate of physical restraints and aggression-related. Changes in staff attitudes about rehabilitation programming were noted on a subsample of IST participants. Implications for more controlled research into IST are discussed. [ABSTRACT FROM AUTHOR]

This study assessed the effects of providing treatment in a Specialized Foster Care (SFC) program for children and adolescents who had been previously hospitalized. Cases were randomly assigned for placement in Sit or other extrahospital settings, including residential treatment centers and family relative homes. The SFC program used carefully selected foster parents who were trained and supervised in the implementation of the child's treatment plan. One child or adolescent was placed in each home. SFC placements were augmented by individual therapy for the child or adolescent and by case management services, including coordination with schools and employer, weekly clinical staffings, and crisis intervention. Results showed that the SFC model is a viable treatment option for severely emotionally disturbed children and adolescents, that cases in the SFC group were placed outside of the hospital more frequently and quickly than cases in the control group and that once placed outside of the hospital, SFC cases were slightly more successful at maintaining in their communities than were control cases. [ABSTRACT FROM AUTHOR]

Two questionnaires, Characteristics of the Treatment Environment (CTE) and the Residential Management Survey (RMS), were administered on two occasions to the staffs of various types of community residential facilities serving retarded persons. The results were consistent with those of previous studies of public institutions, i.e., the responses of staff to the questionnaires were only minimally related to their demographic characteristics and employment history, and the CTE and RMS mean scores for three types of community facilities were relatively stable over time. A major finding was that treatment practices differed among a variety of residential settings—an institution, skilled nursing facilities, resident facilities, and family homes. These differences, as measured by the CTE and RMS, were along the dimensions of Activity, Autonomy, and staff orientation. [ABSTRACT FROM AUTHOR]

The article reports on the state hospital operation of a community program. Connecticut Valley Hospital (CVH) has gone through many phases with its patient population peaking at 3,350 in 1940. The hospital admission rate has dropped to approximately one-third of its 1986 level of 1,000 a year and the hospital census has declined by 165 patients during the same period with the development of community-based comprehensive mental health service systems.

The article examines the relationship of a variety of demographic factors to Beta Intelligence Quotient (IQ) test performance for a sample of state hospital patients. Numerous social factors and various clinical diagnostic groups were shown to have significant independent sources of variation. Beta IQ scores and 14 social history variables were recorded for a sample of 257 children and adolescent patients referred for psychological testing in a state hospital setting between January, 1966 and January, 1972.

The article investigates high, average and low-rated clergymen in a state hospital clinical program. Relatively little research is available on either the characteristics or the competence as clinicians of clergymen who seek special clinical training in nonsectarian settings. This investigation compared clergymen rated high, average, and low in competence as clinicians by their supervisor upon completion of a 12-week program of clinical pastoral education on the basis of selected intellective and nonintellective variables.

The article presents the results of variety of analyses of automated MMPI interpretive program. Briefly, MMPIs were obtained from inpatients from five traditional state hospitals and two community mental health centers in Missouri. Generally speaking, patients whose MMPIs fall in the 2-4/4-2 category are apt to display less psychotic psychopathology and fewer defects in judgement and orienation than the typical state hospital inpatient. Both males and females who generate this profile are more likely to be diagnosed as alcoholic than non-2-4/4-2s.

This article investigates the relationship between stress-related social events and psychological impairment. Patients who entered one unit of a state mental hospital were screened by a psychiatric social worker to determine their suitability as subjects. Patients who were incapable of responding, who were deemed uncooperative, and/or who had been in a state hospital for more than 3 months in the preceding year were excluded. The results indicate that there is a partial relationship between stress-related social events and psychological impairment. A relationship exists between these events and the patients' previous psychiatric histories.

Focuses on the need for state psychiatric hospitals in the 21st century. Speculations concerning the replacement of state hospitals by community-based services; Impact of developments in biomedical and psychosocial technologies on the need for long-term care in public psychiatric institutions; Production of a polarized configuration of beliefs and perspectives regarding the need for state hospitals due to the infusion of ideology.

The article presents a short-term study which aims to characterize and examine the mentally ill patients who elope from the Bronx State Hospital in the U.S. The study was conducted to all wards of 70 mentally ill patients who eloped 80 times in February 1972. The results reveal that the overwhelming majority of leave without consent patients return to the hospital in which most of them return within a short period time. It was also found out that most of the leaves without consent appeared over weekends.

The article cites a study to investigate a particular aspect of the patient role--the relationship between personal role and the staff evaluation of the patient as "good" or "not-good." The personal role is rooted in the patient's background outside the hospital. Subjects were 120 patients from a large, 2300 bed state mental hospital. All subjects were schizophrenics. The respondent patient population were all from two 220 bed cottages comparable to each other in both treatment approaches and types of patients. As a matter of tact, the successful patient was the individual who, at least in his self- and ideal-conceptions, was more appropriately masculine or feminine, and the unsuccessful patient was the individual who showed relative sex role cone fusion.

The article presents a discussion on a new actuarial-empirical automated Minnesota Multiphasic Personality Inventory (MMPI) interpretive program, that is, the 4-3/3-4 type. MMPIs were obtained from inpatients at all five state hospitals and two of the three mental health centers in Missouri. Non-MMPI data were obtained by psychiatric residents who used mental status checklists and pre-admission history checklists. Tests and rating scales both were completed within a few days of admission. Twelve mental status descriptors differentiated 4-3/3-4s from the remainder of the original sample at the 0.05 level or better, but not one of these descriptors was confirmed by replication.

Editorial. Discusses the problems involved with the transformation of state hospitals from institutions directly managed by the health ministry to institutions with a degree of self-management responsibility or autonomy in developing countries. Poor access to quality services by the poor due to incentive problems and weak regulatory capacity; Inability of poor patients to pay high fees due to the dual payment system.

The article investigates some parameters of helping in chronic schizophrenics. The subjects were 90 male chronic schizophrenics from a large urban state hospital who had been hospitalized continuously for a minimum of 1 year. Results suggest that the subjects responded to legitimacy of helping rather than being simply overcompliant; subjects who received a positive prior experience tended to help more when helping was appropriate than subjects who did not receive such an experience.

The article cites a study to test-retest stability of the Shipley Institute of Living Scale. The Shipley Scale was administered twice to 181 psychiatric patients. The product-moment correlation coefficient between first and second admission Shipley scores was 0.73, however, the intraclass correlation coefficient between the same two sets of scores was 0.48. Second admission Shipley scores were observed to be significantly higher than first admission scores. The intraclass correlation coefficient seemingly provided a more accurate picture of the agreement relationship between the test and retest IQ estimates than did the product-moment correlational model.

The article presents information on the pattern of admission rates to a state hospital during the period 1920-1956. What appeared to be a consistent pattern of admission rates to a state hospital for the three years from 1953 to 1955 proved upon further investigation to be only a temporary state. When admission rates were examined for each month from 1920 to 1956 it was found by inspection that more patients were admitted during the summer months than during the winter months. A test of significance, however, showed that none of the months were actually statistically favored with more admissions than any other. When the months were combined into seasonal groups, there were again no significant statistical differences found.