Search

Background and Objectives: In 2016, Medical Assistance in Dying (MAiD) became legal in Canada for those suffering a grievous and untreatable medical condition. Currently, it is not available to minors or to those with an untreatable mental illness, although it is likely the scope of MAiD will be widened to include persons with severe and untreatable mental illnesses. However, little is known about the factors predicting acceptance or rejection of MAiD for persons with either a grievous medical condition or an untreatable mental illness. Methods: A survey was administered to 438 undergraduate students to examine factors associated with their acceptance or rejection of MAiD. The survey included four different scenarios: a young or old person with an untreatable medical condition, and a young or old person with an untreatable mental illness. Demographic questions (age, sex, religion, etc), personality measures, and an attitude towards euthanasia scale were also administered, as well as questions assessing participants’ general understanding of MAiD and their life experiences with death and suicide. Results/Conclusion: Overall, most of the Canadian undergraduate participants accepted MAiD for both terminally ill and mentally ill patients; however, different variables, such as age, religion, and ethnicity, predicted the acceptance or rejection of MAiD for each scenario.

Increasing industrialization, urbanization, and a failure of many world leaders to appreciate the consequences of climate change are deleteriously impacting quality of life as well as diminishing the prospects for long term survival. Economic competitiveness and corporate profitability often pre-empt environmental concerns. The calving of an iceberg in Antarctica and the hurricane activity in the Caribbean during 2017 are unfortunate illustrations of the continuing escalation of environmental issues. We provide historical and current evidence for the importance of Nature Exposure (NE) and introduce the continuum Nature Exposure Sufficiency (NES) and Insufficiency (NEI). Insufficiency includes impoverished environments (e.g., slums and prisons) where nature exposure is very limited. Nature Exposure Sufficiency (NES) is an optimal amount of exposure to nature where many benefits such as reinvigoration can be obtained by everyone. NES also has several benefits for individuals with various health conditions such as arthritis, dementia, or depression. The benefits of NE are not just derivable from parks, forests, and other natural settings. Interiors of buildings and homes can be enhanced with plants and even pictures or objects from nature. Additionally, there is abundant evidence indicating that virtual and artificial environments depicting nature can provide substantial NE and therefore contribute to general wellbeing. Besides the difficulty in achieving cooperation amongst nations, corporations, and other collectives in developing and implementing long range plans to deal with climate change, there is also sometimes an aversion at the individual level whereby people are unwilling to experience nature due to insects and other discomforts. Such individuals are often averse to supplanting the comforts of home, even temporarily, with inadequate facilities that are seemingly less pleasant than their typical dwellings. We propose using the term Nature Exposure Aversion (NEA) to describe such behavior and propose that the aversion is largely due to conditioning. Such behavior may be addressed through desensitization in virtual environments which in turn may contribute to an endorsement of the view that climate change is occurring and must be dealt with. The issues of Nature Exposure Sufficiency and Insufficiency are intertwined with the sustainability of the planet and future planning and efforts to deal with the environment. If the outcome is unfavorable, the descent of civilization will be more rapid than the ascent.

To improve patient care/outcome, an evaluation was conducted of nursing procedures and protocols for pro re nata (PRN) medications.A 14-day chart review was conducted for 27 patients with mood and thought disorders (MTD) and for 24 patients with organic disorders (OD) at a geriatric psychiatric hospital, and a questionnaire was completed by 20 nurses.377 PRNs were administered to patients in the MTD and OD units (240 and 137, respectively). The majority of PRNs were administered during the evening shifts on the MTD unit and during the day shifts on the OD unit. Chart notes indicated the behavior requiring PRN administration was not always specifically described and therapeutic interventions were not often attempted before PRN administration. Inconsistency between chart notes and medication record books was noted in the majority of cases. It was often not known whether the PRN was initiated by the staff, patient, or family. PRNs were reported to be not effective in the majority of cases.Documentation was suboptimal and effectiveness was poor.It would be worthwhile to train all staff in a patient-centered or ecopsychosocial (i.e., non-pharmacological) model of care, which would provide staff alternatives to PRNs. In that context, it would be important to implement standards of practice into geriatric psychiatry inpatient settings for PRN administration and documentation.

The direct or indirect experience of crime can cause individuals to feel vengeful against the perpetrator(s). The prison system reflects this sentiment by creating austere environments that are dehumanizing, punitive, and hopeless. Prisons are, therefore, environments in which retribution and punishment take priority over rehabilitation. Frequently, prisoners are believed to be untreatable because of their antisocial orientation. However, several factors influence an antisocial orientation such as socioeconomic status, family of origin, and mental health. The ubiquitous nothing works misbelief has resulted in prisoner marginalization and increased recidivism because of insufficient treatment. In 2015, 10 million individuals were incarcerated worldwide with around 30 million circulating through prisons each year. The prison environment decreases prisoner life expectancy and overall health. Sadly, prisoner benefits from treatment post-incarceration dissipate after 3–6 months and many prisoners die by suicide or drug overdose. Prison overpopulation, as well as poor outcome post-incarceration, requires more effective treatment. We hypothesize that Prisoner Exposure to Nature (PEN) can transform prisons into environments that are conducive to maintaining and improving physical and mental health. In prior work we proposed the continuum Nature Exposure Sufficiency (NES) versus Nature Exposure Insufficiency (NEI). Prisons are impoverished environments that limit Nature Exposure (NE) which results in NEI. Individuals experience fluctuations in mental and physical health as a result of NEI. Numerous studies have shown that direct and indirect NE can improve mood, physical health, and facilitate connectivity with self and society. It is necessary to consider ways in which we can incorporate NE for prisoner wellbeing. Additionally, it is crucial that prison personnel and prisoners develop a therapeutic/helping relationship (i.e., alliance) that is facilitated by friendliness and warmth to foster social change and citizenship. Many prisoners experience isolation and disconnection with society upon reentry. Given that most prisoners are eventually released into the community, we are obligated not to make them worse. Hence, it is important that prisons create programs that develop citizenship to engender prisoner volition to become positive and active citizens. We focus on the prison and prisoners, however our work is relevant to all total institutions (e.g., mental hospitals, nursing homes, schools, etc.). The prison system favors punishment and mass incarceration over treatment and decarceration. The deleterious effects of incarceration are clear and it is time to implement treatments based on the principles of PEN to improve prisoner wellbeing and citizenship.

Foreslår et paradigme - "Living in history" - til undersøgelse af forholdet mellem samtidshistorie og selvbiografisk hukommelse. Metoden spørger ikke direkte og altså ikke til den anknytning, man bevidst ville vælge at fremhæve, men undersøger indirekte, om der spontant associeres til samtidsbegivenheden fra andre erindringer. Vi undersøgte 10 grupper unge i forskellige lande med paradigmet. Resultaterne tyder på, at begivenheder som krig og jordskælv bliver organiserende for den selvbiografiske hukommelse - dvs mange andre erindringer associerer spontant dertil - men stærk symbol-værdi og emotionel ladning er ikke nok til at danne effekten; fx sås ingen effekt af World Trade Center-angrebet med denne metode, end ikke blandt unge fra Manhattan eller andetsteds i USA. Derimod sås klar effekt hos unge fra Balkan - især Bosnien-Herzegovina - og i et jordskælvramt område i Tyrkiet. Vi foreslår på den baggrund "Fabric of daily life"-teorien: Når (og kun når) samtidsbegivenheder giver direkte og længerevarende omvæltninger i hverdagen, får de organiserende effekt på den mentale selvbiografi. Udgivelsesdato: APR

The predictive accuracy of the Psychopathy Checklist-Revised, Level of Service Inventory-Revised, Violence Risk Appraisal Guide, and the General Statistical Information on Recidivism were compared to four instruments randomly generated from the total pool of original items. None of the four original instruments better predicted post-release failure than the four randomly generated instruments. These results suggest two conclusions: (a) the instruments are only measuring criminal risk, and (b) no single instrument has captured sufficient risk assessment theory to result in better prediction than randomly derived instruments measuring criminal risk. A two-stage factor analysis was completed on 1614 cases. This analysis of the risk items indicated a 4-factor solution and all 4 factors were equal to the original instruments in predicting post-release failure. Thus, the original instruments did not improve prediction over randomly structured scales, nor did the restructuring of items improve risk assessment, suggesting substantial deficiencies in the conceptualization of risk assessment and instrumentation. We argue that developing a risk-based construct, which involves hypothesis testing and an explanation of behavior, is the optimal method to advance risk assessment within the criminal justice and mental health systems. Such an approach would provide targeted areas for clinical intervention that are salient to risk.

The Transitional Impact Scale (TIS) advances the measurement of event cognition into the real world. The TIS was created to provide a measure of change for important life transitions, including an index of their transitional properties and magnitude. Pilot work prior to Study 1 led to the creation of a 95-item version (TIS-95). A principal components analysis of TIS-95 (n = 215) resulted in two dimensions that we rotated to a Varimax criterion and interpreted as (1) material change (e.g., "This event changed where I live") and (2) psychological change (e.g., "This event changed the way I think about things"). TIS-95 was reduced to 25 items. In Study 2, the structure of TIS-25 was replicated (n = 531) using the same method. The best 12 items were retained. TIS-12 was evaluated in two random split-half samples (n = 557 and n = 553). These samples produced essentially identical results, as assessed through factor comparison. The cumulative scales formed from items constituting each factor demonstrated good internal consistency (Cronbach's alpha ranged from .79 to .86).

The story of how a midwife many years ago dealt with defective newborns is used to illustrate complete control by a system external to the family. Similarities exist with current public policy concerning the interrelated issues of abortion, neonatal euthanasia, and infanticide in which the family system is often ignored. It is argued that the family's values, expectations, and desires are relevant to the establishment of public policy in this sensitive domain.

OBJECTIVE: Process model of stress and coping guided psychometric assessment of two brief measures of psychological well-being: Parenting Morale Index (PMI); Family Impact of Childhood Disability (FICD) scale. METHODS: Canadian mothers (N = 195) of children with disability (CWD) completed PMI, FICD, and validation measures (Brief Family Assessment Measure [FAM], Personal Well-Being Index, Positive and Negative Affect Schedule, General Self-Efficacy Scale, Social Desirability Scale) via computer-assisted telephone interview. Of these, 154 completed additional validation measures (Center for Epidemiological Studies-Depression Scale, Parenting Stress Index, Family Hardiness Index, Brief FAM) 1 year later. RESULTS: Factor structures of PMI and FICD were supported; both demonstrated internal consistency, temporal stability, and convergent and discriminant validity. After 1 year, PMI and FICD jointly predicted depressive symptoms, parenting stress, family hardiness, and family adjustment. CONCLUSION: PMI and FICD can identify mothers of CWD at risk for poor psychological well-being to increase the specificity of supports. Language: en

Mothers' cognitive appraisal of the family impact of childhood disability and their positive affect as a psychological coping resource, both key elements of the process model of stress and coping, were tested as explanatory variables of family adjustment.In a sample of Canadian families, 195 mothers of children with intellectual and developmental disability completed telephone interviews.In regression modelling, 35% of the variance in family adjustment was explained by mothers' positive cognitive appraisal of family impacts of childhood disability and by their positivity (ratio of positive to negative affect). After controlling for positivity, negative cognitive appraisal of family impacts of childhood disability was non-significant.Family adjustment to childhood disability is associated with elements of strength in mothers' psychological coping; namely, their ability to perceive positive family consequences of childhood disability and to maintain higher proportions of positive emotion in their daily activities. The findings of this study provide support for the broaden-and-build theory to explain the role of positivity in mothers' coping and adjustment to childhood disability.

Penile circumference responses (PCRs) to a visual age/gender erotic preference battery were analyzed from 60 normal controls and 227 sexual offenders. Sixty offenders were classified as sexual aggressives on the basis of their behavior and damage to their victims. The mean PCR to sadism slides (visual portrayals of nonsexual violence against fully clothed females) was significantly larger for the sexually aggressive group compared to the sexual nonaggressive offender and normal control groups. There were no significant differences in mean victim damage scores between the sexual aggressives who responded significantly to the sadism slides and those who did not. Thus, PCRs were not useful in identifying more from less dangerous sexual aggressives. The incidence of a clinically significant PCR to any of the four paraphilic categories included in the assessment battery was 28, 60, and 65% in the normal controls, sexual nonaggressives, and sexual aggressives, respectively. For sadism, it was 5, 8, and 45% respectively, for these groups. Pedophilia had a low incidence of co-occurrence with other paraphilias whereas sadism, transvestism/fetishism, and the courtship disorder paraphilias had a high incidence of co-occurrence.

BACKGROUND: Numerous studies have demonstrated the beneficial effects of vocational rehabilitation on vocational outcomes in individuals with a mental illness, yet effects on secondary outcomes remain largely unexplored. This study investigates the impact of vocational rehabilitation on the utilization of emergency, ambulatory care and inpatient services in individuals with a mental illness. METHODS: Using a repeated measures study design, the utilization of health services by individuals with a mental illness (n= 37) was compared before and during their engagement in training and employment at a social enterprise - a form of vocational rehabilitation. RESULTS: Individuals with a mental illness had significantly less emergency department visits (p=0.01), ambulatory care visits (p=0.01) and hospital admissions (p=0.05), but no difference in hospital length of stay (p=0.39), during training/employment, compared to pre-training/employment at a social enterprise. CONCLUSION: The reduction in health services utilization found in this study may reflect symptom and overall health improvement, highlighting the importance of vocational rehabilitation programs for individuals with a mental illness. In addition, results from this study can inform stakeholders and policymakers about the impact of vocational rehabilitation on the healthcare system to help guide decisions regarding program implementation or continuation, and funding allocation.

This study examined the generalizability of a self-report measure of psychache to an offender population. The factor structure, construct validity, and criterion validity of the Psychache Scale was assessed on 136 male prison inmates. The results showed the Psychache Scale has a single underlying factor structure and to be strongly associated with measures of depression and hopelessness and moderately associated with psychiatric symptoms and the criterion variable of a history of prior suicide attempts. The variables of depression, hopelessness, and psychiatric symptoms all contributed unique variance to psychache. Discussion centers on psychache's theoretical application to the prediction of suicide.

The relationship between serum testosterone and sexual violence was examined in a sample of 501 convicted adult male sex offenders attending an intensive in-hospital group psychotherapy treatment program. It was found that men with higher testosterone tended to have committed the most invasive sexual crimes (p < .001, two-tailed). Further, a positive partial correlation (controlling for age) between testosterone and sexual offense recidivism over a lengthy follow-up period (mean = 8.9 years) was found. When the sample was separated into one group that completed treatment and one group that did not, an important ameliorating treatment effect was observed. Although controlling for age, serum testosterone remained significantly predictive of sexual recidivism for the treatment noncompleter group (p < .05, two-tailed). For those who completed treatment testosterone was no longer predictive of sexual reoffense (p > .05, two-tailed). Among convicted sex offenders, higher serum testosterone appears to be associated with greater likelihood of further sexual violence. Effective therapy, however, appears able to intercede in the influence of testosterone on sexually deviant behavior. It is suggested that serum testosterone may be an informative static risk factor and completion of intensive treatment should be accorded significance in future actuarially based risk prediction instruments.

Extant pharmacological literature seems to indicate that antidepressants are the most effective treatment for depression. However, there are flaws in the traditional paradigm for evaluating the efficacy of antidepressants. The traditional paradigm in pharmacology has adopted a biologically monistic causal structure, suggesting that the efficacy of antidepressants resides exclusively in biological pathways. The current paradigm in pharmacology has ignored the potential impact of psychological factors associated with the efficacy of antidepressants. This has occurred because psychological effects are seen as being a "paradigmatic anomaly," phenomena that are at odds with the traditional paradigm. Thus, the psychological factors associated with the administration of antidepressants have collectively been labeled as a "placebo effect" and discounted as a potential treatment pathway. However, empirical evidence suggests that the psychological factors, such as the formation of patient expectancies and a therapeutic alliance between physician and patient, increase the efficacy of antidepressants. Consequently, the current paper proposes the adoption of a transactional model that reflects the reciprocal interaction between psychological and biological factors associated with the efficacy of antidepressants.

34 long-term psychiatric patients with psychotic-type diagnoses, participating in a Psychiatric Rehabilitation program, completed the Basic Personality Inventory 5 times at 6-mo. intervals. In comparison with normative data, participants had statistically significant ( p

Three subjects were used to compare superior visual-field threshold for 5 North American industry-standard opaque safety hard hats with a prototype clear translucent-visor safety hard hat and a no-hat baseline condition. Average maximum degrees of superior visual field was equivalent for the clear-visor safety hat and no-hat conditions (52.0 degrees versus 48.3 degrees) but the opaque-visor safety hats resulted in only 15.1 degrees. The opaque safety hats were worse than the clear-visor safety hat and no-hat conditions by, on the average, an order of 3. Analysis indicated that visual-field obstruction is a potential problem for wearers of opaque safety hats. Field research will be required to assess the extent of injuries caused by an impaired superior field of vision when wearing opaque-safety-hat visors. The potential positive effects of the clear-visor safety hat on reduction of accidents also must be determined.

26 normal, self-reported dextral subjects (12 men, 14 women) were assessed with a Purdue Pegboard 5 times at weekly intervals to evaluate temporal stability and efficacy of lateralization with this test. There was a statistically significant increase in performance over time for men on the right- and left-hand placing subtests and for women on the assemblies subtest. For men/women the test-retest reliability over the 5 sessions averaged .63/.76 for the right-hand, .64/.79 for the left-hand, .67/.81 for both-hands, .81/.83 for assemblies, and .33/.22 for the right/left-hand ratio.

18 normal, self-reported dextral subjects (9 men, 9 women) were assessed with a Halstead Manual Finger Tapping device, with 10 trials per hand for 10 consecutive wk. The test-retest reliability of the 10-trial average between the 10 sessions averaged .94 for men and .86 for women, for both preferred and nonpreferred hands. There were DO statistically significant effects of increases in performance over sessions or effects of fatigue over trials for either sex or hand. There were, however, significant increases over trials for men for both preferred and nonpreferred hands.

The sexually arousing effects of erotic and nonerotic slides were monitored with a penile mercury strain gauge in 14 exhibitionists, 21 normal controls, and 34 nonexhibitionist sex offenders. Responses to 60 slides, constituting 12 distinct categories, were analyzed. The exhibitionists responded sexually to scenes of fully clothed erotically neutral females, whereas the two control groups did not respond to this slide material. No other significant differences were observed between the three groups on the remaining 11 categories. The results support previous reports of sexual arousal in exhibitionists to nonerotic signals from females and are consistent with a hypothesis of exhibitionists displaying culturally unapproved sexual display signals as a consequence of cortical disinhibition.

12 normal, self-reported dextral subjects (6 men, 6 women) were assessed with a hand dynamometer with 10 trials per hand for 10 consecutive wk. The test-retest reliability of the 10-trial average across the 10 sessions averaged .91 for men and .94 for women for both preferred and non-preferred hands. Fatigue effects over trials were statistically significant for both sexes and hands except for women's preferred hand. Skill acquisition effects over sessions were only statisically significant for men's nonpreferred and women's preferred hands.