Category: Nevin Manimala

Psychiatr Rehabil J. 2021 Jun;44(2):166-175. doi: 10.1037/prj0000462. Epub 2020 Oct 12.

ABSTRACT

Objective: The Internalized Stigma of Mental Illness (ISMI) scale is widely used to examine internalized stigma among people with mental illness. However, an Indonesian version does not yet exist. We developed an Indonesian translation of the ISMI scale and assessed its psychometric properties. Method: We included 280 inpatients with mental illness diagnoses in 2 hospitals and a rehabilitation center. We followed the guidelines proposed by Sousa and Rojjanasrirat (2011) to translate the questionnaire. The reliability was evaluated by measuring the internal consistency (Cronbach’s alpha) and test-retest reliability. Test validity was measured through exploratory factor analysis (EFA) to examine the structure of the scale and confirmatory factor analysis (CFA) to determine the model fits. Results: The EFA yielded 5 factors with Cronbach’s alpha coefficients of .96 for the total scale and .95, .95, .93, .94, and .82 for the 5 subscales. The test-retest reliability indicated excellent results, demonstrated by the interclass correlation coefficient ranging between .76 and .92 for all ISMI scale items. The Kaiser-Meyer-Olkin test statistic was 0.95, and Bartlett’s test of sphericity value was significant. Conclusions and Implications for Practice: The CFA indicated that the ISMI scale has an acceptable model fit. The Indonesian version of the ISMI scale demonstrated good psychometric properties for measuring internalized stigma of psychiatric patients in Indonesia. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34060890 | DOI:10.1037/prj0000462

J Fam Psychol. 2021 May 31. doi: 10.1037/fam0000875. Online ahead of print.

ABSTRACT

Joint physical custody (JPC), a parental care arrangement in which children live with each parent about equally after separation or divorce, is an increasingly common phenomenon in many countries. This is a major shift away from the standard of sole physical custody (SPC), in which children live primarily with one parent (usually their mother) after family dissolution. Although attention to JPC by social scientists is growing, and the effects of this arrangement on children’s well-being are the subject of highly ideological debates, there is currently little empirical evidence with statistical power on JPC. Using data from Family Models in Germany (FAMOD), a survey of postseparation families conducted in 2019, we estimated four linear regression models for children aged 2-14 in SPC and JPC families, with analytic samples of up to 1,161 cases. We investigated the association between physical custody arrangements after separation or divorce and four dimensions of children’s well-being: psychological, physical, social, and cognitive/educational. The bivariate results provided support for the hypothesis that children living in JPC families fare significantly better than children living in SPC families on all four dimensions of well-being. However, after controlling for a set of child, parent, and separation characteristics, as well as for the quality of family relationships, the differences between children from SPC and JPC families disappeared. Additional analyses revealed that the parent-child relationships fully mediated this association. In sum, the quality of family relationships accounted for the positive association between JPC and children’s well-being in this study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34060891 | DOI:10.1037/fam0000875

ACS Chem Neurosci. 2021 Jun 1. doi: 10.1021/acschemneuro.1c00115. Online ahead of print.

ABSTRACT

Depression has drawn increasing attention from the public around the world in recent years. Studies have shown that liver injury caused by chronic stress is relevant to depression and neurotransmitter changes. It is essential to clarify the relationship between neurotransmitter changes and hepatic gene expression in depression. In this study, we used the chronic unpredictable mild stress (CUMS) model combined with UHPLC-MS to explore the changes of neurotransmitters in serum and hippocampus and to decipher the differential gene expression in the liver by using the RNA-Seq combined with multivariate statistical analysis. Compared with the control group, the levels of neurotransmitters including 5-hydroxytryptamine (5-HT), acetylcholine, glutamate (Glu), and dopamine (DA) in the hippocampus and 5-HT, norepinephrine, γ-aminobutyric acid (GABA), and 5-hydroxyindoleacetic acid in serum were significantly changed in the CUMS rats. The results of liver transcriptomic analysis and correlation analysis showed that the Glu, DA, 5-HT, and GABA were impacted by 68 liver genes which were mainly enriched in three pathways including circadian rhythm, serotonergic synapse, and p53 signaling pathway. The expressive levels of clock genes and serotonergic synapse genes were validated by using q-PCR, and the diurnal rhythms of neurotransmitters were validated by in vivo hippocampus microdialysis. The CUMS stressors might cause phase advance of Glu and GABA by adjusting clock genes. The transcriptomic technique combined with correlation analysis and in vivo microdialysis could be used to discover comprehensive pathways of depression. It provides a new strategy for the rational assessment of the mechanism of disease.

PMID:34060807 | DOI:10.1021/acschemneuro.1c00115

J Exp Psychol Gen. 2021 May 31. doi: 10.1037/xge0001069. Online ahead of print.

ABSTRACT

When researchers choose to identify and exclude outliers from their data, should they do so across all the data, or within experimental conditions? A survey of recent papers published in the Journal of Experimental Psychology: General shows that both methods are widely used, and common data visualization techniques suggest that outliers should be excluded at the condition-level. However, I highlight in the present paper that removing outliers by condition runs against the logic of hypothesis testing, and that this practice leads to unacceptable increases in false-positive rates. I demonstrate that this conclusion holds true across a variety of statistical tests, exclusion criterion and cutoffs, sample sizes, and data types, and shows in simulated experiments and in a reanalysis of existing data that by-condition exclusions can result in false-positive rates as high as 43%. I finally demonstrate that by-condition exclusions are a specific case of a more general issue: Any outlier exclusion procedure that is not blind to the hypothesis that researchers want to test may result in inflated Type I errors. I conclude by offering best practices and recommendations for excluding outliers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34060886 | DOI:10.1037/xge0001069

J Addict Nurs. 2021 Apr-Jun 01;32(2):159-164. doi: 10.1097/JAN.0000000000000403.

ABSTRACT

BACKGROUND: Tobacco is the leading cause of preventable death, and over 200,000 women die each year of diseases caused by tobacco. Women with substance use disorders (SUDs) are disproportionately affected. Smoking prevalence among individuals enrolled in SUD treatment is 2-4 times higher than that of the general population, yet less than half of all treatment facilities offer tobacco treatment services. However, when individuals combine treatment, they have a greater likelihood of long-term abstinence from alcohol and other substances of use.

METHODS: A quality improvement project was undertaken to implement the U.S. Public Health Service guideline for tobacco cessation in a women’s residential substance use treatment facility. Tobacco users were advised on their health risk and recommended to cut down or quit. They were advised that help was available using nicotine replacement therapy, behavioral counseling, or both.

RESULTS: Upon admission, 67% of clients received brief advice to quit, and 30% participated in an intensive treatment aimed at reducing or eliminating cigarette use. At discharge, counseling participants (n = 21) smoked an average of nine cigarettes per day, reduced from 23, which was statistically significant.

IMPLICATIONS FOR PRACTICE: Interventions reduced cigarette smoking in a population at a high risk for adverse outcomes related to use. Results suggest that more clients are interested in tobacco treatment than previously estimated. Increased administrative, clinical, and pharmacy support can sustain and further assist clients with cessation efforts.

PMID:34060768 | DOI:10.1097/JAN.0000000000000403

J Cardiovasc Surg (Torino). 2021 Jun 1. doi: 10.23736/S0021-9509.21.11722-7. Online ahead of print.

ABSTRACT

BACKGROUND: The strategy of isolated tricuspid valve surgery has undergone innovations in recent years. This study aimed to summarize our experience using an endoscopic approach to repeat isolated tricuspid valve surgery (RITS) after left-sided valve replacement (LSVR).

METHODS: From June 2013 to May 2019, 79 patients underwent endoscopic RITS after LSVR at our institution. Patients were divided into the tricuspid valvuloplasty (TVP) group (n = 49) and the tricuspid valve replacement (TVR) group (n = 30); perioperative outcomes and followup results were compared.

RESULTS: There were seven postoperative deaths (8.9%). In-hospital mortality was higher in the TVR group than in the TVP group, although this difference was not statistically significant (13.3% vs. 6.1%, P = 0.417). More patients experienced residual moderate-tosevere tricuspid regurgitation (TR) at discharge in the TVP group than in the TVR group (26.7% vs. 0%, P = 0.003). Five patients died from heart, and multiorgan failure during follow-up; the overall 3- and 5-year survival rates were 93.8% [95% confidence interval (CI): (87.1-99.9%)] and 85.3% (95% CI: 73.3-9.2%), respectively, and no significant differences were found between the two groups (P = 0.103). The overall rates of the 3- and 5-year freedom from severe recurrent TR were 93.2% (95% CI: 85.9-99.9%) and 89.0% (78.7-99.9%), respectively, and no significant difference was found between groups (P = 0.176).

CONCLUSIONS: Repeat isolated tricuspid valve surgery after left-sided valve replacement is associated with adverse perioperative outcomes. Endoscopic access offers an alternative approach for RITS after LSVR with acceptable results. TVP results in lower surgical mortality than TVR while carrying a higher risk of residual moderate-to-severe TR.

PMID:34060774 | DOI:10.23736/S0021-9509.21.11722-7

Am Fam Physician. 2021 Jun 1;103(11):672-679.

ABSTRACT

Since the 1970s, most births in the United States have been planned to occur in a hospital. However, a small percentage of Americans choose to give birth outside of a hospital. The number of out-of-hospital births has increased, with one in every 61 U.S. births (1.64%) occurring out of the hospital in 2018. Out-of-hospital (or community) birth can be planned or unplanned. Of those that are planned, most occur at home and are assisted by midwives. Patients who choose a planned community birth do so for multiple reasons. International observational studies that demonstrate comparable outcomes between planned out-of-hospital and planned hospital birth may not be generalizable to the United States. Most U.S. studies have found statistically significant increases in perinatal mortality and neonatal morbidity for home birth compared with hospital birth. Conversely, planned community birth is associated with decreased odds of obstetric interventions, including cesarean delivery. Perinatal outcomes for community birth may be improved with appropriate selection of low-risk, vertex, singleton, term pregnancies in patients who have not had a previous cesarean delivery. A qualified, licensed maternal and newborn health professional who is integrated into a maternity health care system should attend all planned community births. Family physicians are uniquely poised to provide counseling to patients and their families about the risks and benefits associated with community birth, and they may be the first physicians to evaluate and treat newborns delivered outside of a hospital.

PMID:34060788

J Addict Nurs. 2021 Apr-Jun 01;32(2):95-106. doi: 10.1097/JAN.0000000000000395.

ABSTRACT

PURPOSE/BACKGROUND/SIGNIFICANCE: The purpose of this feasibility study was to make system level change using motivational interviewing (MI), tailored discharge education, and electronic medical record (EMR) flow sheet intervention in patients with alcohol use disorder (AUD). Alcohol is known to be one of the most commonly misused addictive substances.

METHODS: It is a feasibility study with a descriptive exploratory design of an intervention with MI, tailored discharge education, and EMR flow sheet documentation. Participants were patients with AUD chosen over 3 months from two medical surgical floors. Instruments used were the readiness and confidence rulers (reliability/validity = .84 and .77, respectively). Analysis included descriptive statistics, estimation of effect size, and hypothesis generation.

RESULTS: Of 14 participants, EMR flow sheet documentation was completed and the mean post readiness and confidence scores were 8.86 (1.167) and 8.07 (1.639), respectively.

CONCLUSION: The pre/post confidence scores were statistically significant (p = .095) using the .10 significance level, indicating the intervention was effective in raising the confidence level for behavior change. High scores indicated patients were in contemplation and intending to change. Seven scores increased postintervention suggesting a future hypothesis that MI, tailored education, and EMR flow sheet documentation intervention is feasible for patients with AUD contemplating change in the near future.

PMID:34060760 | DOI:10.1097/JAN.0000000000000395

J Addict Nurs. 2021 Apr-Jun 01;32(2):115-120. doi: 10.1097/JAN.0000000000000397.

ABSTRACT

PURPOSE: Nurse practitioners (NPs) are in a unique position to address the problem of opioid use disorders (OUDs) because they provide a large percentage of primary care services (Agency for Healthcare Research and Quality, 2014). This study aimed to increase doctoral NP students’ beliefs/attitudes about their ability to care for and about individuals with OUDs through a multifaceted educational approach, guided by social cognitive theory.

METHODS: Researchers used a quasi-experimental pre/post design. Five doctoral students attended lectures and 16 hours of direct clinical exposure to individuals with OUDs at a medication-assisted treatment center. The 22-item Drug and Drug Problems Perception Questionnaire examined students’ attitudes toward individuals with OUDs before and after receiving this multifaceted education. Students completed reflective writings. Descriptive statistics and effect sizes were computed, and reflective writings were reviewed.

RESULTS: Changes in Drug and Drug Problems Perception Questionnaire scores before and after intervention showed a fairly large effect size. This suggests that the intervention may have clinical significance for practice and is likely to attain statistical significance with a larger sample size. Greatest changes occurred in students’ perceptions of role adequacy and self-esteem scores, indicative of higher self-efficacy. Measured score increases correspond to increases in confidence, knowledge, and skills to therapeutically engage with this population.

CONCLUSION: Doctoral NP students had more positive attitudes and beliefs about individuals with OUDs after the multifaceted intervention. Enhancement of self-esteem and adequacy in the caregiver role for this population were promising signals that education can reduce stigma. Further study is warranted with a larger and more diverse sample.

PMID:34060762 | DOI:10.1097/JAN.0000000000000397

J Addict Nurs. 2021 Apr-Jun 01;32(2):141-151. doi: 10.1097/JAN.0000000000000401.

ABSTRACT

Prescription opioid use disorder in the United States has increased to epidemic proportions and poses a challenging problem to health care providers. Motivational interviewing (MI) is a patient-centered counseling style that can effectively reduce substance abuse, but MI training has not been well incorporated into advanced practice nursing curricula. Standardized patient (SP) simulation is an educational tool that is growing in popularity because of its success in improving nursing skills. Medical students and residents who underwent a formalized MI training with an SP simulation showed positive results. This study aimed to determine whether an MI training with an SP simulation improved NP students’ knowledge, confidence, and skills in MI. A one-group pretest-posttest repeated measures design was used. Quantitative data were analyzed using descriptive statistics and repeated measures analysis of variance, and qualitative data were analyzed using content analysis. Results indicated that the MI training showed a significant impact on students’ confidence in MI and promising impacts on students’ MI knowledge and skills. Students valued the training, favoring the SP component, and plan to use MI in future practice. An MI training can be effectively incorporated into an advanced practice nursing program and would better prepare students to address prescription opioid use disorder and effectively encourage behavior change among their patients.

PMID:34060766 | DOI:10.1097/JAN.0000000000000401