Dementia: a serious and enduring mental illness

At the 1997 RCN Congress, the RCN Mental Health and Older People Forum put forward a matter for debate--how the definition of 'serious and enduring mental illness' affects services to people with dementia. Subsequently, the RCN agreed both a position paper, which includes dementia in the definition, and an action plan for dissemination and support of the RCN position. Alison Soliman describes the background to the position paper.     

Effects of cannabis abuse on people with serious mental health problems

No conscientious nurse involved in perioperative nursing in Kenya can afford to be isolated from the special needs and circumstances that apply to all nurses in this country. These needs and circumstances are very real and very compelling in determining the pattern of perioperative nursing and enforcing a logical solution to the problems of broken equipment, shortage of supplies, and understaffing.     

The clinical skills of community psychiatric nurses working with patients who have severe and enduring mental health problems: an empirical analysis

Both cis-[Pt(NH3)2(4-Me-Py)Cl]+ and trans-[Pt(NH3)2(4-Me-Py)Cl]+ bind DNA covalently at the N7 site of guanine residues forming mono-dentate adducts. However, like cisplatin and transplatin, only the cis isomer has anti-cancer activity, whereas the trans-isomer does not. In order to understand the molecular basis of the different activities associated with cis-[Pt(NH3)2(4-Me-Py)Cl]+ and trans-[Pt(NH3)2(4-Me-Py)Cl]+, the interactions of these two platinum compounds with the DNA heptamer CCTG*TCC:GGACAGG duplex (G* is the platinated guanine) have been examined. The reaction rate of cis-[Pt(NH3)2(4-Me-Py)Cl]+ with the single-stranded CCTGTCC is significantly faster than that of the trans isomer. The solution structure of the platinum-DNA adducts has been studied by two-dimensional NMR spectroscopy. Both the cis-platinum adducts and the trans-platinum adducts destabilize the DNA duplex significantly. The melting temperature (Tm) of the platinated heptamer duplex is estimated to be 10 degrees C lower than for the unplatinated duplex by NMR. At 2 degrees C, the base pairs located on the 5' side of the oligonucleotide, beyond the platinum lesion site, are disrupted. Over time, the platinum-DNA complex decomposes and the cis-[Pt(NH3)2(4-Me-Py)] platinum complex is gradually detached from DNA. No interstrand crosslinking is observed. The biological implications of the structural studies are discussed.     

Intensive care for people with serious mental illness

This article describes the development of a psychiatric 'intensive care' service for men and women with serious or enduring forms of psychotic disorder. The authors suggest that such a residential therapeutic service may be an essential part of the development of community care for the most vulnerable people served by mental health services.     

Enhancing medication compliance for people with serious mental illness

A 23 year-old man with prolonged fever caused by Brucella abortus is reported. The uncommon feature of this case was the presence of a spleen abscess identified by computer tomography of the abdomen. Patient evolution was favorable after treatment with antibiotics, with complete regression of the lesions.     

Psychology and mental health: An enduring partnership.

Discusses the relationship between psychology and the National Institute of Mental Health's (NIMH's) funding of research in the behavioral sciences and the diagnosis, treatment, and prevention of mental illness. It is pointed out that, despite the fears of biological reductionism, the NIMH is determined to maintain a balanced program across the broad spectrum of its efforts. The funding of current research efforts in a variety of areas is outlined. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical risk assessment for mental health nurses

This article proposes a risk management cycle for mental health nurses, it can be used as a guide to assessing and managing the risk of harm associated with people with mental health problems alongside systematic approaches to planning care.     

Job strain and evolution of mental health among nurses.

The objective of this 2nd phase of a 2-year study among female nurses was to provide further empirical validation of the demands-control and social support model. The association of job strain with psychological problems and the potential modifying role of social support at work were examined. A questionnaire was sent at the workplace to 1,741 nurses. The same associations were found between psychological demands, decision latitude, and a combination of the 2 with psychological distress and emotional exhaustion for current exposure and for cumulative exposure. Social support had a direct effect on these psychological symptoms but did not modify their association with job strain. Longitudinal and prospective data are needed to study the occurrence and persistence of health problems when exposure is maintained or retrieved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health services for young people: ''inadequate and patchy''

Adolescents requiring inpatient care for anorexia nervosa present an exciting challenge for nurses because of the complex biopsychosocial nature of the illness. Nurses currently play a major role in caring, not only for the physical health of these patients, but for many of their psychological, social and family needs as well. With the strong foundation in holistic care which underpins nursing, scientific research and innovative nursing interventions may well hold the key to improving the current less-than-ideal long-term outcome for young people with anorexia nervosa.     

Promoting health and preventing disease: an international perspective on youth health promotion

PURPOSE: To advocate strategies to promote the health of young people that include action to create supportive social and economic conditions, alongside more traditional actions to strengthen individual capacity to protect health. METHODS: Analysis of different strategies for youth health promotion from different countries, including education, public policies, laws, and regulations that protect young people from exploitation and physical harm, and enhance their capacity to make healthy lifestyle choices. RESULTS: Access to education and the promotion of basic literacy are, in their own right, important public health goals. Beyond this, efforts to promote health through schools should focus on the creation of an integrated and mutually reinforcing set of experiences for young people, including classroom health education, the creation of a safe and healthy physical environment, and provision of appropriate school health services. The creation of supportive social and economic conditions are also essential, and require political action through the development of public policy. Such policies include restricting access to tobacco, alcohol, and illicit drugs, improving access to essential health services; and regulation of economic exploitation of young people. CONCLUSIONS: Health promotion is inherently political. Health professionals have to find ways to become more effective political advocates for young people. This should be reflected in the education of health professionals and educators, and in the work of agencies and professional associations.     

The working alliance and employment outcomes for people with severe mental illness enrolled in vocational programs.

Purpose: The purpose of this study was to determine the relationship between the working alliance and employment outcomes in persons with severe mental illness receiving vocational services. Another purpose of this study was to determine whether working alliance differences exist between clients receiving evidence-based supported employment services and those receiving traditional stepwise vocational services. Design: This study was a secondary analysis of a 2-year randomized controlled trial comparing two employment programs providing services to people with severe mental illness. Results: Contrary to expectations, no overall relationship was found between the working alliance and employment outcomes. As predicted, supported employment participants each assigned to a single vocational worker had more positive working alliances than participants served by a team of vocational workers in the traditional vocational program. Conclusions/Implications: The lack of an association between the working alliance and employment outcomes is inconsistent with previous literature. Further research is needed using standardized working alliance measures and larger samples that include both working and nonworking clients. Evidence-based supported employment, which employs individual caseloads, seems to foster better relationships than a team-based vocational approach, although future research is needed to replicate this finding. (PsycINFO Database Record (c) 2010 APA, all rights reserved)