Mental health consultant to law enforcement: Secret Service development of a Mental Health Liaison Program

The Mental Health Liaison Program developed and used by the Secret Service is presented as a model for comprehensive, multidimensional interactions between law enforcement and mental health systems, with particular focus on assessing and preventing violent behavior. The structure of the program pairs consultants--psychologists and psychiatrists--with Secret Service field offices to provide (a) consultation regarding risk assessment and case management of individuals who threaten or display inappropriate interest in the President or other protectees; (b) training for agents on risk assessment, mental illness, and mental health care issues; and (c) liaison activities between the Secret Service and the mental health community. Practical benefits to the Secret Service are discussed to encourage more systematic use of broad based psychological and psychiatric consultation to law enforcement, with a goal of enhanced intersystem communication and collaboration. The need for program evaluation and outcome research is discussed in the context of applying the model to improve other mental health and law enforcement systems interactions.     

Predicting behavioral intentions and physical exercise: A test of the health action process approach at the intrapersonal level.

Objective: Theories of health behavior are usually tested on the between-person level. Associations between variables on the between- and the within-person level, however, can differ substantially. Thus, in order to better understand intrapersonal processes in the domain of health behavior, studies applying within-person analyses are needed. This study tested the Health Action Process Approach (HAPA) on the within- and between-person level in the context of physical exercise. Design: Participants were 265 first-year students who completed nine online questionnaires every second week. Data were analyzed by focusing on intrapersonal associations applying multilevel modeling. Main Outcome Measures: Intentions for physical exercise and self-reported physical exercise served as main outcome measures. Results: Analyses mainly confirm associations specified by the HAPA at the intrapersonal level: outcome expectancies and self-efficacy, but not risk awareness, were positively associated with intentions for physical exercise. Physical exercise in turn was positively associated with intentions, self-efficacy, action control, but not with action planning. Conclusion: The HAPA could be confirmed on the within-person level. Future studies should focus on testing other theories of health behavior at the within-person level. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

施用稀土多元复合肥对减少蔬菜中硝酸盐积累的研究

随着单元素氮类化肥的大量施用，蔬菜中富集了大量的硝酸盐，对人体存在着潜在的危害性，是食物污染的主要来源之一。本文介绍了采用萘乙二胺盐酸法（水果、蔬菜及其制品中硝酸盐和亚硝酸盐含量测定国标法）测定施用稀土多元复合肥后蔬菜中硝酸盐含量的变化情况，进行了稀土多元复合肥在农业生产中有效地控制蔬菜中硝酸盐积累的探索。     

How the new NIH guidelines on inclusion of women and minorities apply: Efficacy trials, effectiveness trials, and validity.

The NIH (National Institutes of Health) Guidelines on the Inclusion of Women and Minorities as Subjects in Clinical Research requires investigators applying for NIH research funds to develop and, if funded, implement plans for the inclusion of women and minority populations in their research, when that research involves human participants. It is the purpose of this article to help investigators understand (a) the scientific context and rationale behind the NIH Guidelines; (b) the NIH-defined concepts and the specific content of the NIH Guidelines; and (c) how the intent of the NIH Guidelines is related to mental health services research, the most applied area of mental health research. The article also discusses where investigators can find additional information as they work to implement the NIH Guidelines. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

State health care reforms: how they affect children and adolescents with emotional disorders and their families

This article reports on the Health Care Reform Tracking Project, a national study designed to describe and analyze state health care reforms and their impact on children and adolescents with emotional disorders and their families. It summarizes the results of the baseline survey of states conducted in 1995, exploring the nature and extent of the reforms in which states are engaged, most of which involve applying managed care technologies to their Medicaid programs. Trends across states are identified with respect to mental health service delivery, particularly with respect to children and adolescents. The article concludes with a discussion of issues and concerns related not only to mental health service delivery for children and adolescents with emotional disorders and their families but also to the systems of care that have been developing over the past decade to serve them. Some of these concerns include the lack of pilots or demonstrations, limited mental health coverage in some reforms, the lack of integration between mental health and substance abuse systems, the lack of special provisions for children, the need for more reliable bases for deriving capitation rates, the limited incorporation of systems of care, the need to incorporate interagency treatment planning and service delivery approaches, the lack of outcome measures specific to and appropriate for children, and the need for greater family involvement in the planning and implementation of these reforms.     

Predictors of preintake attrition in a rural community mental health center.

[Correction Notice: An erratum for this article was reported in Vol 6(2) of Psychological Services (see record 2009-06563-006). The article contains data that were obtained from archival records of the same community mental health center (serving adults, adolescents, and children), and that reflect information from initial consumer contacts made with the center during the same period of time, as that reported in “Clinical Intake of Child and Adolescent Consumers in a Rural Community Mental Health Center: Does Wait-time Predict Attendance?” by Marne L. Sherman, David D. Barnum, Adam Buhman-Wiggs, and Erik Nyberg (Community Mental Health Journal, 2009, Vol. 45, No. 1, pp. 78–84). Information is provided in this clarification about the data used in both articles.] Preintake attrition presents a challenge in outpatient mental health settings, in part due to the waste of limited clinical resources when potential consumers do not attend appointments. While understanding the phenomenon of mental health consumer attrition has received clinical and empirical attention for more than 40 years, the data remain somewhat mixed as to the key predictors of preintake attrition. Additionally, little attention has been directed at understanding missed intake appointments in community mental health centers within rural settings. This study examines predictors of attended appointments for intake in a rural community mental health center, with particular attention to the effect of intake delay or wait-time between call for appointment and scheduled appointment. Wait-time is identified as a significant predictor of appointment attendance in logistic regression analysis, even after controlling for consumer variables, such as referral source and payor source. The impact of wait-time on the likelihood of attending the intake appointment was not moderated by the case urgency. Considerations for applying these results to the organization of clinical service delivery in a rural community mental health center are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An experimental test of adolescents' compliance with dental appointments

This study assessed factors associated with adolescents' compliance with dental appointments. Patients (n = 162) attending an adolescent clinic were administered a pretest questionnaire assessing health locus of control, self-esteem, and beliefs and attitudes about dental health from the Health Belief Model. Adolescents needing dental care were randomly assigned to groups for whom their dental appointment was made by a health professional or one in which the patient made his or her own appointment and to groups receiving an appointment reminder card versus not receiving a reminder card. Dental records were then reviewed to examine previous experiences with dental treatment. Neither the method used for making the appointment nor the use of reminder cards had a significant effect on compliance with the dental appointments. Also, compliance was not associated with health locus of control, self-esteem, or variables from the Health Belief Model. Older patients were more noncompliant than younger patients (tau = 0.14). Noncompliance was negatively correlated with the number of previous dental visits and previous dental procedures, oral hygiene instruction, and x-rays. Number of previous x-rays and previous broken appointments explained 5.1% of the variation in noncompliance. The Health Belief Model was not successful in predicting compliance behavior in this sample of adolescents.     

“Predictors of preintake attrition in a rural community mental health center”: Clarification.

Reports an error in "Predictors of preintake attrition in a rural community mental health center" by Marne L. Sherman, David D. Barnum, Erik Nyberg and Adam Buhman-Wiggs (Psychological Services, 2008[Nov], Vol 5[4], 332-340). The article contains data that were obtained from archival records of the same community mental health center (serving adults, adolescents, and children), and that reflect information from initial consumer contacts made with the center during the same period of time, as that reported in “Clinical Intake of Child and Adolescent Consumers in a Rural Community Mental Health Center: Does Wait-time Predict Attendance?” by Marne L. Sherman, David D. Barnum, Adam Buhman-Wiggs, and Erik Nyberg (Community Mental Health Journal, 2009, Vol. 45, No. 1, pp. 78–84). Information is provided in this clarification about the data used in both articles. (The following abstract of the original article appeared in record 2008-16478-003.) Preintake attrition presents a challenge in outpatient mental health settings, in part due to the waste of limited clinical resources when potential consumers do not attend appointments. While understanding the phenomenon of mental health consumer attrition has received clinical and empirical attention for more than 40 years, the data remain somewhat mixed as to the key predictors of preintake attrition. Additionally, little attention has been directed at understanding missed intake appointments in community mental health centers within rural settings. This study examines predictors of attended appointments for intake in a rural community mental health center, with particular attention to the effect of intake delay or wait-time between call for appointment and scheduled appointment. Wait-time is identified as a significant predictor of appointment attendance in logistic regression analysis, even after controlling for consumer variables, such as referral source and payor source. The impact of wait-time on the likelihood of attending the intake appointment was not moderated by the case urgency. Considerations for applying these results to the organization of clinical service delivery in a rural community mental health center are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HL7 version 3--an object-oriented methodology for collaborative standards development

In January of 1997, Health Level Seven (HL7) began developing Version 3.0 of its standard. The Version 3 effort represents a transformation of the way that HL7 and its Technical Committees will develop future HL7 information interchange standards. This transformation involves applying object-oriented modelling to the development and specification of information interchange standards. This paper discusses the rationale that led HL7 to undertake this change and provides an overview of the Version 3 Message Development Framework which is HL7's new methodology. It also considers the features of the Version 3 methodology that can facilitate the development of international collaboration and consensus in health informatics standards.     

Feedlot health and management

Health programs based solely on vaccination and treatment regimens are often short-lived and unrewarding. The basis of any successful ongoing health program is a working health management system. The key to the success of the system is a functioning record system that generates information meaningful to management. The basic information generated should include morbidity and mortality data categorized by cause, the number of repeat treatments, and the number of chronic animals or railers. Goals should be set for each major category so that a database can be established for a feedlot operation to assess problems and progress. The most common reason for expectations not being achieved is factors that are largely beyond the control of the feed yard. Although attempts to address these factors should be periodically reviewed, attention to the health program and potential modifications are among the factors that we can control and modify as appropriate. BRD is the most important economic disease in the feedlot. Prearrival management is extremely important in assessing the risk category of incoming calves and in applying a preventive health strategy. Good husbandry, proper nutrition, proper pen maintenance, and selective immunization help to ensure that the cattle adapt quickly to the feed yard environment. Careful observation, timely effective therapy, and excellent hospital management increase the opportunity to produce cost-competitive, safe, and wholesome beef in a humane fashion with limited effects of the environment.     

Surgical results of complete hypospadias repair in two stages

The Department of Health requires District Health Authorities to have plans ready for dealing with chemical incidents to protect public health. The three aspects of a chemical incident are environmental, medical toxicology, and public health advice and information. Public health surveillance plans require generation of a causal hypothesis and assessment of risk. Training provision should emphasize the need for application of epidemiological precepts in drawing up such surveillance plans. The epidemiological principles are systematically outlined with emphasis on their significance.     

Health care reform: The 1993–1994 evolution.

Health care costs in the US continue to increase, as does the number of individuals who lack health care coverage. The magnitude of these critical problems assures that reform of the health care system will continue to be debated over the next decade. Increasing health care costs are associated with increased complexity of services and a greater number of health care providers. As health costs increase and the number of individuals covered by private insurance decreases, states will face increasing pressure to develop effective methods of providing coverage for those without health insurance. Employer mandates will be viewed as one method of extending health coverage. Psychologists must be involved in policy issues so as to ensure the utilization of psychological knowledge and attention to psychological and behavioral health needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community dentistry: rationale

The present curricula in dentistry are biased in favor of cure and technical capability ... individualism rather than promotive, preventive and community orientation. The team "approach" and "total patient care" concepts must be given emphasis in these curricula. Dentistry, being a profession, should accentuate service, rather than materialism and profit. The Philippine situation demands than adoption of a "New Horizon in Health" which emphasized positive health as part of human development. The educational system, organized dentistry, the licensing board, the legislators, policy makers, oral health providers and research formulators will have important roles to perform in the successful implementation of this "new horizon in health" concept. "Primary Health Care" is another strategy adopted to realize the global goal of "Health for all by Year 2000". This is a positive approach for both individual and community oral health intervention programs.     

Benefits of comprehensive health care for improving health outcomes in women.

The American Psychological Association Health Care for the Whole Person Task Force was formulated to provide a rationale for integrating behavioral health services in primary care. Collectively, the task force called for a transformation of the biomedical system into one based on the biopsychosocial model. This article is a summary of the Women's Health Committee position paper that reviewed contextual factors in women's health, provided recommendations for clinical service action, and recommended an integrated primary health care system to address women's health needs. This article provides a vision of integrated care and a practical guide for psychology practitioners as they collaborate with other health care providers and health policy groups to improve health outcomes for women over the life course. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What practicing dentists should know about EPSDT. Early and Periodic, Screening, Diagnosis and Treatment

Dr. Al-Tannir was formerly working as a student intern in the West Virginia Bureau of Public Health Division of Dental Health. He is currently the Dental Public Health Resident for the Department of Veterans Affairs, VA Medical Center, Perry Point, Maryland and Clinical Instructor at the University of Maryland at Baltimore Dental School, Department of Oral Health Care Delivery. The purpose of this paper is to provide practicing dentists in West Virginia with an overview, understanding and appraisal of the Early and Periodic, Screening, Diagnosis, and Treatment (EPSDT) dental program. EPSDT is one of the least understood and least publicized programs in the Department of Health and Human Resources and is the children's preventive health component of Medicaid. West Virginia can meet the oral health needs for its children by making dental services, both curative and preventive, more available through the EPSDT program. This program can be a principal means, if sufficiently utilized, of meeting the oral health care needs of West Virginia Children by minimizing financial and attitudinal barriers.     

Cross-infection in dentistry: an appraisal of the control guidelines with regard to contamination of dental unit water systems

The incidence of emotional disorders and mental illness among Native American adolescents is strikingly high. Yet despite promises of support from the federal government, the mental health resources available among Indian communities are negligible and must be expanded. Two federal laws--the Indian Health Care Amendments of 1990, and the Indian Health Care Amendments of 1992--help address this problem, including the integration of community health services into schools, the development of innovative mental and physical health programs for Native American youth, and the recruitment of more health professionals into Native American communities.     

Child health psychology.

[Correction Notice: An erratum for this article was reported in Vol 9(6) of Health Psychology (see record 2008-09119-001). The name of the author, Sharon Millstein, should be Susan Millstein.] The term child health psychology refers to the field of research on the behavioral aspects of children's health and illness. At this time we need to continue the work of the child health psychology special interest group and to draw into the Division of Health Psychology a much larger number of developmental psychologists, who need to be informed about the relevance of their scientific training to child health issues. We call the Division's attention and that of granting agencies such as the National Institute of Child Health and Human Development to the following high-priority child health research issues: adherence to pediatric medical regimens; child health promotion; family influences on child and adolescent health and disease; and stress and coping in childhood illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey

Cross-sectional data from a representative sample of the general population in Japan were analyzed to test the validity of Japanese SF-36 Health Survey scales as measures of physical and mental health. Results from psychometric and clinical tests of validity were compared. Principal components analyses were used to test for the hypothesized physical and mental dimensions of health and the pattern of scale correlations with those components. To test the clinical validity of SF-36 scale scores, self-reports of chronic medical conditions and the Zung Self-Rating Depression Scale were used to create mutually exclusive groups differing in the severity of physical and mental conditions. The pattern of correlations between the SF-36 scales and the two empirically derived components generally confirmed hypotheses for most scales. Results of psychometric and clinical tests of validity were in agreement for the Physical Functioning, Role-Physical, Vitality, Social Functioning, and Mental Health scales. Relatively less agreement between psychometric and clinical tests of validity was observed for the Bodily Pain, General Health, and Role-Emotional scales, and the physical and mental health factor content of those scales was not consistent with hypotheses. In clinical tests of validity, the General Health, Bodily Pain, and Physical Functioning scales were the most valid scales in discriminating between groups with and without a severe physical condition. Scales that correlated highest with mental health in the components analysis (Mental Health and Vitality) also were most valid in discriminating between groups with and without depression. The results of this study provide preliminary interpretation guidelines for all SF-36 scales, although caution is recommended in the interpretation of the Role-Emotional, Bodily Pain, and General Health scales pending further studies in Japan.     

Prophylaxis after occupational exposure to human immunodeficiency virus (HIV)

Reasons for seeking consultation among health care workers due to potential or supposed risk of HIV infection were analyzed. From August 1990 till July 1996 41 health care providers were consulted including: 22 nurses, 1 student of nursing college, 3 midwives, 4 laboratory workers and 7 physicians (surgeons and gynaecologist). Type of exposure to HIV and applying of safety precautions were evaluated in each case. In 10 cases the offer of postexposure prophylaxis with zidovudine was accepted (6 nurses, 1 student of nursing college, 3 surgeons). Exposure to HIV was described as: needlestick immediately after it was used in a HIV/AIDS patient, injury with a surgical needle while operating on an HIV infected blood. In the remaining cases the fear of HIV infection was due to work without protective gloves (nurses, laboratory workers), performing surgery on HIV (+) patient, (surgeons, nurses) or short-time contact of HIV infected blood with undamaged skin (nurses). Following conclusions can be drawn from our study: 1. Health care workers undertake safety precautions only when they are informed about HIV seropositivity of the patient. 2. Patients whose HIV serologic status is not known are considered not to create health risk for medical staff. 3. The level of knowledge of health care workers about risk of acquiring HIV infection, lack of risk and ways of diminishing the risk is poor. 4. None of followed health care workers was HIV-seropositive after occupational exposure to HIV.