Achieving a Mental Health Bill of Rights.

The Mental Health Patient's Bill of Rights was the culmination of a meeting of the presidents of 9 national associations of mental health professionals to examine how to best educate the public, policy makers, and benefit managers about ensuring the availability of quality mental health and substance abuse treatments. The principles to which they unanimously agreed hold that mental health clients must have guaranteed confidentiality, a real role in determining their treatment, and a choice of provider. The clients have the right to full information about their coverage as well as parity of mental health and physical health coverage. The actual text of the Mental Health Patients' Bill of Rights is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transdermal nicotine use in postmenopausal women: does the treatment efficacy differ in women using and not using hormone replacement therapy?

This study of postmenopausal female smokers (N = 94) asked: During short-term smoking abstinence, do the beneficial effects of transdermal nicotine replacement therapy (NRT) on acute symptomatology (i.e., withdrawal, cigarette craving, smoking urges, mood, depressive symptoms, motor speed, and reaction time) differ in women who use and do not use hormone replacement therapy (HRT)? Participants were recruited according to HRT and non-HRT use (self-selecting), then randomized within strata to active nicotine or placebo nicotine patch. After 1 baseline week of smoking, participants quit smoking for 2 weeks. Women received cessation counseling and were monitored for abstinence. Dependent measures were collected during five clinic visits. Two-way analysis of covariance (ANCOVA) were run on change scores for dependent variables, with nicotine patch group (active/placebo) and HRT group (HRT/non-HRT) as independent variables and age as a covariate. No interactions were found between HRT and patch condition, but both showed specific effects. During the first abstinent week, women on active nicotine patch (compared with placebo) experienced less severe withdrawal, greater reductions in cigarette cravings, and lower (more favorable) Factor 1 scores on the Questionnaire of Smoking Urges. During the second abstinent week, women using HRT (compared with the non-HRT group) exhibited better mood (Profile of Mood States scores) and less depression (Beck Depression Inventory scores). These results suggest the following: First, the efficacy of transdermal nicotine replacement is not adversely modified by women's HRT use; second, ovarian hormones might influence women's responses to smoking cessation, and thus should be considered in developing effective strategies for women to quit smoking.     

Attitudes and knowledge about nicotine and nicotine replacement therapy.

Nicotine replacement therapies (NRTs) represent an effective means of promoting smoking cessation, but they remain underutilized. Negative attitudes and false beliefs about nicotine and nicotine replacement may cause NRT underutilization. In a randomized, controlled, single-blind study of nicotine gum, 97 smokers were assessed on their attitudes and knowledge about nicotine, nicotine replacement, and smoking cessation therapy. Information from these self-report measures was used in an intervention that provided tailored, brief feedback to promote positive attitudes and accurate knowledge about NRT. Considerable variability in pretreatment attitudes and knowledge was observed across individuals. Moreover, attitudes and knowledge showed a consistent pattern of intercorrelation and were systematically related to smoking characteristics (e.g., prior use of NRT, nicotine dependence, treatment completion). The brief feedback intervention led to a significant global elevation in attitudes about nicotine, NRT, and assisted cessation but not knowledge about nicotine. Changes in attitudes and knowledge were not significantly related to gum use or smoking cessation. Recommendations for the appropriate application of brief feedback are offered.     

Review of Madhouse and The Lobotomist.

Reviews the books, Madhouse: A Tragic Tale of Megalomania and Modern Medicine by Andrew Scull (see record 2005-06776-000); and The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness by Jack El-Hai (see record 2005-02343-000). In both books, the history of experimental clinical psychiatry is laid bare with devastating accounts of the efforts to conquer mental illness by any means necessary. Both books are fascinating reading and may illuminate our current context in which the biological avenues for treating mental disorders continue to traffic in hopes of a one-size-fits-all cure, while psychoanalysis ambivalently struggles with how to conduct rigorous research to demonstrate the efficacy of our treatment. Andrew Scull's book Madhouse offers a well-documented historical account of a bizarre episode in American psychiatric history. The centerpiece of Scull's investigative work is Henry Cotton, MD, the superintendent of the Trenton State Hospital in Trenton, New Jersey, from 1907-1930. Once Cotton arrived at Trenton, he was appalled by the conditions he found and instituted reforms such as eliminating the culture of violence by attendants, removing over 700 pieces of restraining equipment from the hospital, and introducing occupational therapy. Jack El-Hai gives us the next segment of psychiatric surgery in his book The Lobotomist, a biography of the neurologist, turned surgical outlaw, Walter Freeman, MD. Walter Freeman was a neurologist fascinated with science and experimentation. Settling into work at St. Elizabeth's hospital in Washington, DC, in 1924, Freeman eventually joined the faculty of George Washington University where he remained until 1954. At that time neurosyphilis was the scourge of mental hospitals producing thousands of victims who were totally disabled by the neurological sequellae of tertiary illness. Thus lobotomy became an efficient outpatient procedure that could be applied to a larger patient population. Both of these books are important reading. Of all the great medical advances of the last century, surely the one that stands out as perhaps the greatest is the Nuremberg Code of 1947, which requires a competent patient giving informed consent to treatment and to research efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smokeless tobacco topography and toxin exposure.

This study examined the relationship between oral smokeless tobacco (ST) topographical measures and biomarkers of tobacco and carcinogen exposure. During 2 weeks of baseline ad libitum ST use, 54 male participants (mean age=32.1+/-7.5 years) were required to record the time each dip was placed in and removed from their mouths. Urine samples were collected twice during baseline and analyzed for nicotine, cotinine, and their glucuronides (total nicotine and total cotinine) and for metabolites of the tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides (total NNAL). The results suggest that frequency and duration measures of ST use (p<.01 to p<.001), particularly total dip duration, are significantly correlated with total cotinine, total nicotine, and total NNAL. These results suggest that how long a ST user has tobacco in his mouth is most predictive of tobacco toxin exposure.     

Mary Cover Jones (1896–1987).

This articles provides an obituary for Mary Cover Jones, 1896-1987. Her contributions to the field of developmental psychology are listed by the authors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Project Scheduling for Maximum IS Productivity

All IS managers are faced with the challenge of meeting project deadlines and using their staff and resources most efficiently. This article discusses the impact project scheduling can have on IS productivity.