<p> The importance of investigating relationships between depression and mineral intake is necessary due to concerns over the mental health and nutrition status of the growing older adult population in America. Due to lack of research in this area, the development of nutrition therapies for depressed older adults with special consideration for minerals is hindered. This study explored whether mean depression scores significantly differed between quartile intake groups of selenium, magnesium, zinc, and copper in a nationally representative sample of older adults (<i>n</i> = 901) from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). For all four minerals, those within the highest quartile of intake had significantly lower depression scores than those within the lowest quartile. Nutrition and mental health care professionals should be aware of a possible association between mineral intake and depression and emphasize healthy eating patterns and nutrient-dense diets to maintain optimal mental and physical functioning.</p>

<p> This study examined the relationships among stress, differentiation of self (DoS), and burnout in Child Protection Services (CPS) workers. Bowen defined DoS as the capacity of an individual to modulate emotional responses, stay calm in the midst of crisis, maintain emotional responses in highly charged situations, maintain a coherent sense of self, and maintain balance between independence and closeness within relationships. This nonexperimental correlational and comparative study sought to determine whether stress predicts burnout when controlling for DoS and whether DoS moderates the relationship between stress and burnout. Furthermore, the study examined the differences between male and female as well as novice and veteran CPS workers&rsquo; level of stress, DoS, and burnout. Data from a sample of 243 CPS workers showed that stress significantly predicted burnout when controlling for DoS, and DoS did not significantly moderate the relationship between stress and burnout. The results also found that there are no significant differences between male and female, novice and veteran workers&rsquo; level of stress, DoS, and burnout. A major finding was that the overall model for the domains of burnout showed stress and DoS to significantly predict emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Stress significantly positively predicted EE (<i>&beta;</i> = 0.56, <i>t</i> = 10.18, <i>p </i> &lt; .001), whereas DoS significantly negatively predicted EE (<i> &beta;</i> = -0.18, <i>t</i> = -3.22, <i>p</i> = .001). Stress significantly positively predicted DP (<i>&beta;</i> = 0.29, <i>t</i> = 4.53, <i>p</i> &lt; .001), whereas DoS significantly negatively predicted DP (<i>&beta;</i> = -0.24, <i> t</i> = -3.83, <i>p</i> &lt; .001). Stress significantly negatively predicted PA (<i>&beta;</i> = -0.24, <i>t</i> = -3.65, <i> p</i> &lt; .001), whereas DoS significantly positively predicted PA (<i> &beta;</i> = 0.21, <i>t</i> = 3.17, <i>p</i> = .002). In other words, those who reported high stress tend to have high level of EE and DP, and reduced PA. Conversely, those who reported high DoS tend to have low level of EE and DP, and higher PA. Despite limitations, the study sheds new light on the relationship between DoS and burnout and indicates the need for further research on the explicit role of Dos in predicting burnout. </p>

<p> The purpose of this thesis project was to write a grant proposal to make peer specialist trainings available in Orange County, California. The trainings will be funded by Mental Health Services Act&rsquo;s Workforce Education and Training funds and take place at the Recovery Education Institute, in the City of Orange. The trainings will be coordinated by Orange County Health Care Agency&rsquo;s Behavioral Health Services branch, using the Peer Employment Training program developed by Recovery Innovations, Inc. The trainings will help contribute to the development of the growing peer workforce in Orange County and increase the quality and efficacy of the peer support services provided. The implementation and/or submission of this grant proposal was not a requirement for the successful completion of this thesis project.</p>

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Childhood abuse and neglect, as suffered by in-patients of medium secure psychiatric hospitals, is an under-researched clinical variable within the literature. Associated study and work in this area is considered to be a core skill of the forensic mental health nurse (FMHN), as well as of other clinicians working in such hospitals. The study undertook an examination of childhood abuse and neglect in three medium secure units (n= 117), finding that 41% of the sample suffered abuse/neglect in childhood/adolescence. An examination of a wide range of patient characteristics in the units was also conducted, findings included observations of 94% of patients having committed a violent index offence, and 81.2% of patients being diagnosed with schizophrenia. A hypothesis test conducted on this data revealed a significant relationship between the gender of patients and abuse/neglect suffered in childhood. A further analysis of inter-rater reliability was undertaken, of FMHN's and Nurse Consultants against a Benchmark nurse, in rating the severity of abuse suffered by inpatients. This revealed findings of both fair to moderate, and poor agreement, between the nurses, Nurse Consultants and Benchmark nurse. Allied study of a range of clinicians knowledge and opinions concerning agreement or disagreement with statements related to concepts of abuse, mental disorder and violence revealed mixed results, dependent upon either a quantitative analysis indicating no variation amongst the clinician's, or qualitative analysis identifying some specific differences. The study overall has concluded that the use of a mixed methodology is beneficial to examining consistency of agreement, and knowledge and opinions, regarding clinical phenomena amongst clinicians. The study makes recommendations in terms of adjustments to forensic educational curricula and clinical practice, regarding inclusion of more, and improved, information concerning childhood abuse and neglect.

This study makes an original contribution to the evidence base for service user involvement in the teaching of interpersonal skills. The study is a synthesis of three different types of research activity. Firstly a systematic review which reviews the evidence base for service user involvement in interpersonal skills teaching. This review used inclusion criteria that restricted its scope to research that included elements that used outcomes, either qualitative or quantitative related to mental health service users involvement in teaching interpersonal skills. Four quantitative and eight qualitative studies met the criteria for inclusion. All the quantitative studies were methodologically weak. Qualitative studies lacked clear statements of qualitative methods used. Overall the studies reviewed provided some evidence of the efficacy of service user involvement. Qualitative findings included some negative effects of involvement. The second research approach used was reliability and validity testing of the Observed Assessment of Interpersonal Skills Scale (OAISS) using Factor Analysis and Cronbach’s Alpha. The OAISS is an observational instrument intended to measure an observer’s impression of another’s interpersonal skills during simulated interviews. Two factors were retained that accounted for 34% of the variance within the scale. Internal consistency of the scale was good. Two factors were interpreted to produce subscales called feedback and collaborative reflection and listening. The final study used mixed methods including a quasi-experiment and interview based qualitative data gathering. The quasi-experimental part of the study examined the effects on the student nurses (n = 75) interpersonal skills of a teaching intervention run by mental health service users. The experiment used a pre-test post-test design with a teaching as normal control group compared with the service user-teaching group. No significant difference was found between the two groups on measures of interpersonal skills. Qualitative results indicated that students had been affected by the service user teaching. Evidence was found of changes in empathic responses, attitudes and deep reflection on practice. Some polarization of views was also found particularly regarding the shocking nature of some of the personal accounts used in service user teaching and student concerns related to the representativeness of service users involved in teaching.

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