The current study investigated maternal determinants of mental health service use, namely, individual child therapy, among preadolescent children diagnosed with ADHD. The Behavioral Model of Health Care Utilization (Andersen, 2008) was used as a theoretical framework for the study. Data from the last three rounds of ECLS-K dataset were employed to test a longitudinal model using Bayesian analysis. Socio-demographic variables and maternal mental health were tested as exogenous variables and mother-child relationship variables, discipline variables, and perceived maternal concern about child’s overall behavior and child’s emotional symptoms were tested as intervening variables. Results showed that only maternal mental health remained in the model as an exogenous variable. The effect of mental health on child therapy was mediated by maternal aggravation and maternal concern about overall behavior in one path and by maternal concern about emotional symptoms in another path, suggesting that maternal mental health needs to be considered when attempting to understand help-seeking determinants. Both concern variables were found to have large direct effects on child therapy. The results of the current study showed the importance of maternal mental health and the importance of determinants related to mother-child relationship in a mother’s decision to seek therapy for a child.

Callous and unemotional (CU) traits in children with conduct problems have been indicated as precursors to adult psychopathy. The analysis of the sensitivity to rewards and punishment in this population may be useful in the identification of effective behavior modification programs and particularly the delineation of ineffective punishment procedures. Scores on the Child Psychopathy Scale, Inventory of Callous and Unemotional Traits, Contingency Response Rating Scale and the Sensitivity to Reward Sensitivity to Punishment – Children Revised scale were used to evaluate 20 children, aged 7-13, recruited from FIU’s Center for Children and Families. The sample comprised 14 males and 6 females displaying a range of psychopathic traits measured by the CPS, with scores from 9 to 46 (M = 28.45, SD = 10.73). Sensitivity to punishment was examined using a behavioral task in which children endured various amounts of either white noise (type I punishment) or time-out from positive reinforcement (type II punishment) in order to gain access to a demonstrated reinforcer. The sample was stratified on the basis of the magnitude of psychopathy scores, and sensitivity to rewards and punishment were evaluated using a Behavioral Activation / Behavioral Inhibition framework by examining task performance: the frequency and duration of punishment conditions selected, electrodermal activity (skin conductance response), and parent-reported measures of child sensitivity to reward and punishment. Results indicated that the magnitude of CU traits was directly proportional to hyposensitivity to punishment and hypersensitivity to reward. Children with elevated levels of CU traits elected to endure a greater frequency and duration type I punishment in order to maintain continued access to the reinforcer. Significant differences were not found between high- and low-psychopathy children in the selection of type II punishment. The findings indicate that although there may be a hyporeactivity to type I punishment in children with CU traits, the use of a type II punishment by the removal of a positive stimulus has demonstrated treatment efficacy. The difference in sensitivity to rewards and the types of effective punishment in children with CU traits may affect reinforcement based learning, leading to the ineffectiveness of traditional methods informing the development of social responses.

D.Cur. / South Africa is currently undergoing radical transformational changes in all facets of its society. This is an era immediately following the first democratic elections in the country. The new Government, the Government of National Unity (GNU) which is dominated by the African National Congress (ANC), has introduced what is known as the Reconstruction and Development Programme (RDP)(ANC, 1994), which seeks to redress disparities of the past. This programme has significant social, political and economical implications for the South African community. It proposes that statutory bodies and institutions should be rationalized and restructured to reflect the diversity of the South African people and should be better able to promote and protect the standards of health care and training. It aims to, inter alia, promote mental health and to increase the accessibility, quality and quantity of mental health support and counselling services. In line with this goal and based on problems that arise because of anxieties and fears that are inherent in change, the mental health of nurse educators and nursing students of a selected nursing college was investigated utilizing a qualitative, theory – generative design which is exploratory, descriptive and contextual in nature. The study was conducted in two phases. In Phase 1, in-depth phenomenological interviews were conducted individually with ten nurse educators and nine nursing students to explore and describe their experience of interaction with one another. Follow-up interviews were also conducted with some of the participants. Data was analysed using Tesch's method. Based on the results of the analysis, the major concept, understanding was identified as the essence of a model for constructive nurse educator - student interaction envisaged. In Phase 2, a theory -generative design was utilized to develop a constructive nurse educator - student interaction model, founded on a mental health approach. The identified concept was examined in existing writings to determine essential criteria of the concept. In addition, a model case was written in which the concept was constructed to the best of the researcher's understanding. Essential criteria of the concept were identified and a concept map was drawn to depict the essential criteria in relation to each other. The related concepts were identified and portrayed in a structural form. The visual model depicts nurse educators and nursing students who function as a family, as the recipients of activity, and the advanced psychiatric nurse practitioner, who facilitates their interaction, as the agent. By utilizing the deductive reasoning strategy, relationship statements were inferred from the model. Guidelines were described for the advanced psychiatric nurse practitioner with regard to all three phases, namely, the Interaction Initiation Phase, the Interaction Cohesiveness Phase and the Interaction Dissolution Phase, in terms of objectives, strategies and proposed activities.

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This study measured the effectiveness of rehabilitative day treatment (RDT) programs for persons with severe and persistant mental illness in San Bernardino County. The effectiveness of RDT services was determined by rates of recidivism.

Introduction: Ventricular arrhythmias (VAs) are common after an acute coronary syndrome (ACS) and are associated with worse clinical outcomes. However, little is known about recent trends in their occurrence, their association with serum glucose levels, and their psychological impact in ACS setting. Methods: We examined 25-year (1986-2011) trends in the incidence rates (IRs) and hospital case-fatality rates (CFRs) of VAs, and the association between serum glucose levels and VAs in patients with an acute myocardial infarction (AMI) in the Worcester Heart Attack Study. Lastly, we examined the relationship between in-hospital occurrence of VAs and 12-month progression of depression and anxiety among hospital survivors of an ACS in the longitudinal TRACE-CORE study. Results: We found the IRs declined for several major VAs between 1986 and 2011while the hospital CFRs declined in both patients with and without VAs over this period. Elevated serum glucose levels at hospital admission were associated with a higher risk of developing in-hospital VAs. Occurrence of VAs, however, was not associated with worsening progression of symptoms of depression and/or anxiety over a 12-month follow-up period in patients discharged after an ACS. Conclusions: The burden and impact of VAs in patients with an AMI has declined over time. Elevated serum glucose levels at hospital admission may serve as a predictor for in-hospital occurrence of serious cardiac arrhythmias. In-hospital occurrence of VAs may not be associated with worsening progression of symptoms of depression and anxiety in patients with an ACS.

The main goal of the Strategy for the Reform of Psychiatric Care, published in 2013 by the Ministry of Health of the Czech republic, was to improve the quality of life of people suffering from mental illness. One of the results of this strategy was the emergence of new mental health centres. These mental health centres are meant to provide individualized social and health care to people with mental illness in order to prevent or minimize their hospitalization. The service is ensured by multidisciplinary teams which include professionals such as psychiatrists, psychologists, psychiatric nurses, and social workers. Case management is supposed to be a dominant form of the service provided. The theoretical part of the thesis describes the historical context of the case management and its recent exploitation in the mental health centres in the Czech republic. The empirical part focuses on a particular multidisciplinary team applying the case management method. Through qualitative research, it aims to identify the different parts of the case management and the constraints and obstacles of its application. The analysis of the data collected brings the definition of the key problem areas the team is facing. The final part of the thesis provides recommendations for further development and proposes steps...