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Collins R, Skinner J, Leary M, Burrows TL. Dietary and quality-of-life outcomes of the FoodFix intervention for addictive eating: a short report. J Hum Nutr Diet 2024; 37:815-822. [PMID: 38549279 DOI: 10.1111/jhn.13300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/26/2024] [Accepted: 03/04/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Interest in addictive eating continues to grow from both a research and clinical perspective. To date, dietary assessment alongside food addiction status is limited, with management options for addictive eating behaviours variable, given the overlap with myriad conditions. The aim of this study was to report the dietary intake and quality-of-life outcomes from a personality-targeted motivational interviewing intervention delivered by dietitians using telehealth. METHODS The study was conducted in adults exceeding their healthy-weight range with symptoms of addictive eating, as defined by the Yale Food Addiction Scale. The 52 participants were randomised to either intervention or control, with 49 participants commencing the intervention. Individuals participated in the 3-month, three-session FoodFix interventions, with dietary outcomes assessed by the Australian Eating Survey and quality of life assessed using the SF-36 at baseline and 3 months. RESULTS There were small-to-moderate effect sizes, specifically in the intervention group for decreased added sugar intake, increased protein intake, increased meat quality and increased vegetable servings per day. Six out of eight quality-of-life domains had small-to-moderate effect sizes. CONCLUSIONS This intervention has highlighted the need for further research in larger sample sizes to assess dietary behaviour change by those who self-report addictive eating.
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Affiliation(s)
- Rebecca Collins
- School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Food and Nutrition Research Program, New Lambton Heights, New South Wales, Australia
| | - Janelle Skinner
- School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Food and Nutrition Research Program, New Lambton Heights, New South Wales, Australia
| | - Mark Leary
- School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Food and Nutrition Research Program, New Lambton Heights, New South Wales, Australia
| | - Tracy L Burrows
- School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Food and Nutrition Research Program, New Lambton Heights, New South Wales, Australia
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Leary M, Skinner JA, Pursey KM, Verdejo-Garcia A, Collins R, Collins C, Hay P, Burrows TL. The effectiveness of the TRACE online nutrition intervention in improving dietary intake, sleep quality and physical activity levels for Australian adults with food addiction: a randomised controlled trial. J Hum Nutr Diet 2024. [PMID: 38652589 DOI: 10.1111/jhn.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three-arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian-led telehealth intervention at 3 months. METHODS Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non-core foods were reported. RESULTS The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) -0.0 to 12.9], p = 0.049), non-core foods (-6.4%/day [95% CI -12.9 to 0.0], p = 0.049), sweetened drinks (-1.7%/day [95% CI -2.9 to -0.4], p = 0.013), takeaway foods (-2.3%/day [95% CI -4.5 to -0.1], p = 0.045) and sodium (-478 mg/day [95% CI -765 to -191 mg], p = 0.001). CONCLUSIONS A dietitian-led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change.
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Affiliation(s)
- Mark Leary
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Janelle A Skinner
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Kirrilly M Pursey
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Rebecca Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Clare Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, NSW, Australia
- Mental Health Services, South Western Sydney Local Health District, Camden and Campbelltown Hospitals, NSW, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
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Skinner JA, Leary M, Whatnall M, Collins RA, Pursey KM, Verdejo-Garcia A, Hay PJ, Baker AL, Hides L, Paxton SJ, Wood LG, Colyvas K, Collins CE, Burrows TL. A three-arm randomised controlled trial of a telehealth intervention targeting improvement in addictive eating for Australian adults (the TRACE program). Appetite 2024; 195:107211. [PMID: 38215944 DOI: 10.1016/j.appet.2024.107211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/14/2024]
Abstract
There is a substantial research base for addictive eating with development of interventions. The current 3-arm RCT aimed to investigate the efficacy of the TRACE (Targeted Research for Addictive and Compulsive Eating) program to decrease addictive eating symptoms and improve mental health. Participants (18-85 yrs) endorsing ≥3 addictive eating symptoms were randomly allocated to 1) active intervention, 2) passive intervention, or 3) control group. Primary outcome was change in addictive eating symptoms 3-months post-baseline measured by the Yale Food Addiction Scale. Depression, anxiety and stress were also assessed. A total of 175 individuals were randomised. Using Linear Mixed Models, from baseline to 3-months, there was significant improvement in symptom scores in all groups with mean decrease of 4.7 (95% CI: -5.8, -3.6; p < 0.001), 3.8 (95% CI: -5.2, -2.4; p < 0.001) and 1.5 (95% CI: -2.6, -0.4; p = 0.01) respectively. Compared with the control group, participants in the active intervention were five times more likely to achieve a clinically significant change in symptom scores. There was a significant reduction in depression scores in the active and passive intervention groups, but not control group [-2.9 (95% CI: -4.5, -1.3); -2.3 (95% CI: -4.3, -0.3); 0.5 (95% CI: -1.1, 2.1), respectively]; a significant reduction in stress scores within the active group, but not passive intervention or control groups [-1.3 (95% CI: -2.2, -0.5); -1.0 (95% CI: -2.1, 0.1); 0.4 (95% CI: -0.5, 1.2), respectively]; and the reduction in anxiety scores over time was similar for all groups. A dietitian-led telehealth intervention for addictive eating in adults was more effective than a passive or control condition in reducing addictive eating scores from baseline to 6 months. Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12621001079831.
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Affiliation(s)
- Janelle A Skinner
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Mark Leary
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Megan Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Rebecca A Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Kirrilly M Pursey
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, 3800, Australia
| | - Phillipa J Hay
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2751, Australia; Mental Health Services, South Western Sydney Local Health District, Camden and Campbelltown Hospitals, NSW, 2560, Australia
| | - Amanda L Baker
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia; School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Susan J Paxton
- Department of Psychology and Counselling, Latrobe University, Melbourne, VIC, 3086, Australia
| | - Lisa G Wood
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia; School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Kim Colyvas
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia.
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Itzchakov G, Weinstein N, Leary M, Saluk D, Amar M. Listening to understand: The role of high-quality listening on speakers' attitude depolarization during disagreements. J Pers Soc Psychol 2024; 126:213-239. [PMID: 37917499 DOI: 10.1037/pspa0000366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Disagreements can polarize attitudes when they evoke defensiveness from the conversation partners. When a speaker talks, listeners often think about ways to counterargue. This process often fails to depolarize attitudes and might even backfire (i.e., the Boomerang effect). However, what happens in disagreements if one conversation partner genuinely listens to the other's perspective? We hypothesized that when conversation partners convey high-quality listening-characterized by attention, understanding, and positive intentions-speakers will feel more socially comfortable and connected to them (i.e., positivity resonance) and reflect on their attitudes in a less defensive manner (i.e., have self-insight). We further hypothesized that this process reduces perceived polarization (perceived attitude change, perceived attitude similarity with the listener) and actual polarization (reduced attitude extremity). Four experiments manipulated poor, moderate, and high-quality listening using a video vignette (Study 1) and live interactions (Studies 2-4). The results consistently supported the research hypotheses and a serial mediation model in which listening influences depolarization through positivity resonance and nondefensive self-reflection. Most of the effects of the listening manipulation on perceived and actual depolarization generalized across indicators of attitude strength, specifically attitude certainty and attitude morality. These findings suggest that high-quality listening can be a valuable tool for bridging attitudinal and ideological divides. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Netta Weinstein
- School of Psychology and Clinical Language Sciences, University of Reading
| | - Mark Leary
- Department of Psychology and Neuroscience, Duke University
| | - Dvori Saluk
- Department of Human Services, University of Haifa
| | - Moty Amar
- Faculty of Business Administration, Ono Academic College
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Skinner JA, Whatnall M, Leary M, Collins RA, Pursey KM, Verdejo-García A, Hay PJ, Baker AL, Hides L, Paxton SJ, Wood LG, Colyvas K, Collins CE, Burrows TL. Examining the efficacy of a telehealth intervention targeting addictive eating in Australian adults (the TRACE Programme): a randomised controlled trial protocol. BMJ Open 2023; 13:e064151. [PMID: 37280025 DOI: 10.1136/bmjopen-2022-064151] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION Approximately 15%-20% of the adult population self-report symptoms of addictive eating. There are currently limited options for management. Motivational interviewing-based interventions, containing personalised coping skills training, have been found to be effective for behaviour change in addictive disorders (eg, alcohol). This project builds upon foundations of an addictive eating feasibility study previously conducted and co-design process involving consumers. The primary aim of this study is to examine the efficacy of a telehealth intervention targeting addictive eating symptoms in Australian adults compared with passive intervention and control groups. METHODS AND ANALYSIS This three-arm randomised controlled trial will recruit participants 18-85 years, endorsing ≥3 symptoms on the Yale Food Addiction Scale (YFAS) 2.0, with body mass index >18.5 kg/m2. Addictive eating symptoms are assessed at baseline (pre-intervention), 3 months (post-intervention) and 6 months. Other outcomes include dietary intake and quality, depression, anxiety, stress, quality of life, physical activity and sleep hygiene. Using a multicomponent clinician-led approach, the active intervention consists of five telehealth sessions (15-45 min each) delivered by a dietitian over 3 months. The intervention uses personalised feedback, skill-building exercises, reflective activities and goal setting. Participants are provided with a workbook and website access. The passive intervention group receives the intervention via a self-guided approach with access to the workbook and website (no telehealth). The control group receives personalised written dietary feedback at baseline and participants advised to follow their usual dietary pattern for 6 months. The control group will be offered the passive intervention after 6 months. The primary endpoint is YFAS symptom scores at 3 months. A cost-consequence analysis will determine intervention costs alongside mean change outcomes. ETHICS AND DISSEMINATION Human Research Ethics Committee of University of Newcastle, Australia provided approval (H-2021-0100). Findings will be disseminated via publication in peer-reviewed journals, conference presentations, community presentations and student theses. TRIAL REGISTRATION NUMBER Australia New Zealand Clinical Trials Registry (ACTRN12621001079831).
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Affiliation(s)
- Janelle A Skinner
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Megan Whatnall
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Mark Leary
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Rebecca A Collins
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Kirrilly M Pursey
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Antonio Verdejo-García
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Phillipa J Hay
- Translational Health Research Institute and School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Amanda L Baker
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Lisa G Wood
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, New South Wales, Australia
- Viruses, Infections / Immunity, Vaccines and Asthma Research Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Kim Colyvas
- School of Mathematical and Physical Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Tracy L Burrows
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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Erwin SR, Liu PJ, Datta N, Nicholas J, Rivera-Cancel A, Leary M, Chartrand TL, Zucker NL. Experiences of mimicry in eating disorders. J Eat Disord 2022; 10:103. [PMID: 35841035 PMCID: PMC9288029 DOI: 10.1186/s40337-022-00607-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/13/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND People unknowingly mimic the behaviors of others, a process that results in feelings of affiliation. However, some individuals with eating disorders describe feeling "triggered" when mimicked. This study explores the effects of implicit non-verbal mimicry on individuals with a history of an eating disorder (ED-His) compared to healthy controls (HCs). METHOD Women (N = 118, nED-His = 31; Mage = 21 years) participated in a laboratory task with a confederate trained to either discreetly mimic (Mimicry condition) or not mimic (No-Mimicry condition) the mannerisms of the participant. Participants rated the likability of the confederate and the smoothness of the interaction. RESULTS Participants in the No-Mimicry condition rated the confederate as significantly more likable than in the Mimicry condition, and ED-His rated the confederate as more likable than HCs. ED-His in the Mimicry condition rated the interaction as less smooth than HCs, whereas this pattern was not found in the No-Mimicry condition. Among ED-His, longer disorder duration (≥ 3.87 years) was associated with less liking of a confederate who mimicked and more liking of a confederate who did not mimic. CONCLUSIONS We discuss the implications of these findings for interpersonal therapeutic processes and group treatment settings for eating disorders. Our study on subtle, nonverbal mimicry revealed differences in social behavior for women with a history of an eating disorder compared to healthy women. For participants with an eating disorder history, a longer duration of illness was associated with a worse pattern of affiliation, reflected in lower liking of a mimicker. Further research on how diverging processes of affiliation may function to perpetuate the chronicity of eating disorders and implications for treatment is needed.
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Affiliation(s)
- Savannah R Erwin
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.
| | - Peggy J Liu
- Fuqua School of Business, Duke University, Durham, NC, USA.,Katz Graduate School of Business, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nandini Datta
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.,Department of Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA, USA
| | - Julia Nicholas
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Alannah Rivera-Cancel
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Mark Leary
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
| | | | - Nancy L Zucker
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Leary M, Pursey K, Verdejo-García A, Skinner J, Whatnall MC, Hay P, Collins C, Baker AL, Burrows T. Designing an online intervention for adults with addictive eating: a qualitative integrated knowledge translation approach. BMJ Open 2022; 12:e060196. [PMID: 35672064 PMCID: PMC9174813 DOI: 10.1136/bmjopen-2021-060196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Codesign is a meaningful end-user engagement in research design. The integrated knowledge translation (IKT) framework involves adopting a collaborative research approach to produce and apply knowledge to address real-world needs, resulting in useful and useable recommendations that will more likely be applied in policy and practice. In the field of food addiction (FA), there are limited treatment options that have been reported to show improvements in FA symptoms. OBJECTIVES The primary aim of this paper is to describe the step-by-step codesign and refinement of a complex intervention delivered via telehealth for adults with FA using an IKT approach. The secondary aim is to describe our intervention in detail according to the TIDieR checklist. DESIGN This study applies the IKT process and describes the codesign and refinement of an intervention through a series of online meetings, workshops and interviews. PARTICIPANTS This study included researchers, clinicians, consumers and health professionals. PRIMARY OUTCOME MEASURE The primary outcome was a refined intervention for use in adults with symptoms of FA for a research trial. RESULTS A total of six female health professionals and five consumers (n=4 female) with lived overeating experience participated in two interviews lasting 60 min each. This process resulted in the identification of eight barriers and three facilitators to providing and receiving treatment for FA, eight components needed or missing from current treatments, telehealth as a feasible delivery platform, and refinement of key elements to ensure the intervention met the needs of both health professionals and possible patients. CONCLUSION Using an IKT approach allowed for a range of viewpoints and enabled multiple professions and disciplines to engage in a semiformalised way to bring expertise to formulate a possible intervention for FA. Mapping the intervention plan to the TIDieR checklist for complex interventions, allowed for detailed description of the intervention and the identification of a number of areas that needed to be refined before development of the finalised intervention protocol.
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Affiliation(s)
- Mark Leary
- College of Health Medicine and Wellbeing, The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Kirrilly Pursey
- College of Health Medicine and Wellbeing, The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | | | - Janelle Skinner
- College of Health Medicine and Wellbeing, The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Megan C Whatnall
- College of Health Medicine and Wellbeing, The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Phillipa Hay
- Western Sydney University, Penrith South, New South Wales, Australia
| | - Clare Collins
- College of Health Medicine and Wellbeing, The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Amanda L Baker
- College of Health Medicine and Wellbeing, The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Tracy Burrows
- College of Health Medicine and Wellbeing, The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Kowalski RM, Leary M, Hendley T, Rubley K, Chapman C, Chitty H, Carroll H, Cook A, Richardson E, Robbins C, Wells S, Bourque L, Oakley R, Bednar H, Jones R, Tolleson K, Fisher K, Graham R, Scarborough M, Welsh SA, Longacre M. K-12, college/university, and mass shootings: similarities and differences. J Soc Psychol 2021; 161:753-778. [PMID: 34392801 DOI: 10.1080/00224545.2021.1900047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In a 2003 study, we examined five antecedents of school shootings - a history of rejection, acute rejection experience, history of psychological problems, fascination with death or violence, and fascination with guns. In three studies, the current project examined the role of these factors in 57 K-12 shootings, 24 college/university shootings, and 77 mass shootings that occurred since the original study. Over half of all shooters had a history of psychological problems. More K-12 shooters than college or mass shooters displayed a history of rejection. However, more mass than school shooters had experienced an acute rejection, such as a workplace firing. The characteristics identified in the original study appeared as common antecedent conditions of not only K-12 shootings but college/university and mass shootings as well. These results identify problems that can be addressed to minimize the occurrence of school and mass shootings.
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Leary M, Pursey KM, Verdejo-Garcia A, Burrows TL. Current Intervention Treatments for Food Addiction: A Systematic Review. Behav Sci (Basel) 2021; 11:80. [PMID: 34071059 PMCID: PMC8224570 DOI: 10.3390/bs11060080] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/28/2022] Open
Abstract
Research on the concept of food addiction (FA) has steadily grown and, based on a widely used self-report, FA is estimated to affect between 16-20% of the adult population. However, there are few interventions available for people with self-reported FA, and their efficacy is unclear. The primary aim of the review was to examine the efficacy of different interventions, including behavioural/lifestyle, medication and surgical approaches, for reducing symptoms and/or changing diagnosis of FA among adolescents and adults. A secondary aim was to examine the influence of sex as a moderator of intervention effects. A systematic search was performed from 2008-2020 to identify studies that used the YFAS to assess the effectiveness of interventions on FA. Nine studies were identified (n = 7 adults, n = 2 adolescents) including a total of 812 participants (range 22-256) with an average of 69% females per study. The types of interventions included medications (n = 3), lifestyle modification (n = 3), surgical (n = 2) and behavioural (n = 1), with FA being assessed as a secondary outcome in all studies. Five studies in adults reported a significant reduction in FA symptoms or diagnosis from pre to post-intervention, two when compared to a control group and three in the intervention group only. Efficacious interventions included: medication (combination of naltrexone and bupropion, as well as pexacerfont), bariatric surgery and lifestyle modification. No significant changes in FA were reported in adolescent studies. Given few studies were identified by the review, there is insufficient evidence to provide clear recommendations for practice; however, some interventions show potential for reducing self-reported FA outcomes in adults. Future research should explore the longer-term efficacy of interventions and the effectiveness of treatments with sufficient sample sizes.
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Affiliation(s)
- Mark Leary
- School of Health Sciences, College of Medicine, Health and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Kirrilly M Pursey
- School of Health Sciences, College of Medicine, Health and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Medicine, Health and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
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Piola R, Leary M, Santander R, Shimeta J. Antifouling performance of copper-containing fused filament fabrication (FFF) 3-D printing polymer filaments for marine applications. Biofouling 2021; 37:206-221. [PMID: 33691551 DOI: 10.1080/08927014.2021.1892085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
3-D printing allows for rapid prototyping and manufacture of components in a cost effective and timely manner, becoming a popular technology for oceanographic and maritime engineering applications. However, 3-D printed components are at risk of accumulating marine biofouling. This study examined the antifouling (AF) performance of three Cu-containing 3-D printing polymer filaments for potential marine use. The amount of Cu present in each filament was the primary determinant of AF performance. The lowest Cu-content (30%) filament recording 29% biofouling cover after 1 month and near 100% cover after 3 months. These AF results were comparable to polylactide acid (PLA) and acrylonitrile butadiene styrene (ABS) polymer filament controls. The medium (50%) Cu-content filament remained largely free of biofouling until 3 months (where 48% coverage was observed), after which fouling cover increased to 100% by ∼12 months. The highest Cu-content (80%) filament remained free of all macrofouling for the entire 24 months of the experiment.
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Affiliation(s)
- R Piola
- Maritime Division, Defence Science and Technology Group, Fishermans Bend, VIC, Australia
- Centre for Environmental Sustainability and Remediation, School of Science, RMIT University, Bundoora, VIC, Australia
| | - M Leary
- School of Mechanical and Automotive Engineering, RMIT University, Bundoora, VIC, Australia
| | - R Santander
- School of Mechanical and Automotive Engineering, RMIT University, Bundoora, VIC, Australia
| | - J Shimeta
- Centre for Environmental Sustainability and Remediation, School of Science, RMIT University, Bundoora, VIC, Australia
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Burrows T, Collins R, Rollo M, Leary M, Hides L, Davis C. The feasibility of a personality targeted intervention for addictive overeating: FoodFix. Appetite 2020; 156:104974. [PMID: 32991946 DOI: 10.1016/j.appet.2020.104974] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/04/2020] [Accepted: 09/14/2020] [Indexed: 12/15/2022]
Abstract
Recent reviews have identified potential treatment targets for addictive overeating. These include: motivational interviewing, development of specific coping strategies for emotional regulation and the use of harm minimisation strategies based on interventions for substance use disorders. However, there is very little experiential evidence. The aim of this study was to determine the feasibility of a personality-targeted motivational interviewing intervention in adults above the healthy-weight range with symptoms of addictive eating, to reduce symptoms of addictive overeating and improve dietary profiles. Individuals with overweight and obesity (BMI >25 kg/m2) with addictive eating as defined by the modified Yale Food Addiction Scale (mYFAS) were recruited to a three-session intervention held over 3 months. Sessions were conducted by telehealth and facilitated by dietitians. Fifty-two individuals were randomised to either intervention or control (mean age 43.6 ± 12.2yrs, mean BMI 36.7 ± 6.8 kg/m2, 96% female). At three month follow up, there were significant reductions from baseline (BL) for both groups in total YFAS 2.0 symptoms, however, these changes were not significantly different between groups (intervention BL 8.0 ± 2.7; 3-months 6.5 ± 3.8, control BL 8.1 ± 2.5; 3-months 6.9 ± 3.9, p > 0.05). At 3 months the intervention group significantly reduced their energy from non-core foods compared with control (intervention BL 48% energy/day; 3-months 38%, control BL 41% energy/day; 3-months 38%, p < 0.01). The FoodFix intervention provides insight to the development of future management interventions for addictive eating.
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Affiliation(s)
- Tracy Burrows
- School of Health Sciences, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308, NSW, Australia.
| | - Rebecca Collins
- School of Health Sciences, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308, NSW, Australia.
| | - Megan Rollo
- School of Health Sciences, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308, NSW, Australia.
| | - Mark Leary
- School of Health Sciences, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308, NSW, Australia.
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, NSW, Australia.
| | - Caroline Davis
- School of Kinesiology and Health Sciences, York University, Toronto, Canada.
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12
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13
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Shumway M, Mangurian C, Carraher N, Momenzadeh A, Leary M, Lee EK, Dilley JW. Increasing HIV Testing in Inpatient Psychiatry. Psychosomatics 2018; 59:186-192. [PMID: 29153630 PMCID: PMC5857211 DOI: 10.1016/j.psym.2017.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND People with serious mental illness (SMI) are at elevated risk of HIV infection, but do not receive HIV tests regularly. Inpatient psychiatric admissions provide opportunities for HIV testing. OBJECTIVE This study retrospectively examined the impact of three sequential interventions designed to increase HIV testing on an acute inpatient psychiatry service: (1) advocacy by an administrative champion, (2) an on-site HIV counselor, and (3) a clinician championing HIV testing. METHOD Demographic and HIV testing data were extracted from hospital data systems for 11,360 admissions of HIV-negative patients to an inpatient psychiatry service between 2006 and 2012. Relationships among interventions, length of stay, patient demographics, and receipt of an HIV test were examined using general estimating equation methods. RESULTS In the year prior to the intervention, 7.2% of psychiatric inpatients received HIV tests. After 1 year of administrative advocacy, 11.2% received tests. Following the HIV counseling intervention, 25.1% of patients were tested. After the counseling intervention ended, continued administrative and clinical advocacy was associated with further increases in testing. In the final year studied, 30.3% of patients received HIV tests. Patients with shorter inpatient stays and those of Black or Asian race/ethnicity were less likely to be tested. Further, 1.6% of HIV tests were positive. CONCLUSION Three interventions of varying intensity were associated with a 5-fold increase in HIV testing on an acute inpatient psychiatry service. Nonetheless, 70% of inpatients were not tested. Continued efforts are needed to increase HIV testing in inpatient psychiatric settings.
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Affiliation(s)
- Martha Shumway
- Department of Psychiatry, University of California, San Francisco Weill Institute for Neurosciences and Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA.
| | - Christina Mangurian
- Department of Psychiatry, University of California, San Francisco Weill Institute for Neurosciences and Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Noah Carraher
- San Francisco Department of Public Health, San Francisco, CA
| | - Amanda Momenzadeh
- Department of Clinical Pharmacy, University of California San Francisco Medical Center, San Francisco, CA
| | - Mark Leary
- Department of Psychiatry, University of California, San Francisco Weill Institute for Neurosciences and Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Emily K Lee
- Department of Psychiatry, University of California, San Francisco Weill Institute for Neurosciences and Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - James W Dilley
- Department of Psychiatry, University of California, San Francisco Weill Institute for Neurosciences and Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
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Seal J, Lee B, Leary M, Riano N, Mangurian C. Implementation of a violence risk assessment tool on a safety-net inpatient psychiatry unit. Gen Hosp Psychiatry 2017; 47:114-115. [PMID: 28342564 PMCID: PMC6205505 DOI: 10.1016/j.genhosppsych.2017.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 03/02/2017] [Accepted: 03/09/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Jeffrey Seal
- UCSF Department of Psychiatry, Weill Institute for Neurosciences, Zuckerberg San Francisco General, 1001 Potrero Ave, Suite 7M, San Francisco, CA 94110, United States.
| | - Bernard Lee
- UCSF Department of Psychiatry, Weill Institute for Neurosciences, Zuckerberg San Francisco General, 1001 Potrero Ave, Suite 7M, San Francisco, CA 94110, United States.
| | - Mark Leary
- UCSF Department of Psychiatry, Weill Institute for Neurosciences, Zuckerberg San Francisco General, 1001 Potrero Ave, Suite 7M, San Francisco, CA 94110, United States.
| | - Nicholas Riano
- UCSF Department of Psychiatry, Weill Institute for Neurosciences, Zuckerberg San Francisco General, 1001 Potrero Ave, Suite 7M, San Francisco, CA 94110, United States.
| | - Christina Mangurian
- UCSF Department of Psychiatry, Weill Institute for Neurosciences, Zuckerberg San Francisco General, 1001 Potrero Ave, Suite 7M, San Francisco, CA 94110, United States.
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Cheng JE, Shumway M, Leary M, Mangurian CV. Patient Factors Associated with Extended Length of Stay in the Psychiatric Inpatient Units of a Large Urban County Hospital. Community Ment Health J 2016; 52:658-61. [PMID: 26883829 PMCID: PMC4930419 DOI: 10.1007/s10597-015-9912-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 07/28/2015] [Indexed: 11/30/2022]
Abstract
This case-control study identified patient-specific factors associated with the longest psychiatric inpatient lengths of stay (LOS) at a large urban county hospital. Subjects with LOS ≥ 60 days comprised the extended LOS (ELOS) case cohort. An equally-sized control cohort consisted of a random sample of inpatients with LOS ≤ 30 days. Chi square tests and t tests were conducted to determine differences between groups. Factors associated with ELOS included older age, cognitive impairment, higher number of medical conditions requiring medication, and violence during hospital stay. Initiatives focused on community placement of patients with these characteristics may reduce prolonged LOS at safety-net hospitals.
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Affiliation(s)
| | - Martha Shumway
- Department of Psychiatry, University of California, San Francisco/San Francisco General Hospital, 1001 Potrero Ave, Box 0852, San Francisco, CA, 94110, USA
| | - Mark Leary
- Department of Psychiatry, University of California, San Francisco/San Francisco General Hospital, 1001 Potrero Ave, Box 0852, San Francisco, CA, 94110, USA
| | - Christina V Mangurian
- Department of Psychiatry, University of California, San Francisco/San Francisco General Hospital, 1001 Potrero Ave, Box 0852, San Francisco, CA, 94110, USA
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Mitsuishi F, Young JQ, Leary M, Dilley J, Mangurian C. The Systems SOAP Note: A Systems Learning Tool. Acad Psychiatry 2016; 40:164-71. [PMID: 24838822 PMCID: PMC4234704 DOI: 10.1007/s40596-014-0128-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 04/03/2014] [Indexed: 05/22/2023]
Abstract
OBJECTIVE Systems-based practice (SBP) is the only Accreditation Council for Graduate Medical Education (ACGME) competency concerned with public health and is relatively neglected in residency curricula. A tool was developed and pilot-tested to improve SBP learning on inpatient psychiatry rotations. METHODS A four-step approach was used: (1) literature review, (2) expert consultation, (3) tool development, and (4) pilot testing on four cases and evaluation for completion time and preliminary efficacy. RESULTS Out of 51 SBP articles, six (12%) focused on psychiatric residency programs, and none had a practical SBP learning tool. The "systems SOAP (subjective, objective, assessment, plan) note" (S-SOAP) was structured after a clinical SOAP note and was easy to use (mean completion time = 60 min), and residents self-reported more insight into systems issues. CONCLUSIONS The S-SOAP tool was effectively integrated into clinical experience and provided insight into systemic complexities. Future research should assess SBP knowledge acquisition after the use of such tools.
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Affiliation(s)
- Fumi Mitsuishi
- University of California, San Francisco, San Francisco, CA, USA.
| | - John Q Young
- Hofstra North Shore LIJ School of Medicine, Glen Oaks, NY, USA
| | - Mark Leary
- University of California, San Francisco, San Francisco, CA, USA
| | - James Dilley
- University of California, San Francisco, San Francisco, CA, USA
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Kemppainen JK, Brion JM, Leary M, Wantland D, Sullivan K, Nokes K, Bain CA, Chaiphibalsarisdi P, Chen WT, Holzemer WL, Eller LS, Iipinge S, Johnson MO, Portillo C, Voss J, Tyer-Viola L, Corless IB, Nicholas PK, Rose CD, Phillips JC, Sefcik E, Mendez MR, Kirksey KM. Use of a brief version of the self-compassion inventory with an international sample of people with HIV/AIDS. AIDS Care 2013; 25:1513-9. [PMID: 23527887 DOI: 10.1080/09540121.2013.780119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objective of this study was to extend the psychometric evaluation of a brief version of the Self-Compassion Scale (SCS). A secondary analysis of data from an international sample of 1967 English-speaking persons living with HIV disease was used to examine the factor structure, and reliability of the 12-item Brief Version Self-Compassion Inventory (BVSCI). A Maximum Likelihood factor analysis and Oblimin with Kaiser Normalization confirmed a two-factor solution, accounting for 42.58% of the variance. The BVSCI supported acceptable internal consistencies, with 0.714 for the total scale and 0.822 for Factor I and 0.774 for Factor II. Factor I (lower self-compassion) demonstrated strongly positive correlations with measures of anxiety and depression, while Factor II (high self-compassion) was inversely correlated with the measures. No significant differences were found in the BVSCI scores for gender, age, or having children. Levels of self-compassion were significantly higher in persons with HIV disease and other physical and psychological health conditions. The scale shows promise for the assessment of self-compassion in persons with HIV without taxing participants, and may prove essential in investigating future research aimed at examining correlates of self-compassion, as well as providing data for tailoring self-compassion interventions for persons with HIV.
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Affiliation(s)
- Jeanne K Kemppainen
- a School of Nursing , University of North Carolina Wilmington , Wilmington , NC , USA
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Abstract
OBJECTIVE Although clinical training programs aspire to develop competency in violence risk assessment, little research has examined whether level of training is associated with the accuracy of clinicians' evaluations of violence potential. This is the first study to compare the accuracy of risk assessments by experienced psychiatrists with those performed by psychiatric residents. It also examined the potential of a structured decision support tool to improve residents' risk assessments. METHODS The study used a retrospective case-control design. Medical records were reviewed for 151 patients who assaulted staff at a county hospital and 150 comparison patients. At admission, violence risk assessments had been completed by psychiatric residents (N=38) for 52 patients and by attending psychiatrists (N=41) for 249 patients. Trained research clinicians, who were blind to whether patients later became violent, coded information available at hospital admission by using a structured risk assessment tool-the Historical, Clinical, Risk Management-20 clinical subscale (HCR-20-C). RESULTS Receiver operating characteristic analyses showed that clinical estimates of violence risk by attending psychiatrists had significantly higher predictive validity than those of psychiatric residents. Risk assessments by attending psychiatrists were moderately accurate (area under the curve [AUC]=.70), whereas assessments by residents were no better than chance (AUC=.52). Incremental validity analyses showed that addition of information from the HCR-20-C had the potential to improve the accuracy of risk assessments by residents to a level (AUC=.67) close to that of attending psychiatrists. CONCLUSIONS Having less training and experience was associated with inaccurate violence risk assessment. Structured methods hold promise for improving training in risk assessment for violence.
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Affiliation(s)
- Alan R Teo
- Department of Psychiatry, University of California, San Francisco (UCSF), CA, USA
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Leary M, Gruijters J, Mazur M, Subic A, Burton M, Fuss F. A fundamental model of quasi-static wheelchair biomechanics. Med Eng Phys 2012; 34:1278-86. [DOI: 10.1016/j.medengphy.2011.12.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 12/20/2011] [Accepted: 12/20/2011] [Indexed: 10/28/2022]
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Shumway M, Alvidrez J, Leary M, Sherwood D, Woodard E, Lee EK, Hall H, Catalano RA, Dilley JW. Impact of capacity reductions in acute public-sector inpatient psychiatric services. Psychiatr Serv 2012; 63:135-41. [PMID: 22302330 DOI: 10.1176/appi.ps.201000145] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study tested the hypothesis that reductions in acute public-sector psychiatric inpatient capacity in a major urban area would be associated with negative impacts on patients and the community. METHODS The impact of two discrete service changes that reduced acute inpatient capacity by 50% in a single public-sector general hospital setting was examined. Indicators of impact were obtained from existing administrative databases for a 33-month period. Indicators included measures of utilization and case mix on the acute inpatient and psychiatric emergency services, suicides among community mental health clients, and psychiatric evaluations conducted in county jails. RESULTS Reductions in inpatient capacity were not associated with hypothesized negative impacts, such as increased demand for psychiatric emergency services, decreased access to emergency or inpatient services, or increased recidivism to inpatient care. Similarly, neither the number of suicides among community mental health clients nor the number of jail psychiatric evaluations increased after capacity reduction. CONCLUSIONS Data from a single urban public-sector setting suggest that acute inpatient psychiatric capacity may be reduced without negative impacts on patients or the community. In this setting, collaboration between inpatient and outpatient providers to speed discharge facilitated reductions in inpatient length of stay that made it possible to serve the same number of patients with fewer resources. Other service system adjustments may be more appropriate in other settings, and alternative approaches to reducing utilization of high-cost inpatient care warrant examination.
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Affiliation(s)
- Martha Shumway
- Department of Psychiatry, University of California, San Francisco, and San Francisco General Hospital, 1001 Potrero Ave. 7M, San Francisco, CA 94110, USA.
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Unick GJ, Kessell E, Woodard EK, Leary M, Dilley JW, Shumway M. Factors affecting psychiatric inpatient hospitalization from a psychiatric emergency service. Gen Hosp Psychiatry 2011; 33:618-25. [PMID: 21816482 DOI: 10.1016/j.genhosppsych.2011.06.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 06/14/2011] [Accepted: 06/16/2011] [Indexed: 11/18/2022]
Abstract
OBJECTIVE As a gateway to the mental health system, psychiatric emergency services (PES) are charged with assessing a heterogeneous array of short-term and long-term psychiatric crises. However, few studies have examined factors associated with inpatient psychiatric hospitalization following PES in a racially diverse sample. We examine the demographic, service use and clinical factors associated with inpatient hospitalization and differences in predisposing factors by race and ethnicity. METHOD Three months of consecutive admissions to San Francisco's only 24-h PES (N = 1,305) were reviewed. Logistic regression was used to estimate the associations between demographic, service use, and clinical factors and inpatient psychiatric hospitalization. We then estimated separate models for Asians, Blacks, Latinos and Whites. RESULTS Clinical severity was a consistent predictor of hospitalization. However, age, gender, race/ethnicity, homelessness and employment status were all significant related to hospitalization. Alcohol and drug use were associated with lower probability of inpatient admission, however specific substances appear particularly salient for different racial/ethnic groups. DISCUSSION While clinical characteristics played an essential role in disposition decisions, these results point to the importance of factors external to PES. Individual and community factors that affect use of psychiatric emergency services merit additional focused attention.
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Affiliation(s)
- George J Unick
- University of Maryland School of Social Work, Baltimore, MD 21201, USA.
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Mallick AA, Sharples PM, Calvert SE, Jones RWA, Leary M, Lux AL, O'Callaghan FJ, Osborne JP, Patel JS, Prendiville AT, Renowden S, Jardine PE. Cerebral venous sinus thrombosis: a case series including thrombolysis. Arch Dis Child 2009; 94:790-4. [PMID: 19556220 DOI: 10.1136/adc.2008.154708] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cerebral venous sinus thrombosis (CVST) in children is associated with a high incidence of serious morbidity and mortality. The presenting features are variable. It can be diagnostically challenging and the optimal treatment is uncertain. AIM To describe the features of a series of children with CVST treated in a single paediatric neurology centre and to discuss the role of local thrombolysis. METHODS Electronic databases were searched using diagnostic labels and International Classification of Diseases (ICD) codes to identify children aged 1 month to under 17 years with CVST. Their records were reviewed. RESULTS 21 children were identified over a period of 8.25 years with a median age of 7.1 years. The presenting symptoms included headache (15 children), vomiting (14 children) and visual disturbance (eight children). Signs found included papilloedema (16 children), fever (six children) and sixth nerve palsy (six children). The most common underlying condition was middle ear infection (13 children). All cases received unfractionated heparin and four severe cases received local pharmacological thrombolysis. 48% of cases had an adverse outcome (death, chronic intracranial hypertension, residual hemiparesis or sixth nerve palsy). DISCUSSION CVST has non-specific presenting features and a high risk of significant morbidity. CVST is typically found in association with a predisposing condition. Although heparin is the mainstay of treatment, thrombolysis may reverse deterioration as seen in three cases in this series. However, there is insufficient evidence to recommend the routine use of thrombolysis at present.
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Affiliation(s)
- A A Mallick
- Department of Paediatric Neurology, Bristol Royal Hospital for Children, Bristol, UK
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Dine J, Gersh R, Leary M, Bellini L, Abella B. Using real-time feedback and debriefing to improve CPR quality and performance. Resuscitation 2008. [DOI: 10.1016/j.resuscitation.2008.03.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Jacob J, Wallbrecht J, Leary M, Edelson D, Weidman E, Becker L, Abella B. Characterization of chest compression pauses during in-hospital cardiac arrest. Resuscitation 2008. [DOI: 10.1016/j.resuscitation.2008.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Caplan L, Chung CS, Wityk R, Glass T, Tapia J, Pazdera L, Chang HM, Dashe J, Chaves C, Vemmos K, Leary M, Dewitt L, Pessin M. New England medical center posterior circulation stroke registry: I. Methods, data base, distribution of brain lesions, stroke mechanisms, and outcomes. J Clin Neurol 2005; 1:14-30. [PMID: 20396469 PMCID: PMC2854928 DOI: 10.3988/jcn.2005.1.1.14] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2005] [Accepted: 03/12/2005] [Indexed: 12/31/2022] Open
Abstract
Among 407 New England Medical Center Posterior Circulation Registry (NEMC-PCR) patients, 59% had strokes without transient ischemic attacks (TIAs), 24% had TIAs before strokes, and 16% had only posterior circulation TIAs. Embolism was the commonest stroke mechanism accounting for 40% of cases (24% cardiac origin, 14% arterial origin, 2% had potential cardiac and arterial sources). In 32%, large artery occlusive lesions caused hemodynamic brain infarction. Stroke mechanisms in the posterior and anterior circulation are very similar. Infarcts most often included the distal posterior circulation territory (rostral brainstem, superior cerebellum and occipital and temporal lobes), while the proximal (medulla and posterior inferior cerebellum) and middle (pons and anterior inferior cerebellum) territories were equally involved. Infarcts that included the distal territory were twice as common as those that included the proximal or middle territories. Most distal territory infarcts were attributable to embolism. Thirty day mortality was low (3.6%). Embolic stroke mechanism, distal territory location, and basilar artery occlusive disease conveyed the worst prognosis.
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Affiliation(s)
- Lr Caplan
- Cerebrovascular Disease Sections of the New England Medical Center, Boston and the Beth Israel Deaconess Medical Center, Boston
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Lowe F, Batista J, Chartier Kastler E, Conti G, Dreikorn K, Leary M, Stoevelaar H. 147 Risk factors for disease progression in patients with lower urinary tract symptoms/benign prostatic hyperplasia; A systematic analysis of expert opinion. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/s1569-9056(04)90148-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Magnard JL, Yang M, Chen YC, Leary M, McCormick S. The Arabidopsis gene tardy asynchronous meiosis is required for the normal pace and synchrony of cell division during male meiosis. Plant Physiol 2001; 127:1157-1166. [PMID: 11706195 DOI: 10.1104/pp.010473] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Male meiosis in higher organisms features synchronous cell divisions in a large number of cells. It is not clear how this synchrony is achieved, nor is it known whether the synchrony is linked to the regulation of cell cycle progression. Here, we describe an Arabidopsis mutant, named tardy asynchronous meiosis (tam), that exhibits a phenotype of delayed and asynchronous cell divisions during male meiosis. In Arabidopsis, two nuclear divisions occur before simultaneous cytokinesis yields a tetrad of haploid cells. In tam, cell divisions are delayed, resulting in the formation of abnormal intermediates, most frequently dyad meiotic products, or in rare cases, dyad pollen (two gametophytes within one exine wall). Temperature-shift experiments showed that the percentage of the abnormal intermediates increased at 27 degrees C. Analysis of tam and the tam/quartet1 double mutant showed that most of these abnormal intermediates could continue through the normal rounds of cell divisions and form functional pollen, though at a slower than normal pace. The asynchrony of cell division started at the G2/M transition, with cells entering metaphase at different time points, during both meiosis I and II. In addition, chromosome condensation defects and mis-segregation were sometimes observed in tam. These observations suggest that the TAM protein positively regulates cell cycle progression, perhaps by promoting the G2/M transition. We speculate that there is a signal, perhaps TAM, that couples the normal pace of cell cycle progression with the synchrony of cell division during male meiosis.
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Affiliation(s)
- J L Magnard
- Plant Gene Expression Center, United States Department of Agriculture/Agricultural Research Service, University of California, 800 Buchanan Street, Albany, CA 94710, USA
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Abstract
A 14-year-old pregnant Caucasian girl presented with a 1-week history of dementia. She had presented 1 year prior with acute unilateral visual impairment and was noted to have macular degeneration of presumed infective aetiology. This evolved to a pigmentary macular lesion. During the course of the current presentation she developed myoclonic jerks. An electroencephalogram revealed periodic spike and slow wave complexes at 1-2 second intervals. Blood and cerebrospinal fluid examination showed raised anti-measles IgG antibody titres. Intrathecal synthesis of anti-measles virus antibody was demonstrated unequivocally and a diagnosis of subacute sclerosing panencephalitis was made. A healthy male infant was delivered by elective caesarean section at 33 weeks' gestation. She continued to deteriorate clinically despite treatment with intraventricular alpha-interferon. She had not had primary immunization against measles.
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Affiliation(s)
- S Jayawant
- Paediatric Neurology, Department of Child Health, University Hospital of Wales, Cardiff, Wales
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32
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Hemingway C, Leary M, Riordan G, Schlegal B, Walker K. The effect of carbamazepine and sodium valproate on the blood and serum values of children from a third-world environment. J Child Neurol 1999; 14:751-3. [PMID: 10593556 DOI: 10.1177/088307389901401114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In third-world countries many children with epilepsy also suffer from malnutrition, anemia, liver disease, and immunosuppression. Doctors might have reservations about the use of anticonvulsants that could aggravate these disorders. The purpose of this study was to establish the prevalence of abnormal blood and serum values in children receiving carbamazepine or sodium valproate as monotherapy who attended a child neurology clinic serving a third-world community in Cape Town, South Africa Blood samples were taken at routine follow-up visits from 104 children who had been on carbamazepine or sodium valproate monotherapy for at least 6 months. Hematology, serum chemistry, immunoglobulins, and anticonvulsant levels were measured by standard laboratory procedures. Very few subjects had any values outside accepted normal ranges. When clinically indicated and available, carbamazepine and sodium valproate can be prescribed for children from a third-world environment. Frequent blood and serum testing is not necessary in asymptomatic individuals.
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Affiliation(s)
- C Hemingway
- Department of Paediatrics and Child Health, University of Cape Town, Red Cross Children's Hospital, South Africa
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33
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Abstract
Subscales of the Empowerment Scale (Rogers, E. S., Chamberlin, J., Ellison, M. L., Crean, T., 1997. A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatr. Serv. 48, 1042-1047) were examined to see whether they fit a model of consumer empowerment that distinguishes self- and community orientations. In addition, the relationship of these two superordinate factors to several psychosocial factors was examined. Thirty-five participants in a partial hospitalization program were administered the Empowerment Scale and measures of quality of life, social support, self-esteem, psychiatric symptoms, needs and resources, global functioning, and verbal intelligence. Analysis of the subscales of the Empowerment Scale yielded two factors consistent with self- and community orientations to empowerment. Correlational analyses revealed that the two superordinate factors were associated with different sets of psychosocial variables. A self-orientation to empowerment was significantly associated with quality of life, social support, self-esteem, and psychiatric symptoms. Community orientation was correlated with self-esteem, resources, verbal intelligence, and ethnicity. The implications of these findings for a model of consumer empowerment are discussed.
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Affiliation(s)
- P W Corrigan
- University of Chicago, Center for Psychiatric Rehabilitation, Tinley Park, IL 60477, USA.
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Abstract
Mental health advocates have proposed recovery as a vision for severe mental illness. The purpose of this study is to examine psychometric characteristics of a measure of the psychological construct. Thirty-five participants in a partial hospitalization program were administered the Recovery Scale and measures of quality of life, social support, self-esteem, consumer empowerment, psychiatric symptoms, needs and resources, global functioning, and verbal intelligence. Results showed the scale to have satisfactory test-retest reliability and internal consistency. Analysis of the concurrent validity of the Recovery Scale showed recovery to be positively associated with self-esteem, empowerment, social support, and quality of life. It was inversely associated with psychiatric symptoms and age. Implications of these findings for a psychological model of recovery are discussed.
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Affiliation(s)
- P W Corrigan
- University of Chicago Center for Psychiatric Rehabilitation, Tinley Park, IL 60477, USA.
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35
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Abstract
The authors present the findings of the first phase of a 3-year study developing a skills training curriculum for mental health team leaders. A factor model empirically generated from clinical team members was compared to Bass' (1990) Multifactor Model of Leadership. Members of mental health teams generated individual responses to questions about effective leaders. Results from this survey were subsequently administered to a sample of mental health team members. Analysis of these data yielded six factors: Autocratic Leadership, Clear Roles and Goals, Reluctant Leadership, Vision, Diversity Issues, and Supervision. Additional analyses suggest Bass' Multifactor Model offers a useful paradigm for developing a curriculum specific to the needs of mental health team leaders.
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Affiliation(s)
- P W Corrigan
- University of Chicago Center for Psychiatric Rehabilitation, Tinley Park, IL 60477, USA.
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36
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Venter A, Leary M, Schoeman J, Jacklin L, Rodda J, Adnams C, Lippert MM. Hyperbaric oxygen therapy for children with cerebral palsy. S Afr Med J 1998; 88:1362-3. [PMID: 9861934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
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37
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Corrigan P, McCracken S, Edwards M, Brunner J, Garman A, Nelson D, Leary M. Collegial support and barriers to behavioral programs for severe mental illness. J Behav Ther Exp Psychiatry 1997; 28:193-202. [PMID: 9327298 DOI: 10.1016/s0005-7916(97)00020-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Previous investigations have identified staff beliefs about barriers to implementing behavioral interventions in programs for persons with severe mental illness. One of these barriers, institutional constraints, was found to be associated with collegial support; i.e., staff who report more collegial support were less likely to endorse institutional constraints. The purpose of this study was to determine how the components of collegial support were associated with beliefs about institutional constraints. Fifty-six staff members completed measures of staff opinions about barriers to implementing behavior therapy, satisfaction with collegial support, source of support, and functions of support. Results suggested that collegial support is significantly associated with co-worker and supervisor support, but not the support of family and friends. Endorsing institutional constraints was inversely associated with the support of co-workers and supervisors; institutional constraints were positively associated with the support of family and friends. Endorsing institutional constraints was also inversely associated with the sense that others rely upon the individual for their well-being. Implications of these findings for diminishing barriers to behavioral interventions are discussed.
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Affiliation(s)
- P Corrigan
- University of Chicago Center for Psychiatric Rehabilitation, Tinley Park, IL 60477, USA.
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38
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Boccellari A, Leary M, Zeifert P. Treatment of cognitive impairment. Focus 1996; 11:1-4. [PMID: 11363152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Affiliation(s)
- A Boccellari
- University of California San Francisco, San Francisco, CA
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Boccellari A, Leary M, Zeifert P. Diagnosis of cognitive impairment. Focus 1996; 11:5-6. [PMID: 11363154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Affiliation(s)
- A Boccellari
- University of California San Francisco, San Francisco, CA
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40
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Kogan MD, Leary M, Schaetzel TP. Factors associated with postpartum care among Massachusetts users of the Maternal and Infant Care Program. Fam Plann Perspect 1990; 22:128-30. [PMID: 2379570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- M D Kogan
- Massachusetts Department of Public Health
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41
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Arens LJ, Silber MH, Leary M. Progressive dystonia with diurnal fluctuation. J Child Neurol 1989; 4:227-8. [PMID: 2768787 DOI: 10.1177/088307388900400316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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42
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Youngner SJ, Landefeld CS, Coulton CJ, Juknialis BW, Leary M. 'Brain death' and organ retrieval. A cross-sectional survey of knowledge and concepts among health professionals. JAMA 1989; 261:2205-10. [PMID: 2926968 DOI: 10.1001/jama.261.15.2205] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A sample of 195 physicians and nurses likely to be involved in organ procurement for transplantation was interviewed about knowledge, personal concepts, and attitudes concerning "brain death" and organ donation. Only 68 respondents (35%) correctly identified the legal and medical criteria for determining death. Personal concepts of death varied widely. Most respondents (58%) did not use a coherent concept of death consistently; others (19%) had a concept of death that was logically consistent with changing the whole-brain standard to classify anencephalics and patients in a persistent vegetative state as dead. The findings demonstrate confusion about correct criteria for determining death and differences in concepts of death that might prove troublesome to the transplantation enterprise. We conclude that health professionals should do more to resolve the clinical and conceptual issues in the definition and determination of death before policies concerning organ retrieval are changed.
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Affiliation(s)
- S J Youngner
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio
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44
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Leary M. Congenital absence of ribs. S Afr Med J 1966; 40:391-2. [PMID: 5941622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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45
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Leary M. A case of aprosopia associated with anencephaly. S Afr Med J 1965; 39:657-8. [PMID: 5889841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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