Assessing dynamic violence risk: Common language risk levels and recidivism rates for the Violence Risk Scale.

The present study features the development of new risk categories and recidivism estimates for the Violence Risk Scale (VRS), a violence risk assessment and treatment planning tool. We employed a combined North American multisite sample ( = 6, = 1,338) of adult mostly male offenders, many with violent criminal histories, from correctional or forensic mental health settings that had complete VRS scores from archival or field ratings and outcome data from police records ( = 1,100). There were two key objectives: (a) to identify the rates of violent recidivism associated with VRS scores and (b) to generate updated evidence-based VRS violence risk categories with external validation.

Training interns in nutrition and dietetics: a cross-sectional study of the barriers and motivators to being a Registered Dietitian Nutritionist preceptor.

Background: As is common across the health professions, training of Registered Dietitian Nutritionists (RDNs) requires experiential learning for interns/students to gain skills and demonstrate entry-level competency. Preceptors are essential to the experiential learning component of health care professional training, providing supervision and mentoring as students and interns gain the skills required for entry-level practice competency. Over the past 27 years, 47-73% of applicants to dietetic internships have received a placement.

Psychometric limitations of the RBANS effort index in forensic inpatient populations.

Although the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely studied and utilized screening measure with an Effort Index (EI), there is a minimal amount of data available regarding the utility of the EI for forensic inpatients. Specific concerns include the possibility that the published cutoffs would result in high false positive rates. The present study investigated this issue by comparing the validity of the RBANS EI with that of the Dot Counting Test (DCT) and Test of Memory Malingering (TOMM) in a forensic psychiatric setting ( = 117).

An Analysis of the Correlates of Aggression in a Social Learning Program for Severely and Persistently Mentally Ill Inpatients.

Purpose: This study aimed to examine the relationship between behavioral variables and aggression among severely and chronically mentally ill inpatients in a Social Learning Program (SLP) at a state psychiatric facility.

Methods: Using archival data over a 24-month period, a total of 23 severely and chronically mentally ill inpatients comprised the sample in this study. The predictor variables included length of current hospitalization; length of stay on SLP; basic activities of daily living (ADLs); instrumental ADLs; attendance in programming; participation in programming; and the number of minor, major, and intolerable infractions received.

Enforced abstinence from tobacco during in-patient dual-diagnosis treatment improves substance abuse treatment outcomes in smokers.

Background And Objectives: Although the prevalence of tobacco use in those in substance abuse treatment is known to be quite high, most treatment programs do not address tobacco. The purpose of this study was to determine substance abuse recovery rates a year after treatment in a fully integrated, 90-day inpatient, dual diagnosis treatment program where patients are required to quit tobacco use in addition to drug and alcohol use for the duration of their 3 month stay. Tobacco is treated in the same way as other drugs and alcohol.

Person-environment interaction in a new secure forensic state psychiatric hospital.

This study examined the person-environment interaction effects of environmental design on ward climate, safety, job satisfaction, and treatment outcomes within a new high security forensic psychiatric facility. Participants included male and female adult psychiatric inpatients and staff members at different security stages. Data were collected once before and twice after the experimental group moved into the new building.

Ear acupuncture for co-occurring substance abuse and borderline personality disorder: an aid to encourage treatment retention and tobacco cessation.

Objectives: Retention of individuals with co-occurring borderline personality disorder (BPD) and substance use disorders in treatment is known to be difficult. An outcome study of a tobacco-free 90-day inpatient dual-diagnosis treatment programme that uses several evidenced-based treatments in addition to ear acupuncture (acudetox) was undertaken to determine overall treatment effectiveness.

Methods: Between January 2009 and December 2011, 231 patients were treated in the programme, 88% with nicotine dependence and 79% with personality disorder diagnoses.

Factors involved in making decisions to prescribe medications for psychiatric disorders by psychiatrists: a survey study.

The objective of this study is to understand psychiatrist's decisions to prescribe psychiatric medications. A survey questionnaire was prepared consisting of 15 factors. Each factor had a five-point Likert scale, rating the importance of each factor in making decisions to prescribe medications.

Differing effects of antipsychotic medications on substance abuse treatment patients with co-occurring psychotic and substance abuse disorders.

This retrospective study of patients treated in a ninety-day, inpatient, dual-diagnosis treatment program examined antipsychotic effectiveness in this population using length of stay in treatment and successful program completion as outcome measures. All patients with co-occurring substance dependence and schizophrenia or schizoaffective disorder treated with olanzapine, risperidone, ziprasidone, and typical depot neuroleptics from January 2001 to December 2003 (N = 55) are the subjects of this study. Patients stayed longer in treatment when taking risperidone (82 +/- 19 days) or ziprasidone (74 +/- 21 days) compared with olanzapine (44 +/- 30 days) or typicals (47 +/- 36 days).

Hepatitis C in patients with co-occurring mental disorders and substance use disorders: is tobacco use a possible risk factor?

This study of a dually diagnosed population in Colorado estimated the prevalence of hepatitis C to be 29.7%, or sixteen times higher than that in the general population. In attempts to determine possible risk factors, a surprisingly high correlation was found between the use of tobacco and HCV infection.

Converting patients from brand-name clozapine to generic clozapine.

Objective: To evaluate safety and dosage requirements when patients taking brand-name clozapine (Clozaril, Novartis Pharmaceuticals) are converted to generic clozapine (Zenith Goldline).

Methods: In November 1999, patients at Colorado Mental Health Institute at Pueblo taking Clozaril were changed to generic clozapine. Seventeen patients had been prescribed Clozaril for three years and were included in the study.

The 'S&R challenge': reducing the use of seclusion and restraint in a state psychiatric hospital.

The Colorado Mental Health Institute at Pueblo (CMHIP) established a performance improvement initiative to reduce the frequency and length of episodes of seclusion, restraint, or both (S&R). The initiative, the S&R Challenge, is a systematic approach to identifying the root causes of the S&R problem and developing solutions to identified causes. CMHIP successfully reduced t h e numberand length of S&R episodes, improved the quality of S&R documentation in the medical record, and passed three surveys by major regulatory bodies with no S&R deficiencies.

Staff injuries from patient attack: five years' data.

We report on five years' experience of staff injuries from patient attack in a large state hospital. In 1984 to 1988, with a total of 6,225 staff person-years of exposure, 209 employees suffered 236 injuries from patient attack. Ward nursing staff sustained 185 of the injuries (5.