Outcomes of a Survey-Based Approach to Determine Factors Contributing to the Shortage of Occupational Medicine Physicians in the United States.

Context: There is a long-standing shortage of formally trained Occupational & Environmental Medicine (OEM) physicians despite OEM practitioners experiencing high satisfaction and low burnout.

Objective: To explore the root causes of this shortage and suggest potential remedies.

Methods: Cross-sectional surveys were administered to medical students queried regarding OEM training, practicing OEM physicians queried regarding timing of specialty choice, and OEM Train-in-Place (TIP) program graduates queried regarding satisfaction with training.

A Literature Analysis of the Inventory of Legal Knowledge.

The Inventory of Legal Knowledge (ILK) is a feigning measure of growing usage, familiarity, and controversy in research and practice. A comprehensive review of a smaller literature base yields recurring themes in the ILK literature. There were mentions of feigned lack of legal knowledge tending to associate with feigned psychopathology, concerns about false positives at or around the ILK cutoff score, and potential complications when the ILK is administered to individuals with very low intellectual functioning.

Food Insecurity is positively related to Dietary Inflammatory Index in Iranian high school girls.

To determine the association between food insecurity and Dietary Inflammatory Index (DII) in high school girls. This cross-sectional study was conducted on 525 students aged 14-18 years in northern Iran. Dietary assessment was performed using a validated and reliable 147-food item questionnaire.

Competency Restoration for Adult Defendants in Different Treatment Environments.

The optimization of trial competency restoration is a topic of growing interest and controversy in the fields of forensics, psychology, criminal law, and public policy. Research has established that adult defendants who have severe psychotic disorders and cognitive impairments are more likely than defendants without these conditions to be found incompetent to stand trial and are less likely to be restored to competency thereafter. Research has also identified some of the benefits of attempting restoration in hospitals, jails, or outpatient settings for defendants with different diagnoses or levels of cognitive functioning.

Climate control: creating a multifaceted approach to decreasing aggressive and assaultive behaviors in an inpatient setting.

Creating an environment that is safe for everyone is a goal for all inpatient mental health units. How to address the aggressive and assaultive behaviors is the challenge. This article discusses how using a multidisciplinary team with a variety of approaches can help create a culture that supports safety.

Support for Linehan's biosocial theory from a nonclinical sample.

Linehan's biosocial theory of borderline personality disorder (BPD) was tested in a sample of 1,044 female college students. Relationships between self-reported BPD symptoms, two personality traits (negative emotionality and constraint), and three key variables from the biosocial theory (emotional vulnerability, invalidation, and emotional dysregulation) were examined using structural equation modeling. Consistent with the biosocial theory, the best fitting model indicated that emotional vulnerability and emotional dysregulation were uniquely related to BPD symptoms after controlling for personality traits, and that dysregulation mediated the relationship between emotional vulnerability and BPD.

The prevalence of low literacy in an indigent psychiatric population.

Research has shown that individuals with low or limited literacy experience significant obstacles in gaining access to and using health care services. In a study of the prevalence of low literacy in an indigent psychiatric population, 45 patients seeking mental health services at a shelter-based clinic for the homeless were given the Rapid Estimate of Adult Literacy in Medicine screening test. Thirty-four participants (76 percent) read at or below the seventh- to eighth-grade level.

Perceived self-care capabilities of abused/neglected and nonabused/non-neglected pregnant, low-socioeconomic adolescents.

Purpose: The purpose of this study was to determine whether abused and nonabused pregnant, low-socioeconomic adolescents differ in regard to perceived self-care capabilities.

Sample: The sample (N = 36) consisted of 18 abused/neglected and 18 nonabused/non-neglected adolescents.

Data Analysis: The adolescents' responses on the Denyes Self-Care Agency Instrument were analyzed to determine significant differences between the two groups regarding self-care agency.

Assessing civil competence in the elderly.

This study was designed to establish reliability of the Community Competence Scale-Revised (CCS-R) and provide evidence for its validity in making discriminations relevant to civil competence in the elderly. The CCS-R is an individually administered structured interview of 17 subscales. Criterion groups were formed by drawing a sample of research participants from a retirement complex with various levels of care and with nurses having extensive knowledge of the residents' level of functioning.

The debate on treating individuals incompetent for execution.

The question of whether to provide mental health treatment to prisoners under death sentence who have been judged incompetent for execution presents a powerful ethical dilemma for mental health professionals. Arguments that favor or oppose the provision of treatment are discussed in the context of the nature of the disorder to be treated, the type of treatment to be provided, the goals of treatment, and the relevant legal standard for determining competency for execution. Arguments against treating the incompetent include 1) the need to avoid harming those who are treated, 2) the risk that disclosures in therapy will be used for assessment purposes, 3) the need for paternalism when sufficient harm is necessary, 4) the adverse impact on the clinician, 5) the potential undermining of patient and public perceptions of mental health professionals, and 6) the poor allocation of limited resources.

The effects of music on the selected stress behaviors, weight, caloric and formula intake, and length of hospital stay of premature and low birth weight neonates in a newborn intensive care unit.

The purpose of this study was to examine the effects of music on selected stress behaviors, weight, caloric and formula intake, and length of hospital stay. Subjects were 52 preterm and low birth weight newborns in a newborn intensive care unit (NBICU) who were in stable condition and restricted to isolettes. Subjects in the experimental and control groups were matched for equivalency based on sex, birth weight, and diagnostic criticality.

Behavioral treatment of violent psychiatric patients.

This article reviewed major accelerative and decelerative behavioral treatments for aggressive and destructive behavior in psychiatric patients. Accelerative procedures supplant antagonistic behavior by teaching adaptive skills, and by strengthening competing responses; they are realized in token economies, social skills training, differential reinforcement of other behavior, and activity programming. Current decelerative procedures reduce violent behavior by decreasing reinforcement accessible to the patient following violent acts; they are exemplified by social extinction, response cost, time out from reinforcement, overcorrection, and contingent restraint.

Training chronic mental patients to independently practice personal grooming skills.

Schizophrenic patients typically have poor grooming and self-care skills, which hinder their social relationships and their chances of successful adaptation in the community. A practical and inexpensive program for teaching grooming skills to hospitalized chronic mental patients has been developed in a California state hospital. Patients are also taught to evaluate their grooming behavior and to carry out grooming activities independently.

Assessment of competency for execution? A guide for mental health professionals.

Assessment of competency for execution presents two compelling ethical questions for mental health professionals: whether clinicians can ethically provide such assessment, and if so, how it should be done in order to maximize quality and minimize ethical conflict. In this article we address the issue of whether to participate and, if so, how. The question of whether to participate is discussed by summarizing the arguments for and against participation and offering guidelines for making a decision.