bluuebunny/crossref_metadata_2025 huggingface dataset:
Empirical Treatment of Highly Suspected Nontuberculous Mycobacteria Infections Following Aesthetic Procedures
Authors: Kim Hyung Rok , Yoon Eul Sik , Kim Deok Woo , Hwang Na Hyun , Shon Yoo Seok , Lee Byung Il , Park Seung-Ha
Published: November 2014

Background Infection caused by nontuberculous mycobacteria (NTM) has been increasing. Awareness of this infection is crucial yet problematic. Delayed management may lead to destructive results. We empirically treated a series of patients with clinical suspicion of NTM infection prior to the identification of the pathogen.

Methods A total of 12 patients who developed surgical site infections between January 2011 and February 2014 were reviewed. Patients with a skin and subcutaneous infection resistant to standard management over two weeks, and previous history of aesthetic procedures within three months were regarded as highly suspected of having an NTM infection. A variety of diagnostic modalities were examined simultaneously, along with starting empirical treatment including a combination of clarithromycin and moxifloxacin, and surgical debridement.

Results All wounds healed completely within 4 weeks. The mean follow-up duration was 7.2 months, and none of the patients developed relapse. Specific NTM pathogens were identified in six patients. Eight patients showed caseating granuloma implying an NTM infection. One patient showed an uncommon Stenotrophomonas infection, which was successfully treated. Three patients had no evidence of a pathogen despite repeated microbial tests. Complications such as scarring, pigmentation, and disfigurement were common in all the patients.

Conclusions NTM should be considered in the differential diagnosis of an unusual skin and soft-tissue infection. We propose an empirical regimen of clarithromycin and moxifloxacin as an efficient treatment option for an NTM infection.
Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone
Authors: Moon Sung Jun , Yang Jae-Won , Roh Si Young , Lee Dong Chul , Kim Jin Soo
Published: November 2014

Background To compare clinical and radiographic outcomes between intramedullary nail fixation and percutaneous K-wire fixation for fractures in the distal third portion of the metacarpal bone.

Methods A single-institutional retrospective review identified 41 consecutive cases of metacarpal fractures between September 2009 and August 2013. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the distal third of the metacarpal bone. The patients were divided by the method of fixation (intramedullary nailing or K-wire). Outcomes were compared for mean and median total active motion of the digit, radiographic parameters, and period until return to work. Complications and symptoms were determined by a questionnaire.

Results During the period under review, 41 patients met the inclusion criteria, and the fractures were managed with either intramedullary nailing (n=19) or percutaneous K-wire fixation (n=22). The mean and median total active range of motion and radiographic healing showed no statistically significant difference between the two groups. No union failures were observed in either group. The mean operation time was shorter by an average of 14 minutes for the percutaneous K-wire fixation group. However, the intramedullary nailing group returned to work earlier by an average of 2.3 weeks. Complications were reported only in the K-wire fixation group.

Conclusions Intramedullary nailing fixation is advisable for fractures in the distal third of the metacarpal bone. It provides early recovery of the range of motion, an earlier return to work, and lower complication rates, despite potentially requiring a wire removal procedure at the patient's request.
Angioimmunoblastic T-Cell Lymphoma: Clinical Aspects and Recent Advances in Biology and Therapy
Authors: Bernardo Garicochea  , Alessandro Igor Cavalcanti Leal  , Fernando Sérgio Blumm Ferreira  , Volney Assis Lara Vilela  , Alesso Cervantes Sartorelli  , Yana Novis  , Paulo Marcelo Gehm Hoff
Published: November 2014

Angioimmunoblastic T-cell lymphoma (AITL) comprehends 20% of the peripheral T-cell lymphomas (PTCL). Although rare, its clinical features may overlap with many other inflammatory, infectious or neoplastic disorders. Therefore, that patients are often diagnosed with advanced stage disease, which contributes for the disease´s dismal prognosis. The clinical presentation of AITL is frequently an assemblage of symptoms including generalized and painful lymphadenopathy, multiple cutaneous alterations, hypergammaglobulinemia, fever, loss of weight and significant autoimmune phenomena. Recent advances in AITL biology have implicated a cell with T-follicular helper phenotype as the origin of the disorder. This rare type of T lymphocyte has a peculiar capacity of interact with microenviroment, which results in an important production of cytokines, explaining the clinical findings of this type of lymphoma. In addition to its pathologic features, AITL can be distinguished from other T-cell lymphomas based on gene expression arrangement, suggesting that AITL has a uniquebiology. Moreover, somatic mutations in the epigenetic regulators DNMT3A, TET2, IDH2, and, especially, in the multifunctional RHOA GTPase gene, have emerged as very consistent genetic abnormalities in AITL. Considering its low incidence, the development of clinical trials in AITL is a challenging matter. Furthermore, the majority of data available originates from studies that contain other subtypes of PTCL, making prognosis analysis and treatment decision a tough work. In this review, we discuss the biological and clinical aspects of AITL and the alternatives for frontline treatment and the management of relapsed disease.
Expression Profile of Wnt/β-Catenin Signalling Molecules and the Wnt Antagonist Secreted Frizzled-Related Protein 4 in Apoptosis in Breast Cancer Tissue Micro-Arrays
Authors: A. Clare Berry  , Adrian Charles  , Nikolajs Zeps  , D. Mark Cregan  , Frank Arfuso  , Arun Dharmarajan
Published: November 2014

Wnt proteins are often up-regulated in cancer. The secreted frizzled-related proteins (sFRPs) can abrogate Wnt signalling and are involved in apoptosis. We investigated the expression of Wnt1, β-Catenin, and an antagonist, sFRP4, as well as apoptosis in breast cancer using tissue micro-arrays (TMAs) comprising 191 tissue cores. Results demonstrated stronger staining intensity for Wnt1 in tumour versus non-tumour samples (p<0.05). Epithelial sFRP4 did not differ between invasive and non-invasive tissue; however, there was increased sFRP4 expression in the blood vessels and lymphocyte cells of tumour compared to non-tumour tissue. These data suggest Wnt involvement in determining the breast cancer phenotype and highlight a potential new role for sFRP4 as a diagnostic/prognostic marker.
Primary Intracranial Thalamic Leiomyosarcoma: Clinical Report of a Case and Review of the Literature
Authors: Jing Jiang  , Shunjiang Yu  , Li Chen  , Feng Gao  , Xiaoguang Qiu
Published: November 2014

Purpose:The incidence of the primary intracranial leiomyosarcoma is extremely rare, and few cases have been previously reported worldwide to date. This report was to clarify the potential role of radiotherapy in the management of primary intracranial leiomyosarcoma.
Methods and Materials:This report presented a 49-year old man with a 3-month history of a progressively headache and walking unsteadily. The diagnosis was confirmed with thalamic leiomyosarcomaof high-grade malignancyaccording to the pathologic examination after neurosurgical biopsy. The patient didnt undergo surgical resection because of a high risk death. After biopsy, radiotherapy using 3D-CRT technique to the mass site with 55.8Gy/31f/43d was given accordingly.
 
Results: The mass didnt reduce much at the end of radiotherapy. The patient refused systemic chemotherapy, he was alive without signs of local relapse and brain side-effectswith 6 month follow-up. After living eleven months and three weeks after radiotherapy, he died of local progression.
 
Conclusions: Through literature review, the current therapeutic approaches including surgery, radiotherapy as well as chemotherapy appear to have limited effect, but could be beneficious of patients in tumor local control and improvement of the life quality.
The Portrayal of Suicide and Mental Illness: A Province-Wide Survey of Nova Scotia
Authors: Kisely Stephen , Denney Jennifer
Published: November 2014

This study tested the feasibility of a surveillance system of the media's portrayal of suicide and mental illness in Nova Scotia. The general public was asked to monitor nonfiction media in the province using standardized checklists over 6 months. The checklists were available on the World Wide Web and various locations in the community, and participants could identify either appropriate or inappropriate coverage. The researchers received 414 submissions covering 366 media items (304 on mental illness and 62 on suicide) during the 6-month survey: 311 from print media and 55 from radio and television. Ratings showed good agreement. On most dimensions, the majority of media items were of good quality. However, details about getting appropriate help were included in only 8.5% of media reports. Items covering suicide were 3.5 times as likely to contain inappropriate content as those on mental illness (95% CI = 1.5–8.0). These results are guiding the development of media guidelines in Nova Scotia. The study also showed that the present methodology can be used to monitor any subsequent effect on the portrayal of mental illness and suicide in the media.
Processes of Influence Between Groups of Actors Concerning the use of Ritalin® and Analogous Medications by Children
Authors: Garnier Catherine , Quesnel Martine , Marinacci Lynn , Caporossi Gilles
Published: November 2014

Autonomy with respect to psychostimulant medication for children has proven to be problematic in the face of the many influence processes at work in a climate of uncertainty and controversy over both the diagnosis of attention deficit disorder with or without hyperactivity (ADHD) and the medications associated with it, Ritalin® and analogous medications (RAM). The reconstruction of these influence processes using the framework of social representations theory allowed, in turn, for the reconstruction of a rather complex set of social dynamics based on a review of the literature. Among other things, this investigation revealed a landscape dominated by groups of professionals, where collaboration is more purposive than operative. In this context parents are subject to a concentration of influences in the form of pressure and scientific legitimation exerted mainly by groups of professional and scientific actors.
Differences Among Core Dimensions of The Centre for Epidemiological Studies Depression (CES-D) Scale Across Age and Gender Groups
Authors: Johnson C. Shanthi , Mcleod Peter J. , Sharpe Donald , Johnston Elizabeth M.
Published: November 2014

The Centre for Epidemiological Studies Depression Scale (CES-D) is a widely used self-report scale to assess depressive symptom levels among the general population. The purposes of the study are to explore the factor structure of CES-D in a population-based Canadian sample and to compare focal constructs of CES-D across age and gender. Confirmatory factor analysis supported the four-factor structure of the CES-D across three age categories and both genders. Subscales scores, however, showed important differences primarily based on gender. Attending to these specific symptom dimensions could help explain known gender differences in depression.
Does the Introduction of Shared Care Therapists in Primary Health Care Impact Clients' Mental Health Symptoms and Functioning?
Authors: Goossen Randolph B. , Staley J. Douglas , Pearson Michelle L.
Published: November 2014

This study reports the results of two self-report measures (PHQ & SF-12v2) completed before and at the end of a therapeutic intervention in a shared mental health care program. A significant reduction in symptoms was noted for 5 diagnostic categories, including depression. Statistically significant improvement was found for items assessing general health, interference in activities and work due to emotional problems or pain, feelings of calm and peace, level of energy, depression, and interference with social activities. The results suggest that integration of mental health therapists within primary care practice settings may significantly improve participants' mental health symptoms and functioning.
After Shared Care: Patients' Symptoms and Functioning 3 to 6 Months Following Care at A Rural Shared Mental Health Care Clinic
Authors: Haggarty John , Klein Rupert , Chaudhuri Bob , Boudreau Daniel , McKinnon Tammy
Published: November 2014

The present study evaluates the mental health of participants 3 to 6 months after completing treatment at a shared mental health care clinic. Twenty-five participants completed the Patient Health Questionnaire (PHQ) and the World Health Organization Disability Assessment Scale version II (WHODAS-II) at entry, exit, and 3 to 6 months following treatment. Results for the PHQ found significant sustained improvement for major depression, other anxiety syndrome, and somatoform disorder. The WHODAS-II scale demonstrated that significant improvement was maintained 3 to 6 months following treatment completion. These findings suggest that patients receiving short-term therapy and psychiatric consultation in a shared care setting may show significant, sustained improvement in mental and physical functioning.
Development and Implementation of a Collaborative Mental Health Care Program in a Primary Care Setting: The Ottawa Share Program
Authors: Swenson J. Robert , Aubry Tim , Gillis Katharine , Macphee Colleen , Busing Nicholas , Kates Nick , Pantin Sarah , Runnels Vivien
Published: November 2014

This article presents the results of a needs assessment of family physicians and residents concerning the provision of mental health care and an implementation evaluation of a multidisciplinary mental health service demonstration project, linking 2 family practices with mental health services of a general hospital. Family physicians and residents reported that collaborative mental health care provision would enhance but not replace their management of patients with mental health problems. The implementation evaluation found that collaborative care provided by a multidisciplinary mental health team co-located with family physicians was accepted by patients and valued by family physicians. Because of a shortage of family physicians, few patients from the mental health system who lacked family physicians were able to gain access to primary care through this project.
Findings from A Comparison of Mental Health Services in Primary Care and Outpatient Mental Health Services
Authors: Kates Nick , George Lindsey , Crustolo Anne Marie , Mach Michele
Published: November 2014

This project used the Colorado Client Assessment Record to compare individuals being seen by mental health teams in primary care with individuals being seen in outpatient services in the same community and to look at the implications for service delivery. While more individuals with a psychotic illness were seen in outpatient settings, many individuals seen in primary care had similar levels of need to those in outpatient clinics. Family physicians were more actively involved in the care of patients being seen in primary care. These findings suggest that a stronger role could be played by primary care in delivering mental health care, while differentiating which populations are best served in which setting.
Optimizing Maternal Mental Health Within A Primary Health Care Centre: A Model Program
Authors: Bowen Angela , Baetz Marilyn , Mckee Nora , Klebaum Nancy
Published: November 2014

Depression is a common problem that affects approximately 10 to 15% of pregnant and postpartum women. Health care providers often fail to recognize depression in this population, and pregnant and postpartum women may be reluctant to seek help because of the stigma associated with mental illness. This article describes the Maternal Mental Health Program, an innovative, shared care program that brings together previously fragmented services and co-locates multidisciplinary clinicians within a primary care setting. This approach shows promise with respect to improving mental health outcomes; meeting the needs of women, health care students, and service providers; and increasing awareness of and access to specialized mental health care.
Building Interprofessional Primary Care Capacity in Mental Health Services in Rural Communities in Newfoundland and Labrador: An Innovative Training Model
Authors: Heath Olga J. , Cornish Peter A. , Callanan Terrence , Flynn Kate , Church Elizabeth , Curran Vernon , Bethune Cheri
Published: November 2014

The benefits of interprofessional care in providing mental health services have been recognized, particularly in rural communities where health services are limited. In addition, there is a need for more continuing professional education in mental health intervention in rural areas. Although interprofessional collaboration and continuing education have both been proposed to address the paucity of mental health services available in rural areas, there have been no programs developed in which the two components have been combined. This paper describes the development, implementation, and evaluation of an interprofessional continuing education program specifically designed to enhance rural mental health capacity.
A Quality Improvement Initiative for Depression: Finally, a Model for use in “Real” Family Physician Time
Authors: Campbell Helen , Miller Magee , Stretch Janet , Weinerman Rivian
Published: November 2014

Many patients with mental illness depend on family physicians (FPs) for their physical and mental health care, yet FPs often report dissatisfaction with the quality of mental health care they provide. A 2-year, quality improvement (QI) manual-based initiative was developed to increase FPs' diagnostic, cognitive-behavioural, and interpersonal treatment skills for depression. Two teams, each consisting of a psychiatrist and a mental health therapist, rotated through 18 family practices in Victoria, British Columbia, mentoring the model on-site with physicians and patients. Feedback suggests that this initiative enhanced the ability of FPs to diagnose depression and comorbid disorders, organize problems, and treat depression using non-pharmaceutical approaches.
Risk and Protective Factors for Adolescent Substance Use and Mental Health Symptoms
Authors: Barnes Gordon E. , Mitic Wayne , Leadbeater Bonnie , Dhami Mandeep K.
Published: November 2014

The purpose of this study was to gain a better understanding of the association between youth substance use patterns and mental health symptoms, and the risk and protective factors unique and common to each of these areas. A survey was administered to a random sample of 663 youth ages 12 to 18 in Victoria, British Columbia. As expected, age was a strong predictor of greater frequency and amounts of alcohol consumption. Males were at higher risk for alcohol consumption and externalizing problems while females were more susceptible to internalizing problems. Youth who scored lower on substance use and reported fewer mental health symptoms rated their parents and peers as being more protective. Youth who scored higher on substance use scored higher on the risky peer affiliations scale.
Mental Illness and Police Interactions in a Mid-Sized Canadian City: What the Data Do and Do Not Say
Authors: Hoch Jeffrey S. , Hartford Kathleen , Heslop Lisa , Stitt Larry
Published: November 2014

This study examines the quantity and nature of police interactions for people with mental illness in London, Ontario, Canada, in 2001. An algorithm designed for a police services administrative database was used to identify 817 people with mental illness and 111,095 people without mental illness. Charges and arrests were examined using 100 randomly selected records. People with mental illness had 3.1 more police interactions on average than the general population, and they were more frequently charged and arrested. As police officers became more familiar with the individuals, they were not much more likely to identify them as violent even when a person with mental illness had been a violent perpetrator.
“Reengineering” Residential Care Facilities: A Case Study of Hamilton, Ontario
Authors: Edge Sara , Wilton Robert
Published: November 2014

Residential care facilities are an enduring feature of Ontario's community mental health system. While these facilities offer affordable housing, they are also custodial environments that are poorly suited to goals of recovery and rehabilitation. This paper examines the extent to which facilities can be “reengineered” to improve tenants' daily lives using a case study of facilities in Hamilton, Ontario. Data from a 2005 survey of 50 people with psychiatric disabilities living in residential care facilities were used to assess quality of life and the extent to which operators have implemented newly revised municipal regulations. The findings are compared with those of earlier researchers (Taylor, Elliott, & Kearns, 1989) who conducted a similar survey in 1986 in Hamilton. While the two surveys differ with regard to specific items, broad comparison suggests little has changed, raising questions about the extent to which such facilities should continue to play a central role in housing for people with psychiatric disabilities.
Suicidality in Seriously Mentally Ill Clients of Two Intensive Community Mental Health Programs
Authors: Langley John , Gehrs Margaret , Wasylenki Donald , Dewa Carolyn , Rueda Sergio , Rourke Sean
Published: November 2014

The purpose of this study was to evaluate the effect of two intensive community mental health programs on the suicidality of clients with serious mental illness. Eighty individuals with severe and persistent mental illness were enrolled in this randomized controlled study comparing two models of intensive community support: Assertive Community Treatment (ACT) and Intensive Case Management (ICM). Suicidal ideation and behaviours were measured using the Modified Scale for Suicide Ideation. Study clients underwent comprehensive interviews at baseline and were reinterviewed 9 and 18 months later. The Dartmouth Assertive Community Treatment Scale (DACTS) instrument was used to gain more insight into the specific ACT and ICM program structures and characteristics that provide crisis support and suicide intervention. A chart review of 2 randomly chosen months of service looked at the on-call after-hours pager use of ACT program clients. The ACT intervention was effective in reducing suicidal ideation over 18 months. In addition, the prevalence of suicidal ideation was significantly lower at 18 months in ACT clients versus ICM clients. This is the first study to suggest that ACT may confer some additional benefit in terms of reduced suicidality in clients with severe and persistent mental illness.
Recovery in the Canadian Context: Feedback on the Framework for Mental Health Strategy Development
Authors: Mulvale Gillian , Bartram Mary
Published: November 2014

The Mental Health Commission of Canada is developing a strategy to transform the mental health system in Canada. National consultations held in spring 2009 provided feedback on a proposed framework of goals for the strategy. The first goal discusses a recovery orientation for people living with mental health problems and illnesses. Consultation participants strongly supported a recovery orientation but raised a number of concerns, especially for children, youth, and seniors. In response, the strategy will position recovery as part of a comprehensive approach that includes promoting the best possible mental health and well-being across the lifespan.
The Creation of “We Are Neighbours”: Participatory Research and Recovery
Authors: de Wolff Alice , Cabezas Pedro , Chamberlain Linda , Cianfarani Aldo , Dufresne Phillip , Lye Peter , Morency Dennis , Mulder Bradley , Mwange Esther , Shapiro Mark
Published: November 2014

Community-based participatory research is an enabling and empowering practice that is based in principles that overlap with those of mental health recovery. Using a participatory approach, an advocacy group called the Dream Team, whose members have mental health issues and live in supportive housing, planned and conducted a study of the neighbourhood impact of two supportive housing buildings in Toronto. The study found that tenants do not harm neighbourhood property values and crime rates, and that they do make important contributions to the strength of their neighbourhoods. This article demonstrates the strength of a self-directed collective of individuals who are prepared to challenge stigma and discrimination, and documents their use of participatory action research as a proactive strategy to contribute their knowledge to discussions that shape the communities, services, and politics that involve them.
Combating Stigma and Discrimination Among Social Work Students
Authors: Matsuoka Atsuko K. , Thompson Ann
Published: November 2014

This paper presents an anti-stigma and anti-discrimination program for social work students. This educational module is designed to be incorporated into current courses on anti-discriminatory/oppressive social work practice, which are mandatory in Canadian social work education. The program is novel, as it builds on both mental health recovery values and critical social work.
Supporting Prosumer Employment: Results From an Ethnography of Two Ontario Community Mental Health Organizations
Authors: Grant Jill G.
Published: November 2014

This paper describes an ethnographic study exploring the employment of consumer-survivors at 2 Ontario community mental health organizations. The methodology included interviews with agency staff, participant observation, and document analysis to examine the natural environment of the employees at the 2 organizations and the ways in which the organizations supported the employment of consumer-survivors. The themes identified uncover some of the strategies these organizations use to support consumer-survivor employees: (a) create the context for consumer-survivor employment, (b) encourage autonomy, (c) provide a supportive atmosphere, and (d) set up consumer-survivors for success. These themes lead to specific recommendations related to hiring processes, working conditions, and attitudes.
Community Mental Health Organizations in Ontario: Perceptions of Cultural Responsiveness
Authors: Westhues Anne , Janzen Rich , Roth Don , Grant Jill G.
Published: November 2014

This paper reports the findings from an online survey that explored the perceptions of 111 leaders within community mental health organizations in Ontario about how responsive they are to the service needs of people from diverse cultural-linguistic groups. The findings show that more than half of respondents said they engaged in 20 of the 27 practices that promote cultural responsiveness. Comparisons of community organizations with different service philosophies found only one difference in terms of engaging in culturally responsive practices. Specifically, the difference was in whether or not staff received ongoing training in how to work with people from the cultural-linguistic groups the organization serves. These data provide a baseline against which progress can be measured toward greater cultural responsiveness in community mental health organizations in Ontario.
Continuity of Care in Early Intervention Programs and Court Support Programs: Giving Voice to Service Recipients and Their Families
Authors: Nandlal Joan , Palarchio Nadia Ianni , Dewa Carolyn S.
Published: November 2014

Studies of continuity of care (CoC) have largely been quantitative and have originated outside of Canada. This qualitative study examined CoC using verbatim transcripts of interviews with 45 clients and 22 family members of early intervention or court support programs in Ontario. Data were analyzed drawing on Dewa et al.'s (this volume) conceptualization of CoC, which has orderliness, and temporal and cross-sectional aspects. Our analysis revealed a high degree of convergence in clients' and families' perspectives regarding key features of each of the five dimensions, indicating that indeed all dimensions are important to clients and families.
Police-Citizen Encounters That Involve Mental Health Concerns: Results of an Ontario Police Services Survey
Authors: Durbin Janet , Lin Elizabeth , Zaslavska Natalia
Published: November 2014

The present study surveyed police services in Ontario to learn about changes in volume of contacts with persons with mental illness and use of pre-arrest diversion practices between 2003 and 2007, when significant new funding was provided to community mental health services. Participants included 37 municipal services (54% of services serving 92% of provincial population) and the Ontario Provincial Police. Findings indicated a trend of increasing police encounters with persons with mental illness. Police services had a range of diversion practices in place although actual implementation was lower. Some of these practices were implemented after 2005, coinciding with the entry of the new resources, although other system activities during that period also promoted police-mental health system collaboration and pre-arrest diversion. Police service ability to report data improved over the study period, but common reporting practices are lacking. Continuing work to create a provincial standardized database of police-citizen encounter data would facilitate efforts to better understand when and how diversion practices are implemented and with what results.
An Evaluation of a Community-Based, Integrated Crisis-Case Management Service
Authors: Krupa Terry , Stuart Heather , Mathany Alan , Smart Jennifer , Chen Shu Ping
Published: November 2014

This study presents findings of an evaluation of a community-based crisis service that used systems enhancement funding to modify services. In addition to developing timelier crisis services and increasing mobile capacity, the service adaptations focused on broadening the scope of the crisis service and addressing the follow-up needs of individuals served. While service development was guided by the research and best practice literature, there was little guidance available on how to address the latter two goals. The development of a transitional case management model integrated with crisis services was an innovation in service delivery. The evaluation used existing databases to compare crisis service delivery between two distinct periods (i.e., “old model” vs. “new model”). Study findings suggest that the new model did lead to the expected changes in service utilization patterns, specifically to increased service capacity, greater access to mobile crisis services, improved access to a broader community population, and more appropriate patterns of service delivery with respect to fewer days of crisis service and exit dispositions more consistent with crisis resolution. Rankings of acceptance of the new crisis service by the local service network varied greatly across service sectors, suggesting the need for more strategic community outreach efforts. The findings indicate that policy and funding opportunities within the mental health system need to be flexible and sensitive enough to address emerging issues in the field and to facilitate service innovations.
Living in a Rural Community Is Good for Your Health … Or Is It? Young Women Talk About Rural Living and Their Emotional and Mental Health
Authors: Jackson Lois A. , Unruh Anita , Donahue Margaret
Published: November 2014

Relatively little is known about how rural living influences the health of women. We explored how young women (18–39 years) living in two rural communities in Nova Scotia, Canada, perceive the impact of the physical and social environments on their emotional and mental health. Qualitative interviews were conducted with 27 women. Our research indicates that specific characteristics of the physical and social environments promote feelings and experiences of “connectedness,” thus contributing positively to emotional and mental health. However, other features of the environments operate as obstacles to connectedness (particularly to services and supports), and negatively impact the women's emotional and mental health.
Developing a Population Health Framework for Studying Problem Gambling
Authors: Afifi Tracie O. , Cox Brian J. , Martens Patricia J. , Sareen Jitender , Enns Murray W.
Published: November 2014

Research has shown that the expansion of gambling is an important public health concern and a public health approach should be applied to study problem gambling (Canadian Public Health Association, 2000; Korn, 2000; Korn & Shaffer, 1999). However, such an approach is underutilized. Therefore, a conceptual framework was developed to study problem gambling (or pathological gambling) based on Evans and Stoddart's (1990) popular population health model. This framework can be used to identify psychosocial/social, genetic, and environmental correlates of problem gambling and important relationships between problem gambling and health and functioning, mental and physical health conditions, and help-seeking behaviours.
Comparison of Brief and Standard Interventions for Drug and Alcohol Dependence: Considerations for Primary Care Service Delivery
Authors: Gauthier Gail , Palacios-Boix Jorge , Charney Dara A. , Negrete Juan C. , Pentney Helen , Gill Kathryn J.
Published: November 2014

Although brief intervention (BI) is an empirically validated treatment modality for alcohol dependence, it has generally failed to gain wide acceptance in practice. Most studies have focused exclusively on individuals with alcohol problems, and little is known about the effectiveness for patients with other drug problems. The objective of this study was to examine the effectiveness of BI compared to standard therapy for drug and alcohol dependence in an outpatient treatment program. The study was conducted at the Addictions Unit of the McGill University Health Centre in Montreal. The trial compared 72 patients randomly assigned at intake to an individual 5-session brief intervention (BI) or a 6-month conventional treatment (CT) consisting of individual and group therapy. At 6 months' follow-up, the BI (N = 19) and CT (N = 20) groups were compared in terms of substance use, psychological, health, and occupational outcomes. There were approximately equivalent changes in both treatment groups compared to intake. Under the conditions of the present trial, CT did not show superiority over BI, providing additional support for the notion that BI can be an effective first step in the treatment of alcohol and drug dependence in a variety of health care settings.
Declaring Label Preferences: Terminology Research in Mental Health
Authors: Gardiner Mary , Radian Elizabeth , Neiman Amanda , Neiman Robin
Published: November 2014

This exploratory descriptive research attempts to determine current preferences and understandings of terms used to refer to persons with a mental illness. From September 2005 to January 2006, 760 surveys were completed across Canada at mental health conferences and meetings, via provincial and national mental health websites, and during college classes. Respondents were asked to indicate whether they were a mental health service provider, an individual with mental illness, a friend or family member, or someone not in the three categories mentioned. Quantitative and qualitative data were collected. Analyses of the data indicate that respondents show an aversion to labels, and a majority of respondents prefer to use the term individual or the person's name.
“Because it was expected”: Heterosexism as a Determinant of Pregnancy among Sexually Diverse Youth
Authors: Travers Robb , Newton Heidi , Munro Lauren
Published: November 2014

Sexually diverse youth are more likely than their heterosexual counterparts to be involved in a pregnancy. The social exclusion (heterosexism and homophobia) experienced by sexually diverse youth may help to contribute to our theoretical understanding of the phenomenon. Seventy-one sexually diverse youth and 23 service providers participated in interviews and focus groups which were transcribed and thematically coded. Pregnancy involvement can be understood as a response to heterosexism, where the “dominance of heterosexuality” in youths' lives produce extreme pressures to conform to heterosexist expectations of relationships and a desire to prove one's heterosexuality through heterosexual sex.
The Development of a Questionnaire to Explore Stigma from the Perspective of Individuals With Serious Mental Illness
Authors: Gibbons Carrie , Dubois Sacha , Morris Kelly , Parker Barbara , Maxwell Hillary , Bédard Michel
Published: November 2014

The stigma associated with mental illness impacts individuals with serious mental illness (SMI). We developed a questionnaire to explore stigma from the perspective of individuals with SMI. In the first of two studies, we examined content validity, internal consistency, and convergent validity. In Study 2 we explored test-retest reliability, interrater reliability, and concurrent validity. Internal consistency reliability was high (Cronbach's α = 0.852), convergent validity (p < 0.001) and test-retest reliability (ICC = 0.75) were demonstrated, while analyses of concurrent validity were in the expected direction (p < 0.01). The final questionnaire is short with good psychometric properties.
Les conditions d'hébergement favorables au rétablissement : perspective des usagers et usagères
Authors: Piat Myra , Boyer Richard , Cloutier Simon , Fleury Marie-Josée , Lesage Alain
Published: November 2014

Cette recherche vise à mieux comprendre le rôle de l'hébergement dans le rétablissement des personnes vivant avec une maladie mentale grave. Quarante résidents et résidentes de différents types d'hébergement communautaire structuré ont été interrogés sur les conditions d'hébergement qui favorisent leur rétablissement. Les résultats indiquent qu'aux yeux des résidents et résidentes, les conditions matérielles d'existence ont une influence déterminante sur le rétablissement. Leurs préoccupations s'articulent autour des besoins de base tels que l'alimentation, le coût, les commodités et la qualité de leur hébergement. Les relations sociales avec leur entourage immédiat ont également une grande influence sur le rétablissement des personnes, lesquelles souhaitent d'abord conserver leurs modestes acquis, tant matériels que sociaux. Cette stabilité est prérequise à leur rétablissement.
Toward a Culturally Responsive Approach to Child and Youth Mental Health Practice: Integrating the Perspectives of Service Users and Providers
Authors: Sundar Purnima , Todd Sarah , Danseco Evangeline , Kelly Laura-Jean , Cunning Sandra
Published: November 2014

An increased awareness of barriers facing visible minority populations in Canada has prompted the growth of “cultural competence” research to inform service provision with these groups (Este, 2007; Thomas Bernard & Moriah, 2007). Overwhelmingly, this literature is rooted in the perspectives of practitioners and/or academics who view cultural competence as the process of acquiring knowledge and skills to work with “others.” In this paper, we summarize findings from an empirical study aimed at understanding the complex meanings and practices of working across cultures, from service user and practitioner perspectives. We conclude that drawing upon a “cultural responsive” approach to pedagogy (Gay, 2000; Villegas & Lucas, 2002) can enrich the way we work across difference with diverse families.
Challenges in Implementing Recovery-Based Mental Health Care Practices in Psychiatric Tertiary Care
Authors: Battersby Lupin , Morrow Marina
Published: November 2014

Despite increased interest in the concept of recovery, not enough is known about the challenges of implementing recovery models in mental health care settings. Findings are presented from a 3-year feminist ethnographic study that followed recently deinstitutionalized women and men as they moved into psychiatric tertiary care facilities in British Columbia where a psychosocial rehabilitation model based on recovery principles was implemented. We found that inconsistent staff training and stretched community supports have resulted in uneven implementation that does not yet maximize opportunities for people's recovery. Further, care is organized and delivered in ways that emphasize individual needs as opposed to social and collective needs based on factors such as gender, ethnicity, and culture. These findings indicate that greater political will, as measured in commitments to community-based mental health services, is required to fully realize the philosophy of recovery and equitable mental health care.
Soil CO2 emissions as a proxy for heat and mass flow assessment, Taupō Volcanic Zone, New Zealand
Authors: Bloomberg S. , Werner C. , Rissmann C. , Mazot A. , Horton T. , Gravley D. , Kennedy B. , Oze C.
Published: November 2014

The quantification of heat and mass flow between deep reservoirs and the surface is important for understanding magmatic and hydrothermal systems. Here, we use high‐resolution measurement of carbon dioxide flux (φCO2) and heat flow at the surface to characterize the mass (CO2 and steam) and heat released to the atmosphere from two magma‐hydrothermal systems. Our soil gas and heat flow surveys at Rotokawa and White Island in the Taupō Volcanic Zone, New Zealand, include over 3000 direct measurements of φCO2 and soil temperature and 60 carbon isotopic values on soil gases. Carbon dioxide flux was separated into background and magmatic/hydrothermal populations based on the measured values and isotopic characterization. Total CO2 emission rates (ΣCO2) of 441 ± 84 t d−1 and 124 ± 18 t d−1 were calculated for Rotokawa (2.9 km2) and for the crater floor at White Island (0.3 km2), respectively. The total CO2 emissions differ from previously published values by +386 t d−1 at Rotokawa and +25 t d−1 at White Island, demonstrating that earlier research underestimated emissions by 700% (Rotokawa) and 25% (White Island). These differences suggest that soil CO2 emissions facilitate more robust estimates of the thermal energy and mass flux in geothermal systems than traditional approaches. Combining the magmatic/hydrothermal‐sourced CO2 emission (constrained using stable isotopes) with reservoir H2O:CO2 mass ratios and the enthalpy of evaporation, the surface expression of thermal energy release for the Rotokawa hydrothermal system (226 MWt) is 10 times greater than the White Island crater floor (22.5 MWt).
Microstructures, composition, and seismic properties of the Ontong Java Plateau mantle root
Authors: Tommasi Andréa , Ishikawa Akira
Published: November 2014

To study how an impacting plume modifies the mantle lithosphere, we analyzed the microstructures and crystal preferred orientations (CPO) of 29 peridotites and 37 pyroxenites that sample the mantle root of the Ontong Java Plateau (OJP) from 60 to 120 km depth. The peridotites show a strong compositional variability, but homogeneous coarse granular to tabular microstructures, except for those equilibrated at the shallowest and deepest depths, which are porphyroclastic. All peridotites have clear olivine CPO, with dominant fiber‐[010] patterns. Low intragranular misorientations and straight grain boundaries in olivine suggest that, above 100 km depth, annealing often followed deformation. Calculated density and P wave velocities of the peridotites decrease weakly with depth. S wave velocities decrease faster, resulting in increasing Vp/Vs ratio with depth. Calculated densities and seismic velocity profiles are consistent with those estimated for normal mantle compositions under a cold oceanic geotherm. Enrichment in pyroxenites may further increase seismic velocities. The calculated seismic properties cannot therefore explain the low S waves velocities predicted by Rayleigh wave tomography and ScS data in the mantle beneath the OJP. Calculated P and S waves anisotropy is variable (2–12%). It is higher on average in the deeper section of the lithosphere. Because olivine has dominantly [010]‐fiber CPO patterns, if foliations are horizontal, vertically propagating S waves and Rayleigh waves will sample very weak anisotropy in the OJP mantle lithosphere. Moreover, if the orientation of the lineation changes with depth, the anisotropy‐induced contrast in seismic properties might produce an intralithospheric reflector marking the stratification of the OJP mantle root.
Ionospheric response to 2009 sudden stratospheric warming in the Northern Hemisphere
Authors: Oyama K.‐I. , Jhou J. T. , Lin J. T. , Lin C. , Liu H. , Yumoto K.
Published: November 2014

We study the behavior of the F region ionosphere in the Northern Hemisphere during the sudden stratospheric warming period of 19–30 January 2009 by using FORMOSAT‐3/Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC) ionosphere data (NmF2, hmF2, and height profile). We concentrated our study in the longitude bands 30°E–30°W, as well as 150°E–150°W, where no detailed study has been reported so far. At low magnetic latitude, the NmF2 decreases except during 09–12 LT: in the latitude zone of 20–40° NmF2 shows an increase of 30% during 09–12 LT. At higher magnetic latitude the NmF2 shows an increase during daytime and a reduction in the evening (21–03 LT). There is a latitude zone where NmF2 does not change. The latitude seems to correspond to the latitude where atmospheric temperature does not change. The behavior of the NmF2 seems to suggest a reduction of neutral density in low latitude and increase of neutral density in higher latitude. During the period of day of year (DOY) 25–31, the NmF2 shows a drastic reduction only during 06–09 LT in low latitudes, which is slightly away from geomagnetic equator. This special feature which occurred during declining phase of the sudden stratospheric warming (SSW) might be explained as due to enhanced dynamo electric field. The study suggests global change of the thermosphere including dynamo region, in spite of the fact that SSW is a high‐latitude phenomenon which occurred much below the height region of thermosphere.
Multispacecraft Cluster observations of quasiperiodic emissions close to the geomagnetic equator
Authors: Němec F. , Pickett J. S. , Santolík O.
Published: November 2014

We present a detailed analysis of three electromagnetic wave events observed by the Cluster Wide‐Band Data instruments at frequencies of a few kilohertz, which exhibit a periodic time modulation of the wave intensity (quasiperiodic emissions). The events were measured when crossing the geomagnetic equator at radial distances of about 3–4 RE during the close separation campaign in July–October 2013. Coincident compressional magnetic field pulsations with the magnitude on the order of a few tenths of nanotesla were detected in two events. Their period corresponded to the modulation period of the quasiperiodic emissions in one event, while it was about double in the other. A possible explanation for this discrepancy between the two periods is given. Although Cluster 1, Cluster 3, and Cluster 4 were close to each other, Cluster 2 was located by more than 0.5 RE closer to the Earth. The same quasiperiodic modulation was observed by all Cluster spacecraft, but the emissions detected by Cluster 2 had a noticeable time delay. This can be explained by the wave propagation from the generation region located at larger radial distances, close to the plasmapause. The large range of L shells where the emissions are detected thus appears to be due to the unducted propagation from a spatially limited source. The frequency‐time structure of individual elements forming the events is evaluated, and it is shown that the time dependence of the intensity modulation can be approximated by a simple model.