Background Non-treatment-engaged individuals experiencing suicidal thoughts have been largely overlooked in the intervention literature, despite reviews suggesting most individuals who die by suicide were not in treatment immediately prior to their death. Most intervention studies recruit individuals from treatment providers, potentially neglecting those individuals who are not already engaged in services. These individuals clearly represent a group in need of additional empirical attention. Methods A randomized clinical trial was conducted to compare a single-session dialectical behavior therapy skills-based intervention to a relaxation training control condition. Ninety-three non-treatment-engaged subjects participated in a single in-person assessment, received one of the intervention protocols, and completed follow-up phone interviews for three months including measures of suicidal ideation, emotion dysregulation, and coping skills, as well as other relevant assessments. Results Both conditions reported significantly reduced levels of suicidal ideation, depression, and anxiety; however, analyses revealed no significant differences between conditions on the main outcome measures of suicidal ideation, emotion dysregulation, skills use, depression, or anxiety. Limitations The two interventions may have been too similar to permit detection of differential effects with this sample size. Specifically, the control condition may have been too active and there may have been stylistic overlap by providers who delivered both interventions. Conclusions Encouragingly, half of subjects contacted other mental health services during the follow-up period. Although the two interventions under investigation did not yield differential results, the significant changes in important domains across interventions suggest that brief interventions may hold promise for this difficult-to-reach population.
Purpose: The purpose of this project was to examine whether initiating a standardized pressure injury (PI) assessment and prevention protocol early in adult patients' ED stay reduces hospital-acquired PIs (HAPIs) in those patients admitted from the ED to acute care inpatient medical units. Methods: A nurse-led evidence-based practice team studied the problem of increasing HAPIs on four acute care inpatient units and found that, among patients who had been admitted to inpatient care from the ED, longer ED boarding times correlated with a higher rate of HAPIs. ED staff and acute care unit nurses collaborated to develop new protocols to prevent HAPIs in the ED, including staff education and standardized assessments and prevention care for at-risk patients. Data collection was performed at three time periods over approximately two and a half years: baseline, intervention, and postintervention. Results: The incidence rate for HAPIs decreased from 3.56 per 1,000 patient-days at baseline to 1.31 per 1,000 patient-days during the intervention period. This reduction was sustained over the next five months, during which the HAPI incidence rate was 1.53 per 1,000 patient-days. Implications: At a time when ED length of stay is difficult to manage and continues to increase, the use of evidence-based interventions and protocols can reduce the rate of PIs in high-risk patients waiting for hospital admission, leading to a reduction in PI rates and overall hospital costs.
Stainless steel circular mirrors were employed in an enrichment plan for 105 singly housed male African green monkeys. We observed 25 randomly selected males to measure mirror use and to assess the mirrors' effectiveness as an enrichment item. We conducted additional mirror-use surveys on all 105 males using fingerprint accumulation as an indicator (rated on a scale of 0 to 4). Use was defined as either being in contact with the mirror (contact use (CU)) or looking directly into the mirror without contact (non-contact use (NC)). Mirror-use data were collected 10 months after the initial introduction of the mirrors and again at 16 months. The two time points were compared by paired t-tests. No significant difference in use was found between the two data collection points. On average, the monkeys used the mirrors 5.2% of the total time intervals recorded (approximately 3 min/hr). Results from the five fingerprint-accumulation surveys showed that 102 of 105 males (97%) had CU with their mirrors over the survey points. Based on the sustained use of the mirrors over a 6-month period, we concluded that the mirrors were an effective enrichment tool that the vast majority of our monkeys routinely used. Habituation did not appear to occur even a year after the mirrors were introduced.
It is acknowledged that care leavers experience an accelerated transition into adulthood, despite often having complex psychosocial needs with limited support networks. The ‘Skills for Living’ programme was designed to improve the psychological wellbeing of care leavers and offers an adapted Dialectical Behaviour Therapy skills group as its primary intervention. This paper provides a qualitative evaluation of the programme. Semi-structured interviews were undertaken with 10 participants, and the data were analysed using thematic analysis ( Braun & Clarke, 2006 ). Four key themes emerged: ‘Initial Apprehension and Reluctance to Participate’, ‘Connection, Understanding and Validation’, ‘Confidence with Social Skills’, and ‘Emotional Acceptance and Self-Soothing’. Clinical implications and recommendations are discussed.
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