In clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. As such, transdiagnostic therapies are needed to address these co-occurring issues efficiently. The aim of the present study was to conduct a pragmatic randomized controlled trial comparing Mindfulness-Oriented Recovery Enhancement (MORE) to group Cognitive-Behavioral Therapy (CBT) and treatment-as-usual (TAU) for previously homeless men residing in a therapeutic community. Men with co-occurring substance use and psychiatric disorders, as well as extensive trauma histories, were randomly assigned to 10 weeks of group treatment with MORE (n=64), CBT (n=64), or TAU (n=52). Study findings indicated that from pre- to post-treatment MORE was associated with modest yet significantly greater improvements in substance craving, post-traumatic stress, and negative affect than CBT, and significantly greater improvements in post-traumatic stress and positive affect than TAU. A significant indirect effect of MORE on decreasing craving and post-traumatic stress by increasing dispositional mindfulness was observed, suggesting that MORE may target these issues via enhancing mindful awareness in everyday life. This pragmatic trial represents the first head-to-head comparison of MORE against an empirically-supported treatment for co-occurring disorders. Results suggest that MORE, as an integrative therapy designed to bolster self-regulatory capacity, may hold promise as a treatment for intersecting clinical conditions.

Nurse managers are instrumental in achievement of organizational and unit performance goals. Greater spans of control for managers are associated with decreased satisfaction and performance. An interprofessional team measured one organization's nurse manager span of control, providing administrative assistant support and transformational leadership development to nurse managers with the largest spans of control. Nurse manager satisfaction and transformational leadership competency significantly improved following the implementation of large span of control mitigation strategies.

Aim Academic distress is a leading cause of attrition among nursing students. The present study tested a positive psychology‐oriented model detailing the potential links between nursing students’: (a) psychological resilience; (b) depressive symptoms; (c) intrapersonal well‐being; (d) interpersonal well‐being; and (e) academic distress. Additionally, we tested whether the academic benefits of resilience were conditional upon nursing students’ perceptions of their campus climate as supportive of mental health and well‐being. Design A correlational, cross‐sectional design was employed. Method Nursing students (N = 933) were selected from the national 2017–2018 Healthy Minds Study (HMS). Students completed measures of resilience, depressive symptoms, intrapersonal well‐being (flourishing), interpersonal well‐being (belonging), and academic distress. Results Conditional process modelling tested depression, belonging, and flourishing as mediators of the associations between resilience and academic distress variables. Furthermore, perceptions of campus climate were included as potential moderators of these mediation effects. Results indicated that the protective academic benefits of resilience were primarily explained by decreases in depression but that this effect was strongest for nursing students with negative perceptions of their campus climate. Conclusion Findings highlight the psychological and academic benefits of greater resilience and the moderated mediation results suggest that such benefits were conditional on the broader campus climate. Impact Nurse educators and policymakers should consider addressing contextual factors, such as campus climate, in addition to resilience training in their efforts to reduce the negative academic impacts of mental health problems and stress in nursing school.

This study evaluated the effectiveness of a 2-day, simulation-based orientation for baccalaureate nursing students preparing to begin their first clinical experience. Students were recruited for participation in the study from a clinical foundation course. Actors (standardized patients) provided students with the chance to engage with simulated real patients in realistic clinical situations prior to entering the clinical setting. Students' perceived stress, knowledge acquisition, anxiety, self-confidence, and satisfaction with the orientation process were assessed. Findings indicated a statistically significant increase in knowledge of and confidence in skills needed when first entering the clinical setting and a decrease in anxiety following the orientation activity. Students had a positive attitude about interaction with real patients, faculty, and other students during the experience. Improved self-confidence and satisfaction were reported as a result of participation in simulation-based orientation.

Specific heat, thermal expansion and electrical resistivity measurements on PrB6 single crystals show that there are two low temperature phase transitions at 6. 9 K and 4. 2 K, respectively, the latter temperature varying somewhat among different crystals.Neutron diffraction measurements were made on both single and polycrystalline samples of PrB6. The neutron data indicate a spontaneous incommensurate magnetic ordering at 6. 9 K with 0 = (0. 23, 0. 23, 0. 5) 21T/a0. At 4. 2 K a commensurate magnetic phase is seen with 0 (0. 25, 0. 25, 0. 5) ZTT/a0 coexisting with the incommensurate phase At 1.74 1<, only the commensurate phase remains.A model is proposed for the commensurate antiferromagnetic structure and a profile analysis based on that model yields a magnetic moment of 1.77 Bohr magnetons per praseodymium ion at 1.74 K.

This study examined self- and caregiver-reported health-related quality of life (HRQOL) of 60 adults with Down syndrome (DS) using the QualityMetric Short Form-12 version 2 (SF-12v2). All HRQOL scores exceeded means and fell within one standard deviation of the SF-12v2 normative sample. Similarities between eight self- and caregiver-reported HRQOL scales were found with the exception of role physical scores (impact of health problems on typical accomplishments), which were lower when obtained by caregiver-report. A positive association was found between self- and caregiver-reported physical functioning scores (impact of health problems on physical activity). The SF-12v2 had high construct validity in this study. These findings support the feasibility of measuring HRQOL of adults with DS using self-report rather than reliance on caregiver-report.

BACKGROUND: Researchers have documented significant psychological problems among nursing students, but findings have been inconclusive as to whether nursing students are “at-risk” for mental health problems compared with their non-nursing peers. Aims: This study examined whether nursing students have unique mental health characteristics compared with students from other professions. METHOD: Undergraduates ( N = 18,312; nursing n = 1,399) were selected from the 2016-2017 National Healthy Minds Study. Participants completed the Patient Health Questionnaire-9 (depression), the Generalized Anxiety Disorder-7 (anxiety), and the Flourishing Scale (positive psychology). RESULTS: Nursing students were equally likely to screen positive for depression and anxiety compared with their non-nursing peers. However, when controlling for gender, age, and year in school, multigroup structural equation modeling analyses revealed that female (but not male) nursing students reported significantly higher levels of specific anxiety symptoms and certain psychological strengths than female students from other professions. DISCUSSION: Nursing students are equally likely to screen positive for depression or anxiety as their non-nursing peers; however, anxiety disorders may reflect symptom profiles unique to nursing students. CONCLUSIONS: Findings suggest a need for tailored screening and interventions to reduce mental health problems and harness psychological strengths unique to nursing students.

Sickle cell disease (SCD) is a lifelong disorder that involves progressive organ damage and requires ongoing medical attention to prevent and treat episodic acute complications. Children with SCD need ongoing monitoring and extra attention that may be stressful to family members. Communication within families can help resolve family stress and may be associated with medical follow-up and management of SCD. Focus groups were conducted with 12 African American families to explore the communication that occurred within and outside of the family from the perspectives of adolescents with SCD, siblings, and parents. Factors that influence family communication were explored. The extended family was an important social network and resource to adolescents, siblings, and parents. Family member knowledge of SCD was an important factor that influenced communication about SCD; adolescents and parents communicated more easily than siblings and also reported having more knowledge of SCD than siblings. Future research focusing on the knowledge of immediate and extended family members and their recognition of their contribution to the child with SCD is recommended.