The Relationships of Historical Loss, Acculturation, and Alcohol Expectancies with Alcohol Use Among American Indian and Alaska Native People.

The primary purpose of this study was to 1) explore the relationship among the following variables: thoughts and feelings associated with historical loss, levels of acculturation, alcohol expectancies, and alcohol use among American Indian and Alaska Native (AI/AN) people, as well as to 2) explore predictive relationships among historical loss thoughts and feelings, alcohol expectancies, and alcohol use for AI/AN people within this sample. A convenience (community, non-clinical) sample of 188 AI/AN people completed an online survey, including questions related to alcohol use, alcohol expectancies, thoughts and feelings of historical loss, and acculturation experiences. Results indicated that gender and feelings of historical loss were the significant individual predictors of alcohol use and alcohol expectancies in a sample of AI/AN people. In addition, specific types of alcohol expectancies, when considered together, explained 24% of the variance in alcohol use experiences. Gender differences were noted in that AI/AN men were more likely than AI/AN women to engage in hazardous drinking and expected more feelings of social and physical pleasure as well as power and aggression as a result of drinking alcohol. Areas for further research were highlighted, with an emphasis on further research exploring the correlates and predictors of alcohol use and alcohol expectancies for community, non-clinical samples of AI/AN people, to further understand alcohol use motivation among AI/AN people.

Primary Psychiatric Diagnoses, Commercialized Tobacco Use, and Homelessness: Comparisons Between Urban American Indian/ Alaska Native and Non-American Indian/Alaska Native Adult Clinical Samples.

Although over 70% of American Indians and Alaska Natives (AI/ANs) reside in urban areas, our knowledge of urban AI/AN adults receiving mental health treatment is limited. This study compares primary psychiatric diagnoses, commercialized tobacco use, and homelessness between AI/AN and non-AI/AN adults receiving services in an urban public mental health agency serving primarily AI/AN people in southern California. Depressive disorders were the most common psychiatric diagnoses for both groups. However, AI/AN adult clients demonstrated significantly less anxiety disorders and significantly more homelessness. Schizophrenia spectrum and other psychotic disorders, bipolar and related disorders, and commercialized tobacco use were higher among AI/AN adults compared to non-AI/AN adults. Results from this study offer data needed to further understand important public health issues that exist among AI/AN adults receiving mental health services in urban areas. We provide suggestions to enhance integrated and culturally appropriate treatment approaches and homelessness initiatives for this under-resourced, yet resilient population.

Participation in a clinical trial: views of children and young people with diabetes.

AIM: To investigate whether involvement in research can have a positive effect on the education and management of disease of children and young people with diabetes. METHOD: Children's and young people's experiences of exposure to intensified intervention during a clinical trial were examined by a questionnaire given to 44 young patients with type 1 diabetes from the UK and Ireland. The young people had participated in a trial comparing specific insulin regimes. Most patients were obliged to increase injection frequency, clinic attendance, glucose monitoring and diary entries. FINDINGS: Of the 44 patients, 36 completed the questionnaire. Most, including the younger children, did not regard basal-bolus therapy, additional injections or intensified self-monitoring as barriers to self-management. They also believed that the management of their diabetes was further supported as a result of increased contact and intensive insulin management. Many of the children participating in this study felt they had learned something about their diabetes, and, furthermore, almost all opted to remain on an intensive treatment regimen. CONCLUSION: These results suggest that trial involvement benefits the young person's approach to self-management of diabetes.