Considering a Potential Role of Linalool as a Mood Stabilizer for Bipolar Disorder.

Epidemiologic studies suggest that the lifetime prevalence of bipolar spectrum disorders ranges from 2.8 to 6.5 percent of the population. To decrease morbidity and mortality associated with disease progression, pharmacologic intervention is indicated for the majority of these patients. While a number of effective treatment regimens exist, many conventional medications have significant side effect profiles that adversely impact patients' short and long-term well-being. It is thus important to continue advancing and improving therapeutic options available to patients. This paper reviews the limitations of current treatments and examines the chemical compound Linalool, an alcohol found in many plant species, that may serve as an effective mood stabilizer. While relatively little is known about Linalool and bipolar disorder, the compound has been shown to have antiepileptic, anti-inflammatory, anxiolytic, anti-depressive, and neurotrophic effects, with mechanisms that are comparable to current bipolar disorder treatment options.

HIV: A Socioecological Case Study.

INTRODUCTION: New strategies are needed to lower health care costs and address the health care needs of communities, especially for marginalized persons and subpopulations. Improved education in health systems, which encompasses population, community, preventive, and public health, is one way to better train the future physician workforce to meet national and local health care needs. This resource was created as part of an 18-month science of health systems and navigation curriculum. METHODS: The purpose of this resource is to use the socioecological model lens to analyze health disparities for marginalized persons and subpopulations. A medically and socially complex patient with HIV is presented as the initial case study that leads to identification of barriers and needs on individual, community, and public policy levels. This is an active-learning resource that includes both small- and large-group discussion driven by self-directed learners using the provided resources. RESULTS: This resource was successfully implemented as a required session for 150 medical students beginning the second year of medical school. A cohort of 21 students randomly selected to complete a standard online course evaluation for the session, rated their agreement (1 = strong disagreement, 5 = strong agreement) to the statement "Rate the extent to which the lecture supported your mastery of the learning objectives," as 4.4, on average. DISCUSSION: This curriculum has been implemented and evaluated for medical students, but it is broadly applicable to residents and interprofessional students in health-related fields. It is designed to give learners a practical medical context for the application of principles that may be taught within a health systems or population health course.

Measuring Nurse Attitudes About Childbirth: Revision and Pilot Testing of the Nurse Attitudes and Beliefs Questionnaire.

BACKGROUND AND PURPOSE: Labor/delivery nurse attitudes and beliefs may affect nursing care decisions and patient outcomes. This psychometric study was conducted to revise the Nurse Attitudes and Beliefs Questionnaire-Revised (NABQ-R). METHODS: The NABQ-R contains 42 items scored with a 4-point Likert scale from 1 (strongly disagree) to 4 (strongly agree). An online survey invitation was sent to Colorado intrapartum nurses with 84 complete surveys returned. RESULTS: The NABQ-R scores ranged from 82 to 156 and the Cronbach's alpha was .90. An exploratory factor analysis was conducted, and all items loaded on at least 1 factor. CONCLUSIONS: Our results support acceptable initial psychometric properties for the NABQ-R consistent with existing theory indicating that the NABQ-R shows promise for use in future studies.

Optimal Frequency of Psychosocial Distress Screening in Radiation Oncology.

PURPOSE: To accurately hypothesize the optimal frequency of psychosocial distress screening in patients undergoing radiation therapy using exploratory modeling of prospective data. MATERIALS AND METHODS: Between October 2010 and May 2011, 71 RT patients underwent daily screening with the Distress Thermometer. Prevalences of Distress Thermometer scores ≥ 4 were recorded. Optimal screening frequency was evaluated by planned post hoc comparison of prevalence rates and required screening events estimated by numerical modeling, consisting of data point omission to mimic weekly, every-other-week, monthly, and one-time screening intervals. Dependence on clinical variables and chronologic trends were assessed as secondary end points. RESULTS: A total of 2,028 daily screening events identified that 37% of patients reported distress at least once during the course of treatment. Weekly, every-other-week, monthly, and one-time screening models estimated distress prevalences of 32%, 31%, 23%, and 17%, respectively, but required only 21%, 12%, 7%, and 4% of the assessments required for daily screening. No clinical parameter significantly predicted distress in univariable analysis, but "alone" living situation trended toward significance (P = .06). Physician-reported grade 3 toxicity predicted distress with 98% specificity, but only 19% sensitivity. CONCLUSION: Thirty-seven percent of radiation oncology patients reported distress at least once during treatment. Screening at every-other-week intervals optimized efficiency and frequency, identifying nearly 90% of distressed patients with 12% of the screening events compared with daily screening.

Nurse attitudes toward childbirth: a concept clarification.

AIM: To clarify the concept of "nurse attitudes toward childbirth." BACKGROUND: It has been suggested that the international trend of escalating cesarean birth rates can be attributed to attitudes that perceive childbirth as an illness. Nurses' attitudes about childbirth direct their nursing care and may influence patient outcomes like cesarean birth. However, the concept "nurse attitudes toward childbirth" must be clarified to inform future research. DATA SOURCES: An English-language literature review, from 1990 to present, was performed using CINAHL, PubMed, and Ovid. REVIEW METHODS: Norris's model of concept clarification was used. RESULTS: Although the nursing literature poorly defined "nurse attitudes" and rarely used a conceptual framework, the discipline of psychology has been refining this concept for over 40 years. Psychologists have established that attitude can predict behavior as demonstrated through testing of the theory of planned behavior. Various types of "nurse attitudes toward childbirth" were identified through our literature review, and five central beliefs were noted. This resulted in the development of a preliminary model using theory of planned behavior as a foundation. Finally, potential research hypotheses were generated. CONCLUSIONS: This paper clarifies "nurse attitudes toward childbirth" and supports its use for research. Nurse scholars have demonstrated that labor and delivery nurses do have individual attitudes toward childbirth, and the measurement of these attitudes may predict nursing care intentions and behavior. This concept is appropriate, important, and may be used as a means of exploring relationships between nursing care and the rising primary cesarean birth rate.

Effects and linguistic analysis of written traumatic emotional disclosure in an eating-disordered population.

CONTEXT: In previous studies, writing about traumatic life events produced positive physical and psychological outcomes in various populations. Specific linguistic trends, such as increasing insight and cognitive words, have paralleled health benefits. OBJECTIVE: This study explored the effects of written traumatic emotional disclosure on eating disorder behavior and cognitions as well as linguistic dimensions of the disclosure writings completed by eating-disordered patients. DESIGN: Twenty-nine female patients, aged 16 to 39 years, from the Penn State Hershey Eating Disorders partial-hospitalization program participated. Twenty-five subjects completed a traumatic disclosure or control writing task, and 21 completed all writings and baseline and follow-up questionnaires to assess eating-disorder symptoms, emotional regulation strategies, self-efficacy, and motivation to change eating-disorder behaviors. The handwritten essays were transcribed into a word-processed document and analyzed on numerous dimensions using the Linguistic Inquiry and Word Count software. RESULTS: Individuals completing the disclosure writing did not differ from those in the control task group on any of the questionnaires at follow-up. However, the disclosure group did use more negative emotion, insight, cognitive, function, and filler words on all writing days along with decrease of tentative words. These changes in word use correlated with previous study findings. CONCLUSIONS: Whereas the expected linguistic trends were evident in the disclosure group writings, no correlating health benefits could be found between the disclosure and control groups. Eating-disordered populations, often alexithymic, may have difficulty engaging with the disclosure task and could potentially benefit from guidance in processing traumatic events and their affective states.

Loneliness and eating disorders.

This article examines the link between loneliness and eating disorders. This concept is evaluated through a systematic review of the literature that links loneliness and eating disorders and through a survey of themes connecting the 2 conditions. Eating disorders-including anorexia nervosa, bulimia nervosa, and eating disorders that are not otherwise specified, which include binge eating disorder-are challenging health issues. Each of these diagnoses specifically relates to loneliness. This negative emotion contributes to and fuels eating disorder symptoms. Negative interpersonal relationships, both real experiences and individuals' skewed perceptions, exacerbate eating disorders and feelings of loneliness. Characteristics that have been associated with loneliness clearly relate to eating disorders. Understanding this relationship is vital, so that we can appreciate our patients' struggles and work to target these intense emotions within the treatment setting. We need to be aware of the power of loneliness as it applies to individuals in general and specifically to those struggling with disordered eating.

Social information-processing and coping in adolescent females diagnosed with an eating disorder: toward a greater understanding of control.

The objective of this study was to examine differences in social information-processing and coping strategies between adolescent females in treatment for an eating disorder and asymptomatic peers. Adolescent females in treatment for an eating disorder (n = 50) were compared to asymptomatic control participants (n = 59) on a measure of social information-processing. Participants were presented with 4 hypothetical, ambiguous social dilemmas in which the intent of a peer provocateur was unclear. Questions followed each dilemma assessing intent attributions, the participant's emotional reaction, the intensity of the emotion, and coping strategies. The participants in treatment for an eating disorder were significantly more likely to perceive hostile intent from a peer provocateur, reported a greater intensity of negative emotions, and identified a significantly greater number of avoidant coping strategies. Specifically, the eating disorder group identified significantly more intrapunitive avoidant coping strategies that reflect maladaptive and self-destructive means of coping with distressing events. Results indicate social cognitive processing biases and maladaptive coping strategies may be instrumental in perceived loss of control and influence the development/maintenance of eating disorders.