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Biomedical subjects

P Solomon

Publications and source records attributed to P Solomon.

At least 37 records · Page 2Linked to original sources
PubMed2000

Releasing information to families of persons with severe mental illness: a survey of NAMI members.

OBJECTIVE: Guidelines for the treatment of severe mental illness recommend that providers share information with families and involve them in treatment. However, research indicates that consumer-provider-family collaboration is not part of routine clinical practice. This study examined the process of releasing information to families and the types of information they receive. METHODS: Self-administered surveys were completed by 219 family and consumer members of the National Alliance for the Mentally Ill. The surveys gathered information about their experiences with providers' releasing information. Consumers' attitudes toward collaboration and family members' satisfaction with providers were also measured. Regression analyses examined the relationship between consumers' attitudes toward family involvement and whether providers discussed family involvement or the release of information with consumers. Further analyses examined the relationship between family satisfaction and release of information. RESULTS: The majority of family respondents (72 percent) reported that they received some specific information about their relative's mental illness. Most families received information about diagnosis and medications, but few received information about the treatment plan. Few consumers reported that their permission was requested to release information to their families. Consumers' attitudes toward their family and toward family involvement were significantly associated with whether they were encouraged by their provider to involve a family member in their treatment. No significant relationship was found between consumers' attitudes and whether their provider discussed the release of information. Family members' satisfaction was positively related to whether they received information from providers. CONCLUSIONS: The findings suggest that although some information is shared with families, collaboration is not currently part of routine clinical practice.

Adult↗
PubMed2000

Impact of vertical dome division on nasal airflow.

OBJECTIVE: Vertical dome division is an effective maneuver in nasal tip surgery. Its applications include reduction of the tip projection, increasing tip rotation, narrowing of the domal arch, and correction of lobule asymmetry. Nevertheless, some surgeons avoid this technique, fearing tip deformity and possibly impaired nasal airflow. RESULTS: In this study, nasal airflow measurements were made before and after septorhinoplasty with vertical dome division. There was no significant change in the airflow before and after septorhinoplasty with vertical dome division. The airflow was negatively affected in 37.5% and improved postoperatively in 25% of patients. CONCLUSIONS: Despite objective findings of diminished nasal airflow in some patients following vertical dome division, no subjective correlation was identified. Furthermore, during the postoperative testing, alar retraction on all of these patients failed to normalize airflow results, indicating that alar collapse was not contributing to the airflow impairment in those cases. All of the patients were found clinically asymptomatic after surgery.

Follow-Up Studies↗
PubMed1999

Self-help groups for families of persons with mental illness: perceived benefits of helpfulness.

Self-help groups have become important resources for families of persons with mental illness. The present study was an attempt to understand the factors perceived by group members as helpful using Yalom's factors in clarifying the dynamics of groups. Members (N = 202) of the Alliance for the Mentally Ill of Pennsylvania (AMI of PA), an association of self-help groups for families of the mentally ill, were recruited and responded to a self-administered questionnaire. Hierarchical block multiple regression indicated that those AMI members who felt information provision and gaining support and self-understanding from the group process was helpful and were longer term participants in their group were more likely to perceive benefit from belonging to the group. The findings may provide the basis for evaluating and improving self-help group effectiveness and contribute to understanding process factors within a self-help group which members find beneficial. Implications for how these groups can attract and maintain members are discussed.

Adult↗
PubMed1999

Using clinical and criminal involvement factors to explain homelessness among clients of a psychiatric probation and parole service.

This study sought to examine the rate of homelessness and the extent to which lifetime homelessness was associated with clinical factors, such as diagnosis and treatment history; or criminal factors, such as criminal behavior and arrest history, among psychiatric probationers and parolees. Nearly half of the clients screened had experienced homelessness in their lifetime. In a logistic regression model to explain lifetime homelessness, significant factors were younger age, less education, a greater number of lifetime arrests, a schizophrenia diagnosis, and reporting both an alcohol and drug problem. Implications for service delivery with this population are discussed.

Adult↗
PubMed1999

Extracranial drainage of cerebrospinal fluid: a study of beta-transferrins in nasal and lymphatic tissues.

OBJECTIVE: To determine whether an alternative route of cerebrospinal fluid (CSF) drainage exists through the nasal mucosa and the cervical lymphatic system. STUDY DESIGN: A prospective study was carried out on 18 patients at a university teaching hospital. METHODS: Ten patients undergoing routine endoscopic sinus surgeries and eight patients undergoing neck dissections were recruited for this study. Tissues were sampled from the middle turbinate, nasopharynx, and upper septum in the first group; jugulodigastric lymph nodes and nasopharyngeal tissues were obtained from the second group. Specimens were subjected to immunofixation electrophoresis in an attempt to identify the presence of beta-1 and beta-2 transferrins. Serum samples were obtained from each subject to serve as controls. RESULTS: All tissue specimens contained beta-1 transferrin; none showed evidence of beta-2 transferrin. CONCLUSION: Using this technique, an alternate route of CSF drainage through the nose and the cervical lymphatic system could not be confirmed. Nevertheless, a new technique of performing immunofixation in solid tissues for the purpose of beta-transferrin identification is described.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1999

Describing and evaluating jail diversion services for persons with serious mental illness.

Despite efforts over the last 30 years to promote diversion from jail for individuals with serious mental illness who have engaged in criminal behavior, few jail diversion programs have been adequately studied. To guide development of jail diversion services and encourage empirical research on their effectiveness, the authors describe the overall concept of jail diversion and the basic operations of such a program. They also outline research issues in evaluating the effectiveness of jail diversion programs, including problems encountered in randomized field trials and quasiexperimental designs. Implications of jail diversion services for mental health professionals include learning how to collaborate with law enforcement personnel, sufficiently integrating mental health and substance abuse services into the criminal justice system despite segregated funding streams, and ensuring that clients who are intensively monitored are also provided with adequate treatment to avoid jail recidivism.

Commitment of Persons with Psychiatric Disorders↗
PubMed1999

Procedures to share treatment information among mental health providers, consumers, and families.

Although practice guidelines for the treatment of persons with severe mental illness recommend involving family members in all phases of the treatment process, in many states unclear confidentiality statutes and regulations may present a barrier. This paper describes approaches used by a few locales to clarify confidentiality procedures for releasing information to families. It presents a model of steps that regional systems or local agencies may take to manage this barrier to provider-family collaboration. Policy guidelines must clearly state that release of information to family members requires client consent. A specific form for release of information to families indicating the types of information that may be released is then developed. Verbal release of information and a one-year time limit on release are recommended. The form, which should comply with state statutes and regulations, can then be integrated into routine clinical practice. Providers should be trained to discuss and explore issues about the release of information with both consumers and family members.

Community Participation↗
PubMed1999

Explaining lifetime criminal arrests among clients of a psychiatric probation and parole service.

This study examines the extent to which sociodemographic characteristics, clinical characteristics, substance abuse problems, and the array of lifetime criminal behavior may explain lifetime arrests among offenders supervised by the psychiatric probation and parole service. Three hundred twenty-five clients with new cases at a psychiatric probation and parole service in a large urban center were screened for major psychiatric disorders. They were also interviewed for socio-demographic characteristics, mental health treatment history, criminal behavior, and arrest history. Hierarchical block multiple regression analysis tested a model explaining lifetime arrests. After controlling for age and other demographic variables, the number of lifetime psychiatric hospitalizations and lifetime occurrences of mania diagnosis significantly explained lifetime arrests. The total model explained about 10 percent of the variance in lifetime arrests after controlling for opportunity variables, which explained 45 percent. The explanatory power of lifetime hospitalizations and mania support the contention that symptoms, rather than diagnosis, may be the most important clinical factor in explaining criminal arrest among persons with mental illness. Implications for psychiatric services include the development of effective jail diversion programs.

Adult↗
PubMed1998

Consumers as providers in psychiatric rehabilitation.

Issues that arise in employing consumers as providers in psychiatric rehabilitation programs include readiness of the sponsoring agency, consumer disclosure, and adjustments in employment practices. Psychiatric rehabilitation agencies are obligated to seriously consider employing consumers, since they frequently ask the same of the other organizations.

Attitude to Health↗
PubMed1998

Correlates of retention on the South Australian Methadone Program 1981-91.

OBJECTIVES: To investigate correlates of retention on the South Australian Methadone Program during 1981-91. DESIGN: Retrospective study of a nonstratified random sample of 229 HIV-negative clients who received methadone between January 1981 and June 1991. Data were collected from clinical records of the 229 HIV-negative clients and also from the 40 clients known to be infected with HIV during the decade. RESULTS: Being HIV positive, receiving larger maximum doses of methadone, receiving methadone from a private pharmacy and enrolling later in the decade were all associated with longer retention times on the program. CONCLUSIONS: This study supports the findings of previous studies, that maximum dose of methadone is crucial to retention in methadone programs, But even allowing for maximum dose, obtaining methadone from a private pharmacy was also strongly associated with retention on the program. The more 'humane' clinic policy later in the decade is likely to have increased retention and reduced illicit drug use also.

HIV Seropositivity↗
PubMed1998

Increased contact with community mental health resources as a potential benefit of family education.

OBJECTIVE: This study examined the hypothesis that families of adults with severe mental illness who participate in either a group family education workshop or individual family consultation will try to seek more assistance from community services than those in a control group assigned to a waiting list. METHODS: A total of 225 family members who agreed to participate in the study were randomly assigned to one of three conditions: a ten-week group workshop, individual family consultation, or a waiting list (control group). Family members were interviewed about the extent of their contact with mental health professionals, providers, and community resources at baseline, termination of the interventions, and at six months after termination. RESULTS: No differences were found between conditions in the extent of family members' contact with three types of services: conventional, psychosocial, and ancillary mental health services. CONCLUSIONS: Neither of the educational interventions produced any change in behaviors of families seeking advice and assistance on behalf of their ill relative from the three types of services examined. Modifications in the interventions may be worthwhile. Increasing family members' contacts with community resources on behalf of their ill relative may increase the benefits of the intervention to the family as well as to the ill relative.

Adult↗
PubMed1998

Adult epiglottitis: the Toronto Hospital experience.

OBJECTIVE: This study was conducted to gain insight into the diagnosis, treatment, and outcome measures in adult patients presenting with acute epiglottitis. METHOD: A retrospective clinical study was conducted on fifty-seven consecutive adult patients presenting with acute epiglottitis over a 13-year period to The Toronto Hospital, University of Toronto. Demographic description of patient population, presenting symptoms and signs, investigations performed, treatment provided, and incidence of complications were described. RESULTS: Soft-tissue lateral neck x-rays were abnormal in 88.1% of patients tested but had a 12% false-negative rate. Indirect, direct, or flexible laryngoscopy were the most accurate investigations to establish diagnosis and were not associated with any complications. Four of 45 patients (8.9%) had positive blood cultures for Haemophilus influenzae, with the remainder demonstrating no growth, while 22% of patients (8/36) grew possible pathogenic organisms on throat culture. A rapid clinical course (< 12 hr), evidence of tachycardia, or positive pharyngeal or blood cultures were factors that selected for a group of patients requiring formal airway intervention. CONCLUSIONS: Adult epiglottitis is different from its paediatric counterpart in that organism identification is less common, the clinical course is more gradual, there is less seasonal variation, airway compromise is more uncommon, and conservative airway management can be contemplated in the selected patient. Adult epiglottitis can be managed safely with a selective approach to airway management with airway intervention for any patient with signs of critical airway compromise.

Acute Disease↗
PubMed1997

Applying research on family education about mental illness to development of a relatives' group consultation model.

Results from a random field trial of family education interventions were applied to create a new model of family education programs. This paper reviews the family education literature, the random field trial results, and the pre-piloting of an adapted service model called group consultation. The new model emphasizes a more interactive approach to the conventional group workshop model as opposed to adherence to a pre-planned curriculum. Pre-pilot group participants were all past members of group workshops. In a process evaluation these group members were questioned about their reactions to the new group format and its usefulness.

Family Health↗
PubMed1997

Effectiveness of two models of brief family education: retention of gains by family members of adults with serious mental illness.

The retention of benefits from two models of family education was compared with maturational effects in an untreated control group. The three-month interventions showed an initial effect for self-efficacy regarding a mentally ill relative that did not significantly diminish during the following six months. However, no significant differences on this measure were found between the treated groups and the untreated controls. Ways of refining the interventions and measures so as to improve gains and retain them over time are discussed.

Adaptation, Psychological↗
PubMed1996

A computational model of cholinergic disruption of septohippocampal activity in classical eyeblink conditioning.

A previous neurocomputational model of corticohippocampal interaction (Gluck & Myers, 1993) can provide a framework for examining the behavioral effects of septohippocampal modulation during classical conditioning. The model assumes that the hippocampal region is necessary for forming new stimulus representations during learning, but not for the formation of simple associations. This paper considers how septohippocampal interaction could affect this function. The septal nuclei provide several modulatory inputs to the hippocampus, including a cholinergic input which Hasselmo (1995) has suggested may function to regulate hippocampal dynamics on a continuum between two states: a storage state in which incoming information is encoded as an intermediate-term memory and a recall state when this information is reactivated. In this theory, anticholinergic drugs such as scopolamine should disrupt learning by selectively reducing the hippocampus's ability to store new information. An approximation of Hasselmo's idea can be implemented in the corticohippocampal model by a simple manipulation of hippocampal learning rate; this manipulation is formally equivalent to adjusting the amount of time the hippocampus spends in learning and recall states. With this manipulation, the model successfully accounts for the effects of scopolamine in retarding classical conditioning in humans (Solomon, Groccia-Ellison, Flynn, Mirak, Edwards, Dunehew, & Stanton, 1993) and animals (Solomon, Soloman, van der Schaaf, & Perry, 1983). The model further predicts that although cholinergic agonists (such as Tacrine) may improve learning in subjects with artificially depressed brain acetylcholine levels, there may be limited memory improvement in normal subjects from such cholinergic therapy. This is consistent with the general finding of a U-shaped dose response curve for cholinergic drugs in normal subjects: low to moderate doses may improve learning, but higher doses are ineffective or even degrade learning (e.g., Ennaceur & Meliani, 1992; Dumery, Derer, & Blozovski, 1988; etc.).

Animals↗
PubMed1996

Examination of grief among family members of individuals with serious and persistent mental illness.

Many family members experience a profound sense of loss when a relative becomes mentally ill. The adjustment to this loss is similar to grief as a response to death. The extent of this grief may be explained by personal characteristics of family members, the severity of the illness, and the extent of social support available. A family member's emotional response to a relative's mental illness may be exacerbated by increases in both objective and subjective burden. While grief among families with a seriously mentally ill relative is the emotional response to reflecting on the loss of an emotionally healthy relative, burden reflects the present state of responsibility for the ill relative, expressed in both subjective and objective terms. In this study, family member characteristics, social support, objective burden and subjective burden contributed to explaining expressed grief among 225 family members of seriously mentally ill individuals. Mental health and family support professionals are encouraged to recognize the grief response in family members with a mentally ill relative.

Caregivers↗