Mental Health & Disabilities Workforce Workgroup, December 12, 2012

The Iowa 2012 General Assembly charged the Iowa Department of Public Health with creating a mental health and disabilities group to make workforce recommendations in support of services to Iowans (Senate File 2315, Division II, Section 24). The Department of Human Services Mental Health Redesign Initiative was already underway since 2010. Workforce supply is a critical element of service capacity. IDPH leadership reviewed the legislative language, conferred with DHS leadership, appointed the workforce, and began deliberations in fall 2012.

Effects of mental stress on insulin-mediated glucose metabolism and energy expenditure in lean and obese women.

The effects of the sympathetic activation elicited by a mental stress on insulin sensitivity and energy expenditure (VO(2)) were studied in 11 lean and 8 obese women during a hyperinsulinemic-euglycemic clamp. Six lean women were restudied under nonselective beta-adrenergic blockade with propranolol to determine the role of beta-adrenoceptors in the metabolic response to mental stress. In lean women, mental stress increased VO(2) by 20%, whole body glucose utilization ([6,6-(2)H(2)]glucose) by 34%, and cardiac index (thoracic bioimpedance) by 25%, whereas systemic vascular resistance decreased by 24%. In obese women, mental stress increased energy expenditure as in lean subjects, but it neither stimulated glucose uptake nor decreased systemic vascular resistance. In the six lean women who were restudied under propranolol, the rise in VO(2), glucose uptake, and cardiac output and the decrease in systemic vascular resistance during mental stress were all abolished. It is concluded that 1) in lean subjects, mental stress stimulates glucose uptake and energy expenditure and produces vasodilation; activation of beta-adrenoceptors is involved in these responses; and 2) in obese patients, the effects of mental stress on glucose uptake and systemic vascular resistance, but not on energy expenditure, are blunted.

Subjective mental time: the functional architecture of projecting the self to past and future.

Abstract Human experience takes place in the line of mental time (MT) created through 'self-projection' of oneself to different time-points in the past or future. Here we manipulated self-projection in MT not only with respect to one's life events but also with respect to one's faces from different past and future time-points. Behavioural and event-related functional magnetic resonance imaging activity showed three independent effects characterized by (i) similarity between past recollection and future imagination, (ii) facilitation of judgements related to the future as compared with the past, and (iii) facilitation of judgements related to time-points distant from the present. These effects were found with respect to faces and events, and also suggest that brain mechanisms of MT are independent of whether actual life episodes have to be re-experienced or pre-experienced, recruiting a common cerebral network including the anteromedial temporal, posterior parietal, inferior frontal, temporo-parietal and insular cortices. These behavioural and neural data suggest that self-projection in time is a fundamental aspect of MT, relying on neural structures encoding memory, mental imagery and self.

Depression-like behavior is dependent on age in male SAMP8 mice

Aging is associated with an increased risk of depression in humans. To elucidate the underlying mechanisms of depression and its dependence on aging, here we study signs of depression in male SAMP8 mice. For this purpose, we used the forced swimming test (FST). The total floating time in the FST was greater in SAMP8 than in SAMR1 mice at 9 months of age; however, this difference was not observed in 12-month-old mice, when both strains are considered elderly. Of the two strains, only the SAMP8 animals responded to imipramine treatment. We also applied the dexamethasone suppression test (DST) and studied changes in the dopamine and serotonin (5-HT) uptake systems, the 5-HT2a/2c receptor density in the cortex, and levels of TPH2. The DST showed a significant difference between SAMR1 and SAMP8 mice at old age. SAMP8 exhibits an increase in 5-HT transporter density, with slight changes in 5-HT2a/2c receptor density. In conclusion, SAMP8 mice presented depression-like behavior that is dependent on senescence process, because it differs from SAMR1, senescence resistant strain.

L'Envelliment en persones amb trastorn mental sever

Són moltes les investigacions que han aprofundit en l’estudi de l’esquizofrènia i algunes aporten resultats de persones que estan a la tercera edat. L’objectiu principal d’aquest estudi és descriure alguns aspectes mèdics i de gestió de casos en població gran afectada de trastorn mental. Un segon objectiu és observar si hi ha un major risc cardiovascular en edat avançada en comparació amb persones de menor edat. Es tracta d’un estudi descriptiu i transversal amb una mostra de 220 subjectes afectats de trastorn mental sever, 33 dels quals sobrepassen els 60 anys. Es van utilitzar els registres sobre les dades mèdiques, clíniques i de funcionament social durant l’any 2011. Entre els resultats principals s’ha trobat una bona adherència al tractament i al seguiment(95,3%-90% respectivament) una bona participació familiar en el tractament(90%), nivells més elevats de dislipèmies(colesterol 70,6%; triglicèrids 64,3%), menor nombre de fumadors(28%). Les valoracions psicopatològiques no mostren significació estadística respecte al grup més jove (p=.468) ni en reingressos ni urgències(p=.181;.420 respectivament). Les dades que es presenten en aquest estudi fan èmfasi en la necessitat de tenir cura dels malalts mentals també a la tercera edat, on la fragilitat física i psicosocial s’accentua a nivell de comorbilitat amb altres malalties mèdiques.

A comparison of the dental status and treatment needs of older adults with and without chronic mental illness in Sevilla, Spain

Objectives: To study the dental status and treatment needs of institutionalized older adults with chronic mental illness compared to a non-psychiatric control sample. Study Design: The sample size was 100, in which 50 were psychogeriatric patients (study group; SG) classified according to DSM-IV, with a mean age of 69.6 ± 6.7 years, and 50 non-psychiatric patients (control group; CG), with a mean age of 68.3 ± 6.9 years. Clinical oral health examinations were conducted and caries were recorded clinically using the Decayed, Missing and Filled Teeth Index (DMFT). Results were analyzed statistically using the Student"s t-test or analysis of variance. Results: Caries prevalence was 58% and 62% in SG and CG, respectively. DMFT index was 28.3 ± 6.6 in SG and 21.4 ± 6.07 in CG (p < 0.01). Mean number of decayed teeth was higher in SG (3.1) compared to CG (1.8) (p=0.047). Mean number of missing teeth were 25.2 and 16.4 in SG and CG respectively (p<0.05). DMFT scores were higher in SG in all the age groups (p < 0.01). Mean number of teeth per person needing treatment was 3.4 in SG and 1.9 in CG (p= 0.037). The need for restorative dental care was significantly lower in the SG (0.8 teeth per person) than in the CG (1.7 teeth per person) (p = 0.043). Conclusions: Institutionalized psychiatric patients have significantly worse dental status and more dental treatment needs than non-psychiatric patients.

Control mental

La revista especialitzada NeuroReport ha publicat un article que m'ha aportat nous elements de reflexió sobre els mecanismes neurals de control mental que, de forma innata, realitzem les persones com a part de la nostra vida social.

Influence of biocontrol strain Pseudomonas fluorescens CHA0 and its antibiotic overproducing derivative on the diversity of root colonizing pseudomonads

Non-target effects of biocontrol strains of Pseudomonas on the population of resident pseudomonads should be assessed prior to their large scale application in the environment. The rifampicin resistant bacterium P. fluorescens CHA0-Rif and its antibiotic overproducing derivative CHA0-Rif/pME3424 were introduced into soil microcosms and the population of resident pseudomonads colonizing cucumber roots was investigated after 10 and 52 days. Both CHA0-Rif and CHA0-Rif/pME3424 displaced a part of the resident pseudomonad population after 10 days. To investigate the population structure, utilization of 10 carbon sources and production of two exoenzymes was assessed for 5600 individual pseudomonad isolates and 1700 isolates were subjected to amplified ribosomal DNA restriction analysis of the spacer region (spacer-ARDRA). After 10 days, only the proportion of pseudomonads able to degrade -tryptophan was reduced in treatments inoculated with either biocontrol strain. In parallel the phenotypic diversity was reduced. These effects were only observed 10 days after inoculation, and they were similar for inoculation with CHA0-Rif and CHA0-Rif/pME3424. Changes in the population structure of resident pseudomonads on cucumber roots during plant growth were more pronounced than changes due to the inoculants. The inoculants did not affect the genotypic diversity detected with spacer-ARDRA, but the genotypic fingerprints corresponded only partially to the phenotypic profiles. Overall CHA0-Rif had a small and transient impact on the population of resident pseudomonads and the effect was essentially the same for the genetically engineered derivative CHA0-

El nuevo título de Grado en Enfermería y la formación en salud mental

Sobre el nou títol d'Estudi de Grau d' Infermeria i de Salut Mental

Benestar físic, mental i social

Dossier dedicat a la Salut en general

Nous enfocaments en salut mental

L’atenció a la salut mental al llarg de la història es troba plena de desoris i de grans injustícies. Durant molts segles les persones amb malaltia mental han estat arraconades i menyspreades per la societat, que les ha reclòs en institucions psiquiàtriques tancades: els manicomis

Cambios en los cuidadores informales en cuanto a estilos de vida, relaciones y alteraciones de salud mental

Changes in the informal caregiver life styles, relations and alterations of mental health. Justification.The increase of the population aged 65 years and older in developed countries is generating a proportional increasing of the dependency caused by chronic pathologies. The care of these persons is being carried out by relatives, informal carers, leading to some alterations in diverse areas, among them mental alterations, as a consequence of taking care. Objectives. To develop a profile of the informal carers and to correlate the caregiver burden with the carers disorders. To detect risk factors to allow carrying out premature nursing interventions to diminish the disorders in the informal carers. Design. An observational and cross-sectional study is made in primary care health services area of the city of Girona. Methodology. Random sample of carer of dependent people at their home , assigned to the program of domiciliary attention (ATDOM) of the educational basic areas of health (ABS). A sample size of 269 persons, with a level of precision of 9% was needed. Questionnaire ICUB 97, the test of Barthel, the Philadelphia Geriatric Center scale, and a questionnaire are used as instruments that includes demographic and social variables, and mental and physical carers disorders.Results. A total of 80 participants were interviewed. The most common problems as consequence of taking care were the backache, to feel more tired, to feel impotent and to have less free time. Correlation between the level of dependence of the patient with the number of problems perceived by the caretaker does not exist. Since they are informal carers they eat frequently outside the habitual schedule, took place an increase or loss of weight, experienced more disorders in sexual life and an increasing lack of interest in surroundings. A 33% of the informal carers are being treated for problems related to the mental health.Conclusion. The fact of being informal carer carries important consequences in their health, the lifestyles and the social relations. These can be attenuated if the nursing interventions are able to consider to the well-taken care of subject, and its surroundings in an holistic way. The professionals of infirmary of mental health must contribute to their knowledge and abilities contributing to make an assessment, a diagnosis and an intervention paying special attention to psycho-social aspects mentioned

Cambios en los cuidadores informales en cuanto a estilos de vida, relaciones y alteraciones de salud mental

Changes in the informal caregiver life styles, relations and alterations of mental health. Justification.The increase of the population aged 65 years and older in developed countries is generating a proportional increasing of the dependency caused by chronic pathologies. The care of these persons is being carried out by relatives, informal carers, leading to some alterations in diverse areas, among them mental alterations, as a consequence of taking care. Objectives. To develop a profile of the informal carers and to correlate the caregiver burden with the carers disorders. To detect risk factors to allow carrying out premature nursing interventions to diminish the disorders in the informal carers. Design. An observational and cross-sectional study is made in primary care health services area of the city of Girona. Methodology. Random sample of carer of dependent people at their home , assigned to the program of domiciliary attention (ATDOM) of the educational basic areas of health (ABS). A sample size of 269 persons, with a level of precision of 9% was needed. Questionnaire ICUB 97, the test of Barthel, the Philadelphia Geriatric Center scale, and a questionnaire are used as instruments that includes demographic and social variables, and mental and physical carers disorders.Results. A total of 80 participants were interviewed. The most common problems as consequence of taking care were the backache, to feel more tired, to feel impotent and to have less free time. Correlation between the level of dependence of the patient with the number of problems perceived by the caretaker does not exist. Since they are informal carers they eat frequently outside the habitual schedule, took place an increase or loss of weight, experienced more disorders in sexual life and an increasing lack of interest in surroundings. A 33% of the informal carers are being treated for problems related to the mental health.Conclusion. The fact of being informal carer carries important consequences in their health, the lifestyles and the social relations. These can be attenuated if the nursing interventions are able to consider to the well-taken care of subject, and its surroundings in an holistic way. The professionals of infirmary of mental health must contribute to their knowledge and abilities contributing to make an assessment, a diagnosis and an intervention paying special attention to psycho-social aspects mentioned

El compromiso con la Enfermería de Salud Mental

Editorial al volum 2, número 3 de la revista "Presencia : revista de enfermería de salud mental" sobre l'especialitat d' Infermeria de Salut Mental

Children's Mental Health and Well-Being Work-group Final Report, December 15, 2015

The children's mental health and well-being work group was formed in response to legislative direction to facilitate a study and make recommendations regarding children's mental health and the systems that assist children and families in Iowa.