Medical Chart Review to Explore Suicidal and Self-Harm Thoughts and Behavior Among Psychiatric Inpatients.

Suicide and self-harm events are elevated in psychiatric inpatient populations. In this study, health data were retrospectively collected from the medical records of 183 patients (97 civil and 86 forensic) who had resided in, or been admitted to, a public psychiatric hospital in Saskatchewan, Canada from April 1 to December 31, 2021. Descriptive and inferential analyses were conducted to estimate prevalence and correlates of (non-fatal) suicide and self-harm events, including recent and lifetime occurrences, according to patients' health information. Nearly two-thirds (62%) of patients had any record of non-fatal suicide or self-harm events, including a lifetime history of self-harm (42%) and suicidal behavior (37%) as well as recent self-harm (24%) and suicidal (31%) thoughts or behaviors. Forensic patients were significantly more likely to have a record of suicide and self-harm events. This study emphasizes the need for further research into the course of suicidality and self-harm in psychiatric inpatients.

Lifetime and Jail-Specific Suicidal Ideation: Prevalence and Correlates in a Sample of People in Jail in the United States.

Despite high suicide mortality in U.S. jails, there is limited research into precursors for suicide in this population, such as suicidal ideation. The current study examined the prevalence and correlates of lifetime and jail-specific suicidal ideation among a sample of 196 individuals (137 men) in custody in a U.S. jail. Nearly half the sample had reported lifetime suicidal ideation (45%), whereas 30% had reported jail-specific suicidal ideation. Adjusted correlates of lifetime suicidal ideation included a history of mental illness (OR = 2.79) and drug use (OR = 2.70). Adjusted correlates of jail-specific suicidal ideation included a history of mental illness (OR = 2.74), drug use (OR = 3.16), and a dehumanizing custodial environment (OR = 3.74). Some theoretically and empirically relevant factors were not significantly associated with suicidal ideation. Both expected and unexpected findings are discussed within the context of suicide theory and research, and practical implications are explored.

Older people in custody in a forensic psychiatric facility, prevalence of dementia, and community reintegration needs: an exploratory analysis.

BACKGROUND: Across much of the developed world, the number of older people in custody has been increasing, which presents challenges for correctional systems due to the complex social, medical and mental health needs of this subgroup, especially those living with dementia. The present study therefore aimed to increase insight into the extent to which older people in custody are (a) potentially living with dementia and (b) receiving appropriate supports/services (particularly, with respect to community reintegration). RESULTS: Cross-sectional data were drawn from a sample of 29 older people in custody and 20 correctional health care professionals at a regional forensic psychiatric hospital in a medium-sized Canadian city. In general, analyses revealed that: (a) scores from a modified version of the Community Screening Instrument for Dementia (CSI'D') suggest that 45% of older individuals screened positive for dementia; (b) 35% of Social Workers and 25% of Primary Nurses (i.e., RNs/RPNs) suspected that at least one older individual on their caseload has dementia, and there was adequate agreement between health staffs' perception of the presence or absence of dementia and the CSI'D' assessment; (c) varying supports/services may be required for older individuals' successful community reintegration and living; and (d) Social Workers and Primary Nurses generally lack training/education to adequately support older people in custody. CONCLUSIONS: A substantial number of older people in custody may experience age-related challenges, including dementia. This necessitates the development and implementation of programming to effectively address older individuals' needs during incarceration and community reintegration and living.

Putting the world as classroom: an application of the inequalities imagination model in nursing and health education.

This article focuses on the description of an educational initiative, the Interdisciplinary Population Health Project (IPHP) conducted in the academic year of 2006-2007 with a group of nursing and health care students. Inspired by population health, community development, critical pedagogy, and the inequalities imagination model, students participated in diverse educational activities to become immersed in the everyday life of an underserved urban neighborhood. A sample of convenience composed of 158 students was recruited from 4 health disciplines in a Western Canadian university. Data were collected using a modified version of the Parsell and Bligh's Readiness of Health Care Students for Interprofessional Learning Scale. A one group pretest-posttest design was used to assess the outcomes of the IPHP. Paired t tests and one-way analyses of variance were used to compare the responses of students from different academic programs to determine if there were differences across disciplines. Findings suggest that students' readiness to work in interprofessional teams did not significantly change over the course of their participation in the IPHP. However, the inequalities imagination model may be useful to enhance the quality and the effectiveness of fieldwork learning activities as a means of educating culturally and socially conscious nurses and other health care professionals of the future.

"But there's a million jokes about everybody . . .": prevalence of, and reasons for, directing negative behaviors toward gay men on a Canadian university campus.

The purpose of this study was to assess the frequency and types of negative behaviors directed toward gay men on university campuses and to understand heterosexual men's and women's motivations for engaging in antigay discrimination. Using a mixed methods approach, results from a quantitative survey (N = 286) indicated that students primarily engaged in covert antigay behaviors, such as telling antigay jokes and spreading gossip about gay men. Follow-up qualitative interviews with 8 highly homonegative individuals (4 men, 4 women) were then conducted to better understand their self-perceived motivations for perpetrating antigay discrimination. Results indicated that antigay behaviors were conducted to reinforce traditional male gender roles, alleviate feelings of discomfort, and convey heterosexual identity. Participants also expressed concern about being perceived as prejudiced and were motivated to control their prejudicial reactions to some degree. Implications regarding the contemporary nature of antigay violence on university campuses are discussed.

Rate of healing in skin-grafted burn wounds.

BACKGROUND: Skin grafting is a simple and common procedure for achieving wound closure. Despite its widespread use, there is little objective information about the outcomes of skin-grafted burn wounds. The purposes of this study were to determine the length of time it takes to achieve complete wound healing in split-thickness skin-grafted burn wounds and to identify factors that affect time to complete wound healing. METHODS: The authors prospectively collected information from January through September of 2003 on 52 consecutive patients. Time to complete wound healing was defined as the number of days from burn wound skin grafting until the wound was 100 percent epithelialized. Percentage of total body surface area burned, preoperative prealbumin level, sex, age, graft type, burn mechanism, cause of graft loss, and presence of hypergranulation tissue were assessed and correlated with time to complete wound healing. RESULTS: The time to complete wound healing ranged from 2 to 75 days. Forty-six percent of skin grafts had 100 percent wound closure at postoperative day 7. No grafts were lost to infection. Factors that significantly affected time to complete wound healing were graft loss by seroma, preoperative prealbumin level, presence of hypergranulation tissue, and burns caused by hot solids. CONCLUSIONS: The authors' results suggest that most patients will heal skin-grafted burn wounds within 2 weeks. Meticulous attention to prevention of seroma, hypergranulation tissue formation, and malnutrition might decrease time to complete wound healing. Factors thought to influence time to complete wound healing, such as total body surface area burned, sex, age, graft type, and infection, did not significantly affect the authors' patient group.