Development and Feasibility of a Cell Phone-Based Transitional Intervention for Women Prisoners with Comorbid Substance Use and Depression.

This article describes the development and feasibility testing of a cell phone-based intervention (Sober Network IPT) among 22 women with comorbid substance use and depressive disorders transitioning from prison to surrounding communities. Feasibility/acceptability measures included phone logs, exit interviews, and pre-post measures of substance use and depressive symptoms up to 9 months post-release. Results indicated that phone-based transitional treatment is feasible and acceptable. Participants valued the opportunity to maintain contact with familiar prison treatment providers by phone after release, and used the cell phones for help with service linkage, support, and crisis management. We describe relational and practical lessons learned.

Forced treadmill exercise training exacerbates inflammation and causes mortality while voluntary wheel training is protective in a mouse model of colitis.

The purpose of this study was to examine whether exercise training reduced inflammation and symptomology in a mouse model of colitis. We hypothesized that moderate forced treadmill running (FTR) or voluntary wheel running (VWR) would reduce colitis symptoms and colon inflammation in response to dextran sodium sulfate (DSS). Male C57Bl/6J mice were randomized to sedentary, moderate intensity FTR (8-12 m/min, 40 min, 6 weeks, 5x/week), or VWR (30 days access to wheels). DSS was given at 2% (w/v) in drinking water over 5 days. Mice discontinued exercise 24 h prior to and during DSS treatment. Colons were harvested on Days 6, 8 and 12 in FTR and Day 8 post-DSS in VWR experiments. Contrary to our hypothesis, we found that moderate FTR exacerbated colitis symptomology and inflammation as measured by significant (p<0.05) increases in diarrhea and IL-6, IL-1ß, IL-17 colon gene expression. We also observed higher mortality (3/10 died vs. 0/10, p=0.07) in the FTR/DSS group. In contrast, VWR alleviated colitis symptoms and reduced inflammatory gene expression in the colons of DSS-treated mice (p<0.05). While DSS treatment reduced food/fluid intake and body weight, there was a tendency for FTR to exacerbate, and for VWR to attenuate, this effect. FTR (in the absence of DSS) increased gene expression of the chemokine and antibacterial protein CCL6 suggesting that FTR altered gut homeostasis that may be related to the exaggerated response to DSS. In conclusion, we found that FTR exacerbated, whereas VWR attenuated, symptoms and inflammation in response to DSS.

Toxic Stress in a Mid-Sized Urban Community: An Initial Needs Assessment of Families with Children in Maywood, IL.

BACKGROUND: Loyola Medical Center is located in Maywood, IL, a community that faces high rates of poverty, violence, and barriers to healthcare. These factors can contribute to toxic stress, which has been shown to negatively impact children's health. OBJECTIVES: The goal of this project was to partner with community organizations to obtain a baseline needs assessment from families in Maywood regarding sources of toxic stress and to identify interventions of interest. METHODS: In total, 75 anonymous surveys were collected from the Loyola Outpatient Center Pediatric Clinic and a Maywood community center. Survey responses were statistically analyzed in order to determine toxic stressors most commonly impacting families in Maywood as well as interventions of most interest to the community. RESULTS: There were 78 respondents for a response rate of approximately 71%. The most common stressors were smoking in the home (33.3%), food insecurity (29.5%), and exposure to violence (26.9%). In this sample, Black respondents were 11.5 times more likely than non-Black respondents to report that their child was exposed to violence in the community - even after controlling for concern about their child's behavior which served as a surrogate measure of the child's exposure to toxic stress (P = 0.001). Further, those living with food insecurity were 7.40 times more likely to report that access to food and transportation vouchers were important (P < .001). For every 1-point increase in the total toxic stress score, respondents were 1.35 times more likely to report that increasing access to mental health resources was important to them, though this was not significant (P = .10). CONCLUSION: The data demonstrate that toxic stressors, health risks and unmet social needs are prevalent in the Maywood community, which puts local children at risk for future adverse health outcomes. With this information, pediatricians at Loyola Medical Center can work with community organizations to allocate resources to address toxic stressors in Maywood.

Cardiac Ischemia Associated With Marijuana Use in an Adolescent.

With the increasing use of marijuana globally, including in pediatric populations, healthcare providers see more adverse health effects associated with this substance. This report details a case presentation of cardiac ischemia in an adolescent male associated with marijuana use. The patient presented with palpitations and chest pain shortly after consuming marijuana. Clinical workup demonstrated anterior ST-segment elevations and troponin elevation with no inflammatory marker elevation or findings of myocarditis on MRI. Extensive drug screening was only positive for marijuana, with a synthetic THC panel negative. These findings resolved after close observation and the patient was discharged in good clinical condition. This case shows a concerning presentation of marijuana-associated cardiac ischemia in an otherwise healthy adolescent, illustrating a potentially severe health concern with an increasingly common substance and demonstrating the need for pediatric centers to have a high index of suspicion for cardiac causes of chest pain when marijuana ingestion is involved even when there are no prior medical or cardiac risk factors.

Role strain among male RNs in the critical care setting: Perceptions of an unfriendly workplace.

PURPOSE: Traditionally, nursing has been a female-dominated profession. Men employed as registered nurses have been in the minority and little is known about the experiences of this demographic. The purpose of this descriptive, quantitative study was to understand the relationship between the variables of demographics and causes of role strain among male nurses in critical care settings. The Sherrod Role Strain Scale assesses role strain within the context of role conflict, role overload, role ambiguity and role incongruity. Data analysis of the results included descriptive and inferential statistics. Inferential statistics involved the use of repeated measures ANOVA testing for significant difference in the causes of role strain between male nurses employed in critical care settings and a post hoc comparison of specific demographic data using multivariate analyses of variance (MANOVAs). RESULTS: Data from 37 male nurses in critical care settings from the northeast of the United States were used to calculate descriptive statistics standard deviation, mean of the data analysis and results of the repeated ANOVA and the post hoc secondary MANOVA analysis. The descriptive data showed that all participants worked full-time. There was an even split from those participants who worked day shift (46%) vs. night shift (43%), most the participants indicated they had 15 years or more experience as an registered nurse (54%). Significant findings of this study include two causes of role strain in male nurses employed in critical care settings which are: role ambiguity and role overload based on ethnicity. CONCLUSION: Consistent with previous research findings, the results of this study suggest that male registered nurses employed in critical care settings do experience role strain. The two main causes of role strain in male nurses are role ambiguity and role overload.

"I know if I drink I won't feel anything": substance use relapse among depressed women leaving prison.

PURPOSE: The purpose of this paper is to explore treatment needs and factors contributing to engagement in substance use and sobriety among women with co-occurring substance use and major depressive disorders (MDDs) as they return to the community from prison. DESIGN/METHODOLOGY/APPROACH: The paper used qualitative methods to evaluate the perspectives of 15 women with co-occurring substance use and MDDs on the circumstances surrounding their relapse and recovery episodes following release from a US prison. Women were recruited in prison; qualitative data were collected using semi-structured interviews conducted after prison release and were analyzed using grounded theory analysis. Survey data from 39 participants supplemented qualitative findings. FINDINGS: Results indicated that relationship, emotion, and mental health factors influenced women's first post-prison substance use. Women attributed episodes of recovery to sober and social support, treatment, and building on recovery work done in prison. However, they described a need for comprehensive pre-release planning and post-release treatment that would address mental health, family, and housing/employment and more actively assist them in overcoming barriers to care. PRACTICAL IMPLICATIONS: In-prison and aftercare treatment should help depressed, substance using women prisoners reduce or manage negative affect, improve relationships, and obtain active and comprehensive transitional support. ORIGINALITY/VALUE: Women with co-occurring mental health and substance use disorders are a high-risk population for negative post-release outcomes, but limited information exists regarding the processes by which they relapse or retain recovery after release from prison. Findings inform treatment and aftercare development efforts.