Alcohol and cannabis co-use: Receptiveness to treatments and application to intervention planning.

Given the prevalence of alcohol and cannabis co-use among college students, prevention for co-use is crucial. We examined hypothetical receptiveness to substance-specific interventions among students who reported co-use. Students who use alcohol and cannabis were more receptive to alcohol interventions than cannabis interventions. Campus prevention experts should consider offering evidence-based alcohol-focused interventions as a potential pathway for decreasing substance use among college students who engage in co-use.

A mixed-method evaluation of the adoption and implementation of the College Alcohol Intervention Matrix among prevention experts: a study protocol.

BACKGROUND: Risky drinking among college campuses has been a long-standing concern and there have been dedicated efforts to develop evidence-based prevention and treatment strategies (EBSs) to decrease alcohol use and increase healthy behaviors among college students. Further, the College Alcohol Intervention Matrix (CollegeAIM) was developed as a tool with accompanying resources, to assist institutions of higher education in selecting EBSs that are appropriate and a good fit for their campuses. However, the CollegeAIM tool and selection of prevention strategies from stakeholders' perspectives has yet to be evaluated. This study protocol describes the methodology for a research project evaluating CollegeAIM from an implementation science perspective using the Exploration, Preparation, Implementation, and Sustainment framework. METHODS: The aims of this study will be accomplished with a mixed-method design comprised of reviews of strategic planning documents, quantitative surveys and interviews with prevention experts, and focus groups to identify key components of a decision-support program for prevention experts to support the use of CollegeAIM. Participants are members of the multi-site Missouri Partners in Prevention coalition to reduce risky substance use on college campuses across the state. DISCUSSION: The results of this study will provide key information to support the development of additional supportive tools for campuses that can improve their selection and implementation of EBSs that fit the needs of their respective campuses. This work is important to further advance the implementation and sustainment of extant EBSs for risky college alcohol use.

Effects of a campus-wide tobacco-free policy on tobacco attitudes, norms and behaviors among students, staff and faculty.

Objective: In 2016 a private Missouri university implemented a campus-wide tobacco-free policy to change social norms and prevent tobacco use among students, staff and faculty. This study assesses impact on tobacco and policy-related perceptions and behaviors. Methods: Before the policy went into effect and again one year later, all university students, staff and faculty were invited to participate in an online survey. Missouri Assessment of College Health Behaviors survey findings supplement results for students. Results: Policy support and norms disapproving tobacco use on campus increased, and self-reported use of any tobacco decreased after the ban was enacted. Conclusions: Our results suggest that the policy led to an increase in the proportion of university community members who agree that smoking on campus is unacceptable, which contributed in turn to a decline in tobacco use on campus, consistent with our theory of effects.

The efficacy of a personalized feedback-only intervention for at-risk college gamblers.

OBJECTIVE: College students have been shown to be at higher risk than the general adult population for gambling-related problems. Thus, the purpose of this study was to examine the efficacy of a personalized feedback only intervention (PFB) among at-risk college student gamblers. METHOD: Three hundred thirty-three college students who met screening criteria were randomized into 1 of 3 conditions: PFB, education only (EDU), or assessment only (AO). RESULTS: At 3-month follow-up, individuals in the PFB condition reported fewer dollars gambled and fewer gambling-related problems than those in the AO condition. There were no differences between those in the EDU and the AO conditions, or between those in the PFB and the EDU conditions. CONCLUSION: These findings are consistent with clinical trials examining other health behaviors, and have implications for the development and delivery of effective intervention programming for at-risk gamblers.

The suitcase simulation: an effective and inexpensive psychiatric nursing teaching activity.

A tabletop simulation was developed as a patient safety activity that involved checking in a patient admitted to a psychiatric care unit. Students were second-degree (n = 79) and traditional (n = 53) BSN students. They were given suitcases or backpacks containing various items, and following a fictional hospital policy, they had to decide whether to give the items to the patient, place them in a secured area, or send them to the pharmacy or security personnel. The activity was evaluated using the Simulation Effectiveness Tool (SET) and two open-ended questions. Students reported that they found the simulation to be enjoyable and a good learning experience. Checking in a patient's belongings is not an activity students typically perform, but the simulation can help prepare them for situations they will experience in the workplace. This inexpensive activity can easily be adapted for staff orientation and competencies. [Journal of Psychosocial Nursing and Mental Health Services, 52(8), 39-44.].

Looking for a good book. Reading and teaching with psychiatric practitioner memoirs.

Memoirs can be more interesting to read than textbooks and are frequently just as informative. Many people have written excellent memoirs about their own or family member's psychiatric illness. However, psychiatric practitioner memoirs have the advantage of showing how an enthusiastic but novice clinician develops into a skilled practitioner, something students are usually eager to understand. Twenty-nine memoirs by psychiatric practitioners (nurses, advanced practice nurses, psychiatrists, and psychologists) were reviewed and critiqued for clinical accuracy and relevancy, positive role-modeling, advocacy, a promotion of a positive image of nursing, and suitability for use in teaching undergraduate nursing students; of these, 3 are outstanding books written by nurses ( The Comfort Garden: Tales from the Trauma Unit by Barkin and Tales from the page Chronicles and The Pager Chronicles Volume Two by Rancour) and one by psychiatrist(Psychward by Seager). An annotated bibliography of all practitioner memoirs reviewed is provided.

Taking the sting out of examination review.

Since using this method, examination reviews have focused less on arguing for points and more on comprehending the material. Examination reviews are already stressful for students and faculty; posting the examination on the walls is a quick and easy way to facilitate a difficult task.

Moderate drinking and cardiovascular disease.

The adverse consequences of heavy alcohol use are well known. However, recent media reports of a possible cardiovascular benefit associated with moderate drinking have revived public interest in the use of alcohol for "medicinal purposes." Knowledge development regarding guidelines for moderate alcohol use has lagged behind public interest in the possible health benefits of moderate alcohol use. At this time, evidence-based primary health promotion interventions related to the risks and benefits of moderate alcohol use are lacking in the health care literature. This chapter reviews 22 reports describing the relationship between moderate drinking and cardiovascular disease. The reports are classified by the level of evidence and critiqued on seven aspects of method. Conclusions related to the strength of the evidence that moderate drinking is a useful primary health promotion intervention are presented.

Hollywood in the classroom: using feature films to teach.

Feature films have been successfully used in other disciplines to teach both undergraduate and graduate students but are seldom used in nursing. The purpose of this study was to evaluate two classes of BSN student's perceptions of viewing films as an alternative to some clinical time in a psychiatric mental-health nursing course. A 12-item, 7-point Likert-type scale was constructed to assess students' beliefs about the value of films as a learning experience. An experienced faculty member evaluated the instrument for content validity. Coefficient alpha for the 12-item scale was .95. The film experience was highly rated by the students in learning and liking. Using films to teach nursing is a creative way to engage students in learning complex material.

Predictors of alcohol misuse and abuse in older women.

PURPOSE: To determine the predictive ability of self-report questions, physical measures, and biomarkers to detect alcohol misuse and abuse among older women. DESIGN AND METHODS: Healthy women volunteers age 60 and older who fit selection criteria were enrolled. The 135 participants were divided into nondrinkers (ND; n = 63) and drinkers (D; n = 72) based on self-reports of quantity and frequency of standard drinks consumed per month. The mean ages for the groups were 69.2 (ND) and 69.6 (D). FINDINGS: The best predictor was a score >0 on the T-ACE, a four-item instrument to detect alcohol abuse. Other significant predictors were: (a) behaviors: smoking, mixing over-the-counter (OTC) drugs with alcohol, heavy coffee drinking, using alcohol to sleep, and less sleep latency; and (b) biomarkers: higher mean corpuscular volume (MCV), hemoglobin (Hgb), hematocrit (Hct), and high-density lipoprotein cholesterol (HDL). The heaviest drinker subgroup had more physical stigmata, including broken blood vessels in nose and larger liver spans. CONCLUSIONS: The "best predictor model" showed that older women who were at risk for alcohol misuse or abuse had T-ACE scores of 1 or higher, used two or more OTC drugs regularly, drank large amounts of coffee, used alcohol to fall asleep, and had less sleep latency. Because positive T-ACE scores have high sensitivity and specificity for alcohol abuse, scores of 1 or greater should be addressed in clinical settings, e.g., referrals for more definitive diagnoses and relevant treatment.

The association between moderate drinking and heart rate variability in healthy community-dwelling older women.

The relationships among moderate alcohol use, autonomic tone, and arrhythmogenesis in older adults have not been adequately studied. Knowledge about these relationships is of increasing importance in light of population aging and recent epidemiological findings that associate moderate alcohol use with decreased rates of coronary artery disease. The purpose of this study was to assess the association between moderate drinking and autonomic tone in older women. Fifty-two Caucasian female participants (age 69 +/- 5.2) were enrolled in the study. Autonomic tone was estimated by time-domain and frequency-domain measures of heart rate variability. Multivariate analysis revealed that alcohol consumption rate in the sample accounted for approximately one third of the 24-h variability in the SDNN and the SDANN, measures of variability cycle lengths of 24-h and more than 5-min, respectively. Significant contributions of alcohol consumption rate to the shorter-term time-domain measures rMSSD and ASDNN, all frequency-domain measures, and HR were not confirmed. However, repeated measures ANOVA revealed that, between the hours of 0000 and 0600, women who drank approximately 0.5 to 3 standard drinks per day had significantly lower [log] HF and [log] LF power compared to abstainers and a tendency toward sympathetic predominance during the evening and nighttime hours. The authors discuss the implications of these findings.

Moderate alcohol consumption and unappreciated risk for alcohol-related harm among ethnically diverse, urban-dwelling elders.

The purpose of this cross-sectional survey was to gather data describing how older adults define moderate alcohol consumption and how they have interpreted media reports of the health benefits of moderate alcohol consumption. Results showed that many older adults define moderate alcohol use at levels above Federal guidelines, and a notable number of older adults agree that moderate use is good for health. The disparity between older adults' definition of moderate drinking and Federal guidelines for low-risk drinking may contribute to the underrecognition of problem drinking by nurses and other health care providers and place older adults at an unappreciated level of risk for alcohol-related harm.

A theoretical model of the role of brain stem nuclei in alcohol-mediated arrhythmogenesis in older adults.

Uncertainty about the mechanism of alcohol-mediated arrhythmogenesis and the effect of alcohol use on arrhythmic risk among older adults is an increasing concern in light of population aging and recent reports that moderate alcohol consumption may protect older adults against coronary artery disease. In this review, a theoretical model of the role of brain stem nuclei in alcohol-mediated arrhythmogenesis in older adults is developed. The model is based on the hypothesis that the effects of alcohol on central autonomic pathways of cardiac control may alter the threshold for alcohol-mediated arrhythmogenesis among older adults. Findings from multiple lines of research including cellular, electrophysiological, epidemiological, experimental, and clinical studies in human, animal, and in vitro models were synthesized in developing the model. Suggestions for future research on the topic of alcohol-mediated arrhythmogenesis in older adults are offered.