Reducing re-admissions at St. Ann’s psychiatric hospital

OBJECTIVE: This study addressed the psychoeducational approach to understand mental illness, illness self-management and social skills. It evaluated the effects of a structured-mannualized psychoeducation programme that taught inpatients about their illness and how to maintain remission after discharge and avoid re-admissions. DESIGN AND METHODS: A total of 505 inpatients admitted with mental disorders were randomly assigned to either an experimental group or control group. The psychoeducation programme consisted of six teaching modules distributed in 219 sessions of 45-minute-sessions in each of 5 wards, on a continuous, five-day-a-week schedule. The effects were measured reviewing the records of admissions and re-admissions after discharge. RESULTS: Results indicated that inpatients of the experimental group significantly improved their knowledge and performance of the skills taught in sessions, compared with the control group who did not participate in the educational group sessions. Re-admissions of participants of the experimental group were significantly less than the control group (2.1 percent versus 16.6 percent). CONCLUSIONS: Not only can patients learn relatively complex material during a typical inpatient stay despite the acuteness of their illness, but they can also meaningfully improve the continuity of their own care by participating in brief and highly structured teaching programmes in inpatient and outpatient settings.

Landscaping employment services for the mentally ill

OBJECTIVE: This project was intended to compare the quality of life of rehabilitees engaged in the Landscaping Employment Services programme with an unemployed group of rehabilitees. DESIGN AND METHODS: A total of 26 rehabilitees were invited to participate in the study with a diagnosis of schizophrenia, schizoaffective disorder, and bipolar disorder. An experimental group of 13 rehabilitees was assigned to the Landscaping Employment Services for Rehabilitees, and a control group of 13 rehabilitees were also evaluated. The landscaping programme consisted of seven days of activity. The effects were measured using a ‘Quality of Life Inventory’ applied to rehabilitees. Patients' knowledge and performance of the specific materials taught in the Landscaping Employment Services for Rehabilitees programme was ascertained through assessments conducted before and after training. RESULTS: Results indicated that participants of the Landscaping Employment Services for Rehabilitees programme significantly improved their knowledge, performance of the skills and their quality of life. CONCLUSIONS: Not only can patients learn relatively complex material, but they can also meaningfully improve the continuity of their employment capability by participating in a brief and highly structured employment training programme.

Visual acuity screening of patients who are institutionalized and suffering from mental disorders

OBJECTIVE: Visual problems in persons who are institutionalized suffering from mental disorders are overwhelmingly under-recognized. The aim of this study was therefore to screen for visual acuity among 285 patients at the St. Ann’s Psychiatric Hospital (SAH) and 27 at the Arima Rehabilitation Centre (ARC). The projected number of patients to be screened was 427 persons. However, only 312 inpatients were included to participate in the study. The study evaluated the patients who were chosen to assess their visual acuity. The project was conducted from August to December, 2011. DESIGN AND METHODS: A total of 312 inpatients admitted to the hospital and rehabilitation centre with mental disorders were evaluated using either the Snellen or Lea Charts by trained technicians from the Lions Club of Trinidad and Tobago. The evaluations were conducted for four months on 25 wards and at the Arima Rehabilitation Centre. A Stereo Optical Vision Tester was used for the evaluation of patients using a Snellen Chart and/or a Lea Chart. Analysis was done using SPSS version 20.0. RESULTS: One hundred and twenty-five (125) patients were found to have visual acuity problems and recommended for further evaluation by an ophthalmologist. This represents 40.1% of the sample tested. CONCLUSIONS: Our findings coincided with the existing literature that visual impairment appears to be an area of physical health which is under-recognized, under-diagnosed and under-treated in people with severe mental health problems, even though certain psychiatric medications are known to cause visual problems as a side effect.

Effect of Cowpea severe mosaic virus on Crop Growth Characteristics and Yield of Cowpea.

Field experiments were carried out in St. Augustine, Trinidad & Tobago, West Indies to determine the effects of time of inoculation of Cowpea severe mosaic virus (CPSMV) and cultivar on crop growth and yield in cowpea (Vigna unguiculata). Crop growth and yield loss were investigated through growth analysis and yield component analysis on three cultivars in two seasons (wet and dry). Time of inoculation had the most profound impact on yield. Inoculations during the early log phase (seedling stage), 12 days after seeding (DAS), consistently had the greatest impact (50 to 85% yield loss) compared with those inoculated during the exponential growth phase (24 DAS; 22 to 66% yield loss) or linear growth phase (35 DAS; 2 to 36% yield loss). The effects were particularly pronounced in the dry season and in the more determinate cultivar, H8-8-27. Reduction in maximum leaf area index, leaf area duration, or maximum vegetative dry matter explained reductions in yield. Yield reductions resulted primarily from reduced pod number per plant and, to a lesser extent, from reduced average pod dry weight. The results show that CPSMV control measures should be aimed at delaying infection by CPSMV to minimize the impact on cowpea yield.

Carbon Dioxide and Light Responses of Photosynthesis in Cowpea and Pigeonpea during Water Deficit and Recovery.

Greenhouse-grown pigeonpea (Cajanus cajan, [L.] Millsp.; cultivar UW-10) and cowpea (Vigna unguiculata, [L.] Walp.; cultivar California No. 5) were well-watered (control) or subjected to low water potential by withholding water to compare their modes of adaptation to water-limited conditions. Leaf CO(2) exchange rate (CER), leaf diffusive conductance to CO(2) (g(l)), and CO(2) concentration in the leaf intercellular air space (C(i)) were determined at various CO(2) concentrations and photon flux densities (PFD) of photosynthetically active radiation (400 to 700 nanometer). In cowpea, g(l) declined to less than 15% of controls and total water potential (psi(w)) at midafternoon declined to -0.8 megapascal after 5 days of withholding water, whereas g(l) in pigeonpea was about 40% of controls even though midafternoon psi(w) was -1.9 megapascal. After 8 days of withholding water, psi(w) at midafternoon declined to -0.9 and -2.4 megapascals in cowpea and pigeonpea, respectively. The solute component of water potential (psi(s)) decreased substantially less in cowpea than pigeonpea. Photosynthetic CER at saturation photon flux density (PFD) and ambient external CO(2) concentration (360 microliters per liter) on day 5 of withholding decreased by 83 and 55% in cowpea and pigeonpea, respectively. When measured at external, CO(2) concentration in bulk air of 360 microliters per liter, the CER of cowpea had fully recovered to control levels 3 days after rewatering; however, at 970 microliters per liter the PFD-saturated CERs of both species were substantially lower than in controls, indicating residual impairment. In stressed plants of both species the CER responses to C(i) from 250 to 600 microliters per liter indicated that a substantial nonstomatal inhibition of CER had occurred. Although the sensitivity of g(l) to water limitation in cowpea suggested a dehydration avoidance response, parallel measurements of CER at various C(i) and PFD indicated that photosynthetic activity of cowpea mesophyll was substantially inhibited by the water-limited treatment.