Spirituality and people with psychosis: A content analysis of influential primetime television programs.

OBJECTIVE: This mixed methods study examined depictions of spirituality among people with psychosis in influential television programming. Spirituality is a central strength for many people with psychosis. Yet, despite the important role media plays in shaping perceptions, little research has examined the intersection between spirituality and psychosis in popular media. METHODS: To address this gap, we conducted a content analysis of the 50 most viewed primetime fictional television shows over a 10-year period as determined by the Nielsen rating organization. Characters with psychosis were identified via keyword searches of online sources (wikis, IMDb, etc.) and subsequently independently coded by two individuals. Characters were rated on 18 items in three domains related to demographics, life status, and character framing. Inter-rater reliability ranged from good to excellent across variables. RESULTS: Of 120 identified focal characters with psychosis, just 16 percent (n = 19) had a spiritual identity. Analysis revealed few differences between spiritual and secular characters on demographic and life status variables. Conversely, an examination of framing variables revealed spiritual characters were comparatively less attractive, exhibited a greater negative impact on society, and were more likely to be referred to pejoratively (as a psychopath) and engage in criminal activity. Trend analysis indicated portrayals of spiritual characters decreased over time. CONCLUSIONS: The results suggest media depictions of spirituality contribute to the stigmatization of spirituality among people with psychosis, potentially mitigating access to important coping resources and discouraging professional help-seeking. Primary care physicians should consider incorporating a spiritual assessment into care to operationalize spiritual coping assets.

The 100 Leading Contributors to English-Language Gerontological Journals: An International Study of Scholarly Impact.

The two aims of this study were to: 1) identify the 100 most impactful contributors to English-language gerontological journals, and 2) map their respective disciplinary affiliations to help illuminate the perspectives shaping gerontological discourse. Toward that end, we conducted a secondary data analysis of a publicly available database of the world's leading scientists. After extracting all scientists in the gerontological category, we rank ordered them according to a composite measure of scholarly impact that controls for self-citations and author order while also calculating other bibliometric statistics. Disciplinary affiliations were assigned based upon the Classification of Instructional Programs codes developed by the National Center for Education Statistics at the United States Department of Education. The results reveal the mean contributor to the gerontological literature published 241.15 (SD = 203.95) papers and - after correcting for self-citations - had an h-index of 50.05 (SD = 25.00), and an hm-index 23.67 (SD = 7.50). A diverse array of professional affiliations characterized the contributors with a plurality being located in the health professions category, followed by the biological and biomedical science, and social sciences categories. The results reveal that gerontology is home to some of the world's leading scientists. Leveraging their expertise can help advance the field's collective knowledge development.

Identifying the Leading Global Contributors to Scholarship in Religion Journals: A Bibliometric Study.

This study identified the 100 most impactful global contributors to religion journals and mapped their respective disciplinary affiliations. To conduct this investigation, we performed a secondary data analysis of a Scopus-derived database featuring the world's leading scientists. The mean contributor published 51.93 papers, had an h-index of 13.57, and an hm-index 11.50. Most contributors were located in the USA with the most common disciplinary affiliations being religion, non-specialized (n = 22), sociology, non-specialized (n = 21), sociology of religion (n = 20), and theology (n = 11). The results reveal that religion discourse is populated by some of the leading scholars in the world. Leveraging their expertise can help advance the field's knowledge development.

Religious Involvement and DSM-IV Anxiety Disorders Among African-Americans.

ABSTRACT: This study examined the relationship between eight measures of religious involvement and five anxiety disorders among a nationally representative sample of African-Americans ( N = 3403). The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition , World Mental Health Composite International Diagnostic Interview was used to assess 12-month and lifetime prevalence for each disorder. Logistic regression indicated weekly service attendance was inversely associated with 12-month and lifetime panic disorder, lifetime agoraphobia, and 12-month and lifetime posttraumatic stress disorder (PTSD). Prayer was inversely associated with 12-month agoraphobia, 12-month social phobia, and lifetime PTSD. Listening to religious radio and looking to God for strength were also inversely related to, respectively, 12-month and lifetime panic disorder. Conversely, reading religious materials was positively associated with 12-month panic disorder, 12-month agoraphobia, lifetime PTSD, and lifetime generalized anxiety disorder. The results are discussed in light of conceptual models that specify multiple and sometimes divergent pathways through which religion impacts health, and suggestions for clinicians addressing anxiety disorders are delineated.

Leadership challenges and strategies to dementia care in Chinese faith-based nursing homes: A qualitative study.

AIM: To address the need and fill a knowledge gap in understanding challenges and coping strategies from the perspectives of nursing home leadership. BACKGROUND: The rapid increase of older adults with dementia in China highlights the need for research on dementia care in long-term care facilities. METHODS: Semistructured interviews were conducted among 20 facility directors employed by faith-based nursing homes across 12 provinces in China via phone or in-person in their native language. Two researchers fluent in Mandarin Chinese- and English-coded interview transcripts; thematic analysis was conducted to identify patterns. RESULTS: Four primary challenges were identified, including recruiting and retaining nursing staff, funding, lacking governmental support and discord with family members. The coping strategies included using external resources, incorporating religious beliefs, teamwork, rewarding performance and improving staff skills and empathy. CONCLUSIONS: This study contributes to nursing home practice knowledge by disseminating insights of administrators regarding culturally relevant dementia management strategies in China. IMPLICATIONS FOR NURSING MANAGEMENT: Implications for nursing management are as follows: teamwork and staff encouragement; advocate for a sustainable governmental financial support; staff training and staff-resident ratio regulations and policy; seeking external resources; integrate faith-based means for problem management and service quality improvement.

Religious service attendance typologies and African American substance use: a longitudinal study of the protective effects among young adult men and women.

PURPOSE: This study sought to identify variation by gender in the associations between religious service attendance from adolescence to young adulthood and seven measures of lifetime and short-term substance use. METHODS: To conduct this nationally representative study, data from the Add Health Surveys was abstracted from Waves I and IV (N = 3,223) to construct four types of service attendance (non-attenders, attenders only as adolescents, attenders only in young adulthood, and consistent attenders). A series of logistic regressions were conducted to identify the independent effects of each pattern of service attendance on each substance among all black young adults, as well as male and female sub-samples. RESULTS: Analysis revealed consistent attenders were generally less likely to use substances, with the effects being strongest among females. Among young adult only attenders, males recorded lower odds across all three short-term measures whereas females reported lower odds only for monthly cigarette use. CONCLUSION: The protective effects of religious service attendance are more robust for African Americans who consistently attend in adolescence and young adulthood, especially among females.

Examining Psychological Self-Sufficiency Among Low-Income Jobseekers with Mental Health Barriers.

The study is to investigate psychological self-sufficiency-the force within someone that activates cognitive and non-cognitive process of shifting perceived barriers into hope actions-as it relates to economic self-sufficiency among jobseekers with mental health barriers. Among a sample of 2455 low-income jobseekers in job readiness programs at six community-based agencies in Chicago, a subsample of 424 who self-identified as having mental illness barriers are selected to analyze the relationships between employment hope, employment barriers, and economic self-sufficiency using structural equation modeling. Results indicate that employment hope mediates the path between perceived employment barriers and economic self-sufficiency. The study further highlights the positive effects of employment barriers on employment hope among jobseekers with perceived mental illnesses. The findings support growing evidence that psychological self-sufficiency is positively associated with gaining economic self-sufficiency in workforce development programs.

Spirituality among People with Disabilities: A Nationally Representative Study of Spiritual and Religious Profiles.

This study examined the relationship between eight dimensions of spirituality (and religion) and people with four different types of disability status: hearing, vision, physical mobility, and emotional or mental disabilities. The overarching aim was to identify specific spiritual-religious profiles within each disability population relative to the general population. To conduct this cross-sectional examination, the authors used nationally representative data from the General Social Survey in the United States. The results reveal unique spiritual and religious profiles across the four types of disability status examined, although people with emotional or mental disabilities may have the most distinct profile. Compared with their counterparts among the general public, people with hearing, physical, and emotional disabilities were more likely to report praying several times a day; people with all four types of disability were more likely to report having a turning point when they became less committed to religion. Understanding which spiritual and religious dimensions are disproportionately more likely to exist among a given population with a particular disability helps practitioners provide more effective services to members of that group.

Behavioral Risk Profiles of Homeschooled Adolescents in the United States: A Nationally Representative Examination of Substance Use Related Outcomes.

BACKGROUND: The homeschool population continues to grow in size and now accounts for 3.4% of all students in the United States. OBJECTIVE: Given the heterogeneous nature of the population, this study examines the relationship between different types of homeschoolers and a number of substance use related outcomes. METHODS: To conduct this study, we used pooled data (2002-2013) from the National Survey on Drug Use and Health (NSDUH). Respondents aged 12-17 who reported they had been homeschooled at any time during the previous 12 months were classified as homeschoolers (N = 1,321). Latent profile analysis (LPA) was conducted to identify latent subgroups of homeschoolers and multinomial regression was executed to assess the relationship between the subgroups and perceived substance use risk, availability, and past 12-month use. RESULTS: The LPA yielded four subgroups, which were summarized as (1) highly religious and engaged, (2) limited parental monitoring, (3) high parental warmth and support, and (4) secular permissive. Of these, the highly religious and engaged subgroup was the least likely to report using substances. CONCLUSION: The results underscore the variation that exists among homeschoolers and the importance of examining the relationship between different types of homeschoolers and outcomes of interest.

Examining the relationship between encouragement and health-related quality of life among Muslims.

This study examines the relationship between encouragement and health-related quality of life (HRQOL) among a sample of American Muslims, in tandem with the potential mediating effects of depression and spirituality. To conduct this cross-sectional study, a model was developed and tested using structural equation modeling (SEM) with a community sample of Muslims (N = 284). The results indicate that encouragement has a direct, positive effect on HRQOL. Neither depression nor spirituality mediated the relationship between encouragement and HRQOL. Rather, both variables exhibited a direct, independent effect on HRQOL. In addition, spirituality exhibited an indirect effect on HRQOL through attenuating depression. The findings underscore the importance of encouragement as a pathway to enhance HRQOL among Muslims in post-9/11 America. The results also suggest that spirituality can play a significant role in fostering HRQOL among Muslims, both directly and indirectly by reducing the effects of depression on HRQOL.

Administering a two-stage spiritual assessment in healthcare settings: a necessary component of ethical and effective care.

AIM: This article delineates rationales for administering a spiritual assessment as a universal component of care. BACKGROUND: The notion that nurses should identify and address patients' spiritual needs remains controversial, particularly in the UK where criticisms derived from secularization theory have appeared in the literature. EVALUATION: To respond to these criticisms and to develop rationales supportive of spiritual assessment, I draw upon scholarship from a variety of disciplines including social work, sociology, and medicine. KEY ISSUES: Five rationales are posited to support the concept of universal spiritual assessments: professional ethics, patient autonomy, knowledge of patients' worldviews, the identification of spiritual assets, and accrediting and governmental requirements. Criticisms based on secularization theory are discussed and analysed. CONCLUSION: A two-stage spiritual assessment - consisting of a brief preliminary assessment followed, if necessary, by a comprehensive assessment - provides a mechanism to efficiently identify patients' spiritual needs. IMPLICATIONS FOR NURSING MANAGEMENT: As key members of the healthcare team, nurse managers are ideally situated to ensure that all patients receive a spiritual assessment as a routine component of care. In so doing, they help ensure the provision of ethical and effective care to the diverse spiritual groups that will continue to populate the UK for the foreseeable future.

Addressing the spiritual needs of American Indians: predictors of satisfaction.

Spirituality is instrumental to health and wellness in many American Indian (AI) cultures. Although the Joint Commission requires spiritual assessments to identify and address clients' spiritual needs during hospitalization, little is known about the operationalization of this process for American Indians (AIs). To address this gap in the literature, the present study employed a national sample of AIs (N = 1,281) to identify predictors of satisfaction with the manner in which their spiritual needs were addressed. The results suggest the discharge process, physicians, room quality, and nurses play important roles in satisfactorily addressing AIs' spiritual needs. Of these, the discharge process had the largest effect on satisfaction, underscoring the salience of social workers in addressing the spiritual needs of hospitalized AIs.

Failure to address African Americans' spiritual needs during hospitalization: identifying predictors of dissatisfaction across the arc of service provision.

Using a national sample of recently hospitalized older African Americans (N = 2,227), this study identified predictors of dissatisfaction with the manner in which clients' spiritual needs were addressed during hospitalization. Of 8 major areas of service provision examined, 3 were significant predictors of dissatisfaction: nurses, physicians, and the discharge process. The findings underscore the importance of collaborative efforts to address elderly Black clients' spiritual needs. Social workers, who frequently oversee the discharge process, can play an important role in addressing African Americans' spiritual needs by developing discharge plans that incorporate clients' spiritual strengths and resources into the planning process.

Identifying and Addressing the Spiritual Needs of Older Adults in Care Facilities: Administrators of Chinese Nursing Homes Relate Their Perspectives.

Addressing the spiritual needs of older adults is a central component of holistic service provision. Using a qualitative description design, this study identified: (1) common spiritual needs among Chinese nursing home residents, including the needs of residents with dementia, (2) the process staff use to identify these needs when residents are unable to verbalize them, and (3) the strategies staff implement to meet the identified needs. Semi-structured interviews were conducted with 21 nursing home administrators. Analysis produced five themes, including the need for older adults to express their faith, receive love and care, have contact with their children, interact with others, and participate in activities. For residents with dementia who are unable to verbalize their concerns, staff used two primary strategies to identify spiritual needs: careful observation and communication with family members. To address the identified spiritual needs, multiple strategies were offered including arranging clergy visits and personalizing care.

How to Work with Muslim Clients in a Successful, Culturally Relevant Manner: A National Sample of American Muslims Share Their Perspectives.

Despite the growing size of the American Muslim community, little research exists on the provision of culturally relevant services to members of this population. The purpose of this study was to identify American Muslims' perceptions regarding what practitioners should know about Muslims and Islamic culture to provide successful mental health services to members of this community. To conduct this study, a purposive snowball sampling method was employed to obtain a national sample of community-dwelling American Muslims (N = 213). Qualitative analysis identified eight interlaced themes, which can be summarized as follows: (1) know basic Islamic beliefs, (2) recognize intragroup ethnic/cultural differences, (3) develop self-awareness of personal biases, (4) respect Islamic gender roles, (5) avoid making assumptions, (6) use Islamic beliefs/practices as strengths, (7) understand bias in the larger secular culture, and (8) consult with Muslim therapists/Imams. The findings equip practitioners with the information they need to provide effective, culturally relevant services to members of the unique American Muslim community from a posture of respect and cultural humility.

Enterobacterales draft genome sequences: 15 historical (1998-2004) and 30 contemporary (2015-2016) clinical isolates from Pakistan.

The continued emergence and spread of antimicrobial resistance among pathogenic bacteria are ever-growing threats to health and economy. Here, we report the draft genomes for 45 Enterobacterales clinical isolates, including historical and contemporary drug-resistant organisms, obtained in Pakistan between 1998 and 2016: 5 Serratia, 3 Salmonella, 3 Enterobacter, and 34 Klebsiella.

Investigation of multidrug-resistant plasmids from carbapenemase-producing Klebsiella pneumoniae clinical isolates from Pakistan.

Objectives: The study aim was to investigate multidrug-resistant (MDR) plasmids from a collection of 10 carbapenemase-producing Klebsiella pneumoniae clinical isolates identified within the same healthcare institution in Pakistan. Full characterization of the MDR plasmids including structure, typing characteristics, and AMR content as well as determination of their plasmid-based antimicrobial susceptibility profiles were carried out. Methods: Plasmids were isolated from 10 clinical isolates of Klebsiella pneumoniae, and from a corresponding set of Escherichia coli transconjugants, then sequenced using Nanopore/Illumina technology to generate plasmid hybrid assemblies. Full characterization of MDR plasmids, including determination of next generation sequencing (NGS)-based AMR profiles, plasmid incompatibility groups, and types, was carried out. The structure of MDR plasmids was analyzed using the Galileo AMR platform. For E. coli transconjugants, the NGS-based AMR profiles were compared to NGS-predicted AMR phenotypes and conventional broth microdilution (BMD) antimicrobial susceptibility testing (AST) results. Results: All carbapenemase-producing K. pneumoniae isolates (carrying either blaNDM-1, or/and blaOXA-48) carried multiple AMR plasmids encoding 34 antimicrobial resistance genes (ARGs) conferring resistance to antimicrobials from 6 different classes. The plasmid incompatibility groups and types identified were: IncC (types 1 and 3), IncFIA (type 26) IncFIB, IncFII (types K1, K2, K7, and K9), IncHI1B, and IncL. None of the blaNDM-1 and blaESBL-plasmids identified in this study were previously described. Most blaNDM-1-plasmids shared identical AMR regions suggesting potential genetic material/plasmid exchange between K. pneumoniae isolates of this collection. The majority of NGS-based AMR profiles from the E. coli transconjugants correlated well with both NGS-based predicted and conventional AST results. Conclusion: This study highlights the complexity and diversity of the plasmid-based genetic background of carbapenemase-producing clinical isolates from Pakistan. This study emphasizes the need for characterization of MDR plasmids to determine their complete molecular background and monitor AMR through plasmid transmission between multi-resistant bacterial pathogens.

Positive feelings of caregiving among Latino Alzheimer's family caregivers: understanding the role of spirituality.

This study used structural equation modeling to examine the effects of spirituality on positive aspects of caregiving (PAC) among a sample of American Latino family members caring for a relative with Alzheimer's disease (AD). Participants consisted of 209 Latino caregivers (CGs) drawn from baseline data from the Resources for Enhancing Alzheimer's Caregivers Health II study. The findings indicate that spirituality is positively related to PAC and may partially mediate the effect of subjective stress on PAC. AD CGs typically provide better care when they perceive the caregiving experience to be satisfying and rewarding. Toward this end, gerontological practitioners should adopt a proactive stance to ensure Latino AD CGs can operationalize their spiritual strengths.

Spirituality and religion: intertwined protective factors for substance use among urban American Indian youth.

BACKGROUND AND OBJECTIVE: This article explores the aspects of spirituality and religious involvement that may be the protective factors against substance use among urban American Indian (AI) youth. METHODS: Data come from AI youth (N = 123) in five urban middle schools in a southwestern metropolis. RESULTS: Ordinary least squares regression analyses indicated that following Christian beliefs and belonging to the Native American Church were associated with lower levels of substance use. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Following AI traditional spiritual beliefs was associated with antidrug attitudes, norms, and expectancies. Having a sense of belonging to traditions from both AI cultures and Christianity may foster integration of the two worlds in which urban AI youth live.