An Exploratory Study on the Role of Burnout and Devaluation among Staff in Psychiatric Correctional Facilities

Author(s):  
Lindamarie Olson ◽  
Robin Gearing ◽  
Berenice Pérez Ramírez ◽  
Luis R. Torres

Correctional staff work in demanding job environments that can lead to increased burnout. Research aims were to determine the prevalence of burnout and devaluation of consumers (i.e., individuals in their care) and their families among correctional staff, examine associations between burnout and devaluation of consumers and their families, and determine significant predictors of burnout. This exploratory study investigated 30 correctional staff in a specialized psychiatric correctional facility for individuals with mental illness in Mexico City. Correctional staff experienced low to moderate burnout, reported high levels of devaluation of consumers (DCS), and low levels of devaluation of consumers’ families (DCFS). The implications of burnout on DCS and DCFS warrant large scale research and should compare burnout and devaluation in specialized psychiatric correctional facilities versus general correctional facilities.

Author(s):  
Alan E. Kazdin

This chapter places the challenge of reducing the burdens of mental illness in broader contexts and progresses from these to concrete recommendations on how to proceed toward next steps. The notions of wicked problems and grand challenges provide two contexts for understanding the challenge. From broad concepts, the chapter moves to means of addressing challenges and making progress in concrete ways to reduce the burdents of mental illness. Illustrations are provided of promising efforts in relation to physical health, mental disorders, and substance use and abuse. The critical role of assessment, especially large-scale surveillance measures from public health, is also discussed.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 337-337
Author(s):  
Markus Rojewski ◽  
Natalie Fekete ◽  
Daniel Fuerst ◽  
Philippe Bourin ◽  
Ramin Lotfi ◽  
...  

Abstract Abstract 337 Background: MSC cells can differentiate into different tissues and exhibit non-HLA-restricted immunosuppressive properties. They are promising candidates for cellular therapy. Therapeutic use requires large-scale GMP-grade expansion of MSC. Several protocols have been published. Here we systematically compare different expansion procedures with particular emphasis on role of cytokines/chemokines in the expansion medium. Materials and Methods: Bone marrow (BM) was obtained by aspiration from the iliac crest of healthy donors after informed consent and IRB approval. BM aspirate (anticoagulated with heparin (500 U/ml)) was incubated without manipulation in 5-chamber stacks (CellStacks; Corning) in a medium free of animal components (α-MEM (Lonza) with 10% human platelet lysate (hPL)). In the single-step protocol 1.2×104 MNC/ cm2 were seeded. Non-adherent cells were washed off after 72–96 hrs. Partial medium exchange (40%) was performed twice a week (wk). After 11 days MSC were harvested by incubation with recombinant trypsin (TrypZean, Lonza). In the two-step protocol 5×104 leukocytes/cm2 were seeded in 2-chamber stacks. Non-adherent cells were removed after 72–96 hours and complete medium exchange was performed twice/wk. Cells were harvested after 10 days and the harvest was seeded in a 2nd culture at a density of 0.4×104 MSC/cm2. This 2nd culture was harvested after 5 days. Cytokines/chemokines in hPL and in culture medium during the course of expansion was measured by Milliplex MAP Kit (Millipore Corp). Surface marker expression was measured on FACSAria and FACScan. Results: Higher number of MSC could be achieved in cultures with hPL compared to fetal calf serum. hPL was equally effective in supporting MSC proliferation if prepared from apheresis platelet concentrates (PC), buffy coat-derived pooled PC in plasma or pooled PC in additive solution. hPL contained large amounts of PDGF-AB/BB (790 ng/ml; mean of 3 batches of hPL from buffy coat-derived pooled PC), PDGF-AA (266 ng/ml), RANTES (2706 ng/ml), sCD40L (27 ng/ml), GRO (11 ng/ml), sVCAM (2511 ng/ml), sICAM (188 ng/ml). During culture, sCD40L declined rapidly to very low levels. Concentration of PDGF-AA, RANTES and sICAM remained almost stable. In contrast, PDGF-AB/BB declined to low levels (<0.007 ng/ml) in MSC expansion culture whereas concentration remained stable under the same conditions in the absence of MSC. Decline was associated with MSC numbers in the expansion. BM samples from healthy donors (n=4) were split in order to perform paired comparison of single-step vs. two-step expansion protocol. In the single-step protocol 16.3×103±5.8×103 MSC/μl BM seeded were harvested after 11±0 days. In the two-step protocol 12.0×103±4.4×103 MSC/μl BM were harvested after 10 days at the end of passage 0 and 104.0×103±60.4×103 after 5±1 days at the end of passage 1. The overall consumption of medium in the single-step protocol was substantially higher than in the two-step protocol. Phenotype of MSC from the two culture systems did not significantly differ regarding standard markers (positive for CD73, CD90, CD105, HLA-class I; neg. for CD45, CD3, CD34, HLA-DR). However, in passaging experiments we could demonstrate that proportion of MSC positive for CD49a, CD71, CCR4/CD194, CD349 and MSCA-1 decreased whereas proportion of cells positive for c-kit/CD117, CCR3/CD193, CXCR4 and CD200 increased. Conclusion: hPL-based system allows efficient expansion of MSC up to a total number >1×109 MSC from a 15 ml BM aspirate in 2–3 wks with only one passaging step. hPL is a rich source of cytokines, some of which (PDGF-AB/BB) seem to be consumed during expansion and arrive at very low concentrations at the end of the expansion culture. A two-step system provides higher number of MSC per BM cells seeded and requires less medium/culture vessels. Phenotype and differentiation capacity does not differ between single- or two-step culture. However, further passaging goes along with substantial changes of the phenotype. Previous conflicting results regarding chemokine expression of MSC might be due to differences in ex-vivo culture period. Given that chemokine receptor expression affects in-vivo behaviour of cells, MSC harvested after initial expansion (passage 0 or 1) substantially differ from older cells, emphasizing the need to highly standardize all parameters of expansion. (Supported by EU 7th Framework Programme, Projects CASCADE and REBORNE). Disclosures: Fekete: Institute of Clinical Transfusion Medicine and Immunogenetics: Employment. Fuerst:Institute of Clinical Transfusion Medicine and Immunogenetics: Employment. Schrezenmeier:Institute of Clinical Transfusion Medicine and Immunogenetics: Employment.


2018 ◽  
Vol 65 (1) ◽  
pp. 46-68 ◽  
Author(s):  
Ashleigh LaCourse ◽  
Shelley Johnson Listwan ◽  
Shannon Reid ◽  
Jennifer L. Hartman

The high rate of recidivism among those reentering the community post incarceration can be partially attributed to various barriers to reentry, including unemployment, financial difficulties, and mental illness. Learning to cope with these barriers is demanding and stressful for many people. The current article examines whether individual coping styles could act as a significant predictor of recidivism. Utilizing a cross-sectional data set collected from previously incarcerated individuals, this study examines the relationship between individual coping styles and arrest or reincarceration. Results from this study indicate a relationship between coping and arrest. Implications from this study are noteworthy given that our understanding of coping can increase the ability of the correctional staff to reduce later recidivism in the community.


2018 ◽  
Vol 42 (5) ◽  
pp. 522 ◽  
Author(s):  
Monica Taylor ◽  
Liam J. Caffery ◽  
Paul A. Scuffham ◽  
Anthony C. Smith

Objective The provision of healthcare services to inmates in correctional facilities is costly and resource-intensive. This study aimed to estimate the costs of transporting prisoners from 11 Queensland correctional facilities to the Princess Alexandra Hospital Secure Unit (PAHSU) in Brisbane for non-urgent specialist outpatient consultations and identify the cost consequences that would result from the substitution of face-to-face visits with telehealth consultations. Methods A 12-month retrospective review of patient activity at the PAHSU was conducted to obtain the number of transfers per correctional facility. The total cost of transfers was calculated with estimates for transport vehicle costs and correctional staff escort wages, per diem and accommodation costs. A cost model was developed to estimate the potential cost savings from substituting face-to-face consultations with telehealth consultations. A sensitivity analysis on the cost variables was conducted. Costs are reported from a government funding perspective and presented in 2016 Australian dollars (A$). Results There were 3539 inmate appointments from July 2015 to June 2016 at the PAHSU, primarily for imaging, general practice, and orthopaedics. Telehealth may result in cost savings from negligible to A$969 731, depending on the proportion, and travel distance, of face-to-face consultations substituted by telehealth. Wages of correctional staff were found to be the most sensitive variable. Conclusions Under the modelled conditions, telehealth may reduce the cost of providing specialist outpatient consultations to prisoners in Queensland correctional facilities. Telehealth may improve the timeliness of services to a traditionally underserved population. What is known about the topic? Specialist medical services are located in only a few metropolitan centres across Australia, which requires some populations to travel long distances to attend appointments. Some face-to-face specialist outpatient consultations can be substituted by telehealth. What does this paper add? Prisoners from correctional facilities represent one specific population that requires complex travel arrangements for specialist medical appointments. Transportation of prisoners for specialist health appointments represents a substantial cost to the government. This paper quantifies the annual cost in Queensland for transporting prisoners, taking into account fuel and vehicle costs, staff wages, per diem rates, and accommodation. In addition, it quantifies the costs of substituting face-to-face consultations with telehealth consultations. What are the implications for practitioners? This research encourages practitioners to consider using telehealth services for prisoners, as well providing an argument for tertiary centres to include telehealth as a model of care for this population. Telehealth can result in major cost savings and state and federal governments should consider implementation especially in Australia where correctional facilities and specialist services are separated by great geographic distances.


Author(s):  
Edward Shaw ◽  
Daniel J. Smith

Most psychiatric disorders have a genetic component. Mental illness tends to occur as a consequence of the dynamic interaction between genetic vulnerabilities and environmental risk factors. Future advances in public mental health should bear in mind the important role of genetics in determining mental health and well-being. Genetic research raises important ethical considerations. The challenges of discovering genetic risk factors for psychiatric disorders are outlined, along with examples of recent discoveries from large-scale genetic epidemiological research. The focus is on an age span perspective, with consideration of the role of epigenetic processes during development. Discoveries in childhood (attention deficit hyperactivity disorder), adulthood (schizophrenia and bipolar disorder) and older-age (Alzheimer’s disease) are summarized. The public health significance of psychiatric genetics is considered within the context of ongoing global efforts to understand the causes of mental illness and how this might lead to new approaches to diagnosis, classification, and treatment.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hugo Barbosa ◽  
Surendra Hazarie ◽  
Brian Dickinson ◽  
Aleix Bassolas ◽  
Adam Frank ◽  
...  

AbstractGiven the rapid recent trend of urbanization, a better understanding of how urban infrastructure mediates socioeconomic interactions and economic systems is of vital importance. While the accessibility of location-enabled devices as well as large-scale datasets of human activities, has fueled significant advances in our understanding, there is little agreement on the linkage between socioeconomic status and its influence on movement patterns, in particular, the role of inequality. Here, we analyze a heavily aggregated and anonymized summary of global mobility and investigate the relationships between socioeconomic status and mobility across a hundred cities in the US and Brazil. We uncover two types of relationships, finding either a clear connection or little-to-no interdependencies. The former tend to be characterized by low levels of public transportation usage, inequitable access to basic amenities and services, and segregated clusters of communities in terms of income, with the latter class showing the opposite trends. Our findings provide useful lessons in designing urban habitats that serve the larger interests of all inhabitants irrespective of their economic status.


2017 ◽  
Vol 76 (4) ◽  
pp. 145-153 ◽  
Author(s):  
Jana Nikitin ◽  
Alexandra M. Freund

Abstract. Establishing new social relationships is important for mastering developmental transitions in young adulthood. In a 2-year longitudinal study with four measurement occasions (T1: n = 245, T2: n = 96, T3: n = 103, T4: n = 85), we investigated the role of social motives in college students’ mastery of the transition of moving out of the parental home, using loneliness as an indicator of poor adjustment to the transition. Students with strong social approach motivation reported stable and low levels of loneliness. In contrast, students with strong social avoidance motivation reported high levels of loneliness. However, this effect dissipated relatively quickly as most of the young adults adapted to the transition over a period of several weeks. The present study also provides evidence for an interaction between social approach and social avoidance motives: Social approach motives buffered the negative effect on social well-being of social avoidance motives. These results illustrate the importance of social approach and social avoidance motives and their interplay during developmental transitions.


2016 ◽  
Vol 37 (2) ◽  
pp. 96-104 ◽  
Author(s):  
Hasida Ben-Zur

Abstract. The current study investigated the associations of psychological resources, social comparisons, and temporal comparisons with general wellbeing. The sample included 142 community participants (47.9% men; age range 23–83 years), who compared themselves with others, and with their younger selves, on eight dimensions (e.g., physical health, resilience). They also completed questionnaires assessing psychological resources of mastery and self-esteem, and three components of subjective wellbeing: life satisfaction and negative and positive affect. The main results showed that high levels of psychological resources contributed to wellbeing, with self-enhancing social and temporal comparisons moderating the effects of resources on certain wellbeing components. Specifically, under low levels of mastery or self-esteem self-enhancing social or temporal comparisons were related to either higher life satisfaction or positive affect. The results highlight the role of resources and comparisons in promoting people’s wellbeing, and suggest that self-enhancing comparisons function as cognitive coping mechanisms when psychological resources are low.


2013 ◽  
Author(s):  
Elisabeth J. Ploran ◽  
Ericka Rovira ◽  
James C. Thompson ◽  
Raja Parasuraman

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