New Family Care Model Aids At-Risk Families

Monday, September 7, 2009

Many families struggle on a day-to-day basis with insufficient in-home care or problematic out-of-home care for their emotionally or behaviorally troubled children and adolescents. Researchers have recently shown that an integrative family care model, which incorporates the strengths of external agencies and care providers, may be the answer. The latest issue of Family Process features this new model.

The I-FAST system was developed specifically to assist families dealing with a diversity of ongoing, severe, emotional and behavioral issues. Its foundational techniques are based on evidence-based practices found within the mental health and psychotherapy communities.

I-FAST allows clinicians, therapists, case managers, and agencies working with at-risk children, adolescents, and families to modify and creatively tailor their approach to meet the needs of their clients. These measures can not only improve the child's and family's situation and overall functioning level, but can also reduce frequent out-of-home placements and train parents to directly care for their children's problems at the home with less difficulty.

The model empowers agencies such as community mental health centers to further utilize their therapists' strengths, skills and expertise. This practice in turn leads to a less costly operation. It encourages agencies to develop and cater their own home-based treatment and protocol rather than continually depend on external clinical support and monitoring. It also reduces the need for families to rely on out-of-home support at psychiatric hospitals or residential treatment facilities to handle the problems in their children.

This study is published in the September 2009 issue of Family Process.

Mo Yee Lee, PhD is a Professor at the College of Social Work at Ohio State University and has led several studies on integrative and creative social care for families.

Source:
Bethany Carland-Adams
Wiley-Blackwell

MedicalNewsToday.Com

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Scientists Create Genetically Accurate Mouse Model for Autism

Thursday, May 29, 2008

Marlene Busko

May 28, 2008 (London, United Kingdom) — Mice containing a mutation in a gene encoding neuroligin-3, which is implicated in human autism, may represent the first genetically accurate model of autism that is not confounded by other neurological diseases, researchers report.

The study, by Craig M. Powell, MD, and colleagues, from the University of Texas Southwestern Medical Center, in Dallas, Texas, showed that mice with a neuroligin-3

R451C substitution exhibited impaired social interaction but also showed superior spacial learning skills.

Dr. Powell presented these findings in an oral presentation at the 7th Annual International Meeting for Autism Research. Part of this work was recently published (Tabuchi K et al. Science. 2007;318:71-76).

"We've created the first animal model that’s a genetically accurate model of autism that’s not associated with other neuropsychiatric syndromes like fragile X syndrome, Rett's syndrome, or tuberous sclerosis," Dr. Powell told Medscape Psychiatry.

Their data suggest that this mouse model may be useful to better understand the molecular mechanism of autism and ultimately to design and test new therapeutic approaches, he added.

What Is Happening in the Autistic Brain?

During the past several years, scientists have been attempting to develop an appropriate animal model for autism, the group writes.

A small percentage of patients with autism spectrum disorder (ASD) carry mutations in genes encoding neuroligin-3 and -4, which are postsynaptic cell-adhesion molecules, they note. In addition, mutations in neuroligin binding partners, neurexin-1 and shank-3, have also been found in patients with ASD.

The team aimed to create and characterize a genetically accurate mouse model of autism by introducing a mutation linked with autism — the R451C substitution in neuroligin-3 — into mice.

The researchers examined the performance of 19 "knock-in" mice with this mutation vs 19 wild-type littermate controls in a variety of behavioral tests relevant to autism. They also performed various tests to measure synaptic protein activity.

Compared with the control mice, the R451C-mutant knock-in mice showed impaired social interaction, but they had normal anxiety, coordination, and sensitivity to pain. Interestingly, the mice with the mutated gene performed better in the Morris water maze, which showed that they had enhanced spatial learning ability.

Unexpectedly, these behavioral changes in the mutant mice were accompanied by an increase in inhibitory synaptic transmission in the cortex.

Encouraging Early Results

"These are very encouraging preliminary data," said Dr. Powell.

"What we are trying to do now is target the changes in synaptic function in these mice — the increase in inhibitory synaptic function in the cortex," he said. "We're using drugs that might reduce the level of inhibition that's abnormally elevated in the knock-in mice," he added, noting that it is hoped that this will treat the behavioral symptoms in the mice.

By looking at more mouse models and gaining a better understanding of what is wrong with the brain in autism, researchers hope to find common pathways that would some day be potential drug targets for patients, he said.

7th Annual International Meeting for Autism Research: Oral Presentation 132.1. May 15-17, 2008

taken from medscape.com

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Mental Health Nursing: The Roles of Psychiatric Nurses

Wednesday, February 27, 2008

With the introduction of newer issues and recent needs, the concepts in mental health nursing or psychiatric nursing expanded dramatically. From the need to provide nursing care for mental health patients during the end of the 19th century, nurses are nowadays commissioned to provide psychiatric-mental health services on a variety of settings.

A psychiatric nurse works on different settings such as community mental health programs, psychiatric hospitals and facilities, the academe and even in the criminal justice system. There are only two levels of psychiatric nursing: the basic and the advanced. Both of which have various responsibilities.

For the basic level, the psychiatric nurse will carry out the physician's orders. These are registered nurses who are equipped with the knowledge on developing, implementing and assessing nursing care plans; they also administer medications and provide direct nursing care. They are usually found in family-based settings, assisting the family members in dealing with a member's mental disorder. However, they may also be found in education settings where their primary role is to teach the public or other mental health care providers about mental health and psychological disorders. They may also assist with counseling and intervention.

On the other hand, registered nurses who also have a master's degree or a doctoral degree in mental health nursing could qualify as Psychiatric Nurse Practitioners. Having more advanced skills and knowledge on this field, they could practice assessments, diagnoses and treatments for patients of mental health. Depending on the state, they are also qualified to practice psychotherapy and case management, and prescribe medications. Also, they may choose to hold administrative positions in schools and hospitals and may also conduct researches of their own.

These are the basic roles of psychiatric nurses. But due to the development of further needs in the management of psychiatric disorders, the roles were expanded to meet the demands.

For example, the problems presented through the need of nursing care facilities in high security areas such as those similar in forensic nursing. The nurses working in this setting need to meet the balance between protecting the public from the potential harm caused by the patients and providing an environment that will also aim to offer therapeutic interventions.

Another change in the roles of psychiatric nurses is the extension of psychiatric services to prisons. This pose the challenge to psychiatric nurses to give the same mental health care services to inmates regardless of the boundaries set by the lack of facilities and trained people to do the work.

Lastly, the need to advance psychiatric custody to disordered individuals who are under the criminal justice system. As we may know, not all correctional institutions have dedicated units for inmates with psychiatric disorders. But in the past years, psychiatric facilities are being integrated into the criminal justice system. Because of the formation of the mental health courts, newer responsibilities were added to psychiatric nursing.

Mental health nursing, like many other professions, have met fundamental changes in the past recent years. This may be largely attributed to the improvements of newer facilities therefore newer needs for professionals which are mirrored in nursing professions. In many areas of psychiatric though, there is no doubt that there are fewer changes. However, as seen in the mental healthcare, these changes have prepared the way towards better systems and better people working in the field.

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