Seth Latimer

Time to Prison Return for Offenders With Serious Mental Illness Released From Prison A Survival Analysis

Serious mental illness (SMI) represents a major risk for repeated incarceration, yet recidivism studies often do not specifically focus on persons with SMI as compared to non-SMI offenders. The study reported here systematically identified Utah State prisoners released from 1998 to 2002 (N = 9,245) who meet criteria for SMI and compared SMI and non-SMI offenders on length of time to prison return. Findings indicate that 23% of the sample met criteria for SMI (n = 2,112). Moreover, survival analyses demonstrated a significant difference in return rates and community tenure for offenders with SMI compared to non-SMI offenders when controlling for demographics, condition of release, offense type, and condition of return (parole violation vs. new commitment). The median time for all SMI offenders to return to prison was 385 days versus 743 days for all non-SMI offenders, 358 days sooner (p < .001). Implications of these findings are discussed.

Women, serious mental illness and recidivism: A gender-based analysis of recidivism risk for women with SMI released from prison

&NA; Two groups now constitute the fastest growing segment of the U.S. prison population: women and persons with mental illness. Few large‐scale studies have explored associations among serious mental illness (SMI), gender, and recidivism, or compared factors such as illness severity and clinical history as these construct notably different situations for incarcerated women and men. We report on our recent study comparing prison recidivism rates, severity of mental illness, and clinical history for women and men released from Utah State Prison 1998–2002. Implications: While women generally have better recidivism outcomes than men, we find that SMI related factors have a greater negative effect on the trajectories of women in this sample as compared with the men. This suggests that programs and policies focused on the SMI‐specific risks and needs of women could significantly reduce prison recidivism and increase community tenure for this group, with far‐reaching effects for families and communities.

High call volume at poison control centers: identification and implications for communication

Context. High volume surges in health care are uncommon and unpredictable events. Their impact on health system performance and capacity is difficult to study. Objectives. To identify time periods that exhibited very busy conditions at a poison control center and to determine whether cases and communication during high volume call periods are different from cases during low volume periods. Methods. Call data from a US poison control center over twelve consecutive months was collected via a call logger and an electronic case database (Toxicall®).Variables evaluated for high call volume conditions were: (1) call duration; (2) number of cases; and (3) number of calls per staff member per 30 minute period. Statistical analyses identified peak periods as busier than 99% of all other 30 minute time periods and low volume periods as slower than 70% of all other 30 minute periods. Case and communication characteristics of high volume and low volume calls were compared using logistic regression. Results. A total of 65,364 incoming calls occurred over 12 months. One hundred high call volume and 4885 low call volume 30 minute periods were identified. High volume periods were more common between 1500 and 2300 hours and during the winter months. Coded verbal communication data were evaluated for 42 high volume and 296 low volume calls. The mean (standard deviation) call length of these calls during high volume and low volume periods was 3 minutes 27 seconds (1 minute 46 seconds) and 3 minutes 57 seconds (2 minutes 11 seconds), respectively. Regression analyses revealed a trend for fewer overall verbal statements and fewer staff questions during peak periods, but no other significant differences for staff-caller communication behaviors were found. Conclusion. Peak activity for poison center call volume can be identified by statistical modeling. Calls during high volume periods were similar to low volume calls. Communication was more concise yet staff was able to maintain a good rapport with callers during busy call periods. This approach allows evaluation of poison exposure call characteristics and communication during high volume periods.

Caregiver, patient, and nurse visit communication patterns in cancer home hospice

Few studies have examined the triadic communication between patients, spouse caregivers, and nurses in the home hospice setting. Thus, little is known about the types of communication patterns that unfold. The goals of the study were to, first, identify common patterns of communication in nurse‐patient‐caregiver home hospice visits and, second, to identify nurse, caregiver‐patient dyad, and visit characteristics that predict visit communication patterns.

Communication among cancer patients, caregivers, and hospice nurses: Content, process and change over time

OBJECTIVE First, to describe communication of home hospice nurse visits to cancer patient-caregiver dyads. Second, to assess change in communication related to domains of care over the course of visits. METHODS Multi-site prospective observational longitudinal study of audio-recorded home hospice visits (N=537 visits; 101 patient-caregiver dyads; 58 nurses). Communication was coded using the Roter Interaction Analysis System to describe content and process. Conversation representing three care domains (physical, psychosocial/daily life, and emotional) was calculated from RIAS categories across speakers and analyzed to assess change in communication over time. RESULTS On average, nurses spoke 54% of total utterances, caregivers 29%, and patients 17%. For all participants, the predominant conversational focus was on physical care. Linear mixed effects models indicated that combined participant emotional talk showed a small systematic decrease over time; however, the results for all domains indicated variability unexplained by time or speaker effects. CONCLUSIONS Home hospice conversations are predominantly focused on physical care. Systematic change in communication versus responsiveness to the dynamic effects of patient death and family response over time are discussed. PRACTICE IMPLICATIONS Communication strategies already in use by hospice nurses could be leveraged and expanded upon to better facilitate family competence and confidence.

Communication patterns for the most serious poison center calls

Context. The communication demands faced by specialists in poison information (SPI) are unique in the health-care context. Objectives. (1) To describe SPI communication patterns for the highest risk poison exposure calls using cluster analysis, and (2) to describe variation in communication patterns or clusters. Methods. A sample of 1 year of poison exposure calls to a regional poison control center with SPIs’ perceived severity rating of major or moderate perceived was collected. Digital voice recordings were linked with medical records and were coded using the Roter Interaction Analysis System. Descriptive analyses were applied, and cluster-analytic techniques were used to assess variation in call communication and factors associated with that variation. Results. Cases were described, and four communication styles were identified. The informational cluster represents calls with relatively high levels of SPI clinical information and caller questions. The Facilitative cluster represents calls with a pattern of relatively high SPI questions and caller information provision. The Planning cluster represents calls with relatively high levels of SPI relationship talk. The Emotional cluster represents calls with relatively high caller and SPI emotion. Further analyses revealed relationships between call characteristics, SPI identity, and cluster membership. Conclusion. This study provides a beginning step to understanding SPI communication behaviors. Our results suggest that SPIs are able to use a range of communication strategies that often involve not only information but also emotional responsiveness and rapport building. Findings also point to the opportunity for future communication training for SPIs to meet the needs of the heterogeneous caller population.

Positive emotion communication: Fostering well-being at end of life

OBJECTIVE Little is known about positive emotion communication (PEC) in end-of-life care. This study aims to identify types and patterns of PEC among hospice nurses, caregivers, and patients. METHODS A coding system based on positive psychology theory was applied as a secondary analysis to audio recordings of hospice nurse home visits with cancer patients and family caregivers, collected as part of a prospective longitudinal study. Eighty recordings (4 visits from 20 triads) were coded for humor, connection, praise, positive focus, gratitude, taking joy/savoring, and perfunctory statements. RESULTS Descriptive statistics revealed the greatest proportion of PEC was made by nurses. Humor was most frequently used across all speakers. Cluster analysis revealed four PEC visit types: Savor/Take Joy; Humor; Perfunctory; and Other-focused Expressions of Positive Emotions. Linear mixed effect regression was used to estimate the trajectory of PEC over time, but no significant change was found. CONCLUSION We found that positive emotions are common in nurse, caregiver and patient communication at end-of-life and do not decline closer to death. PRACTICE IMPLICATION This study is among the first to explore PEC at end-of-life, and offers a way to bring strengths-based approaches into end of life communication research.

Attitudes of Parents of Children with Serious Health Conditions regarding Residual Bloodspot Use

Background/Objectives: Studies have shown that the general public is supportive of newborn screening (NBS) and supportive of the storage and use of residual bloodspots for quality assurance and biomedical research. However, the attitudes of parents of children with serious health conditions have not been assessed. In this study, we assessed attitudes of parents with children who have phenylketonuria (PKU) and leukemia towards NBS and storage and use of residual bloodspots for research. Methods: A total of 49 individuals were recruited and responded to a validated 41-item survey regarding NBS and the retention and use of residual bloodspots. Of these participants, 22 had a child with PKU and 27 had a child with leukemia. We compared their responses to those of 1,927 individuals from the general public obtained in a previous study using the same survey instrument. Results/Conclusions: We found that parents of children with a serious health condition had higher levels of support than the general public towards the use of residual NBS samples for research but similar attitudes regarding choice and privacy protections. It is important to assess the attitudes of various stakeholders for policy development.