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Despite inverse associations with insulin resistance and adiposity, adiponectin has been associated with both increased and decreased risk of cardiovascular disease. We examined whether adiponectin is associated with total and cardiovascular mortality in older adults with well-characterised body composition.We analysed data from 3,075 well-functioning adults aged 69–79 years at baseline. Mortality data were obtained over 6.6 ± 1.6 years. We used Cox proportional hazards models adjusting for covariates in stages to examine the association between adiponectin and total and cardiovascular mortality.There were 679 deaths, 36% of which were from cardiovascular disease. Unadjusted levels of adiponectin were not associated with total or cardiovascular mortality. However, after adjusting for sex and race, adiponectin was associated with an increased risk of both total mortality (hazard ratio 1.26, 95% CI 1.15–1.37, per SD) and cardiovascular mortality (hazard ratio 1.35, 95% CI 1.17–1.56, per SD). Further adjustment for study site, smoking, hypertension, diabetes, prevalent heart disease, HDL-cholesterol, LDL-cholesterol, renal function, fasting insulin, triacylglycerol, BMI, visceral fat, thigh intermuscular fat and thigh muscle area did not attenuate this association. This association between adiponectin and increased mortality risk did not vary by sex, race, body composition, diabetes, prevalent cardiovascular disease, smoking or weight loss.Higher levels of adiponectin were associated with increased risks of total and cardiovascular mortality in this study of older persons.

Summary: A Thoroughbred colt with a history of dystocia was referred for further management of suspected hypoxia. The foal showed signs of neonatal maladjustment syndrome and hindlimb paralysis. Radiography revealed the presence of a severe lumbosacral injury. The foal was subjected to euthanasia due to a hopeless prognosis. Computed tomography was performed post‐mortem and revealed a type I Salter Harris fracture of the cranial physis of the first sacral vertebra. [ABSTRACT FROM AUTHOR]

Over the course of history, people living with mental illness who have the experience of being confined in institutional settings have made significant impacts in their efforts to reform and transform the mental health service delivery system. This article will examine individual, social, and political forces influencing a movement of interested stakeholders, once confined, who became inspired to create a peer-operated service model. This model will be described, including types of the peer-delivered services. An overview of peer-operated services research will be discussed briefly, including the development of two fidelity instruments. This article will provide the historical context in regards to how the peer-operated service model evolved and why the peer-operated service model should be considered an important resource for mental health systems transformation. [ABSTRACT FROM AUTHOR]

During the early part of 2003, as part of the Collaborative Support Programs of New Jersey (CSP-NJ) quality improvement and program evaluation process, we organized an effort to examine quality-of-life ratings of supportive housing and services participants. We were able to complete interviews with 134 supportive housing and services participants using the Lehman Quality of Life Interview-Brief version (Lehman, Kernan, & Postrado, n.d). The interview is organized into nine general areas: life in general, living situation, daily activities and functioning, family, social relations, finances, work and school, legal and safety issues, and health. In addition, some demographic information was also included. Specifically, information about gender, age, marital status, and length of stay with CSP-NJ supportive housing and services program was also collected. The interview consisted of 86 items, and data were collected during a one-on-one interview. Participation in this survey was voluntary and interviews were conducted in location of the participant's preference (mainly their homes). The CSP-NJ board of directors and quality improvement department approved the interview protocol for this program evaluation project. This section is divided into two main parts. Part I will contain descriptive information based on the data collected from all 134 participants. Part II will assess whether or not differences exist between males and females and individuals younger than the median age, compared to those older than the median age. In addition, differences in quality of life based on length of stay with CSP-NJ was also assessed and is reported. [ABSTRACT FROM AUTHOR]

As part of its broad array of services to foster wellness, recovery, and economic self-sufficiency for individuals with disabilities, the Institute for Wellness and Recovery Initiatives at Collaborative Support Programs of New Jersey (CSP-NJ) offers a monthly newsletter, Words of Wellness. This publication features valuable information and resources, including details about educational events, to help people to achieve and maintain wellness. The purpose of the newsletter is to bring useful information to readers, whether pursuing recovery themselves, supporting recovery in clients or family members, helping to administer and change our mental health and related services system, or researching the field and educating future practitioners. The authors are the co-editors of Words of Wellness. The following will present some examples from this publication. The majority of these articles were developed by the authors unless otherwise noted. [ABSTRACT FROM AUTHOR]

Why Examine Peer-Operated Self-Help Centers? There has been a growing knowledge base that describes the feasibility and value of peer-operated services. An abundance of unpublished peeroperated service literature was discovered during my review of the research literature. Most research consisted of descriptive program reports and surveys of member characteristics. In the early 1990s, a number of researchers made attempts toward more rigorous examination; however, few studies have examined distinct aspects of a peer-operated service environment and its associations with outcomes. Empowerment and satisfaction are two outcomes identified by mental health peer leaders and studied with scales developed to measure these constructs. Peer-operated services seem to offer a unique service and environment that offer peers both an alternative and a complement to traditional mental health services. The literature is very limited regarding the association between social environment and participant outcomes in peer-delivered services. As the level of public resources for these services increased, the need for an evaluation of their effectiveness seemed warranted. In order to provide further support for peer-operated services as an adjunct to traditional mental health services, it seemed important to better understand characteristics of the peer-operated self-help center environment and their relationships to participant outcomes. Few studies have examined the relationship among the variables of empowerment and satisfaction as related to variables of the social environment, and none have used self-report. This is a dimension of great importance in the studies of self-help models. [ABSTRACT FROM AUTHOR]

This manuscript has revealed the vast array of practical services and resources that have been designed and delivered by persons living with mental illness. This article will present a unique service organization, Collaborative Support Programs of New Jersey (CSP-NJ). This agency is considered a leader in creating a vast range of these resources designed to meet the needs of people living with mental illness. The history of CSP-NJ parallels the mental health consumer-survivor self-help movement described in the article ''Historical Perspective -- From Institution to Community'' (this issue). Many of the services portrayed in this issue (self-help centers, wellness, and recovery programs and the peer employment support project) were conceived by leaders and innovators at CSP-NJ. This section will offer a snapshot of some of the other CSP-NJ innovations in order to further demonstrate how peer-operated services can be an instrumental resource for mental health systems transformation. [ABSTRACT FROM AUTHOR]

Consumer-operated self-help centers were designed to provide social environments that promote participant empowerment and satisfaction. This exploratory, descriptive study examined how variance in empowerment and satisfaction scores could be explained by participants' perceptions of the social environment factors (relationship, personal growth, and systems maintenance and change) and quantity of participation. Participants (N = 144) involved in consumer-operated self-help centers completed a four-part, 161-item survey designed to capture perceptions of satisfaction, empowerment, social environment factors, quantity of center participation, and demographic data. Significant relationships were found between participant satisfaction and the three social environment factors. Findings also indicated that participant empowerment was related to quantity of self-help center involvement. From these exploratory analyses, recommendations are made on how to improve consumer-run self-help center operations. [ABSTRACT FROM AUTHOR]

Despite the well-documented effectiveness of psychiatric medication, studies reveal that it is used by only approximately half of those for whom it is prescribed. Whereas large-scale studies have focused primarily on the consequences of not taking medication as prescribed, a number of recent qualitative studies have tried to understand the phenomenon from the perspective of consumers. Findings have revealed that nonadherence may not always reflect psychopathology or a lack of insight, but rather a personal choice directed toward engaging in activities that provide meaning and purpose. In this article, we review the literature on medication use, emphasizing the importance of the practitioner-consumer relationship. We also present a recovery-oriented perspective to understand consumers' choices regarding medication use and discuss practical guidelines for psychiatric nurses. [ABSTRACT FROM AUTHOR]

To create a mental health system focused on recovery, consumer-operated services, for which an evidence base is emerging, should be promoted. Consumer-operated services have become a viable, cost-effective model designed to provide social support and recovery opportunities for people diagnosed with a psychiatric disability who are living in the community. This article describes the consumer-operated services model and uses a self-help center as an example. The core components of consumer-operated self-help centers are outlined. Qualitative data gathered through a larger study of self-help centers is presented. The article highlights the benefits of and areas for improving this innovative resource, which offers many advantages and opportunities for people living with a psychiatric disability in the community. [ABSTRACT FROM AUTHOR]

This program represents an innovative approach to traditional money-management services. This asset-building, financial self-management service model has the potential to positively affect recovery, self-sufficiency, and community integration for people with mental illnesses. It is hoped this program will be replicated by other providers in a way that may effect systems change. [ABSTRACT FROM AUTHOR]

Objective: Many people receiving services for psychiatric disorders live on low incomes, navigate complex financial situations, and have limited economic security. The authors sought to determine whether a financial wellness intervention delivered virtually by peers would increase financial literacy, reduce economic strain, and improve financial competency., Methods: One hundred participants receiving services for psychiatric disorders were recruited from community programs and via social media and were randomly assigned (1:1) to receive either an intervention called Building Financial Wellness (N=51) or services as usual (N=49). The intervention involved six virtual 1.5-hour group sessions, followed by three virtual one-on-one booster sessions. Outcomes were assessed with the Consumer Financial Protection Bureau's Financial Well-Being Scale (primary), Financial Strain Questionnaire, Financial Capability Scale, and Financial Self-Sufficiency Scale. Knowledge regarding money management was measured with a financial literacy assessment based on class content. Intent-to-treat longitudinal multivariable analysis included random-effects linear and logistic regression models., Results: Overall, 86% of the study participants either lived in poverty (46%) or met the federal definition of low income (40%). Participants assigned to the intervention had greater improvement over time in financial well-being, capability, strain, self-sufficiency, and literacy. Satisfaction with the intervention was high. Reports from participants receiving booster sessions indicated that ongoing support facilitated their achievement of longer-term financial goals., Conclusions: Provision of financial education and support improved monetary well-being, competence, and literacy. With poverty long considered to be an intractable problem associated with psychiatric disorders, peer-taught financial education focused on financial wellness can help people acquire money management skills and manage economic stressors., Competing Interests: The authors report no financial relationships with commercial interests.

Objective: Wellness has been associated with various general medical and mental health outcomes; however, few empirically supported measures capture the breadth of the wellness construct. The first author had previously developed the Wellness Inventory through an iterative process with key stakeholders to establish face and content validity and examined the psychometric properties of the Wellness Inventory as a tool for assessing wellness across eight dimensions., Methods: The authors assessed the Wellness Inventory by using data from self-report online surveys in three samples of data collected from two groups of respondents: students and faculty members in a public university and behavioral health providers (N=3,446; 50% White and 43% female). Exploratory and confirmatory factor analyses and data from samples 1 and 2 were used to examine the factor structure and fit of the inventory. Data from sample 3 were used to assess test-retest reliability and convergent and discriminant validity., Results: Factor analyses yielded a one-factor model comprising 54 items. A revised instrument based on this model revealed good fit to the data, internal consistency, and test-retest reliability and reasonable construct validity., Conclusions: The Wellness Inventory is a comprehensive and psychometrically valid tool for assessing wellness. The findings support a single dimension of wellness, suggesting wellness as a holistic, general construct. This inventory has implications for research on health promotion and prevention and clinical outcomes in both research and treatment., Competing Interests: The authors report no financial relationships with commercial interests.

Research shows that guests experience peer-run respites as empowering and safe places where they feel more seen, heard, and respected than they do in conventional settings. This column describes the successful and unique processes of peer-run respites that support guests in emotional crisis and facilitate healing. In a discussion informed by their experiences and the literature, the authors examine how peer-run respites differ from conventional psychiatric crisis response services in their basic philosophy: how emotional crisis is understood, the goal of crisis response, how trauma is viewed, the importance of self-determination, power dynamics, and relationality., Competing Interests: The authors report no financial relationships with commercial interests.

Peer support models have existed for decades in behavioral health care and are being developed for health care professionals to help address high rates of burnout and stress in the health care environment. Such models typically involve individuals from the same profession. With the concurrent increase of interprofessional integrated behavioral health care models, interprofessional peer support seems a viable model. This Open Forum describes how a peer support program for physicians and faculty scientists evolved to include a broader range of health care professionals, providing a framework for interprofessional peer support programs for the behavioral health care workforce., Competing Interests: The authors report no financial relationships with commercial interests.

There is growing awareness of the significant mental health impacts of the COVID-19 pandemic on many Americans. Less is known about the effects on individuals who were living with mental health conditions prior to the pandemic's onset. In addition, little research has explored how this group is coping positively with the challenges of COVID-19. Understanding the strengths these individuals bring to pandemic demands and disruptions can inform recovery for these individuals in the aftermath of this public health emergency. Using results from a cross-sectional, online survey administered during April and May 2020, we use qualitative methods to examine how individuals with symptoms of depression and anxiety were coping with COVID-19. Participants were recruited from two networks of statewide behavioral health community programs in New Jersey and New York. Data come from 48 participants who reported current symptoms of anxiety assessed by the Generalized Anxiety Disorder-2 Scale and/or depression assessed by the Patient Health Questionnaire-2. These respondents demonstrated resilience in navigating disruptions brought on by COVID-19 and reported a range of healthy coping strategies. We identified three themes characterizing successful coping strategies, including utilizing social support systems, practicing self-care, and adjusting one's mindset to deal with challenging experiences. When designing programs, policies, and clinical approaches to support people with mental health conditions, it is essential to focus on strengths. The coping strategies shared by the individuals in this study demonstrate and build on their resilience. More research is needed to discover the strengths people exhibit to deal with the challenges caused by the COVID-19 pandemic., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.