Quality improvement in patient distribution at a major university student health center

Healthcare in a major university setting poses unusual challenges and great opportunities. Two traditionally challenging areas in patient distribution are the initial intake of allergy/immunization patients and the triage of outpatients in the general medical clinic. The authors describe the use of the FOCUS-PDCA quality improvement (QI) problem-solving process for each situation. After identifying major problems, the health center established cross-functional teams of experts representing the allergy/immunization and general medical clinics. The teams analyzed the problems with a flow chart and undertook studies to further elucidate causes and potential solutions. They listed potential solutions in order of priority and submitted them to the student health center director for review and initiation. Each team then used the PDCA (plan-do-check-act) cycle to put approved solutions into effect. Permanent improvements made in each area resulted in a more effective and efficient patient distribution system, favorable staff comment, and greater patient satisfaction.     

"I Am the Man!" Performing gender and other incongruities

The following essay details the genesis of the performance "I Am the Man" for the First International Drag King Extravaganza. In it the authors explain both their autobiographical performances and the relationship between their drag performances and transgender theory by linking Shakespeare to queer theory and by overlapping their personal narratives.     

Social support as a mediator of revictimization of low-income African American women

Mediating effects of social support on the link between childhood maltreatment and adult intimate partner violence (IPV) were explored in a sample of 362 low-income, African American women. We examined relations between childhood maltreatment experiences (total maltreatment, sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect) and adult maltreatment (physical IPV and nonphysical IPV). Results of hierarchical multiple regression analyses revealed small, but significant, effects. Further, social support mediated revictimization. Social support fully mediated relations in which the form of childhood maltreatment was different than the form of adult IPV (e.g., the relation between childhood sexual abuse and adult nonphysical IPV), but only partially mediated the relations in which the form of childhood maltreatment was similar to adult IPV (e.g., the relation between childhood emotional abuse and adult nonphysical IPV). Implications for clinical interventions for women with intimate partner violence experiences are discussed.     

Why Study Risk Perception?

Studies of risk perception examine the opinions people express when they are asked, in various ways, to characterize and evaluate hazardous activities and technologies. This research aims to aid risk analysis and societal decision making by (i) improving methods for eliciting opinions about risk, (ii) providing a basis for understanding and anticipating public responses to hazards, and (iii) improving the communication of risk information among laypeople, technical experts, and policy makers.     

Conducting Large‐Scale Surveys in Secondary Schools: The Case of the Youth On Religion (YOR) Project

There are few published articles on conducting large‐scale surveys in secondary schools, and this paper seeks to fill this gap. Drawing on the experiences of the Youth On Religion project, it discusses the politics of gaining access to these schools and the considerations leading to the adoption and administration of an online survey. It is concluded that successful research in schools has to be planned carefully in collaboration with key members of staff, and justified as an educational activity. Providing speedy feedback was helpful to ensure schools benefited from the research and to keep them engaged with the project. © 2011 The Author(s). Children & Society © 2011 National Children’s Bureau and Blackwell Publishing Limited     

Drinking Game Participation Among Undergraduate Students Attending National Alcohol Screening Day

Abstract

Objectives, Participants, Methods: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007. Results: A large percentage of the sample reported lifetime (77%) and recent (52%) drinking game participation. Males were more likely to report recent participation and reported higher levels of consumption while playing drinking games. Drinking game participants were more likely to experience a range of alcohol-related problems, and the relationship between drinking game participation and alcohol-related problems was mediated by weekly alcohol consumption. Conclusions: These results suggest that drinking game participation is a risk factor for elevated levels of alcohol consumption and alcohol-related problems. Programs should be developed to educate students about the risks of drinking game participation, and prevention programs like NASD should address drinking games.     

Combining Occurrence and Toxicity Information to Identify Priorities for Drinking-Water Mixture Research

Characterizing all possible chemical mixtures in drinking water is a potentially overwhelming project, and the task of assessing each mixture's net toxicity even more daunting. We propose that analyzing occurrence information on mixtures in drinking water may help to narrow the priorities and inform the approaches taken by researchers in mixture toxicology. To illustrate the utility of environmental data for refining the mixtures problem, we use a recent compilation of national ground-water-quality data to examine proposed U.S. Environmental Protection Agency (EPA) and Agency for Toxic Substances and Disease Registry (ATSDR) models of noncancer mixture toxicity. We use data on the occurrence of binary and ternary mixtures of arsenic, cadmium, and manganese to parameterize an additive model and compute hazard index scores for each drinking-water source in the data set. We also use partially parameterized interaction models to perform a bounding analysis estimating the interaction potential of several binary and ternary mixtures for which the toxicological literature is limited. From these results, we estimate a relative value of additional toxicological information for each mixture. For example, we find that according to the U.S. EPA's interaction model, the levels of arsenic and cadmium found in U.S. drinking water are unlikely to have synergistic cardiovascular effects, but the same mixture's potential for synergistic neurological effects merits further study. Similar analysis could in future be used to prioritize toxicological studies based on their potential to reduce scientific and regulatory uncertainty. Environmental data may also provide a means to explore the implications of alternative risk models for the toxicity and interaction of complex mixtures.     

Telling a Good Story: Using Narratives in Vocational Rehabilitation With Veterans

Because of the high chronicity of work-related problems in a Veterans Administration Medical Center population, many of the traditional methods of career assessment, counseling, and placement have proven ineffectual. In this article the authors detail the development of an intervention based on narrative or storytelling principles. They describe efforts to introduce this model to patients as well as to relate patients' stories to vocational outcomes. The usefulness of stories as an organizing principle for counselors and clients is discussed, and suggestions are offered for further uses of storytelling interventions.