Alcohol-Related Problems Seen at the Student Health Services

Abstract

The number and types of alcohol-related problems seen by medical, nursing, and mental health professionals at the University of Massachusetts Health Services has been assessed since 1975 as part of a Demonstration Alcohol Education Project.

Medical outpatient clinic alcohol-related contacts using encounter forms completed on every outpatient visit during 1975 and 1976 revealed that 0.08% of approximately 92,500 visits annually were alcohol related, including 0.03% for chronic problems and 0.05% for acute problems (mainly contusions, lacerations, and fractures). Week-long contact surveys conducted in November 1976, and April 1977 recorded a much higher proportion of alcohol-related problems for over 60% of about 2,200 contacts each week. In November 1976, 1.4% of 1,346 reported visits were alcohol related, including 8.0% of contacts which occurred on weekends. In April 1977 2.7% of 1,582 reported visits were alcohol related, including 17.0% of weekend visits. No chronic alcohol problems were reported either week, and most of the acute problems involved traumatic injuries, such as contusions, lacerations, and sprains.

Mental health outpatient clinic alcohol-related contacts self-reported by students at the initial visit revealed that 5.8% of 1,179 initial visits between January 1976, and June 1977 were alcohol related, most involving their own alcohol use. Week-long contact surveys involving all 256 contacts during November 1976 and 192 contacts during April 1977 showed that 13.7% of contacts were for alcohol-related problems, over half due to alcohol abuse by someone else, such as a parent or boy/girlfriend.

The findings suggest that a significant proportion of students seen by student health services have acute rather than chronic alcohol-related problems, especially acute traumatic injuries and relationship problems.     

When bubbles burst: Mimetic insights into minimising confidentiality breaches

This paper presents a theoretical model to help managers visualise and manage confidential situations more effectively. The model metaphorically likens a confidential setting to the properties of a soap bubble, e.g. elastic expansion or contraction, minimal surface area to contain a given volume, fragility, surface tension, pressure, stress, strain and the potential for bursting thereby releasing the contents to the external environment. We explore the conceptual developments in two phases. Firstly, looking at how a bubble and confidential scenario form and grow. Secondly, we consider how a bubble may burst and map these forces to ways in which confidentiality may be breached. Many attributes are mapped, the key ones being: the embedded value within the system, the criticality of maintaining confidentiality, increasing pressure, the corresponding stress/strain dynamics and the levels of trust between stakeholders. Key research propositions are derived from the model which aims to minimise the risk of a confidentiality breach.     

Some theoretical considerations on confidential adoption part IV: Countertransference

Psychological self-awareness is as essential to the maturation of one's professional self as is the development of theoretical and clinical expertise in child placement. This paper represents a first published attempt at examining countertransference in adoption. The focus is within the context of confidential adoptions, which the authors believe is more child-focused and intrapsychically based than the current experimentation with open adoptions. A distinction is made between countertransference and non-countertransference issues. Countertransference responses are divided into Racker's three categories: the concordant; the complementary; and the disjunctive. Clinical data illustrates these responses in actual practice from the perspective of confidential adoptions.This paper was presented in 1985 before the Illinois Infant Mental Health Association, National Society of Clinical Social Workers, and the National Association of Social Workers National Professional Symposium.This is the last of a series. Parts I, II, and III were published in Vol. 2, Nos. 1, 2, and 3.     

Seroadaptive Strategies of Vancouver Gay and Bisexual Men in a Treatment as Prevention Environment

British Columbia’s treatment as prevention policy has provided free access to highly active antiretroviral therapy (HAART) to all HIV-positive provincial residents since 1996. One outcome is an increase in HIV-positive gay and bisexual men (GBM) with suppressed viral loads. Previous cross-sectional analyses indicated that some Vancouver GBM now recognize condomless anal sex with men on HAART who report a suppressed viral load as a seroadaptive strategy. To test the hypothesis that this new strategy, termed viral load sorting (VLS), is recognized and used among by GBM in the Momentum Health Study, we analyzed longitudinal data for HIV-negative/unknown (n = 556) and HIV-positive (n = 218) serostatus participants. Analyses indicated that both groups reported VLS, and that serostatus and Treatment Optimism Scale scores were significant determinants in frequency and use. Results exemplify the medicalization of sex and Rogers’ Diffusion Of Preventative Innovations Model, and they have important implications for HIV research and GBM sexual decision-making.     

Nonmedication Treatments for Adult ADHD: Evaluating Impact on Daily Functioning and Well-Being

Abstract

Professor J. Russell Ramsey has written a short book aimed at practicing mental health clinicians, describing various non-medication approaches to the treatment of adult attention-deficit/hyperactivity disorder (ADHD). It includes a variety of strategies, some of which are validated and others of which are currently being developed but do not yet demonstrate effectiveness, alongside the documented effectiveness of medications for the treatment of core symptoms of ADHD, especially inattention, hyperactivity and impulsivity. He includes an up-to-date bibliography and critical evaluations of effectiveness for each treatment, especially functional outcomes. Given the high rate of postsecondary students with ADHD, the book should be helpful for college health professionals who are trying to assist such students.     

Hope as a coping resource among parents at risk for child maltreatment

This study investigated hope as a protective factor buffering the relationships between parenting stress and well-being among a sample of parents identified at moderate to high risk for child maltreatment. Two hundred parents were recruited from a nonprofit organization providing secondary and tertiary child maltreatment prevention programs. Results of the analyses showed that parental stress was negatively associated with subjective and emotional well-being. Hope was positively correlated with well-being and negatively associated with parenting stress. Hierarchical regression analyses showed that hope had a significant incremental relationship to well-being and that the negative effects of parenting stress fell below statistical significance. These findings provide preliminary support for hope as a coping resource social workers can target when working with parents in the prevention of child maltreatment.     

Love and Hooking Up in the New Millennium: Communication Technology and Relationships among Urban African American and Puerto Rican Young Adults

Communication technology is a central feature of young people's lives, but its role in romantic and sexual relationships has not been thoroughly examined. This article describes how young adults use communication technology for partnering across relationship stages (formation, maintenance, and dissolution) and types (serious/casual), and proposes implications of usage in relationships. This study analyzed qualitative data from a five-week, prospective, coital diary method with related debriefing interviews (N = 70) of African American and Puerto Rican men and women aged 18 to 25 years in Hartford and Philadelphia. Cell phones, including calls, text messaging, and mobile Internet, were the most common forms of communication technology used for partnering goals. Participants reported using cell phones to pursue partnering goals across all relationship stages, including formation (meeting, screening, and getting to know new partners), maintaining existing relationships, and breaking up. Cell phone uses depended on the type of relationship (serious/casual) and the participants' intentions and desires. Results indicated that cell phones are an important element of communication among young adults in romantic and sexual relationships. Specific features of cell phone communication shape the process and context of partnering. Future research should explore emerging communication technologies and implications for psychosocial development, dating violence, and sexual behavior.     

Musical Ties That Bind: Nostalgia,Affect, and Heritage in Festival Narratives

Affective heritage embracement, a collective narrative of nostalgia, is identified at two popular music festivals. “MusicFest” embraces a tradition of “Red Dirt” country music through performance (music festival), whereas the “Walnut Valley Festival” embraces a bluegrass/folk musical heritage through performance and participation (musicians' festival). The symbolic importance of musical interaction is explored to highlight the experienced emotionality that leads to the affective ties that bind these otherwise temporary communities. This collective narrative reveals the various functions of nostalgia wherein collective sentiment both reflects and creates the perceived authentic experiences of festival attendees.     

New Issues in an Old Dilemma: The Confidentiality of Mental Health Records

Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey instrument developed by the ACHA in 1998 to assist institutions of higher education in achieving this goal. The ACHA-NCHA contains approximately 300 questions assessing student health status and health problems, risk and protective behaviors, access to health information, impediments to academic performance, and perceived norms across a variety of content areas, including injury prevention; personal safety and violence; alcohol, tobacco, and other drug use; sexual health; weight, nutrition, and exercise; and mental health. Twice a year, the ACHA compiles aggregate data from participating institutions in a reference group report for data comparison. Results from the Spring 2004 Reference Group (N = 47,202) are presented in this article.