Real Men,Real Women,Real Lives? Gender issues in learning disabilities and challenging behaviour

This article seeks to define gender issues and explores the significance of these issues for challenging behaviour in the field of learning disability. It is argued that lack of awareness about these issues contributes to the development of challenging behaviour and to difficulties in identifying the needs expressed through these behaviours, whatever their origin. Specific areas examined include models of residential provision for adults, prioritisation of service activities, attribution processes (needs identification), and the sexuality of people with learning disabilities. In each area issues are raised and the implications for service practice defined.     

Prevalence of alcohol-use disorders and alcohol-related problems in a college student sample

Most studies of alcohol consumption patterns and alcohol-related problems among college students have failed to include a diagnostic measure based on Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Applying the DSM-IV standards would facilitate an analysis of the prevalence of alcohol-use disorders and individual symptoms of those disorders. A structured diagnostic interview based on DSM-IV criteria (the alcohol section of the Substance Abuse Module) and several alcohol screening instruments were administered to 306 undergraduate students at an urban commuter campus. The prevalence of current and lifetime alcohol-use disorders, individual symptoms of those disorders, and other alcohol-related problems are reported, as well as data regarding alcohol consumption patterns and binge drinking. The data are analyzed in terms of demographic variables, including sex, ethnicity, year in school, age, and marital status of those in the sample.     

Cultural perspectives of death,grief, and bereavement

The cultural makeup of the United States continues to change rapidly, and as minority groups continue to grow, these groups' beliefs and customs must be taken into account when examining death, grief, and bereavement. This article discusses the beliefs, customs, and rituals of Latino, African American, Navajo, Jewish, and Hindu groups to raise awareness of the differences health care professionals may encounter among their grieving clients. Discussion of this small sample of minority groups in the United States is not intended to cover all of the degrees of acculturation within each group. Cultural groups are not homogeneous, and individual variation must always be considered in situations of death, grief, and bereavement. However, because the customs, rituals, and beliefs of the groups to which they belong affect individuals' experiences of death, grief, and bereavement, health care professionals need to be open to learning about them to better understand and help.     

Review of outcome research on marital and family therapy in treatment for alcoholism

This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better, and CRAFT promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics, and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate the following: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning.     

Maternal mortality: What can we learn from stories of postpartum haemorrhage?

Death from pregnancy is rare in developed countries such as Australia but is still common in third world and developing countries. The investigation of each maternal death yields valuable information and lessons that all health care providers involved with the care of women can learn from. The aim of these investigations is to prevent future maternal morbidity and mortality.Obstetric haemorrhage remains a leading cause of maternal death internationally. It is the most common cause of death in developing countries. In Australia and the United Kingdom, obstetric haemorrhage is ranked as the 4th and 3rd most common cause of direct maternal death respectively. In a number of cases there are readily identifiable factors associated with the care that the women received that may have contributed to their death. It is from these identifiable factors that both midwives and doctors can learn to help prevent similar episodes from occurring.This article will identify some of the lessons that can be learnt from the recent Australian and UK maternal death reports. This paper presents an overview of the process and systems for the reporting of maternal death in Australia. It will then specifically focus on obstetric haemorrhage, with a focus on postpartum haemorrhage, for the 12-year period, 1994–2005. Vignettes from the maternal mortality reports in Australia and the United Kingdom are used to highlight the important lessons for providers of maternity care.