Factors Associated with Drug Treatment Entry Patterns Among Hispanic Women Injection Drug Users Seeking Treatment

SUMMARY

This paper examines patterns of drug treatment entry and factors that are associated with these patterns among 1,849 Hispanic women injection drug users (IDUs). The data analyzed originates from a statewide drug-treatment database covering seven years, 1996–2002. Through the use of logistic regression analyses, the study identified significant differences in predisposing, need and enabling factors in the use of detoxification only, residential treatment, or methadone maintenance. Compared to other Hispanics, Puerto Rican women were 40 percent less likely to use only detoxification services and one and a half times more likely to use methadone maintenance. Having health insurance was an especially important factor associated with methadone treatment utilization. Two of the most important factors associated with residential treatment use were history of mental health services utilization and involvement with the criminal justice system. This article discusses specific social work practice implications including the need for social work practitioners to promote services such as residential treatment, to be trained in treatment of co-occurring mental health disorders, especially among women in residential treatment, and the need to establish close linkages with the mental health and criminal justice systems.     

Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

Abstract

Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between January and April 2006. Methods: A standardized 2-tiered screening approach for an inception cohort of students utilizing primary services. Primary care providers were trained to triage students with depressive symptoms. Results: Six percent of participants had clinically significant depressive symptoms (CSD). Severe depressive symptoms were found in less than 1.0% of participants. Male rates of severe depressive symptoms were more than double that of females. Only 35.7% of untreated depressed participants started treatment within 30 days following identification. Conclusions: Systematic primary care depression screening in a college health center is a promising approach to identify untreated students with depression. More study is needed to improve rates of treatment engagement.     

Diagnosis of Pregnancy

Abstract

Contraceptive failure is a growing problem, especially on the college campus. Because of this, college health care providers are treating more and more college women not only for pregnancy-related problems, but women that present to the health center with other health complaints and are pregnant as well.

For these reasons, the diagnosis of pregnancy must always be entertained by all health care providers treating young women. Pregnancy must always be excluded before any tests or procedures are done that may be teratogenic. This is not only important for optimal health care, but also for medical-legal reasons.

This paper presents four unusual presentations of pregnancy and reviews the guidelines for diagnosis of pregnancy.     

Parent Conflict as a Mediator Between Marianismo Beliefs and Depressive Symptoms for Mexican American College Women

Abstract

Objective: The purpose of this study is to examine how marianismo is related to the depressive symptoms of Mexican American women with family conflict as a mediator. Participants: During January of 2010, 170 Mexican American women college students in a southern, Hispanic-serving institution were sampled. Methods: A mediation analysis was conducted to determine if parent conflict mediates the relationship between marianismo values and depressive symptoms. Results: Results from Barron and Kenny's¹ mediation analysis method, in conjunction with a Sobel² test indicated that parent conflict significantly mediated the relation between marianismo and depressive symptoms. Conclusion: Findings and implications of the mediation will be discussed for the mental health and treatment of Mexican American women college students.     

Drinking Patterns,Problems, and Motivations Among Collegiate Bisexual Women

Objective and Participants: The authors compared the drinking behaviors, motivations, and problems of collegiate bisexual women with those of heterosexual women (N = 2,788; n = 86 bisexual women). Methods: Data came from the 2003 Student Life Survey, a random population-based survey at a large midwestern university. The authors explored the hypothesis that bisexual women would be more likely than heterosexual women to report drinking motivations related to stress and coping as a result of sexual identity stigma. Results: They found that bisexual women drank significantly less than did heterosexual women. There were few differences between the 2 groups in drinking motivations and problems. Bisexual women reported a comparable number of problems related to their drinking but were significantly more likely to report contemplating suicide after drinking than were heterosexual women. Conclusions: More research is needed to understand the finding that despite lower levels of alcohol consumption, bisexual women reported a comparable number of drinking problems. College health educators and health care providers need to be aware of findings related to heightened suicidal risk among bisexual women.     

Psychiatric Symptoms and Perceived Need for Psychiatric Care After Divorce

Abstract

The study investigated level of psychiatric symptoms and perceived need for psychiatric care among recently divorced males and females. Furthermore, various demographic factors and characteristics of the marriage and divorce related to psychiatric symptoms and perceived need for psychiatric care, were identified. Six hundred fifty eight recently divorced males and females living in five different counties in Norway participated. Their level of psychiatric symptoms was compared with the general Norwegian population. Divorced individuals had substantially higher level of psychiatric symptoms as compared to the general population. No consistent gender differences were observed. For both males and females, level of conflict with the ex-spouse and being leaver or being left, were the variables being most strongly related to psychiatric symptoms and need of psychiatric care. However, the variables accounted for only a modest proportion of the variance in the mental health outcome.     

Patterning in Citations: An Analysis of References to George Herbert Mead

Abstract

Family work in dual-earner families has been studied extensively, but the focus has been primarily on household tasks and child care, neglecting the component of health care behavior. In this paper, I introduce scales to study the performance of family health care behaviors in dual-earner families. The items assess topics such as who arranged and accompanied family members to health care appointments, who left work early or took time off from work for health care, and who handled the paperwork of medical expenses. The sample consisted of 174 married women employed in health care and education. The study results indicate that the health care scales are reliable. They are also not highly correlated with demographic variables that might affect the utility of the scales to examine how health care behaviors are linked to other family work.     

GEOGRAPHICAL PERSPECTIVES ON SAFE MOTHERHOOD IN THE HILL COUNTRY OF SRI LANKA: A CASE STUDY OF THE DORAGALA TEA PLANTATION IN PUSSELLAWA

ABSTRACT

In comparison with other South Asian countries, Sri Lanka maintains well-developed health care systems. Nonetheless, limited health care services are provided to mothers and children in the hill country. This research raises a series of questions concerning current challenges for safe motherhood, such as health care services already present, spatial distribution of health care professionals, and health policy in the hill counties of Sri Lanka. The authors argue that to understand the existing infrastructure of health care systems and future challenges to provision of health care services, it is important to depict the spatial location of health care units and to recognize the complexity of interactions between these units and the social, economic, and health environment. Such assessment provides a human geography approach that investigates health care systems in spatial dimensions. This study uses the geographical techniques of Geographic Information Systems and Global Positioning Systems to answer the fundamental questions of “what is where,” “why is it there,” and “why do we care.” The questions underline the importance of spatial methodology in assessment of safe motherhood and the importance of accurate and precise knowledge about the status of maternal health.     

Culturally-Protective Health Practices

ABSTRACT

Everyday pregnancy care may play an important role in explaining why Mexican immigrant women have positive birth outcomes despite relatively low incomes, low formal education levels, and lack of access to medical care. The paper is based on findings from a qualitative study utilizing in-depth ethnographically-in-formed interviews with 41 Mexican immigrant women in Chicago who had recently given birth. Results indicate that everyday pregnancy care guides maternal behaviors in pregnancy and has important effects on birth weight. Implications for the design of prenatal health care and social services for immigrant women are discussed.     

Student and faculty perceptions about mandatory influenza vaccinations on a health sciences campus

Objective: To examine the perceptions among faculty and health professional students regarding mandatory vaccination policies on a health sciences campus. Participants: A total of 296 faculty and 244 students completed surveys during Fall 2015. Methods: The online survey administered to individuals who received the influenza vaccine during the fall 2015 influenza vaccination clinic season included five items evaluating perceptions of employer mandatory vaccination requirements. Results: Chi-square analysis indicated that although faculty and students agree mandatory vaccinations in a health care environment are appropriate, faculty are more likely than students to get vaccinated in the absence of a mandate. Additionally, a small fraction of faculty would consider employment elsewhere when facing this mandate. Conclusions: Overall, faculty and students had favorable perceptions about mandatory influenza vaccine policies. Since students were less likely to be vaccinated in the absence of a mandate, education of students should be improved to support the importance of vaccinations in a health care environment.     

Evolve Therapeutic Services: A 5-year outcome study of children and young people in out-of-home care with complex and extreme behavioural and mental health problems

BackgroundLittle evaluation research has been conducted on the effectiveness of services and intervention provided to children in out-of-home care. This study evaluated an innovative Queensland, Australia program employing a collaborative wrap-round model of care in combination with a flexible intervention approach, individually tailored to children and young people in out-of-home care presenting with complex and extreme behavioural and mental health problems.MethodThe sample consisted of 664 children and young people. Two clinician-rated measures, the CGAS and HoNOSCA, were used to assess young people's functioning via a pre-post-treatment design.ResultsResults revealed significant improvements across a range of problems areas: general functioning and adjustment; disruptive, antisocial and aggressive behaviour; overactivity, poor attention and concentration; non-accidental self-injury; problems with scholastic and language skills; non-organic somatic symptoms; emotional symptoms; peer and family relationships; self-care and independence; and school attendance.ConclusionFindings provide good evidence for the effectiveness of the therapeutic intervention program. Implications for future research are explored.     

Residential group care workers' recognition of depression: Assessment of mental health literacy using clinical vignettes

BackgroundResidential group-care workers have a critical role to play in recognizing mental health problems amongst children in their care. However, little is known about the extent to which workers recognize and respond to mental health and behavioral concerns.MethodA sample of 124 residential group care workers completed an online survey in which vignettes of children experiencing either internalized or externalized symptoms of depression and ‘typical’ behavior were presented. In order to explore aspects of mental health literacy, workers were asked to rate each vignette for severity of a specific mental health concern (adolescent depression), portrayed as internalized or externalized behavior. Ratings of worker confidence and concern for the young person were also obtained.ResultsWorkers were able to recognize the existence of depression in these fictional vignettes. Depression in the presence of externalized behavior was rated as both more severe and more concerning than depression accompanied by internalized behaviors. Furthermore, workers had greater confidence in endorsing the presence of a mental health issue when accompanied by externalized behavior compared to an internalized presentation.ConclusionsResidential group-care workers are able to recognize the existence of depression amongst children in their care. Externalized presentation of mental health appears to be more easily recognized by workers and they are also more confident in identifying mental health concern when it is accompanied by externalized, compared with internalized behaviors. The implications for training and support of residential group care workers are discussed.     

Ethnicity and Health Service Use in a Women's Prison

ABSTRACT

This paper highlights the findings in relation to health need, ethnicity, and health service use among a sample of women in prison. Medical records review for 129 women and interviews with 15 women were conducted to determine factors associated with differential service use. Statistical analyses reveal that ethnicity and an interaction between ethnicity and whether one is on medication at prison admission (a health need variable) significantly predict extent of service use. Women of color use fewer services overall, with the exception of those on medication. Qualitative analyses reveal that women of color view the quality of medical care and the ways they are treated less positively than White women. Implications for equitable service provision are explored.     

Gender Preference toward Providers of Genital Examinations and Frequency of Genital Self-Examination among College Students

Abstract

Both male and female students who utilize Brandeis University Health Services for primary care were assessed regarding their preference as to the gender of providers of genital examinations, together with the frequency with which each sex and academic class performs genital self-examinations, during a two-month period of the 1981 Spring Semester, using a brief self-administered questionnaire.

Among 234 undergraduate and graduate student men and women who returned questionnaires, women and men preferred to be examinated by same-sex examiners; less than half of the women and nearly none of the men would want a chaperone present during the examination, even when the examiner is not the same gender. An increasing percentage of these young women perform breast examinations as they get older, but there is no comparable rise in testicular self-examinations with increasing age among the men. It is important for physicians who care for adolescents and young adults in university health services to provide access to same-gender health care providers when genital exams are done. It is also important to educate men about testicular examinations, just as women are educated about breast examinations.