Dying patients' thoughts of ending their lives: a pilot study of rural New Mexico

Forty-nine hospice patients in rural New Mexico were directly interviewed concerning their thoughts about ending their lives. Thirty-one patients (63%) did not have thoughts of ending their lives, whereas 18 patients (37%) reported having suicidal thoughts. There were no differences between patients with and without thoughts of suicide related to gender; ethnicity; age; education; disease; religion; importance of religion; location of hospice agency; remaining financial, family, or spiritual issues; satisfaction with hospice care; sum of hospice personnel seen; or sum of medical equipment used. There were significant differences between patients with and without thoughts of suicide related to the number of household members (p = .02); the symptoms of trouble sleeping (p = .04) and nervousness (p =.03); and Medicare insurance coverage for hospice care (p =.01). No other symptom, including pain and hopelessness, was significant. Seven (39%) of the 18 patients who thought of ending their lives told someone about these thoughts. There were no variable differences between patients who did and did not tell someone about these thoughts.     

Musculoskeletal symptoms among dentists in relation to work posture

OBJECTIVE: To determine the effect of work posture on musculosketal complaints in Israeli dentists. METHODS: The population included 60 male dentists mean age was 46.0 (+/- SD 8.66), 30 worked in sitting position and 30 were altering positions. Study population completed the standardized Nordic questionnaire and informative form concerning recipient's practice of dentistry, bio-demographic variables and questions about workloads. RESULTS: Musculoskeletal symptoms in the last 12 months were localized primarily in the lower back and in the neck (55% and 38.3% respectively). There was a significant correlation between the time spent sitting and the severity of low back pain (r = 0.41, p = 0.01). On the other hand there was no significant correlation between time spent sitting and other musculoskeletal complaints (r = - 0.16). CONCLUSIONS: Dentists who work in the sitting position have more severe low back pain than do those who alternate between sitting and standing despite the fact that those who sat at least 80% of the time worked less hours and had less of a workload during their working hours. This suggests that altering position should be recommended to dentists. An intervention study, however, is needed to demonstrate that changing posture will decrease the prevalence of low back pain in dentists.     

Early Family Transitions and Depressive Symptom Changes From Adolescence to Early Adulthood

Some research and theory suggest that early cohabitation, parenthood, and marriage have negative long‐term implications. Nevertheless, in the context of their resources and opportunities, early transitions may represent positive choices for some individuals. We studied the family and personal characteristics of young adults (N = 8,172) who did, versus those who did not, make early family transitions. We assessed changes in their depressive symptoms from adolescence to young adulthood. Individuals who made early family transitions were disadvantaged in many respects, but differed little from those who did not with respect to changes in depressive symptoms. That they stay “even” with those who do not make transitions suggests that some young adults make positive choices from among limited options.     

Ergonomics evaluation of a government office building

An ergonomics team from the US Army Center for Health Promotion and Preventive medicine evaluated 465 video display terminal (VDT) workstations in a Government office building over an 18-day period. Each workstation evaluation involved an assessment of the worker, the chair, the desk, the keyboard, the pointing device, the monitor, and the office environmental conditions. The team also collected worker pain and injury information. The problems seen during the evaluation were characteristic of most office environments where VDT workstation furniture was purchased before the advent of mouse-driven software. The majority of furniture evaluated was not designed to meet the demands of intensive mouse use for prolonged periods of time. Much of the workstation furniture was not adjustable, chairs lacked adequate back support, and workers assumed non-neutral postures. As a result, more than 35% of the workers evaluated complained of on-the-job pain. New office furniture that is adjustable, adequate desk space and storage space were among the solutions recommended by the ergonomics team.     

Body image, body satisfaction, and unsafe anal intercourse among men who have sex with men

Using survey results from the 1998 Twin Cities Lesbian, Gay, Bisexual, and Transgender (LGBT) Pride Festival (N = 535), we explored associations between body image and unsafe anal intercourse (UAI) among men who have sex with men (MSM), and evaluated whether body satisfaction mediated this association. MSM who reported underweight body image had lower odds than those who reported average weight of UAI (AOR = 0.33; 95% CI = 0.13, 0.85); body satisfaction was not found to mediate this association. 13.3% of men who reported overweight/obese body image had engaged in UAI compared with 21.6% of those who reported average weight and 8.2% of those who reported underweight (p < .05). Compared with MSM in exclusive relationships, MSM in non exclusive relationships had increased odds of UAI (AOR = 5.78; 95% CI = 2.96, 11.29) as did men who were not partnered (AOR = 3.20; 95% CI = 1.72, 5.93). These findings highlight the importance of including body image in sexual behavior models of MSM to better understand body image's role in influencing sexual risk and sexually transmitted infections (STI)/human immunodeficiency virus (HIV) transmission.     

Recurrent pain in college students.

The authors investigated the prevalence of recurrent pain in a college student sample. Of the 1,564 students surveyed, 467 (29%) indicated that they had experienced recurrent pain at an intensity that was mostly in the mild-to-moderate range. Students who reported having recurrent pain were significantly older and more depressed than students who did not indicate they suffered from recurrent pain. Pain intensity was positively correlated (r = .14) with depression among the students who reported having recurrent pain. Implications of the findings for future research, treatment, and health promotion efforts are discussed.     

Cryotherapy for treatment of ECT-induced headache

Because headache is a common side effect of electroconvulsive therapy (ECT), this study sought to determine the effectiveness of cryotherapy (i.e., a frozen gel band) in relieving pain in patients with post-ECT headaches, and whether headache intensity and physiological measurements could predict use of an alternative analgesic (rescue medication). We used a quasi-experimental, crossover design to collect data from 31 patients ages 24 to 85 who had been referred for ECT at two medical facilities in San Diego, California. Measurements of patients' pain intensity were made at three intervals: upon perceiving headache, and at 30 and 60 minutes following the cryotherapy or acetaminophen interventions, based on the order of the crossover design. Data were analyzed using Hotelling's T2 and logistic regression. No significant difference was found between cryotherapy and acetaminophen in relieving ECT-induced headaches (p = .420). There was no influence due to the crossover design (p = .313), nor where there significant changes in physiological measures from treatment (p = .420). Logistic regression showed that 50% of patients required rescue medication after 60 minutes for both treatments (R2 = .498, p = .001), and 66% required rescue medication based on pain level and physiological measures (R2 = .662, p < .008). Based on these results, cryotherapy is an alternative treatment that may be helpful to some patients with ECT-induced headaches.     

It takes a team: Improving placement stability among children and youth with Fetal Alcohol Spectrum Disorder in care in Canada

Concerted efforts have been devoted to improving placement stability for children in care. These efforts have been driven by evidence of negative outcomes for foster children who experience frequent placement changes. Of particular concern are significantly higher rates of placement disruptions among children in care who experience Fetal Alcohol Spectrum Disorder (FASD). This mixed methods study examines the impact of enhanced child welfare practice interventions on placement stability for 182 children in care who experience FASD. A quasi-experimental matched comparison group design was employed, where rates of placement change were compared between children in the Project Regions who received enhanced practice standards to those in the Comparison Regions who did not. The sample included 182 participants including 98 children and youth in care from the Project Region and 84 cases from the Comparison Region. The Project Regions reported considerably lower placement changes (M = .33) than the Comparison Region (M = .98). Logistic regression analysis revealed that worker contact was found to be predictive of placement stability. Specifically, as worker contact increased, the likelihood of placement change decreased [B = − .28, W (5.35, p = .02)]. In keeping with the adage that it takes a village to raise a child, one could add for children affected by FASD, that it takes a dedicated team to promote placement stability and better life trajectories.     

A validity scale for the Sharp consumer satisfaction scales.

Because of the apparently inflated scores commonly reported for consumer satisfaction with mental health services, we developed a 5-item validity scale for the SHARP questionnaire. The scale discriminated significantly (P less than .001) between those former clients who offered suggestions for improvement of services and those who did not (N = 38). In another experiment, the scale significantly improved the ability to predict the 46 clients' true scores from their obtained scores via stepwise regression (p less than .01). Weights were obtained from that sample of former clients, which significantly reduced the deviation of the obtained satisfaction scores from the true scores, with all p less than .05. In two successive experiments (N = 49 and 26), weights were applied to new samples, significantly reducing deviation from the criterion scores for 5 of the 6 scales (p less than .05), and new weights were then derived. A final set of weights was derived from the combined samples of the three experiments, (N = 121) which significantly improved prediction of the criterion and lowered the mean on all scales, with all p less than .05.     

Repression and other Forms of Cognitive Evasiveness: Implications for Stress Symptoms in College Students

Abstract

Lazarus has proposed that palliative defenses against threat that interfere with direct efforts to alleviate the threat may prove maladaptive. Three evasive cognitive attributes that circumvent awareness of threat were studied to determine whether they related to the prevalence of stress symptoms in college students. Repression (selective forgetting of threatening material), awareness of the repressive defense, and internal scanning (breadth of association to cues) were considered. College students of both sexes who engaged in evasive cognitive activity reported more stress symptoms than those who did not, with a progressive increase in stress as increasingly homogeneous groups were considered. Students who defended themselves by repression experienced more stress than those who did not. Repressors who were the least aware of their use of this defense reported even more stress. Unconscious repressors who were the least reflective (narrow scanners) showed the highest frequency of stress symptoms.     

Divorced Father with Custody

Telephone interviews were conducted with 56 fathers who had obtained at least one-third custody of their child, an average of 4.9 years prior. Contrary to the widespread assumption among divorce professionals, there were no significant difference on measures of divorce adjustment between those who had obtained custody through mediation (n = 16) versus through litigation (n = 16), and only one near significant difference comparing these two groups to those who obtained custody through mutual agreement with their former spouse (n = 24). The interview included the Self-Worth, Social Self-worth and Social Trust subscales of the Fisher (1978) Divorce Adjustment Scales, plus items on work adjustment, symptoms of distress, and self-improvement courses attended. Correlations of background variable's with these divorce adjustment measures suggested that single-parent fathers were likely to be better adjusted if they were older and had completed college, if they had older children and greater percentages of custody, and if they were dating.     

Context matters: The state of racial disparities in mental health services among youth reported to child welfare in 1999 and 2009

Upwards of 50% of youth reported to the child welfare system (CWS) do not receive mental health services, despite need. While children of color are less likely to receive services than Caucasians, the mechanisms through which disparities are sustained remain largely unknown. Data come from two nationally representative cohorts of youth who were referred to the CWS in 1999 and 2009. Results showed that while need for mental health services decreased, significant differences in the number of children who received services was not detected between cohorts. African American youth were less likely to receive services compared to their Caucasian counterparts, even after controlling for age, gender, type of maltreatment, and placement instability. However, after taking into account urbanicity, poverty, and the organizational-social context, the disparity between African American and Caucasian youth dissipated. Service disparities between Latino and Caucasian youth were not detected. The odds of service receipt were lower among youth nested within stressful organizational climates and urban (versus rural) counties, and the organizational-social context did not moderate the relationship between race and service receipt. Findings underscore the need to develop and implement strategies to increase access to services in urban counties and to promote an organizational climate conducive to reducing racial disparities.     

Sexual minority youth in romantic relationships: Associations with youth well-being

This study investigated differences in depressive symptoms, loneliness, and self-esteem for monosexual (lesbian, gay) and plurisexual (bisexual, pansexual, queer) sexual minority youth (SMY) by relationship status (single, partnered) and relationship configuration (same-gender partner, different-gender partner). Participants included 338 SMY (M_age = 19.10 years) who reported on their relationship status, partner's gender identity, well-being, and ability to confide in partner about LGBTQ issues. Results indicated that for plurisexual youth, single status was associated with greater loneliness; plurisexual youth with same-gender partners reported fewer depressive symptoms and marginally greater ability to confide in their partner about LGBTQ issues than those with different-gender partners. Findings reveal similarities across SMY while also highlighting some unique challenges among plurisexual youth with different-gender partners.     

Understanding perpetrators of nonphysical sexual coercion: characteristics of those who cross the line

Sexual coercion is defined here as a form of male sexual misconduct in which nonphysical tactics (e.g., verbal pressure) are utilized to gain sexual contact with an unwilling female partner. This study compares the risk characteristics of sexually coercive (n=81) and nonoffending college males (n=223) across several domains. Results revealed that sexual coercers differed from nonoffenders in that they more often subscribed to rape myths, viewed interpersonal violence as more acceptable, reported greater hostility toward females, and perceived male-female relationships as more inherently adversarial. In addition, compared to nonoffenders, sexually coercive males showed stronger indicators of promiscuity and delinquency, reported more psychopathic personality traits, had more empathic deficits, and were more likely to have experienced certain forms of childhood abuse. In most respects, coercers did not differ from those who reported engaging in more severe forms of sexual assault involving the use of physical force. These results suggest important differences between nonoffending males and those who "cross the line" by engaging in sexually coercive acts. In addition, consistent parallels can be drawn between the predictors of sexual coercion identified in this study and those documented in the sexual aggression (e.g., forcible rape) literature.     

Barrier versus oral contraceptive use: a study of female college students

Although they provide birth control and are easier to use, oral contraceptives (OCPs) are not the preferred approach to preventing sexually transmitted disease (STD). Do the knowledge, attitudes, and experiences of oral contraceptive users place them at greater risk for STDs than those who employ barrier methods? This study examined differences between sexually active female college students (ie, those who reported ever having had vaginal intercourse) who used OCPs and those who employed barrier methods of contraception at the time of their most recent intercourse. The authors analyzed HIV- and other STD-related knowledge, attitudes, and behaviors from three consecutive annual health surveys of young women about to begin their first year of college. Findings showed barrier and OCP users to be comparable in knowledge about the effectiveness of various contraceptive methods in protecting them against STDs, perceived personal susceptibility to HIV, and experiences with alcohol before sexual intercourse. Oral contraceptive users, compared with those in the group who used barrier methods, reported a greater number of recent partners (p less than .03) and greater perceived vulnerability to STDs (p less than .03). Student healthcare providers must develop creative educational strategies to encourage simultaneous use of both oral contraceptives and barrier methods to protect students against STDs and pregnancy.     

The effects of life events and interpersonal loss on exercise adherence in older adults

Associations of life events and interpersonal loss with participation in home- and group-based exercise were studied in 97 older adults (64 % women, 70.2 +/- 4.1 years). Life events were assessed with a modified Social Readjustment Rating Scale at baseline and 6 and 12 months. Exercise logs and class-attendance records documented exercise participation. Participants experienced 3.62 +/- 3.56 unique life events over the course of the study, and 28 participants reported an interpersonal loss (5 men, 23 women). Number of life events was negatively associated with home-based exercise participation (p <.05); among women, this association approached significance (p =.06) for class-based exercise. Women who experienced an interpersonal loss had lower class-based participation than those who did not (p =.02), but home-based participation rates were unaffected. Life events, particularly interpersonal loss, appear to have a negative impact on exercise in women, and this effect appears greater for class-based than for home-based exercise.     

Earnings mobility of first and "1.5" generation Mexican-origin women and men: a comparison with U.S.-born Mexican-Americans and non-Hispanic whites

"This study addresses the following questions: Are Mexican immigrants closing the earnings gap with greater time in the United States, compared to U.S.-born Mexican Americans and non-Hispanic whites? What factors are most important in determining their earnings? How are earnings determinants different for women versus men, and those who came to the United States as children, versus those who came as adults and those born in the United States?... With greater time in the United States, male immigrants achieve average earnings comparable to U.S.-born Mexican Americans, but not to non-Hispanic whites, controlling for human capital variables. With greater time in the United States, female immigrants approach the number of hours of paid work of U.S.-born women, but not the earnings received per hour. Gains in earnings associated with age, time in the United States, and English proficiency differ by gender, reflecting structural differences in the labor market."