COBRA compliance: guidelines for employers.

Employers should review their COBRA compliance procedures to make sure that they are consistent with the proposed Internal Revenue Service regulations. The author discusses these regulations and gives practical recommendations for compliance. Until final regulations are published, employers are advised that compliance with the proposed regulations will constitute good-faith compliance with the statute.     

Medication management, antidepressant drugs, and the elderly: an overview.

1. Several factors may affect an elderly client's use of medications: polypharmacy, potentially leading to interactions; over-the-counter drugs taken without a physician's knowledge; noncompliance or poor compliance with medication regimens; and ageist beliefs. 2. Psychiatric nurses must be aware that the signs and symptoms they observe may be the result of normal physical or biological aging, psychosocial changes, disease-related changes, medication side effects, or a drug interaction. 3. Nurses must ask two questions when psychotropic drugs are used with elderly clients: What will be the onset, duration, magnitude, and characteristic action of a specific drug in an individual; and What are the characteristics of an "ideal" medication?     

Do it yourself. Medication management for community based clients

1. Nurses in mental health-care settings have many opportunities to influence and promote health-care behaviors through the use of long-term education programs for their clients. 2. Acquisition and mastery of client-centered medication management skills increases the likelihood of client participation in treatment at the community level. 3. Psychiatric impairment among clients may require modification of usual teaching strategies. A variety of approaches enhances the success of an education program for this client population. 4. Psychiatrically impaired clients have the right to information and education. Nurses need to continue to develop skill with regard to patient education for this challenging group.     

Family life education: a treatment modality.

Family life education is a long-established form of help that continually ramifies into new areas. It aims at healthier family living, and reduction of family breakdown and child placement. Most child welfare personnel know about family life education, and some are practitioners in it. Many, however, may not be familiar with its present extensiveness or method of organization and operation. This personalized account of one agency's program, presented at the CWLA Central Regional Conference in Detroit, 1975, provides useful information.     

Leadership in education: Effective U.K. college principals

College leaders face increasing challenges to manage complex responsibilities. They must possess a wide variety of managerial and leadership skills to be successful in academic environments, which are beginning to resemble more traditional organizational frameworks. The study examined in this article explored the relationships among managerial style, organizational climate, and several measures of college‐student performance with a sample of British further education college principals (similar to U.S. community college presidents). While considering the influence of various background factors, such as the size of the college, student funding, and years of experience, several significant relationships emerged demonstrating a significant association between principals' managerial behaviors and measures of college and student performance.     

Smoking education and prevention: a developmental model.

A developmental approach to smoking education and prevention for children and adolescents is proposed. Literature is reviewed concerning the most appropriate agent, content, and presentation, of anti-smoking education for each of three age groups: children to age ten, pre/early adolescents eleven to fifteen, and adolescents fifteen to eighteen. For children to age ten, it is suggested that parents are the best agents of education, with teachers, peers, and the mass media, also playing some role. For pre/early adolescents, peers are suggested as the best agents of education, building onto the earlier and ongoing work of the agents mentioned above. For adolescents, the role of the media hero-figure is discussed. It is emphasized that sources of influence may function additively in affecting the child or adolescent's decisions about smoking, and that education in each stage must build on the stage before.     

Relationship of interpersonal behaviors and health-related control appraisals to patient satisfaction and compliance in a university health center

OBJECTIVE: The authors' aim was to evaluate patient-provider relationships in a college health center. PARTICIPANTS: Eighty student patients and their health-care providers. METHODS: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before and after the consultation. They evaluated their satisfaction with care and compliance after the consultation and again 2 weeks later. Providers completed measures of their participatory behavior and patients' interpersonal behavior after the consultation. RESULTS: Patients preferred to be well informed and to have their preferences taken into account, and generally felt competent at managing their own health affairs. They indicated they obtained the high level of participation they desired. Patients desired and actually experienced friendly and submissive providers. Degree of match between patients' desired and actual level of involvement in their care was associated with greater satisfaction. A greater match between the extent to which they desired the provider to be affiliative and the provider's actual affiliative behavior was associated with more satisfaction. No variables were predictive of patient compliance. CONCLUSION: The authors discuss results in terms of the influence of situational factors characteristic of a college health center.     

Interracial rape: Examining the increasing frequency argument

A number of researchers have recently challenged the long-held notion among criminologists that rape, along with most other violent crimes, is an intraracial crime. Based on analysis of survey data they concluded that black rapists “prefer” or “seek out” white victims and that the likelihood of a black offender selecting a white victim has been increasing during recent years. Data presented here (1977–88 National Crime Surveys) refute the notion that black rapists “prefer” white victims. Moreover these same data fail to support the contention that rapes involving black offenders and white victims have been increasing. According to National Crime Survey estimates, the proportion of black offenders that victimize whites has been declining. An earlier version of this paper was presented at the annual meetings of the American Society of Criminology, November 1991.     

Toward increasing avian diversity: urban wildscapes programs

Residential development in urban and suburban settings is a major cause of habitat change affecting avian communities. The effects from land-clearing prior to initiation of construction followed by landscaping focused on traditional aesthetics has reduced habitat diversity at multiple levels. These residential developments generally emphasize the use of ornamental, nonindigenous vegetation with little to no concern for native species and natural vegetation parameters. As a result, avian community composition and diversity is changed. We compared avian communities at three sites in Bexar County, Texas; two residential neighborhoods in the city of San Antonio and an unincorporated undeveloped site, Government Canyon State Natural Area. The residential neighborhoods were a Texas Parks and Wildlife Department certified wildscapes development and a traditionally developed neighborhood. Bird abundance and species richness in the neighborhoods were greater than at Government Canyon State Natural Area (P < 0.01), but no differences existed between the neighborhoods. Bird diversity was greatest at the wildscapes neighborhood (P < 0.01). Further, bird diversity did not differ between the traditional neighborhood and the natural area. Evenness differed among sites (P = 0.006) with the natural area having the greatest value. Bird diversity measures correlated with woody plant density and vertical cover (r = 0.358 to 0.673, P < 0.05) at residential sites. Residential areas incorporating natural landscapes into their design attracted a greater variety of birds than traditionally landscaped residential areas.     

Perceptions of seclusion: comparing patient and staff reactions.

Seclusion, or the use of locked, closely monitored containment, is widely used in psychiatric practice and is legally sanctioned. Involving humanitarian, ethical, and legal issues, seclusion poses dilemmas and raises questions for health-care professionals. Among those defending the practice, some would argue that it is used reluctantly and only as a last resort, whereas others consider it to be a positive therapeutic treatment modality, whether used alone or in conjunction with other treatments. Opponents of seclusion disagree, considering seclusion to be punitive, arbitrary, and geared toward serving the needs of other patients and staff. Although professionals have interpreted seclusion differently with regard to its function, efficacy, and impact, the vast majority of patients view it negatively. Wadeson and Carpenter (1976) found that individuals interviewed 1 year after seclusion still felt bitter about the experience; for many, that experience symbolized their entire psychiatric illness.     

Sexual compliance: gender,motivational, and relationship perspectives

This paper provides a systematic review of research on sexual compliance in heterosexual relationships. Three perspectives shed light on which individuals are the most likely to comply with a sexually interested partner's desire for sex and why. A gender perspective highlights the common male-female asymmetry in compliant sexual behavior and identifies factors that contribute to women's greater likelihood of being the sexually compliant partner. A motivational perspective distinguishes between approach and avoidance motives for compliance and considers the possible consequences of these motives for emotional reactions, sexual risk taking, and sexual violence. A relationship maintenance perspective views sexual compliance as illustrative of broader patterns of sacrifice in committed relationships. Each perspective suggests important new directions for empirical research.     

The “Other” Effects of Psychotropic Medication: Social Workers’ Perspectives on the Psychosocial Effects of Medication Treatment on Adolescent Clients

This study explores social workers’ perspectives on the psychosocial effects of psychotropic drug treatment of their adolescent clients. Using a mail survey, we asked a national sample of experienced clinical social workers to answer questions about their perceptions of the effects of such treatment on the sense of self and social well-being of an adolescent client. The survey questions also explored associations between perceived psychosocial medication effects and characteristics of the client and the treatment. The findings suggested that social workers viewed medication treatment as having greater beneficial than harmful psychosocial effects on their adolescent clients, but that both effects existed simultaneously. The most important factors associated with the perceived effects of medication that emerged from social workers’ reports included the etiology of the disorder, the type of drug treatment and its effectiveness in addressing symptoms, the client’s “competence,” and the quality of the relationship between the client and the treating social worker. This study provides direction for future research on a neglected but important question. It would be helpful to broaden the scope of professional discourse on the advantages and disadvantages of psychopharmacologic treatment for youth beyond the effectiveness or safety of the treatment to include questions concerning clinicians’ perceptions of the effects of drug treatment on youths’ sense of self and social well-being.