When they drink too much. Nursing interventions for patients with disordered water balance

Disordered water balance affects as many as 60% of severely psychiatrically disabled persons. Most patients do not progress to the point of a medical emergency, but are in a state of mild chronic intoxication, making them unavailable for treatment and requiring nursing care to treat the effects of the chronic intoxicated state. Interventions depend on the severity of the disordered water balance and vary from teaching fluid intake control to controlling all patient access to fluids. Nursing management of water intoxication is a trial and error approach. Through a thorough assessment and close observation of the patient, the nurse can determine which interventions would be most appropriate for the patient.     

A target weight procedure for disordered water balance in long-term care facilities.

1. Water intoxication is a severe complication of disordered water balance. Hyponatremia precedes water intoxication and can be identified through abnormal diurnal weight variation. 2. The St. Louis Target Weight Procedure (STWP) is a nonintrusive method that includes a client's baseline weight, frequent weights throughout the day, a target weight of 5% above the baseline weight, and restricted fluids if the target weight is exceeded. 3. The STWP was positively related to an increase in urine concentration; thus it is successful in restoring normal fluid balance.     

Early detection of water intoxication.

1. It has been estimated that between 3% and 6% of patients in psychiatric treatment settings are affected by water intoxication. Water intoxication with consequent hyponatremia can result in disturbing clinical conditions. 2. Early detection is an important factor because of the insidious nature and rapid development of this syndrome. 3. A risk analysis for the early detection of this serious condition has been developed. It is easily administered and effective in categorizing a patient's level of risk.     

Hitting the Skids: Social Policy and the Control of Public Intoxication

Abstract

Attempts by policymakers to control public intoxication have brought only marginal success. Through an analysis of previous control models and an examination of the specific target concerns this paper endeavors to shed light upon recent public health policies affecting public intoxication control Implications of this public health model of control as applied to this particular form of deviant behavior, are discussed.     

Queer youth,intoxication and queer drinking spaces

Research on intoxicating substances and gender has developed considerably in the last 30 years, especially in the social sciences as feminist scholars highlighted the contradictory discourses about young women’s intoxication. Nevertheless, there still remain significant gaps if we are to fully understand the role and meaning of intoxication for all young people and not merely for heterosexual, cisgender young people. As a way of exploring the possible limitations of this legacy, we will examine the qualitative data from 52 in-depth interviews with self-identified LGBTQ young people. Our analysis explores the relationships between meanings of intoxication and sexual and gender identities, drinking spaces, and the extent to which notions of masculinity and femininity influence alcohol consumption and drinking practices among LGBTQ youth. As gender expressions among young people, especially those who identify as LGBTQ, become increasingly nuanced and fluid, understanding the role of social and cultural practices of alcohol consumption in the performance of sexual and gender identities may increase our understanding of the ways in which sexuality and gender influence alcohol consumption.     

Gin Lane Revisited: Intoxication and Society in the Gin Epidemic

The massive increase in gin consumption which occurred in eighteenth-century London produced a marked shift in the cultural understanding of alcohol consumption. Prior to the formalization of addiction as a medical concept, gin consumption produced both sustained legal intervention and a wealth of concerned social commentary. This suggests that the medical construction of addiction is pre-dated by a social and political problematization of intoxication, and in many ways emerges from that process. Using William Hogarth's 1751 prints Beer Street and Gin Lane as its focal point, this paper argues that intoxication raised specific political and metaphysical problems for an emergent modernity. On the one hand, Hogarth reflects a series of common anxieties over urbanization, consumption, mass production and economic prosperity. On the other hand, he articulates a relationship between art, intoxication, and social class that prefigures modernist aesthetics and practice in the late nineteenth and early twentieth centuries. This paper explores both the ways in which intoxication was problematized in the gin epidemic and how that process inflected contemporary and subsequent representations of modern life in the arts.     

A Pilot Investigation of Media Multitasking and Trauma Symptoms Among Adolescents

Effective prevention and intervention for trauma symptoms are still needed, particularly for adolescents, in whom high-risk behavior is common. This pilot study examines how media multitasking may be related to trauma symptoms in a sample of adolescent college students (N = 55). Results indicate that higher media multitasking is uniquely and independently associated with higher trauma symptoms. These results hold even after controlling for alcohol intoxication, which is commonly associated with trauma symptoms. Adolescents may be more forthcoming in revealing information about media multitasking than other behaviors commonly associated with trauma symptoms, such as alcohol and drug use. The present study provides the first evidence that media multitasking could be an additional tool for clinicians treating adolescents with trauma symptoms.     

Validation of a measure of college students' intoxicated behaviors: associations with alcohol outcome expectancies, drinking motives, and personality

OBJECTIVE: The authors aimed to develop a measure of college students' intoxicated behaviors and to validate the measure using scales assessing alcohol outcome expectancies, motives for drinking, and personality traits. PARTICIPANTS AND METHOD SUMMARY: The authors administered these measures and an inventory describing 50 intoxicated behaviors to 198 college students and conducted factor analysis on intoxicated behaviors. Logistic regression models examined relationships between intoxicated behavior dimensions and expectances, motives, and personality traits. RESULTS: Self-reported behaviors during intoxication episodes were reducible to 3 basic dimensions that formed reliable and valid scales: social, antisocial, and emotionally labile intoxication. CONCLUSIONS: Researchers can use the Intoxicated Behaviors Inventory to evaluate the effectiveness of interventions targeting drinking or to identify college students at risk for problematic consequences of alcohol use. In addition, results point to the need for community efforts to encourage more moderate drinking among college students.     

Biological Determinism and Symbolic Interaction: Hereditary Streams and Cultural Roads

This article discusses current claims to have demonstrated a biological basis for elements of human behavior. It argues that many of these are seriously flawed by their misunderstandings of the nature of culture and social interaction, which leads to the adoption of an inappropriate realist epistemology. These issues were extensively debated during the late nineteenth and early twentieth century when the intellectual and institutional boundaries between the social and biological sciences were more fluid. The arguments of that period about the role of “instinct” in human behavior are important resources for responding to the recent revival of biological determinism. As defined by Blumer and Strauss, however, symbolic interactionism has moved away from its engagement with biology. This article argues for reengagement and for a reappraisal of the historical resources available to sociologists in sifting the “imperialist” claims of biology while acknowledging the importance of embodiment as a constraint on social constructionism.     

The impact of family structure and social change on adolescent sexual behavior

This article presents a biophysical perspective on adolescent sexual feelings and behavior. The study particularly analyzes sexual attraction, desire, and mate selection as evolutionary adaptations just as important to species survival. Sex differences in mating strategies are described as part of this evolutionary adaptation. Recent research findings demonstrate how these strategies explain contemporary sexual and reproductive behavior in Western societies today, as they do sexual behavior in the past or across diverse cultures. The implications of this analysis are significant to intervention efforts to postpone sexual initiation and avert nonmarital births. Discussion on demographic and normative changes that affect adolescent sexual behavior included trends in sexual maturation and changing marriage norms. The author urges greater emphasis on the early pubertal years; increased attention to teaching adolescents more about their own sexual development; a less absolutist focus on sexual abstinence, which may be appropriate and more feasible for 12 year olds but not for 16 year olds; better and more widespread sex education at earlier ages and throughout the school curriculum; frank discussion of all the options available for those who experience an unwanted pregnancy; and same level of attention towards adolescent boys and girls.     

Alcohol and Sexual Health Behavior: “What We Know and How We Know It”

Alcohol, despite salutary associations with sexuality, has been implicated in sexual health problems. This review examines the relationship between alcohol and outcomes related to sexual health. Methodological considerations limiting causal assertions permissible with nonexperimental data are discussed, as are advantages of experimental methods. Findings from laboratory experiments are reviewed evaluating causal effects of acute alcohol intoxication on a variety of outcomes, including sexual arousal, sexual desire, orgasm, and sexual risk behaviors related to sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Several variables exerting mediating and moderating influences are identified. It is concluded that acute alcohol intoxication is capable of exerting a causal impact on multiple constituent components of sexual responding related to sexual health. Both alcohol expectancy and alcohol myopia theories have been supported as explanations for these causal effects. Furthermore, for sexual risk behavior, noteworthy recent developments include research highlighting the importance of women’s sexual victimization history and men’s condom use resistance. Limitations and implications associated with this body of research are also discussed.     

Memento Mori: The Book as a Cut

Despite Testo Junkie’s overt criticisms of psychoanalysis, this essay attempts to read the formal aspect of the work—as a process of mourning, a body-essay, an experimental protocol of intoxication—through the lens of the everyday practice of clinical psychoanalysis. Looking at the way soma erupts in the consulting room, the conundrums of agency and identity, Preciado’s (2013) work on the biopolitics of the psychopharamacopornographic era is shown to be critical to any unraveling of a symptom. On a more personal scale, Preciado’s own stated intention that the writing of the book should function as a cut, as a Memento Mori, is read in this essay as a depiction of the extreme limits one must traverse to locate an experience of desire, beneath or beyond the apparatuses of the state—something that Preciado shows as penetrating further into our lives and bodies than many of us are prepared to acknowledge.     

Collegiate-Based Emergency Medical Service: Impact on Alcohol-Related Emergency Department Transports at a Small Liberal Arts College

Abstract

Objective: The authors examined the impact of a collegiate-based emergency medical service (CBEMS) on the frequency of emergency department (ED) transports. Participants: Students transported to the ED for acute alcohol intoxication during the Fall 2008 and the Fall 2009 semesters (N = 50). Methods: The frequency of students receiving transportation to a hospital ED and the reported blood alcohol content (BAC) levels during the initial operational semester of the CBEMS were compared to those values over the same time period the previous year. Results: More than twice the number of students was transported to the ED following the introduction of CBEMS. There was no change in mean BAC levels. Conclusions: CBEMS could promote a culture conducive to increased reporting behavior, which makes the campus safer. Similar BAC levels suggest that the degree of intoxication was similar for the 2 reporting periods, but students sought emergency assistance more frequently following the inception of CBEMS.     

Recurrent issues in efforts to prevent homicidal youth violence in schools: expert opinions

Developmental research on social influences on adolescents can guide practices aimed to prevent homicidal youth violence. School shootings have repeatedly raised questions about the contributory role of bullying and entertainment violence, how news media publicity might produce copycat crimes, and whether stiffer criminal sanctions might have a deterrent effect. This article presents the thoughts and recommendations of a group of experts on these topics summarizing the current knowledge base. In brief, bullying reduction programs may be a useful early prevention effort. Television and video games with violent themes can encourage aggressive behavior, but these media can be used to teach more prosocial behavior as well. The potential copycat effects of highly publicized crimes might be diminished with more restrained reporting, although more research is needed. Finally, there is substantial evidence that increased criminal sanctions for youthful offenders have not had a deterrent effect.     

Perceptions of sexual coercion in heterosexual dating relationships: the role of aggressor gender and tactics

A large body of research has found a concerning prevalence rate of sexual coercion in heterosexual college student dating relationships; however, little research has examined how college students perceive and interpret these behaviors. In the current study we examined the impact of initiator gender and sexually coercive strategy (verbal pressure, purposeful intoxication, physical force, or control/mutual consent) on perceptions of the aggressor, victim, behavior, and relationship quality. Results indicated that men who coerce are viewed as aggressive; women who coerce are viewed as promiscuous. Targets of sexual coercion are not perceived as experiencing high levels of victimization following the incident. These findings suggest that college students do not perceive sexually coercive behaviors to be highly problematic. The results are discussed in terms of gender roles and practical implications for college student relationships.     

Rank and response: A field experiment on peer information and water use behavior

Perception of peer rank, or how we perform relative to our peers, can be a powerful motivator. While research exists on the effect of social information on decision making, there is less work on how ranked comparisons with our peers influence our behavior. This paper outlines a field experiment conducted with 3896 households in Castro Valley, California, which uses household mailers with various forms of social information and peer rank messaging to motivate water conservation. The experiment tests the effect of a visible peer rank on water use, and how the competitive framing of rank information influences behavioral response. The results show that households with relatively low or high water use in the pre-treatment period responded differently to how rank information was framed. I find that a neutrally-framed peer rank caused a small “boomerang effect” (i.e., an increase in average water use) for low water use households, but this effect was eliminated by competitive framing. At the same time, a competitively-framed peer rank demotivated high water use households, increasing their average water use over the full period of the experiment. This result is supported by evidence that the competitive frame on rank information increased water use for households who ranked “last” in the peer group – a detrimental “last place effect” from competitively-framed rankings.     

Child maltreatment, revictimization, and violent behavior

The study investigates the cumulative impact of child maltreatment and victimization in adolescence on violent behavior in young adulthood in a nonclinical high-risk sample. The sample consists of 1,526 incarcerated young men (14 to 24 years) who were interviewed with standardized instruments during their prison term. Violent and nonviolent offenders with and without repeated victimization experiences throughout the life cycle were compared. Results show that child maltreatment doubles the risk for violent victimization in adolescence. Repeated victimization experiences in adolescence heighten the risk for later violent offending. This is the case for officially registered violence and self-reported violent behavior. In addition, child maltreatment increased the probability of self-reported violence as well. However, the interaction effect of victimization in childhood and victimization in early adolescence counteracted the main effects. Being repeatedly victimized throughout the early life cycle slightly reduced the probability of being a frequent offender.     

Acculturation and Risk Behavior among Pregnant Mexican American Females: A Structural Equation Model

The purpose of this study was to test a theoretical model designed to predict risk behavior (i.e., cigarette and/or alcohol use) in a sample of Mexican American females who were pregnant and ranged in age from adolescence to early adulthood. The model consisted of six hypothesized predictors–acculturation status, intergenerational family conflict, acculturative stress, educational attainment, household income, and age of respondent, which were proposed as antecedents of risk behavior. Structural equation modeling was used to test both the direct and indirect effects for a set of proposed antecedents to the tendency for Mexican American females to engage in risk behaviors. Several of the hypothesized relationships were supported, with the strongest predictors of risk behavior being acculturation status, intergenerational family conflict, and acculturative stress. An important conclusion was that risk behavior by Mexican American females increased as they became more acculturated to the social circumstances of the U.S. Another notable result was that risk behavior increased among Mexican American females as they experienced higher levels of intergenerational conflict within their families.     

Assessment of undergraduate and graduate programs

Data from an international survey of public relations educators and practitioners raises a number of concerns about how achievement is measured among public relations students. Fewer than one in four academic programs have actually assessed learning outcomes and used the results to enhance their students' educational experiences. Fewer than one in four practitioners have been involved in some way as assessors. The survey suggests that educators place too much stock in grades alone as an appropriate assessment tool.While both educators and practitioners value portfolio reviews as an assessment protocol, practitioners see much greater value in their involvement in this form of assessment than their faculty counterparts. These differences of opinion notwithstanding, current practice and the opinions of educators and practitioners coalesce around the value of capstone experiences such as internships, simulation or case study analysis and surveys of alumni satisfaction as a core around which assessment plans can be built.The Assessment Task Team at the 1998 NCA Summer Conference developed a multidimensional model of assessment that reflects three principles of good practice. First, assessment plans which measure knowledge, behavior and affect at various points in students' academic careers rather than only at the end of a degree program are able to demonstrate change and the value added by the program of study. Second, specific outcomes may be measured by repeated applications of the same assessment protocol or by the use of different protocols over time. Third, appropriate use of a single assessment protocol to measure multiple outcomes, especially when those outcomes are drawn from two or more of the broad categories of knowledge, behavior and affect results in maximizing the information gained while minimizing the resources devoted to assessment.