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.     

Target weight procedure: preventing water intoxication.

1. Prevention of water intoxication depends on early intervention for polydipsic patients who seem to be retaining fluid. The Target Weight Procedure is designed to detect early signs of fluid retention by means of weight gain and low sodium levels. 2. The use of this protocol, in addition to successfully decreasing the number of acute water intoxication episodes, has also led to increased awareness of the meaning of patient behavior, an increased sense of control of patients with water intoxication over their behavior, and an increased feeling of competence among the staff. 3. The success of the protocol seems to be based on its purpose of identifying patients at risk and those with an impending episode, as well as secondary advantages, for example, giving the patients the option to alter their behavior to be removed from the protocol.     

Think they're drunk? Alcohol servers and the identification of intoxication

Despite alcohol server training programs and legal liability aimed at controlling intoxication, server intervention appears to be rare. Given the difficulty in assessing intoxication, it can be assumed that improvement in assessment skills would increase the likelihood of intervention. Unfortunately, little is known regarding practices servers use to identify intoxication. In order to build a more informed base for policy formation and server training, the focus of this inquiry was to examine practices used by servers to assess intoxication. The analysis was based upon questionnaires mailed to a random probability sample of licensed servers from one state (N = 822). Indicators found to be most important were examined in relation to a variety of occupational characteristics. Implications for training curricula, policy formation, and future research are discussed.     

Frenzied attacks. A micro‐sociological analysis of the emotional dynamics of extreme youth violence

Inspired by phenomenological and interactionist studies of youth violence, this article offers an empirical evaluation of Collins's micro‐sociological theory of violence. The main question is whether situations of extreme violence have distinct situational dynamics. Based on analyses of 159 interactions taken from judicial case files, situations of extreme youth violence, here called frenzied attacks, were identified on the basis of the state of encapsulation of the attackers (absorbed in the violence, their sole focus is the destruction of the victim) and the disproportionateness of the violence (the attackers continue to hurt the victims even though they do not pose a threat or a challenge to them). Qualitative and statistical analyses revealed that this emotional state results from a social figuration in which the emotional balance shifts toward complete dominance of the attackers. Thus, the occurrence of frenzied attacks is associated with the moment victims hit the ground, paralyse and start to apologize, with the numerical dominance of the attackers' supportive group and with feelings of group membership, in the form of solidarity excitement and family ties in the attackers' group. Alcohol intoxication is of influence as well, but contrary to the expectation, this effect was independent from solidarity excitement. The article concludes that Collins's theory on the emotional dynamics of violence adds a new dimension to the phenomenological and interactionist traditions of research.     

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.     

More than just pain?! A systemic compass for working with people with chronic pain

Over one in four people in Belgium experience severe physical pain. One in 10 people develop chronic pain every year worldwide. Treatment of chronic pain is based on the biopsychosocial model. Scientific views state, among other things, that pain is a threat to the social self, which is an interesting point of entry for (mental) health-care providers. Conversations with people with chronic pain are always about more than just their pain; they are interesting and cover a lot of ground. Talking about feelings of being hard done-by, clarifying the complexity of the situation, examining the body as an autonomous entity, offering psychoeducation as a hypothesis, and a general attitude of not-knowing form a compass that allows us to attune to the patient and not take up an advisory position. Living with chronic pain requires negotiating with the outside world, being allowed to care for and consider the body, and being allowed to differ from the norm and still fit in enough in a world where the body is just a background figure. An identity transformation and the effects of trauma are described. We meet Eddy and Anne, both dealing with chronic pain, who bring theory alive. The author gives an insight into her personal search and struggles as a psychotherapist introducing systemic psychotherapy in chronic pain patients.     

Social impacts of sporhase in the arid West

The United States Supreme Court decision in Sporhase v. Nebraska (458 U.S. 941 [1982]) has changed the way groundwater is distributed in western United States. Since water is a crucial factor for economic development, the change has generated social impacts at the individual, community, and state levels. Adjustments are being made which might alter the balance of power in the western United States for years to come.     

国家资产负债表研究

企业资产负债表是反映企业在某一特定日期全部资产、负债和所有者权益情况的静态会计报表,是企业中长期决策的根本依据,也是甄别企业财务状态的主要信息来源之一。我国的企业资产负债表编制已较成熟,但国家资产负债表编制相对滞后。政府在实施经济政策、制定经济规划时,缺少必要的财务决策依据。同时,政府经常对经济实施＂宏观调控＂,且拥有相当大的财政支配权、裁定权,但对政府缺少必要的财务约束机制。因此,研究国家资产负债表对我国现有体制下的经济建设与社会发展尤为重要。重点应研究：资产、负债和所有者权益的组成;国家资产负债表的编制方法;国家资产负债表的应用;国家资产负债表对地方政府的影响等。     

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.     

创新福利模式 优化社会管理

创造适合国情的福利模式,是社会管理成功的基础和奥妙所在。一个好的福利模式要能保持四个基本均衡:经济发展与福利支出的均衡,福利支出中的基础部分与非基础部分的均衡,福利机制中的刚性与柔性的均衡,福利责任结构中的政府与市场、家庭、个人之间的均衡。中国一些富裕农村所搞的集体福利为实现这些均衡提供了实践经验,而这些经验与底线公平理论非常契合。底线公平福利模式具有四个特点和优势:教育为基,劳动为本,服务为重,健康为要。它充分发挥中国优秀文化和社会结构优势,把发展性要素内置于福利模式之中,可以实现社会福利的内外平衡,为社会安全奠定基础。     

Mothers and work–life balance: exploring the contradictions and complexities involved in work–family negotiation

This article presents data from a project exploring women's experiences of work and care. It focuses primarily on work–life balance as a problematic concept. Social and economic transformations across advanced post-industrial economies have resulted in concerns about how individuals manage their lives across the two spheres of work and family and achieve a work–life balance. Governments across the European Union have introduced various measures to address how families effectively combine care with paid work. Research within this area has tended to focus on work–life balance as an objective concept, which implies a static and fixed state fulfilled by particular criteria and measured quantitatively. Qualitative research on women's experiences reveals work–life balance as a fluctuating and intangible process. This article highlights the subjective and variable nature of work–life balance and questions taken-for-granted assumptions, exploring problems of definition and the differential coping strategies which women employ when negotiating the boundaries between work and family.     

Disability and Chronic Illness Identity: Interviews with Lesbians and Bisexual Women and Their Partners

Disability rights activists and cultural workers are articulating disability identity and culture. Through interviews with lesbians and bisexual women with disabilities or chronic illnesses and their partners, the present study examined disability/chronic illness identity on the level of individual, couple, and community. Participants shared differing perspectives about how disability/chronic illness identity relates to other aspects of identity, and about whether disability/chronic illness identity is fluid or constant. They described several challenges they have encountered in developing disability/chronic illness identity. Couples talked about developing boundaries and balance in their relationships, and about how disability or chronic illness has strengthened their relationships. A number of participants spoke about identity as intimately linked with community. Implications for community building 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.     

The Medicare Assignment Controversy

The conflict between the elderly and organized medicine over "mandatory assignment" and "balance billing" is a significant public policy issue. Considerable ideological importance has been attached to this conflict by both sides, despite the relatively modest proportion of total revenue for physician services received through balance billing in payment for care of Medicare beneficiaries. The positions of these two coalitions are examined as well as the effort of the Physician Payment Review Commission (PPRC) to craft a public policy response. Three alternative resolutions-those adopted by Congress in 1989 on the recommendation of the PPRC, the Canadian solution, and actions taken on a state level-are then contrasted. The concentrated impact on the elderly of balance billing practices is considered as a problem, especially for elderly of limited income and resources. Justification of the practice is typically provided by the profession on thc ideological grounds of preservation of professional autonomy rather than economic gain, which also reflects the current relatively limited use of balance billing; a significant majority of all claims submitted in the United States are now assigned to physicians. A continuation of the gradualist strategy of the PPRC is endorsed as thc most appropriate short-range solution to these problems, which diminish in significance with a more comprehensive national health financing scheme.     

Economic infrastructure and the development of state autonomy: A case study of U.S. maritime policy

This paper interprets the development of the U.S. maritime industry as reflecting changes in the economic substructure of American capitalism. The analysis seeks to explain how the changing interests of the state, as well as the changing balance of power between capitalists, workers and the state stimulated changes in the maritime industry. Three time periods are used: the Revolution until 1867; 1868 to 1897; and 1898‐on. These three periods represent distinct periods of policy change and strategies of capital accumulation for the state and for capitalists. A combination of Marxian and Weberian theories of political economy are used to explain these capital‐state relations.     

State Policy? Traditional Gender Stereotypes? Relative Contributions of Factors Affecting Positive Work–Family Interface for Working Mothers in Korea

This study explores the gap between policy rhetoric and the reality faced by Korean working mothers, by addressing the following question; whether and to what extent do policy measures for work–family balance contribute to positive work–family interface for working mothers? Although the Korean government has advocated a positive relation between state policy and satisfaction with work–family balance, this is not necessarily the case in practice. To this end, this study focuses on the relative contribution of policy measures to achieve work–family balance reported by working mothers, in relative to traditional gender stereotypes based on Confucian culture as well as working conditions. An empirical analysis with 1,082 Korean working mothers shows interesting findings. First of all, the contribution of policy towards the reported satisfaction in work–family balance is not supported, while the set of traditional gender stereotypes is found to be a negative contributor. Husbands’ psychological support for their wives’ employment, which seems to strengthen the impact of traditional gender stereotypes, follows. The implications of the findings are discussed in depth, by considering the relationships between policy outcomes and traditional gender stereotypes in Korea.     

The Medicare assignment controversy: the construction of public-professional conflict

The conflict between the elderly and organized medicine over "mandatory assignment" and "balance billing" is a significant public policy issue. Considerable ideological importance has been attached to this conflict by both sides, despite the relatively modest proportion of total revenue for physician services received through balance billing in payment for care of Medicare beneficiaries. The positions of these two coalitions are examined as well as the efforts of the Physician Payment Review Commission (PPRC) to craft a public policy response. Three alternative resolutions--those adopted by Congress in 1989 on the recommendation of the PPRC, the Canadian solution, and actions taken on a state level--are then contrasted. The concentrated impact on the elderly of balance billing practices is considered as a problem, especially for elderly of limited income and resources. Justification of the practice is typically provided by the profession on the ideological grounds of preservation of professional autonomy rather than economic gain, which also reflects the current relatively limited use of balance billing; a significant majority of all claims submitted in the United States are now assigned to physicians. A continuation of the gradualist strategy of the PPRC is endorsed as the most appropriate short-range solution to these problems, which diminish in significance with a more comprehensive national health financing scheme.     

Women's Unprotected Sex Intentions: Roles of Sexual Victimization,Intoxication, and Partner Perception

Sexually victimized women may make sexual decisions differently than nonvictimized women. This study used an eroticized scenario and laboratory alcohol administration to investigate the roles of victimization history, intoxication, and relationship context in women's perceptions of a male partner and their subsequent intentions for unprotected sex. A community sample of 436 women completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. After random assignment to an alcohol or control condition, participants read and projected themselves into a sexual scenario that depicted the male partner as having high or low potential for a lasting relationship. Participants rated their perceptions of his intoxication, sexually transmitted infection (STI) risk level, and anticipated reactions to insistence on condom use. They then indicated their likelihood of allowing the partner to decide how far to go sexually (abdication) and of engaging in unprotected sex. Structural equation modeling (SEM) analyses revealed that intoxication predicted greater unprotected sex likelihood indirectly via abdication. CSA and ASA predicted partner perceptions, which in turn predicted unprotected sex likelihood. These findings indicate that, compared to their nonvictimized counterparts, sexually victimized women may respond differently in sexual encounters partly as a function of their perceptions of partners' STI risk and anticipated reactions to condom insistence.     

Patient satisfaction with mental health services: a meta-analysis to establish norms

Patients typically express high rates of satisfaction with their mental health care. This finding and the lack of well controlled studies on patient satisfaction in the literature underscore the need for meaningful guidelines for clinicians and program evaluators in interpreting patient satisfaction data. To address this problem a meta-analysis was undertaken to establish norms on patient satisfaction for various types of mental health programs. Programs were categorized according to three dimensions: inpatient vs. outpatient vs. residential care; chronic vs. non-chronic; and conventional vs. innovative. Meta-analysis procedures were modified to accommodate the single-group study designs that dominate the literature. The analysis revealed that chronic patients express less satisfaction with their treatment compared to non-chronic patients. Innovative programs are viewed more positively than conventional ones. No differences were found in rates of patient satisfaction between inpatient and outpatient programs. Acceptably reliable norms and confidence intervals of patient satisfaction were established for conventional inpatient programs serving either chronic or non-chronic patients; conventional outpatient programs for non-chronic patients; and for all programs combined according to chronic vs. non-chronic, inpatient vs. outpatient, and conventional vs. innovative. However, data were insufficient to compute norms for other program types. The norms thus established can be used for comparative purposes by program evaluators. A cumulative, national data base on patient satisfaction is recommended to further refine these norms.     

Maintaining identity in elderly couples with chronic illness.

With the onset of chronic illness, it has been necessary for these couples to evaluate and redefine their separate as well as merged identities. As each of these individuals sought to realize a mature identity, role adjustments were required. Although not every member of the two illustrated couples had been able to accept the effects and concurrent responsibilities of chronic illness, the nurse practitioner was in a unique position to provide guidance. By reinforcing the importance of healthy identity states, these clients were able to merge temporarily and respond to their partner's basic needs, exchanging a sense of mutual satisfaction, and then to separate into distinct individual identity states. A major task of the older adult is to re-evaluate identity in light of the roles currently being played in life. Through this process, a workable philosophy of life and death should evolve. Most older people engage in a life review of accomplishments and failures, seeking to integrate the diverse elements to obtain an acceptable view of their life's worth (Kaluger, 1984). Couples experiencing chronic illness must reconsider the consequences of this illness state to adequately formulate healthy individual and merged identities. The role of the nurse practitioner is essential in providing guidance for adapting to the life changes confronting elderly couples with chronic illness while maintaining healthy individual and merged identities.