Effect of the doctor on college students' attitudes toward physician-assisted suicide

Ninety-six students were presented with eighteen different vignettes describing different types of active and passive observed suicide, assisted suicide, and euthanasia. Attitudes regarding the morality and desired legality of each situation were measured. Results indicated that the interaction between the doctor and the patient, and, to a lesser extent, the active or passive nature of the agent of death, were more important than the actual actions of the doctor in allowing or causing death to occur.     

The development of the physicians' end-of-life care attitude scale

The Physicians' End-of-Life Care Attitude Scale (PEAS) was developed as an outcome measure for palliative care education. PEAS assesses the willingness of medical trainees to care for dying patients. Sixty-four Likert-type questions were created on the basis of discussions with focus groups of medical trainees, then administered to sixty-two medical students and residents. Total PEAS scores as well as personal preparation and professional role subscales (where higher scores indicated greater concern) possessed excellent internal consistency and reliability. In addition, there were substantial correlations between PEAS scores and the CA-Dying scale, a measurement of laypersons' fears about interacting with dying persons. Thus, PEAS adequately assesses the unique communication concerns of physicians in training regarding working with dying persons and their families. Correlations between PEAS scores and age were negative, while those who had experienced the death of a loved one had higher PEAS scores than those who did not. This suggests that for some persons, life experiences may lessen difficulties in dealing with dying persons, while for others, personal losses may exacerbate such concerns. The utility of PEAS in evaluating the efficacy of palliative care education as well as its potential to measure medical trainee's willingness to care for the terminally ill is discussed.     

The disruptive physician. A quality of professional life factor.

Medical leaders need to understand that attending to quality of professional life issues includes dealing with the insidious costs and stress associated with disruptive physician behavior. The disruptive physician or professional undermines practice morale, heightens turnover in the organization, steals from productive activities, increases the risks for ineffective or substandard practice, and causes distress among colleagues. Physician executives need to help reduce or prevent this behavior and develop accepted systems in which to manage, confront, and rehabilitate the person labeled "disruptive." Suggested strategies to consider in developing a system include: (1) Defining reasonable and competent interpersonal behavior; (2) educating in interpersonal skills; (3) evaluating interpersonal skills; (4) developing disruptive policy; and (5) assessing, confronting, and rehabilitating.     

The discourse and dimensions of irregularity in post-apartheid South Africa

South Africa's migration policy since 1994 has been described as contradictory and confused. Indeed, there are profound differences of opinion within government and civil society over the best means to deal with what is believed to be a massive and threatening increase in clandestine migration and irregular employment.
Clarity of thought and policy debate has been hampered by an inflammatory discourse which fixates on the issue of numbers, and views all migrants as a problem and threat. Partly this reflects fundamental inadequacies in systems of data collection and analysis, and partly a poor understanding of the causes and character of cross-border migration in Southern Africa.
As a corrective, this article presents an overview of the causes and spatial/sectoral distribution of irregular employment in post-apartheid South Africa, drawing on recent research. It then critically examines efforts to ascertain the dimensions of undocumented migration to South Africa, concluding that the results are fundamentally flawed by the methodologies used. The article then disaggregates irregular migration and assesses current knowledge about each subcategory.
In conclusion, the article argues for a comprehensive labour market survey as the foundation for a coordinated and rational approach to the challenges of irregular migration and employment.     

Homeless mothers and depression: misdirected policy.

This paper is a critique of recent service-intensive shelter programs for homeless mothers and the policies that underlie these shelters. We first document the process by which mental health problems and family homelessness became so closely but mistakenly linked. We then demonstrate empirically that shelter programs for homeless families nonetheless presume that mental health problems are part of the causal nexus of family homelessness and indiscriminately deliver mental health services to homeless mothers. Simultaneously, shelter programs encourage the isolation of their residents from what they presume to be their "problematic" social networks. We show that, while mental health services had little impact on depression levels among homeless mothers, isolation from social networks did increase depression among homeless mothers. Our findings suggest that policy should put more emphasis on rapid reintegration into the community through providing housing, and it should put less emphasis on providing services.     

Gender, social status, and emotional reliance

Past research has suggested the potential importance of considering emotional reliance, a dimension of interpersonal dependence, when addressing social and developmental risk factors for depression. Based on a probability sample of 1,393 adults aged 18-55 residing in Toronto, Canada, this paper addresses gender differences in emotional reliance and the relevance of emotional reliance in explaining the gender-depression association. We also explore link-ages between emotional reliance and status factors. Findings indicate that emotional reliance is significantly related to depression and that women report greater reliance than men, independent of social status factors like marital and parental status, education, income, and occupational prestige. Moreover, the positive association between emotional reliance and depression is greater for women. Several social status factors modify the relationship between gender and emotional reliance. Both education and occupational prestige reduce reliance, and are particularly beneficial in this regard for women. Marriage, on the other hand, increases emotional reliance, especially for men. We offer interpretations of this pattern of findings.     

A qualitative exploratory study of substance abuse prevention outcomes in a heterogeneous prevention system

The prevention of abuse of alcohol and other drugs is a concern for parents, policy-makers, educators, and social service professionals. Prevention programs are sponsored by many different types of social and educational agencies using a variety of intervention strategies. This article reports a study of a sample of such programs in the state of Nevada. The overall prevention system in the state espouses a "risk and resiliency" approach to prevention. Focus group methodology was used to study perception of outcomes of these programs from the viewpoints of various program stakeholders (youth participating in the programs, parents of participants and program staff). Analysis of the qualitative data yielded findings about potential outcomes as well as implicit program theories. Implications for future planning efforts as well as further evaluation efforts are discussed.     

Do male dropouts benefit from obtaining a GED, postsecondary education, and training?

The authors use longitudinal data from the National Longitudinal Survey of Youth to investigate whether the wage trajectories of male high school dropouts are affected by the acquisition of the General Educational Development (GED) credential, by postsecondary education, and by training. The authors show that acquisition of the GED results in wage increases for dropouts who left school with weak skills, but not for dropouts who left high school with stronger skills. College and training provided by employers are associated with higher wages for male dropouts.     

A comparative assessment of public opinion toward immigrants and immigration policies

"This article is part of a larger study of public attitudes toward immigration in seven countries that historically and currently have had different policies and practices vis-a-vis immigration. The countries involved are Australia, Canada, France, Germany, Great Britain, Japan and the United States. The time frame for which most of the public opinion data will be reported is from 1970 through 1995. The data have been collected from national surveys that were conducted in each of the countries."     

Death at the border

"Debates about United States border control policies have generally ignored the human costs of undocumented migration. We focus attention on these costs by estimating the number, causes and location of migrant deaths at the southwest border of the United States between 1993 and 1997.... Deaths from hyperthermia, hypothermia and dehydration increased sharply from 1993 to 1997 as intensified border enforcement redirected undocumented migration flows from urban crossing points to more remote crossing areas where the migrants are exposed to a greater risk of death."