Chlamydia Trachomatis Infection in a Female College Student Population

Abstract

“Physical Dependence on Nicotine in Gum: A Placebo Substitution Trial,” JOHN R. HUGHES, et al. To test whether ex-smokers become physically dependent on nicotine in gum, we entered eight ex-smokers who were using nicotine gum into a randomized, double-blind, placebo-substitution trial. When placebo was substituted, seven of the eight subjects were observed to have withdrawal symptoms and two relapsed to smoking or nicotine gum. This result suggests that physical dependence (i.e., withdrawal) may be a cause of behavioral dependence on nicotine gum (i.e., use of gum beyond the recommended period) and physicians should emphasize the need for gradual reduction of nicotine gum. (Journal of the American Medical Association 1986;255:3277–3279.)

“Absence of Therapeutic Benefit From Antacids or Cimetidine in Non-Ulcer Dyspepsia,” OLOF NYREN, et al. We randomly assigned 159 patients with non-ulcer dyspepsia, defined as chronic or recurrent epigastric pain without concomitant symptoms of the irritable bowel syndrome and with no evidence of organic disease, to treatment for three weeks with an antacid suspension one and three hours after meals, 400 mg of cimetidine twice a day, or placebo, according to a double-blind, double-dummy model. The intensity and duration of epigastric pain were recorded by the patients four times daily during a one-week period without therapy and during the three weeks of treatment. The mean reduction in pain intensity after three weeks in the placebo group was 25 percent. Neither antacid nor cimetidine treatment resulted in more than a 4 percent better effect. The reduction of pain was statistically significant (P < 0.01) in all three groups. The time course of the pain scores in the groups receiving active drugs followed closely those in the placebo group, and there were no significant differences between the groups at any stage of the treatment. We conclude that the neutralization or suppression of gastric acid is of no clinical value in patients with this syndrome. (New England Journal of Medicine 1986;314:339–43.)     

A framework for providing telecommuting as a reasonable accommodation: some considerations on a comparative case study

Telecommuting, whether full time, part time, or over short periods when the need arises, can be an important accommodation for employees with disabilities. Indeed, telecommuting may be the only form of accommodation that offers employees whose disabilities fluctuate a means to stay consistently and gainfully employed. This article describes one employer's experience in considering a request for telecommuting as a reasonable accommodation for a particular employee. Drawing on real-life examples, both positive and negative, this article provides a win/win framework for decision-making that can help employers evaluate the use of telecommuting as a possible accommodation and facilitates open and ongoing communication between employer and employee.     

An update on the Kevorkian-Reding 93 physician-assisted deaths in Michigan: is Kevorkian a savior,serial-killer or suicidal martyr?

This report presents an update of the Kevorkian-Reding physician-assisted (or physician-aided) deaths to include the ninety-three publicly acknowledged cases as of November 25, 1998. These deaths are divided into ten distinct time phases. The following trends emerge. Over two-thirds of the decedents are women, the ratio of females to males varying widely with phase. The proportion of women seems to be the highest when Kevorkian is free to act as he wants and lowest when he seems to be acting under legal or political restraints. Based on autopsy results, only 29.0 percent of the cases are terminal, this percentage being higher among men (37.9%) than among women (25.4%). However, 66.7% of the decedents were disabled, no significant difference emerging between men and women. Further, five out of the six decedents showing no apparent anatomical sign of disease at autopsy were women. Over 80 percent of the physician-assisted deaths are cremated, approximately twice as high a proportion as that emerging for suicides in Michigan and four times as high as cremations occurring with regard to overall deaths. Finally, death by carbon monoxide decreases dramatically with time phase while the use of the contraption dubbed the "suicide machine" increases, suggesting an increasing routinization over time. Finally, during the ninth and tenth phases, Kevorkian's aims and his own suicidality emerge more clearly involving 1) harvesting organs and 2) threat of starving himself in prison if he is convicted. Phase 10 can be seen as an escalation from assisted death to overt euthanasia, repeating the same need for a demonstration (Thomas Youk) that was first exhibited in Phase I (Janet Adkins).     

Kevorkian,Martha Wichorek and us: a personal account

In this short article, the authors describe their attempt to do suicide-prevention with a patient that ultimately died as the result of a physician-assisted suicide. Autopsy revealed no sign of physical disease but the patient's letters indicate a preoccupation with independence as the definition of life, and conviction that people who lose independence are no longer alive.     

NASW’s Supervisory Leaders in Aging: An Acceptable and Feasible Model for Training and Supporting Social Work Supervisors

Social services are instrumental in addressing challenges associated with aging. Yet, practitioners report needing expanded gerontological knowledge and better supervision. The Supervisory Leaders in Aging (SLA) program of the National Association of Social Workers (NASW) was designed to improve gerontological services by strengthening supervision of the social service workforce. With support from the John A. Hartford Foundation, the program was adopted between 2015 and 2017 in four regions, where NASW trained 134 MSW supervisors who support 1200 social service staff, potentially enhancing the well-being of 264,000 clients annually. The SLA curriculum and in-person educational approach constitute a model for supervisor professional development. Quality improvement evaluations suggested feasibility of program adoption and acceptability. Participants rated each of 10 workshops and 97% agreed that instructors were effective, that knowledge was expanded, and that content was relevant, appropriate, and likely to be used. Implications of this model for enhancing supervisory practice are discussed.     

Hispanic Adolescent Girls’ Attitudes Toward School

Hispanic adolescent girls are at elevated risk for dropping out of school. The authors interviewed 54 Hispanic adolescent girls who were attending after-school programs in the New York metropolitan area. The study investigated how the multiple factors of mother–daughter and friend mutuality, coping, acculturation, self-esteem, depression and family environment influenced the way these girls felt about school. The final logistical regression analysis appeared to support our hypothesis that girls who have a higher degree of mutuality with their mothers will be more likely to like school a lot. In addition, girls who liked school a lot were significantly more likely to have higher overall grades and to be somewhat religious. Findings are discussed within the context of the empirical and theoretical literature and implications for prevention of school drop-out are considered.     

Social Insurance and Older Adults in China: Effect of Education and Household Income on Coverage Following the 2009 Health Reform

Abstract

Education and income have been considered two primary determinants to affect individuals’ health outcomes. China initiated a comprehensive health reform in 2009, with the goals to provide equal access yet sufficient healthcare to all residents. However, social disparities continue to persist following this large reform. This research hypothesized that older adults’ years of education and income are determinants of participation in each social insurance scheme following the 2009 health reform. Multilevel logistic regression models were used with a nationally representative sample (n?=?5,274) to investigate the education and income disparities in each social insurance scheme for older adults, with random effects among provinces at the national level. The analyses show that years of education was not associated with enrollment in three social insurances, with the exception of the association between 11?years of formal education or above and the rural coverage. Participants with higher levels of household income had greater odds of having urban social insurances, but had lower odds of having the rural scheme. Further research should continue to investigate the disparities of enrollment of each social insurance. Chinese policy makers should consider these social factors carefully to reach a true universal coverage.