Exposure of medical students to body fluids

Three hundred forty-two students at 3 Florida medical schools were surveyed concerning occupational exposures to blood and body fluids during their 3rd-year clerkship. The 16-item questionnaire was anonymously returned by 150 students, and differences among groups were assessed at p < .05. Most of the students complied with universal precautions guidelines (UVPG); 62 reported 101 exposures, including 9 with HIV-positive blood and body fluids. Most of the exposed students knew about the guidelines but regarded the incidents as irrelevant to their safety or supervision training. Noncompliant students reported significantly more exposures than compliant students. Time constraints, inconvenience of using gloves during procedures, and belief that patients were at low HIV risk discouraged adherence to the guidelines. Common practices following exposure were "no action" or "washed area only" without medical follow-up. Medical students' UVPG adherence should be increased by workload modification, user-friendly safety products, and supervised practice training in clinical exposure settings.     

Prevalence of alcohol-use disorders and alcohol-related problems in a college student sample

Most studies of alcohol consumption patterns and alcohol-related problems among college students have failed to include a diagnostic measure based on Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Applying the DSM-IV standards would facilitate an analysis of the prevalence of alcohol-use disorders and individual symptoms of those disorders. A structured diagnostic interview based on DSM-IV criteria (the alcohol section of the Substance Abuse Module) and several alcohol screening instruments were administered to 306 undergraduate students at an urban commuter campus. The prevalence of current and lifetime alcohol-use disorders, individual symptoms of those disorders, and other alcohol-related problems are reported, as well as data regarding alcohol consumption patterns and binge drinking. The data are analyzed in terms of demographic variables, including sex, ethnicity, year in school, age, and marital status of those in the sample.     

Well siblings living with schizophrenia. Impact of associated behaviors.

As a result of the ongoing hallucinations and delusions, life at home became "anxious and chaotic" with "lots of stress." Because there was no on-site crisis intervention by professionals, well siblings were sometimes called upon to control the violent behavior and were vigilant and fearful regarding the potential for abuse. Negative symptoms were the most disturbing to well siblings. Siblings need help to understand that social isolation and lack of motivation are symptoms of the illness--not due to "laziness."     

The five "S" levels of enterprise health.

Whether pride, necessity, or inattention is at the root, some "slowly boiling" physicians find themselves working harder for fewer compensations of all sorts, and may not be fully cognizant of their circumstances. This article helps to diagnose and manage the health of physicians' practices and/or related enterprises. There are five levels of enterprise health, ranging from success (S-1) to shutdown (S-5), that serve as weather vanes about how the enterprise is adapting to changes in its environment. How should physicians respond to chaos and the threats of deteriorating enterprise health? A five-step approach is offered: (1) Discern what is important; (2) place and keep your program in alignment with those patient interests that will enhance your enterprise viability; (3) keep score with an internal balanced scorecard; (4) manage and shepherd your resources in a manner that demonstrably adds value to patient care; and (5) know the score and use it.     

Civil war, social integration and mental health in Croatia

Research has shown that social relationships are generally beneficial for mental health (Thoits 1995). However, few scholars have examined this association after the occurrence of a significant shock to the social system as a whole. The purpose of this article is to examine the relationship between social integration and war-related distress in Croatia immediately following the recent civil war. Does social integration decrease war-related distress? Does social integration buffer the effect of traumatic events on war-related distress? We analyze these questions using nationally representative survey data collected in Croatia in 1996. Results suggest that social integration has both positive and negative direct effects on distress. Being a member of informal organizations, such as sports clubs, and participating in social activities are beneficial for mental health. On the other hand, being a member of some formal organizations, such as church organizations and unions, is detrimental to mental health. There is little support for the idea that social integration buffers the effect of traumatic events on distress. Only one of thirty-six possible interactions is significant and supports the buffer hypothesis. Frequent participation in social activities buffers the effect of experiencing violence on war-related distress. Also, some forms of social integration appear to aggravate the effect of traumatic events on war-related distress. In sum, social integration does affect war-related distress after a system shock, but in complex and sometimes unexpected ways.     

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.     

Effectiveness of refusal skills software

This research explores the potential of making social skills training more accessible to schools by the use of computer-aided instruction. An easy-to-use software program called Refusal Challenges, which targets important social skills with effective training methods, was tested. The dependent measure was demonstration of refusal skills strategies. One-hundred-eighty-eight male and female eighth-grade students were stratified according to pre-treatment refusal skill level, gender, and teacher. They were then randomly assigned from the stratified blocks to either the computer-based refusal skills training group or a control group. Repeated measures analyses of variance indicated a significant and meaningful time by treatment interaction for refusal skills scores. The difference between treatment and control groups remained significant and meaningful at both the post-test and follow-up testing.     

What's Playing in the Organizational Theater? Collusive Relationships in Management

This article takes as its point of departureconcepts derived from couple therapy to betterunderstand collusive relationships in organizations. Aswe examine these dysfunctional workplace relationships— these interpersonal gridlocks —four main types of collusive superior subordinateinteraction patterns are identified — thenarcissistic, the controlling, the paranoid, and thesadomasochistic — and the consequences of each such dyad in organizationsare explored. In conclusion, the paper presents a numberof recommendations on how to recognize the presence ofsuch collusive arrangements (taking leadership behavior as a point of departure) and suggestspreventive steps that can be taken.