Outbreaks of acute gastroenteritis associated with Norwalk-like viruses in campus settings

Norwalk-like viruses (NLVs) are transmitted by fecally contaminated food, water, fomites, and person-to-person contact. They are a leading cause of acute gastroenteritis epidemics in industrialized countries. NLV outbreaks are characterized by a 12- to 48-hour incubation period; nausea, vomiting, and diarrhea for 24 to 72 hours; and high secondary attack rates. NLV infections spread rapidly on college and university campuses because of close living quarters, shared bathrooms and common rooms, many food handlers, popular self-service salad bars in dining halls, and person-to-person contact through sports and recreational activities. The illness is generally mild and self-limited but an outbreak can strain the resources of campus health services and cause high absenteeism among both students and staff. Treatment is primarily through antiemetic medication and oral rehydration. Prevention and control of NLV outbreaks rests on promoting hand washing; enforcement of strict hygiene in all food preparation areas; and prompt, rigorous cleaning of potentially contaminated areas where someone has been ill.     

Reiki. A complementary therapy for nursing practice

1. Reiki is an ancient healing art involving the gentle laying on of hands. It can be practiced anytime and anywhere. 2. Reiki can be used as a complementary treatment to medical protocols. 3. Hand positions customarily correspond to the body's endocrine and lymphatic systems and major organs, focusing on seven main chakras. 4. More research investigating the effects of Reiki on persons with psychiatric and medical disorders is necessary.     

The power of outcomes: FOTO Industrial Outcomes Tool -- Initial assessment

OBJECTIVE: To demonstrate how outcomes assessment can assist in describing clients receiving rehabilitation in occupational health rehabilitation clinics and to describe the preliminary assessment of internal consistency reliability and construct validity of the FOTO Industrial Outcomes Tool. METHODS: 266 adults referred for acute work rehabilitation (AWR), work conditioning/hardening (WC/WH) or a Functional Capacity Evaluation (FCE) comprised the data set. Clients were treated between July 1998 and January 1999 in 15 clinics from 6 states by 46 clinicians participating in the Focus on Therapeutic Outcomes (FOTO) national rehabilitation database beta test. For AWR and WC/WH, clients completed a health status questionnaire on intake and discharge, and health status was assessed prior to the FCE. Comprehensive demographic data were collected describing the clinics, clinicians, clients and work status collected 2 weeks following discharge. RESULTS: Internal consistency reliability coefficients for the health status scores ranged from 0.57 to 0.89. Construct validity was supported. CONCLUSION: Results demonstrate the power of collecting outcomes from a variety of constructs for clients receiving industrial rehabilitation services. Initial reliability and construct validity findings were adequate and support continuing data analyses.     

Work hardening: Outdated fad or effective intervention?

OBJECTIVES: The purpose of this outcome measurement study was to determine the effectiveness of a work hardening program as measured by the participants' work status at three months after program completion. Predictors of successful return to work were explored. STUDY DESIGN: The sequential case series design was employed, and data were gathered at three points: the initial work hardening assessment, the discharge assessment, and three months post-discharge from the work hardening program. Seventy-nine participants were included. RESULTS: Eighty-two percent (82%) of the clients who completed a work hardening program reported that they were working in some capacity three months after program completion. They listed their employment status in 5 sub-categories. Significant predictors of employment included "single" marital status, lower perceived disability scores at program entry, reduction in reported pain during program duration, and funding source. CONCLUSION: Work hardening remains an effective treatment strategy which promotes successful return to the workplace. Ongoing analyses of these programs is imperative.     

Volunteer work and well-being

Using two waves of panel data from Americans' Changing Lives (House 1995) (N = 2,681), we examine the relationships between volunteer work in the community and six aspects of personal well-being: happiness, life satisfaction, self-esteem, sense of control over life, physical health, and depression. Prior research has more often examined the effects of voluntary memberships than of volunteer work, has used cross-sectional rather than longitudinal data, and, when longitudinal, has emphasized social causation over selection effects. Focusing only on the consequences of volunteer work overlooks the antecedents of human agency. People with greater personality resources and better physical and mental health should be more likely to seek (or to be sought for) community service. Hence, we examine both selection and social causation effects. Results show that volunteer work indeed enhances all six aspects of well-being and, conversely, people who have greater well-being invest more hours in volunteer service. Given this, further understanding of self- versus social-selection processes seems an important next step. Do positive, healthy people actively seek out volunteer opportunities, or do organizations actively recruit individuals of these types (or both)? Explaining how positive consequences flow from volunteer service may offer a useful counterpoint to stress theory, which has focused primarily on negative life experiences and their sequelae.     

Effectively responding to the commercial sexual exploitation of children: a comprehensive approach to prevention, protection, and reintegration services.

The commercial sexual exploitation of children is one of the most destructive forms of abuse. Although some efforts have been made to stop the trafficking in children and youth, they are far from sufficient. A coordinated local and global response is needed if this "ultimate evil" is to be ended.     

Recent developments in aged care policy in Australia

A series of major reforms implemented through the mid 1980s sought to contain residential care and expand community care in Australia's long-term care system. While this goal has been maintained, a number of new policy initiatives followed the change of federal government in 1996. This article presents a systematic account of current policy objectives, implementation measures, and outcomes in three major policy areas: changing the balance between residential and community care, targeting in community care, and support for family caregivers. This analysis shows that while there have been shifts in emphasis from time to time, concerted policy efforts over the last 20 years have contained the growth of expenditure on long-term care and realized significant change in the service system.     

Measuring sexual arousal

The impact of sexual offenses and abuse is incalculable, both on the victims themselves and the society responsible for protecting them. Identifying people who sexually offend against adults and children and preventing them from engaging in abusive behavior in the future requires valid and reliable methods that accurately identify the perpetrators' characteristics and measure treatment effectiveness. This article reviews the literature on penile plethysmography (PPG), a mechanism by which erectile response to deviant sexual stimuli can be measured.     

Boater training, drinking and boating, and other unsafe boating practices

OBJECTIVES: Identify associations between lack of formal boater training, drinking and boating, and other unsafe boating practices. METHODS: A telephone survey queried respondents (age 16 or older in continental United States) about boating experience, type of boat used, and training. RESULTS: Of the 3,042 boaters surveyed (70% response), most had no formal training (73%). Boaters with formal training failed to use PFDs about as often as those without formal training and were equally or more likely to use alcohol while boating. CONCLUSIONS: The unexpected association between formal training and unsafe boating practices is probably due to reduced risk perception and inadequacies of boater training programs. Such programs seldom mention the risks of alcohol use while boating. Decisions to mandate formal training should be informed by these results; if mandated, training should address the risks of alcohol use while boating, and should be renewed frequently enough to offset reductions in risk perception.     

Maximizing learning outcomes by videotaping nursing students' interactions with a standardized patient

1. Videotaping is a beneficial instructional methodology to help undergraduate students develop awareness of their strengths and opportunities for growth in therapeutic interactional skills. 2. Educational interventions with undergraduate students provide an opportunity to involve doctoral students in vital instruction, research, and knowledge dissemination through publication and presentation. 3. Allowing novice nurses to view their interactional skills with a simulated patient can reduce the anxiety they experience in first therapeutic encounters with assigned patients. 4. Continuous quality improvement in educational methodology is dependent on listening carefully to students who have invaluable feedback to offer and making appropriate correction as indicated.