Caught between different worlds: how transgendered women may be "forced" into risky sex

We qualitatively explored reasons why transgendered women may engage in sexual risk that could lead to HIV infection. Specifically, we conducted this investigation with transgendered women identifying as Black/African American. Interviews from 17 participants were audio taped and analyzed. Four themes emerged. Women commonly reported they had a strong need/desire to be loved by men. Many stated they had and would engage in unprotected sex to obtain and preserve such a relationship. Nearly all were currently using female hormones. Nine obtained their hormones through non-medical means including the Internet, transgendered friends, and street vendors. For these women hormone injections often involved sharing needles/syringes. Selling sex was a common practice and many women did so without the benefit of condom use. Finally, women experienced multiple forms of societal discrimination. By being caught between worlds (straight, gay, male, and female) transgendered women may be placed into situations where avoiding HIV risk is extremely difficult.     

Domestic violence screening and service acceptance among adult victims in a dependency court setting

Many child welfare systems are unable to effectively identify and address co-occurring domestic violence and child maltreatment. In response, the Dependency Court Intervention Program for Family Violence implemented a protocol to identify indicators of domestic violence in families involved with child protection proceedings. This article highlights data that demonstrate the ability of an outreach and screening process to identify adult victims of domestic violence in dependency court and to offer them appropriate intervention services.     

Characteristics of children in residential treatment in New York State

This study addresses three questions about the population of children and families served in the highest level of care in the child welfare system in New York State residential treatment centers (RTCs): (1) How prevalent are emotional and behavioral problems in the youth entering RTCs? (2) Has the proportion of youth with such problems increased compared to 10 years ago? (3) Are there identifiable subgroups of youth entering RTCs? One-fourth of RTC admissions in fiscal year 2001 were randomly selected from a representative sample of 16 RTCs. The study completed a standardized data collection instrument based on a review of agency records, and included information that was known at the time each child was admitted. The results show significant increases compared to t10 years earlier in the proportion of youth with mental health problems and juvenile justice backgrounds. The findings suggest that youth who traditionally have been served by other systems of care are now being served in the child welfare system. The increased treatment needs of these youth and the heterogeneity of the RTC population have important implications for policies, programs, and practice.     

Response Order Effects in Dichotomous Categorical Questions Presented Orally: The Impact of Question and Respondent Attributes

Using data from 548 experiments in telephone surveys conductedby the Gallup Organization, we explored how attributes of questionsand respondents moderate response order effects in dichotomouscategorical questions. These effects were predominantly recencyeffects and occurred most in questions that were more difficultto comprehend (especially among respondents with the least education),with response choices that were more difficult to comprehend(because they were complete sentences instead of words or phrasesand because they were not mutually exclusive), and that wereasked after many prior questions. Recency effects were alsomore common in questions that explicitly or implicitly encouragedrespondents to wait until they had heard all the answer choicesbefore formulating a judgment than in questions that inducedrespondents to begin formulating a judgment before all the answerchoices had been read (especially among the least educated respondents).A study of interviewer behavior revealed patterns of pausingbetween and within sentences that help to explain why some typesof questions are especially prone to recency effects and othersare not.     

Passing Encounters East and West: Comparing Japanese and American Pedestrian Interactions

This study examined the microinteractions of pedestrians in Japan and in the United States as they walked past a confederate. Specifically, the effects of culture, condition (avoid, look-only, and look plus smile) and sex of confederate on glances, smiles, nods, and greetings by passing pedestrians were examined in a field study on over 1000 participants. The hypotheses of (1) lower responsiveness in Japanese pedestrians than in American pedestrians and (2) increased responsiveness as a function of condition were supported in a series of log-linear analyses of pedestrian glances, smiles, nods, and greetings. Both of these main effects were, however, qualified by Culture X Condition interactions on smiles, nods, and greetings, with the large condition effects present in the American pedestrians, but absent in the Japanese pedestrians. The results are discussed in terms of the functions of glances, smiles, nods, and greetings in these brief encounters and how differing cultural norms affect Japanese and American responsiveness. Finally, the limitations of this study and the broader utility of this research paradigm are discussed.

Dopamine Genes and Pathological Gambling in Discordant Sib-Pairs

Pathological gambling (PG) is an impulse control disorder that has been considered as a behavioral addiction. Recent studies have suggested the involvement of the dopaminergic system in addictions and impulse control disorders and associations of dopamine receptor genes (DRD1, DRD2, and DRD4) and PG have been reported. In the present study, 140 sib-pairs discordant for the diagnosis of PG (70 males and 70 females on each group) were recruited through the Gambling Outpatient Unit at the Institute of Psychiatry, University of Sao Paulo and were assessed by trained psychiatrists. A family-based association design was chosen to prevent population stratification. All subjects were genotyped for dopamine receptor genes (DRD1 -800 T/C, DRD2 TaqIA RFLP, DRD3 Ser9Gly, DRD4 48bp exon III VNTR, DRD5 (CA) repeat) and the dopamine transporter gene (SCL6A3 40 bp VNTR). Our results suggest the association of PG with DRD1 -800 T/C allele T (P = .03).     

Hospital-to-community transitions. A bridge program for adolescent mental health patients

Making the transition from the hospital to a community setting can be extremely challenging for patients with acute mental health conditions. Transitional services have been created to help patients overcome difficulties associated with this transition. Nurses frequently play an integral role in the success of these services. By providing patients with individualized support during such transitions, nurses act as clinical liaisons and directly contribute to an increase in positive patient and system-level outcomes. This article describes a transitional service called the Bridge Program, designed to help adolescents make a successful transition from the hospital to the community. An overview of the Bridge Program is provided, and the results of an evaluation of this program are presented. Results suggest that the Bridge Program contributes to a decrease in the length of hospital stays and improves continuity of care for patients and their families.     

Fatigue and sleep quality in nurses

Fatigue is a critical issue for nurses that may lead to medical errors, degradation in performance, decreased mental acuity, and social problems. Poor sleep quality is also a contributing factor in fatigue that nurses experience. Therefore, the purpose of this study was to examine the differences in perceptions of fatigue between night-shift and day-shift nurses, as measured by scores on the Brief Fatigue Inventory (BFI) and to examine differences in sleep quality between the two groups, as measured by responses on the Pittsburgh Sleep Quality Index (PSQI). Univariate analysis of variance showed significant differences between the two groups on the BFI, with the night-shift cohort reporting higher mean scores on the BFI. Significant differences were also found between the two groups on PSQI mean scores, with the night-shift cohort reporting higher mean scores. Findings from this study suggest that night-shift nurses, compared with day-shift nurses, perceived a much higher level of fatigue and had poorer sleep quality. Further research is needed to evaluate interventions that might decrease fatigue in nurses and improve their sleep quality.     

Financial Issues Associated with Having a Child with Autism

Data from the Family Experiences with Autism Survey are used to identify factors associated with financial problems in families that have a child with autism. Likelihood of financial problems was positively associated with use of medical interventions, having unreimbursed medical or therapy expenses, and having relatively lower income. Use of speech and language therapy was negatively associated with likelihood of financial problems. Many survey respondents forfeited future financial security and even experienced bankruptcy to provide needed therapy for a child with autism. Specific ways that financial advisors can help families that have a child with autism are outlined.