Treatment of psychotic children and adolescents: A psychoanalytic social work approach from the Federal Republic of Germany

This paper offers data from the inpatient treatment of four psychotic adolescents in a clinic in Tubingen, in the Federal Republic of Germany. The author describes crucial episodes in therapy of each, and includes his own physical sensations and reactions, his dreams, and the thinking and feeling that determined his responses to these young patients. This way of working is a non-medical form of psychoanalysis.     

The front lines of domestic violence. Training model for rural EMS personnel

1. Domestic violence is a major public health problem requiring committed, coordinated community response. 2. Domestic violence is a significant cause of morbidity and mortality for women and children in the United States. 3. EMS personnel play a frontline role in the critical response and prevention of domestic violence. 4. EMS education and training are requisite for safe, effective responses to domestic violence in rural communities.     

OPTIMAL DESIGNS FOR FITTING A PROPORTIONAL HAZARDS REGRESSION MODEL TO DATA SUBJECT TO CENSORING

Suppose the probability model for failure time data, subject to censoring, is specified by the hazard function λ(t)exp(β_T x), where x is a vector of covariates. Analytical difficulties involved in finding the optimal design are avoided by assuming that λ is completely specified and by using D-optimality based on the information matrix for β Optimal designs are found to depend on β, but some results of practical consequence are obtained. It is found that censoring does not affect the choice of design appreciably when β^T x ≥ 0 for all points of the feasible region, but may have an appreciable effect when β_ix_i 0, for all i and all points in the feasible experimental region. The nature of the effect is discussed in detail for the cases of one and two parameters. It is argued that in practical biomedical situations the optimal design is almost always the same as for uncensored data.     

Patterns and determinants of union growth in the hospital industry

Recent changes in the National Labor Relations Act have increased the possibility that union coverage will expand among private non-profit hospitals. This study examines the success of union organizing efforts in the industry during the 1974–1978 period. The analysis focuses on the influence of environmental and organizational variables as well as the nature of the election process itself. The results suggest that hospital union success is largely dependent uponprior union success in the hospital (+), voter turnout (−) and unit size (−). The annual rate of election victories is predicted to fall to nearly 25 % by 1983 from an average of 50% in the 1974–1978 period.     

Moving targets: bicycle-related injuries and helmet use among university students.

We conducted a cross-sectional study to evaluate bicycling habits and helmet use in a sample of university students in a southwestern state university. Thirty-one of 100 students in our sample owned bicycle helmets; of these, 17 (54.8%) wore helmets during most (more than three fourths) of their bicycle trips. Almost half of the students reported that more than 25% of their bicycling was done in heavy traffic but they rarely used bicycle trails. Sixty-five students in the sample had sustained at least one minor injury during the previous 5 years, and 18 had been hospitalized as a result of bicycle-related injuries. We found no substantial differences between male and female subjects in bicycle-related hospitalizations, although male subjects were more likely to sustain minor injuries than were females. Helmet ownership was most strongly associated with previous injury experience, especially hospitalization resulting from bicycling injuries (OR = 3.6; 95% CI = 1.3, 10.1). We also observed an association between helmet ownership and possession of insurance coverage for bicycling injuries (OR = 3.0; 95% CI = 1.2, 7.6). Ethnicity was a factor in helmet ownership--helmets were owned by 26 of 69 (37.7%) of non-Hispanic whites, in contrast to 1 of 24 (4.2%) of all other ethnic groups combined. Our survey data suggest that perceived risk is an important factor in bicyclists' use of safety helmets.