Prevalence and correlates of alcohol-induced blackouts among college students: results of an e-mail survey

The authors conducted an e-mail survey of 772 college students to learn more about their experiences with blackouts. Approximately half (51%) of those who had ever consumed alcohol reported they had experienced a blackout at some point in their lives, and 40% had experienced 1 in the year before the survey. Among those who drank in the 2 weeks before the survey, nearly 1 in 10 (9.4%) had experienced a blackout during that period. Many later learned that, during the blackout, they had vandalized property, driven an automobile, had sexual intercourse, or engaged in other risky behaviors. Experiencing 3 or more blackouts was associated with a variety of other experiences, including heavier drinking, lower grades, an earlier age of drinking onset, and having others express concerns about their drinking. The female students who reported blackouts during the 2 weeks before the survey drank far less than male students did during this time period, supporting the use of gender-specific definitions of risky drinking.     

The South Oaks Gambling Screen: a review with reference to Australian use

The South Oaks Gambling Screen (SOGS) is a psychometric instrument widely used internationally to assess the presence of pathological gambling. Developed by Lesieur and Blume (1987) in the United States of America (USA) as a self-rated screening instrument, it is based on DSM-III and DSM-III-R criteria. This paper describes the origins and psychometric development of the SOGS and comments critically in relation to its construct validity and cutoff scores. Reference is made to the use of the SOGS in the Australian setting, where historically gambling has been a widely accepted part of the culture, corresponding to one of the highest rates of legalised gambling and gambling expenditure in the world. An alternative approach to the development of an instrument to detect people who have problems in relation to gambling is proposed.     

Calculating the density and distribution function for the singly and doubly noncentral F

Simple, closed form saddlepoint approximations for the distribution and density of the singly and doubly noncentral F distributions are presented. Their overwhelming accuracy is demonstrated numerically using a variety of parameter values. The approximations are shown to be uniform in the right tail and the associated limitating relative error is derived. Difficulties associated with some algorithms used for exact computation of the singly noncentral F are noted.     

Knowledge and Perceptions of Child-Care Social Workers about ADHD

Correspondence to David Pentecost, Department of Child and Adolescent Mental Health, Finchley Memorial Hospital, Granville Road, London, N12 0JE. E-mail: david.pentecost{at}lineone.net Summary Four hundred and forty social work practitioners for children,including those of Guardian ad Litem status, were surveyed regardingtheir knowledge and perceptions concerning attention deficithyperactivity disorder (ADHD). Questionnaires were distributedto the social workers via managers in seven boroughs in thesouth-east of England. The majority of practitioners in thesample were able to correctly identify the key diagnostic criteriaclosely associated with the condition. Over a third of respondentswere unsure of the appropriateness of treatment with stimulantmedication while the large majority felt that psychosocial interventionsinvolving the families were appropriate. Length of post-qualifyingexperience was found to be a crucial variable influencing bothknowledge about ADHD and the preferences for interventions forthe condition. Less than three out of ten practitioners regardedit as important to involve the Children with Disabilities Teams(CDTs) in such cases and a similar proportion were unaware oflocal resources that may support these children and their families.The results are discussed in relation to previous studies, implicationsfor social work practice and training and the role of CDTs inthe field.     

The role of the health care leader. Past, present, future

Strong, effective communication may be the single most important key to success for any type of executive. Leaders of health care organizations must be able to promote ideas that others will implement, help staff see the value of their work, and have the vision to overcome limitations that stand in the way of progress.     

Customized clinical case management for chronically ill patients. Health system sees remarkable results with teams of case managers,physicians, patients

Securing excellent care and positive outcomes for seriously ill, high-risk patients requires extraordinary measures. A health system in Georgia is experiencing strong results by taking a team approach to health care with case managers, physicians and patients working together.     

Practical Methods for Meeting Remediation Goals at Hazardous Waste Sites

Risk-based cleanup goals or preliminary remediation goals (PRGs) are established at hazardous waste sites when contaminant concentrations in air, soil, surface water, or groundwater exceed specified acceptable risk levels. When derived in accordance with the Environmental Protection Agency's risk assessment guidance, the PRG is intended to represent the average contaminant concentration within an exposure unit area that is left on the site following remediation. The PRG, however, frequently has been used inconsistently at Superfund sites with a number of remediation decisions using the PRG as a not-to-exceed concentration (NTEC). Such misapplications could result in overly conservative and unnecessarily costly remedial actions. The PRG should be applied in remedial actions in the same manner in which it was generated. Statistical methods, such as Bower's Confidence Response Goal, and mathematical methods such as "iterative removal of hot spots," are available to assist in the development of NTECs that ensure the average postremediation contaminant concentration is at or below the PRG. These NTECs can provide the risk manager with a more practical cleanup goal. In addition, an acute PRG can be developed to ensure that contaminant concentrations left on-site following remediation are not so high as to pose an acute or short-term health risk if excessive exposure to small areas of the site should occur. A case study demonstrates cost savings of five to ten times associated with the more scientifically sound use of the PRG as a postremediation site average, and development of a separate NTEC and acute PRG based on the methods referenced in this article.     

Perspectives on Incorporating Human Neurobehavioral End Points in Risk Assessments

Three topics are addressed: (1) measurement issues (e.g., the reliability and validity of neurobehavioral test scores), (2) general principles of assessment, including test selection, and (3) interpretation of scores. Psychological tests generally perform as well as medical tests in terms of reliability and validity. Test manuals, assessment textbooks, and psychologists are useful resources to the risk assessor. The variety of different tests employed in neurobehavioral studies complicates interstudy comparisons. In addition, tests that ostensibly assess the same general domain of function might assess somewhat different abilities within that domain. Although a uniform battery for use in all studies seems desirable, the battery appropriate for a specific study depends on study goals, knowledge about the mechanism(s) of neurotoxicity, nature of the study population, and pattern of exposure. Exposure-related neurobehavioral deficits are generally indicators of "altered function" rather than of "clinical disease." Limiting concern to end points corresponding to clinical disease might not be appropriate. Many neurobehavioral diagnoses are phenomenological and a neurotoxicant might cause a unique pattern of deficits for which no label has been created. The concern that a small shift in the central tendency of a distribution of test scores has no significance for the individual should be reexamined in light of the prevention paradox, formulated on the basis of epidemiologic studies of chronic disease. Poor performance on a neurobehavioral test does not necessarily map clearly onto underlying behavioral or neural substrate. The absence of such linkages, given current knowledge about brain-behavior relationships, should not reduce confidence in neurobehavioral end points. Use of neurobehavioral test scores involves considerations that differ little from those that the risk assessor routinely addresses in using end points commonly used in research on other topics in environmental epidemiology.