A scope-of-practice survey leading to the development of standards of practice for health promotion in higher education

To review and analyze the scope of practice of health promotion services and draft standards of quality indicators for higher education communities, the American College Health Association (ACHA) initiated a Task Force on Health Promotion in Higher Education in May 1996. Members of the task force developed a National Survey on Health Promotion and Education in Institutions of Higher Education and mailed the survey to a stratified random sample of 600 ACHA member institutions, as well as to 97 key "best-practice health promotion leaders". The larger sample produced a 75.3% response rate, and 90.7% of the key informants returned usable surveys. The authors report selected findings from both groups that chronicle the state of health promotion practice in higher education at the close of the 20th century. The task force used the findings to establish a data-driven framework for the Year 2001 Standards of Practice for Health Promotion in Higher Education.     

Cultural perspectives of death,grief, and bereavement

The cultural makeup of the United States continues to change rapidly, and as minority groups continue to grow, these groups' beliefs and customs must be taken into account when examining death, grief, and bereavement. This article discusses the beliefs, customs, and rituals of Latino, African American, Navajo, Jewish, and Hindu groups to raise awareness of the differences health care professionals may encounter among their grieving clients. Discussion of this small sample of minority groups in the United States is not intended to cover all of the degrees of acculturation within each group. Cultural groups are not homogeneous, and individual variation must always be considered in situations of death, grief, and bereavement. However, because the customs, rituals, and beliefs of the groups to which they belong affect individuals' experiences of death, grief, and bereavement, health care professionals need to be open to learning about them to better understand and help.     

Stalking and other forms of intrusive contact after the dissolution of adolescent dating or romantic relationships

Social science research has recently begun to focus on stalking and other forms of intrusive contact occurring among adolescents and young adults. This article presents results from a survey of 681 undergraduates about their experiences with stalking or other forms of intrusive contact occurring after the end of a dating or romantic relationship. Twenty percent of the respondents had been the target of intrusive contact, 8% had initiated intrusive contact, and 1% had been the target of intrusive contact after one relationship and had initiated intrusive contact after another. More females than males were the target of intrusive contact; however, there were no sex differences associated with initiating intrusive contact. About 20% of the respondents had feared for their safety during the intrusive contact. Thirty-one percent of the respondents described the intrusive contact as having a decidedly negative influence on either their subsequent dating relationships or their lives in general.     

Does Intercultural Education Lead to More Cultural Homogeneity and Tolerance?

Intercultural education is often assumed to lead to more tolerance towards other cultures. It may also entail an acculturation process that will lead to more cultural homogeneity. The European School system provides an interesting experiment in intercultural and multilingual education, which can help us answer these questions. A value survey among European Schools alumni showed that a "European School effect" does indeed seem to exist. Students staying longer at a European School and entering the European Schools system at a younger age form a somewhat more culturally homogenous group. There are also strong indications that European Schools' alumni are much more tolerant towards people from other nations and cultures than their average compatriots. However, it is not completely possible to rule out the possibility that this is caused by a sampling effect.     

"He is everything": religion's role in the lives of immigrant youth

Using emergent theme analysis of qualitative interview data in combination with quantitative survey data, the role of religion in the lives of immigrant youth was explored. Latino, Haitian, and Chinese teenagers described, in their own rich words, the significance of religion to them; their responses are reflected in themes that point to the potential protective role of religion for some immigrant groups.     

Estimation of a Change Point in a Hazard Function Based on Censored Data

The hazard function plays an important role in reliability or survival studies since it describes the instantaneous risk of failure of items at a time point, given that they have not failed before. In some real life applications, abrupt changes in the hazard function are observed due to overhauls, major operations or specific maintenance activities. In such situations it is of interest to detect the location where such a change occurs and estimate the size of the change. In this paper we consider the problem of estimating a single change point in a piecewise constant hazard function when the observed variables are subject to random censoring. We suggest an estimation procedure that is based on certain structural properties and on least squares ideas. A simulation study is carried out to compare the performance of this estimator with two estimators available in the literature: an estimator based on a functional of the Nelson-Aalen estimator and a maximum likelihood estimator. The proposed least squares estimator tums out to be less biased than the other two estimators, but has a larger variance. We illustrate the estimation method on some real data sets.     

Working with women in secure environments

1. Women's adverse experiences as patients in secure and other mental health services appear to reflect sexism in wider social and historical contexts. 2. A Women's Service Development Group in a medium secure unit in the United Kingdom has made improvements in services for female patients, including an independent advocacy and befriending service, a Well-Woman Clinic, and other gender-sensitive activities. 3. In general, services were evaluated positively by women. Some dissatisfaction primarily was related to activities, issues concerning seclusion, and the lack of a day area for women only. 4. Women had mixed views about their contact with male staff and patients. Because of this, policies and services in this and related areas should account for individual needs.     

Dialectical behavior therapy for patients with borderline personality disorder.

This study examined the effectiveness of dialectical behavior therapy (DBT) in the treatment of people diagnosed with borderline personality disorder (BPD). The frequency of self-injurious behaviors of 15 women hospitalized on a DBT unit was traced over a 4-week period. Data on self-injurious behaviors and the use of the DBT approach were collected from a review of incident reports and patients' charts. The self-injurious behaviors decreased by almost 50%. In addition, four RNs, who were involved on the DBT unit both before and after the institution of the treatment approach, were interviewed. Semi-structured interviews were conducted to determine the nurses perceptions of the effectiveness of DBT. Their responses were uniformly positive. The most commonly occurring phrase was "it works."     

GAPS between MFT supervision assumptions and common practice: suggested best practices

This article summarizes gaps between assumptions that appear in the literature, research, and accepted standards for marital and family therapy (MFT) supervision, and the common practice of supervisors. Issues that stem from these gaps are highlighted and recommendations are made for closing them. In an effort to refine the standard of practice for MFT supervision, best practice recommendations are offered for MFT supervision.     

Beyond enmeshment: evidence for the independence of intrusiveness and closeness-caregiving in married couples

In a 1996 article on family theory, we (Green & Werner) proposed that family enmeshment should not be equated with high cohesion and that the construct of enmeshment fails to discriminate between two distinct relationship processes: Closeness-caregiving and intrusiveness. In this study, our model of these two independent dimensions of family connectedness was tested by assessing spouses from 264 couples, using the California Inventory for Family Assessment (CIFA). The CIFA scales showed acceptable reliability. Significant interspouse validity correlations also were obtained. As predicted by our theory, factor analyses distinguished dimensions of intrusiveness (blurring of boundaries) from dimensions of closeness-caregiving (such as warmth and nurturance). On all but two factors, behaviors of only one spouse (but not of both) had interpretable loadings. That is, in most areas, the two spouses' behaviors did not load together to form meaningful factors. The latter finding suggests that family systems theory--with its central notion of reciprocally contingent behaviors between family members--may be useful in understanding only a few dimensions of spouses' behavior (such as reciprocal aggression) whereas personality-in-context theories may be better for understanding most other dimensions (such as warmth and nurturance).