Does disease management work?

Is disease management the "solution of the month" or a valid approach to organizing patient care? In the era of rapid change in health care, disease management is emerging as one technique suited to improving measurable health care outcomes at greater cost effectiveness. By taking a leading role in the process, those physician executives who commit to this approach can greatly enhance the potential of these programs to accomplish the desired results.     

Public Beliefs About the Beliefs of the Public

Perceptions of the opinions of others are examined on a varietyof issues using data from three sample surveys of metropolitanDetroit. A greal deal of inaccuracy in such perception is evident.Three broad tendencies or patterns can be discerned: "lookingglass perceptions," the general propensity to believe that others'opinions are the same as one's own; "conservative bias," thebelief that the population is more conservative on racial issuesthan it actually is; and limited response to reality constraints.The overall findings suggest that perceptions of public beliefsand attitudes are personally and socially constructed to a muchlarger degree than is often assumed.     

Smoking and Membership in a Fraternity or Sorority: A Systematic Review of the Literature

Abstract

Objective: Fraternity and sorority members have higher rates of smoking than other college students. This systematic review examines studies that included fraternity/sorority membership in their investigation of smoking behaviors. Participants/Methods: Studies identified in MEDLINE, PsychInfo, JSTOR, CINAHL, ERIC, and Google Scholar published between 2003 and 2013 were included if they included fraternity and/or sorority membership, were written in English, published in a peer-reviewed journal, and had smoking as an outcome variable. Nineteen studies were identified for the review. Results: Fraternity/sorority members were more likely to be nondaily smokers. Members who lived in the fraternity/sorority house had higher rates of smoking than members who lived elsewhere. Fraternity/sorority member smoking was associated with alcohol and other substance use. The influence of no-smoking policies on fraternity/sorority member smoking was also examined. Conclusions: Fraternity/sorority membership was associated with higher rates of smoking, but this association was influenced by other substance use and environmental factors.     

Time out for team practice: structured participation as a method of training for team maintenance and development

The social Work service in most Social Services Departments is organised in distinct geographically based units. Indeed, such units have become synonymous with social work teams. These “teams” rely heavily for their success, as responsive and resourceful units, on their ability to work together. The authors believe there are advantages in a collective approach to a team's decision making and service delivery. They describe a method for developing teamwork, centred around a study day, organised on the basis of structured participation and planned in a way which addresses a range of team concerns.

The programme used on the study day stresses the importance of clear objectives, agreed democratically, and the active involvement of all team members. Although this training method developed gradually and pragmatically it is based on a model of team development which identifies a progression through stages of team functioning. The model of learning emphasises change through participation in a climate of openness and trust.

Examples of a programme used by the authors, together with a report prepared as feedback to a team, are included as appendices.     

Chronic strain,daily work stress and pain among workers with rheumatoid arthritis: Does job stress make a bad day worse?

The structure of the job and the daily experience of work are challenges for workers with rheumatoid arthritis. Yet little is known about how these two factors interact to put workers with chronic pain at risk for worse pain on a given day. This exploratory 20 workday diary study of 27 workers with rheumatoid arthritis used hierarchical linear modelling to examine how the structure of the job and neuroticism moderate the relationship between daily undesirable work events (daily stressors), and pain reports within a day. On days with more undesirable work events compared to days with fewer events, individuals with jobs associated with job ‘strain’ (high demand/low control) reported greater midday pain, irrespective of neuroticism and negative mood, than workers with other combinations of demand and control. These findings demonstrate the utility of analysing fluctuating within-person relationships among pain, mood and daily work stressors within the context of the structure of the job, and helps to explain why daily work stressors result in worse health outcomes for some but not all workers with RA.     

Dementia and Dementia Care: The Contributions of a Psychosocial Perspective

The social sciences have and continue to play a unique role in the study of dementia and dementia care. For central to the social sciences, particularly the discipline of sociology is a history of critical inquiry that challenges long held societal assumptions, a concern for issues of social justice, social exclusion and the treatment of marginalized populations. All significant areas to consider when caring for a person with dementia. This chapter will trace the development of the study of dementia and dementia care starting with its biomedical roots, examine the contributions of the social sciences in furthering the conceptual development of the field, and suggest future areas where sociologists can play a critical role in the provision of quality dementia care.     

An Examination of the Association Between Relationship Mindfulness and Psychological and Relational Well-being in Committed Couples

Relationship mindfulness is the degree to which individuals tend to be mindful during interactions with romantic partners. In this study, we examined both the intrapersonal and interpersonal links between relationship mindfulness and psychological and relationship functioning in a sample of 219 couples who had been in their relationship for at least 1 year. Even when accounting for the general tendency to be mindful, relationship mindfulness was linked with markers of relationship well-being and psychological functioning, both intrapersonally and interpersonally. The findings bring to light the importance of considering relationship mindfulness in clinical work with couples that focuses on addressing deficiencies in relationship or psychological well-being.     

Efficacy of newer medications for lower urinary tract symptoms attributed to benign prostatic hyperplasia: a systematic review

We conducted a systematic review to evaluate the efficacy and adverse effects of newer drugs used to treat lower urinary tract symptoms (LUTS). The drugs were either Food and Drug Administration (FDA) approved for benign prostatic hyperplasia (BPH) or not FDA approved for BPH but have been evaluated for treatment of BPH since 2008. We searched bibliographic databases through September 2017. We included randomized controlled trials (RCTs) lasting one month or longer published in English. Outcomes of interest were LUTS assessed by validated measures. Efficacy was interpreted using established thresholds indicating clinical significance that identified the minimal detectable difference. Twenty-three unique, generally short-term, RCTs evaluating over 9000 participants were identified. Alpha-blocker silodosin and phosphodiesterase type 5 inhibitor tadalafil were more effective than placebo in improving LUTS (moderate strength evidence) but these drugs had more adverse effects, including abnormal ejaculation (silodosin). Anticholinergics were only effective versus placebo when combined with an alpha-blocker. Evidence was generally low strength or insufficient for other drugs. Evidence was insufficient to assess long-term efficacy, prevention of symptom progression, need for surgical intervention, or long-term adverse effects. Longer trials are needed to assess the effect of these therapies on response rates using established minimal detectable difference thresholds, disease progression, and harms.