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.     

Gays and lesbians in local races: a study of electoral viability

Although lesbians and gays are more visible in the political arena than in the past, there is little published research on their electoral viability. This article helps to fill that void by presenting results of experimental research featuring respondents' reactions to a hypothetical candidate for a non-partisan city council seat. Sex and sexual orientation of the candidates were manipulated so that six categories were tested: a straight woman, a lesbian, a woman rumored to be lesbian, a straight man, a gay man, and a man rumored to be gay. The findings suggest that openly gay and lesbian candidates are seen as less viable than straight candidates or those rumored to be homosexual. Hence, the extent to which a candidate portrays his or her sexual orientation appears to make a difference in the chance to win elective office.     

Widowhood and spirituality: coping responses to bereavement

Nearly half of women age 65 or older are widows and nearly 70% of these women live alone. Because older women are three times more likely than their male counterparts to be widowed, widowhood has been labeled a primarily female phenomenon. This review article has two aims: (a) to discuss the impact of widowhood on the lives of older women and (b) to discuss how religion and spirituality may be used as coping methods for conjugal loss. After reviewing the literature the authors conclude that older women use religious coping as well as religious and spiritual beliefs and behaviors to facilitate positive adjustment to the loss of a spouse.     

Casual sex among Australian schoolies

This study of the casual sexual partnering of 570 male and 776 female Australian high school students on a schoolies week vacation expands on earlier research on factors that influence the sexual activity of vacationing youth. Over 60% of the men and nearly 40% of the women who engaged in sexual intercourse during schoolies week did so with a casual partner. We used logistic regression to test an expanded version of Triandis Theory of Interpersonal Behavior (TIB) in explaining casual sexual partnering. Situational experiences (similar to what others have called situational disinhibition), prior sexual experiences and intentions (similar to what others have called spillover) influenced casual sexual partnering. Different causal pathways were demonstrated for men and women.     

It's a rave new world: estimating the prevalence and perceived harm of ecstasy and other drug use among club rave attendees

The use of 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy") appears to be increasing worldwide, with "rave" attendees being one high-risk population. To date, however, only one study has collected ecstasy use information from rave attendees in the United States. To address this limitation, we collected self-report drug use information from 70 adult "club rave" attendees within the Baltimore-Washington corridor in April and May 2002. Data collection was scheduled between 12 A.M. and 5 A.M. Participation rates were high, with 85 percent of the club rave attendees completing the interview. Eighty-six percent of the respondents reported lifetime ecstasy use, 51 percent reported 30-day use, and 30 percent reported using ecstasy within the two days preceding the interview. While past-year ecstasy users were comparable to non-users with respect to a host of demographic and drug use variables, non-ecstasy users were significantly more likely than past-year users to perceive risks associated with the regular use of alcohol and ecstasy. Not surprisingly, non-ecstasy users were significantly more likely than past-year users to perceive harmful long-term physical and psychological effects associated with ecstasy ingestion. These findings suggest that rave attendees may be an important population for ecstasy-related prevention efforts.     

Low emotional intelligence as a predictor of substance-use problems

This study explored the relationship between low emotional intelligence and substance-use problems in adults. One hundred and forty-one participants completed the Self-Administered Alcoholism Screening Test, the Drug Abuse Screening Test, an emotional intelligence scale, and a measure of psychosocial coping. Low emotional intelligence was a significant predictor of both alcohol-related problems and drug-related problems. Poorer coping predicted drug-related problems, but not alcohol-related problems. Coping was not found to be a significant mediator between emotional intelligence and substance-use problems. Possible implications for intervention and treatment efforts are discussed.     

Beliefs and social norms about codeine and promethazine hydrochloride cough syrup (CPHCS) onset and perceived addiction among urban Houstonian adolescents: an addiction trend in the city of lean

In the current study, we used a qualitative approach to investigate relevant beliefs and norms associated with codeine and promethazine hydrochloride cough syrup (CPHCS) consumption, initiation, and perceived addiction among 48 alternative school students who identified themselves as current CPHCS users. In general, both boys and girls believed that CPHCS addiction started during an individual's initial consumption. A majority of both groups reported that their second CPHCS event was initiated during the same or next day after their first event. Our findings suggest that friends and an innovative form of hip-hop music called "screw" are strong reinforcers of CPHCS use.     

The impact on the family therapist of a focus on death, dying, and bereavement

Recognizing the growing numbers of family therapists who are choosing a focus on death, dying, and bereavement, this article addresses the nature of the commitment required--as well as the gifts and challenges presented by work in this area. Particular attention is given to therapists' vulnerability to compassion fatigue and/or vicarious traumatization, both of which are described and discussed. A variety of strategies for individuals and institutions, aimed at supporting professionals and preventing problems, are considered. It is concluded that as family therapists focus on self-care as well as client care, they have the potential to increase not only their effectiveness but also to enhance their own well-being. Implications for training and for research on this topic also are considered.     

Multi-family psychoeducation groups in the treatment of children with mood disorders

This study examined the impact of adjunctive multi-family psychoeducation groups (MFPG) on mood-disordered children aged 8 to 11 and their families. Participants were 35 children and 47 parents from families randomly assigned to either immediate MFPG plus treatment as usual (n = 18) or a 6-month wait-list condition plus treatment as usual (n = 17). At the 6 month follow up, immediate treatment families reported: Increased parental knowledge about childhood mood symptoms; increased positive family interactions as reported by the parent; increased perceptions of parental support as reported by children; and increased utilization of appropriate services by families. Expected impact on decreasing negative family interactions was not found. Results are largely consistent with hypothesized findings and support the need to further investigate the adjunctive role of psychoeducation in the treatment of childhood mood disorders.