Physician perceptions of medical malpractice and defensive medicine

Using judgments obtained in interviews with 33 Massachusetts physicians, the annual statewide volume of expenditures incurred for defensive medical reasons in 1982 was estimated to be $1.0 billion, 12% of all medical care expenditures. Estimates for the nation were $37 billion, 14% of expenditures. Nationally, 180,000 cesarean deliveries were thought to be performed for defensive motives. In their own institutions, respondents judged 43% of all skull x-rays following injury to be medically justified, 30% to be defensive medicine, 16% to be placebos, and 11% to be physician misjudgments. In considering the economic and noneconomic costs of medical malpractice procedures, the dollar costs of insurance were considered most serious, followed closely by defensive medicine, unfairness, and poorer relations with patients. Thirty-two percent of the responsibility for the negative aspects of malpractice processes was assigned to lawyers, 21% to physicians, 18% to legislatures and courts, 16% to patients, and 13% to insurance companies.     

Public Meetings and Risk Amplification: A Longitudinal Study

This article offers longitudinal data tracking people who did and did not attend a series of public meetings in an upstate New York rural community grappling with the expansion of an existing solid waste landfill and remediation of an adjacent inactive hazardous waste site. Before and after the public meetings, mailed questionnaires measured risk perceptions and perceived credibility of risk managers (here, the state government agencies and the responsible industry) conducting the meetings. Respondents at each measurement point included meeting attendees and nonattendees, with some fluctuation over time when attendees at one measurement point were nonattendees at the next and vice versa. The results from the first survey indicate that following the first two public meetings, attendees perceived greater risks from the waste sites than did nonattendees; attendees also perceived the risk managers as less credible. After the third public meeting, the results showed that attendees' risk perceptions remained steady; however, perceptions of government agency credibility significantly decreased. After the fourth public meeting, the survey found that attendees' risk perceptions were again not significantly different, whereas perceptions of government agency credibility increased significantly. The industry's credibility also increased, though only among attendees who had attended the most recent public meeting, not among attendees who had attended both the third and fourth public meetings. For nonattendees, risk perceptions and credibility ratings did not change. The discussion examines how distinctive characteristics of communication at each public meeting may have resulted in different effects and proposes hypotheses for future research.     

Staying strong: gender ideologies among African-American adolescents and the implications for HIV/STI prevention

This paper explores adolescents' definitions of what it means to be a man and a woman, the psycho-social context surrounding the formation of gender ideologies and their relationship to HIV/STI prevention. Semi-structured, in-depth interviews were conducted with fifty African-American adolescents living in Baltimore, Maryland. Female gender ideologies included economic independence, emotional strength and caretaking. Male gender ideologies emphasized financial responsibility, toughness and sexual prowess. Findings suggest that stronger adherence to male gender ideologies related to toughness and sexual prowess is influenced by male participants' perceived inability to fulfill their primary gender role as economic providers and the importance of gaining approval from male peers in the absence of adult male role models. Stronger adherence to female gender ideologies related to emotional strength and caretaking may be linked to a heightened desire for male intimacy and tolerance of male sexual risk behavior. Implications of the gender ideologies documented and their commonalities are discussed in terms of HIV/STI prevention.     

Adolescent self-mutilation: diagnosis & treatment

Self-mutilation is complicated and difficult to diagnose. Its incidence among adolescents has increased during the past 10 years. Most mental health professionals discover that the behavior has been part of patients' lives long before their initial visit and that patients have become very good at hiding their behavior. The literature on self-mutilation is increasing, but newer statistics, specifically about cutting and picking behaviors, need to be assessed. The disorder often co-exists with another disorder that requires psychotropic medications, the administration of which should be managed by psychiatric clinicians who specialize in children and adolescents. A multidisciplinary team is necessary to achieve the best outcomes.     

Characteristics of the female athlete triad in collegiate cross-country runners

The Female Athlete Triad is a life-threatening syndrome defined by disordered eating, amenorrhea, and osteoporosis. OBJECTIVE AND PARTICIPANTS: The author's purpose in this study was to examine female cross-country runners' (N=300) calcium consumption, along with the prevalence of 2 components of the triad: disordered eating and menstrual dysfunction. METHODS: The author used measures including the Orientation to Exercise Questionnaire, Calcium Rapid Assessment Method, and questions related to height, weight, exercise time, perceptions of eating disorders, and menstrual status. Previous or current eating disorders were reported by 19.4% of the women, 23.0% had irregular menstrual cycles, and 29.1% had inadequate calcium intake. RESULTS: Those athletes perceiving a previous/current eating disorder scored higher on the Orientation to Exercise questionnaire than did those who did not perceive such. CONCLUSION: The author recommends educational efforts for the prevention of components of the Female Athlete Triad.     

The effect of a novel ADL-based training program on performance of activities of daily living and physical fitness

The purpose of this study was to determine the degree to which a novel training program based on activities of daily living (ADL) would affect performance of ADLs, as well as the fitness of older adults. Fourteen individuals (mean age 82 years) took part in a 10-week control period followed by a 10-week ADL-based training program. Pre- and posttests included the Physical Performance Test (PPT), the Physical Functional Performance-10 (PFP-10), and the Senior Fitness Test (SFT). After the training period, improvements ranging from 7% to 33% (p<.05) were seen on the PPT and PFP-10 and on three items of the SFT. After conversion to standard scores, the magnitude of change in the PPT and the PFP10 was significantly greater (p<.05) than the magnitude of change in the SFT. These data support the idea that this novel ADL-based training program was able to facilitate improved performance of ADLs, as well as select measures of fitness among older adults.     

Differential Recovery Migration across the Rural–Urban Gradient: Minimal and Short-Term Population Gains for Rural Disaster-Affected Gulf Coast Counties

Places affected or threatened by extreme environmental disturbances confront a number of significant issues, including whether their populations will stay the same or change through migration. Research on Hurricanes Katrina and Rita shows some displaced residents returned to their disaster-affected communities once the built environment was restored, new migrants settled in affected places as part of the rebuilding effort, and the regional migration system grew more urbanized and spatially concentrated during post-disaster years. Research also shows that not all disaster-affected places recovered their populations. Our study examines whether differential recovery is systematically patterned along the rural–urban gradient. Using U.S. Census Bureau estimates and IRS county-to-county migration data, we investigate whether the 2005 hurricane season differentially exacerbated or altered previous migration trends across a rural–urban gradient that incorporates proximity to metropolitan areas and disaster-related housing loss. We find a rural–urban differential in Gulf Coast recovery migration: The disaster boosted migration among non-metropolitan counties, yet these increases were smaller and short-lived compared to the patterns found for metropolitan counties, most especially high loss metropolitan counties. Our findings encourage theories of environmental migration to incorporate spatial differentiation and scenarios of environmental changes to account for differential impacts on settlement patterns across the rural–urban continuum.     

Writing resistance together

This piece of writing is a joint initiative by the participants in the Gender, Work and Organization writing workshop organized in Helsinki, Finland, in June 2019. This is a particular form of writing differently. We engage in collective writing and embody what it means to write resistance to established academic practices and conventions together. This is a form of emancipatory initiative where we care for each other as writers and as human beings. There are many author voices and we aim to keep the text open and dialogical. As such, this piece of writing is about suppressed thoughts and feelings that our collective picket line allows us to express. In order to maintain the open‐ended nature of the text, and perhaps also to retain some ‘dirtiness’ that is essential to writing, the article has not been language checked throughout by a native speaker of English.