Moral imagination in long-term care workers

Our study focused on the cultural construction of dying and death in long-term care facilities. This article centers on direct care workers' perspective of residents' deaths. The data on which this article is based were gathered in a multi-year, multi-site study through formal ethnographic interviews, informal conversations, and on-site observations of residents and staff members. During fieldwork, we noticed an aptitude of direct care workers to deal with residents' deaths, which we named "moral imagination." The term is borrowed from other disciplines to describe a "way of seeing" residents. The case studies presented--that of three direct care workers: a dietary aide, a nurse aide, and an assistant activities director--are suggestive of workers in each category. Our study offers implications for future research concerning direct care workers' value to residents' quality of life. We also propose questions for long-term care facilities about standards of formal caregiving at the end of life.     

Doctor/politician. Physicians often shocked by political reality

What motivates doctors to get into politics? Some say it's a broader sense of accomplishment--helping not only patients, but society as a whole. Learn how some doctor/politicians got into the game, and what they're learning as they play it.     

The Gambling Self-Efficacy Questionnaire: An Initial Psychometric Evaluation

Instruments to assess individuals' self-efficacy for the control of addictive behaviors have been useful for monitoring behavior change, predicting maintenance of treatment gains, and identifying potential relapse situations. The Gambling Self-Efficacy Questionnaire (GSEQ) was developed to assess perceived self-efficacy to control gambling behavior. A demographically diverse sample of 309 adult gamblers completed an initial set of 42 items, of which 16 were selected to form the final version of the GSEQ. The GSEQ showed high internal consistency ( = .96) and good test-retest reliability (r = .86). A factor analysis provided some support for a unitary factor structure. As expected, GSEQ scores were negatively correlated with reports of problematic gambling behavior. Participants experiencing problems related to their gambling behavior scored significantly lower on the GSEQ than those who were not experiencing gambling problems. This psychometric examination of the GSEQ supported its potential utility for treatment planning and outcome evaluation with problem gamblers.     

Engaging Intercollegiate Athletes in Preventing and Intervening in Sexual and Intimate Partner Violence

Abstract

Objective: The object of this exploratory evaluation was to evaluate the “Bringing in the Bystander” sexual and intimate partner violence prevention program with a new sample of intercollegiate athletes. Participants and Methods: Fifty-three male and female athletes participated in the program (experimental group), and 86 were in the control group. All completed pretest, posttest, and 2-month follow-up surveys, including assessment of rape myth acceptance, intent to engage in bystander behaviors, bystander confidence, and bystander behaviors. Results: The program worked overall and for both women and men, improved bystander confidence and intent to engage in bystander behaviors, and did not create significant backlash effects (ie, worsening of attitudes as a result of program). Conclusions: The program fits with the intent of the National Collegiate Athletic Association CHAMPS/Life Skills program regarding its focus on the overall development of student-athletes and demonstrates the promising bystander approach compatible with the 2007 American College Health Association toolkit, Shifting the Paradigm: Primary Prevention of Sexual Violence.     

Aging with HIV: Historical and Intra-Community Differences in Experience of Aging with HIV

Gay men living with HIV/AIDS face a complex of health issues, including those associated with the aging process, long-term HIV infection (25 years or more), and side effects from Highly Active Anti-Retroviral Therapy (HAART). If aging can increase marginalization, this is more likely for the aging HIV positive gay man, who is already marginalized for being queer and living with a stigmatizing disease. This article presents findings from a study of a long-running HIV support group. It locates the members, all gay men living with HIV, in a specific historical and political context to explore how feelings of loss and the struggle to sustain community affect long-term survivors and other older HIV+ gay men. We identify specific challenges presented by aging for men who contracted HIV early in the epidemic, contrasting them with those faced by men infected with the virus later in life. While both groups appear to struggle with a vision of what life could have been, had AIDS not forced loss and change, they also celebrate the community their shared plight has enabled.     

Binge Drinking Among Undergraduate College Students in the United States: Implications for Other Substance Use

Abstract

The authors examined the relationship between binge drinking and other substance use among US college students, using nationally representative data from the 1995 National College Health Risk Behavior Survey implemented by the Centers for Disease Control and Prevention. Compared with nonbinge drinkers, current binge drinkers were significantly more likely to report “ever” using and current use of cigarettes, marijuana, cocaine, and other illegal drugs. The researchers also found that the more often students binge drank, the more likely they were to have ever used cigarettes, marijuana, cocaine, and other drugs, and the more likely they were to report current use of cigarettes and marijuana. Those who design programs to prevent binge drinking and use of other substances should take into account the reality that many students use more than one substance and that the more frequently students report binge drinking, the more likely they are to be using other substances as well.     

Drinking Game Participation Among Undergraduate Students Attending National Alcohol Screening Day

Abstract

Objectives, Participants, Methods: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007. Results: A large percentage of the sample reported lifetime (77%) and recent (52%) drinking game participation. Males were more likely to report recent participation and reported higher levels of consumption while playing drinking games. Drinking game participants were more likely to experience a range of alcohol-related problems, and the relationship between drinking game participation and alcohol-related problems was mediated by weekly alcohol consumption. Conclusions: These results suggest that drinking game participation is a risk factor for elevated levels of alcohol consumption and alcohol-related problems. Programs should be developed to educate students about the risks of drinking game participation, and prevention programs like NASD should address drinking games.     

Student Drinking-Related Problems in an Urban Campus: Implications for Research and Prevention

Abstract

Objective: Researchers who study the etiology of college drinking typically employ measures of alcohol-use behaviors as outcomes; however, relatively little is known about the properties of alcohol-related problems (AP). This study aims to develop a single continuous measure of AP. Participants: The sample included 531 undergraduate college students who were surveyed in March 2007. Methods: The Rasch model was employed for dichotomous variables to analyze the measurement properties of 17 AP items. Results: Although issues with respect to differentiation at low levels of problem severity were identified, based on most strategies, the Rasch-based scale was shown to be a valid and reliable measure of AP among college students. Conclusions: Although there may be some need for slight modification and adjustment in the future, the AP scale developed here can potentially serve as a useful measure for etiological and prevention research.     

The Neurosequential Model of Therapeutics: An Interview with Bruce Perry

In this interview with Bruce Perry, MD, PhD, Senior Fellow of The Child Trauma Academy, Laurie MacKinnon discusses with Dr Perry developmental trauma and the Neurosequential Model of Therapeutics, an approach to clinical problem solving that utilises a developmental lens and incorporates advances in neurobiological development. Dr Perry gives his perspective on the causal connection between childhood abuse and later psychiatric diagnosis, the child's contact with a violent parent post‐separation, the importance of interventions that address the organisation and functioning of lower parts of the brain and his perspective on the use and limitations of psychotropic medications, cognitive behaviour therapy and family therapy.