Caring for the caregivers

National Family Caregivers month is a reminder of the invaluable contributions of family caregivers--contributions that are too often unrecognized when addressing the costs of health care. Unpaid caregivers spend a substantial percentage of each week "helping out," often with older relatives, which requires major changes in their work patterns. It is clear that these caregivers may need help balancing their work and caregiving responsibilities, and it is tempting to want to help them by "taking over" some of the seemingly overwhelming tasks they face daily. Yet, it is also important to recognize the ways in which these tasks may enrich caregivers' own quality of life. Through listening to caregivers, nurses and other health care professionals can better understand the embedded values, goals, joys, and disappointments that connect their lives with those for whom they care.     

Relationship of interpersonal behaviors and health-related control appraisals to patient satisfaction and compliance in a university health center

OBJECTIVE: The authors' aim was to evaluate patient-provider relationships in a college health center. PARTICIPANTS: Eighty student patients and their health-care providers. METHODS: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before and after the consultation. They evaluated their satisfaction with care and compliance after the consultation and again 2 weeks later. Providers completed measures of their participatory behavior and patients' interpersonal behavior after the consultation. RESULTS: Patients preferred to be well informed and to have their preferences taken into account, and generally felt competent at managing their own health affairs. They indicated they obtained the high level of participation they desired. Patients desired and actually experienced friendly and submissive providers. Degree of match between patients' desired and actual level of involvement in their care was associated with greater satisfaction. A greater match between the extent to which they desired the provider to be affiliative and the provider's actual affiliative behavior was associated with more satisfaction. No variables were predictive of patient compliance. CONCLUSION: The authors discuss results in terms of the influence of situational factors characteristic of a college health center.     

Fatigue and sleep quality in nurses

Fatigue is a critical issue for nurses that may lead to medical errors, degradation in performance, decreased mental acuity, and social problems. Poor sleep quality is also a contributing factor in fatigue that nurses experience. Therefore, the purpose of this study was to examine the differences in perceptions of fatigue between night-shift and day-shift nurses, as measured by scores on the Brief Fatigue Inventory (BFI) and to examine differences in sleep quality between the two groups, as measured by responses on the Pittsburgh Sleep Quality Index (PSQI). Univariate analysis of variance showed significant differences between the two groups on the BFI, with the night-shift cohort reporting higher mean scores on the BFI. Significant differences were also found between the two groups on PSQI mean scores, with the night-shift cohort reporting higher mean scores. Findings from this study suggest that night-shift nurses, compared with day-shift nurses, perceived a much higher level of fatigue and had poorer sleep quality. Further research is needed to evaluate interventions that might decrease fatigue in nurses and improve their sleep quality.     

Pearls and pitfalls in evaluating a Student Assistance Program: a five-year case study

This article presents data from a five-year evaluation-research case study of a large urban schools district's internal Student Assistance Program (SAP). The district employed specially trained and licensed school-based counselors to implement an internal SAP expanded to include tertiary prevention, and modeled after an employee assistance program established for adults. From the population of more than 10,000 students who received some type of program assistance for at-risk behaviors, a stratified random sample of 2,238 cases, over a five year period, were reviewed. Results indicate a statistically significant decline (p < .05) in students' drug use and a significant improvement in internal locus of control occurred each year. While not statistically significant, the average number of student discipline referrals was less than the year prior to program admission; however, there was no significant change in academic performance. A significant correlation between students' drug use and the amount of time in program, the type of assistance received, and the student's custody status was also found.     

Rhetoric and Reality of Economic Self-sufficiency Among Rural,Low-Income Mothers: A Longitudinal Study

This study examined the contributions of maternal labor force participation and marital status on economic self-sufficiency over time for rural mothers. Data were from 174 rural families participating in three waves of data collection in Rural Families Speak. χ ² and multiple logistic regression were utilized. Results revealed only one-third of mothers moved toward economic self-sufficiency over three years. Maternal education, employment status, and weekly work hours were associated with improved economic well-being. Compared to single-parent families, unmarried-couple and married-couple families had increased odds of improving economically. In an analysis of all mothers with partners, married or unmarried, martial status was not significant in economic improvement. Findings suggest the role of marriage in welfare reform for rural families should be reconsidered.

'Where are the lesbians in Chaucer?' Lack, opportunity and female homoeroticism in Medieval Studies today

This article explores the study of lesbians in the Middle Ages and proposes that the unstable construct of lesbian poses a problem for traditional Medieval Studies that can lead to the development in Medieval Studies of more nuanced and productive theorizing.     

Bridging the divide in urban sustainability: from human exemptionalism to the new ecological paradigm

This paper reviews the main bodies of contemporary urban sustainability theory. From this analysis, two underpinning paradigms of urban sustainability are identified: (1) The ‘Human Exemptionalism Paradigm’ (HEP), which emphasizes the ability of humans to overcome environmental problems—see Urban Sociology, Urban Ecology, Urban Geography, Urban Psychology and Political Economy; and (2) The ‘New Ecological Paradigm’ (NEP), which emphasizes the criticality of ecological limits to human progress—see Urban Metabolism, Energy/Emergy Analysis and Ecological Footprinting. Each of these approaches is critically reviewed, highlighting their main assumptions, theoretical and practical foci. It is argued in the paper that if the related issues of urban sustainability and development are to be progressed, there needs to be: (1) a greater maturation of the NEP approaches, which are ‘relative newcomers’ to the area of urban theory; and (2) greater integration and dialogue between the HEP and NEP approaches to urban sustainability than has hitherto been the case.