Framing nursing practice within a forensic outpatient service

The role of the outpatient forensic nurse is evolving as a specialized area of nursing practice in the community. Nurses must have comprehensive knowledge of the patients, keen intuition, and sound judgment in the continuous clinical assessment of the criminogenic factors that help determine the patients' level of risk. In addition, it is crucial to know and understand the court system, the process of the ORB, and the implications of the disposition order. The comprehensive, client-centered care provided by the Forensic Outpatient Service encompasses multifunctional and complex roles and responsibilities and clearly demonstrates the importance of the forensic outpatient nurse in working with this group of patients.     

DO WE REALLY UNDERSTAND? AN EXPERIENTIAL EXERCISE FOR TRAINING FAMILY THERAPISTS

This paper presents an experiential exercise for training beginning marriage and family therapists, as well as several adaptations of the format. The basic exercise consists of role playing a therapy session in which the people playing the clients speak a language that is not understood by the therapist-in-training. Although the therapist cannot understand the clients, the clients can understand the therapist. This exercise assists students to become more cognizant of the need to be cautious and curious in the cocreation of meaning in therapy. In addition, this exercise builds confidence and clinical skills, such as learning about nonverbal communication while observing process.     

Reiki. A complementary therapy for nursing practice

1. Reiki is an ancient healing art involving the gentle laying on of hands. It can be practiced anytime and anywhere. 2. Reiki can be used as a complementary treatment to medical protocols. 3. Hand positions customarily correspond to the body's endocrine and lymphatic systems and major organs, focusing on seven main chakras. 4. More research investigating the effects of Reiki on persons with psychiatric and medical disorders is necessary.     

The program effect of batterer programs in three cities

Recent meta-analyses and experimental designs of batterer program evaluations suggest little or no program effect. This finding may be compromised by a variety of analytical issues. Instrumental variable analysis addresses some of these issues, especially the relationship of program dropout to batterer reassault. This method of analysis was, therefore, used to test for program effect in a multi-site evaluation. The sites were three well-established batterer programs using a gender-based, cognitive-behavioral approach (n = 640). Completing a batterer program reduced the likelihood of reassault by 44% to 64%, depending on the specification used. Completing a 3-month program appeared to be as effective as completing a 5 1/2- or 9-month program. This moderate effect is an accomplishment considering the problems associated with the program participants and the inconsistency in the criminal justice system at the research sites. The findings remain tentative because of weak instrumental variables for reassault, but do confirm the need for more complex analyses of program effect.     

Effects of alcoholic beverage, instigation, and inhibition on expectancies of aggressive behavior

To investigate the role of alcohol expectancy, situational factors, and personality variables in predicting postdrinking aggression, two questionnaire studies were conducted. Subjects were randomly assigned to imagine themselves and their responses in a scenario situation, which was a combination of different beverages (soda vs. alcohol), instigation, and inhibition conditions. Both studies found significant 3-way interactions of personality aggression proneness (Buss-Durkee Hostility Inventory Assault scale) by beverage condition and by situational cue condition on subjects' reported likelihood of engaging in aggressive behavior. Expected aggression was strongly associated with greater aggression proneness in the nonalcoholic condition when there was a situational cue (low inhibition in Study 1, high instigation in Study 2) invoking aggression, but not when the situational cue was absent. This relationship between aggression proneness and expected aggression, however, was attenuated in the alcoholic drink conditions in both studies. In general, it was found that the effect of alcohol on expected aggression was minor relative to the large and significant effects of aggression proneness, instigation, and inhibition.     

Attitudinal acceptance of intimate partner violence among U.S. adults

Attitudinal acceptance of intimate partner violence (IPV) is an important correlate of violent behavior. This study examined acceptance of IPV using data collected from a nationally representative telephone survey of 5,238 adults. Multivariable logistic regression analyses were used to test for associations between sociodemographic characteristics, exposure to violence, question order, and acceptance of hitting a spouse or boyfriend/girlfriend under specific circumstances. Depending on the circumstance examined, acceptance of IPV was significantly higher among participants who were male and younger than 35; were non-White; were divorced, separated, or had never married; had not completed high school; had a low household income; or were victims of violence within the past 12 months. Participants were more accepting of women hitting men; they also were consistently more likely to report tolerance of IPV if they were asked first about women hitting men rather than men hitting women. Reports of IPV tolerance need to be interpreted within the context of the survey. Efforts to change IPV attitudes can be tailored to specific IPV circumstances and subgroups, and these efforts should emphasize that the use of physical violence is unacceptable to both genders.     

The epidemiology of physical attack and rape among crack-using women

This prospective study examines the epidemiology of physical attack and rape among a sample of 171 not-in-treatment, crack-cocaine using women. Since initiating crack use, 62% of the women reported suffering a physical attack. The annual rate of victimization by physical attack was 45%. Overall, more than half of the victims sought medical care subsequent to an attack. The prevalence of rape since crack use was initiated was 32%, and the annual rate was 11%. Among those women having been raped since they initiated crack use, 83% reported they were high on crack when the crime occurred as were an estimated 57% of the perpetrators. Logistic regression analyses showed that duration of crack use, arrest for prostitution, and some college education were predictors of having experienced a physical attack. Duration of crack use and a history of prostitution were predictors of suffering a rape. Drug abuse treatment programs must be sensitive to high levels of violence victimization experienced by crack-cocaine using women. Screening women for victimization, and treating the problems that emanate from it, may help make drug abuse treatment more effective.     

Health professional students' occupational exposures to blood-borne pathogens: primary and secondary prevention strategies

Health science students, along with the health professionals they hope to become, are at increased risk for certain occupational injuries and illnesses. One of these risks is occupational exposure to blood-borne pathogens, such as human immunodeficiency virus (HIV) and hepatitis, which may result in severe illnesses or even death. Two case studies demonstrate postexposure care of exposed individuals at the University of Texas Medical Branch Student Health Services before and after policy changes and prevention strategies were strengthened in response to exposure incidents.     

Outbreaks of acute gastroenteritis associated with Norwalk-like viruses in campus settings

Norwalk-like viruses (NLVs) are transmitted by fecally contaminated food, water, fomites, and person-to-person contact. They are a leading cause of acute gastroenteritis epidemics in industrialized countries. NLV outbreaks are characterized by a 12- to 48-hour incubation period; nausea, vomiting, and diarrhea for 24 to 72 hours; and high secondary attack rates. NLV infections spread rapidly on college and university campuses because of close living quarters, shared bathrooms and common rooms, many food handlers, popular self-service salad bars in dining halls, and person-to-person contact through sports and recreational activities. The illness is generally mild and self-limited but an outbreak can strain the resources of campus health services and cause high absenteeism among both students and staff. Treatment is primarily through antiemetic medication and oral rehydration. Prevention and control of NLV outbreaks rests on promoting hand washing; enforcement of strict hygiene in all food preparation areas; and prompt, rigorous cleaning of potentially contaminated areas where someone has been ill.