When, catastrophe happens. Assessment and intervention after sudden traumatic death

The goals of grief after sudden traumatic death is to acknowledge the loss, identify the changes the loss will have in the co-victim's life, and reinvest in life within the new structure. Although these goals seem simple, there is no definitive timeline for when these tasks will be engaged and completed by each of the family members. The pathway and time frame for each co-victim may differ.     

New Agendas and New Patterns of International NGO Political Action

International advocacy strategies devised for the political environment in which World Bank policy is decided are often not suitable for advocacy on broader financial policy and trade issues. Advocacy in these new agendas challenges prevailing models, which depict NGOs as mobilizing powerful governments and international organizations to influence a government's behavior. The patterns of international NGO political activity are diverse, sometimes restraining the power of international rules and authorities over individual governments, and require a new or broader model     

The natural history and risk factors of musculoskeletal conditions resulting in disability among US Army personnel

We describe the natural history of 13 musculoskeletal conditions requiring hospitalization and identify demographic, behavioral, psychosocial, occupational, and clinical characteristics most strongly associated with disability discharge from the Army. Subjects included 15,268 active-duty personnel hospitalized for a common musculoskeletal condition between the years 1989-1996 who were retrospectively followed through 1997. Back conditions had the greatest 5-year cumulative risk of disability (21%, 19%, and 17% for intervertebral disc displacement, intervertebral disc degeneration, and nonspecific low back pain, respectively). Cox proportional hazards models identified the following risk factors for disability among males: lower pay grade, musculoskeletal diagnosis, shorter length of service, older age, occupational category, lower job satisfaction, recurrent musculoskeletal hospitalizations, more cigarette smoking, greater work stress, and heavier physical demands. Among females, fewer covariates reached statistical significance, although lower education level was significant in more than one model. Modifiable risk factors related to work (job satisfaction, work stress, physical demands, occupation) and health behaviors (smoking) suggest possible targets for intervention.     

Drinking and other risk taking behaviors of enlisted male soldiers in the US Army

High-risk drinking is among the top three prevention priorities of the Department of Defense. Research suggests that enlisted male soldiers are particularly at risk for unhealthy drinking behaviors. 292,023 enlisted male soldiers who responded to a Health Risk Appraisal (HRA) survey between 1990 and 1998 were dichotomized into high and low-risk drinking groups. Logistic regression analysis showed that high-risk drinkers wore seatbelts less frequently, were more likely to drive > 15 mph over the speed limit, and to smoke more than 20 cigarettes/day. This high-risk group was predominately young (< 25), Caucasian, high school educated or less, and most likely employed as infantrymen or craftsworkers. The two highest risk occupational groups (infantrymen and craftsworkers) differ from each other, and from other Army occupations. Intervention programs should include safe driving habits and smoking cessation, as well as high-risk drinking, and should be tailored to the specific needs of the group at highest risk.     

Single-cell antisense RNA amplification and microarray analysis as a tool for studying neurological degeneration and restoration

Neurodegenerative diseases typically affect subpopulations of neurons. Characterizing these vulnerable cells and identifying the factors that make them susceptible to damage while neighboring cells remain resistant are essential to the understanding of molecular pathogenesis that underlies neurodegenerative diseases. Classically, molecular analysis of the central nervous system involves the identification and isolation of an anatomic region of interest; next, the relevant tissue is pulverized, and the resulting homogenate is analyzed. Although this method provides useful data, its effectiveness diminishes when used in areas of high cellular diversity or in instances in which one cell type is lost as a consequence of selective cell death or quiescence. A technique that affords the ability to assess molecular events in a very precise anatomical site would provide a powerful tool for this research discipline. In this review, we discuss the amplification of messenger RNA from single neural cells and the subsequent use of the RNA to probe DNA microarrays in an effort to create cell-specific molecular profiles. Specifically, recent work in single-cell expression profiling in Alzheimer's and Huntington's diseases is discussed. We also review some new work with neural stem cells and their application to restorative neurobiology. Finally, we discuss the use of cell-specific molecular profiles to better understand the basics of neuronal cell biology.     

Inclusive Governance and “Minority” Groups: The Role of the Third Sector in Wales

Following the establishment of a national legislature in Wales in 1999 the third sector has entered into a pioneering cross-sectoral partnership with the Welsh government. This paper presents the results of a research project that has studied the new structures of devolved governance through the expectations and participation of voluntary organizations representing three marginalized or minority groupings: women, disabled people, and those from an ethnic minority background. The findings reveal that despite varying levels of expectation expressed by minority voluntary groups, active engagement of minority groups in policy making has been a feature of the Assembly's first months. Nevertheless, formidable challenges face both sectoral partners in the new system of governance, not least in creating organizational structures that facilitate partnership working in the devolved polity.     

Training Mental Health Professionals on Ethical Issues and HIV/AIDS

This report describes the importance of ethics training for mental health professionals working with persons infected or affected by HIV/AIDS. We first describe three major ethical dilemmas (confidentiality, duty to warn, and suicide) faced by mental health providers serving persons with HIV/AIDS, and the legal and clinical aspects of these dilemmas. We present data from the South Texas AIDS Training Project describing the types of mental health professionals who have attended workshops on ethical issues and HIV/AIDS. Finally, we report observations about the impact of the ethics training sessions on the participants' knowledge and attitudes.     

Predictors of Adolescent Adjustment: Parent-Peer Relationships and Parent-Child Conflict

A telephone survey of 114 mothers and their sons, 132 mothers and their daughters, 64 fathers and their sons, and 64 fathers and their daughters investigated the predictors of adolescent adjustment, as separately estimated by parents and their children. Results revealed that the best predictors of adolescent adjustment were the level of conflict within the household over mundane domestic matters and the parent's general disposition towards the child's friends. When results were broken into parent-child gender dyads (mother-son, mother-daughter, father-son, father-daughter), it emerged that the father's perceptions tended to be the dominant predictor of adolescent male adjustment.