The ethical aspects of gain sharing with physicians

Gain sharing arrangements involving physicians can be a model combination of ethical business practices and maximizing profits. Or, gain sharing can be as unethical as fee-splitting was at the turn of the century, and as corrupt as any conflict of interest. The devil is--or is not--in the details.     

Misbehaving physicians and professional ethics

Consider a true story about physician misbehavior and see how it was handled. Sometimes a gentle touch works well in situations of unexpected and unintended behavioral problems.     

Wigs, laughter, and subversion: Charles Busch and strategies of drag performance

This paper examines the strategies of drag performer/ playwright Charles Busch. His performance aesthetic is explored and shown to be subversive even though its initial impulse is to entertain. Basing my arguments on the work of Judith Butler, Elin Diamond, and others, I argue that drag queens like Busch can not only entertain but also make audiences question and criticize through drag's power to create a Brechtian alienation effect and historicize the subject. After showing how he can be viewed as a drag queen, I give a brief biography and discuss such contested terms as "camp" and "gay sensibility." I then focus on Busch's staged reading of Ibsen's Hedda Gahler andA Doll's House, both done in one afternoon at Theatre for The New City (6 May 2000). By examining the performance of Busch and his fellow actors, I demonstrate how a contemporary relevancy is achieved by having the roles played by a female impersonator whose acting choices are filtered through a gay sensibility. The ongoing dialectic between spectator and performer creates a historicized moment in performance that underscores the gender dynamics in unexpected and stimulating ways.     

Programa shortstop: a culturally focused juvenile intervention for Hispanic youth

Culturally sensitive juvenile delinquency and substance abuse interventions are relatively limited and unavailable to many first-time Hispanic juvenile offenders. The purpose of this study was to test the effectiveness of a culturally focused juvenile and substance abuse intervention program for first time Hispanic youth offenders. The intent of the program was to decrease juvenile recidivism and increase substance abuse resistance. Programa Shortstop is a family based intervention designed for Hispanic youth ages 9-17. The intervention was delivered to 352 youth and at least one parent/caregiver over the 5-year study period. For intervention youth, the results of the recidivism study (n = 321) indicated that 89% of youth participating in Programa Shortstop between 1995 to 1997 were not rearrested within one year of completing Programa Shortstop. Additionally, statistical paired t-test analysis found that the intervention model had a positive effect on legal knowledge and school related factors associated with substance abuse and delinquency. Parent participants demonstrated significant increases in knowledge related to substance abuse and the legal system.     

A place for marriage and family services in employee assistance programs (EAPs): a survey of EAP client problems and needs

Marriage and family services have not been widely recognized as part of employee assistance programs (EAP), although family and relational problems are widely cited as sources of problems on the job. EAP clients (N = 800, 97% self-referred) indicated how much family, psychological/emotional, drug, alcohol, employment-related, legal, and medical problems troubled them and the need for services in each area. Psychological/emotional (66%) and family (65%) problem areas frequently were rated "considerable" or "extreme." Both areas were rated as "considerable" or "extreme" by 48.6% of participants. In view of the evidence that marriage and family services can be effective with both family and psychological/emotional problems, professionals who are competent to provide such services have much to offer EAP programs.     

Osteoarthritis

In this case study, we describe the symptoms, evaluation, and management of a woman with osteoarthritis (OA). OA is the most common form of arthritis worldwide and it is a major cause of disability in the elderly. Although there are several aging-related changes in the musculoskeletal system that may contribute to the pathogenesis of this disease, research suggests that OA is not merely an inevitable result of aging. OA is most likely a multifactorial process whereby non-aging-related factors also contribute to the onset, progression, and symptomatology of the disease. Specifically, both biochemical factors, including physiological properties of cartilage and bone, and biomechanical factors such as muscle strength, proprioception, and joint loading have been implicated in the pathogenesis of OA. Newer nonpharmacological treatment options are focusing on how to improve symptoms and prevent progression of the disease through mechanical interventions.     

Aging cartilage and osteoarthritis--what's the link?

Cartilage aging can contribute to the development of osteoarthritis (OA), the most common cause of chronic pain and disability in older adults. Articular cartilage is a unique tissue from the perspective of aging in that the cells (chondrocytes) and the majority of the extracellular matrix proteins experience little turnover, resulting in a tissue that must withstand years of use and can also accumulate years of aging-associated changes. Accumulation of advanced glycation end products (AGEs) occurs in cartilage, and the potential role of AGEs in the development of OA is being investigated. An age-associated reduction in growth factor signaling and an increase in oxidative stress may also play an important role in the age-OA connection. Further elucidation of mechanisms that affect chondrocyte function with aging should lead to novel interventions designed to slow the aging process in cartilage with the goal of preventing age-associated OA.     

Sexual behavior among HIV-positive men who have sex with men: what's in a label?

Relatively little attention has been paid to the use and importance of labels used by men who have sex with men to describe insertive or receptive sexual behavior during intercourse. This study examines sexual self-labels, sexual behavior, HIV transmission risk, and psychological functioning among 205 HIV-seropositive men who have sex with men. The majority of participants (88%) identified as a top, a bottom, or versatile. Tops were more likely to engage in insertive anal intercourse than bottoms, and bottoms were more likely to engage in receptive anal intercourse than tops, with versatiles reporting intermediate rates of both behaviors. Although the results suggest preliminary evidence regarding the predictive utility of self-labels, sexual behaviors of self-label groups were greatly overlapping. Differences were found among self-label groups in gay self-identification, internalized homophobia, sexual sensation seeking, and anxiety. Results suggest an added value in assessing self-labels in addition to asking about sexual behavior.     

Support for Waste Facility Siting: Differences between Community Leaders and Residents

Abstract Decisions regarding hazardous waste facility siting are now open to extensive public debate. Efforts on the part of public officials and private companies to site waste management facilities have been thwarted by public opposition. Using survey data from leaders and residents in communities which are hosting or siting facilities, this study examines their sociodemographic characteristics, knowledge, levels of trust, perceptions of risk, perceptions of economic impacts, perceptions of equity issues and the differential effects of these factors on acceptance of local waste facility siting. Leaders in these communities were more supportive of local waste facility siting than were other community residents. The major determinant of leaders' acceptance of waste siting was their perceptions of the economic benefits of a facility to the community. Although this was also important to residents, perceptions of health, safety, and environmental contamination risks had larger effects on their acceptance of such facilities.