bluuebunny/crossref_metadata_2025 huggingface dataset:
The Nurse and the Terminally Ill Patient: Some Perspectives and Projected Actions
Authors: Hoggatt Loretta , Spilka Bernard
Published: May 2005

The views of health professionals on death and dying are of the utmost significance to all members of our society. In the present study nurses in seven specialties offered their outlooks in this area. Descriptive and inferential data are reported on twenty items. Relative to terminality, questions are raised on the adequacy of nursing education in this realm, the feelings of capability of nurses of varying experience when working with dying patients, the desirability of employing heroic measures to sustain life and many other considerations. Variation in specialty perspectives are also evidenced.
Children's Internet Uses at Home
Authors: Wang Yu-Mei
Published: May 2005

The Internet is rapidly making its way to American residences. Nowadays, millions of children spend a tremendous amount of time at home, riding on the Internet superhighway. However, little is known about how children are using the Internet at home. This study is designed to investigate sixth graders' Internet uses at home environment. Questions investigated are: 1) What Internet activities were the children likely to engage in at home? 2) What were the children's perceptions about online information resources? 3) What were the roles of parents in supervising and guiding children's Internet uses at home? 4) What were the teachers' roles in associating with children's home Internet uses? 5) What were the children's perceptions of how knowledgeable their parents and teachers were in providing them guidance and advice in the Internet use?
Primary Prevention in Public Health: An Analysis of Basic Assumptions
Authors: Ratcliffe John , Wallack Lawrence
Published: May 2005

The common definition of primary prevention is straightforward; but how it is transformed into a framework to guide action is based on personal and societal feelings and beliefs about the basis for social organization. This article focuses on the two contending primary prevention strategies of health promotion and health protection. The contention between the two strategies stems from a basic disagreement about disease causality in modern society. Health promotion is based on the “lifestyle” theory of disease causality, which sees individual health status linked ultimately to personal decisions about diet, stress, and drug habits. Primary prevention, from this perspective, entails persuading individuals to forgo their risk- taking, self-destructive behavior. Health protection, on the other hand, is based on the “social-structural” theory of disease causality. This theory sees the health status of populations linked ultimately to the unequal distribution of social resources, industrial pollution, occupational stress, and “anti-health promotion” marketing practices. Primary prevention, from this perspective, requires changing existing social and, particularly, economic policies and structures. In order to provide a basis for choosing between these contending strategies, the demonstrated (i.e., past) impact of each strategy on the health of the public is examined. Two conclusions are drawn. First, the health promotion strategy shows little potential for improving the public health, because it systematically ignores the risk- imposing, other-destructive behavior of influential actors (policy-makers and institutions) in society. And second, effective primary prevention efforts entail an “upstream” approach that results in far-reaching sociopolitical and economic change.
The Suicide Survivors Grief Group
Authors: Wrobleski Adina
Published: May 2005

A description is given of the six-year-old Suicide Survivors Grief Group in Minneapolis-St. Paul. The structure, dynamics, and problems of survivors, as well as the unique problems of grief in suicide death are presented. There are remaining problems, primarily in reaching survivors who are too stigmatized to respond, but there is widespread community and professional acceptance and support. It is concluded that at least for as long as suicide death is tabooed and stigmatized, there will be a need for separate grief groups for suicide survivors.
The Case of the Mysteriously Appearing Child
Authors: Cernada George P.
Published: May 2005

The story of how a family planning postage stamp managed to get pasted on several million envelopes in Taiwan. Its chronological unfolding illustrates the complexity of applying research findings to an ongoing program in a developing country setting. The need for involving program planners early in research development, for in-service staff education, for linkage between related agencies implementing programs, and for caution in using western theoretical orientations is considered. Suggestions for discussion are provided.
Drug Abuse and Eating Disorders: Prevention Implications
Authors: Watts W. David , Ellis Ann Marie
Published: May 2005

This article explores the relationship between drug and alcohol abuse and eating disorders in a sample of adolescent females using a self-report methodology. An Eating Disorders Risk (EDR) Scale is adopted and correlated with drug and alcohol use, other forms of deviance, family and peer relationships, and depression. The findings support the concept of a generalized theory of addictions based on psychosocial, family, and peer factors. Family and peer prevention applications and a need for further research on the correlates of depression are discussed.
Overcoming Ethnic Barriers in Mass-Media Employment
Authors: Hoglin J. G.
Published: May 2005

The qualitative and quantitative deficiencies in mass-media hiring of ethnic minority members can be traced largely to the lack of special training. Motivation toward the college education required for many jobs in mass communication has been lacking in the South.

The University of Central Florida started a summer workshop in 1977 designed to acquaint minority high school students with the variety of occupations in the media and the kinds of training required for them.

The goal of encouraging college training is being fulfilled so far, and the participants in the Minority Auxiliary Summer Session in Communication responded in highly favorable terms to surveys of opinion on the program.
Thinking in Pixels: An Editing System for Electronic Texts
Authors: Kuhlenschmidt Sally , Mosby Charmaine
Published: May 2005

On-line publication alters the relationship between editor and writer, creating a potentially more collaborative and fluid text. This article explores implications of increased publication options and examines conceptual distinctions among Fixed-Format, Electronic, and Meta-media Editors. We propose a keyboard editing/commenting technique that will work across platforms and software programs and in every mode of electronic communication including simple e-mail. This ASCII based system uses only four symbols in various combinations to convey all of the print editor's marks and also allows the editor or reader to insert comments in the immediate context. The result is increased efficiency and flexibility for writer and editor or teacher and student.
The Neuropsychiatric Aspects of Boxing
Authors: Mendez Mario F.
Published: May 2005

Objective:

To review the neuropsychiatry of boxing.

Method:

This update considers the clinical, neuropsychological, diagnostic, neurobiological, and management aspects of boxing-related brain injury.

Results:

Professional boxers with multiple bouts and repeated head blows are prone to chronic traumatic encephalopathy (CTE). Repeated head blows produce rotational acceleration of the brain, diffuse axonal injury, and other neuropathological features. CTE includes motor changes such as tremor, dysarthria, and parkinsonism; cognitive changes such as mental slowing and memory deficits; and psychiatric changes such as explosive behavior, morbid jealousy, pathological intoxication, and paranoia. Screening with neuropsychological tests and neuroimaging may help predict those boxers at risk for CTE.

Conclusions:

Boxing results in a spectrum of CTE ranging from mild, nonprogressive motor changes to dementia pugilistica. Recent emphasis on safety in the ring, rehabilitation techniques, and other interventions do not eliminate the risk for CTE. For this reason, there is an active movement to ban boxing.
Characteristics of Physicians Interested in Psychiatric Education
Authors: Haar Esther , Hyams Lyon , Green Maurice R.
Published: May 2005

720 primary (nonpsychiatrist) physicians responded to a mail distributed questionnaire investigating their attitudes to and practices with psychiatric education, psychiatrists and emotionally disturbed patients. Respondents were divided into two groups on the basis of whether or not they had attended postgraduate courses in psychiatry. Outstanding characteristics of the physicians who had taken courses compared to those who had not were: 1) a higher percentage in general practice than in a specialty, 2) greater confidence in their own psychiatric diagnostic and therapeutic skills, 3) higher estimates of psychiatric disorders in their practices, 4) more willingness to treat emotionally disturbed patients, including aftercare patients, 5) more competent use of psychoactive drugs for depression and schizophrenia, 6) greater interest in psychiatry, 7) stronger subjective needs for help with the management of their disturbed patients, and 8) higher frequency of personal psychotherapy. The two groups did not differ in: 1) evaluations of their previous educational experiences in psychiatry, 2) the hours per week devoted to medical practice, or the number of patients seen per day, 3) indications for intervention or preferred modes of treatment with psychiatric cases, 4) attitudes towards the usefulness of psychiatry, 5) frequency of making psychiatric referrals, and 6) skill with psychoactive drugs for anxiety.
Adult Romantic Attachment among Women who Experienced Childhood Maternal Loss
Authors: Mireault Gina , Bearor Kimberly , Thomas Toni
Published: May 2005

This study examined the relationship between childhood maternal loss and adult attachment quality among 30 motherless women and their matched controls. Motherless women reported significantly more anxiety and avoidance in their adult romantic relationships, despite the fact that two-thirds of them recalled positive relationships with their deceased parents. The role of perceived vulnerability to loss is discussed as a possible explanation, whereby motherless women may feel preoccupied with the potential loss of their spouses (anxiety) and protect themselves from future losses by disengaging from their spousal relationships (avoidance).
Population Learning among Rural Turkish Youth from an Adult-Oriented Family Planning Program
Authors: Carpenter-Yaman Carol E. , Poffenberger Thomas
Published: May 2005

This study indicates that rural Turkish youth learn indirectly from family planning programs directed toward adults. Female youth in villages, however, seem to pick up much more family planning information than male youth. Two program implications emerge: first, that unmarried youth should be included in ongoing family planning program efforts and second, that stronger efforts must be made to reach adolescent males who eventually will be major decision-makers on family size.
Mentor/MacVideo: A Videodisc Authoring System for Educators Who are Not Computer Specialists
Authors: Davis George E. , Schach Stephen R.
Published: May 2005

Mentor/MacVideo is a videodisc authoring system. It is designed for use by educators who know little or nothing about computers; no programming knowledge is needed to construct a course. Further, MacVideo enables authors to perform videodisc editing without using frame numbers. Mentor supports relational format, a method of organizing three concepts that permit the student to explore the concepts in any order, based on how much of the material has been understood at that point. Mentor also supports linear format, where the underlying concept is multi-way branching. The system is currently in use in a number of universities and medical institutes.
Standardizing Writing in Business and Industry
Authors: Fleischhauer F. W.
Published: May 2005

Business and industry spends a great deal of time and money in standardizing office and shop methods, all to promote efficient operations. Yet they give little—if any—thought to one pervasive operation that wastes an unfathomable amount of time and money: written communication. They allow almost any writing approach, as long as something is written. Why? … because they believe that to know how to write an English essay is to know how to communicate on the job. Nothing is further from the truth. Writing in business and industry requires a particular philosophy as well as special writing mechanics that, when combined and standardized, promote efficient communication. This article advances such a philosophy—and some basic writing mechanics—for that standardization.
Sex and Gender: The Challenges for Epidemiologists
Authors: Doyal Lesley
Published: May 2005

Gender issues are now receiving more attention on global and national health agendas. However, the evidence base for policy and practice in this area remains limited and conceptual confusion is still common. This article reviews the challenges facing epidemiologists and other researchers who aim to make their work more “gender sensitive.” It begins by exploring the concepts of biological “sex” and social “gender” and assesses their implications for the health of both women and men. It then reviews a range of strategies for mainstreaming sex and gender into health research. The article concludes with brief comments on the links between gender equity and wider equality concerns.
A Strategic Response to the Occupational Health Establishment
Authors: Sass Robert
Published: May 2005

The experiences of occupational health and safety “activists” in Canada reveal the limits of achieving reform in working conditions by technical efforts in combination with rank-and-file activation. The author argues that the way union “activists” approach occupational health and safety limits workers in dealing with their actual experiences and understanding about workplace hazards and risk, then discusses the conditions for the awakening of their critical consciousness as a basis of acting on hazardous working conditions. The first movement in the way the worker apprehends the work environment is a movement of negation and is the prior condition to a critical and disclosive discourse about workplace hazards. It is the positive side of “No!” and the taking seriously of workers' rights. It is this negation of the negative that holds out the greatest hope for solidarity and a liberatory community in workplaces, since legislated workers' rights as the basis of protection have become a facade. Workers can respond with the power of saying “No!” in solidarity with suffering workers, and then work through appropriate principles, ends, or strategies avoiding entrapment by a “telos” in the first instance. By laying out these “ends” or a strategic paradigm, one introduces a “conversation stopper” for workers and atrophies their activation.
The Effectiveness of Psychosocial Support during Post-Surgical Treatment of Breast Cancer
Authors: Vachon M. L. S. , Lyall W. A. L. , Rogers J. , Cochrane J. , Freeman S. J. J.
Published: May 2005

Sixty-four women undergoing radiotherapy for breast cancer in a residential setting which offered structured cognitive and emotional support, are compared for level of psychological distress and satisfaction with staff support with 104 women living at home during treatment. The outcome measures were the 30-item Goldberg General Health Questionnaire (GHQ) and a 5-item author-constructed Treatment Support Index. A surprisingly large percentage of the sample did not, at any time, manifest appreciable psychological distress. For those women whose level of distress changed by a GHQ score of 3 or more over the three week course of treatment, residence in the Lodge was associated with decreased risk of change for the worse, and increased probability of change for the better. Results from the Treatment Support Index indicate that a significantly greater percentage of Lodge residents than non-residents were satisfied with the quantity, quality, and/or diversity of support available to them.
Comparing the Validity of Automated and Human Scoring of Essays
Authors: Powers Donald E. , Burstein Jill C. , Chodorow Martin S. , Fowles Mary E. , Kukich Karen
Published: May 2005

Automated, or computer-based, scoring represents one promising possibility for improving the cost effectiveness (and other features) of complex performance assessments (such as direct tests of writing skill) that require examinees to construct responses rather than select them from a set of multiple choices. Indeed, significant advances have been made in applying natural language processing techniques to the automatic scoring of essays. Thus far, most of the validation of automated scoring has focused appropriately (but too narrowly, we contend) on the correspondence between computer-generated scores and those assigned by human readers. Far less effort has been devoted to assessing the relation of automated scores to independent indicators of examinees' writing skills. This study examined the relationship of scores from a graduate level writing assessment to several independent, non-test indicators of examinees' writing skills—both for automated scores and for scores assigned by trained human readers. The extent to which automated and human scores exhibited similar relations with the non-test indicators was taken as evidence of the degree to which the two methods of scoring reflect similar aspects of writing proficiency. Analyses revealed significant, but modest, correlations between the non-test indicators and each of the two methods of scoring. These relations were somewhat weaker for automated scores than for scores awarded by human readers. Overall, however, the results provide some evidence of the validity of one specific procedure for automated scoring.
The Politics of Reproductive Hazards in the Workplace: Class, Gender, and the History of Occupational Lead Exposure
Authors: Morello-Frosch Rachel A.
Published: May 2005

Over the past two decades, several U.S. companies have sought to bar women from jobs that expose them to potential reproductive hazards, justifying these exclusionary policies by their professed concerns for the well-being of unborn children and potential liability. Although recent court cases have stimulated academic interest in this issue, a historical review of the public health and medical literature reveals that this debate is not new. To understand the logic behind the emergence of “fetal protection” policies, one must examine the scientific history of occupational teratogens and the sociopolitical and economic forces that have driven scientific research in this field. Using lead as an example, the author argues that research on the reproductive hazards of employment has historically emphasized the risks to women and downplayed the risks to men. This results in environmental health policies that do not uphold the ultimate goal of occupational safety for all workers, but rather reinforce the systemic segregation of men and women in the workplace. Although the political struggle over exclusionary policies has a feminist orientation, it also has important class dimensions and ultimately must be viewed within the broader context of American capitalist production.
Environmental Influences on Children's Fantasy
Authors: Sheaffer Christopher I. , Gold Steven R. , Henderson Bruce B.
Published: May 2005

A new scale, the Environmental Support for Fantasy Scale (ESFS) was developed to assess factors within the home environment which correlate with measures of children's fantasy. The sample consisted of forty preschool children and their parents. Three scales were derived from the ESFS; a measure of parental attitude, parental control, and environmental fantasy stimulation. A significant first root canonical correlation was found between the three scales of the ESFS and three measures of children's imagination. Parents who provided a role model, were supportive of their children's fantasies, exerted less control over their children's time and activities, and used learning approaches to discipline had children who were more frequent and fanciful fantasizers.
Community-Based Sexual Risk Prevention Program for SRI Lankan Youth: Influencing Sexual-Risk Decision Making
Authors: Nastasi Bonnie K. , Schensul Jean J. , De Silva M. W. Amarasiri , Varjas Kristen , Silva K. Tudor , Ratnayake Priyani , Schensul Stephen L.
Published: May 2005

This article describes the design, implementation, and evaluation of a sexual-risk prevention program focused on the development of individual competencies and cultural norms promoting healthy sexual decision making. The community-based peer-facilitated intervention targeted adolescents and young adult men and women in Sri Lanka, who participated in small-group activities targeting sexual knowledge, attitudes, and practices; risk perception; and sexual-risk decision making. The intervention and evaluation tools were based on formative research data collected from members of the target population. Researchers from Sri Lanka and North America collaborated with local community health workers and community members in formative data collection and program development. The pilot intervention project was successful in improving sexual-risk perception and decision making, and (for women) knowledge of condoms and sexual terminology. The use of group process showed promise as a tool for fostering negotiation of perspectives and consensus building regarding sexuality and sexual risks. The lessons learned from this project can inform the development of culture-specific sexual-risk prevention programs worldwide.
Social Science and Health Policy in the United Kingdom: Some Contributions of the Social Sciences to the Bureaucratization of the National Health Service
Authors: Draper Peter , Smart Tony
Published: May 2005

A current and major health policy, the first fundamental reorganization of the administrative structure of the National Health Service (NHS), is reviewed in this paper. The shake-up in the administration of the NHS is seen as having two main components: a partial integration of the three separate administrative branches, and an injection of a particular kind of managerial ideology. This “management revolution” is seen as consisting essentially of a powerful thrust toward central and bureaucratic control of the NHS.

Social sciences in the broad sense–ranging from work study (organization and methods study) through social medicine and sociology to economics-are reviewed in relation to their contributions to this bureaucratization of the NHS. It is shown that narrow and out-of-date organizational studies and technocratically oriented social medicine have contributed significantly, if sometimes unwillingly and unwittingly, to the drive toward centralization and bureaucratization.

Rejecting a highly bureaucratic form of organization for a national health service, the authors discuss briefly some developments which reflect a more decentralized and more adaptive pattern of administration. The paper suggests that independent research foundations with a strong interest in health have a responsibility to break the incestuous relationships which have developed with the health department in some instances. It is suggested that foundations, professional associations, unions, and consumer groups could promote the maturation of “medical sociology” and “administrator's social science” into a full-blooded sociology of health. Currently social science within the health field in the United Kingdom is seen as being both underfinanced and prostituted to the interests of medical and administrative power groups. A participatory framework for social science is outlined as an alternative to the current models which are based on Taylorism or “scientific management.”
Who Pays for the State? A Reply to Robert Chernomas and Ardeshir Sepehri
Authors: Wright Erik Olin
Published: May 2005

Robert Chernomas and Ardeshir Sepehri indicate that various state-supported transfers that go to the “underclass” are largely paid for by taxation of workers' compensation. Such expenses therefore cannot be considered drains on the social surplus which would otherwise be available to dominant classes in the form of “exploitation.” These arguments are criticized on two grounds. First, Chernomas and Sepehri greatly underestimate the total social costs of the existence of an underclass, and this broader array of costs almost certainly impinges on the social surplus even if direct transfer payments do not. Second, they incorrectly identify the empirical target with the relationship of taxation to the social surplus. Even if state revenues take the form of an income tax on ordinary workers, at least some of this taxation should be considered a deduction from social surplus rather than from workers' standard of living (since, in the absence of the taxation, workers' equilibrium wages would not increase by the equivalent of the taxes).
Needs Assessment and the Problem-Solving Process
Authors: Delamere Trish
Published: May 2005

The purpose of this article is to identify, characterize and exemplify several types of needs assessment procedures which are currently applied in educational and other organizations. The relationship of those different needs assessment procedures to the problem-solving process is discussed [1–3]. An innovative paradigm, the Organizational Elements Model is presented as a pragmatic approach to contemporary decision-making and problem-solving [4]. The Model allows for maximum consideration of the kinds of societal impact our decisions have and presents a useful alternative to planning for organizational success.
The Application of the Free-Market Economic Model in Chile and the Effects on the Population's Health Status
Authors: Haignere Clara S.
Published: May 2005

After the military coup in 1973, probably the most dogmatic application ever of free-market economic policies was implemented in Chile. The military junta has credited the drop in infant mortality since then to the free-market model. This article explores whether lower infant mortality rates are due to improvements in the socioeconomic conditions created by the free-market, or whether they are due to state-sponsored health care services. It concludes that the socioeconomic conditions since 1973 have generally deteriorated, while government supplemental feeding programs and maternal and child health care services have increased. It appears that the free-market has not been the primary determinant of the decline in infant mortality. Rather, state intervention appears to have been more important. Other morbidity statistics, however, indicate a decline in the population's health status since 1973.
The Living and the Dead: Community in the Virtual Cemetery
Authors: Roberts Pamela
Published: May 2005

Rheingold (1993) and others have described the potential for increased connectedness and community in cyberspace, but critics have charged that the Web increases social isolation rather than fostering interpersonal relationships. The present article explores how creating and visiting Web memorials (activities that initially appear isolating) affect the bereaved. Data from three studies on Web memorialization (descriptions of Web memorials, guestbook entries, and a survey of Web memorial authors) are used to examine three aspects of bereavement community: continuing bonds with the dead, strengthening existing relationships among the living, and creating new communities of the bereaved in cyberspace. Analysis suggests that rather than serving as a poor substitute for traditional bereavement activities, Web memorialization is a valued addition, allowing the bereaved to enhance their relationship with the dead and to increase and deepen their connections with others who have suffered a loss.
Stages of Drug Use Acquisition among College Students: Implications for the Prevention of Drug Abuse
Authors: Werch Chudley E. , Meers Betty W. , Farrell Joan
Published: May 2005

The purpose of this study was to examine the stages of drug use acquisition among college students, and the relationship between stage status and motivation to avoid drugs and the frequency of drug use. Six hundred and sixty-nine students from a mid-size public university were selected to participate in the survey. College students were found to differ with regard to their stage of habit acquisition across five drugs. Stage status for a particular drug was associated with motivation to avoid that drug, with less motivation generally being related to greater stage advancement. Stage of acquisition for certain drugs was also found to be related to the frequency of use of other drugs, with alcohol and marijuana stage status being associated with the consumption of the greatest number of drugs. These results suggest that an acquisition stage heuristic holds promise in increasing our understanding of important developmental stages of drug use.
Is Absorption a Diathesis for Dissociation in Sexually and Physically Abused Patients?
Authors: Kunzendorf Robert G. , Hulihan Deborah M. , Simpson William , Pritykina Natasha , Williams Karen
Published: May 2005

In a sample of 251 psychiatric outpatients, either a dissociative disorder or Post-Traumatic Stress Disorder (PTSD) was present in 47 percent of the sixty-four patients with abuse histories and above-median Absorption scores. In contrast, a dissociative disorder or PTSD was present in only 21 percent of the fifty-six patients with abuse histories and below-median Absorption scores, in only 5 percent of the fifty-six patients with no abuse and above-median Absorption, and in only 1 percent of the seventy-five patients with no abuse and below-median Absorption. The current evidence, in conjunction with past evidence for 50 percent heritability of Absorption, raises the possibility that Absorption is a diathesis for dissociative responses to traumatic stress.
Sixteen Years of Dreams Following Spousal Bereavement
Authors: Belicki Kathryn , Gulko Norman , Ruzycki Kate , Aristotle Jill
Published: May 2005

This study compares two contrasting models concerning the relationship of dreams to phases of bereavement. To accomplish this, a content analysis of a widower's 16-year dream diary was conducted. While there was a small tendency for dreams of the deceased being alive again to occur earlier in the diary, and dreams of being separated from the deceased to occur later, in general there was no evidence of an orderly emergence of dream themes across time. These findings are supportive of more recent views of bereavement that stress the importance of redefining a relationship with the deceased rather than resolving grief in an orderly and timely manner. More generally, the present study contributes to a growing recognition that dreams can be a valuable tool for studying reactions to bereavement.
Depression, Perception of Illness and Mortality in Patients with End-Stage Renal Disease
Authors: Peterson Rolf A. , Kimmel Paul L. , Sacks Carol R. , Mesquita Mary Louise , Simmens Samuel J. , Reiss David
Published: May 2005

A role of depression in affecting outcome in patients with end stage renal disease (ESRD) has been suggested but few have assessed psychological parameters and medical factors thought to influence survival simultaneously and prospectively. To assess whether depression or perception of illness influences survival in patients treated for ESRD, we prospectively evaluated fifty-seven patients with ESRD treated with hemodialysis (HD, n = 43) or continuous ambulatory peritoneal dialysis (CAPD, n = 14). Patients were interviewed and completed the Beck Depression Inventory (BDI) and the Illness Effects Questionnaire (IEQ). An ESRD severity coefficient was used to measure chronic illness severity. A cognitive item subset of the BDI (CDI) was used as an additional measure of depression. One and two years later, records were examined to determine survival. When initial results of the assessment of survivors and non-survivors were compared, at one year follow-up, there were no differences in mean age, duration of dialysis, severity scores, BDI or IEQ scores. The initial mean CDI scores in the group of non-survivors, however, were significantly greater than the scores in the survivor group. At two year follow-up, CDI scores were significantly different between groups, and were significant in a hazards regression. Disease severity, age and duration of dialysis were also significantly related to mortality at two year follow-up. We conclude cognitive depression is an important, early, indicator of grave prognosis in patients treated for ESRD. Early recognition of and therapeutic efforts directed toward the treatment of depression might modify outcome in ESRD patients.
Are Persons Reporting “Near-Death Experiences” Really near Death? A Study of Medical Records
Authors: Stevenson Ian , Cook Emily Williams , Clean-Rice Nicholas Mc
Published: May 2005

In the cases of 107 patients who reported unusual experiences during an illness or injury, such as seeing their own body from a different position in space, medical records were obtained for forty patients. These were examined and rated according to the evidence they provided of grave, life-threatening illness or injury. Eighteen patients (45%) were judged to have had serious, life-threatening illnesses or injuries, but twenty-two (55%) were rated as having had no life-threatening condition. Nevertheless, thirty-three (82.5%) of the patients believed that they had been “dead” or near death. Deficiencies in the medical records may account for a few of the discrepancies between patients' reports and medical records. However, it seems likely that an important precipitator of the so-called near-death experience is the belief that one is dying—whether or not one is in fact close to death.
Medical Dominance in Canada in Historical Perspective: The Rise and Fall of Medicine?
Authors: Coburn David , Torrance George M. , Kaufert Joseph M.
Published: May 2005

Freidson's concept of medical dominance is compared to the alternative conceptions of neo-Marxist writers. Dominance is then examined in historical perspective, using medicine in Canada (mainly Ontario) as a case study. Medicine emerged as the dominant health occupation in Canada in the late 19th and early 20th centuries, consolidating its power between World War I and the Saskatchewan doctors' strike of 1962. The authors argue that medical dominance has declined since that time due to such factors as the involvement of the state in health insurance, the rise of other health occupations, increasing public or at least elite skepticism, and possible internal fragmentation. The underlying social explanation for this historical process is sought in changes in the Canadian class structure, specifically the spread of the capitalist mode of production, the decline of the petite bourgeoisie, and the rise of the state. It is suggested that Freidson's specific accounts of the history of medicine must be incorporated for explanatory purposes within the broader neo-Marxist view of medicine as an intermediary rather than an ultimately determining institution.
More Myths and Misconceptions: A Reply to Comments on an Article
Authors: Coyte Peter C.
Published: May 2005

Two issues in the debate about the relative economic success of Canada's health care system require clarification. First, while the upward trends in the share of health expenditures in GNP and in real per capita health expenditures have been similar in Canada and the United States for the last 30 years, only the latter has increased at a significantly lower rate since the early 1970s. Second, the trends in health expenditures are similar in Canada and the United States. The author therefore speculates that an explanation for the similarity in health expenditure trends may transcend international borders.
Coping Strategies Following a Child's Violent Death: How Parents Differ in their Responses
Authors: Murphy Shirley A. , Johnson L. Clark , Weber Nancy A.
Published: May 2005

This study examined coping strategies used by bereaved parents whose adolescent and young adult children died by accident, suicide, or homicide. Death event data were verified from Medical Examiner's records. A community-based sample of 261 parents was recruited 6 to 28 weeks following the deaths and followed prospectively up to five years postdeath. Coping data were obtained five times during the study, using COPE, a 53-item standardized questionnaire with 13 conceptually distinct subscales (Carver, Scheier,&Weintraub, 1989). The data provide partial support for the gender socialization hypothesis. Bereaved mothers reported using emotion-focused strategies in conjunction with other coping methods. Similarly, bereaved fathers did not report problem-focused coping at the exclusion of other strategies. Nonetheless, logistic regression analyses showed that 4 of the 53 COPE items correctly predicted gender 75 percent of the time. Current conceptualizations of coping are called into question.
Determinants of the Occupational Strategies Adopted by British Hospital Nurses
Authors: Bellaby Paul , Oribabor Patrick
Published: May 2005

This paper focuses on the position of the nurse in the division of labor in health care and the occupational strategies British hospital nurses have adopted in response to their changing employment situation. The authors suggest a Marxist framework as an alternative to current approaches to the study of occupational strategy, which tend to focus on the level of distribution relations. An adequate analysis of the situation of hospital nurses, the paper suggests, depends upon locating the occupation within the wider setting of the mode of control and delivery of health care. The central feature of this setting is the dominance of medicine and medical technology, and the main factors shaping it are the activities of individual capitalists involved in the health industry and the State operating within the constraints of capital in general and within the context of class struggle. It is suggested that the characteristic feature of nurses' occupational strategy—the vacillation between professionalism and unionism—can best be understood in relation to the changing mode of control and delivery of health care and nurses' contradictory position within the social relations that constitute that mode.
Review of Recent Vietnamese Studies on the Carcinogenic and Teratogenic Effects of Phenoxy Herbicide Exposure
Authors: Sterling Theodor D. , Arundel Anthony
Published: May 2005

The methodology and results of several Vietnamese studies on the possible health effects of exposure to herbicides among the Vietnamese during the Second Indochina War are reviewed. The results of the studies appear to link either paternal or maternal exposure to herbicides to unfavorable outcomes of pregnancy. There is some evidence to suggest that the injury to reproduction diminishes over time. Two studies found statistically significant odds ratios of 4.6 and 12.0 for hydatidiform moles after exposure. One case-control study found a statistically significant odds ratio of 5.2 for liver cancer. Elevated odds ratios were also found for major externally detectable birth defects. Many of the detailed findings are in agreement with the results of animal experiments. Unfortunately, the Vietnamese do not have the resources to fully examine the health effects of phenoxy herbicides. It is our hope that recognition of the importance of the Vietnamese studies will lead to further work in this area.
Thalidomide and Beyond: Some Recommendations regarding Public Policies toward the Ethical Drug Industry
Authors: Schifrin Leonard G.
Published: May 2005

The ethical drug industry in the United States has been the subject of numerous congressional investigations, much criticism by medical and economic experts, and other attacks from which a large number of reform proposals have been suggested. Nonetheless, the only significant legislation enacted in this regard is the 1962 Amendments to the Food, Drug, and Cosmetic Act, the substantive portions of which are probably more the result of the thalidomide disaster than of other criticisms of the industry. Now that these changes have been in effect for a decade, an appraisal of their effects is warranted, as is a reconsideration of other changes that may also be called for, in the light of the shortcomings and strengths in the industry's performance.
Should Curriculum Planning Start with Subject Matter?
Authors: Wales Charles E.
Published: May 2005

Curriculum planning often starts and ends with a specification of the subject matter knowledge students will study. This paper argues that a better way to start is by performing an educational systems design which considers knowledge needs along with the need to clarify values and make effective decisions. One result of this design work is the new teaching-learning approach called Guided Design which has already been applied to a variety of disciplines.
Psychiatric Consultation for Somatizing Patients in the Family Practice Setting: A Feasibility Study
Authors: van der Feltz-Cornelis Christina M. , Wijkel Dirk , Verhaak Peter F. M. , Collijn Dorine H. , Huyse Frits J. , Van Dyck Richard
Published: May 2005

Objective:

The purpose of the study was to assess the feasibility of a psychiatric consultation intervention for somatizing patients in the family practice setting in terms of 1) patient compliance, 2) patient satisfaction, and 3) compliance and satisfaction of general practitioners (GPs).

Method:

In a period of nine months, forty-six patients were selected for psychiatric consultation in six solo family practices in a semi-urban area in the Netherlands. The consultation included an interview with the consulting psychiatrist, the patient, and the GP. A written summary of the consultation was provided to the GP and the patient. A booster session with a GP and psychiatrist was included to evaluate and reinforce the recommendations.

Results:

The majority of the selected patients agreed to participate after informed consent. An intervention was implemented containing interpersonal techniques, reattribution, clarification, and structuring. GP compliance with recommendations was 100 percent, patient compliance 75 percent.

Conclusion:

A standardized psychiatric consultation for somatizing patients in a family practice setting can be implemented. Several levels of implementation can be distinguished.
Interaction of Coping Style and Cognitive Strategies in the Management of Acute Pain
Authors: Stevens Michael J.
Published: May 2005

Congruence between coping style and cognitive strategy was hypothesized to maximize the management of acute pain. Forty-eight undergraduates, half repressors and half sensitizers, were assigned to cognitive distraction, sensation monitoring, or no instruction, after which they were exposed to pressure stimulation. Two 2 × 3 (coping style x experimental condition) ANOVAs of pain tolerance and distress ratings did not yield interactions, but demonstrated that cognitive distraction facilitated higher tolerance than sensation monitoring or no instruction. These findings are discussed in terms of flexibility in cognitive coping and the methodological paradigms used in analogue research on pain, and are generalized to acute clinical pain.
Enlisting the Support of Traditional Healers in An AIDS Education Campaign in Zambia
Authors: Chirwa B. U. , Sivile E.
Published: May 2005

A nationwide AIDS education campaign in Zambia was constrained by lack of support from traditional healers. First, some of them did not appreciate the nature of the new disease, and second, others hampered the education efforts by publicly claiming that they possessed curative and/or preventive medicines for HIV infection. To overcome communication barriers, the health education unit convened a workshop for traditional medical practitioners and their orthodox counterparts. An important feature of the workshop was interactive participatory small group discussion. At the close of the workshop significantly more healers understood the nature of AIDS and were willing to participate in the national information and education effort against AIDS.
A Computer Course for Educators
Authors: Spero Samuel W.
Published: May 2005

A course for educators introducing the potential of the computer as a tool of instruction is described. The course is divided into five parts: 1) computer literacy, 2) motivation, 3) learning experiences, 4) reinforcement, and 5) evaluation. Each of the educators in the course receives credit by undertaking a project in his own area of interest and presenting it to the class. The course has been successful in improving the attitudes of the participating educators towards the potential of the computer as a tool of instruction.
Psychosocial and Psychopathologic Influences on Management and Control of Insulin-Dependent Diabetes
Authors: Eaton William W. , Mengel Marvin , Mengel Lynn , Larson David , Campbell Ross , Montague Ruth B.
Published: May 2005

The objective of this research was to explore the relationship of psychosocial variables to management and control of insulin-dependent diabetes, as measured by a scale of reported behavioral adherence and by glycosylated hemoglobin, respectively. The method includes a relatively large sample (127 subjects) drawn from a clinic, a broad range of psychosocial variables (depression, anxiety, family process, health locus of control), and documented reliability and validity of psychosocial measurement (alpha coefficients ranging from .63 to .95). The results show that both anxiety and depression have weak positive correlations with blood sugar. Family process variables also are weakly correlated with blood sugar. The measure of behavioral adherence is moderately correlated with blood sugar. The life stage of the diabetic appears to affect these relationships markedly. The conclusion is that there is no broad strong association of psychosocial variables with blood sugar but that there may be subgroups of diabetics, especially adolescents with recent onset, for whom the relationships may be more powerful.
Differences in Imagined Interactions as a Consequence of Marital Ideology and Attachment
Authors: Honeycutt James M.
Published: May 2005

This study examined the relationship between attachment theory and Fitzpatrick's [1] marital typology based on traditional, independent, and separate ideologies in terms of imagined interactions or covert dialogues that individuals have with relational partners. According to attachment theory, individuals have internal schemata of themselves and their relationships which provide expectancies for adult relationships. These expectancies are reflected in secure, anxious/ambivalent, and avoidant attachment based on the typology derived by Hazan and Shaver [2]. A series of five hypotheses were tested exploring the relationship between attachment styles, marital types, and the prediction of attachment as a function of having imagined interactions with a relational partner in which individuals imagine talking with significant others about important relationship issues. The data revealed that sharing as a marital ideology was associated with a secure attachment and negatively associated with an anxious/ambivalent attachment. In addition, the data revealed that an anxious/ambivalent attachment was associated with having discrepant imagined interactions and that a secure attachment was associated with rehearsing messages that were vivid and nondiscrepant from real encounters. Results are discussed in terms of attachment theory, imagined interaction functions, and marital ideologies.