bluuebunny/crossref_metadata_2025 huggingface dataset:
Special Image Contents, Personality Features, and Aesthetic Preferences
Authors: Giannini Anna Maria , Bonaiuto Paolo
Published: May 2005

The theory of aesthetic emotion predicts higher aesthetic appraisals when images fit the beholder's main motivations, and, moreover, a relative equivalence between representations of violent scenes or incongruent configurations sensu strictu (Bonaiuto, 1966, 1983, 1998). Our new study aimed to specify distinctions among conflictual images, providing insights into taste formation processes that prefigure substantial differences found in studies on adulthood. Ten pairs of color laser reproductions of paintings by great artists were prepared, contrasting harmonious configurations with scenes strongly contradicting expectations. Five pairs contained an openly aggressive scene juxtaposed by a calm one; the others a structurally very incongruous picture juxtaposed by a congruent one. We first examined 500 children (7-10 years old), with appropriate scales, selecting two extreme subgroups: very aggressive and pro-social subjects (“altruists”). The image pairs were individually presented, recording the preferences. Data show a clear rejection of aggressive images by altruists, and attraction for such images in aggressive participants. The latter, nevertheless, had a greater liking for the incongruous images, that more indirectly and symbolically correspond to destructive drives. Socio-cultural variables were found to be non-influential.
Emergency Medical Workers' Responses to Death
Authors: Jenkins Sharon Rae
Published: May 2005

Four aspects of emergency medical workers' exposure to death in a mass casualty shooting incident were related to their reactions to the incident and their reported psychological and psychosomatic symptoms. This study assessed thirty-six emergency medical workers' psychological and psychosomatic symptoms self-rated for the weeks before and after the shooting; thirty-one responded again one month post-event. Obsessive-Compulsive, Hostility, Depression, Anxiety, and Global Severity Index SCL90R Scales showed acute elevations that resolved within a month except for the first two. Objective and subjective exposure to the twenty-one on-scene deaths was related to acute increases in Obsessive-Compulsive and Depression self-ratings; stress from triage decisions was also related to the former, and was best relieved by help from coworkers. A task-focused first reaction was associated with more positive outcomes than was an initial shock reaction.
Are Women in Female Jobs for Their Health? A Study of Working Conditions and Health Effects in the Fish-Processing Industry in Quebec
Authors: Messing Karen , Reveret Jean-Pierre
Published: May 2005

A questionnaire concerning environmental conditions, work organization, and health-related symptoms was administered to 209 male and female workers in fish-processing plants in Quebec. Jobs in these factories were “ghettoized,” with 88.9 percent of job titles held primarily (more than 75 percent) by members of one sex. In general, significantly more women than men reported that their work sites exposed them to environmental aggressors such as noise and cold. Women also reported significantly more often that their jobs were uninteresting, that they could not move around, and that their work speed was fast. Women reported fatigue, stress, insomnia, digestive problems, and aches and pains significantly more often than did men (analysis controlled for age). When the effects of work speed were examined specifically, it was found that a fast work speed was associated with fatigue, stress, insomnia, and digestive problems in both sexes, and with aches and pains in women. It is suggested that women are required to work at a faster speed than men, and that this is a factor in the greater prevalence of health-related symptoms among women. Our interpretation of these data calls into question the commonly held belief that men and women are assigned to sex-specific jobs in order to protect the health of “the weaker sex.”
Primary Medical Care in the Soviet Union
Authors: Ryan T. M.
Published: May 2005

The development of the Soviet Health Service reflects centrally determined decisions on the deployment of resources throughout all sectors of the economy. The fragmentation of first-line care and disaggregation of patients in urban areas have occurred in response to government dictates. Specialization has proceeded to the point where almost 90 percent of the medical work force are classed as specialists, although many have no formal postgraduate qualifications. In urban areas, primary care is provided by general physicians and pediatricians assigned to districts and by a range of specialists based in polyclinics and similar units. Norms for ambulatory care predict nearly 10 visits per person each year, only 4.3 of which are in connection with the treatment of symptoms. District physicians form a small percentage of the total work force and spend about half their time on district work. Surveys reveal a rate for first visits to patients at home of 186.5 per 1000 persons and a hospitalization rate of 148.4 per 1000. There are plans to increase the supply of hospital beds (10.92 per 1000 population in 1970), although interest is also being shown in the “hospital at home” concept. The grievances of district physicians include their isolation from hospital medicine. One critic recommends that the district general physicians should be assigned the function of interpreting specialist findings to patients and should receive broader training.
High Circles, High Art: An Investigation of Museums and Urban Conditions
Authors: Blau Judith R.
Published: May 2005

Social historians note the importance of social and economic elites for the establishment of cultural institutions. Using cross-sectional data on museums in the largest U.S. urban centers, this article investigates the importance for museums of social and economic elites and of urban governmental structure.
Application of Demographic Methods in Population Planning
Authors: Mosley W. Henry
Published: May 2005

Demographic methods provide an invaluable foundation for population program planning by giving quantitative expression to present and future characteristics of a population. It must be recognized that, while the formulas may be precise, the validity of the outputs are constrained by the quality of input data available and the assumptions required. Fertility projections present special problems because of the multiplicity of factors that can independently influence reproductive performance. The estimation of births averted by family planning programs is particularly tenuous. Population planners must be cognizant of all the dimensions of population change if effective programs are to be developed.
An Introduction to ARS Moriendi
Authors: Fryer John E.
Published: May 2005

“The arte and krafte to knowe well how to die” came to the fore in religious texts of the fifteenth century that were intended to be of value both to the dying person and those who would survive him. Ars Moriendi, the art of dying, related the fact of mortality to the individual's total way of life. The communication and application of knowledge concerning dying and death is valuable today as well. This article introduces a new national confederation known as Ars Moriendi that has educational objectives in this field. Projected functions of the group are briefly described, and those possibly interested in becoming a part of the organization are invited to do so.
Assessment of Job-Related Burnout among Health Education Specialists in Taiwan
Authors: Chen W. William , Lu Laura P.
Published: May 2005

This study examined the degree of job-related burnout and the relationship between burnout and gender, age, practice settings, years in the profession, and the level of religiosity among health education specialists in Taiwan. A Chinese version of Maslach Burnout Inventory (MBI) was used to assess burnout symptoms among 184 respondents. Results indicated that younger respondents had a significantly higher degree of burnout symptoms on both emotional exhaustion and depersonalization than older respondents and female respondents had a higher score on emotional exhaustion symptoms than male counterparts. There were no other significant differences of burnout symptoms between groups concerning practice setting, years in profession, and level of religiosity. It was concluded that some health education specialists were suffering from burnout symptoms, especially women and younger professionals and there is a need for stress management training for retention and training of health education specialists.
Self-Help Medical Literature in 19th-Century Canada and the Rhetorical Convention of Plain Language
Authors: Connor Jennifer J.
Published: May 2005

In earlier centuries, authors of medical works intended for popular readers defended their use of the vernacular against potential criticism from their learned colleagues. Scholars have shown that by the sixteenth to seventeenth centuries such defence reflected rhetorical posturing more than political reality. This article examines self-help medical literature in 19th-century Canada, revealing that authors adopted a similar stance in writing for the public. Not only did this rhetorical convention continue, but it also did not assure adoption of the plain style advocated. Moreover, a comparison of their style with that of medical textbook authors reveals few real differences.
College Students' Views of Excessive Drinking and the University's Role
Authors: Posavac Emil J.
Published: May 2005

Views of college students ( N = 133) regarding excessive drinking were explored in terms of the amount of drinking which constitutes a drinking problem, the behaviors that indicate a student has been drinking excessively, and university alcohol policies that students would endorse. Students accepted levels of drinking by peers that markedly exceed definitions of excessive drinking by experts. A sizable minority of students refuse to label very dangerous behaviors associated with excessive drinking as indicating a drinking problem. The views of male and female students differed only marginally. Since students seem to define excessive drinking in ways that differ from professionals, it is suggested that student affairs personnel need to plan programs that recognize the students' views, otherwise students may continue to believe that while excessive drinking is bad, their level of drinking cannot lead to any problems.
The other Who is Also the Same: The Relevance of Epidemics in Space and Time for Prevention of HIV Infection
Authors: Frankenberg Ronald
Published: May 2005

The history of epidemics reveals the imposition of controls over time and space on the sick and powerless other in the interests of the well and powerful same. In contrast, effective prevention requires the sharing of values, space, and time: coevality in the broadest sense. Adolescents are seen as merely transitional: they were children in the recent past, they will be adults in the recent future. Thus as an other who must become the same, they are seen as out of time and threatening. Conventional adults fear uncontrolled sexuality, especially if it is perceived as taking place out of time and is therefore anachronistic or in the wrong places, out of bed and through the wrong orifices (anatopistic). These unshared cultural perceptions are a barrier against both education for life and effective prevention of HIV infection.
What Factors Influence the Prescribing of Antidepressant Pharmacotherapy? An Assessment of National Office-Based Encounters
Authors: Sclar David A. , Robison Linda M. , Skaer Tracy L. , Galin Richard S.
Published: May 2005

Objective:

This study was designed to identify: 1) predictors of antidepressant pharmacotherapy among patients diagnosed with depression; and 2) predictors of prescription for either a selective-serotonin reuptake inhibitor (SSRI), or a serotonin-norepinephrine reuptake inhibitor (SNRI).

Method:

Data from the 1995 National Ambulatory Medical Care Survey (NAMCS) were used to discern the number of office-based encounters documenting a diagnosis of depression (ICD-9-CM codes 296.2–296.36; 300.4; or 311) among patients eighteen years of age or older. Logistic regression-derived odds ratios (OR) and 95 percent confidence intervals (CI) were used to elucidate factors predictive of receipt of antidepressant pharmacotherapy, and, more specifically, factors predictive of receipt of an SSRI or an SNRI. Model variables included age (18–49 years as compared to ⩾ 50 years); race (white as compared to nonwhite, inclusive of Hispanics); gender; self-report of depression as a reason for the office-based encounter; and payer type (private insurance program as compared to public).

Results:

Among the estimated 18,046,293 office-based visits resulting in a diagnosis of depression, 56.2 percent of patients self-reported depression as a reason for the office-based encounter; 67.5 percent were prescribed or continued a regimen of antidepressant pharmacotherapy; and 48.3 percent were prescribed an SSRI or an SNRI. Factors predictive of receipt of antidepressant pharmacotherapy included age less than fifty years (OR = 1.30, CI = 1.01–1.67); female gender (OR = 1.45, CI = 1.13–1.85); and self-report of depression as a reason for the office-based encounter (OR = 1.98, CI = 1.57–2.51). Factors predictive of receipt of an SSRI or an SNRI included age less than fifty years (OR = 1.31, CI = 1.03–1.65); female gender (OR = 1.55, CI = 1.23–1.95); and self-report of depression as a reason for the office-based encounter (OR = 1.56, CI = 1.25–1.95). In addition, having private insurance increased the likelihood of having been prescribed an SSRI or SNRI by 46 percent (OR = 1.46, CI = 1.13–1.89).

Conclusions:

Among patients with a diagnosis of depression, the pattern of prescribing antidepressant pharmacotherapy is influenced by a patient's age, gender, self-report of depression, and type of insurance coverage. Further research is required to discern the reasons for these observed effects and to advance clinically rational and equitable access to pharmacotherapeutic innovation.
Remembering Becky
Authors: Lichtenberg Peter A.
Published: May 2005

Little is known about the unique experiences of the young widower. This narrative recounts my four-year experience with grief-from its shattering pain to its healing-when I lost my wife to death at age twenty-five. Underlying the story are several aspects of grief unique to young adults. Young adults typically have limited experience with loss. This lack of experience coupled with the cultural recognition of youth as a symbol of vitality makes grief more troublesome and isolating. The sudden loss of a young person helps prolong grief much longer than people expect. I learned you cannot grieve alone; grief is frightening due to its immense range and the intensity of feelings it provokes; and even when healing occurs, there remains a heightened sensitivity to loss.
Responsible Decision Making regarding Alcohol: A Re-Emerging Prevention/Education Strategy for the 1990s
Authors: Milgram Gail Gleason
Published: May 2005

Adolescent alcohol use and strategies to deal with drinking and related problems in this population have been the focus of many programs. The concept of responsible decision making regarding the use of alcohol evolved in the late 1970s/early 1980s; it was disregarded as a viable approach by the mid-1980s due to incorrect definitions of the term and misrepresentation that it condoned adolescent drinking/intoxication. However, statistics on youthful drinking indicate that young people have continued to consume alcohol, and many are experiencing problems related to their drinking. Grounded in the reality of the adolescent experience, responsible decision making regarding the use of alcohol provides information, motivates discussion of adolescent activities, and promotes responsible decisions.
Private Experience and Public Expectation on the Cancer Ward
Authors: Baider Lea
Published: May 2005

A sociologist relates her experiences with staff and patients on a cancer ward. Within a short time the staff perceived her as a threat to their system of efficiency-oriented norms and regulations, a system which she, in turn, came to regard as an institutionalized defense against that-which-could-not-be-confronted. In becoming acquainted with the patients themselves, the phenomenon of pain was brought to the fore. The patient's existence sometimes was dominated by pain, and yet there were significant differences from one cancer patient to another in how they interpreted and related to pain. These variations included positive valuation of pain as a symbol of life. Ethnic differences in the interpretation of pain, especially between people from Latin and Anglo-Saxon backgrounds, were observed. In general, pain behavior in terminal patients was strongly colored by the individual's feelings concerning impending death. The observer also shares some of her personal feelings of the rhythms of hospital life and their impact upon the individual.
If You Build it They Will Come, or Collaborative Web Site Development “Out of Hide”
Authors: Perry Claudia , Yager Dean , Mozlin Rochelle , Krumholz David , Jackson Kevin
Published: May 2005

In the fall of 1995, a grass-roots groups of campus computer users championed the extension of network access and the formation of a College presence on the World Wide Web. Despite a lack of money, technical support, experience or equipment, the initiative moved forward, and by July 1996 the Web site was up and running. Key success factors included strong motivation, hard work, a critical mass of supporters, a willingness to experiment and to start small, as well as log file software to justify our existence and well-publicized demonstrations to sustain interest and build support. Despite many positive aspects of the project and unexpected dividends, the effort has not been without its problems. This article addresses design, implementation and assessment issues from the perspectives of administration, student, and educator. Ongoing development and maintenance issues remain a challenge, as does the need to develop consistent policies and procedures, continue training programs, extend participation beyond the initial group of “early adopters,” and encourage a reward mechanism for involvement in innovative campus projects.
Late Woodland Settlement Patterns of New Jersey
Authors: Pagoulatos Peter
Published: May 2005

Late Woodland settlement patterns in the State of New Jersey are poorly understood in comparison with other parts of the Middle Atlantic region. This study is designed to evaluate current settlement pattern data using logistical models of land use against available historical and archaeological data. Current data indicate that at least two major socioeconomic systems coexisted during late prehistory, either by exploiting different resource zones or by exploiting similar resource zones at different times of the year. Interior riverine groups focused more on horticulture, exhibiting greater residential stability; these groups are best characterized as collectors and broadly classified as mixed cultivators/mobile agriculturalists. Coastal groups were highly mobile foragers and oriented more toward maritime resources, with only a minor reliance upon horticulture; these groups most resemble partial cultivators.
Education for Death, or Death Becomes Less a Stranger
Authors: Leviton Dan
Published: May 2005

A death education course for large numbers of students (n = 300+) is described. Students were asked to write essay type responses to certain questions as part of a pilot project to develop a testing instrument. Results indicate that the death education course has an effect on improving conscious thinking about death, communication with others about death, etc. Students are most concerned about the pain associated with dying. About 3 per cent of the students were contemplating suicide both at the time of enrollment and after the course ended. Some observations on the students' psychological styles of adaptation to the course were discussed.
Indices of Severity for Emergency Medical Evaluative Studies: Reliability, Validity, and Data Requirements
Authors: Gibson Geoffrey
Published: May 2005

Indices of severity, that is, numerical ratings denoting the probability of mortality or morbidity resulting from a critical illness or injury, are important research, programmatic, and clinical tools. They are essential techniques for making screening decisions in the pre-hospital and emergency department arenas, describing the impact of environmental hazards, allocating and evaluating emergency medical resources, and assessing the effectiveness of emergency care. In view of these important roles, such indices should meet minimal standards of methodologic rigor. Three sets of methodologic requirements—reliability, validity, and data requirements—are suggested and used to evaluate the methodologic adequacy of 16 commonly used severity indices. In general, the indices were found to depend on clinically subjective judgments, lacked clear or objective definitions, and offered little evidence that they could be used reliably. While all correlated with mortality, few had a documented ability to predict morbidity. Most indices had not been validated prospectively and retrospectively, nor been tested in different settings. Thus, they may be substantially contaminated by the idiosyncratic patient mix in the facility and series used for scale development, and not generalizable as a severity measure to other populations. Only five of the 16 indices met even minimal methodologic criteria. It is likely, therefore, that the methodologic basis of most existing and commonly used indices of severity is insufficient to support the heavy burden of their current usage. It is concluded that a single severity index is neither desirable nor possible, and recommendations are made for future developmental work for multiple indices each predicting separate outcomes within different time slices with varying information needs and differential predictive capacities.
An Approach to the Integration of Communication Skills Development within an Undergraduate Civil Engineering Program
Authors: Hedges Peter D. , Walley W. J.
Published: May 2005

Graduate engineers in the United Kingdom are frequently criticized for lacking communication skills. In undergraduate courses, such as civil engineering, which are mathematically and technically oriented, it is very difficult to find space within a full timetable for the development of communication skills. At Aston University this work has been integrated successfully into a course on Public Sector Planning. Lectures are complemented by a project which culminates in the students participating in a simulated Public Inquiry—part of the planning process intended to provide a forum for public debate. Not only do the students learn about the planning process, tangible and intangible aspects of a water resource development, but at the same time develop their written, oral, and decision-making skills.
The Social Costs of the International Monetary Fund's Adjustment Programs for Poverty: The Case of Health Care Development in Ghana
Authors: Anyinam Charles A.
Published: May 2005

A primary health care (PHC) strategy was adopted in Ghana in 1978, but the civilian government at the time failed to implement the program designed to achieve health for all Ghanaians. In 1982, the revolutionary military government under Rawlings indicated its commitment to the full implementation of the PHC program. In this article, the author seeks to examine the extent to which the Economic Recovery Program initiated by the Rawlings' regime, its policy of decentralization and mobilization of the masses, and its promise to institute some fundamental organizational and structural changes in the health care delivery system, are contributing to the process of achieving “health for all” Ghanaians.
Health and Social Security Reforms in Latin America: The Convergence of the World Health Organization, the World Bank, and Transnational Corporations
Authors: Armada Francisco , Muntaner Carles , Navarro Vicente
Published: May 2005

International financial institutions have played an increasing role in the formation of social policy in Latin American countries over the last two decades, particularly in health and pension programs. World Bank loans and their attached policy conditions have promoted several social security reforms within a neoliberal framework that privileges the role of the market in the provision of health and pensions. Moreover, by endorsing the privatization of health services in Latin America, the World Health Organization has converged with these policies. The privatization of social security has benefited international corporations that become partners with local business elites. Thus the World Health Organization, international financial institutions, and transnational corporations have converged in the neoliberal reforms of social security in Latin America. Overall, the process represents a mechanism of resource transfer from labor to capital and sheds light on one of the ways in which neoliberalism may affect the health of Latin American populations.
Learner Evaluation on the Use of Collaborative Instructional Method and Instructional Media
Authors: Hashim Yusup
Published: May 2005

We have heard of instruction being teacher-directed, giving less learner participation in the teaching-learning process. This article examines the roles of teacher-facilitator and students in classroom instruction. Inservice teachers enrolled in an educational technology course took over the classroom instruction while the class teacher managed the instructional process. Throughout the course, students worked together to prepare their lessons and the instructional media and method to be used in instruction. At the end of the course, participants evaluated the media and method used during instruction. Results of the evaluation showed in-service teachers preferred the learner-centered and collaborative approach. The collaborative method helped them to learn the use of instructional data.
Sense of Humor, Hassles, and Immunoglobulin A: Evidence for a Stress-Moderating Effect of Humor
Authors: Martin Rod A. , Dobbin James P.
Published: May 2005

This study was designed to investigate whether sense of humor moderates immunosuppressive effects of stress. At two time periods one and one-half months apart, forty subjects completed the Daily Hassles Scale and provided saliva samples for determining secretory immunoglobulin A (S-IgA) levels. Four scales were used to assess different aspects of the sense of humor. A negative correlation was obtained between frequency of hassles at time 1 and S-IgA levels at time 2 ( r = –.32, p < .05), suggesting an immunosuppressive effect of hassles. In support of our hypothesis, hierarchical multiple regression analyses revealed significant moderating effects of three of the four humor measures on this relationship between hassles and S-IgA. Subjects with low scores on the humor scales revealed a stronger negative relationship between hassles and S-IgA than did those with high humor scores. These results are discussed in terms of other research examining psychological influences on immune function.
An Experimental Investigation of Specificity and Generality in Memory Narratives
Authors: Singer Jefferson A. , Moffitt Kathie Halbach
Published: May 2005

Research in memory and personality has distinguished between memory narratives of specific events and summaries of many events blended together. This differentiation has been linked to both the hierarchical organization of memory and to individual differences in personality. Four experiments, with 506 subjects, were conducted to demonstrate that this single event/summary memory narrative distinction could be formalized and reliably scored, using both written and spoken memory narratives. Mean interrater agreement was 93 percent, Kappa = .78. The mean frequency of recall of single event memory narratives was 78 percent, summary memory narratives, 22 percent. It was also demonstrated that a request for personally significant memories relevant to one's self-understanding increases the number of summary memory narratives retrieved. Summary and single event memories were not significantly different in affective quality.
A Group Dynamic Approach to Teaching and Learning about Grief
Authors: Engel George L.
Published: May 2005

Effective classroom teaching, and learning about grief and mourning must involve both didactic instruction and the group dynamics of personal involvement. An appreciation of the individuality of the grieving experience must be incorporated into the broader understanding of grief in its generic aspects. In this paper such an approach is described and illustrated with verbatim excerpts from an exercise conducted with eighty participants in a workshop on helping the bereaved.
Video-Based Instruction: Issues of Effectiveness, Interaction, and Learner Control
Authors: Barnard John
Published: May 2005

Decades of research has shown that television, as a medium for delivering instruction, is at least as effective as classroom lecture. Although many educators have expressed concern over the quality and frequency of student/teacher interaction available through televised courses, studies indicate that different learners may have distinct needs for varying types of interaction. As the use of videocassette recorders has become widespread possibilities have increased for new methods of video-based instruction. The increasing use of videocassettes for delivery of instruction has also raised questions for possible future research on how student use of this medium differs from broadcast television or live classroom lecture.
The Use of Methylphenidate for Cognitive Decline Associated with HIV Disease
Authors: Brown George R.
Published: May 2005

Objective:

Complaints of cognitive changes are often expressed by patients at all stages of HIV infection. Such changes include decreased memory and attention span, diminished concentration, apathy, and “slowing.” Methylphenidate (MPD) has been used in several clinical studies in men with late-stage HIV disease in an attempt to ameliorate these difficulties. The objectives of this review article are to review salient psychopharmacological characteristics of MPD and to describe the research and clinical literature supporting the use of MPD in patients at all stages of HIV infection.

Methods:

Seven studies, case reports, or abstracts from International Conferences on AIDS were available in the English literature through August, 1993, directly addressing the use of MPD in patients with HIV disease. Twenty-nine papers were reviewed for pharmacokinetic data, eighteen for safety and side effects issues, and seventeen for relevant contributions from the neuropsychological testing literature.

Results:

Studies in clinical settings have used doses ranges from 10–90 mg. per day in two or three divided doses with reportedly good results in improving both affective and cognitive symptoms associated with HIV disease. Side effects have been relatively mild and patient satisfaction with treatment has been high. However, no studies have been conducted in early stage HIV disease, where a significant minority of patients have similar complaints in the absence of clinically apparent immunosuppression. Likewise, placebo-controlled, dose-finding studies in AIDS patients are entirely lacking, and no studies in women with HIV disease and cognitive changes have been published.

Conclusions:

In spite of these important research shortcomings, clinical experience with MPD treatment of cognitive changes in men with HIV/AIDS is consistent with the notion that this medication holds significant promise to improve the quality of life for persons living with HIV/AIDS. Controlled studies to test this hypothesis are warranted.
Assisted Suicide: Some Ethical Considerations
Authors: Slater Eliot
Published: May 2005

When we die, it is only very rarely that we do so without days, weeks, or months of illness in which the suffering may be very great, sometimes from pain, often from breathlessness, impairment of consciousness, depression, anxiety, vomiting, bedsores, and incontinence. If we were able to choose our own time to die, there would be no need to suffer any of this. There should be a “right to die.” It should be ethically and legally possible for the doctor attending a terminally ill patient, who asks him for help to take his own life, to put the means within his reach.
Preventing Suicide and Depression: A Training Program for Long-Term Care Staff
Authors: Walker Bonnie L. , Osgood Nancy J.
Published: May 2005

Approximately 5 percent of those sixty-five and older live in long-term care facilities (1.5 million). Neither suicide and depression among the elderly who reside in long-term care facilities nor prevention techniques are well-understood by staff. This article discusses the development of a curriculum designed to train long-term care staff in preventing suicide among the elderly and the results of a pilot test of a training program based on that curriculum. The participants ( N=43) significantly improved their scores from pre- to post-test on the knowledge, attitudes, and practices subtests. The knowledge areas in which staff performed the most poorly at pre-test were related to identifying appropriate primary and secondary interventions, the relationship between dementia and suicide, methods of self-destruction used by the elderly, and understanding of depression in the elderly. There was a significant relationship between pre-test and post-test scores on all subtests. Staff with higher levels of education had significantly higher pre- and post-test scores on the knowledge and attitudes subtests. More experienced staff had significantly higher post-test scores on the practices subtest. A large majority of the participants had highly positive attitudes toward the program and thought the program had been very useful or useful to them as caregivers. The study demonstrated the need for staff training related to suicide prevention in long-term care as well as the usefulness of even a brief training.
Promoting Health and Preventing Disease: Ethical Demands and Social Challenges
Authors: Callahan Daniel , Koenig Barbara , Minkler Meredith
Published: May 2005

This article argues that a critical impasse has been reached in American health promotion and disease prevention and examines the three factors that must be confronted and addressed if we are to move forward. These factors are: 1) the cultural and political contexts of health promotion, including the continuing tension between individualism and a common good/public health perspective, 2) the increasing power of narrow, biomedical conceptualizations of disease and illness, and 3) the variety of ethical options available to governments, employers and HMO's concerned with changing unhealthy behaviors. A public interest perspective on health promotion then is presented, with attention to both the obstacles it faces and the advantages it may hold as we pursue the goal of a healthy society at the turn of the century.
She Died for Love and He for Glory: Gender Myths of Suicidal Behavior
Authors: Canetto Silvia Sara
Published: May 2005

Epidemiological studies have long reported that, in North America, patterns of suicidal behavior differ by gender: women “attempt” suicide; men “complete” suicide. Theories of suicidal behavior also differ according to gender. Traditionally, women are said to be suicidal for love; men, for pride and performance. Are these gender differences “real?” Are women's attempts “failed” suicides? Do suicidal men “succeed” when they kill themselves? Is women's self-definition dependent on love? Is men's dependent on performance? Evidence currently available does not support traditional theories of gender and suicidal behavior. As culturally shared assumptions, however, traditional theories may influence the suicidal choices of women and men, as well as the assumptions and research methods of suicidologists.
The U.S. Health Insurance Industry: An Alternative View
Authors: Woodward Albert
Published: May 2005

The health insurance industry in the U.S. can be characterized as a concentrated industry. It has evolved into its current structure as a result of certain historical conditions, particularly those following the Great Depression. The structure of the industry has had an effect on the manner in which the industry functions and the cost increases in the health care sector. Specifically, the pricing mechanism is that of a price leader setting a limit price; health premium prices are higher than would be expected under a competitive structure. Regulation has been ineffective, because it has been dominated historically by health care providers and insurers. The costs of health care in general, and hospital care in particular, have increased beyond what would be expected as a result of “cost-pass-through.”
Risk Assessment—Risk Perception: Who Shall Decide?
Authors: Winder Alvin E.
Published: May 2005

Since the Chernobyl disaster, the people of the world have become concerned with environmental pollution and its effect on their health and safety. This article addresses a fundamental question arising from that concern, namely, how safe is safe enough and who should make this decision? The controversy arising from this question is between the private stakeholders and the technicians who assess risk, control information and influence public policy and both the public's perception of risk and their desire to participate directly in public policy decisions affecting their health and safety. This article proposes a solution to this controversy that is relevant to all people, since all people are stakeholders in a fair and balanced solution.
Gridding a Grid: An Artist Reviews and Comprehends his Own Exhibition
Authors: Diamond C. T. Patrick
Published: May 2005

The empirical study of appreciators' psychological processes includes the examination of self-generated aesthetic schemas and meanings. If the individual voice and vision of the artist has often been missing from much of the previous literature and discussion of aesthetic response, non-empirical art critics may have promoted their own voices and positions instead by using the recondite and all but impenetrable metalanguage of criticism. As a counterexample from numerical phenomenological methodology, Kelly's psychology of personal constructs and its Repertory grid technique [1] are shown helping an artist-spectator to recover and to reflect on his own responses to one of his exhibitions. Shaw's interactive and multivariate FOCUS technique enables the grid to serve these ideographic purposes [2].
Interactive Multimedia Preventive Alcohol Education: An Evaluation of Effectiveness with College Students
Authors: Reis Janet , Riley William , Baer John
Published: May 2005

A self-selected sample of 4695 university and college students participated in a short-term evaluation of an interactive CD-ROM addressing harm reduction for alcohol use. The CD-ROM (Alcohol 101) uses a mix of video, text, music, graphics, and animation elements to present behavioral change strategies for safe and responsible use of alcohol. Student learning about alcohol as measured by self-report was generally in the desired direction and supportive of the impact of the CD-ROM on understanding of the physiological impact of alcohol and the range of behavioral options for pacing consumption and helping friends in potential peril.
New Patterns in Health Sector Aid to India
Authors: Jeffery Roger
Published: May 2005

Criticisms of health aid have largely been derived from African and Latin American experiences. It is suggested that such analyses, while valuable, cannot be applied wholesale to India without detailed examination of the patterns of health sector aid which have actually characterized the period since 1947. This article brings together material on the scale and form that this assistance has taken, and demonstrates that its focus has been preventive in emphasis and oriented towards the primary care sector. In some periods it has contributed a substantial share of total public sector expenditures, and in some spheres, it has played a major role, particularly the control of communicable diseases. However, the impact of less substantial sums going to prestige medical colleges or to population control programs should not be ignored; and several of the aid categories have been of dubious origin (PL-480 counterpart funds and U.S. food surpluses as the prime examples). However, the “new” health aid programs do not deserve the ready dismissal they have received in some quarters.
A Workshop for Distance Learning Educators of the 21st Century
Authors: Ben-Jacob Marion G.
Published: May 2005

There is evidence that the context for learning is undergoing a metamorphosis, that this metamorphosis brings with it a new relationship between the teacher and the student, and that distance learning is becoming a viable option for furthering one's higher education. Advances in technology, academic research, pedagogical innovation, the increase in the chronological age, maturity level and personal commitments of the average college student, and geography and demography have led to a substantial alteration in the structure of the learning environment. The use of distance learning technologies for instruction is growing rapidly and institutions of higher education are adopting interactive technologies. For those of us with knowledge and experience using innovative media, it is our obligation to encourage our colleagues to become familiar with the technology and the redesign of academics that will be prevalent in the new millennium. It is imperative that we assure the integration and success of the new media and formats into our learning environments. This article describes a workshop supported by the NSF for distance learning educators. The focus of the workshop is to aid its participants and their institutions to deliver better online courses from the points of view of the institutions, the professor, and the students. Among the goals of the workshop is the formation of a network for future research for its participants. Follow-through activities, including a reconnoitering of the participants to share results of how they integrated the information provided into their courses and their institutions, a videotape, and the formation of a repository of information regarding the teaching of online courses will be addressed.
Problems Associated with Mastectomy
Authors: Silverman-Dresner Toby , Restaino-Baumann Lillian
Published: May 2005

This study looks at the demographic characteristics of women treated for breast cancer, the specific problems they encountered after surgery, and their choice of postsurgical aftercare options.
From the Symbolic Stimulus to the Pathophysiologic Response: Immune Mechanisms
Authors: Amkraut Alfred , Solomon George F.
Published: May 2005

Indirect evidence from a variety of sources, particularly clinical studies of emotional and stress factors in the onset and course of diseases associated with dysfunction or hypofunction of the immune system (infectious, allergic, autoimmune and neoplastic), support the notion that experiential factors can influence the functions of the immune system, presumably via neuroendocrine mediation. We dissect the immunologic system into its components in order to find identifiable targets within disease processes that are stress-responsive. The immune system can be divided into three limbs: afferent, comprising presentation of antigen; central, in which different classes of cells give rise to immune responses; and efferent, concerned with the sequelae of immunization. We must also consider sites in which the immune reaction occurs. We try to defend the assumption that emotional factors lead to small alterations in “immune balance” that can convert latent or mild illness to manifest or severe illness. We consider the interaction of specific components of the immune response with a variety of stress-responsive hormones and with cyclic AMP and cyclic GMP. We also speculate on the possibility of direct central nervous system influence on the immune response, particularly via the thymus which plays an endocrine role in immunologic competence. We outline a variety of influences hormones can play on specific components of each limb of the immune response. Since the interaction of neuroendocrine and immune systems no doubt involves an interplay of multiple mechanisms with multiple targets in the immune system, establishing and studying relationships within the entire matrix will be necessary. Evidence so far suggests that stress affects chiefly the efferent, and to some extent the afferent, limbs of the immune system and that macrophage activities are probably a major target.
Diagnostic Errors of Primary Care Screens for Depression and Panic Disorder
Authors: Leon Andrew C. , Portera Laura , Olfson Mark , Kathol Roger , Farber Leslie , Lowell Kira N. , Sheehan David V.
Published: May 2005

Objective:

As the health care reimbursement system has changed, brief screens for detecting mental disorders in primary care have been developed. These efforts have faced the formidable task of identifying patients with mental disorders, while at the same time minimizing the number of misclassified cases. Here we consider the balance between sensitivity and positive predictive value. Primary care patients with false positive and false negative results on screens for depression and panic disorder are compared with regard to comorbidity and functional impairment.

Methods:

This was a cross- sectional psychometric study. The study sample included 1001 primary care patients from the Department of Internal Medicine at Kaiser Permanente in Oakland, California. The Symptom-Driven Diagnostic System for Primary Care (SDDS-PC) screens and Sheehan Disability Scale were completed by the subjects. The SDDS-PC diagnostic interviews were administered to all subjects.

Results:

Patients with false positive results on the panic disorder screen did not differ from patients with false negatives results with regard to rates of other psychiatric disorders, functional impairment, or mental health service utilization. In contrast, patients with false negative depression screen results had significantly more psychiatric disorders and functional impairment than those with false positive depression results.

Conclusions:

A substantial number of patients with either false positive or false negative screen results met diagnostic criteria for other mental disorders. Given the nominal burden of follow-up assessments for patients with positive screens, these data suggest that erring on the side of sensitivity may have been preferable when algorithms for these screens were selected.
Criteria for Engineering Job Oriented Instruction Delivery Systems
Authors: Fox Raymond G.
Published: May 2005

The design of instruction delivery systems is described as an engineering discipline. Structured learning for individualization of instruction is defined. Instruction delivery applications are identified in formal training and job performance areas. Examples of basic systems design models, delivery methods, instruction delivery units, evaluation methods, cost/value measurements, and empirical data are cited as tools for design implementation. Utility of the concept of structured learning is discussed.