Biomedical subjects
Publications and source records attributed to M Potts.
In this article, the first of two parts, the sources of stress and satisfaction experienced by nursing and social service staff working in group homes with young people with severe learning disabilities are investigated. It focuses on the stresses and satisfactions arising out of the performance of the direct care role for staff working in ordinary housing in the community.
The first part of this article focused on the stresses and satisfactions arising out of the performance of the direct care role for staff working in three houses in the community for young people with severe learning disabilities and challenging behaviour. This article focuses on the experience of home/work conflict by staff and the impact of organisational issues in relation to staff-staff and staff-management communication, the processes for decision making and standard setting, operational policies and rotating shifts and their effects on the morale and stress levels of staff.
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U.S. women have fewer birth control options than do women in other developed countries. Reliance on sterilization helps many couples make up for their lack of choices, but high rates of sterilization among relatively young women are a cause for concern, given the chance of later regret. Although pill use is very high among young women, it falls dramatically among those in their 30s and, often unnecessarily, is minimal among those over 35. The IUD is most appropriate for older women in mutually monogamous relationships who have completed their families, and its availability has been limited in recent years because of liability problems. Although barrier methods are widely used by women of all ages, they are less effective than the pill or IUD. It is fair to conclude that given U.S. women's sometimes long intervals of exposure to the risk of unintended pregnancy, too few safe and effective reversible contraceptives are available in the United States. The addition of an acceptable new method would certainly lead to a reduction in unintended pregnancies, but many potentially useful new methods will not be developed in this century unless the amount of money invested in contraceptive research and development is substantially increased.
Life expectancy for women in the United States is 77.34 years; women who take oral contraceptives (OCs) for five years before the age of 30 can expect to live about four days longer. This is due primarily to protection against ovarian and endometrial cancers. For women taking pills for five years in their thirties there is a maximum loss of 18 days on the average that is attributable to OC use, and for women over 45 this rises to 80 days. The decreased life expectancy is due mainly to the increased mortality from myocardial infarction and stroke. This is substantially less than life lost due to use of a variety of other substances, most notably tobacco.
A Reproductive Risk Factors Survey was carried out in 1982 in conjunction with a community-based distribution (CBD) program in Matamoros, Mexico, to determine whether the distribution of oral contraceptives to women through CBD programs exposes any demonstrable group of users to more health risks than if the program had not been put in place. The methodology involved interviews by nurses of program pill users and non-program pill users. Health indicators related to cardiovascular accidents were the main focus of comparison between the groups. The data indicate that respondents were well informed about their own health status, and, in terms of the conditions studied, program users were found to be similar in health status to non-program pill users whether or not they were ever examined for contraindications to pill use. The study indicates that this CBD program has not increased the risks associated with pill use for its clients and has, in fact, given protection from pregnancy to women who may otherwise not have had access to oral contraceptives.
BACKGROUND AND OBJECTIVES: This study describes a student-centered third-year clerkship involving student choice and on-site investigation of rural community health care agencies. The objective of the clerkship was student understanding of how to explore and use community agencies to enhance the care of patients. METHODS: The course was evaluated through pre- and postcourse surveys of attitudes about primary care, care of the socially disadvantaged, knowledge of social agencies, and specialty orientation. Also analyzed were student clerkship evaluation forms, student performance evaluations, and review by external consultants. RESULTS: Students reported statistically significant increases in knowledge about social agencies (P = .0001). Attitudes of social responsibility for health care and greater concern about patients' social well-being were reported but were not statistically significant. While students agreed with the philosophy of the experience, they felt the course would have been more valuable later in their training. Student performance exceeded faculty expectations in all cases. External evaluators felt the community agency contacts were crucial experiences for future caregivers. CONCLUSIONS: A student-centered clerkship using community-based agencies can provide a valid educational experience, even in remote rural areas. Students develop facility in contacting and using community resources. Participation can give new perspectives on patient care not achievable in other sites. The long-term benefits of this early community exposure remain to be investigated.