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Dangerousness and dentistry: an explanation of dentists' reactions and responses to the treatment of HIV-seropositive patients.

Factors which influence health professional's willingness to treat HIV seropositive patients have been explained in terms of the concept of dangerousness. Can this concept be used as a vehicle to explain dentists' responses? All dentists currently in practice in Northern Ireland (n = 664) were invited to take part in the study. A final valid response rate of 73.3% was achieved. Attitudes and behavioural aspects of dental practice were examined in relation to whether they had or had not treated and HIV seropositive patients. In addition correlation and factor analyses were conducted. The results indicated that the concept of "dangerousness' provides a useful framework to explain dentists' attitudes and behaviours with respect to the provision of dental care for this patient group.

Attitude of Health Personnel↗

Calming an escalated psychiatric milieu.

On inpatient psychiatric units, nurses control the tone, pace, and activity level of the environment. But under the influence of factors such as high patient acuity and negative group contagion, a milieu can become unacceptably loud and chaotic. A volatile milieu is a potentially dangerous environment because patients' anxiety and agitation can quickly lead to acting out and aggression. This article focuses on how nurses can regain control of a milieu spiralling into chaos by tightening the structure of the routine, anticipating potential problems, and maintaining a confident calm manner. The charge nurse orchestrates the staff group's response to escalation through detailed planning, decisive interventions, and strategic use of every available resource.

Child↗

A profile of rural Texas adolescents who carry handguns to school.

Students in randomly selected eighth and 10th grade English classrooms (n = 1,072) in central Texas schools were surveyed in fall 1994 regarding carrying weapons to school and associated risk factors. Students who carried a handgun to school one or more times during the preceding 12 months were compared to those who had not done so, using discriminant analysis and chi-square. Gun carrying at school increased 138% from seven years earlier in the same area using the same survey procedures. Most students reported they carried a gun out of fear or anger. Those who carried a gun at school had extremely elevated rates of repeated victimization of several types during the previous year: 589% higher for attack at school, 552% higher for attack outside school supervision, 576% higher for attempts to force sex at school, and 216% higher for rape. They also were more likely to enter dangerous situations repeatedly, were 17 times more likely to have used crack cocaine, had less instruction on preventing violence, less knowledge about means of avoiding fighting, and felt an obligation to fight under a wider variety of situations. Study variables accurately classified 78.4% of gun carriers as such. Researchers concluded that efforts at prevention of handgun violence in schools should include interventions to increase the safety of a select group of vulnerable students, while providing psychological counseling to assist them in overcoming emotional effects of victimization as part of larger violence prevention efforts.

Adolescent↗

From hospitals to jails: the fate of California's deinstitutionalized mentally ill.

This paper describes a shift of mentally ill persons from custodial care in state institutions during the 1960s to prosecution in criminal courts during the 1970s. The shift is attributed to the unforeseen clinical needs of this new outpatient population, the inability of community mental health centers to meet these needs, and the changes in mental health laws, specifically their emphasis on the concept of dangerousness.

California↗