PubMed Health⌕ Search

Biomedical subjects

E Bassuk

Publications and source records attributed to E Bassuk.

14 recordsLinked to original sources
PubMed1999

HIV-risk practices among homeless and low-income housed mothers.

BACKGROUND: Knowledge of human immunodeficiency virus (HIV) and its risk behaviors have not been systematically studied in homeless mothers. The identification of the factors associated with HIV-risk practices will guide interventions for low-income housed and homeless women. METHODS: We interviewed 220 homeless and 216 low-income housed mothers living in Worcester, Massachusetts, to gather information on demographic, psychosocial , and HIV-risk practice characteristics. We used standardized instruments and questions drawn from national surveys. The primary study outcome was high HIV-risk behavior. RESULTS: Although homeless mothers were more likely than low-income housed mothers to report first sexual contact at an early age, multiple partners during the last 6 months, and a history of intravenous drug use, homelessness was not associated with high HIV-risk practices. Both homeless and low-income housed mothers demonstrated misconceptions about HIV transmission through casual contact. Among high-risk women, approximately 75% perceived themselves as having low or no risk for contracting HIV. A history of childhood victimization, adult partner violence, or both placed women at a significantly increased likelihood of high HIV-risk practices. African American race, knowledge about HIV, and self-perception of risk were also significantly associated with high-risk practices. CONCLUSIONS: Homeless mothers are a subgroup of poor women at high risk for HIV and should be targeted for preventive interventions. In addition, there are potentially modifiable factors associated with HIV-risk practices in both low-income housed and homeless mothers that should be directly addressed.

Adult↗
PubMed1998

Determinants of health and service use patterns in homeless and low-income housed children.

OBJECTIVE: Previous studies of homeless children have described more health problems and service use than in housed children, but failed to control for potential confounding factors that may differ between these children. This observational study examines the relationship of homelessness and other determinants to health status and service use patterns in 627 homeless and low-income housed children. METHODS: Case-control study of 293 homeless and 334 low-income housed children aged 3 months to 17 years and their mothers conducted in Worcester, Massachusetts. Information was collected about mothers' housing history, income, education, emotional distress, and victimization history. Standardized instruments were administered to assess children's health. Health service use questions were adapted from national surveys. Main outcome measures included health status, acute illness morbidity, emergency department and outpatient medical visits. Multivariable regression analyses were used to examine the association of family and environmental determinants, including homelessness, with health status and service use outcomes. RESULTS: Mothers of homeless children were more likely to report their children as being in fair or poor health compared with their housed counterparts. Homeless children were reported to experience a higher number of acute illness symptoms, including fever, ear infection, diarrhea, and asthma. Emergency department and outpatient medical visits were higher among the homeless group. After controlling for potential explanatory factors, homeless children remained more likely to experience fair or poor health status (adjusted odds ratio [OR] = 2.83; 95% confidence interval [CI], 1.16, 4.87), and a higher frequency of outpatient (OR = 1.71; 95% CI, 1.18, 2.48) and emergency department visits (OR = 1.21; 95% CI, 0.83, 1.74). Mothers' emotional distress was independently associated with acute illness symptoms and frequent use of outpatient and emergency department settings. CONCLUSIONS: Homelessness is an independent predictor of poor health status and high service use among children. The present findings highlight the importance of preventive interventions and efforts to increase access to primary care among homeless children.

Adolescent↗
PubMed1983

Differences among clinicians in the decision to admit.

Despite considerable efforts by researchers and clinicians to elucidate the nature of the decision to admit patients for psychiatric treatment, they disagree about the criteria for hospitalization and have made little progress understanding the decision-making process. This study further investigated factors influencing the decision to admit by incorporating two unusual (for this area) features: (1) use of a multivariate analysis and (2) examination of individual differences among clinicians. The results showed both strong similarities and differences in the criteria used by individual clinicians. For each caretaker, a relatively small list of criteria was developed. Taken together, these criteria correctly classified 90% of the patients (96% of nonhospitalized and 60% of hospitalized patients) in a large, urban, general-hospital emergency room.

Bipolar Disorder↗
PubMed1983

Are there sex biases in rape counseling?

To test the common assumption that only women should treat rape victims, the authors examined the effect of therapists' gender on their counseling of 41 rape victims. The men and women counselors did not differ significantly in their descriptions of their affective responses to the patients or in their treatment recommendations. The women therapists rated victims as having more functional impairment on the Global Assessment Scale, possibly suggesting that they were more sensitive to the victims' distress. The total group of therapists viewed the rape victims more positively than they viewed other female emergency room patients, probably reflecting "undesirable" characteristics of persons who use this setting.

Adolescent↗
PubMed1983

A network approach to rural psychiatric emergency training.

The relative lack of objective data delineating rural needs has limited the development of creative training programs. The authors describe the process of developing a network approach to teaching psychiatric emergency skills. Using information collected from questionnaires, they defined the attributes of the rural setting, the emergency services, the staff, and the patients, and then tailored a program to meet these needs. The questionnaire results suggested that the extensive informal network of crisis care providers gives rural emergency services their unique character. The authors conclude that a successful training workshop should gather together members of both informal and formal networks to address group process and teaming issues. The faculty, consisting of urban and rural staff, must also overcome regional differences to build an effective working alliance.

Adolescent↗
PubMed1980

Ongoing outcome research on short-term dynamic psychotherapy.

In this paper short-term dynamic psychotherapy (STAPP) is described briefly in terms of its selection criteria and technique, and the preliminary findings of an ongoing outcome study are presented. Of 22 experimental patients who were treated with STAPP, 14 were rated as 'recovered' by two evaluators, 4 were 'much better', 3 'little better' and 1 was 'unchanged'. Of 8 controls who waited a period of 2--5 months, 5 were 'unchanged' and 3 'a little better' at the end of their waiting period. When they were treated subsequently, 4 had 'recovered', 2 were 'much better' and 2 withdrew having moved from the Boston area. The complexities inherent in psychotherapy evaluation are described, and the 3 patients who improved 'a little' and the 1 who was 'unchanged' are discussed briefly.

Anxiety↗
PubMed1980

Psychiatric emergencies: an overview.

The psychiatric emergency ward has become a primary entry point into the network of mental health services for people who need help to cope with their problems of living. It is also the only source of treatment for many chronically mentally ill patients living in the community. The authors critically review the literature on emergency psychiatric services, focusing on the ways these services are used, the atmosphere in the emergency room, and the determinants of disposition decision making. On the basis of their research, they suggest a model for emergency services that includes an evaluation of the patient's and his on her community's resources and competence and minimizes subtle diagnostic considerations.

Age Factors↗
PubMed1980

Chronic crisis patients: a discrete clinical group.

Patients who made repeated visits to a psychiatric emergency ward and who were studied appeared to comprise a discrete clinical group characterized by a distinct symptom profile, common psychiatric history, and similar styles of interacting with caretakers. They generally did not differ from nonrepeater patients with regard to acute symptomatology but were hospitalized more frequently. They were generally negativistic, had a lengthy psychiatric history consisting of multiple inpatient hospitalizations and current outpatient treatments, and had difficulty establishing rapport with the emergency ward therapists, often evoking intense feelings of dislike. The authors offer an approach to the management of these patients based on an understanding of their cycle of seeking and rejecting help.

Adult↗
PubMed1978

Rampant dental caries in the treatment of depression.

Dental Caries are an uncommon, but significant side effect of the tricyclic antidepressants and other anticholinergic psychoactive drugs. The authors trace the etiological aspects of this syndrome including the effects of depression and antidepressant medication on salivary properties. A typical clinical presentation of the syndrome is described and the side effect profiles of the various tricyclic antidepressants are compared. With this clinical background guidelines for the management of dry mouth are presented, emphasizing the importance of technical skill, safety and continuity of care.

Adult↗
PubMed1976

Development of a medical center rape crisis intervention program.

The Rape Crisis Intervention Program at Beth Israel Hospital utilizes volunteer multidisciplinary counseling teams drawn from psychiatry, social work, psychology, and nursing staffs. The premise of the program is that early crisis intervention can prevent later development of psychological disturbances in later development of psychological disturbances in victims. Counselors accompany victims throughout emergency room procedures: follow-up begins 48 hours after the initial contact and continues at regular intervals for at least a year. The authors discuss the problems of implementation, which include staff resistance, finding questions, and varying levels of counseling sophistication, and describe how these difficulties have been handled in their program. They note that this program is becoming a resource center for the community.

Counseling↗