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Biomedical subjects

F L Nelson

Publications and source records attributed to F L Nelson.

12 recordsLinked to original sources

Evaluation of an AIDS prevention education program for health service providers working with i.v. drug users.

A 12-hour training program was designed and pilot tested on 46 staff from three methadone maintenance and detoxification clinics. Also, 525 clients enrolled in a methadone clinic completed a questionnaire assessing their knowledge of AIDS and then participated in an AIDS education program. The staff and the patients had a high level of pretraining knowledge of AIDS. Both groups showed marginal improvement following education.

Acquired Immunodeficiency Syndrome↗

Youth suicide in California: a comparative study of perceived causes and interventions.

Comparative survey data were obtained from five sample groups of respondents composed of young people 12 to 20 years of age, parents of young people within this age range, and respondents to psychological autopsies of decreased youth. The findings revealed that family dysfunction, intrapersonal psychopathology and distress, problems with interpersonal relationships, and drug and alcohol abuse were most frequently mentioned by the respondents as the major causes of youth suicide. In terms of solutions, the availability of social support from family and friends and access to formal intervention programs for troubled adolescents were seen as the most effective measures that could be taken to stop young people from intentionally hurting themselves.

Achievement↗

Evaluation of a youth suicide prevention school program.

Adolescent suicide is a subject of increasing national concern. In California, this problem was addressed through the implementation of a three-year youth suicide prevention school program established by legislative mandate in 1983. Findings for the first two years of the program indicate significant gains in understanding of youth suicide prevention techniques for those high school students who completed a four-hour training course. School staff and parents completing 90-minute youth suicide awareness seminars indicated that they most appreciated receiving practical advice and resources they could use in responding to a potentially suicidal young person.

Adolescent↗

Suicide: issues of prevention, intervention, and facilitation.

The practice of suicide prevention directs the suicidal person to continue living despite the presence of a wish to die. In contrast, the concept of suicide intervention attempts to maintain a relatively more neutral position, one that allows for the possibility of death facilitation as well as prevention. The concept of suicide intervention implies the appropriateness of suicide for certain chronically distressed individuals and anticipates the emergence of prodeath intervention as a valid clinical procedure. A proposed suicide intervention model is contrasted with the goals and methods of existing suicide prevention and crisis counseling services. The issues of an appropriate death, premature death, an ambivalent attraction to death, and continued living in the face of chronically low life satisfaction are discussed.

Attitude to Death↗

The development of an Indirect Self-Destructive Behaviour Scale for use with chronically ill medical patients.

The development and content of a scale to measure indirect self-destructive behaviour (ISDB) among chronically ill medical patients is described. Findings for a sample of predominantly elderly, male, chronically ill patients indicate a generally high incidence of ISDB over a seven-day period continuous observation. Most frequently observed were behaviours involving noncompliance with the treatment programme, and conflicts with the medical staff. Based upon an analysis of nine classes of behaviour included in the ISDB Scale, three groups of patients emerged with distinct patterns of indirect self-destructive activity: two consisting largely of noncompliant acting-out behaviours, and one involving more direct forms of self-injury.

Adult↗

A study of 44 PCP-related deaths.

Data on 80 PCP-related deaths, occurring in a 12-month period in 1977-1978, were obtained from the files of the Los Angeles County Coroner. Of these deaths, 44 cases were evaluated by means of the psychological autopsy procedure. This procedure involves abstracting data from available records of the decedent and interviewing persons having personal or professional knowledge of the decedent's life history. Findings indicate that the decedents tended to be young minority persons with markedly disturbed personal and family backgrounds. Prior to their deaths, they had used PCP extensively and had a long history of polydrug use. Considerable psychosocial maladjustment was evident prior to their deaths, with crises and significant losses often occurring within 3 months of death.

Adolescent↗

Indirect self-destructive behavior in the elderly nursing home patient.

The incidence of indirect self-destructive behavior (ISDB) is explored in a sample of 99 male, predominantly elderly nursing home patients, using a rating scale (ISDB Scale) developed by the authors in a previous study. Scores from the ISDB Scale are correlated with psychological test material, background information, and other descriptive data for the sample of patients. Findings indicate that the use of ISDB in the elderly patient group is associated with direct suicide potential, dissatisfaction with the treatment program and with life in general, confused reasoning and judgment, poor prognosis for discharge, the absence of religious commitment, and significant losses in the patient's life. It appears from the findings that ISDB serves as an alternative form of suicide for many of these patients.

Aged↗

The certification of suicide in eleven western states: an inquiry into the validity of reported suicide rates.

From Durkheim's time to the present social researchers interested in the problem of suicide have relied upon officially reported rates of suicide to develop and test their theories. Despite the fact that the validity of any theory rests upon the accuracy of its underlying data, the relative accuracy of reported suicide rates have rarely been questioned or systematically evaluated. This paper investigates the process of death certification as practiced by a sample of 191 coroners in 11 western states. Findings indicate extensive variation in the backgrounds, professional resources, operating procedures, and governing statutes of coroners and coroners' offices and in policies concerning the use of the suicide mode. Since the coroner is generally charged with the official responsibility for certifying the mode of death when unnatural mode is suspect, the extent of variation found here calls into question the validity and comparability of reported suicide rates.

Coroners and Medical Examiners↗

Religiosity and self-destructive crises in the institutionalized elderly.

The relationship of religiosity to self-destructive behavior has largely been considered in terms of the impact of religious affiliation, or church membership, on rates of suicide for various geographical populations. This study departs from that approach and focuses instead on the relationship of intensity of religious commitment to the use of indirect life-threatening behavior (ILTB) among elderly, chronically ill hospital patients. A rating scale to measure the occurrence of ILTB was developed and administered to a sample of 58 patients in a Veterans Administration hospital. Findings for this sample indicate that intensity of religious commitment is a potentially more meaningful measure of religiosity than is formal church membership, that intensity of religious commitment tends to vary inversely with the extent of ILTB observed for the patient, and that "stigma avoidance" may play a role in the tendency for certain religious affiliates to make more extensive use of ILTB.

Aged↗

The association of preexisting psychosocial pathology with deaths involving propoxyphene or codeine.

The study utilized a sample of 94 propoxyphene- (Darvon) and codeine-related deaths that had occurred in Los Angeles County within a 1-year period (during 1979-1980). Data describing these deaths were obtained from the records of the Los Angeles County Medical Examiner's Office and from interviews with informants who had know the deceased subjects. The findings revealed the presence of extensive psychosocial pathology. High levels of prior drug abuse involving both prescription and illicit drugs were reported. Other findings included a markedly high incidence of prior drug overdoses, arrests, psychiatric disorders, interpersonal conflicts, and prior suicide attempts.

Adult↗

Suicide: who's counting?

A study of suicide certifications explored their accuracy in the light of the difficulties inherent in the certification of death. The primary question addressed was whether the variation in reported suicide rates was significantly related to the structure, function, and procedures of coroners' offices, in comparison with traditional social aspects of the community, such as demographic factors, socioeconomic status, and residential mobility. A stratified sample of 202 counties in the 11 continental western States was selected, and data on coroners' offices were obtained from 191 of these counties. These data were analyzed by means of weighted least squares, which separately related coroner's office variables and community variables to indirectly age-standardized suicide rates. Data for counties with populations of 30,000 or more and those with less than 30,000 were also separately analyzed. Assessment of the multiple regression analyses suggests that the coroner's office variables compare favorably with the community variables in predicting suicide rates, provided a distinction is made between large and small counties. The coroner's office variables in counties with 30,000 or more population explained 37 percent of the variation in reported suicide rates, whereas the community characteristics explained 41 percent. In the counties with less than 30,000 coroner's office variables explained 24 percent of the variation, while community variables explained 13 percent. In the more populous counties, the characteristics of the coroners most predictive of the suicide rates were a nonrejecting attitude toward suicide, an interest in the personal aspects of the deceased, and concern with the physical circumstances of the death. In the less populous counties, the variables most predictive of the suicide rates were related to the physical aspects of the death.

Adolescent↗