Assessing alcohol consumption: developments from qualitative research methods.

This paper examines some shortcomings of self-report questionnaires used to assess alcohol use quantity and frequency and demonstrates the advantages of qualitative interviews to more accurately capture drinking patterns among adolescents. The paper considers alcohol use among two ethnic groups of Black adolescents and discusses variations in rates of alcohol consumption. Qualitative interview data collected from African-American and Haitian adolescents suggest higher rates of alcohol consumption than indicated in previous studies of Black adolescents. Furthermore, qualitative interview data demonstrate greater differences across groups in drinking patterns, including amount and type of alcohol consumed in different cultural contexts than have quantitative-based studies. Strategies are suggested for improving the methodology used to assess drinking patterns among adolescents.

Cultural identification and alcohol use among "Black" adolescents.

This study examined the relationship between cultural identification and alcohol use among Black adolescents--77 African-American and 185 Haitian Black adolescents. The Orthogonal Cultural Identification Scale assessed cultural identification. A logistic regression analysis was used to evaluate the association between cultural identification association between cultural identification, friendships, and alcohol use. Results indicate no relationship between cultural identification and alcohol use. Drinking during the past six months was significantly associated with having close friends who drink. Although the direction of friend influence is unclear. Differences were observed in the context of drinking between the two groups and, importantly, youths in both groups reported drinking alone and to relax/because of stress. Sociocultural factors, context and the basis of drinking need to be addressed in programs for youth.

Paths of reentry: employment experiences of injured workers.

BACKGROUND: An injury at work can result in a change in jobs or employers, unemployment, or withdrawal from the labor force. Substantial life changes can occur, often mediated by the initial attempt to return to employment. METHODS: This study uses ethnographic interviews of 204 workers injured in Florida. RESULTS: The study describes three paths to reemployment taken by the injured workers. The "welcome back" path provides workers with a sense of being valued by their preinjury employers. This positive effect remains, even for those who are unable to continue working because of limitations imposed by their injuries. Other paths cause workers to feel undervalued, as discarded or damaged goods, and generate hostility and resentment. Females in all groups are less likely to be currently working. White males were more likely than other groups to be employed in skilled jobs and are also the most likely to return to light-duty jobs and to remain in their preinjury jobs over time. CONCLUSIONS: Half of the workers in this study experience employer indifference or hostility in response to their attempts to return to work after an occupational back injury. After injury, there are both commonalities and meaningful disparities in post-injury experiences of White, Black, and Hispanic male and female workers.

Drinking perceptions and drinking behaviors among urban black adolescents.

PURPOSE: To improve understanding of black (African American and Haitian Blacks) adolescents' drinking behaviors and sexual patterns that put them at risk for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) to determine whether specific cultural differences affect beliefs and behaviors about alcohol use. METHODS: The study used ethnographic interviewing to provide information about the alcohol norms, beliefs, context, and behavior of African-American and Haitian adolescents. Ethnographic open-ended interviews were conducted with 314 students: 116 African American adolescents (50 boys and 66 girls) and 198 Haitian adolescents (93 boys and 105 girls) in inner-city public high schools. RESULTS: The majority of adolescents had drunk alcohol, and African-American boys and Haitian boys and girls were most likely to report general drinking experience. Both ethnic groups distinguished between negative and positive nonnormative behaviors resulting from drinking beyond and within the boundary of one's limits. African-American boys in particular described not drinking beyond the boundary, to maintain control of their actions. Drinking within the boundary and feeling "relaxed" was endorsed by African American youths, as it was by Haitian youths who felt "normal" and/or viewed drinking certain alcoholic beverages as normative and culturally sanctioned. CONCLUSION: The study suggests there are cultural differences in the constructs of the meaning of drink and drinking that may influence alcohol use. Understanding these differences will improve efforts to impact the drinking behaviors of adolescents by recognizing the drinking socialization, normative drinking patterns, and culturally sanctioned drinking behaviors that may influence alcohol use in different ethnic groups.

Alcohol use and sexual behavior among "Black" adolescents.

This paper reports on findings collected from 1993-1995 from an ethnographic interview study that investigated whether a pattern of HIV-related risk behavior varies across subpopulations of minority adolescents by studying behaviors and perceptions of risk for HIV infection among two ethnic groups of 314 Black adolescents-African-American and Haitian Blacks. Of those who had sex within the past 6 months and were current drinkers, 69% said they did not have sex after drinking. Although many of the adolescents believe that drinking has a disinhibitory effect and may be a factor in nonuse of condoms, alcohol is but one element in a constellation of factors related to sexual intercourse and condom use.

Doctor in the lab: what is it like for a doctor to work with scientists?

As clinical academic medical departments strive to improve the quality of their research, clinicians and scientists are forced into closer liaison. In many cases, clinical departments now have research laboratories directed by "basic scientists" but often staffed, in part at least, by doctors. To someone who has not worked in one, these laboratories may seem uncompromising and forbidding work environments. This article presents a "case report" written from the viewpoints of the doctor, the scientist, and the professor.

Anaesthesia with the Boyle's bottle vaporizer.

Having used the Boyle's bottle vaporizer apparatus out of necessity in a developing country, the concentration of agent that had been administered was investigated retrospectively. Three anaesthetic agents, halothane, isoflurane and enflurane, were measured at different temperatures, using a Boyle's anaesthetic machine and a Boyle's bottle in circuit with a Magill breathing system connected to a Rascal II Agent Monitor. Bubbling a fresh gas flow of 5 l.min-1 through the anaesthetic liquids generated concentrations in excess of 12%. Elevating the initial temperature of the vaporizer increased the delivered concentration, although this effect was short-lived. Therapeutic concentrations of vapour were achieved for all three agents by avoiding bubbling and manipulating the 'splitting ratio' lever. The Boyle's bottle vaporizer may be used with modern anaesthetic agents such as halothane, isoflurane and enflurane. However, the limitations of and variations between vaporizers should be borne in mind. An agent monitor employed at the patient end of the circuit would be an important safety feature.

The use of absorbent materials for the disposal of controlled drugs.

The Association of Anaesthetists of Great Britain and Ireland's most recent publication on controlled drugs notes that the Environmental Protection Act (1992) does not permit the disposal of controlled drugs into the water sewerage system. The Association suggests that, in order to conform to the Misuse of Drugs Regulations (1985), controlled drugs may best be disposed of using some sort of absorbent material, for example a small amount of cat litter or wallpaper paste, in the bottom of a sharps bin. The absorbent capacity of three types of cat litter, wallpaper paste and a commercial absorbent material were tested. Both the commercial absorbent and wallpaper paste displayed limited absorbent qualities unless the container was agitated. The cat litter, Snowflake, absorbed more controlled drug than the others (one-way ANOVA, F2,12 = 250.85, p < 0.01). The use of absorbent materials in sharps bins for the disposal of controlled drugs in clinical areas has limitations and may not be suitable. It is concluded, therefore, that small volumes of controlled drugs should be disposed of directly into clinical waste and that large volumes should be dealt with using a commercial absorbent in its own container.

Prediction of postoperative nausea and vomiting using a logistic regression model.

In a previous study, logistic regression analysis was used to determine the association of independent fixed patient factors with the incidence of postoperative nausea and vomiting (PONV). Female sex, previous history of PONV, use of postoperative opioids, previous history of motion sickness and an interaction between male sex and previous history of PONV were combined in an equation from which risk of PONV could be estimated. The present study was designed to test this equation in a group of patients with wide selection criteria. Data on 400 patients were collected in relation to pre-, per- and postoperative factors which may influence the incidence of PONV. The equation was used to predict PONV, and actual outcome was compared with that predicted. The overall incidence of PONV was 36%. The equation predicted an overall probability of PONV of 27.4%. If the model was used to define individual patients as predicted to have or not to have PONV, it was correct only 71% of the time. However, there was good agreement between the actual incidences of PONV and those predicted among the 16 risk groups created by the model.