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The literature demonstrates links between socioenvironmental characteristics, dysregulation of the stress response system, and PTSD, though few studies integrate these factors in one model. In a secondary analysis of cross-sectional data collected by the Survey of the Health of Wisconsin (SHOW), structural equation modeling evaluated the relationships between socioenvironmental stress, cumulative biological risk (CBR), and PTSD symptom severity. The model hypothesized that exposure to socioenvironmental stress was associated with PTSD and that this relationship is mediated by increased CBR. Indices suggest the model provided a good fit to the data and supported socioenvironmental stress and CBR as valid latent constructs. Although the association between CBR and PTSD was not found to be statistically significant in this study, socioenvironmental stress was a significant predictor of PTSD and CBR. Given the role of socioenvironmental factors on CBR and PTSD symptoms, providers need to better assess and incorporate social stressors within evaluation and treatment.

Purpose: To determine the state of evidence on relationships among urban green space, violence, and crime in the United States. Methods and Results: Major bibliographic databases were searched for studies meeting inclusion criteria. Additional studies were culled from study references and authors’ personal collections. Comparison among studies was limited by variations in study design and measurement and results were mixed. However, more evidence supports the positive impact of green space on violence and crime, indicating great potential for green space to shape health-promoting environments. Conclusion: Numerous factors influence the relationships among green space, crime, and violence. Additional research and standardization among research studies are needed to better understand these relationships.

We examined the association between neighborhood-level factors and intimate partner femicide (IPF) using Wisconsin Violent Death Reporting System (WVDRS) data and Wisconsin Coalition Against Domestic Violence (WCADV) reports, in concert with neighborhood-level information. After controlling for individual characteristics, neighborhood-level disadvantage was associated with a decreased likelihood of IPF status, as compared with other femicides, whereas neighborhood-level residential instability was associated with an increased likelihood of IPF status. Neighborhood plays a role in differentiating IPFs from other femicides in our study area. Our findings demonstrate the importance of multilevel strategies for understanding and reducing the burden of intimate partner violence.

Intimate partner violence (IPV) is an important global public health problem, affecting women across the life span and increasing risk for a number of unfavorable health outcomes. Typically conceptualized as a private form of violence, most research has focused on individual-level risk markers. Recently, more scholarly attention has been paid to the role that the residential neighborhood environment may play in influencing the occurrence of IPV. With research accumulating since the 1990s, increasing prominence of the topic, and no comprehensive literature reviews yet undertaken, it is time to take stock of what is known, what remains unknown, and the methods and concepts investigators have considered. In this article, we undertake a comprehensive, systematic review of the literature to date on the relationship between neighborhood environment and IPV, asking, “what is the status of scholarship related to the association between neighborhood environment and IPV occurrence?” Although the literature is young, it is receiving increasing attention from researchers in sociology, public health, criminology, and other fields. Obvious gaps in the literature include limited consideration of nonurban areas, limited theoretical motivation, and limited consideration of the range of potential contributors to environmental effects on IPV—such as built environmental factors or access to services. In addition, explanations of the pathways by which place influences the occurrence of IPV draw mainly from social disorganization theory that was developed in urban settings in the United States and may need to be adapted, especially to be useful in explaining residential environmental correlates of IPV in rural or non-U.S. settings. A more complete theoretical understanding of the relationship between neighborhood environment and IPV, especially considering differences among urban, semiurban, and rural settings and developed and developing country settings, will be necessary to advance research questions and improve policy and intervention responses to reduce the burden of IPV.

The growth of international business calls for the development of universal ethical standards. Corporate and national cultures embody differing codes of conduct. Serious ethical lapses have damaged organizations and societies. Various international groups of business leaders are developing voluntary ethical standards. Citizen activism may be needed to ensure implementation and compliance with such standards.

Research and literature has suggested that the school leader be one who empowers others, encourages creativity and flexibility, promotes collaborative planning and shared decision-making in an effort to develop trust throughout the school setting, and utilizes these qualities as a catalyst for successful school resturcturing and reform. A study of the leadership styles of school principals in the Detroit metropolitan area of Wayne County, Michigan was conducted to determine the extent to which principals are applying these recommended styles of leadership for restructurning schools to serve students in the 21 st century. The article includes an examination of responses received from school principals as they relate to leadership training and school reform issues. Recommendations for development and improvement of leadership preparation and professional development programs are presented.

Based on encouraging experimental evidence, a new myocardial revascularization procedure was, for the first time, used on a sixty-six-year-old patient. This patient suffered from unstable angina (NYHA class III-IV). He had diffuse peripheral coronary artery stenosis (three-vessel disease). Bicycle ergometry showed ischemic ST segment changes at 25 W. After two myocardial infarctions, his prognosis for life was very bad. Therefore, he underwent this new surgery. After a median sternotomy, a free latissimus dorsi muscle flap was grafted onto the anterior wall of the heart. The flap artery was anastomosed end-to-side to the aorta, and venous flow was directed into the right atrium. The graft was fixed with sutures to the epicardium and pericardium. The chest was then closed. The patient had two anginal episodes on the third and fourth postoperative days. Up to the present, these were his last anginal attacks. Eight weeks postoperatively a bicycle ergometry evinced no signs of ischemia at 120 W. Angiographically, a fine vascular network originating from the graft had penetrated into the heart. Four months later, he was able to perform a 10 km walk in one day. Eight months later, he went back to work. His quality of life was 100% improved, although dyspnea on exertion still persists. Up to the present, a year and a half after the intervention, he has had no more anginal episodes. Thus, myocardial revascularization can be achieved with this new aortomyocardial bypass.

Before the event of modern bypass surgery revascularisation of the heart was tried with the transplantation of pedicled muscle flaps onto the heart. For patients who cannot undergo bypass surgery this method could be –- in a modified way –- of help. This was shown in 12 dogs. In those a free muscle flap was transplanted onto the heart which had undergone a previous artificial infarction. The muscle flap was anastomosed with the a. mammaria, venous flow was directed into the right atrium. After 5 months the muscle was almost completely atrofic, but a fit capillary network was penetrating the underlying myocardium

INTRODUCTION Two research strategies may reduce health disparities: community participation and the use of geographic information systems. When combined with community participation, geographic information systems approaches, such as the creation of disease maps that connect disease rates with community context, can catalyze action to reduce health disparities. However, current approaches to disease mapping often focus on the display of disease rates for political or administrative units. This type of map does not provide enough information on the local rates of cancer to engage community participation in addressing disparities. METHODS We collaborated with researchers and cancer prevention and control practitioners and used adaptive spatial filtering to create maps that show continuous surface representations of the proportion of all colorectal cancer cases diagnosed in the late stage. We also created maps that show the incidence of colorectal cancer. RESULTS Our maps show distinct patterns of cancer and its relationship to community context. The maps are available to the public on the Internet and through the activities of Iowa Consortium for Comprehensive Cancer Control partners. CONCLUSION Community-participatory approaches to research are becoming more common, as are the availability of geocoded data and the use of geographic information systems to map disease. If researchers and practitioners are to engage communities in exploring cancer rates, maps should be made that accurately represent and contextualize cancer in such a way as to be useful to people familiar with the characteristics of their local areas.

The article reports on both qualitative and quantitative research evaluating the role and success of an “expanded” network of Occupational Program Consultants. It concentrates on two basic questions: what OPCs actually did, and, second, what outcomes did they achieve relative to their mandated goals—to encourage and aid employers and unions in adopting and implementing job-based alcoholism programs. First, largely qualitative data, with some quantitative, provided a description of inherent difficulties in the role: its newness, problems of legitimacy and power, financial insecurity, role conflicts, and role ambiguities. Initially these produced substantial amounts of goal displacement that were temporarily overcome, but reemerged to plague the network near the end of this three-year study. Despite these problems the OPCs were able to devise a plausible strategy—to carefully select client organizations for their probable responsiveness, and bypass reluctant ones. This resulted in an average of 21 program start-ups per OPC for the first two years of the state network. Next, the study went to a statewide sample of work organizations where the OPC had made substantial presentations and secured data from them on how their organization had responded. This data was used in both bivariate and multivariate analyses to determine what characterized work organizations that responded favorably to the OPC. These characteristics were: prior familiarity with job-based programs, union support, perception of OPC as competent and empathetic, viewing programs as good for both labor and public relations, as relatively easy to administer, and as helping supervisors manage marginally performing employees.

Job-based alcoholism and drug abuse policies/programs have been historically geared to male employees. This article examines the basic strategies of these efforts relative to known characteristics of women employees, both as members of the labor force and as drug abusers. The trend toward equalization of male and female drinking and alcoholism problems, together with the growing participation of women in the workplace, makes such an examination an urgent matter. Features of the labor market suggest that high priority be given to the development of job-based programs where women are concentrated in both professional and service occupations. Extant evidence also suggests that the strategy of constructive confrontation is viable for women employees with two prominent cautions: stressful life events, often present at onset of problem drinking, and higher likelihood of attempted suicide suggest some muting of the confrontation process with an emphasis on positive offers of help.

This study investigates whether supervisors' use of management-initiated policies--in this case, alcoholism and EEO policies--is related to the presence of a union, the power of any union present (measured, among other ways, by certain bargaining outcomes), and the supervisors' awareness of the union's position on the policies in question. An analysis of interview data from supervisors in 71 federal installations, and from both national and local union officials, indicates that the supervisors' awareness of a union's position on the policies was positively related to use of both policies, as were certain aspects of union power. The presence of a union was also associated with greater use of the alcoholism policy, but not of the EEO policy. In addition, the authors analyze the reasons for the various compromises that occur in the use of each policy. (Author's abstract.)

The article describes two concepts relative to the relationship between social controls and deviant behavior: control-managed and control-produced concepts. It uses both to describe a job-based strategy for intervening in problem-drinking behavior: constructive confrontation. Declining job performance that accompanies alcohol abuse is used as a basis for supervisors' confronting employees about deficiencies in performance and constructively offering alternate courses of behavior, emotional support, and practical assistance designed to help them toward rehabilitation. Article traces the development of the strategy, its relationship to social controls that manage drinking behavior in other cultures, and how it represents similar ways to intervene in pluralistic American society. Here, work settings generate formal expectations of performance combined with informal group pressures to define the lower limits of acceptable behavior. Workplaces are also mechanisms for preventing the progression of deviant drinking by helping to keep employees in nondeviant groups, thereby avoiding the deviant process. Various evaluations of the strategy suggest remarkably favorable outcomes. Article concludes that the strategy represents an application of a social learning paradigm that is currently coming into prominence in the behavorial sciences.Current Employee Assistance Programs have grown from the strategy. They have, however, failed to clearly adopt it, and often have tended to ignore it. In addition, the occupational make up of the movement has generated a cooptation trend that could weaken the strategy, even mark its demise, if current trends continue.We wish to gratefully acknowledge the helpful comments of Professor Paul Roman, and the financial assistance of the National Institute of Alcohol Abuse and Alcoholism and the Christopher D. Smithers Foundation.

This paper explores the vital role of unions in job-based alcoholism programs, pointing out the inevitable involvement of unions where they are duly authorized as legitimate representatives of employees. Consequently it is essential that unions be realistically involved in job-based policies and programs. This, however, has typically not been the case. On the other hand, this state of affairs is rapidly changing, and the present paper examines the problems and payoffs involved in union-management cooperation and joint effort. Specific attention is paid to the concern of labor unions about the strategy of constructive confrontation, indicating how this strategy must be adapted to the legitimate concerns of unions. In addition union initiated and collectively bargained programs are examined, and the role of arbitration and the labor arbitrator is analyzed, pointing out the possibility that the psychodynamics of alcoholism may lead to the employee playing his grievance rights against management. In this connection some of the concerns of numerous members of the labor movement about the “broadbrush” pro grams are listed; and the relationship between unions and the treatment community is described. Finally a review of extant data about the involvement of labor unions is presented, pointing out its scarcity.

A major unanswered question relevant to managers and researchers is how to implement policies more effectively. This study advances a model of managerial policy implementation and tests hypotheses derived from 71 federal government organizations. The results show that various facets of managerial receptivity to the policy were the most important positive influences on implementation of the two policies. Other factors such as perceived emphasis by top level management, organizational size, work overload, perceptions of the importance of performance for promotion, and the manager's attitude toward change were also important predictors of the managers' receptivity to the policies. Implications of the findings for management and future research are presented.

The literature was reviewed to identify factors on which men and women have been found to differ that could affect their experiences and success in job-based alcoholism programs. Factors found fell into three categories: personal characteristics, patterns of interpersonal interaction, and situational factors. Records of a large corporate alcoholism program provided data on interactions, situations, and outcomes for all employees who had been in the program over a 13-year period. The results of bivariate analyses of data on a sample of 377 cases showed that men and women who had been in this program differed in interaction patterns and situational variables. Women employees evoked more interactions about their drinking problems than men, and tended to have more solitary home situations and different work statuses. However, overall program outcomes did not differ significantly between men and women on such criteria as job performance, relapses, or attendance. Multivariate analyses of the correlates of program outcomes revealed that, although men and women differed on some details of how interventions and treatment were handled, successful cases of both sexes had been in the program longer, had experienced less labelling in terms of frequency of treatment and interventions, and had greater investments in their jobs in terms of job status or seniority.