Becoming better health care providers: outcomes of a primary care service-learning project in medical school

Medical educators have begun to embrace service-learning as a method for teaching medical students to be more socially responsible, patient-oriented practitioners. However, research documenting the learning outcomes of service-learning in medical education is limited. In this paper, written documents generated through evaluation of a mandatory, structured community service-learning experience were analyzed qualitatively to discover the diverse learning outcomes among 24 students who participated in the experience. Preliminary findings indicate that students developed skills and attitudes directly related to competencies of concern in most U.S. medical programs. These preliminary findings may help other programs articulate learning outcomes for their service-learning programs. Further, these preliminary findings may stimulate more systematic research (qualitative and quantitative) in this area.     

The impact of stress on cognitive components of child abuse potential

The purpose of the present research was to test the effects of situational stress on the components of the cognitive behavioral model, including expectations, interpretations, and behavioral responses to child behaviors (Twentyman et al., 1985). It was predicted that parental abuse potential would be positively related to inappropriate expectations, to negative and internally caused interpretations of child behavior, and to negative parental responses. Second, it was expected that interpretations and responses would be more negative as child abuse potential increased. Sixteen mothers from a child abuse prevention and treatment program completed the Child Abuse Potential Inventory (Milner and Wimberly, 1980) and provided interpretations, evaluations, and responses to a set of vignettes depicting normal child behaviors. The data supported the hypotheses. As abuse potential increased, parent responses were judged as more controlling, punishing, rejecting, and aroused. High stress strengthened the magnitude of these responses. These findings were interpreted within the context of a cognitive behavioral model.     

A Comparison of Disaster Paradigms: The Search for a Holistic Policy Guide

The following article discusses the current emphasis and attention being given to the future of emergency management, as well as theoretical constructs designed to guide research and help practitioners reduce disaster. It illustrates that while the disaster-resistant community, disaster-resilient community, and sustainable development/sustainable hazards mitigation concepts provide many unique advantages for disaster scholarship and management, they fail to sufficiently address the triggering agents, functional areas, actors, variables, and disciplines pertaining to calamitous events. In making this argument, the article asserts that any future paradigm and policy guide must be built on—yet go further than—comprehensive emergency management. The article also reviews and alters the concept of invulnerable development. Finally, the article presents "comprehensive vulnerability management" as a paradigm and suggests that it is better suited to guide scholarly and practitioner efforts to understand and reduce disasters than the aforementioned perspectives.     

Evaluation of the correlation between time corpses spent in in-ground graves and findings at exhumation

To determine how long pathological findings persist after burial and which factors play a role in decomposition of a corpse, we evaluated all bodies exhumed under the auspices of the Institute of Legal Medicine at the Hannover Medical School between 1978 and 1997. A total of 87 exhumations (54 men, 33 women) were performed in this period. The time bodies remained buried varied between 5 days and 16.8 years (mean 1.5 years, median 2.3 months). Fifty-six percent of the bodies were exhumed after at most 3 months, 10% remained buried for greater than 3 years. Pathomorphological changes of the soft tissues and the internal organs remained evident after several months, in some cases after several years of burial. Overall, it was possible to evaluate internal organs after 5 years of burial. Bodies became mostly decomposed after approximately 8 years at the earliest, although it was still possible to evaluate some soft tissue remnants after 16.8 years. In stepwise logistic regression, both the length of time the body was buried (p < 0.00005) and the time of year (p < 0.0019) clearly affected the rate of physical change. The variables of sex (p = 0.33), age (p = 0.61) and changes in the integrity of the body before burial (trauma, autopsy before burial; p = 0.15) did not influence the physical state of the body after exhumation. Our data show that much information may be gained from an exhumation even after significant time has passed since burial.     

Cracked Ceilings, Firmer Floors, and Weakening Walls: Trends and Patterns in Gender Representation among Executives Leading American State Agencies, 1970–2000

Trends of female access to and presence in responsible governmental positions have gained substantial attention. The research reported here assesses and seeks convergence on several issues associated with gender representation. It extends the research by focusing on top executive posts in American state governments. In particular, the presence of women agency heads in all 50 states is examined from 1970 through 2000 using the lenses of passive representativeness and active representation. The authors find, first, that women face fewer blockages in securing top posts—the glass ceilings are cracking. Second, women's access to peak executive positions springs from more solid educational, career, and organizational foundations or "floors." Third, lateral career movements are penetrating the "walls" surrounding traditionally male-dominated agency types. The essay concludes with a framework for understanding relationships involving passive representativeness, active representation, and representative results. That framework assists in shifting attention toward the consequences of both passive and active representation.