Psychiatric disorder symptoms, substance use, and sexual risk behavior among African-American out of school youth

PURPOSE

To examine the association between symptoms of psychiatric disorder (i.e. depression, anxiety, and substance use) and sexual risk behavior in a sample of African-American adolescents and young adults in an employment training program.

METHODS

Baseline data were used from a pilot study of an intervention to reduce depressive symptoms among youth disconnected from school and the workforce. Participants were recruited from two employment training programs in East and West Baltimore (N=617; age 16-23 years). Data were collected through audio computer-assisted self-interview (ACASI). Mental health indicators were measured using the Center for Epidemiological Studies Depression Scale and Beck Anxiety Inventory. Multivariate logistic regression was used to determine the odds of sexual risk behavior for each mental health condition and combinations of conditions.

RESULTS

Lack of condom use at last sex was significantly associated with elevated anxiety symptoms. Number of sexual partners was associated with elevated depression symptoms and substance use. Early sexual debut was associated with substance use in the past 30 days. Also, there were differences in the likelihood of engaging in sexual risk behavior comparing groups with different combinations of mental health problems to those with no symptoms of disorder or substance use.

CONCLUSIONS

The results demonstrate the need for HIV prevention programs that target out-of-school youth, as they are likely to engage in risky sexual behavior. Our findings highlight the need to develop behavioral interventions that address disorder symptoms, substance use, and risky sexual behavior among youth in employment training programs.

Psychiatric disorder symptoms, substance use, and sexual risk behavior among African-American out of school youth

PURPOSE

To examine the association between symptoms of psychiatric disorder (i.e. depression, anxiety, and substance use) and sexual risk behavior in a sample of African-American adolescents and young adults in an employment training program.

METHODS

Baseline data were used from a pilot study of an intervention to reduce depressive symptoms among youth disconnected from school and the workforce. Participants were recruited from two employment training programs in East and West Baltimore (N=617; age 16-23 years). Data were collected through audio computer-assisted self-interview (ACASI). Mental health indicators were measured using the Center for Epidemiological Studies Depression Scale and Beck Anxiety Inventory. Multivariate logistic regression was used to determine the odds of sexual risk behavior for each mental health condition and combinations of conditions.

RESULTS

Lack of condom use at last sex was significantly associated with elevated anxiety symptoms. Number of sexual partners was associated with elevated depression symptoms and substance use. Early sexual debut was associated with substance use in the past 30 days. Also, there were differences in the likelihood of engaging in sexual risk behavior comparing groups with different combinations of mental health problems to those with no symptoms of disorder or substance use.

CONCLUSIONS

The results demonstrate the need for HIV prevention programs that target out-of-school youth, as they are likely to engage in risky sexual behavior. Our findings highlight the need to develop behavioral interventions that address disorder symptoms, substance use, and risky sexual behavior among youth in employment training programs.

Meaningful lives: Supporting young people with psychosis in education, training and employment: an international consensus statement

AIM

Unemployment is the major disability faced by people with psychotic illness. Unemployment rates of 75–95% are found among those with schizophrenia. Unemployment is associated with poorer social and economic inclusion, greater symptomatology, decreased autonomy and generally poorer life functioning. Unemployment also makes up over half of the total costs associated with psychotic illness.

METHODS

A meeting was convened in London in June 2008. Invitees to this meeting included people from the USA, Canada and the UK interested in vocational intervention in early psychosis from either a research, clinical, economic or policy point of view. From this meeting a larger group–the International First Episode Vocational Recovery (iFEVR) group–has developed an international consensus statement about vocational recovery in first episode psychosis.

RESULTS

The document is a basic statement of the rights of young people with psychosis to pursue employment, education and training; the evidence which exists to help them do this; and ways in which individuals, organizations and governments can assist the attainment of these ends.

CONCLUSION

It is hoped that the Meaningful Lives consensus statement will increase the focus on the area of functional recovery and lift it to be seen in parallel with symptomatic recovery in the approach to treating early psychosis.

Acceptability of a microenterprise intervention among female sex workers in Chennai, India

Female sex workers have been central in India's HIV epidemic since it was first diagnosed among them in 1989. Female sex workers' risk of HIV is primarily economically motivated. The Pi pilot study examined the feasibility and association of a microenterprise intervention, the tailoring of canvas bags, on sexual risk behaviors among female sex workers (N = 100) in Chennai. Women were randomized to an intervention or control arm. Between-group comparisons at baseline and at six-month follow-up were performed. Multivariate linear regression with bootstrapping was conducted to estimate the intervention effect. At baseline, women were a median of 35 years old, 61% were married and they had an average of two children. Intervention participants reported a significantly lower number of sex partners and significant increases in income at the 6-month follow-up compared to control participants. In a multivariate model, intervention participants had a significantly lower number of paying clients per month at follow-up compared to control participants. By graduation, 75% of intervention arm participants had made at least one sellable canvas bag and 6 months after the study's end, 60% have continued involvement in bag production. The pilot study demonstrated that microenterprise interventions are successful in both providing FSWs with licit income opportunities and was associated with reductions in HIV risk behaviors.

HIV/AIDS-associated beliefs and practices relating to diet and work in southeastern Uganda

To explore beliefs relating to diet, work, and HIV/AIDS among the Busoga of rural southeastern Uganda, a cross-sectional survey of 322 adults was conducted in 2007 in Mayuge district, Uganda. Of these adults, 56 were HIV-infected, 120 had a family member with HIV/AIDS, and 146 were in households without HIV-infected members. More than 74.2% of the adults knew someone with HIV/AIDS, and more than 90% correctly identified transmission modes and prevention methods of HIV. In total, 93.2% believed that a person with HIV should work fewer hours to conserve energy but all the three participant groups reported the same working hours. Also, 91.6% believed that a person with HIV infection should eat special nutritious foods, and the participants with HIV infection reported eating more fruits (p=0.020) and vegetables (p=0.012) than other participants. The participants expressed a consistent set of health beliefs about practices relating to HIV/AIDS.

Managing problem employees: a model program and practical guide

This article presents a model program for managing problem employees that includes a description ofthe basic types of problem employees and employee problems, as well as practical recommendations for. (1) selection and screening, (2) education and training, (3) coaching and counseling, (4) discipline, (5) psychological fitness-for-duty evaluations, (6) mental health services, (7) termination, and (8) leadership and administrative strategies. Throughout, the emphasis on balancing the need for order and productivity in the workplace with fairness and concern for employee health and well-being.

So you want to work? What employers say about job skills, recruitment and hiring employees who rely on AAC

In order to better understand employer perspectives with respect to hiring and working with people who use AAC and the kinds of employment barriers they believe exist for these individuals, a study into the job requirements, recruitment processes, and hiring processes of 27 employers in the United States was conducted. Interviews with the 27 employers focused on 48 jobs in 25 unique categories, many of which had previously been identified as desirable by 38 adults who used AAC (some of whom were employed and some of whom were seeking employment). Findings suggest that, while level of education is still important to employers, skills such as time management, problem solving, communication, use of an understandable and standard voice, and basic technology may be even more so. The study also found that having an effective job-related network is important, as is the ability to provide credible references and do well during in-person interviews with potential employers.

Revisiting physician employment

All too many trustees remember the last time hospitals employed large numbers of physicians--and the resulting large financial losses they absorbed. Now some hospitals are employing physicians without fearing a repeat of the mistakes from the 1990s.

Can working conditions explain differences in eating patterns during working hours?

Objective

The aim of this study was to examine whether there are associations between working conditions and the use of staff canteen or packed meals among Finnish employees.

Setting

Data were obtained from cross-sectional surveys on working conditions, conducted triennially (1997, 2000, 2003) since 1997.

Subjects

In each survey, the subjects were 25–64-year-old employed Finnish employees: 3096 men and 3273 women.

Results

Employees at large workplaces used canteens far more often than those at smaller workplaces. Working conditions played a different role in canteen use at small and large workplaces, as well as among the different sexes. At small workplaces, physically demanding jobs held by female employees and low job control encouraged employees to use the canteen. On the other hand, at large workplaces, low social support at work encouraged the use of canteens among men whereas high mental strain at work meant they used the canteen less. Among women, eating packed meals was not related to working conditions, but among men, low social support and high mental strain at work were associated with more frequent use of packed meals.

Conclusions

The use of a staff canteen is largely determined by the size of the workplace and by employee education. The underlying factor could be the availability of canteens, a question which must be confirmed in further studies, since well-planned mass catering at workplaces has major effects on public health, well-being and the nutrition education of employees.

An examination of the role of perceived support and employee commitment in employee-customer encounters

The authors examined the relationships between perceived organizational support, organizational commitment, commitment to customers, and service quality in a fast-food firm. The research design matched customer responses with individual employees' attitudes, making this study a true test of the service provider-customer encounter. On the basis of a sample of matched employee-customer data (N = 133), hierarchical linear modeling analyses revealed that perceived organizational support had both a unit-level and an employee-level effect on 1 dimension of service quality: helping behavior. Contrary to affective organizational commitment, affective commitment to customers enhanced service quality. The 2 sub-dimensions of continuance commitment to the organization--perceived high sacrifice and perceived lack of alternatives--exerted effects opposite in sign: The former fostered service quality, whereas the latter reduced it. The implications of these findings are discussed within the context of research on employee-customer encounters.

Effects of rater goals on rating patterns: Evidence from an experimental field study

The goal-based perspective of performance appraisals suggests that raters who pursue different goals give different performance ratings. Yet previous studies have not provided strong empirical evidence that there are different impacts of different goals on mean rating and discriminability, nor have they provided evidence of a goal-rating causality. The authors extend the literature by manipulating rater goals in the context of peer evaluations of graded group projects with a sample of 104 undergraduate students. They find that (a) pursuing a harmony goal increased mean rating and decreased discriminability, and (b) pursuing a fairness goal increased mean rating and decreased discriminability when the group projects had not ended and increased mean rating but did not change discriminability when the group projects had ended.

A successful initiative for getting refugee doctors back into medical employment: the PRIME project

Refugee doctors find it difficult to get back to medical work in their new countries. This article describes the setting up and evaluation of the Placing Refugee doctors In Medical Employment (PRIME) project which resulted in 15 out of 25 participants getting substantive jobs in open competition within a year, and suggests this approach should be more widely adopted.

Social inequalities in the impact of flexible employment on different domains of psychosocial health

STUDY OBJECTIVES

(1) To analyse the impact of flexible employment on mental health and job dissatisfaction; and (2) to examine the constraints imposed by flexible employment on men's and women's partnership formation and people's decision to become parents. For the two objectives the potentially different patterns by sex and social class are explored.

DESIGN

Cross sectional health survey. Multiple logistic regression models separated for sex and social class (manual and non-manual workers) and controlling for age were fitted. Four types of contractual arrangements have been considered: permanent, fixed term temporary contract, non-fixed term temporary contract, and no contract.

SETTING

Catalonia (a region in the north east of Spain).

PARTICIPANTS

Salaried workers interviewed in the 2002 Catalonian health survey with no longstanding limiting illness, aged 16-64 (1474 men and 998 women).

MAIN RESULTS

Fixed term temporary contracts were not associated with poor mental health status. The impact of other forms of flexible employment on mental health depended on the type of contractual arrangement, sex, and social class and it was restricted to less privileged workers, women, and manual male workers. The impact of flexible employment on living arrangements was higher in men. Among both manual and non-manual male workers, those with fixed term temporary contracts were less likely to have children when married or cohabiting and, additionally, among non-manual male workers they also were more likely to remain single (aOR = 2.35; 95%CI = 1.13 to 4.90).

CONCLUSION

Some forms of temporary contracts are related to adverse health and psychosocial outcomes with different patterns depending on the outcome analysed and on sex and social class. Future research should incorporate variables to capture situations of precariousness associated with flexible employment.