A cross-sectional survey was designed to assess interest in geriatric medicine of allopathic and osteopathic medical students and to determine whether their career interests were related to past experiences with and current attitudes toward older adults. The study was conducted at an allopathic and osteopathic medical school with 231 first-year medical students. Experiences with elderly people were measured using survey questions assessing amount and quality of experiences with grandparents, as well as experiences caring for, volunteering with, or having a paid position working with older adults. Attitudes were measured using the University of California at Los Angeles Geriatric Attitudes Scale, revised for applicability to medical students. Interest in geriatrics was measured using a 4-point scale. Overall, students expressed positive attitudes toward older adults. Past experiences, including positive relationships with older relatives (P<.001) and experiences providing care for older adults (P<.001), were related to more-positive attitude scores toward elderly people. Students had low interest in geriatric medicine, but those with more-positive attitudes were more likely to consider geriatrics as a career (odds ratio=8.18, P<.001). Furthermore, having prior experience caring for older persons increased interest in the field (P=.001). No significant differences were found between allopathic and osteopathic student interest in geriatrics or attitudes toward older adults. Efforts toward increasing the pool of future geriatricians and increasing positive attitudes toward older patients could be improved by providing quality experiences caring for and interacting with older adults before medical school training.

This study explores how the method of delivery for early intervention services impacts perceptions of empowerment among families. Analysis of data collected from 270 randomly sampled families participating in the State of Michigan's Early On (Part H of the Individuals with Disabilities Education Act) program suggests two paths by which empowerment is effected. Along one path, implementation of program components via a family-centered framework appears to help increase empowerment. An alternative path models how family-centered delivery may help to build a family's support network. This is related to reduced stress and increased empowerment. Findings support programs emphasizing family-centered methods of service delivery.

Despite growing research interest in co-occurring psychiatric and substance misuse disorders, relatively few longitudinal studies have been conducted with dual diagnosis populations. Many of the longitudinal studies that have been done have experienced excessive attrition. Thus, investigators have noted that one of the primary difficulties of conducting longitudinal studies with this population is successfully minimizing attrition during follow-up. This study, conducted in 1991 1993, describes retention and tracking methods employed in a longitudinal study of 485 dual diagnosis participants. Follow-up interview completion rates at the 2-, 6-, 10-, 14-, and 18-month interviews were 86.7, 85.6, 85.1, 84.5, and 88.4%, respectively. Several case studies are provided that document some of the challenges facing project staff and successful strategies for handling them. A notable finding from this study was that participants reported that the relationship established with the interviewer was more important than material incentives in preventing study attrition.

Psychological sense of community within psychosocial rehabilitation clubhouse programs was examined using concept mapping with 18 members and 18 staff from 10 programs. Members identified four concepts: Recovery, social connections, membership, and tasks and roles. Members described hope and healing as aspects of recovery. Members' views on sense of community focused on the rehabilitation and social nature of the program. Staff also identified four concepts: Affiliation and support for members, shared experiences, clubhouse organization, and task and roles. The staff concept of clubhouse organization, which incorporated the ideas of leadership and organization of physical space and the concept of task and roles, was based on ideas of shared responsibility and clubhouse procedures. Staffs' views on sense of community strongly reflected their formal training in clubhouse principles. The relation of these concepts to McMillan and Chavis' theoretical framework for sense of community is discussed and recommendations for practice provided.