Physician risk management (RM) has been mandated around the world in an effort to reduce pecuniary and non-pecuniary loss associated with avoidable patient injury. However, there has been little empirical RM assessment to determine whether physicians obtain an increased understanding of the law, clinical obligations defined by law, and reduced numbers of injury suits. Here, 210 US primary care physicians were sent a survey requesting demographic information on RM activities, the definition of negligence, and evaluation of ten patient injury jury verdict case scenarios; 138 physicians responded. Although physicians participated in a broad array of RM activities, none were positively associated with overall concordance with case verdicts; indeed, substantive self-study and RM seminar attendance <24 months ago were associated with worse concordance. Recent RM seminar attendance, clinical practice guideline (CPG) use, and self-study were associated with worse concordance in defendant verdict cases; CPG use was correlated with better concordance in plaintiff verdict cases. Respondent physicians were significantly harsher in case evaluations overall when they used insurer CPGs and for defendant verdict cases when they used insurer CPGs, engaged in substantive self-study, or recently attended RM seminars. No RM method was found to correlate with successful jury verdict prediction; having been sued was negatively correlated with defendant verdict case prediction. Finally, respondent physicians had a higher number of patient injury suits associated with participation in RM malpractice training at the training site, RM seminar training, and RM seminar attendance <24 months ago, or if they acted as an expert/consultant in malpractice cases. Most physicians could not identify the rule of negligence; yet correct identification of the negligence rule was not correlated with concordance, prediction, or number of patient injury suits. Thus, physician RM efforts may not be effective in promoting patient safety, may increase risk of patient injury, and may not reduce pecuniary and non-pecuniary costs associated with patient injury.

The aim of this study is to assess the risk of burnout among teachers.

The burnout syndrome is a complex phenomenon which has been studied extensively from different perspectives. However, the focus was always on its causes and effects but seldom on the worsening processes. On the contrary, this study starts from a static analysis of the burnout (Golembiewski and Munzenrider 1998) and develops a dynamic model in order to assess the risks of worsening the current degree of burnout.

The Maslach Burnout Inventory (MBI, Italian validated Ed version) was administered to a sample of 415 Italian teachers across different levels (from primary school to university) together with some questions on socio-demographic variables. Data were submitted to factor analysis (varimax) which suggested a five-factor structure (personal accomplishment, climate, depersonalization, cynicism, emotional exhaustion). The mean values were calculated for both the three Maslach's dimensions and for the five factors and then compared: the latter seemed to provide a finer interpretation of the degree of burnout. Therefore, Golembiewski's eight-phase model was revised and all the possible passages from one phase to another were studied, with the integration of the new five sub-scales. A new phase model was developed, structured of 32 sub-phases which were then appropriately reduced to 16. This new model was used as a dynamic interpretation tool of Golembiewski's phase model. Besides, all the theoretic probabilities were calculated in order to evaluate the risk of worsening.

The MBI is used as an assessment tool of the current degree of burnout and the eight-phase model is used to classify the gravity of the situation, therefore it is possible to make a diagnosis of the situation. The development of the 16 sub-phases model might provide a prognosis of the risks of burnout. Further research should be conducted to validate the model.

Research in USA and the UK has revealed that whilst the incidence of breast cancer is lower in women from black and ethnic minority groups, African and African-American women delay seeking help, have a worse prognosis, and a higher mortality rate. A variety of reasons has been suggested for this: from system delay, to delay by the women arising from educational and socio-economic disadvantage or religious beliefs. Building on this in the UK, from a study conducted in a South London Screening Clinic, a sub-sample of African and African-Caribbean women were interviewed to obtain their narratives of action in delay in seeking help for late-stage breast cancer. The findings suggest that the women were aware of the services offered, were expecting a diagnosis of cancer, but offered a model of fearing extrusion from their community rather than fear of death from the disease, leading to delay in seeking help. The reasons for this are explored and a risk trajectory in biomedicine compared with the African and African-Caribbean women's world is described.

Risk notification was the initial step in a larger study to determine (1) the prevalence of cardiovascular disease as a late effect of mediastinal irradiation, and (2) whether a brief support group intervention would mitigate any negative effects of risk notification.

323 HD survivors attended a 45 minute risk notification session prior to a routine follow-up medical visit. When they arrived at the clinic and following the risk notification session, they completed surveys that included measures of mood dysphoria, sense of coherence, knowledge of late effects of treatment, and demographic factors. Two analytic models were proposed to look at the effects of risk notification: (1) psychosocial state when arriving at the clinic, and (2) psychosocial change in state following risk notification session.

Pre-intervention mood distress was not significantly affected by time since the initial diagnosis, age, education, or gender. Person's who worked and those with better coping skills had lower initial mood distress. Knowledge of the late effects of treatment was not related to mood distress. Following the intervention, the more distressed a person was initially, the better the coping skills, the greater the decrease in mood distress. Partnered survivors experienced less of a decrease in distress. Knowledge of the late effects of treatment (regardless of their knowledge of cardiovascular disease as a consequence), did not effect change in mood distress.

Findings were contrary to expectations. Findings are consistent with Self-Regulation theory and the Health Belief Model and are not explained by anxiety related to the medical visit itself. Limitations of the study design are discussed.

The method through which risks are conveyed can reduce the psychosocial impact of risk notification.

It is not uncommon for the invading economist to arrive at radically different conclusions in areas of social inquiry, hitherto left to specialists from other fields. For example, before the arrival of Chicagoan economics, the received wisdom in the criminological field was that deterrent punishments (especially capital punishment) did not work. In this paper, we attend to the simple question: ‘Is religion a beneficial influence on the health of individuals?’ This has not hitherto attracted much attention from economists. However, epidemiological studies have overwhelmingly concluded that the answer to the above question is ‘yes'. In the context of a simple two equation recursive set up, this paper provides sharply contrasting evidence of there being no relationship between the two variables except where an arbitrary five point measure of subjective health status is used. Although the relationship in this case is negative in accordance with the received wisdom, its magnitude is so small that it may be dismissed as inconsequential for reasons discussed in the main body of the paper. This paper deals solely with physical health unlike some of the prior research which also investigates mental health status.