Help-Seeking for Sexual Difficulties and the Potential Role of Interactive Digital Interventions: Findings From the Third British National Survey of Sexual Attitudes and Lifestyles

Sexual difficulties are common and can negatively impact health and well-being. A wide range of support is available, but there are multiple barriers to accessing help. Interactive digital interventions (IDIs) for sexual difficulties have the potential to provide a convenient, wide-reaching, and cost-effective source of support, but little is known about who might use them. We explored the potential reach of IDIs by assessing the prevalence of help-seeking among people with distressing sexual difficulties, including who seeks which sources of help. Data came from sexually active men and women, ages 16 to 74, participating in Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) (N = 11,637). Help/advice was sought by less than half of those with distressing sexual difficulties, and help-seeking was associated with younger age in women but not men. The most popular sources of support were family doctor (47.5% to 54.8%), Internet (22.0% to 25.6%), and family/friend (20.7% to 41.8%), with older participants (≥ 35), particularly men, preferring to seek help from a family doctor, and younger participants (<35) preferring to seek help from the Internet or family/friend. Despite a paucity of good digital support sites for sexual function, the Internet is a common source of help. As Internet access continues to increase, so too does the potential for well-designed IDIs to support those with sexual difficulties.     

Validating Benefit and Cost Estimates: The Case of Airbag Regulation

Preregulation estimates of benefits and costs are rarely validated after regulations are implemented. This article performs such a validation for the mandatory automobile airbag requirement. We found that the original 1984 model used to estimate benefits became invalid when 1997 values were input into that 1984 model. However, using a published 1997 cost-effectiveness model, we demonstrate, by replacing the model inputs with the values from 1984, that the 1997 cost-effectiveness ratios, based on real-world crash data and tear-down cost data, are less attractive than what would have been originally anticipated. The three most important errors in the 1984 input values are identified: the overestimation of airbag effectiveness, the overestimation of baseline fatality/injury rates, and the underestimation of manual safety belt use. This case study, which suggests that airbags are a reasonable investment in safety, shows that the regulatory analysis tools do not always produce findings that are biased against health, safety, and environmental regulation. Future validation studies of health, safety, and environmental regulation should focus on validation of benefit and risk estimates, areas where we found significant error, as well as on cost estimates.     

The complexity of roles in community action projects: The example of the evaluation of ‘alternatives’

Evaluation of community interventions is a special form of evaluation involving many roles that are key to accomplishing both the intervention and the accompanying research. The present paper describes the roles involved in the evaluation of a community intervention (‘Alternatives’) aimed at safer use of alcohol and depressant medications by seniors.The three core roles were the community developer who provided leadership in the implementation of the project, the researcher/evaluator, and the community committee that sanctioned and facilitated the project. Other roles on the project included: the project coordinator, the nurse-interviewers who collected the survey data for the evaluation, volunteers from seniors groups, local health service providers, the media, the funders, and others on the project team who provided specific technical expertise.The paper describes the competing interests among these roles as well as conflicts that arose and how these conflicts were handled. Although specific roles are described, the types of roles and the potential for competing interests and conflict are generally relevant to community level evaluations.     

Financial Liberalisation in Southern Africa: An Assessment

In the early 1990s many Southern African economies embarked on financial liberalisation. Although it is too soon to carry out sophisticated econometric analysis of this change in policy, the available empirical evidence may be inspected to see whether it lends support to advocates of financial liberalisation. In this article we explore the avenues through which financial liberalisation might be expected to exert an influence. Consistent with much of the existing literature, we discover that a degree of agnosticism is warranted. Financial liberalisation is no panacea and will not improve economic performance unless accompanied by sound economic policies. It remains difficult to isolate the effects of financial liberalisation from the data available.     

Social Isolation and Lethal Violence Across the Metro/Nonmetro Divide: The Effects of Socioeconomic Disadvantage and Poverty Concentration on Homicide*

Abstract This study extends the macro‐level criminological research tradition by examining the links between socioeconomic disadvantage, poverty concentration, and homicide in metropolitan and nonmetropolitan U.S. counties. Most research in this tradition has tested structural theories using urban areas as the unit of analysis. This “urban bias” has resulted in a limited understanding of the social forces driving violence in nonmetropolitan areas. To partially address this problem, we link the literature on the spatial and social organization of nonmetropolitan communities with the social isolation perspective from the urban poverty literature. We hypothesize that the spatial concentration of poverty drives up rates of homicide in both metropolitan and nonmetropolitan areas regardless of levels of socioeconomic disadvantage. Negative binomial regression for 1,746 nonmetropolitan and 778 metropolitan counties suggest that both socioeconomic disadvantage and poverty concentration elevate homicide in metropolitan areas. However, in nonmetropolitan counties only socioeconomic disadvantage has a significant impact. We conclude by discussing the implications of these differential findings for the social isolation perspective.     

Social Work Practice with Polygamous Families

Data are based on student files of 25 Bedouin-Arab children born to senior mothers of polygamous families, and interviews with the children's teachers and mothers. Mothers complained of somatic symptoms, economic problems, poor relations with the husband, and competition and jealousy between the co-wives and among the co-wives' children. Children had a variety of behavioural problems, and below average academic achievement. Social work practice should recognize the cultural and personal significance of polygamy to family members; appreciate the significance of polygamy to children's functioning; select children as a target system for intervention; and reinforce the Islamic value base for interventions.     

The Dyadic Adjustment Scale: A Reliability Generalization Meta‐Analysis

We conducted a reliability generalization meta‐analysis to examine the internal consistency of Dyadic Adjustment Scale (DAS; Spanier, 1976 ) scores across 91 published studies with 128 samples and 25,035 participants. The DAS was found to produce total and Dyadic cohesion, Consensus, and Satisfaction scores of acceptable internal consistency, although lower than those originally reported by Spanier (1976) . Reliability estimates of these scores did not differ by the sexual orientation, gender, marital status, or ethnicity of the sample. The Affective Expression subscale was found to produce scores with poor Cronbach’s alpha across studies. Reliability estimates of Affective Expression scores were highly influenced by sample characteristics. The implications of these results are discussed as they relate to the use of the DAS in research.     

The ubiquitous angle

Summary.  Previously we used the geometry of n -dimensional space to derive the paired samples t -test and its p -value. In the present paper we describe the 'ubiquitous' application of these results to single degree of freedom linear model hypothesis tests. As examples, we derive the p - and t -values for the independent samples t -test, for testing a contrast in an analysis of variance and for testing the slope in a simple linear regression analysis. An angle θ in n -dimensional space is again pivotal in the development of the ideas. The relationships between p , t , θ , F and the correlation coefficient are also described by using a 'statistical triangle'.     

Value of a Life: What Difference Does It Make?1

A comparison of the costs and benefits of 57 lifesaving programs reveals striking disparities across agencies and programs in cost/life saved and even greater disparities in cost/life-year saved. Within a broad range the monetary value assigned to the benefits of averting a death usually does not alter the policy implications of the analyses. The findings suggest that despite the substantial disagreements and uncertainties in the theory and practice of valuing lives, careful quantitative analysis can be helpful in setting health, safety, and environmental priorities.