Compulsive gambling and the medical model

The medical model as a conceptual and operative approach to compulsive gambling is discussed. The terms medical model and disease are defined and the practical implications of their application to compulsive gambling are explored. Special attention is given to the addictive disease concept. Finally, a variety of objections to the medical model are described, but it is concluded that the many individual and social advantages of the medical model make it the preferred conceptualization at our present state of knowledge.     

Evidence for a common dissociative-like reaction among addicts

A questionnaire was designed to test selected aspects of the author's General Theory of Addictions (Jacobs, 1982). Data were collected from groups of compulsive gamblers, alcoholics, and compulsive overeaters, and compared with the responses to the same questionnaire obtained from normative samples of adolescents and adults. The more inclusive term, compulsive gambler, has been used throughout, since the sample of gamblers in this study included an inpatient subgroup who had been diagnosed as pathological gamblers, as well as a subgroup of Gamblers Anonymous members who had not been clinically evaluated. Findings support the author's theoretical position that, when indulging, different kinds of addicts will tend to share a common set of dissociativelike experiences that differentiate them from nonaddicts. This has been termed a state of altered identity.     

Dealing with uncertainty: statistics for an aging population

"Uncertainty in statistics and demographic projections for aging and other policy purposes comes from four sources: differences in definitions, sampling error, nonsampling error, and scientific uncertainty. Some of these uncertainties can be reduced by proper planning and coordination, but most often decisions have to be made in the face of some remaining uncertainty. Although decision makers have a tendency to ignore uncertainty, doing so does not lead to good policy-making. Techniques for estimating and reporting on uncertainty include sampling theory, assessment of experts' subjective distributions, sensitivity analysis, and multiple independent estimates." The primary geographical focus is on the United States.     

Birth control in the early stage of marriage

Results are presented from a 1985 survey containing questions on family planning conducted among 13,392 newly married couples in Poland during the period from two to six months following marriage. The opinions of husbands and wives concerning various methods of contraception are analyzed.     

On a conjecture of Kakosyan,Klebanov and Melamed

Suppose X₁, X₂, ..., X_m is a random sample of size m from a population with probability density function f(x), x>0 and let X_1,m<...m,m be the corresponding order statistics. We assume m as an integer valued random variable with P(m=k)=p(1?p)^k?1, k=1, 2, ... and 0 and n X_1,n for fixed n characterizes the exponential distribution. In this paper we prove that under the assumption of monotone hazard rate the identical distribution of and (n?r+1) (X_r,n?X_r?1,n) for some fixed r and n with 1≤r≤n, n≥2, X_0,n=0, characterizes the exponential distribution. Under the assumption of monotone hazard rate the conjecture of Kakosyan, Klebanov and Melamed follows from the above result with r=1.     

The timing of maternity in the Netherlands

In this paper the timing of maternity is estimated by a hazard model. The novel aspect of this paper is that it is shown that wages and total household labor income have a significant effect on the timing of maternity. Both the wage rate of the woman and the wage rate of the husband have a negative effect on the timing of maternity. Total household labor income increases the probability of having a child at an earlier age. Calculated elasticities show that the timing of maternity is relatively elastic with respect to wage rates. However, the elasticities of the decision whether or not to have children altogether are much smaller. Women working in the labor market delay the timing of maternity compared to non-participating women. Attending school has the same effect. Until the age of 28 the maternity hazard increases with age, after that it decreases.We benefited from comments on previous drafts by Siv Gustafsson, Joop Hartog, Peter Kee, Herriette Maassen van den Brink, Eddie Mekkelholt, Joop Odink, Hessel Oosterbeek, Hans van Ophem, Gusta Renes, Andre Voskamp, two anonymous referees, and the Managing Editor of this Journal. This paper is a revised version of a paper presented at the third annual meeting of the European Society for Population Economics, Paris, June 1989. The usual disclaimer applies.     

Policies and strategies for integrating women in agriculture and rural development

Continued economic stagnation, civil unrest, rural-urban migration, and a series of natural disasters have impeded efforts in the Sudan to integrate women into the development process. Although the Four-Year (1988-1989 to 1991-92) Salvation, Recovery, and Development Programs Plan does not explicitly addresses women's issues, its emphasis on food security, appropriate technology for the agricultural sector, small-scale industries and handicrafts, balanced regional development, and the needs of the poorest 20% of the population guarantees that women will be major recipients. There remains a need, however, to increase women's participation in the development planning process and to base projects on reliable data on women's economic activities. More successful in defining women's needs have been community development projects--Western Savannah Development Corporation, Blue Nile Integrated Rural Development Project, Nuba Mountain Project, and Jebel Marra Rural Development Project--that combine income generation, social welfare, and agricultural research. It is recommended that all such large integrated rural development or agricultural projects allot funds specifically for women's activities and ensure coordination with women's organizations to avoid duplication and identify areas of greatest need. Also urged is the development of appropriate technologies that will alleviate women's double burden of poverty and household chores and address the inequitable distribution of income. Establishment of a women's bureau for women's affairs and development within the National Planning Department would facilitate project formulation and evaluation. In need of change if women in development projects in the Sudan are to be successful are laws that limit female land ownership and practices that deny women loans and credit.     

The effect of a nutrition education programme on pregnant women attending Khartoum model clinic

A comparative study conducted in the Sudan illustrated both the potential of a nutrition education program for pregnant women and the many obstacles to creating more optimal maternal nutrition. Included in the study were 1200 women 18-34 years of age attending the Khartoum Province Model Clinic for a minimum of 5 prenatal visits. 83.3% were Muslims and 48.2% were illiterate. The 60 women who comprised the experimental group were exposed to individual nutrition counseling and home visits. Overall, 70% of subjects were anemic, 27% had malaria, and 18% were hookworm. The average weight gain during pregnancy was 4.5 kgs; 25.0% of controls and 20.0% of those in the experimental group gained 3.5-4.0 kgs, 18.3% of controls and 33.3% of experimental subjects gained 4.5-5.0 kgs, and 23.3% of controls and 30.0% of those in the experimental groups gained 5.5 kgs or more. 53.0% of controls and 61.7% of women exposed to nutrition education breastfed for at least 6 months, and 70% of women in the former group and 95% of those in the latter had enrolled their infants in an immunization program. A baseline nutrition questionnaire revealed widespread misinformation, especially a belief that pregnant women should reduce their food intake from 3 to 1-2 meals per day to prevent the fetus from growing too large and making labor difficult. Foods such as fermented sorghum products, fresh fish, and water melon were regarded as abortifacients and avoided, while hot pepper, sour milk, and cola sodas were considered nutritious. Consumption was self-reported to be poor for milk products by 25% of mothers, for meat by 16%, and for fruits and vegetables by 40% Although the educational intervention increased women's knowledge of basic nutrition, it had only a minimal effect on actual practice. This finding is assumed to reflect the widespread belief that men and their guests should be given preference in food allocation, poverty, and avoidance, on the basis of tradition, of many healthy foods. Since 72% of women reported ownership of a television, use if this medium is recommended for nutrition education.     

Medication management, antidepressant drugs, and the elderly: an overview.

1. Several factors may affect an elderly client's use of medications: polypharmacy, potentially leading to interactions; over-the-counter drugs taken without a physician's knowledge; noncompliance or poor compliance with medication regimens; and ageist beliefs. 2. Psychiatric nurses must be aware that the signs and symptoms they observe may be the result of normal physical or biological aging, psychosocial changes, disease-related changes, medication side effects, or a drug interaction. 3. Nurses must ask two questions when psychotropic drugs are used with elderly clients: What will be the onset, duration, magnitude, and characteristic action of a specific drug in an individual; and What are the characteristics of an "ideal" medication?     

Elective single mothers and their children: The missing fathers

Elective single mothers are adult, unmarried women who intentionally become mothers. This study utilized longitudinal data about 17 Caucasian, elective single mothers and their children to identify fathers' roles in these families, and to understand children's views of their fathers. These single mothers and their children resided for the first six years of the children's lives in father-absent households. By age six, most of the children had ghost fathers, whom they had never met or knew little about. The data suggest that the father often becomes a family secret, and that children may blame themselves for their fathers' absence.