Sequential assignment and treatment-as-usual. Alternatives to standard experimental designs in field studies of treatment efficacy.

Psychosocial treatment research studies encounter obstacles to random assignment (RA). Used together, two procedures offer an alternative to the standard RA design. First, sequential assignment (SA) may create less opposition from administration, staff, and clients. SA operates on the principle that limited bed availability, a common treatment consideration in the field, determines assignment of clients to conditions. Second, treatment-as-usual (TAU) represents an alternative type of control condition. Some clients on the waiting list will, before a slot opens up and they enter an experimental condition, be absorbed into the existing treatment system, in which the amount and type of treatment they receive can vary widely. Substituting SA and TAU for the standard RA design may introduce methodological impurities including certain limited biases.     

Deaths from Alcohol and Violence in Moscow: Socio-economic Determinants

Objective: To examine the association between accidental, violent and alcohol related adult mortality in the Russian capital and socio-economic status characteristics such as educational status, occupational group and marital status.Data and methods: individual death records for Moscow City for the years 1994 and 1995, for 86121 deaths between the ages of 20–59. Proportional mortality analysis was used to compare trends for alcohol related deaths and accidental and violent deaths (representing 5 and 28% of all deaths in this age group), with multiple controls consisting of deaths from cancer at various sites.Results: The probability of death from alcohol related diseases increased as education level decreased, with those men failing to complete secondary education over two and a half times as likely to die from these causes than men with higher education. Blue collar workers were also much more likely to die from these causes than white collar workers. Marriage had a marked protective effect for both men and women.Conclusion: Despite 75 years of official egalitarian ideology, there are marked socio-economic differentials in mortality in Russia. For the causes of death analysed, socio-economic mortality differentials were greater for women than for men.     

Reliability of work-related assessments

Insufficient evidence of the reliability of work-related assessments is a major concern in this area of practice. Despite this concern there has been ongoing development of new assessments, while existing assessments have been revised, modified and updated and others are no longer used or available. OBJECTIVES: The purpose of this study was to determine the extent and quality of evidence for the reliability of work-related assessments. STUDY DESIGN: This study examined available literature and sources in order to review the extent which reliability has been established for 28 work-related assessments. RESULTS: The levels of evidence and reliability are presented for each assessment. This indicates that a number of commercially available work-related assessments have insufficient evidence of reliability. For the limited number of work-related assessments with an adequate level of evidence on which to judge their reliability, most demonstrate a moderate to good level. Few assessments, however, have demonstrated levels of reliability sufficient for clinical (and legal) purposes. CONCLUSION: With this study clinicians will be able to examine their options with regard to the reliability of the assessments they choose to use. Interpretation of changes in test results can be considered in the light of the evidence for the reliability of the instrument used.     

Reconstructing a Sense of Relational Agency in Family Therapy

The concept of agency is relevant in family therapy. As family therapists we approach each family member as a full agent, which means that what each person thinks and feels, makes sense, and that each person contributes in a significant way to the construction of a relationship. A person's sense of relational agency is constructed in relationships through processes of relational influence. Thus, agency is a relational construct and is dependent on bidirectional transactions in a relationship. A person's sense of relational agency refers to the belief a person has about being able to influence another person, that this influence is significant for the other, makes a difference for the other, and contributes to the construction of the relationship. Many family members who enter therapy have lost their sense of relational agency. In this paper we discuss ideas how to reconstruct family members’ sense of relational agency in therapeutic practice.     

The effect of individually adjusted workstations on upper quadrant posture and muscle activity in school children

Evidence suggests there is increasing use of computers by children and poor workstation designs for children. This laboratory study investigated the effect of adjusting computer display height and desk height on upper quadrant posture and muscle activity. Thirty three children aged 4-17 years worked on a desktop computer at a standard school workstation and at a workstation adjusted to the individual, typically consisting of a lower display and desk height. The adjustments resulted in increased head tilt, neck flexion, gaze angle, cervical erector spinae activity and a trend for lower right upper trapezius activity. The recent evidence that suggests more head and neck flexion is not necessarily worse is discussed and normative values for children's head tilt and neck flexion presented. The role of forearm support in decreasing trapezius activity is also discussed.     

The three R's: Residence,religion, and reproduction

Survey research data collected in Rhode Island over a three year interval are used to test six propositions: 1) Suburbanites have higher family size than central city residents. 2) Any differences in family size between Catholics and non-Catholics are larger in central city than in suburban areas. 3) Within religious categories, suburbanites attend church more regularly. 4) Among Catholics, suburban residence is associated with less frequent Communion reception. 5) Among Catholics, church attendance frequency is positively associated with family size. Among non-Catholics no relationship exists. 6) The frequency with which Catholics receive Communion is more strongly associated positively with family size than is church attendance frequency. Propositions 1, 2 and 5 are rejected. Propositions 4 and 6 are accepted. Proposition 3 is accepted for non-Catholics only.