Screening for patients with alcohol problems: severity of patients identified by the CAGE.

Primary care physicians are well situated to identify patients with substance abuse problems and motivate them to seek appropriate assistance, but active programs are the exception. A study in a community setting was undertaken to assess the CAGE (the first letters of key words in a series of four questions about drinking: cut down; annoyed; guilty; and eye-opener), instrument in the routine screening for alcohol problems in both new and established patients. The screening process identified subjects for a pilot evaluation of a motivational interview designed to encourage problem-solving behavior. This article focuses on the screening results and the use of the CAGE instrument. During June and July of 1990, 687 patients of two primary care physicians belonging to a large group practice were asked to complete a health questionnaire that included the CAGE. Those who responded affirmatively to at least two of the four CAGE questions were requested to participate in follow-up assessment of problems associated with alcohol and health. The type and severity of alcohol problems experienced by patients who scored positive on the CAGE are described. Prevalence of a positive score on the CAGE was 8.6 percent with males, smokers, and blue collar and unemployed persons being more likely to score positive. The positive predictive value was .68. Primarily, persons with moderate alcohol problems were identified. Results show that the CAGE instrument is a useful screening device for identifying those with mild to moderate substance abuse problems, increasing the opportunity for intervention prior to serious medical complications. The instrument is easily administered, and has demonstrated relatively high levels of sensitivity and specificity. When combined with assessment and motivational interviews, the CAGE shows promise in the secondary prevention of substance abuse and related health problems.     

Postcards from the Edge of the Color Line: Images of African Americans in Popular Culture, 1893–1917

This paper examines visual representations of African Americans on postcards from 1893 to World War I. Caricatures of African Americans found on these popular cultural artifacts frequently employ the visual metaphor of other-as-beast. To map the discursive features of this form of racist ideology, attention is paid to the icono-graphic and linguistic strategies employed to depict African Americans as physically, intellectually, and temperamentally distinct and inferior. While no oppositional readings to this racist discourse were located in the flip-side messages of the senders, resistance was located in the contemporaneous popular culture of African Americans.     

Women's Changing Attitudes Toward Divorce, 1974–2002: Evidence for an Educational Crossover

This article examines trends in divorce attitudes of young adult women in the United States by educational attainment from 1974 to 2002. Women with 4‐year college degrees, who previously had the most permissive attitudes toward divorce, have become more restrictive in their attitudes toward divorce than high school graduates and women with some college education, whereas women with no high school diplomas have increasingly permissive attitudes toward divorce. We examine this educational crossover in divorce attitudes in the context of variables correlated with women's educational attainment, including family attitudes and religion, income and occupational prestige, and family structure. We conclude that the educational crossover in divorce attitudes is associated most strongly with work and family structure variables.     

The State of Care Management in Learning Disability and Mental Health Services 12 Years into Community Care

This paper reports on the organization of care management froma longitudinal study of community care for people resettledfrom long-stay learning disability and psychiatric hospitals.The findings from a 12-year follow-up of care management arrangementsin 12 learning disability and eight mental health study siteservices are described. The diversity of care management arrangementsfound at earlier points in the evaluation remained evident.Also, many of the former ‘care in the community’service users were excluded from mainstream care managementarrangements in their localities. The difficulty of developingperson-centred arrangements in learning disability and the lackof integration of the Care Programme Approach and care managementwere evident. The findings and observations are placed in thewider policy and practice context, with suggestions for takingcare management forward nationally and locally.     

Inequality and Democratic Responsiveness

By allowing voters to choose among candidates with competingpolicy orientations and by providing incentives for incumbentsto shape policy in the direction the public desires, electionsare thought to provide the foundation that links governmentpolicy to the preferences of the governed. In this article Iexamine the extent to which the preference/policy link is biasedtoward the preferences of high-income Americans. Using an originaldata set of almost two thousand survey questions on proposedpolicy changes between 1981 and 2002, I find a moderately strongrelationship between what the public wants and what the governmentdoes, albeit with a strong bias toward the status quo. But Ialso find that when Americans with different income levels differin their policy preferences, actual policy outcomes stronglyreflect the preferences of the most affluent but bear virtuallyno relationship to the preferences of poor or middle-incomeAmericans. The vast discrepancy I find in government responsivenessto citizens with different incomes stands in stark contrastto the ideal of political equality that Americans hold dear.Although perfect political equality is an unrealistic goal,representational biases of this magnitude call into questionthe very democratic character of our society.     

Die Arbeitsgruppe Professionssoziologie und die Randständigkeit der Professionssoziologie im deutschsprachigen Raum

The article analyzes the consequences of the marginal status of the Sociology of Professions in Germany during the last decades on the efforts of the new working group “Sociology of Professions.” This new working group has been established in order to make professions an attractive research topic. First it will be demonstrated that a lack of a solid grounding in the international literature influences the new efforts to publish textbooks. Second it will be shown that there is a missing historical perspective in the old and new sociology of professions in Germany. Finally everything seems to indicate that the new working group is more interested in questions of general sociology and occupational sociology than in questions of a sociology of professions.     

‘The Effect of Social Networks at Origin Communities on Migrant Remittances: Evidence from Nang Rong District’

The literature on the effect of social networks on migrant remittances has ignored the influence of a household’s embeddedness in social networks in the origin community. This paper, using multilevel statistical modeling and social survey data from Nang Rong district in Thailand, examines how remittances between migrants and origin households are associated with social networks. Social network measures come from data on sibling and rice harvest network ties. Rice harvesting is very important to the rural economy, and households participating in the network are privy to vital sources of news and information that spread through the network. Results support the notion that migrants remit less to households that are isolates in the rice-harvesting network, which is theorized to be associated with access to information about employment options.