Geographic morbidity differentials in the late nineteenth-century united states

We use a national cross-sectional database, the 1880 Integrated Public Use Microdata Sample, to examine aggregate patterns and individual-level estimates of chronic-disease morbidity and long-term disability in the United States in the late nineteenth century. Despite higher levels of urban mortality in 1880, morbidity prevalence rates were highest in the rural areas of the country, especially in the western and the southern regions. Equations using microdata show that the estimated risk of chronic disease and impairment was highest for males and females who were older, of lower socioeconomic status, or from rural areas. This era was marked by geographically uneven but significant levels of endemic chronic disease, likely the outcomes of prior episodes of infectious disease and exposure to conditions generated by human action, such as the Civil War and migration.     

Treating drug-abusing offenders. Initial findings from a five-county study on the impact of California's Proposition 36 on the treatment system and patient outcomes

Five counties (Kern, Riverside, Sacramento, San Diego, San Francisco) that demonstrate both variations and similarities in their implementation of Proposition 36 (e.g., treatment approaches, urine testing) and patient mix have been selected to participate in a study assessing how California's Proposition 36 is affecting the drug treatment system and patient outcomes. Except for San Francisco, treatment admissions increased during the first year of Proposition 36 implementation over the prior year (27% in Kern, 21% in Riverside, 17% in Sacramento, and 16% in San Diego), mostly in outpatient drug-free programs. Compared to non-Proposition 36 patients, Proposition 36 patients were more likely to be men, first-time admissions, treated in outpatient drug-free programs, employed full-time, and users of methamphetamine or marijuana. They were less likely to be treated in residential programs or methadone maintenance programs and fewer reported heroin use or injection drug use. Guided by the multilevel open systems framework, the study examines key issues of Proposition 36 that influence treatment systems and outcomes and empirically identifies "best practice" approaches in treating drug-abusing offenders.     

Medical Decision Making and Elective Surgery: The Case of Hysterectomy

Review and analyses of three sources of data are presented indicating that 25% of hysterectomies are elective. Annual mortality associated with elective hysterectomy is estimated to be 319, or about 12,122 woman years. Cost-benefit analyses of mortality, life expectancy, morbidity, psychological sequelae, as well as dollar expenditures, reveal high costs and relatively limited benefits. Explanations for this apparent anomaly in decision making are explored and include economic incentives, system structure, sexism, and cancer prophylaxis. Principles of risk perception are discussed in terms of potential biases associated with the cancer prophylaxis motive. It is suggested that physicians' judgements of risk may be more salient to the decision process than those of prospective patients.     

Parenting as a moderator of minority, adolescent victimization and violent behavior in high-risk neighborhoods

Adolescent male youth in high-crime neighborhoods are at the greatest risk for personal victimization and violent behavior. The temporal relationship between victimization and violent behavior for minority youth in high-crime neighborhoods was examined to determine whether victimization is a risk factor for or by-product of violent behavior. Whether parenting and other control factors moderated the relationship between victimization and violent behavior was also examined. Interviews with 349 urban Hispanic and African American youth revealed that victimization was strongly associated with violent behavior and violent behavior was found to precede direct victimization. Race was found to moderate the relationship between parental attachment and violent behavior. African American youth with the highest levels of parental attachment also had the highest levels of violent behavior, while higher parental attachment for Latino youth was associated with lower violent behavior.     

Elder Abuse: Clinical,Ethical, and Legal Considerations in Social Work Practice

As a consequence of the steadily growing older population, and increased demands on family for community based care of elderly, elder abuse is an issue to be considered in all domains of social work practice. Intervention in cases of elder abuse is often fraught with ambiguity and ethical dilemmas as the application of professional principles is less than straightforward, bringing to the fore personal, legal, and ethical concerns in the management of the client’s safety and well-being. This article addresses challenges which arise from the complexity of elder abuse cases and reviews clinical, ethical, and legal obligations to inform ethical decision-making.     

Expression and ambivalence over expression of negative emotion: cross-sectional associations with psychosocial factors and health-related quality of life in postmenopausal women

Inhibition of emotional expression has been associated with the incidence and progression of breast cancer and other chronic illnesses. The important health-related factor, however, may be ambivalence about the expression of emotions rather than repression itself. This cross-sectional analysis of baseline data from 159,557 participants in the Women's Health Initiative examined the influence of expression of negative emotion and ambivalence about expression of emotion on psychosocial factors and health-related quality of life measured by the Medical Outcomes Study Short-form 36 (SF-36). Overall, observed correlations were modest but in the expected direction; that is, greater ambivalence about negative emotional expression was associated with worse general health and poorer psychosocial risk profile. Ambivalence about expressing negative emotion was more highly correlated with psychosocial factors and health-related quality of life than emotional expression. In general, our analysis supports prior studies suggesting that ambivalence may be more important to consider in studies of health-related outcomes than expression.     

Internal Infrastructural Impacts on RFID Perceptions and Commitment: Knowledge,Operational Procedures,and Information‐Processing Standards

For many firms, radio frequency identification (RFID) suggests not only a new alternative to existing tracking methods but also a means to a range of previously cost‐prohibitive internal control and supply chain coordination innovations. In any event, and even in light of possible external pressures to adopt, the full potential of RFID for an individual firm must ultimately be viewed in consideration with the infrastructural capabilities of that firm. Furthermore, because adoption decisions are fundamentally based on managerial perceptions, it is critical to consider how certain forms of infrastructure provide the necessary transparency into other infrastructural characteristics to augment such decisions. We use multisource survey data in this work to consider several elements that contribute to this infrastructure and subsequently to perceptions of RFID benefit and actual commitment to adoption. Results demonstrate that the complementary effects of these infrastructural capabilities significantly impact both perceptions of and commitments to RFID.     

Career‐Related Parental Processes and Career Adaptability and Ambivalence Among Chinese Adolescents: A Person‐Centered Approach

Using latent profile analyses and based on two‐wave data from 5,388 Chinese adolescents (M_age = 15.79, SD = 0.66; 51.99% females), this study examined the variety of ways in which adolescents’ perceived career‐related parental processes (i.e., parental expectations, support, interference, barriers to engagement, and parent–child congruence) may be configured within families and how such configurations may be associated with adolescents’ career adaptability and ambivalence one year later. Three meaningful profiles were identified: the “Supportive but not Intrusive” (SNI) profile, the “Unsupportive but not Permissive” (UNP) profile, and the “Ambivalent and Controlling” (AC) profile. Adolescents in the UNP profile reported higher levels of career ambivalence and lower levels of career adaptability than did those in either the SNI or the AC profiles. Implications for career development among Chinese adolescents were discussed.     

College students' perceptions of risk and addictiveness of e-cigarettes and cigarettes

Background: As conventional cigarette use is declining, electronic cigarette (“e-cigarette”) use is rising and is especially high among college students. Few studies examine dual use of e-cigarettes and cigarettes among this population. This study explores the relationship between dual and exclusive e-cigarette / cigarette use and perceptions of harm and addictiveness of both products. Methods: This is a cross-sectional analysis of data from students attending 24 colleges in Texas (n=5,482). Multinomial logistic regression was employed to test the association between current e-cigarette / cigarette use and perceived harm and addictiveness of both products. Three tobacco groups were included: cigarette only users, e-cigarette only users, and dual users. Results: Dual users reported lower perceived harm of e-cigarettes most consistently (p<0.001, all comparisons). Perceived harm of cigarettes was significantly lower among cigarette only and dual users only, compared to non-users (p<0.001, all comparisons). Compared to non-users, all three groups reported significantly lower perceived addictiveness of e-cigarettes (p<0.001, all comparisons). The same finding was observed for perceived addictiveness of cigarettes, though findings were less consistent for the e-cigarette only group (p<0.02, all comparisons except one). Conclusion: Findings demonstrate that among college students, perceptions of harm and addictiveness of e-cigarettes are lower than those for conventional cigarettes. For both products, perceptions of harm and addictiveness were lower among exclusive and dual users, compared to non-users.     

Supporting strengths-based child welfare practice through a dual professional family assessment program

ABSTRACT

Despite the strong need for family-centered, strengths-based practice approaches in child welfare, full-scale implementation remains limited. This qualitative study depicts a specialized Integrated Assessment (IA) program that—though designed primarily to enhance the quality of clinical family assessments—was found to support frontline child welfare caseworkers in their implementation of family-centered, strengths-based practices. Caseworkers differentiated the support of the IA screener from that of their supervisor and reported that the additional support was particularly valuable on complex cases. Key factors for replication and implications for training and professional development are discussed.