The influence of marital and family therapy on health care utilization in a health-maintenance organization

Research has shown that people reduce their use of health care after individual psychotherapy. However, little research has been done to learn if marital and family therapy has a similar effect. Subjects (n = 292) from a health-maintenance organization were randomly selected according to the type of therapy they had received. Subjects' medical records were examined for 6 months before, during, and after therapy. Those who received marital and family therapy significantly reduced their use of health care services by 21.5%. These results show an "offset effect" for marriage and family therapy.     

Individual and crossover effects of stress on adjustment in medical student marriages

High-stress individuals may benefit from social support, although their support providers may be adversely affected via stress crossover effects. Individual and crossover effects of perceived stress within medical student marriages (n = 30) were investigated. Perceived spousal support was positively associated with individuals' own marital and emotional adjustment, attenuating stress effects. With regard to crossover effects, medical students' perceived stress was significantly associated with their spouses' emotional adjustment. Further, medical students' own emotional adjustment fully mediated this crossover effect. Results suggest that the contagion of negative affect may serve as a key mechanism through which stress crossover effects operate in marriage.     

Caring in forensic nursing. Expanding the holistic model

Nurses have practiced forensic nursing for many years without formal recognition of the domain as a discipline for specialized study. Forensic nursing expands the traditional concept of holism to include the medical-legal aspects of potential or actual client problems. The American Nurses Association (ANA) and the International Association of Forensic Nurses (IAFN) recently have designated forensic nursing as a unique specialty. Recognition of forensic nursing as a specialty area of practice within nursing mandates that the specialty define and explicate its major conceptual base. A concept germane to the practice of forensic nursing is that of caring. Caring as a central concept to the role of this specialty is discussed, and the implications for its inclusion in a curriculum preparing forensic nurses are explored.     

Computer-mediated focus groups

This article discusses the feasibility and effectiveness of computer-mediated (CM) focus groups. The study describes technological and practical considerations the authors learned from conducting such groups and reports on a comparison of the reactions of CM and face-to-face (FTF) participants in focus groups discussing academic dishonesty. The results suggest that the CM environment, in comparison to FTF, may lessen members' concern about what the moderator thinks of them and discourage participants from withholding embarrassing information. The article concludes with a list of suggestions for this technique and a discussion of the potential advantages and limitations associated with CM focus groups.     

Trafficking: a perspective from Asia

The main theme of this article is market development and trafficking as a business. It touches upon most of the aspects of the phenomenon, which have been encountered elsewhere, and translates them into the relatively unfamiliar context of many of the Asian and South-East Asian economies. Equally, the literature cited is also probably unfamiliar. Themes touched upon include democratization, inter-state relations, human rights, and scale and perspectives, together with the problems of definitions, theory, and the reliability of data. The directions and characteristics of trafficking flows together with routes and border control are also considered. Coordinated official responses to criminality and criminal organizations, as well as to trafficked individuals, are beginning to emerge. There is a note of caution sounded that contextual and cultural perspectives, particularly on sex workers, must be viewed somewhat differently to those in Western societies. The article concludes that as long as countries in Asia maintain their policies of restrictive immigration, trafficking can be expected to continue and almost certainly increase. This is because accelerating development creates demand for labour at various skill levels and because even in times of recession migrants and brokers will seek to side-step attempts to expel immigrants and restrict access to labour markets. The elimination of trafficking is unlikely to be realistically achieved through legislation and declarations of intent but by improvements in the socio-economic status of the population.     

Assessing the local need for family and child care services: a small area utilization analysis

This article reports the findings of a study to develop a new method for allocating resources to family and child care services within Northern Ireland. Downloads from financial and client databases, together with a survey of social worker case activity, were used to estimate utilization costs across 500 local areas. Regression techniques were then used to account for variations in these costs in terms of local socioeconomic conditions. The resultant needs index represents a fair and equitable means of allocating central family and child care budgets to local units of management and service delivery.     

Abuse, support, and depression among homeless and runaway adolescents

This study examines the effectiveness of social support networks on psychological well-being among 602 homeless and runaway adolescents. The respondents were interviewed in shelters, drop-in centers, and on the streets in cities of four Midwestern states (Missouri, Iowa, Nebraska, and Kansas). The path model was used to test the direct effect of family abuse and precocious independence on adolescent depressive symptoms and indirect effects through social support networks. Results indicate that although abusive family origins contribute directly to depressive symptoms there are indirect effects of family abuse and early independence through social support networks. Family abuse and early independence drive homeless adolescents to rely on peers for social support. While support from friends on the street reduces depression, association with deviant peers increases depression.     

"Sex" versus "gender": a renewed plea

Evidence from scholarly journals, texts, and other sources indicates that the terms "sex" and "gender" continue to be used incorrectly, despite earlier pleas to remedy this and related errors (e.g., the terms sex role, gender role, male/female). I advance the plea again, in the hope of reducing confusion and thereby improving scholarly communication with our students and one another.