The epidemiology of physical attack and rape among crack-using women

This prospective study examines the epidemiology of physical attack and rape among a sample of 171 not-in-treatment, crack-cocaine using women. Since initiating crack use, 62% of the women reported suffering a physical attack. The annual rate of victimization by physical attack was 45%. Overall, more than half of the victims sought medical care subsequent to an attack. The prevalence of rape since crack use was initiated was 32%, and the annual rate was 11%. Among those women having been raped since they initiated crack use, 83% reported they were high on crack when the crime occurred as were an estimated 57% of the perpetrators. Logistic regression analyses showed that duration of crack use, arrest for prostitution, and some college education were predictors of having experienced a physical attack. Duration of crack use and a history of prostitution were predictors of suffering a rape. Drug abuse treatment programs must be sensitive to high levels of violence victimization experienced by crack-cocaine using women. Screening women for victimization, and treating the problems that emanate from it, may help make drug abuse treatment more effective.     

Distribution and utilization of home- and community-based long-term care services for the elderly in North Carolina

Provision of home- and community-based long-term care is a growing concern at the national, state, and local levels. As more persons grow old, the need for these services is expected to rise. This analysis examines the distribution and utilization of three home- and community-based long-term care programs in North Carolina for each of the state's 100 counties. Maps were generated to examine how counties differed in respect to service utilization among the elderly. Great variability was found in number of elderly utilizing the services across the state as well as the percent of Medicaid- and/or age-eligible persons who utilized the programs. Multivariate modeling for associations to service utilization was only possible for one of the long-term care programs. Results indicated that living alone, being non-white, and having a mobility and self-care limitation were all positively related to utilization. Percent of persons 85 years or older and the ratio of institutionalized long-term care beds were negatively associated with utilization. It was concluded that states must engage in concerted efforts to ensure equity in access to home- and community-based long-term care.     

Reverse mortgage decision-making

Reverse mortgages have been suggested as a promising financial tool to help low-income older homeowners who want to remain in their houses. However, actual use of this option has been much below early estimates of potential demand. This study explored response to the new option through open-ended interviews of homeowners who had received reverse mortgage counseling. Decision-making was influenced by attachment to home, family input, and financial attitudes, including desire to leave a legacy. In general, homeowners took reverse mortgages only as a "last resort" that enabled them to maintain their independence.     

Professions and the identification of mental incapacity in eighteenth-century Scotland

Eighteenth-century Scottish legal procedures to investigate the mental capacity of an individual to manage his or her own affairs are examined to discover the relative significance of different professional and lay groups in identifying disabilities. The role of medical men, lawyers and non-professionals is set in the context of contemporary social and political priorities in order to question simple models of medicalisation. A substantial body of empirical evidence is used to reveal the subtle gradations of power in different domestic, legal and institutional domains.     

A survey of problematic sexualized behaviors of children in the New York City Child Welfare System:estimates of problem, impact on services, and need for training

Forty-eight of 52 (92%) agencies contracted with the New York City Administration for Children's Services (ACS) responded to a survey about problematic sexualized behaviors (PSB) of children in different levels of care within the child welfare system. Results revealed that almost all agencies reported PSB within their foster boarding home and residential treatment centers. A majority of agencies perceived PSB to be a significant problem for which staff and families were not sufficiently trained. These findings highlight many avenues for advocacy, clinical intervention, and staff development.     

Juvenile male sexual offenders: the quality of motivation system of assessment and treatment issues

A group of juvenile male sexual offenders (n=100) completed the Quality of Motivation Questionnaire (QMQ) upon entry into a residential treatment facility. The concepts of Quality of Motivation (QM) Theory are presented to explain the QMQ scores. The scores include Disclosure Level, Sources of Motivation, Life Style Characteristics and Power. The results indicate abnormal motivation scores in the area of Disclosure Resistance, Depression, Primary and Learned Sources of Motivation, and all of the Maladaptive Skills Scores. Recommendations of treatment issues for therapists are prioritized according to QM Theory and presented in a treatment plan format called the Personal Development Plan (PDP). Implications for further research with the QMQ include outcome measurement of changes and comparison with non-offender groups.     

Widowhood and spirituality: coping responses to bereavement

Nearly half of women age 65 or older are widows and nearly 70% of these women live alone. Because older women are three times more likely than their male counterparts to be widowed, widowhood has been labeled a primarily female phenomenon. This review article has two aims: (a) to discuss the impact of widowhood on the lives of older women and (b) to discuss how religion and spirituality may be used as coping methods for conjugal loss. After reviewing the literature the authors conclude that older women use religious coping as well as religious and spiritual beliefs and behaviors to facilitate positive adjustment to the loss of a spouse.     

Transgender DeKalb: observations of an advocacy campaign

In September 2000, the Community Members Against Discrimination (CMAD), a grassroots LGBT organization in DeKalb, Illinois, convinced their city council to add protection against discrimination on the basis of gender identity and expression. Written as an autoethnography, this essay considers the events of the campaign in terms of queer theory and the study of public argument by isolating a set of episodes that bring the reader closer to the experiences of transgender citizens who act in a public culture. The author also explores his own responsibilities as a scholar of communication, an activist, and a member of the LGBT community.