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.     

Estimation of noncentrality parameters

We propose some estimators of noncentrality parameters which improve upon usual unbiased estimators under quadratic loss. The distributions we consider are the noncentral chi-square and the noncentral F. However, we give more general results for the family of elliptically contoured distributions and propose a robust dominating estimator.     

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.     

Creating offshore-ready it professionals: A global perspective and strong collaborative skills are needed

Outsourcing of IT functions has become a widespread corporate practice, which has naturally led to concerns among IT works about how this affects their jobs. The issue is complex, and many companies are bringing their IT functions back inhouse. In light of this complexity, what skills do IT workers need to be com-petitive? We address this question first by reviewing the literature and then by examining two corporate case studies that have dealt with outsourcing issues. Based on this view of outsourcing, we discuss the skills that can provide a com-petitive advantage in the current environment.     

Determinants and Consequences of Social Trust*

This article provides an overview of social trust, examining its various aspects and components. Trust is best understood in a sociological sense by focusing on its important relational characteristic. Following this lead, the article discusses briefly how social trust relates to social capital and examines factors that shape the development of social trust, along with outcomes related to variations in trust, classifying them by analytical level (i.e., individual, community, group, organizational, and societal). The article concludes by assessing the strengths and weaknesses of existing research and by identifying some important questions that have not yet been adequately addressed.