In sickness but not in health: self-ratings, identity, and mortality

Self-rated health as a predictor of mortality has been studied primarily in large, representative populations, with relatively little progress toward understanding the information processing that individuals use to arrive at these ratings. With subsamples of National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-up Study (NHEFS) data for respondents with circulatory system disease (N = 3,709) and respondents with no diagnosable disorders (N = 1,127) at baseline, we test the idea that individuals with experience of chronic disease of the circulatory system will have more predictive self-ratings of health than healthy individuals. Poor or fair self-rated health increased the adjusted hazard of all-cause mortality for respondents with circulatory system disease, but not for respondents who were healthy. Additional analyses confirm that poor or fair self-rated health is particularly predictive for respondents with self-reported history of circulatory system diagnoses and perception of symptoms, but not for respondents without symptoms or diagnoses prior to the NHANES physical exam.     

Cost-effectiveness analysis of the New South Wales adult drug court program

In New South Wales, Australia, a cost-effectiveness evaluation was conducted of an adult drug court (ADC) program as an alternative to jail for criminal offenders addicted to illicit drugs. This article describes the program, the cost-effectiveness analysis, and the results. The results of this study reveal that, for the 23-month period of the evaluation, the ADC was as cost-effective as were conventional sanctions in delaying the time to the first offense and more cost-effective in reducing the frequency of offending for those outcome measures selected. Although the evaluation was conducted using the traditional steps of a cost-effectiveness analysis, because of the complexity of the program and data limitations it was not always possible to adhere to textbook procedures. As such, each step involved in undertaking the cost-effectiveness analysis is discussed, highlighting the key issues faced in the evaluation.     

Internet use among community college students: implications in designing healthcare interventions

The Internet has become a commonly used venue for seeking healthcare information. Young adults search the Internet for health information more than any other group, yet little is known about use patterns among community college students. The authors surveyed a diverse community college to assess students' use of the Internet for health-related information. More than 80% had home Internet access, regardless of race or gender. Men and women searched for health information in almost equal numbers. Most students were interested in searching for diet/nutrition topics, and least interested in smoking information. Although the digital divide appears to be closing, varying levels of interest in a variety of important health topics remain. Understanding these differences could guide the design of more effective Web-based health interventions.     

Cognitive-behavioral treatment for adolescents who sexually offend and their families: individual and family applications in a collaborative outpatient program

This article describes an outpatient treatment program for adolescent sexual abusers that was established by a mental health agency in collaboration with a specialized probation program in the juvenile court. Individualized treatment is based on a comprehensive clinical assessment with the youth and guardian, for which examples are provided. Given the heterogeneity of this population, we describe several treatment strategies directed to various individual or family clinical targets, including psychiatric disorders, sexual deviance and sexuality, normal adolescent development and adaptive skills, and parent and family relationships. Ongoing collaborative and coordination issues are also reviewed. The integration of mental health and probationary services provides a balanced approach to the community management and treatment of the low-risk, primarily first-time, adolescent sexual offender.     

Effects of multicomponent training on functional fitness in older adults

The purpose of this study was to evaluate the effects of a 9-week supervised multicomponent exercise program on functional fitness and body composition in independent older adults. Forty-two adults age 60-86 years were randomly assigned to an exercise or a control group and were evaluated before and after training. The training program consisted of 3 sessions of walking, strengthening, and flexibility exercises per week. The multicomponent training program resulted in significant (p < .005) improvements on the chair stand, arm curl, 6-min walk, and up-and-go tests. The findings of this study indicate that a 9-week training program increased upper and lower body strength, aerobic endurance, and agility/dynamic balance in older adults. The most affected components of functional fitness were lower body strength and aerobic endurance. There was no effect of the 9-week training on body composition.     

Age,religious beliefs,and sexual attitudes

Age effects on sexual attitudes were examined using the Hendrick and Hendrick (1987a) Sexual Attitude Scale. The study was cross-sectional, including people from various age groups, from young adults to older adults. The religious beliefs variable, which covaries substantially both with age and sexual attitudes, was controlled. Three main questions guided the study: (a) Is the four-factor structure (Permissiveness, Instrumentality, Communion, and Sexual Practices) previously identified in a sample of young students able to accurately account for data gathered over a full range of adult ages, (b) are older adults much less permissive and less instrumentalist than young people, and (c) to what extent are believers less permissive and instrumentalist than young people when age is taken into account? Factor analyses showed that at least five correlated factors were needed to account for the data; the fourth factor, Sexual Practices, divided itself into two distinct factors: Pleasure and Responsibility. Older adults and believers were shown to be less permissive than young people and nonbelievers, and this result held regardless of the participants educational level. As regards to instrumentality, however, the pattern of differences was extremely complex.     

Evaluating consumer satisfaction in residential continuing care settings

The outcome of the project reported on here is a client-centered consumer satisfaction questionnaire designed to evaluate new models of residential continuing care in Alberta, Canada. Satisfaction is defined as a multi-dimensional construct that is grounded in the consumer's experience. Consultation with the clients of the services during development of the instrument ensured that characteristics important to the clients were assessed. The result is an instrument with which to measure satisfaction that is fully client-centered and that, with appropriate modifications, can be used to monitor any client-centered program for cognitively-able continuing care clients.     

Examining the effectiveness of health and safety committees and representatives: a review

The establishment of a health and safety committee in the workplace and/or the appointment of an elected health and safety representative is believed to foster employee participation and consultation in the workplace. Despite an emphasis within the Australian occupational health and safety legislation towards employee participation in relation to health and safety issues, there is little known about the effectiveness of the strategies used to involve workers in health and safety matters in the workplace. There is anecdotal evidence published in relation to the implementation of health and safety committees and their effectiveness in the Australian workplace. Few opinions however are substantiated by empirical evidence. Significantly more research has been conducted on the role of health and safety representatives in Australia. This paper presents the findings of a review of the literature and identifies the factors that are considered to impact on the effectiveness of workplace health and safety committees and representatives. Several factors are described as being fundamental to the effective performance of committees and representatives. These factors include management commitment, communication, training and information, union involvement, the infrastructure of an organisation, committee processes and the involvement of professional experts. It is concluded that the effectiveness of health and safety committees in Australia is unexplored and it is unknown if these committees achieve the purpose for which they were established. Recommendations are made for future research to be conducted to test the current anecdotal evidence and assumptions associated with the operation and effectiveness of health and safety committees.