Pragmatic decisions in the evaluation of consumer satisfaction with mental health treatment

This article examines pragmatic choices which must be made in conducting consumer satisfaction assessment of mental health treatment. It is argued that choices involving sample, format, and procedure for examining satisfaction may influence the results of such research, and must be considered when creating or evaluating these efforts. These choices are examined in detail.     

The four-parameter logit life table system

Summary Brass's model life table system, which is a two parameter system based on the logit transformation of survivorship values, has been widely and successfully used to describe age patterns of mortality in many populations. As more reliable information has become available for populations with mortality patterns which differ in important ways from the assumed standard pattern of mortality, a more flexible model system is needed. This paper shows how Brass's system can be expanded into a four-parameter model, and evaluates the performance of the new system by examining how well it can fit observed life table data.     

Frustrated fertility: a population paradox

This Bulletin examines the causes of subfecundity -- the diminished ability to reproduce -- and its effect today and in the past on the fertility, or actual reproductive performance, of individuals and, hence, populations. By definition, all real populations are subfecund since all experience some degree of involuntary biological factors affecting coitus, conception, or the ability to carry a conceptus to live birth which reduces their fecundity below the estimated biological population maximum of 15 children per woman. Affecting both men and women, these factors fall into 5 categories: genetic factors such as blood group incompatibilities and inherited sickle cell anemia or diabetes; psychopathology, including psychic stress and behavioral disorders (e.g., drug and alcohol abuse); infectious diseases such as gonorrhea, malaria, tuberculosis, and postabortion infection; malnutrrition, including the chronic undernutrition of the 3rd World and the overnutrition of developed societies; and hazards posed by increasing amounts of radiation and toxic chemicals in the environment. Reducing subfecundity requires improved living conditions, avoidance of or protection from known hazards, and adoption of medical advances which now can help 40 to 60% of subfecund couples. But even in the U.S. fertility would certainly rise among the 15% of couples now estimated to be involuntarily childless and the 10% who have fewer children than they want, and among disadvantaged groups, and teenagers.     

Was there compression of disability for older Americans from 1992 to 2003?

Medical advances and the growth of the elderly population have focused interest on trends in the health of the elderly. Three theories have been advanced to describe these trends: compression of morbidity, expansion of morbidity, and dynamic equilibrium. We applied multistate life table methods to the Medicare Current Beneficiary Survey to estimate active and disabled life expectancy from 1992 to 2003, defining disability as having difficulty with instrumental activities of daily living or activities of daily living. We found increases in active life expectancy past age 65 and decreases in life expectancy with severe disability. These trends are consistent with elements of both the theory of compression of morbidity and the theory of dynamic equilibrium.     

Using age and spatial flow structures in the indirect estimation of migration streams

This article outlines a formal model-based approach for inferring interregional age-specific migration streams in settings where such data are incomplete, inadequate, or unavailable. The estimation approach relies heavily on log-linear models, using them to impose some of the regularities exhibited by past age and spatial structures or to combine and borrow information drawn from other sources. The approach is illustrated using data from the 1990 and 2000 U.S. and Mexico censuses.     

Race,military service,and marital timing: Evidence from the NLSY-79

I use data from the 1979 National Longitudinal Study of Youth to examine the relationship between military service and marital timing for white men and black men during the 1980s. I use information about active-duty and reserve-duty service as well as veteran status to implement strong controls for selectivity. I find that active-duty military service increases the probability of first marriage for both whites and blacks. In part, this relationship is due to positive selectivity into the military and, for whites, to greater income and economic stability. Above and beyond the effects of selectivity, income, and economic stability, the effect of active-duty military service is particularly strong for black men.     

Gay, lesbian, bisexual and transgendered (GLBT) experiences with Earth-spirited faith

Earth-spirited faiths (e.g., Pagan and Wiccan spiritualities) have been described as more affirmative toward gay, lesbian, bisexual, and transgendered (GLBT) members than mainstream Judeo-Christian faiths, but no research has explored Earth-spirited faiths' GLBT-affirming behaviors. This study investigated those behaviors as well as the faith experiences of GLBT Earth-spirited individuals. At time of coming out, participants who were affiliated with mainstream Judeo-Christian faiths reported greater faith conflict than those affiliated with Earth-spirited faiths; however, there were no differences in resolution of the conflict between the two groups, internalized homonegativity, or self-acceptance. In addition, Earth-spirited faiths engaged in many GLBT-affirming behaviors.