The effects of family stressors on substance use initiation in adolescence

Smoking and drinking are critical problems in adolescence that have long-term adverse impacts on health and socio-economic factors. We examine the extent to which family stresses influence the timing of initiation of smoking and drinking. Using national panel data from the National Educational Longitudinal Study (NELS) we capitalize on the survey design and use school-level fixed effects that control for the local environments, including prices of cigarettes and alcohol. In addition, we narrow our control group to classmates who will experience a similar stressor in the future. We find that a composite measure of family stressors when young increases the likelihood of initiating tobacco and alcohol use, with much of the impact attributable to parental divorce. In our baseline estimates, the composite stress measure is associated with a 30% increase in the likelihood of smoking and a 20% increase in drinking. When we control for multiple sources of confounding, the impact shrinks and remains significant for smoking but not for drinking. We conclude that studies which do not control for confounding are likely to significantly overestimate the impact of family stress on substance use. Our approach helps to move the literature forward by separating causal results from spurious associations.     

人口计生宣传教育为“先导”的重心和支点

宣传教育为先导的战略决策,是国家人口计生委党组书记、主任李斌同志2007年年底在河南召开全国农村人口文化建设工作现场会和在宁波市召开全国婚育新风进万家活动经验交流会上提出的重大战略思想。宣传教育为先导战略决策的提出,是在科学发展观指引下尊重思想政治工作、精神文明建设和人口计生工作客观规律,总结正反两方面工作经验教训的必然产物,是今后做好人口计生工作的元点工程。本文主要论述了为什么要先导,先什么、导什么,如何先导三个重大问题。     

Characteristics and Outcomes of College-Age Adults Enrolled in Private Residential Treatment: Implications for Practice

Substance use among college-age adults is of interest due to high levels of use and low levels of treatment access and engagement relative to other adults. Data collected from 1,972 clients in residential services were analyzed to investigate differences in use patterns, treatment outcomes, and other life area problems. Participants completed an Addiction Severity Index (ASI) and the University of Rhode Island Change Assessment (URICA) at baseline, and an ASI and Treatment Services Review at 1-month and 6-month postdischarge interviews. Almost a quarter (24.1%) of participants were college age (18–25 years old). They were more likely to be White and male, and less likely to complete treatment although they had a longer average length of stay. College-age adults improved on all outcome measures, and posttreatment service use shows significant difference between college-age and older participants. Implications for practice are discussed.     

Building,Engaging, and Sustaining a Continuum of Care From Harm Reduction to Recovery Support: The Rutgers Alcohol and Other Drug Assistance Program

Since 1983, the focus of the Rutgers Alcohol and Other Drug Assistance Program (ADAP) has been developing policies, training staff to identify students at risk, developing and implementing evidence-based screening and brief interventions, providing short-term counseling by professionals trained in alcohol and other drug abuse to assist students beyond brief interventions, identifying effective treatment for college students, developing a campus recovery program, on-campus recovery housing, and other supports for students in recovery. This article presents a case study of the Rutgers ADAP program, of building and sustaining a program committed to engaging students in both evidence-based risk reduction interventions and an on-campus recovery community given their stage of change and motivation to make changes. Historical milestones are described as part of a creative model for intervention. We identify the challenges of integrating substance abuse recovery into campus mental health programs, and of integrating recovery into other university communities.     

Poly-victimization and resilience portfolios: Trends in violence research that can enhance the understanding and prevention of elder abuse

ABSTRACT

This literature review assesses the current state of knowledge about elder abuse and mistreatment, focusing on the lack of incorporation of all forms of elder victimization and the benefits of a poly-victimization framework. This review also includes existing knowledge on risk factors and calls for a greater focus on protective factors and a greater inclusion on family and community factors. Future research, prevention, and intervention would benefit from considering the true burden of elder victimization and a greater implementation of strengths-based approaches to programs.     

International adoption and the formation of new family attachments

Clinical studies of children in international adoption reveal unique patterns of psychological adjustment to permanent family care. Pre‐adoption history often includes early object loss, medical and nutritional deprivation, multiple care‐giving disruptions, and the lack of primary care‐giving relationships. These factors and the age at the time of adoption are risks to positive emotional and cognitive development. Adoptive parents may be unprepared for the resulting developmental problems. Most significantly, parents and children are often at different points in readiness to establish an attachment relationship. The parents are eager to claim their child, but the child is unready to respond because of emotional fragility and lack of previous attachment experiences. Two clinical vignettes illustrate the importance of a developmental and medical framework in assessing the unique needs of these survivor children, as well as the necessity of an empathic therapeutic holding environment that can sustain the emerging family attachments under stress. The psychological impact of cross‐cultural adoption and traumatic early beginnings reverberates across time but with empathic parental care and treatment recovery can be significant.     

State Variations in Nursing Home Social Worker Qualifications

ABSTRACT

This is the first published account of state administrative code variations in nursing home social worker qualifications. It is important to review state codes because the majority of nursing homes in the U.S. have fewer than 121 beds and therefore are not required by the federal government to employ at least one full-time qualified social worker. States have the option of extending the federal regulations to homes with 120 or fewer beds, or strengthening the federal requirements in other ways. Findings indicate enormous variation in state requirements for qualifications of nursing home social workers, and even when states define a qualified nursing home social worker (not all do), they often exempt facilities from employing one. Seven states were found to be out of federal compliance. Research describing the qualifications of people employed in nursing home social services is called for, as well as research documenting effective psychosocial interventions, especially as they relate to resident quality of life. Ten recommendations for enhancing nursing home social work services are included.     

Enhancing Student Gerocompetencies: Evaluation of an Intergenerational Service Learning Course

This article describes the development and evaluation of an intergenerational service-learning course designed to promote social work gerocompetencies. Service-learning opportunities were structured into the course, including an optional evidence-based falls prevention program, for older adults, entitled A Matter of Balance (MOB). Significant differences between pre- and posttest scores on the Geriatric Social Work Competency Scale (GSWCS) were noted for students in the service learning course (n = 13). Once MOB was introduced as an independent variable, the MOB participants scored the highest mean posttest scores for 2 GSWCS domains: values, ethics, and theoretical perspectives; and intervention. The benefits of utilizing social work gerocompetencies to guide course objectives, content, and student outcomes are discussed.     

Toward General Principles for Resilience Engineering

Maintaining the performance of infrastructure-dependent systems in the face of surprises and unknowable risks is a grand challenge. Addressing this issue requires a better understanding of enabling conditions or principles that promote system resilience in a universal way. In this study, a set of such principles is interpreted as a group of interrelated conditions or organizational qualities that, taken together, engender system resilience. The field of resilience engineering identifies basic system or organizational qualities (e.g., abilities for learning) that are associated with enhanced general resilience and has packaged them into a set of principles that should be fostered. However, supporting conditions that give rise to such first-order system qualities remain elusive in the field. An integrative understanding of how such conditions co-occur and fit together to bring about resilience, therefore, has been less clear. This article contributes to addressing this gap by identifying a potentially more comprehensive set of principles for building general resilience in infrastructure-dependent systems. In approaching this aim, we organize scattered notions from across the literature. To reflect the partly self-organizing nature of infrastructure-dependent systems, we compare and synthesize two lines of research on resilience: resilience engineering and social-ecological system resilience. Although some of the principles discussed within the two fields overlap, there are some nuanced differences. By comparing and synthesizing the knowledge developed in them, we recommend an updated set of resilience-enhancing principles for infrastructure-dependent systems. In addition to proposing an expanded list of principles, we illustrate how these principles can co-occur and their interdependencies.