Review of outcome research on marital and family therapy in treatment for alcoholism

This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better, and CRAFT promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics, and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate the following: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning.     

Being involved in the country: Productive ageing in different types of rural communities

Productive ageing recognises the contribution of older people to economic, social and cultural growth and helps build a sustainable community. Being involved in community life is good for individuals and good for society. However, we know very little about the participation of and contribution by people aged 50 and over in rural communities. This research aimed to develop a better understanding of productive ageing in different types of communities in rural Victoria, Australia. An anonymous self-complete postal questionnaire was distributed to a sample of households in twenty rural communities using the Australia Post Unaddressed Select Service. Those householders 50 years of age and older were invited to complete the survey. Data collected allowed examination of social and civic engagement, familiarity with community, the value placed on social relations by people aged 50 years and over, and how community involvement was linked to community sustainability. In particular it attempts to address the question ‘Does social and civic engagement differ across declining, stable and growing rural communities?’ Despite differences among rural communities, this study showed that older people develop and maintain strong community connections and well-functioning social capital and that participation in social activities was associated with feelings of being connected with community. It also identified health issues and lack of options as the main constraints on participation. A key message for policy makers is that older people play an important role in the sustainability of rural communities. There is much to be gained from actively supporting their participation in activities that are connected to ageing well.     

Bisphenol A: How the Most Relevant Exposure Sources Contribute to Total Consumer Exposure

Bisphenol A (BPA) is an endocrine disrupting chemical that is found in human urine throughout industrial societies around the globe. Consumer exposure pathways to BPA include packaged food, household dust, air, and dental fillings. To date, information on the relative contribution of the different pathways to total consumer exposure is lacking, but is key for managing substance‐associated risks. We investigated the relative contributions of the pathways known to be most relevant for nine different consumer groups. Our results suggest that the most important pathways for infants and children are the use of polycarbonate (PC) baby bottles and for adults and teenagers the consumption of canned food. Dental surgery can also considerably contribute over a short time directly after the surgery. For infants fed with PC baby bottles with mean dose rates of 0.8 μg/kg_bw/d the highest exposure dose rate was calculated. This dose rate is far below the tolerable daily intake of 50 μg/kg_bw/d. However, it is of the same order of magnitude as recently reported concentrations that caused low‐dose health effects in rodents. We find a pattern of falling exposure levels with rising age that is supported by urinary concentrations of BPA available for selected consumer groups. Similarly, the exposure levels we predict are confirmed by the levels reported in these studies.     

Development and application of a dose–response model for Elizabethkingia spp

Elizabethkingia spp. are common environmental pathogens responsible for infections in more vulnerable populations. Although the exposure routes of concern are not well understood, some hospital-associated outbreaks have indicated possible waterborne transmission. In order to facilitate quantitative microbial risk assessment (QMRA) for Elizabethkingia spp., this study fit dose–response models to frog and mice datasets that evaluated intramuscular and intraperitoneal exposure to Elizabethkingia spp. The frog datasets could be pooled, and the exact beta-Poisson model was the best fitting model with optimized parameters α  = 0.52 and β = 86,351. Using the exact beta-Poisson model, the dose of Elizabethkingia miricola resulting in a 50% morbidity response (LD₅₀) was estimated to be approximately 237,000 CFU. The model developed herein was used to estimate the probability of infection for a hospital patient under a modeled exposure scenario involving a contaminated medical device and reported Elizabethkingia spp. concentrations isolated from hospital sinks after an outbreak. The median exposure dose was approximately 3 CFU/insertion event, and the corresponding median risk of infection was 3.4E-05. The median risk estimated in this case study was lower than the 3% attack rate observed in a previous outbreak, however, there are noted gaps pertaining to the possible concentrations of Elizabethkingia spp. in tap water and the most likely exposure routes. This is the first dose–response model developed for Elizabethkingia spp. thus enabling future risk assessments to help determine levels of risk and potential effective risk management strategies.     

Prevalence of alcohol-use disorders and alcohol-related problems in a college student sample

Most studies of alcohol consumption patterns and alcohol-related problems among college students have failed to include a diagnostic measure based on Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Applying the DSM-IV standards would facilitate an analysis of the prevalence of alcohol-use disorders and individual symptoms of those disorders. A structured diagnostic interview based on DSM-IV criteria (the alcohol section of the Substance Abuse Module) and several alcohol screening instruments were administered to 306 undergraduate students at an urban commuter campus. The prevalence of current and lifetime alcohol-use disorders, individual symptoms of those disorders, and other alcohol-related problems are reported, as well as data regarding alcohol consumption patterns and binge drinking. The data are analyzed in terms of demographic variables, including sex, ethnicity, year in school, age, and marital status of those in the sample.     

Cultural perspectives of death,grief, and bereavement

The cultural makeup of the United States continues to change rapidly, and as minority groups continue to grow, these groups' beliefs and customs must be taken into account when examining death, grief, and bereavement. This article discusses the beliefs, customs, and rituals of Latino, African American, Navajo, Jewish, and Hindu groups to raise awareness of the differences health care professionals may encounter among their grieving clients. Discussion of this small sample of minority groups in the United States is not intended to cover all of the degrees of acculturation within each group. Cultural groups are not homogeneous, and individual variation must always be considered in situations of death, grief, and bereavement. However, because the customs, rituals, and beliefs of the groups to which they belong affect individuals' experiences of death, grief, and bereavement, health care professionals need to be open to learning about them to better understand and help.     

Politics: Butler's Corporeal Politics: Matters of Politicized Abjection

This essay examines the work of Judith Butler in relation to corporeality through an analysis of Bodies that Matter: On the Discursive Limits of Sex and Butler's notion of politicized abjection. Abjection is considered in relation to bodily materiality and proposed as the most promising path for a revamped corporeal politics. Through a reading of two novels, Katherine Dunn's Geek Love and Barbara Gowdy's Mister Sandman, the essay examines how the abject body can function as politically subversive. Throughout, the essay analyses Butler's placing of the material body in a political domain, and argues that she ultimately endorses materiality as potentially disruptive to the symbolic domain of viable bodies. This recasting of matter within her theory is shown as redefining the body as an active agent rather than a passive receptacle for regulatory norms. The essay examines this under-theorized aspect of her work, and illustrates that politicized abjection is as crucial to her philosophy as the notion of gender as performative.     

Positive Attentional Bias,Attachment Style,and Susceptibility to Peer Influence

Susceptibility to peer influence may be related to activation in reward‐related brain regions. The current study extends research on the role of reward sensitivity in peer influence by examining whether preferential attention to positive emotional stimuli predicts behavior in peer interactions, and whether this association is moderated by attachment style in a sample of 36 same‐sex peer dyads. Positive attentional bias was associated with lower autonomy and greater avoidance with peers. This association was attenuated among individuals with secure attachment style. Attention to negative stimuli was associated with less avoidant and more hostile behavior during peer interactions. Results suggest that preferential attention to positive emotional stimuli is associated with greater susceptibility to peer influence, particularly in individuals low in secure attachment.     

Self‐conscious Shyness: Growth during Toddlerhood,Strong Role of Genetics,and No Prediction from Fearful Shyness

Fearful and self‐conscious subtypes of shyness have received little attention in the empirical literature. Study aims included the following: (1) determining whether fearful shyness predicted self‐conscious shyness, (2) describing development of self‐conscious shyness, and (3) examining genetic and environmental contributions to fearful and self‐conscious shyness. Observed self‐conscious shyness was examined at 19, 22, 25, and 28 months in same‐sex twins (MZ = 102, DZ = 111, missing zygosity = 3 pairs). Self‐conscious shyness increased across toddlerhood, but onset was earlier than predicted by theory. Fearful shyness (observed [6 and 12 months] and parents’ reports [12 and 22 months]) was not predictive of self‐conscious shyness. Independent genetic factors made strong contributions to parent‐reported (but not observed) fearful shyness (additive genetic influence = .69 and .72 at 12 and 22 months, respectively) and self‐conscious shyness (additive genetic influence = .90 for the growth model intercept). Results encourage future investigation of patterns of change and inter‐relations in shyness subtypes.