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The passage in the USA of the Americans with Disabilities Act (ADA) has mandated the private sector to provide a sweeping variety of accommodations to individuals with disabilities. Objections to ADA focused on costs in an era of scarcity. These assumptions have been presented with insufficient information about the actual needs of individuals with disabilities. This study is a needs assessment of employees with disabilities at a major university setting. In-depth interviews were conducted with a small number of individuals who described their work situations and accommodations. Findings challenge prevailing assumptions. Costs are often not large, many accommodations are simple, and much depends on the match between a person's disability and job duties. Additionally, informational needs, psychological concerns and the existing social climate provide a more balanced picture of the lives of these employees.  相似文献   
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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.  相似文献   
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Abstract This paper examines rural/urban differences and trends in mental health during the farm crisis of the 1980s in a large panel sample from a midwestern state. A community research perspective, which attributes differences to life styles, culture, and community context, is contrasted with an economic stress perspective, which focuses on individual differences in economic circumstances as determinants of rural-urban differences in mental health. Survey samples from 1981, 1986, and 1989 are used to examine differences among seven categories of community type. Multiple regression analysis of the trend and panel data provide support for both the individual economic distress and community context models.  相似文献   
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Federal minimum wage statutes cover only 70 percent of the work force and 30 percent of all employers. State laws are designed to close some of these coverage gaps and in some cases to set higher wage floors. Hence, differences in state wage floors and coverage should affect employment rates and wage distributions, particularly among low-skilled workers. Evidence from the National Longitudinal Ssurveys of Youth is mixed, however: State wage floors appear to have no impact on youth employment or entry wages, but coverage exemptions appear to increase both employment and wages. These observations underscore the need to include state provisions in models of minimum wage impacts, particularly for later periods (e.g., 1988–1991) when state wage floors were relatively higher.  相似文献   
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