Unlicensed care homes in the United States: a clandestine sector of long-term care

Residential care facilities operating without a state license are known to house vulnerable adults. Such unlicensed care homes (UCHs) commonly operate illegally, making them difficult to investigate. We conducted an exploratory, multimethod qualitative study of UCHs, including 17 subject matter expert interviews and site visits to three states, including a total of 30 stakeholder interviews, to understand UCH operations, services provided, and residents served. Findings indicate that various vulnerable groups reside in UCHs; some UCHs offer unsafe living environments; and some residents are reportedly abused, neglected, and financially exploited. Regulations, policies, and practices that might influence UCH prevalence are discussed.     

The Importance of Sex in the Lives of Women Living with HIV: A Critical Quantitative Analysis

The authors explored the importance of sex for 1,289 women living with HIV in Canada. Approximately half of women viewed sex as “very” (19.6%) or “somewhat” important (32.3%) and the remaining reported “neither important or unimportant” (22.0%), “somewhat unimportant” (5.4%), or “not at all important” (20.1%). Women who had a regular sex partner, identified as African, Caribbean, or Black, were more educated, believed HIV treatment prevents transmission, or had better physical health-related quality-of-life reported greater importance of sex, whereas those who were older, used illicit drugs, or experienced violence in adulthood reported lesser importance. Findings underscore the diversity of women's perspectives within the context of their lives.     

A Self-Psychological Perspective on Chronic Illness

It is becoming increasingly common to encounter patients seeking psychotherapy for symptoms resulting from chronic illness. Regardless of the specific diagnosis, chronic illness is a phenomenon with deep implications for disruption of self-states and narcissistic injuries. Working with chronically ill patients presents many challenges to the patient and the therapist, ranging from acute grief and loss to a reworking of unresolved developmental issues. This paper explores the use of a self-psychological perspective in the treatment of chronic and terminal illness. Approaching treatment from a self-psychological perspective, psychoanalytic psychotherapy can be successfully utilized in conjunction with supportive therapy.     

Trends from 1987 to 1991 in alcohol, tobacco, and other drug (ATOD) use among adolescents exposed to a school district-wide prevention intervention.

This study involved a school-based prevention program initiated to reduce alcohol, tobacco, and other drug (ATOD) use among adolescents in the Troy School District in the Detroit area. One purpose was to describe the current ATOD situation by investigating changes in reported ATOD use from 1987 to 1991. Another purpose was to explore and identify the most salient risk and protective factors present. In 1987, 1,490 students (comprising grades 8 and 11) and in 1991, 3,171 students (comprising grades 8 to 12) completed questionnaires. Significant decreases were found for use of most drugs with the exception of alcohol. Involvement in problem behaviors was identified as the most salient risk factor, while having a member of a non-using peer group was the most salient protective factor. Implications for the design of subsequent intervention programs are discussed.     

Willingness to have unprotected sex

Little is known about people's willingness to engage in sex without protection from unwanted pregnancy. This study surveyed 1,497 women and men at 75 clinics and physician offices across California after their reproductive health care visits in late 2007 and early 2008. When asked if they would have sex without contraception, 30% said definitively that yes, they would have unprotected sex, and 20% indicated they would "sometimes" or "maybe" engage in unprotected sex. In multivariate models, compared to non-Latino White respondents, Latinos who responded to the survey in English were 52% more likely and African Americans were 75% more likely to report willingness to have unprotected intercourse. Wanting a child within the next three years was associated with increased willingness to have unprotected sex. Age, gender, parity, and relationship status were not significant in multivariate models. A considerable proportion of women and men may be willing to have unprotected sex, even with access to subsidized contraceptive services and even when recently counseled about birth control. The dominant behavioral models of contraceptive use need to acknowledge the widespread likelihood of occasional unprotected sex, even among people motivated to usually use contraceptives. Findings underscore the need to make contraceptive methods accessible, easy to use, and even pleasurable.     

Stakeholder participation in evaluation design: Is it worth the effort?

Naturalistic approaches to program evaluation generate multiple interpretations and possible conclusions, but lack inherent guidance on how to choose among or reconcile them. A practical frame of reference for addressing this challenge emphasizes criteria of utility and credibility, as well as an evaluation process that is participatory and openly value-pluralistic. This paper discusses the logic of justification underlying such a practical perspective.     

The gender gap on public opinion towards genetically modified foods

Ever since genetically modified (GM) foods were introduced into the food supply in the 1990s they have provoked debate and concern. The number of GM foods approved by the U.S. Food and Drug Administration and offered on supermarket shelves has steadily grown at the same time that public wariness about the safety of GM foods has increased. Studies within the scientific literature show a strikingly large gender gap in attitudes towards GM foods with women consistently more skeptical than men. However, there have been few efforts to understand the determinants of the gender gap on GM foods within the political science literature. This study employs a 2014 Pew Research Center survey on science issues to test several possible explanations for the gender gap in attitudes towards GM foods rooted in the different life experiences of women and men. The results show that while being a parent predicts more skeptical views about genetically modified foods overall it does not explain the gender gap in attitudes. In contrast, knowledge about science and having confidence in science do play a significant role in mediating the gender gap. By exploring the robust and pervasive gender gap on the issue of GM foods, this study sheds light on the fundamentally different ways men and women approach political issues.