Screening for patients with alcohol problems: severity of patients identified by the CAGE.

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.     

Negotiating Role Definitions and the Working Consensus in Self-Work*

Definitions of social roles and the maintenance of a working consensus are two kinds of background expectations which are important for actors’accomplishment of self-work. Interactionists have traditionally assumed that these background expectations are unambiguously available to social actors as they negotiate situated meanings of selves and situations. Using data from dyadic role-play conversations, this study examines instances where interactants reference these expectations as ambiguous or problematic. The findings show that the situated meanings of role definitions and the working consensus are continually subject to potential negotiation. The implications of these findings for future research and theory on self-work in social interaction are discussed.     

EDITH WHARTON'S SICK ROLE

In this article, we conduct a textual analysis of Edith Wharton's 1911 novel, Ethan Frome . We offer three readings. The first presents Wharton's account of illness through a framework developed foru decades later by Talcott Parsons. Wharton's sick role was less medico-centric than Parsons; it emphasized the importance of class, gender and community in defining and legitimizing the sick role. Our second reading explores the socially constructed nature of roles in illness. The sick role as portrayed by Wharton is not the social fact later conceived by Parsons, but a social construct with no determinate reference beyond that which the local community is willing to grant it. Our third reading examines the social context, particularly the power relations, within which this story of illness has been constructed.     

Public Perceptions about Food Safety in the United States and Japan1

Abstract Consumer concerns over pesticide residues and food additives have been growing in industrialized societies, including the United States and Japan. However, little comparative research has been carried out to determine which household characteristics may be significantly associated with these heightened concerns, and whether or not the same factors are useful for understanding variation in these worries in more than one society. This paper examines food safety attitudes in Seattle, Washington, and Kobe, Japan, and discovers that while the absolute level of expressed concern is higher in Kobe, the predictive power of household characteristics in explaining attitudinal differences within countries is similar. Implications for rural areas and future research on family structures in capitalist societies are discussed.     

MONEY DEMAND DURING HYPERINFLATION AND STABILIZATION: BOLIVIA, 1980–1988

This paper examines the demand for money in Bolivia during the 1980s, a decade of extreme instability with annual inflation rates reaching over 20,000 percent, and a subsequent stabilization, with annual rates falling to less than 25 percent and remaining so for more than five years.
Our empirical analysis makes use of error-correction approaches, time-varying-parameter estimation with Kalman filtering, and GARCH models of expected inflation and inflation variance. We find that expected inflation and inflation uncertainty both matter for money demand. Time-varying estimates show that the reaction to monetary disequilibria was significantly faster during hyperinflation.     

Cognitive-behavioral-expressive interventions with aggressive and resistant youths.

Research into the nature of aggressive behavior in youths has demonstrated that these youths are often the victims of abuse, exhibit aggressive behavior in early childhood, and remain aggressive into young adulthood. The treatment approach described in this article is a modification of Monahan's [1981] model of the prediction of violent behavior and the anger-management approach of Novaco [1985], and integrates the developmental models of Piaget [1963] and Erikson [1959]. The program is a combination of cognitive, behavioral, and expressive therapies and is targeted to the reduction of dysfunctional cognitive, affective, behavioral, and problem-solving patterns of aggressive youths. As referrals of such aggressive clients are often involuntary, interventions with unwilling and resistant clients are also presented.     

THE LEAGUE OF NATIONS AND THE IRISH QUESTION:

This article builds on theoretical work in the social movements literature that uses "master frames" (Snow and Benford 1992) to account for the cyclical clustering of social movement activity within certain historical periods. I identify "master frame alignment" as the dynamic process by which social movement actors rhetorically transform the master frames within a cycle of protest to make them resonate more clearly with a movement's unique social and historical situation. Just as frame alignment processes serve to link a movement organization's activities, goals, and ideology with those of a potential group of adherents, master frame alignment processes link the activities, goals, and ideology of a movement organization with those espoused within the broader symbolic atmosphere of the social movement. I present historical data from Irish newspapers and political documents to show how the Irish Sinn Féin movement, seeking self-determination during the early twentieth century, rhetorically reconstructed the master frames generated by the League of Nations in order to better exploit this particular window of political opportunity.     

Naturally occurring play patterns in groups of latency aged children

This study examines the influence of the socialization of aggression among different gender and social class groupings and the influence of psychosocial stage on cognitive developmental play preferences among groups of school aged children. Observations of 143 play groups were coded for play preference (symbolic play, practice play, games with rules) and play performance (cooperative or competitive). Findings of the log-linear data analysis suggest a middle class and masculine bias in Piaget's cognitive model (i.e., that as age increases children prefer more games with rules). This model held only for middle class and affluent boys. Girls (both latency and prepubertal) and lower socioeconomic groups tended to prefer practice play. Girls were more likely to play cooperatively; boys more likely to play competitively. Implications for theory development and clinical practice are explored.