One-year outcomes from the CASAWORKS for Families intervention for substance-abusing women on welfare

AIM: To evaluate the effectiveness of a multiservice intervention designed to move substance-abusing women on welfare to sobriety and self-sufficiency by addressing their substance abuse, domestic violence, employment, and basic needs. DESIGN: A field evaluation with repeated measures at 6 and 12 months on an intent-to-treat sample of 529 women conducted in 11 selected sites across the country. There were significant improvements shown in substance use and family and social functioning by the 6-month point, and additional improvements in employment by the 12-month point. By 12 months, more than 46% were abstinent from alcohol and other drugs, and 30% were employed at least part-time. There were only modest improvements shown in the medical and psychiatric status of these women. These preliminary findings suggest that site-level interagency coordination and program-level case management were associated with improvements in the targeted areas as predicted by the model. Future work will require a more closely specified, manual-guided form of the intervention plus the inclusion of control groups and cost measures to fully evaluate the cost benefits from the final form of the intervention.     

Tilting at Twindmills: rethinking sociological responses to behavioral genetics

While we commend Horwitz et al. (2003) for speaking to core issues in behavioral genetics, we disagree with many particulars of their article. We are skeptical of their claims regarding the particular contribution offered by both their methods and data. We believe also that the findings they present as challenging the equal environments assumption are, upon closer examination, not persuasive. Most fundamentally, we worry that the way in which Horwitz et al. conceptualize the relationship between genes and environments is not the best means of doing so for sociologists interested in engaging behavioral genetics.     

Intermarriage and the risk of divorce in the Netherlands: the effects of differences in religion and in nationality, 1974-94

A textbook hypothesis about divorce is that heterogamous marriages are more likely to end in divorce than homogamous marriages. We analyse vital statistics on the population of the Netherlands, which provide a unique and powerful opportunity to test this hypothesis. All marriages formed between 1974 and 1984 (nearly 1 million marriages) are traced in the divorce records and multivariate logistic regression models are used to analyse the effects on divorce of heterogamy in religion and national origin. Our analyses confirm the hypothesis for marriages that cross the Protestant-Catholic or the Jewish-Gentile boundary. Heterogamy effects are weaker for marriages involving Protestants or unaffiliated persons. Marriages between Dutch and other nationalities have a higher risk of divorce, the more so the greater the cultural differences between the two groups. Overall, the evidence supports the view that, in the Netherlands, new group boundaries are more difficult to cross than old group boundaries.     

Long-range trends in adult mortality: Models and projection methods

In the study reported here, I had two objectives: (1) to test a new version of the logistic model for the pattern of change over time in age-specific adult mortality rates and (2) to develop a new method for projecting future trends in adult mortality. A test of the goodness of fit of the logistic model for the force of mortality indicated that its slope parameter is nearly constant over time. This finding suggests a variant of the model that is called the shifting logistic model. A new projection method, based on the shifting mortality model, is proposed and compared with the widely used Lee-Carter procedure.     

The influence of network mortality experience on nonnumeric response concerning expected family size: Evidence from a Nepalese mountain village

This article investigates the effects of sociometric network members' self-reported experiences with infant mortality on nonnumeric responses regarding expected family size among women in a small Nepalese community. The hypotheses tested include (1) that uncertainty about child survival, measured as average infant mortality across social networks, increases the likelihood of a nonnumeric response and (2) that this effect will be stronger when there is less variance in infant mortality experience within women a networks. The results suggest that nonnumeric response may be related to uncertainty about mortality derived through social learning.     

Cultural value orientations, internalized homophobia, and accommodation in romantic relationships

In the present study, we examined the impact of cultural value orientations (i.e., the personally oriented value of individualism, and the socially oriented values of collectivism, familism, romanticism, and spiritualism) on accommodation (i.e., voice and loyalty, rather than exit and neglect, responses to partners' anger or criticism) in heterosexual and gay relationships; and we examined the impact of internalized homophobia (i.e., attitudes toward self, other, and disclosure) on accommodation specifically in gay relationships. A total of 262 heterosexuals (102 men and 162 women) and 857 gays (474 men and 383 women) participated in the present study. Consistent with hypotheses, among heterosexuals and gays, socially oriented values were significantly and positively related to accommodation (whereas the personally oriented value of individualism was unrelated to accommodation); and among gays in particular, internalized homophobia was significantly and negatively related to accommodation. Implications for the study of heterosexual and gay relationships are discussed.     

Women's satisfaction with their breast prosthesis: what determines a quality prosthesis?

The aim of this study is to determine what factors constitute a quality prosthesis and ascertain which factors affect prosthesis satisfaction. Sixty-four women who received full funding for their prosthesis and 38 women who received their hospital's usual funding were recruited. Women rated the information provided about breast prostheses very highly, with 85% reporting that it was "very good" or "excellent." Satisfaction was significantly associated with how well the prosthesis fit (1 week, p = .001; 3 months, p = .01), level of comfort (3 months, p=.005), and appearance of the prosthesis when worn (6 months, p = .001). Quality was significantly associated with how well it fit (1 week, p = .001; 3 months, p = .001), how natural it felt (1 week, p = .001; 6 months, p = .01), the weight of the prosthesis (3 months, p = .003), and appearance when worn (6 months, p = .03). The results will be used to improve women's access to a quality prosthesis.     

Seclusion & restraint: a historical perspective

(1) The use of restraints in the care of psychiatric patients has been a topic of ethical controversy since the beginning of psychiatric medicine. (2) Enlightenment physicians regarded psychiatric illness as the loss of reason, and many advocated the use of restraints to help violent patients regain the use of reason. (3) John Conolly, a British alienist (a term used for psychiatrists) of the mid 1800s, claimed it was possible to treat psychiatric patients without the use of mechanical restraints, but he made liberal use of seclusion and physical restraint by attendants to manage violent behavior. (4) American alienists expressed misgivings about the use of mechanical and chemical restraint but most were reluctant to relinquish any usable intervention.     

Risk assessment of forensic patients: nurses' role

One of the unique roles of forensic nurses is to conduct risk assessments. Establishing a therapeutic nurse-patient relationship helps forensic nurses perform accurate and useful risk assessments. Accurate risk assessments can facilitate formulation of individualized risk management plans, designed to meet patients' needs and ensure public safety. The importance of forensic nurses' knowledge and application of appropriate communication and proper documentation cannot be overemphasized.