State of the unions: Assessment by elite American labor leaders

One hundred and sixty-four elite union leaders in the United States completed a survey to assess the condition of the American labor movement and the factors affecting it. The respondents included high-level international union and state federation officers, central labor presidents, and 58 shop stewards. This study compares the responses of these labor officials and finds that they have similar, negative assessments of the condition of the American labor movement. The study also finds that these leaders agree that the most important factors affecting the labor movement are collective bargaining rights, union leadership, union member solidarity, and the NLRB.     

Sexual identity in the ghetto

The more things change, the worse they get.Presented April 18, 1991, Duke University, at the Department of Psychiatry's Grand Rounds, this paper condenses, integrates and updates the author's earlier publication. Acknowledgement and thanks for funding and professional sponsorship of the four research studies this paper draws from are selectively due to the Eugene and Agnes E. Meyer Foundation, the Edgar Stern Family Fund, The National Institute for Mental Health, the Baltimore-Washington Institute for Psychoanalysis and the Department of Psychiatry, Children's Hospital National Medical Center.     

AN EFFICIENCY EXPLANATION FOR WHY FIRMS SECOND SOURCE

Firms facing research costs and demand uncertainty may engage in second-sourcing, in which potential suppliers agree to pool production facilities. I show how sellers and buyers both can benefit from the practice. Second-sourcing allows firms to meet a wider range of possible rates of demand and often to supply a given rate of demand at a lower total cost than under non-cooperation. Buyers benefit through a reduced probability of stock-outs and frequently a lower purchase price. Semiconductor industry data are found to be consistent with the paper's predictions.     

A puzzlement: health-related organisations in the Nonprofit Almanac

Conclusion Data systems created with one purpose inevitably have shortcomings when used for other purposes, so it is not surprising that a database compiled from informational tax returns has serious flaws when used to compile a statistical picture of the non-profit sector. The two-digit NTEE level of aggregation that is published in theAlmanac conceals many problems that appear when the IRS-based data are broken down to the three-digit level.Identification of the problems in the NTEE and in the use of the IRS data is a necessary step toward their correction. At this point, it is clear that the IRS-based numbers in theAlmanac should be regarded, at best, as rough approximations and as a starting point for additional work. My assessment of theAlmanac suggests that, at least as far as health care is concerned, the NTEE needs revision. Correcting the problems with the IRS data will be much, much more difficult.I am grateful for assistance from Steve Noga, Chris Toppe and Virginia Hodgkinson at Independent Sector.     

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.     

The Farm Crisis and Mental Health: A Longitudinal Study of the 1980s1

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.