Epidemic Potential of Measles and Rubella

Abstract

Although there have been major declines in the incidence of measles and rubella in the United States since licensure of vaccines, the incidence of disease in adolescents and young adults has not declined nearly as markedly as that in younger children. As a result, an increasing proportion of cases have occurred in adolescents and young adults. In 1978, 26% of all reported measles cases in which age was known occurred in those 15 years of age and older, and 76% reported rubella cases occurred in this age group. Outbreaks of both diseases have been reported from high schools, military bases, colleges, and universities. During a recent outbreak of measles involving a university, a 22-year-old university employee contracted measles and died of measles encephalitis. In addition to the direct effects of these diseases, the implications of the current pattern of occurrence of two infections known to have adverse effects on the developing fetus are obvious.

Improvements in immunization levels and declines in disease incidence have been brought about effectively by the enactment and enforcement of immunization requirements for school-age children and military recruits. Colleges and universities should also institute immunization requirements as a condition of enrollment.     

Sexual Concerns and Counseling Needs of “Normal” Women Attending a Student Health Service Women's Clinic

Abstract

The responses of approximately 1000 female university students attending a Women's Health Service for gynecologic or contraceptive services are presented. A self-report questionnaire examined the frequency of sexual problems experienced by the respondents and their partners. The most common concerns expressed about themselves were orgasmic difficulties (74%), dyspareunia (58%), and body inhibitions (46%). Forty-five percent of these women expressed a desire for counseling. The most common concerns that the respondents perceived in their partners were premature ejaculation (46%), too much interest in sex (33%), and difficulty maintaining an erection (28%). Twenty percent of the women thought their partners would desire counseling. Specific types of counseling desired (e.g., individual, group, mixed group) were determined. Various self-help educational interests of the students were also evaluated. Substantial numbers of “normal” female university students expressed sexual concerns and desire for counseling services and educational aids.     

Health Services Utilization Among Graduate Students: Patterns of Use,Access, and Satisfaction

Abstract

Utilization of health services by graduate students has been a neglected area of college health research. This paper describes the access problems and utilization patterns of a systematic random sample of the graduate student population at the University of Mississippi.

Survey methodology was used to assess sociodemographic, health status, and attitudinal characteristics of the study sample. In addition to type and number of visits for various health services, other utilization-related items included access to and satisfaction with care, and information received about these health services.

The results indicated that graduate students and their dependents were reliant to a large degree on local health care. Inadequacy of information was viewed as a major problem relating to access. Satisfaction with care appeared to be a function of the quality of care received.     

Applying Relational Models to the Graduation of Disability Schedules

Age-specific rates of particular disability types are important for planning purposes and are a valuable input to estimates and projections of populations with different disabilities. However, survey estimates of schedules of disability rates display evidence of sampling variability and sub-national disability schedules are often unavailable for reasons of disclosure protection. This paper develops and evaluates a method to smooth sampling variability in national schedules of disability using a technique that has applicability to sub-national estimation of age-specific disability rates. Relational models are used to adjust the limiting long-term illness schedule for England (Census 2001) to represent different disability schedules (Health Survey for England 2000/2001) smoothing sampling fluctuations. For hearing disability a simple Brass relational model involving two parameters provides a good fit. For other disability types a modified version of the Ewbank relational model with three parameters is required. This paper illustrates that relational models can accurately capture the relationship between age-specific rates of limiting long-term illness and various disability types.     

Anthropological Takes on (Im)Mobility

In this introduction, we outline the general conceptual framework that ties the various contributions to this special issue together. We argue for the importance of anthropology to “take on” mobility and discuss the advantages of the ethnographic approach in doing so. What is the analytical purchase of mobility as one of the root metaphors in contemporary anthropological theorizing? What are the (dis)advantages of looking at the current human condition through the lens of mobility? There is a great risk that the fast-growing field of mobility studies neglects different interpretations of what is going on, or that only patterns that fit the mobilities paradigm will be considered, or that only extremes of (hyper)mobility or (im)mobility will be given attention. The ethnographic sensibilities of fieldworkers who learn about mobility while studying other processes and issues, and who can situate movement in the multiple contexts between which people move, can both extend the utility of the mobilities approach, and insist on attention to other dynamics that might not be considered if the focus is first and last on (im)mobility as such. In this special issue, we do not want to discuss human mobility as a brute fact but rather analyze how mobilities, as sociocultural constructs, are experienced and imagined.     

Hurdling the Artificial Fence Between Child Welfare and the Community: Engaging Community Partners to Address Disproportionality

As with many national and state social service systems, child welfare agencies have traditionally functioned in isolation. A multitude of federal and state laws and policies direct the functions and practices of child welfare systems, setting up an artificial fence around the agency that has created a culture lacking in interprofessional collaborations. However, recent reform efforts have emphasized the importance of engaging the community in discussions and decisions regarding child welfare practice. Child welfare agencies are now expected to work with community leaders, key stakeholders, affiliated service providers, and families to address issues impacting children and families. A major obstacle is determining where to begin, how to proceed, and what is needed to develop those partnerships. This article reports the efforts of one state agency in hurdling that artificial fence to address the overrepresentation of minority children in the system. Through focus group interviews with community members, child welfare staff, and legal professionals, barriers to community engagement are identified, and recommendations are provided for facilitating meaningful relationships and partnerships between child welfare agencies and the communities they serve.     

African American Families and the Role of Physical Discipline: Witnessing the Past in the Present

The use of physical discipline within African American families is examined from a historical perspective within the context of institutionalized racism and racial disproportionality in the child welfare system. African American parenting strengths are explored, demonstrating that the use of physical discipline can be purposeful, controlled, and appropriate, utilized to protect African American children and instruct them how to behave and survive within a racist society. Available literature on corporal punishment is reviewed, and implications for culturally informed child welfare practice are provided.     

The Exclusiveness of the Political Field: Networks and political mobilization

This paper applies social network analysis to three case study social movement organizations based in the north of England: a local Labour Party branch, an environmental group, and a conservation group. Using a postal survey of members, we chart the extent of ties between members of these three groups, indicating how each group has its own internal social dynamics and characteristics that are related to the nature of the movement organizations themselves. We explore how the network structures interrelate with the socio-demographic structure of the membership of the three organizations, and we show there are important differences in the way that core members of the three organizations are recruited compared to those who are either peripheral or isolated. Our paper is the first to analyse the networks of whole populations of case study organizations in the UK, and can therefore be read as developing the potential of social network analysis for case study research and for understanding social movements. Analytically we argue it is important to distinguish two different types of ways that networks are important. They can be seen as offering resources for mobilization, or they can be seen as providing a means of integrating particular types of individuals into organizations. It is this latter sense that offers a more fundamental role for network analysis, and we argue that it offers an important way of developing insights from resource mobilization theory by relating them to Bourdieu's provocative arguments regarding the exclusiveness of the political field.     

“Mutual Transformation”

The psychoanalytic relationship between patient and analyst has undergone a dramatic evolution over the years. As the illusion of anonymity and neutrality of the analyst has dropped away, a more human engagement and intimacy has developed between them. This paper explores the gains for both participants from such a change, using a clinical case to anchor the discussion. Following up on the work of Ferenczi and Searles, concepts of shared process and mutual transformation are examined from both theoretical and clinical perspectives. A concern remains, however, that issues of hierarchy and self-interest for the analyst still interfere with a more intimate connection and greater benefits for both participants.