In sickness but not in health: self-ratings, identity, and mortality

Self-rated health as a predictor of mortality has been studied primarily in large, representative populations, with relatively little progress toward understanding the information processing that individuals use to arrive at these ratings. With subsamples of National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-up Study (NHEFS) data for respondents with circulatory system disease (N = 3,709) and respondents with no diagnosable disorders (N = 1,127) at baseline, we test the idea that individuals with experience of chronic disease of the circulatory system will have more predictive self-ratings of health than healthy individuals. Poor or fair self-rated health increased the adjusted hazard of all-cause mortality for respondents with circulatory system disease, but not for respondents who were healthy. Additional analyses confirm that poor or fair self-rated health is particularly predictive for respondents with self-reported history of circulatory system diagnoses and perception of symptoms, but not for respondents without symptoms or diagnoses prior to the NHANES physical exam.     

Family therapists' ethical decision-making processes in two duty-to-warn situations

This quantitative study investigated the ethical decision-making process of 177 Missouri members of the American Association for Marriage and Family Therapy using two in-session duty-to-warn scenarios of child abuse and HIV transmission. The components of the critical-evaluative level of ethical decision making include the lower-level decision components of personal/therapeutic response, professional ethics, and legal considerations/laws of the State, and the components of the higher-level decision base, the meta-ethical principles, which are nonmaleficence, autonomy, beneficence, fidelity, and justice. Statistical results indicated that in the child abuse scenario, professional ethics and legal considerations/laws of the State were considered most important, whereas in the HIV scenario, professional ethics were the preferred lower-level decision base. Across scenarios, the preferred higher-level decision base was nonmaleficence. There were differences across the child abuse and HIV scenarios in the perceived significance of the remaining lower-level decision base items as well as differences in perceived significance and ordering of the remaining meta-ethical principles. Limitations are discussed.     

The Gambling Self-Efficacy Questionnaire: An Initial Psychometric Evaluation

Instruments to assess individuals' self-efficacy for the control of addictive behaviors have been useful for monitoring behavior change, predicting maintenance of treatment gains, and identifying potential relapse situations. The Gambling Self-Efficacy Questionnaire (GSEQ) was developed to assess perceived self-efficacy to control gambling behavior. A demographically diverse sample of 309 adult gamblers completed an initial set of 42 items, of which 16 were selected to form the final version of the GSEQ. The GSEQ showed high internal consistency ( = .96) and good test-retest reliability (r = .86). A factor analysis provided some support for a unitary factor structure. As expected, GSEQ scores were negatively correlated with reports of problematic gambling behavior. Participants experiencing problems related to their gambling behavior scored significantly lower on the GSEQ than those who were not experiencing gambling problems. This psychometric examination of the GSEQ supported its potential utility for treatment planning and outcome evaluation with problem gamblers.     

Letters to the editor

Relatively little attention has been paid to the use and importance of labels used by men who have sex with men to describe insertive or receptive sexual behavior during intercourse. This study examines sexual self‐labels, sexual behavior, HIV transmission risk, and psychological functioning among 205 HIV‐seropositive men who have sex with men. The majority of participants (88%) identified as a “top, “ a “bottom, “ or “versatile. “ Tops were more likely to engage in insertive anal intercourse than bottoms, and bottoms were more likely to engage in receptive anal intercourse than tops, with versatiles reporting intermediate rates of both behaviors. Although the results suggest preliminary evidence regarding the predictive utility of self‐labels, sexual behaviors of self‐label groups were greatly overlapping. Differences were found among self‐label groups in gay self‐identification, internalized homophobia, sexual sensation seeking, and anxiety. Results suggest an added value in assessing self‐labels in addition to asking about sexual behavior.     

Using Nursing Students to Enhance One College's Immunization Program

Abstract

In New York State, all college students who were born on or after January 1, 1957, are required to show proof of immunity against measles, mumps, and rubella (MMR) before the 1st day of classes. Colleges have established immunization programs so that those students who do not have the required proof can be given the necessary injections. Often, our health service office does not have enough staff to administer the MMR shots during the registration period, resulting in long lines of students waiting to be immunized. In this article, the authors describe how one college used nursing students to assist with and enhance its immunization program. The 45 nursing students who participated in this project administered 694 injections over a 5-day period, They received credit from the nursing department for clinical time and all of the participants agree that the project was a success.     

Culture and Co‐residence: An Exploration of Variation in Home‐Returning among Canadian Young Adults*

Cet article s'inscrit dans la lignée des études sur les dimensions culturelles de la cohabitation entre générations en examinant de près le comportement des jeunes adultes canadiens qui retournent vivre chez leurs parents. Nous explorons les rapports mutuels entre la famille et la diversité culturelle, entre le capital financier et le capital social, et entre le rythme et les mécanismes de transitions précoces qui se manifestent au cours d'une vie. Les modéles de hasards proportionnels sont appliqués à un sous‐échantillon de 2 549 jeunes adultes, àgés de 19 á 34 ans, en tenant compte des données de l'Enquete sociale générale, cycle 10, de 1995. L'une des principales conclusions tirées ici indique que les jeunes qui sont de langue maternelle anglaise sont beaucoup plus susceptibles de retourner chez leurs parents après un premier départ que ceux dont la langue maternelle est le français ou une autre langue. Les autres variables qui entrent en jeu sont le niveau d'education du père, le nombre de frères et de soeurs, le sexe, l'âge au moment du depart de la maison et la raison de ce départ. L'article aborde aussi les questions des responsabilités et des rôles des parents autour de la cinquantaine, et de la socialisation au sein de la famille au cours de la vie. This article offers a focussed examination of variation in home‐returning behaviour among Canadian young adults. Framed within the life course perspective, we explore the interrelationships among family and cultural diversity, financial and social capital, and the timing and pathways of early transitions. Proportional hazards analyses are performed on a subsample of 2,549 young adults aged 19–34, using data from the 1995 General Social Survey, Cycle 10. A major finding is that those whose mother tongue is English are significantly more likely to return to the parental home than those with French or “other” mother tongues. Other variables include: father's education, number of siblings, gender, age at home‐leaving, and initial reason for home‐leaving. Implications for midlife parental roles and responsibilities, and for family socialization are discussed.