The Social Power of Health-Care Practitioners as Agents of Change

This paper examines dominant sources of social power and influence that affect the degree to which patients adhere to recommended regimens for prevention or treatment and their rate of recovery. Referent power of health-care practitioners, as contrasted with their expert, coercive, reward and legitimate power, is expected to be most effective when internalization of medical recommendations by the patients is essential. The paper explores specific ways that a health-care professional can gain referent power, using weight control treatment as an example. It presents a conceptual framework that provides a rationale for a number of relationship-building techniques and offers evidence that referent power is effective in promoting adherence to treatment and more healthful behavior, and in influencing critical outcome measures such as weight loss. Analysis of the relative efficacy of various methods of building and using referent power and the possible limiting conditions on its effectiveness are also discussed.     

POLICY PARADOXES: THE DISEMPOWERMENT OF YOUNG PEOPLE UNDER THE LABOR GOVERNMENT, 1983–91

This paper explores the restructuring of the experience of young people's lives. It examines Federal Labor Government youth and education policy apparently developed as a response to the high levels of youth unemployment in place since 1976–77. It argues that these policies have dramatically altered the experience of being young by creating greater dependence and further disempowerment. It argues that young people have become the objects of punitive exercises that deny them their basic rights, disenfranchise them and extend the socially constructed features of adolescence into early ‘adulthood’.     

A first look at the 21st Century: Census 2000

This paper examines the initial results from Census 2000. It focuses onpopulation growth and distribution, and the five populationcharacteristics from the 100-percent data: age, sex, Hispanic origin, race, and householdrelationship. It explores emerging trends within an historical and global context.     

The fallacy of the five million women: A re-estimate

Explicit policy to control fertility in the United States to date has focussed on the “unmet need” for contraceptive services in 1966 among an estimated five million poor and near-poor women. This paper reestimates the number of women in need of contraceptive services by disaggregating (on the basis of tabulations from the Current Population Surveys for 1966 and 1967, and the 1965 National Fertility Study) all poor and near-poor women into 54 subgroups differentiated by age, marital status, religion, and color. Data from the 1965 National Fertility Study, and from other studies, are then used to estimate for each subgroup deductions for sterility, pregnancy, waiting time for conception, and negative attitudes toward and current use of contraception. The residual number of women who both want and require contraceptive services, but do not have them, is estimated to be 1.2 million, rather than 4.6 million. The fact that the re-estimate takes into account both existing contraceptive practice and negative attitudes toward family limitation accounts for much of the difference between it and the original figure.     

Municipal Waste Management: Inequities and the Role of Deliberation

Like radioactive waste, municipal solid waste (MSW) requires consideration of a complex mix of intergenerational and intragenerational risks surrounded by uncertain science. Unlike radioactive waste, MSW is a common problem and hence one often perceived to be controllable, at least until a required facility is proposed in a particular community. The intragenerational risks focused on local communities rouse intense public pressures for management. Although some of the risks can be quantified, the risk assessment process cannot deal with all questions. This article examines the multiple dimensions of the decisions required to be made and the weaknesses of a number of decision tools traditionally used. A case is made for the need to integrate decision tools appropriate to the risks into reflexive and iterative decision processes open to public involvement. It is argued that this presents the best hope of both optimizing decisions about the intragenerational risks as well as raising public debate about the importance of sustainable waste management in transgenerational terms.     

The Long‐Term Consequences of Relationship Formation for Subjective Well‐Being

This study examines how relationship transitions affect subjective well‐being (SWB) and how this effect changes over time. We used prospective data containing information about 18 years of young adults' lives (PSIN, N = 5, 514). SWB was measured with the Satisfaction with Life Scale. Within‐person multilevel regression analyses showed that dating, unmarried cohabitation, and marriage had additional well‐being enhancing effects. After entry into a union, well‐being slowly decreased. A large SWB decrease was found after union dissolution, but through adaptation or repartnering well‐being increased again. Well‐being of never‐married and never‐cohabiting young adults decreased slowly over time. These effects were independent of parenthood and employment. Our results confirm expectations from the resources theory but contradict some assumptions of the set‐point theory.     

A cross-national study on adolescent substance use: Intentions,peer substance use,and parent-adolescent communication

This longitudinal two-wave cross-national study investigated whether intentions, friends' substance use, and parent-adolescent substance-use specific communication predict adolescent alcohol and cannabis use 1 year later, while estimating reversed links. The temporal order between these two substances was also examined. We used multi-group cross-lagged panel modeling on data from 2 ethnically and socioeconomically diverse samples: Sint Maarten (N = 350; M_age = 14.19) and the Netherlands (N = 602; M_age = 13.50). Results showed that in the Netherlands, cannabis use predicts more subsequent problems (alcohol use, intention to use cannabis, and affiliation with cannabis-using friends). But for Sint Maarten, alcohol use predicts more subsequent problems (cannabis use, intention to use alcohol, and affiliation with alcohol-using friends). These opposing results demonstrate that caution is warranted when generalizing results across countries.     

Modification of the kolmogorov-smirnov test for the erlang-2 distribution

An adjusted Kolmogorov-Smirnov statistic and critical values are developed for the Erlang-2 probability distribution using data from Monte Carlo simulations. The process used is similar to that of Stephens in the 1970s. The test statistic produced features of compactness and ease of implementation. It is quite accurate for sample sizes as low as ten.     

Detecting bliss synergy in in vivo combination studies with a tumor kinetic model

Linear models are generally reliable methods for analyzing tumor growth in vivo, with drug effectiveness being represented by the steepness of the regression slope. With immunotherapy, however, not all tumor growth follows a linear pattern, even after log transformation. Tumor kinetics models are mechanistic models that describe tumor proliferation and tumor killing macroscopically, through a set of differential equations. In drug combination studies, although an additional drug‐drug interaction term can be added to such models, however, the drug interactions suggested by tumor kinetics models cannot be translated directly into synergistic effects. We have developed a novel statistical approach that simultaneously models tumor growth in control, monotherapy, and combination therapy groups. This approach makes it possible to test for synergistic effects directly and to compare such effects among different studies.