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241.
Alcohol remains the drug of choice for many adolescents; however, the nature of the relationship between athletic involvement and alcohol misuse remains ambiguous. In this article, we used a longitudinal sample of over 600 Western New York adolescents and their families to explore the gender-specific and race-specific relationships between identification with the "jock" label and adolescent alcohol consumption, specifically problem drinking. Operationalization of problem drinking included frequency measures of heavy drinking, binge drinking, and social problems related to alcohol (e.g., trouble with family, friends, school officials over drinking). Self-identified adolescent "jocks" were more likely to engage in problem drinking than their non-jock counterparts, even after controlling for gender, age, race, socioeconomic status, physical maturity, social maturity, and frequency of athletic activity. Jock identity was strongly associated with higher binge drinking frequency in Black adolescent girls. This study underscores the need to distinguish between objective and subjective meanings of athletic involvement when assessing the relationship between sport and adolescent health-risk behavior.  相似文献   
242.
This article explores customers' understandings of their visits to heterosexual strip clubs and the ways in which those visits become meaningful to them in relation to cultural discourses around masculinity, sexuality, leisure, and consumption, as well as in relation to their everyday lives and relationships. Not every man finds strip clubs pleasurable, yet understanding why some men frequent these venues can inform us more generally about the links between sexuality, gender, and the marketplace. This article focuses on regular male customers' stated motives for visiting strip clubs and examines those visits as touristic and masculinizing practices. It also explores gender, sexuality, and power in the men s performances of desire in the clubs, taking up issues of visibility, virility, youthfulness, and commodification.  相似文献   
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244.
Progressive multi-state models provide a convenient framework for characterizing chronic disease processes where the states represent the degree of damage resulting from the disease. Incomplete data often arise in studies of such processes, and standard methods of analysis can lead to biased parameter estimates when observation of data is response-dependent. This paper describes a joint analysis useful for fitting progressive multi-state models to data arising in longitudinal studies in such settings. Likelihood based methods are described and parameters are shown to be identifiable. An EM algorithm is described for parameter estimation, and variance estimation is carried out using the Louis’ method. Simulation studies demonstrate that the proposed method works well in practice under a variety of settings. An application to data from a smoking prevention study illustrates the utility of the method.  相似文献   
245.
246.
Accurate vital statistics are required to understand the evolution of racial disparities in infant health and the causes of rapid secular decline in infant mortality during the early twentieth century. Unfortunately, U.S. infant mortality rates prior to 1950 suffer from an upward bias stemming from a severe underregistration of births. At one extreme, African American births in southern states went unregistered at the rate of 15 % to 25 %. In this study, we construct improved estimates of births and infant mortality in the United States for 1915–1940 using recently released complete count decennial census microdata combined with the counts of infant deaths from published sources. We check the veracity of our estimates with a major birth registration study completed in conjunction with the 1940 decennial census and find that the largest adjustments occur in states with less-complete birth registration systems. An additional advantage of our census-based estimation method is the extension backward of the birth and infant mortality series for years prior to published estimates of registered births, enabling previously impossible comparisons and estimations. Finally, we show that underregistration can bias effect estimates even in a panel setting with specifications that include location fixed effects and place-specific linear time trends.  相似文献   
247.

Background

Vaginal birth after caesarean can be a safe and satisfying option for many women who have had a previous caesarean, yet rates of vaginal birth after caesarean remain low in the majority of countries. Exploring women’s experiences of vaginal birth after caesarean can improve health practitioners’ understanding of the factors that facilitate or hinder women in the journey to have a vaginal birth after caesarean.

Methods

This paper reports on a meta-ethnographic review of 20 research papers exploring women’s experience of vaginal birth after caesarean in a variety of birth locations. Meta-ethnography utilises a seven-stage process to synthesise qualitative research.

Results

The overarching theme was ‘the journey from pain to power’. The theme ‘the hurt me’ describes the previous caesarean experience and resulting feelings. Women experience a journey of ‘peaks and troughs’ moving from their previous caesarean to their vaginal birth after caesarean. Achieving a vaginal birth after caesarean was seen in the theme ‘the powerful me,’ and the resultant benefits are described in the theme ‘the ongoing journey’.

Conclusion

Women undergo a journey from their previous caesarean with different positive and negative experiences as they move towards their goal of achieving a vaginal birth after caesarean. This ‘journey from pain to power’ is strongly influenced by both negative and positive support provided by health care practitioners. Positive support from a health care professional is more common in confident practitioners and continuity of care with a midwife.  相似文献   
248.
Although social justice is a central professional value of social work articulated in ethics codes, clinical social workers have been long criticized for not clearly incorporating this professed commitment into practice. Supervision is an optimal space within which clinicians can develop knowledge and skills to attend to the issues related to social justice in their practice. A growing body of literature emphasizes social justice in the delivery of clinical services, yet there is a death of literature on how clinical supervision can promote social justice seeking clinical work. In this paper, we draw from existing literature to identify key elements involved in social justice seeking clinical supervision. Using Goodyear’s (Clin Superv 33:82–99, 2014) learning mechanisms of clinical supervision, which consists of modeling, feedback, direct instruction, and self-directed learning, we discuss a case composite to illustrate ways in which clinical supervision can serve as a pedagogical space to advance clinical social workers’ commitment to social justice.  相似文献   
249.
Are the marriages of lower income couples less satisfying than the marriages of more affluent couples? To address this question, we compared trajectories of marital satisfaction among couples with a wide range of household incomes. The marital satisfaction of 862 Black, White, and Latino newlywed spouses (N = 431 couples) was assessed five times, each 9 months apart, during the first 4 years of marriage. Lower income couples did not have less satisfying marriages on average, nor did their satisfaction decline more steeply on average. They did, however, experience (a) significantly greater fluctuations in marital satisfaction across assessments and (b) significantly more variability between husbands and wives. If efforts to support the marriages of low‐income couples are to address the unique characteristics of their marital development, these findings suggest that efforts to stabilize their marriages may be more effective than efforts to improve their satisfaction alone.  相似文献   
250.
The first aim of this systematic review was to evaluate the evidence for family psychoeducation (FPE) interventions for major depressive disorder (MDD). A second aim was to compare the efficacy of different modes of delivering face‐to‐face FPE interventions. Ten studies (based on nine distinct samples) were identified comprising four single‐family studies, four multifamily studies, one single versus multifamily comparative study, and one peer‐led, mixed‐diagnosis study. Seven studies measured patient functioning and six reported positive outcomes. Six studies measured carer's well‐being and four reported positive outcomes. Results provide preliminary evidence that FPE leads to improved outcomes for patient functioning and family–carer's well‐being for persons with depression. The implications for future development and delivery of FPE interventions for MDD are discussed.  相似文献   
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