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.     

Postcards from the Edge of the Color Line: Images of African Americans in Popular Culture, 1893–1917

This paper examines visual representations of African Americans on postcards from 1893 to World War I. Caricatures of African Americans found on these popular cultural artifacts frequently employ the visual metaphor of other-as-beast. To map the discursive features of this form of racist ideology, attention is paid to the icono-graphic and linguistic strategies employed to depict African Americans as physically, intellectually, and temperamentally distinct and inferior. While no oppositional readings to this racist discourse were located in the flip-side messages of the senders, resistance was located in the contemporaneous popular culture of African Americans.     

Women's Changing Attitudes Toward Divorce, 1974–2002: Evidence for an Educational Crossover

This article examines trends in divorce attitudes of young adult women in the United States by educational attainment from 1974 to 2002. Women with 4‐year college degrees, who previously had the most permissive attitudes toward divorce, have become more restrictive in their attitudes toward divorce than high school graduates and women with some college education, whereas women with no high school diplomas have increasingly permissive attitudes toward divorce. We examine this educational crossover in divorce attitudes in the context of variables correlated with women's educational attainment, including family attitudes and religion, income and occupational prestige, and family structure. We conclude that the educational crossover in divorce attitudes is associated most strongly with work and family structure variables.     

The current state of the labor queue: National and regional Evidence

We employ vector autoregressive techniques to determine the current state of the labor queue. Unemployment rate differentials have narrowed in recent years, potentially due to a change in the queue ordering, though a tight labor market and a stable queue would yield similar results. We find no evidence that the queue ordering has changed, which brings into question the resiliency of gains made by minority groups. We employ the same techniques to reveal the state of the queue across geographic regions and find that substantial differences exist across regions, implying variation in the relative labor force status of demographic groups.     

Growing Disability Rates — the Gender Issue: The Dutch Case in an International Perspective

In the Netherlands, with its remarkably high disability rates, a new phenomenon seems to be emerging. Growing disability rates in the past few years have been exclusively caused by the growing inflow of women into the disability schemes. Comparing the Dutch situation internationally shows that roughly the same problem seems to exist in those countries in which there is a more general problem of large inflow into disability. Women are overrepresented in these arrangements. The Dutch literature shows that there are many factors (both work- and non-work-related) that contribute to a larger push of women towards disability. We conclude that the benefit system can be seen as a sort of "filter". If the filter is weak, many persons will enter disability. If the pressure on women to enter is larger (or the forces to stop women from entering disability smaller), then inflow risks for women will be higher.     

Bayesian analysis of a marked point process: Application in seismic hazard assessment

Point processes are the stochastic models most suitable for describing physical phenomena that appear at irregularly spaced times, such as the earthquakes. These processes are uniquely characterized by their conditional intensity, that is, by the probability that an event will occur in the infinitesimal interval (t, t+Δt), given the history of the process up tot. The seismic phenomenon displays different behaviours on different time and size scales; in particular, the occurrence of destructive shocks over some centuries in a seismogenic region may be explained by the elastic rebound theory. This theory has inspired the so-called stress release models: their conditional intensity translates the idea that an earthquake produces a sudden decrease in the amount of strain accumulated gradually over time along a fault, and the subsequent event occurs when the stress exceeds the strength of the medium. This study has a double objective: the formulation of these models in the Bayesian framework, and the assignment to each event of a mark, that is its magnitude, modelled through a distribution that depends at timet on the stress level accumulated up to that instant. The resulting parameter space is constrained and dependent on the data, complicating Bayesian computation and analysis. We have resorted to Monte Carlo methods to solve these problems.     

Population constraints on pooled surveys in demographic hazard modeling

In non-experimental research, data on the same population process may be collected simultaneously by more than one instrument. For example, in the present application, two sample surveys and a population birth registration system all collect observations on first births by age and year, while the two surveys additionally collect information on women’s education. To make maximum use of the three data sources, the survey data are pooled and the population data introduced as constraints in a logistic regression equation. Reductions in standard errors about the age and birth-cohort parameters of the regression equation in the order of three-quarters are obtained by introducing the population data as constraints. A halving of the standard errors about the education parameters is achieved by pooling observations from the larger survey dataset with those from the smaller survey. The percentage reduction in the standard errors through imposing population constraints is independent of the total survey sample size.