The cost effectiveness of hepatitis immunization for US college students

Hepatitis B immunization is recommended for all American children, and hepatitis A immunization is recommended for children who live in areas with elevated disease rates. Because hepatitis A and B occur most commonly in young adults, the authors examined the cost effectiveness of college-based vaccination. They developed epidemiologic models to consider infection risks and disease progression and then compared the cost of vaccination with economic, longevity, and quality of life benefits. Immunization of 100,000 students would prevent 1,403 acute cases of hepatitis A, 929 cases of hepatitis B, and 144 cases of chronic hepatitis B. Hepatitis B vaccination would cost the health system $7,600 per quality-adjusted life year (QALY) gained but would reduce societal costs by 6%. Hepatitis A/B vaccination would cost the health system dollar 8,500 per QALY but would reduce societal costs by 12%. Until childhood and adolescent vaccination can produce immune cohorts of young adults, college-based hepatitis immunization can reduce disease transmission in a cost-effective manner.     

Is the Person-Affecting Intuition Paradoxical?

This article critically examines some of the inconsistency objections that have been put forward by John Broome, Larry Temkin and others against the so-called "person-affecting," or "person-based," restriction in normative ethics, including "extra people" problems and a version of the nonidentity problem from Kavka and Parfit. Certain Pareto principles and a version of the "mere addition paradox" are discussed along the way. The inconsistencies at issue can be avoided, it is argued, by situating the person-affecting intuition within a non-additive form of maximizing consequentialism – a theory which then competes with such additive, or aggregative, forms of maximizing consequentialism as "totalism" and "averagism."     

Parents of psychiatrically hospitalized children: A decade of changing perceptions

Psychiatric hospitals for children have changed dramatically during the last decade. The lengths of hospitalizations have been shortened; the psychopathology of children qualifying for admission is more severe, often with neurological or biochemical components. In some hospitals, there has been an increasing emphasis on research. All of these changes have affected the staff's perceptions of the children's parents; these changes appear to have resulted in a more supportive, less critical attitude toward these parents. This may be significant in increasing parents' confidence in coping with their child's illness and their family's stress. The need for empirical, longitudinal research is emphasized.The research mentioned in this article was funded by the American Cancer Society.     

Unintentional injury: A major health problem for young children and youth

This article reviews data on childhood injury and explains how unintentional injuries have become the leading health problem for young children in the United States and a major health problem in teenage years. The article discusses the major types of childhood injuries, trends over time, and variations by location and social, behavioral, and familial risk factors. Results of epidemiological and sociobehavioral research on injury are followed by a discussion of policy considerations in the attempts to deal with childhood injury and its consequences. This includes a discussion of major ways to prevent injuries, a review of government activities, and recommendations for future efforts. Her research interests include child safety, preventive health behaviors, access to health care services, and health policy. She received her Ph.D. from Brown University in sociology in 1976. Her research interests include child safety, preventive health behavior, international health, and alternative health care models. She received her D.Sc. from Johns Hopkins University in 1985.     

A general theory of addictions: A new theoretical model

A general theory of addictions is proposed, using the compulsive gambler as the prototype. Addiction is defined as a dependent state acquired over time to relieve stress. Two interrelated sets of factors predispose persons to addictions: an abnormal physiological resting state, and childhood experiences producing a deep sense of inadequacy. All addictions are hypothesized to follow a similar three-stage course. A matrix strategy is outlined to collect similar information from different kinds of addicts and normals. The ultimate objective is to identify high risk youth and prevent the development of addictions.     

You got a problem with that? Exploring evaluators' disagreements about ethics

A random sample of American Evaluation Association (AEA) members were surveyed for their reactions to three case scenarios--informed consent, impartial reporting, and stakeholder involvement--in which an evaluator acts in a way that could be deemed ethically problematic. Significant disagreement among respondents was found for each of the scenarios, in terms of respondents' views of whether the evaluator had behaved unethically. Respondents' explanations of their judgments support the notion that general guidelines for professional behavior (such as AEA's Guiding Principles for Evaluators) can encompass sharply conflicting interpretations of how evaluators should behave in specific situations. Respondents employed in private business/consulting were less likely than those in other settings to believe that the scenarios portrayed unethical behavior by the evaluator, a finding that underscores the importance of taking contextual variables into account when analyzing evaluators' ethical perceptions. The need for increased dialogue among evaluators who represent varied perspectives on ethical issues is addressed.     

LGBT Religious Activism: Predicting State Variations in the Number of Metropolitan Community Churches, 1974–2000

Armstrong and Bernstein (2008) critique the emphasis movement scholars place upon activism within the formal political sphere, proposing, instead, a multi‐institutional approach which argues that protest can occur within any social institution and that the desired outcomes of activism can include cultural outcomes. The goal of this article is to expand the range of social movement targets studied through an examination of lesbian, gay, bisexual, and transgender (LGBT) activism within the institution of religion. In the United States, religion, particularly Christianity, is used as the primary justification for defining same‐sex sexuality as undesirable and denying LGBT individuals full citizenship. The LGBT community challenges these traditional Christian definitions of same‐sex sexuality in numerous ways, including through the creation of LGBT‐affirming congregations. I examine the development and spread of congregations affiliated with the United Federation of Metropolitan Community Churches (UFMCC), an LGBT‐affirmative denomination, across all 50 states from 1974 to 2000. Drawing upon organizational ecology, resource mobilization, political opportunity, and theories of religious switching, I find that the distribution of UFMCC congregations challenges the usefulness of traditional explanations for activism.     

Online readiness assessment for Smoke- and Tobacco-free campus policies

ABSTRACT

Objective: Develop and test an online survey to assess campus readiness to adopt smoke- and tobacco-free (SF/TF) policies. Participants: Key informants (N = 18) at four campuses in Kentucky without a SF/TF policy recruited April 2015. Methods: Cross-sectional design. The survey assessed six dimensions: knowledge about SF/TF policies; leadership for campus policy; resources for policy development; campus climate surrounding tobacco issues; existing tobacco policies; and political climate for campus policy development. Dimension raw scores were rescaled to range from 0–1 and summed to determine overall stage of readiness (0–6). Results: Political climate was highest dimension across all campuses (0.83–1.0). Knowledge dimension ranked lowest (0.0–0.50). Overall readiness scores ranged from 2.53–3.94; two campuses in preplanning and two in preparation. Conclusions: Development of the online measure is timely considering the impetus to implement SF/TF policies. Findings reinforce that campuses are at varying stages of implementing these policies, and stage-based interventions are necessary.