Cigarette smoking and cessation among trade or technical school students in Texas

Although students enrolled in trade or technical colleges are at an elevated risk for tobacco use, virtually no information exists regarding their smoking behaviors. OBJECTIVE AND PARTICIPANTS: In the present study, the authors examined (1) the prevalence of smoking and quitting among 617 students in 2 trade or technical colleges in East Texas and (2) on-campus media exposure to antitobacco messages. METHODS: Students voluntary completed the 42-item Texas Trade and Technical School Tobacco Survey during a required introductory-level class. RESULTS: Of the participating students, 34% reported past-30-day smoking (current smoking). Of current smokers, 74% reported a previous quit attempt and 64% wanted to quit before graduation. Although most current smokers expressed a desire to quit smoking, the antitobacco message they were least likely to see on campus was that regarding how to quit. Current smokers cited their own health as the most likely reason to quit smoking, and most reported wanting to quit on their own, without the use of resources. However, of the 9 listed resources, students were most likely to report the possible use of medication. CONCLUSIONS: Given that most smoking students desire to quit smoking--and that they are enrolled in trade or technical schools for an extended period of time--additional research should examine how successful interventions can be delivered at the trade or technical school itself.     

Sources of error in reported childlessness in a continuous British household survey

A recent investigation of the British General Household Survey (GHS) found substantial over-reporting of childlessness in recent years, particularly at older ages. We examine the phenomenon in further detail and find that the principal cause was change in survey procedures. To some extent the bias can be corrected for by using information on own children in the household. Revised fertility histories give period estimates of total fertility that are in close agreement with national vital registration statistics, unlike those based on original fertility histories of recent years. Misreporting in fertility histories dates primarily from administrative changes in the GHS in the years 1998-2000, and particularly from 2003, when the option of laptop self-completion (CASI) was introduced for reporting demographic histories.     

Identifying Therapeutic Action in an Attachment-Centered Intervention with High Risk Families

This paper describes an attachment-based intervention for mothers known to Child Welfare Services where past and current trauma complicates family preservation and promotion of child well being. The first part of the paper describes the innovative Attachment-Centered Parent–Child Therapy service that has been delivered to high-risk families with children from 0 to 3 years of age. The intervention uses a group format that has the added benefits of enhancing social support and being highly cost effective. The intervention also integrates video filming both in terms of capturing essential features of the group intervention for review and supervision of clinical staff, and is fundamental in the observation-based empirical assessments. Quantitative data from an initial pilot study supporting the efficacy of the intervention is presented. As well, qualitative data is presented including a case study that highlights therapeutic action shown to positively impact the quality of the mother–child relationship.     

Austerity and the lives of people with learning disabilities. A thematic synthesis of current literature

Abstract

The Financial Crisis of 2008 resulted in many western economies implementing cuts in health and social care. This systematic review provides a holistic picture of the impact of austerity policy on the lives of people with learning disabilities (LD) and the collateral effects on the people who support them. Our review suggests that in the current climate of economic austerity, available funding to support people with LD is no longer aligned to their care needs. Cuts in disability services have adversely affected the well-being both of people with LD and their informal carers. Individuals with LD have lost social support and are experiencing increased social isolation. Heightened demands on family carers’ time have negatively influenced their wider roles, including parental functioning, and labour market participation. Our review provides the foundations for further discourse and research on the effects of austerity on people with LD and their family carers.     

Review and appraisal of guidelines for the management of asthma during pregnancy

Background

Asthma affects 12.7% of pregnancies in Australia. Poorly controlled asthma is associated with increased maternal and infant morbidity and mortality. Optimal antenatal management of asthma during pregnancy has the potential to reduce complications relating to asthma. Evidence-based clinical practice guidelines help to translate health research findings into practice and when implemented can improve health outcomes. National and International guidelines currently provide recommendations for optimal asthma care in pregnancy.

Client Perceptions of Professional Helpers

A questionnaire was administered to 77 employees of a large commercial organization and 61 paramedical workers to ascertain which of a number of professionals were likely to be approached for help with particular types of problems. The findings for this study indicated that for both groups social workers were the most preferred professionals by most subjects for most problems, although there were important and interesting preferences for other professionals also.     

Marginal regression models with a time to event outcome and discrete multiple source predictors

Information from multiple informants is frequently used to assess psychopathology. We consider marginal regression models with multiple informants as discrete predictors and a time to event outcome. We fit these models to data from the Stirling County Study; specifically, the models predict mortality from self report of psychiatric disorders and also predict mortality from physician report of psychiatric disorders. Previously, Horton et al. found little relationship between self and physician reports of psychopathology, but that the relationship of self report of psychopathology with mortality was similar to that of physician report of psychopathology with mortality. Generalized estimating equations (GEE) have been used to fit marginal models with multiple informant covariates; here we develop a maximum likelihood (ML) approach and show how it relates to the GEE approach. In a simple setting using a saturated model, the ML approach can be constructed to provide estimates that match those found using GEE. We extend the ML technique to consider multiple informant predictors with missingness and compare the method to using inverse probability weighted (IPW) GEE. Our simulation study illustrates that IPW GEE loses little efficiency compared with ML in the presence of monotone missingness. Our example data has non-monotone missingness; in this case, ML offers a modest decrease in variance compared with IPW GEE, particularly for estimating covariates in the marginal models. In more general settings, e.g., categorical predictors and piecewise exponential models, the likelihood parameters from the ML technique do not have the same interpretation as the GEE. Thus, the GEE is recommended to fit marginal models for its flexibility, ease of interpretation and comparable efficiency to ML in the presence of missing data.