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.     

Defining child abuse in Hong Kong

Definitions of child abuse are culturally driven. Hong Kong, with a predominantly Chinese population, has managed to eradicate much of the societal abuse that children suffer elsewhere in Asia. Professional and government attention has now shifted to child abuse and neglect within the family. The paper, based on interviews with key professionals. analysis of policy documents and practice records examines traditional Chinese parent-child relationships. the status of parental authority and corporal punishment and changes in contemporary Hong Kong family life. It goes on to outline the development of responses to child abuse in Hong Kong, some of the dilemmas that professionals face in defining abuse and areas for future research.     

“WHAT DOES SHE SEE IN HIM?”: THE EFFECT OF SHARING ON THE CHOICE OF SPOUSE

All husbands and wives share in the spoils of marriage. Sharing makes each partner a residual claimant and encourages spouses to provide marital inputs. However, because each spouse is only a partial residual claimant, each may be inclined to provide a "suboptimal" level of marital inputs. The choice of spouse influences the level of distortion, and under some circumstances the efficient mating is between individuals of equal value     

Agency costs,property rights,and the evolution of labor unions

Collective bargaining requires that an agent represent workers. This paper examines the implications for the trade union movement of the resulting agency costs. Without transferable rights in the union, union members lack the means and incentive to bring forth the innovative agent controls common to the modern corporation. Considerations of the bargaining strengths of employers and employees, each represented by an agent, provide an explanation of the simultaneous decline of private sector union membership (corporate share holders have been more successful at lowering agency costs) and growth of public sector union representation (where the union official, a “double agent,” serves the interest of both employee and bureaucratic employer). The authors acknowledge the helpful remarks Donald L. Martin whose earlier research on property rights in unions inspired this effort. Don Bellante’s work was supported by a grant from the Research Committee of the College of Business Administration, University of South Florida.     

Evaluation of an educational intervention upon knowledge, attitudes, and behavior concerning drinking/drugged driving.

The Contra Costa County educational program for juveniles found guilty of driving under the influence (DUI) was evaluated. Over 600 juveniles convicted of DUI from 1983 to 1988 formed the study group for this research and of these over 100 participated in the educational program. Assessment of program participants was conducted for knowledge, attitudes and behavior. Participants demonstrated increased knowledge, stronger attitudes against driving under the influence, and less risky alcohol and automobile related behaviors. County juvenile records analyzed by the logit procedure showed that class participants had a significantly lower number of repeat offenses compared to non-program participants that could not be explained by race, offense severity, age or gender.     

Naturally occurring play patterns in groups of latency aged children

This study examines the influence of the socialization of aggression among different gender and social class groupings and the influence of psychosocial stage on cognitive developmental play preferences among groups of school aged children. Observations of 143 play groups were coded for play preference (symbolic play, practice play, games with rules) and play performance (cooperative or competitive). Findings of the log-linear data analysis suggest a middle class and masculine bias in Piaget's cognitive model (i.e., that as age increases children prefer more games with rules). This model held only for middle class and affluent boys. Girls (both latency and prepubertal) and lower socioeconomic groups tended to prefer practice play. Girls were more likely to play cooperatively; boys more likely to play competitively. Implications for theory development and clinical practice are explored.     

Small Town in Mass Society Revisited1

Abstract The case study of a small New York town that dramatized the thesis that the secular expansion of macro forces—urbanization, industrialization, bureaucratization—has permanently reduced the autonomy of all small communities is an example of a special type of discovery/persuasion strategy in the social sciences: the “opposition case study.” In contrast to the more rigorous “competitive test” or the atheoretical “negative case,” opposition case studies confront the dominant perspective with a qualitative illustration of a new theory in the context of a zero-sum game. When they are successful, opposition cases meet four criteria: the dominant view is immediately rendered obsolete; the origin of the new idea supports its plausibility; the new perspective is shown to be testable; and the new perspective quickly generates new lines of research. Small Town in Mass Society meets the first criterion, and may have been heuristic, but its probable origin in populist ideology undermines its testability.     

Creating offshore-ready it professionals: A global perspective and strong collaborative skills are needed

Outsourcing of IT functions has become a widespread corporate practice, which has naturally led to concerns among IT works about how this affects their jobs. The issue is complex, and many companies are bringing their IT functions back inhouse. In light of this complexity, what skills do IT workers need to be com-petitive? We address this question first by reviewing the literature and then by examining two corporate case studies that have dealt with outsourcing issues. Based on this view of outsourcing, we discuss the skills that can provide a com-petitive advantage in the current environment.