Gay Affirmative Practice: A Model for Social Work Practice with Gay,Lesbian, and Bisexual Youth

Gay affirmative practice has recently been introduced into the social work literature as a culturally sensitive model for working with gay, lesbian, and bisexual (GLB) adults, however, this model has rarely been applied to practice with GLB youth. In this article, the authors review the literature to present the main tenets of gay affirmative practice, outline the challenges that GLB youth face, and delineate the environmental and individual strengths that can be enhanced to promote well-being. The authors then apply the gay affirmative practice model to GLB youth, offering concrete information about the specific knowledge, attitudes, and skills that social workers should acquire to better serve the unique, yet diverse, needs of GLB youth.     

Case study in the Bayesian analysis of a cost‐effectiveness trial in the evaluation of health care technologies: Depression

We present a case study based on a depression study that will illustrate the use of Bayesian statistics in the economic evaluation of cost‐effectiveness data, demonstrate the benefits of the Bayesian approach (whilst honestly recognizing any deficiencies) with respect to frequentist methods, and provide details of using the methods, including computer code where appropriate. Copyright © 2003 John Wiley & Sons, Ltd.     

Individualism vs Collectivism in Different Cultures: A cross-cultural study

In this study, individualism vs collectivism, in line with the work of Triandis in 1985, was assessed in two groups of male and female students, in Egypt and Germany. The results confirm the effect that cultural background has on individualist vs collectivist orientations in both of these cultures for male and female students. Men and women scored higher on individualism in Germany than in Egypt, whereas collectivism scores were higher in Egypt than in Germany. These findings are discussed in terms of general recommendations for intercultural interventions that discourage viewing people solely in terms of group membership, and instead as distinct individuals.     

Distal and Proximal Factors in Domestic Violence: A Test of an Integrated Model

We employed 4,095 couples from both waves of the National Survey of Families and Households (NSFH) to test a model of couple violence drawn from several theoretical perspectives. The outcome distinguishes among nonviolent couples and those experiencing either physical aggression or intense male violence. According to the model, background characteristics of couples are related to relationship stressors, which affect the risk of violence via their tendency to promote verbal conflict. Considerable support for the model was found. Couples were at higher risk for one or both forms of violence if they were younger at union inception, had been together for less time, were both in their first union, had only one partner who was employed, had a nontraditional woman paired with a traditional man, had at least one partner who abused substances, had more children, had more frequent disagreements, exhibited a more hostile disagreement style, or lived in an economically disadvantaged neighborhood. Moreover, the effects of stressors such as the number of children and couples' employment status disparities appear to be mediated by disagreement frequency and disagreement style.     

"Her" Marriage after the Revolutions

Recent social changes have made husbands' emotional investments and wives' perceptions of equity in the division of housework crucial for women's marital happiness. But wives are also happiest in their marriages when they share a strong normative commitment to lifelong marriage with their husbands and when their husbands take the lead in breadwinning. Thus our research suggests that elements of the new and the old promote marital happiness among contemporary wives.     

Scaling up CBOs for second‐order devolution in welfare reform

The Personal Responsibility and Work Opportunity Act of 1996 created a paradigm shift in the financing, organization, and delivery of welfare programs in the United States. The act shifted revenue and authority to states, giving them great discretion to determine the specifics of their programs. First‐order devolution, combined with time limits and work requirements, set in motion a chain of events that moved Temporary Assistance to Needy Families (TANF) recipients into the labor force and off state welfare rolls. Second‐order devolution shifted revenue and authority to community‐based organizations (CBOs) to help former recipients remain employed, advance to higher paying jobs, and move their families toward economic self‐sufficiency. Early findings from project innovations in Texas and other states raise doubts about the capacity of these organizations to achieve these goals. State funders will need to provide ongoing technical assistance and support to “scale up” the capacity of CBOs to plan, implement, and manage local innovations in welfare reform.     

Loss functions for estimation of extrema with an application to disease mapping

It is often of interest to find the maximum or near maxima among a set of vector‐valued parameters in a statistical model; in the case of disease mapping, for example, these correspond to relative‐risk “hotspots” where public‐health intervention may be needed. The general problem is one of estimating nonlinear functions of the ensemble of relative risks, but biased estimates result if posterior means are simply substituted into these nonlinear functions. The authors obtain better estimates of extrema from a new, weighted ranks squared error loss function. The derivation of these Bayes estimators assumes a hidden‐Markov random‐field model for relative risks, and their behaviour is illustrated with real and simulated data.     

An empirical examination of cost-adjusting in outpatient clinics

This paper presents an empirical methodology for examining cost-adjusting in relation to multiple-output health care providers. The methodology is subsequently implemented using a sample of California outpatient clinics. The empirical evidence is that these clinics do cost-adjust; that is, the clinics respond to low Medicare reimbursement by using lower quality to control the marginal costs of those patient groups not insured under a government-sponsored plan. In addition, clinics do not cost-adjust with respect to Medi-Cal patients, implying that various government reimbursement systems have different effects on a provider’s cost-adjusting behavior.