A Multistate model of fecundability and sterility

This paper develops a multistate hazards model for estimating fecundability and sterility from data on waiting times to conception. Important features of the model include separate sterile and nonsterile states, a distinction between preexisting sterility and sterility that begins after initiation of exposure, and log-normally distributed fecundability among nonsterile couples. Application of the model to data on first birth intervals from Taiwan, Sri Lanka, and the Amish shows that heterogeneity in fecundability is statistically significant at most ages, but that preexisting sterility and new sterility are unimportant before age 40. These results suggest that sterility may not be an important determinant of natural fertility until later reproductive ages.     

Turn it around: short-term management for aggression and anger

1. Although nurses are at considerable risk for assaults, there are few practical and specific guidelines for controlling anger and aggression. 2. A training course was developed to give staff the necessary skills and knowledge to cope with clients who have the potential to become angry and assaultive, or those who have already become violent. 3. Participants in the training course felt more confident in managing potentially violent situations, and they reported relying on methods to de-escalate the situation to halt a sequence that would ultimately lead to violence.     

THE CLINICAL AND THEORETICAL IMPACT OF A CONTROLLED TRIAL OF FAMILY THERAPY IN ANOREXIA NERVOSA

The paper discusses the practical and theoretical implications of the results of a controlled treatment trial. Family therapy was compared with individual, supportive psychotherapy for the management of severe eating disorder. Family therapy was markedly more effective in achieving improvement in one of four subgroups of patients: (a): those with early onset, short duration; (b) early onset, duration more than 3 years; (c) late onset, after the age of 18 years; (d) those with bulimia nervosa. The therapies used are described, as are the changes in clinical practice arising from the study. Theoretical considerations concerning notions of family structure, the family life-cycle and symptomatic and family change are also discussed.     

On estimating the difference of location parameters of two negative exponential distributions

Fixed-width confidence intervals for the difference of location parameters of two negative-exponential distributions have been constructed through two-stage and purely sequential schemes. The two cases when the scale parameters are equal but unknown, and unequal but unknown, have been dealt with separately. Our two-stage procedures guarantee the exact confidence coefficient to be at least the nominal prescribed level. Various second-order expansions are also considered when sequential procedures are proposed. It is noted that no new tables are needed to implement these procedures in practice.     

MARITAL AND FAMILY THERAPY CERTIFICATION AND LICENSING EXAMINATIONS: ONE MODEL*

The design of the North Carolina Marital and Family Therapy Certification Examination is outlined by its authors to provide a frame of reference for the development of other licensing and certification instruments. The purpose, procedures, resources, guidelines, content, and normative data of the examination are described. The model is offered to stimulate meaningful dialogue on marital and family therapy licensing and certification instrumentation. Guidelines toward the development of a national marital and family therapy examination are also presented.     

Borderline daughters: An optimal configuration for their growth

A significant majority of patients with borderline personality disorder, in a long-term psychiatric hospital for adolescents, had been the daughters of younger middle class mothers (14–20) with fathers absent since birth or before age 5. This family configuration is optimal for the growth of a symbiotic mother-daughter relationship and the identity disorder prevalent in borderline patients. The similar histories of these patients are examined. They can be described in two categories: those who combine precocious sexuality with infantile behavior and a smaller group with a somewhat masculine pseudo-mature identity. The first group usually attempts to retreat to the father, has clinging, dependent relationships with males, sexually acts out and is at a very high risk for pregnancy and a repetition of the mothers' lives.This paper was presented at the American Association of Psychiatric Services for Children, Las Vegas, Nevada, March, 1986.Mr. Levy is at Wesleyan University     

Distribution-free test for symmetry based on Wilcoxon two-sample test

McWilliams introduced a test of symmetry based on a runs statistic for a continuous distribution about a known median. His test statistic R* performs better than other competitors considered in his study. In this paper, we present a conditional test for symmetry based on a Wilcoxon two-sample test. The proposed test turns out to be competitive with the test of McWilliams.     

The State of Medical Sociology—A Review Essay*

Birenbaum, Arnold, 1981. Health Care and Society. Montclair: N.J.: Allanheld Osmun. Bowling, Ann. 1981. Delegation in General Practice: A Study of Doctors and Nurses. London: Tavistock Publications. Cockerham, William C. 1982. Medical Sociology. 2d ed. Englewood Cliffs, N.J.: Prentice-Hall. Locker, David. 1981. Symptoms and Illness: The Cognitive Organization of Disorder. London: Tavistock Publications.