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.     

Postcards from the Edge of the Color Line: Images of African Americans in Popular Culture, 1893–1917

This paper examines visual representations of African Americans on postcards from 1893 to World War I. Caricatures of African Americans found on these popular cultural artifacts frequently employ the visual metaphor of other-as-beast. To map the discursive features of this form of racist ideology, attention is paid to the icono-graphic and linguistic strategies employed to depict African Americans as physically, intellectually, and temperamentally distinct and inferior. While no oppositional readings to this racist discourse were located in the flip-side messages of the senders, resistance was located in the contemporaneous popular culture of African Americans.     

Mean squares in saturated fractional designs revisited

In a previous paper (Bissell, 1989) some suggestions were offered for interpreting mean squares in saturated fractional designs where no independent estimate of experimental error is available. One of the methods leads to a simple numerical test of homogeneity which provides an objective accompaniment to half-Normal plotting of effects (Daniel, 1959) in 2n designs or exponential plotting of mean squares (Bissell, 1989) in 3n designs. A table of percentage points for a convenient test statistic is provided in this paper.     

Women's Changing Attitudes Toward Divorce, 1974–2002: Evidence for an Educational Crossover

This article examines trends in divorce attitudes of young adult women in the United States by educational attainment from 1974 to 2002. Women with 4‐year college degrees, who previously had the most permissive attitudes toward divorce, have become more restrictive in their attitudes toward divorce than high school graduates and women with some college education, whereas women with no high school diplomas have increasingly permissive attitudes toward divorce. We examine this educational crossover in divorce attitudes in the context of variables correlated with women's educational attainment, including family attitudes and religion, income and occupational prestige, and family structure. We conclude that the educational crossover in divorce attitudes is associated most strongly with work and family structure variables.     

Factor analysis for ranked data with application to a job selection attitude survey

Summary.  Factor analysis is a powerful tool to identify the common characteristics among a set of variables that are measured on a continuous scale. In the context of factor analysis for non-continuous-type data, most applications are restricted to item response data only. We extend the factor model to accommodate ranked data. The Monte Carlo expectation–maximization algorithm is used for parameter estimation at which the E-step is implemented via the Gibbs sampler. An analysis based on both complete and incomplete ranked data (e.g. rank the top q out of k items) is considered. Estimation of the factor scores is also discussed. The method proposed is applied to analyse a set of incomplete ranked data that were obtained from a survey that was carried out in GuangZhou, a major city in mainland China, to investigate the factors affecting people's attitude towards choosing jobs.     

Gender,lineage, and fertility‐related outcomes in Ghana

A growing literature examines the empirical relationship between the joint reproductive preferences of marital partners and reproductive outcomes in Africa. Less explored is how spousal power in decision making may be influenced by lineage type. Using pooled data from Ghana, we investigate how lineage affects gendered reproductive decision outcomes and find some evidence that matrilineal women are more able than nonmatrilineal women to translate their reproductive preferences into action consistent with their goals.