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.     

石油亚砜PSO—Ⅱ与P_(204),P_(507)萃取稀土的研究

分别用P_(204),P_(507),PSO—Ⅱ单独萃取混合氯化稀土,得到了萃取稀土的最佳条件,并对P_(204)与PSO—Ⅱ、P_(507)与PSO—Ⅱ,协同萃取稀土元素进行了初步探讨,发现P_(204)与PSO—Ⅱ,P_(507)与PSO—Ⅱ两者在萃取混合氯化稀土的试验条件下,均无协同效应。     

Working with Deaf People

Whilst 17% of the population experience some degree of hearing loss, sociology has largely neglected the study of services to this group. This article attempts to move the debate from a sociology of the deaf community to a sociology of deafness that includes an examination of how professionals define the needs of hearing impaired people. Despite differences between different constructions, deafness workers offer a combination of social work, information, and interpreting services. Practice rules have been developed by deafness workers to control workloads, and to work in their preferred way. This article is based on a multi-layered approach with a contextual analysis, a survey of 123 deafness workers, 32 semi-structured interviews, and my own personal experience of deafness work.     

The Farm Crisis and Mental Health: A Longitudinal Study of the 1980s1

Abstract This paper examines rural/urban differences and trends in mental health during the farm crisis of the 1980s in a large panel sample from a midwestern state. A community research perspective, which attributes differences to life styles, culture, and community context, is contrasted with an economic stress perspective, which focuses on individual differences in economic circumstances as determinants of rural-urban differences in mental health. Survey samples from 1981, 1986, and 1989 are used to examine differences among seven categories of community type. Multiple regression analysis of the trend and panel data provide support for both the individual economic distress and community context models.     

Will taxpayers ever like taxes?: Responses to the U.S. Tax Reform Act of 1986

Major policy changes like the 1986 Tax Reform Act (TRA) in the United States provide natural experiments to study attitudinal and behavior responses to law. Surprisingly, public evaluations of the TRA became increasingly negative after passage, while general support for the tax system became more positive in response to the changes. To explain this puzzle, we propose a dynamic model of taxpayer attitudes that is consistent with the observed loose linkage between logically-connected concepts. We briefly review the political context, objectives and impacts of the 1986 Tax Reform Act, and present several studies testing the impact of self-interest, prior beliefs, and social discussion on changes in attitudes and behavior.Results suggest that the complexity of taxes and difficulty in knowing objective impacts weakens the role of self-interest in attitudinal changes, thereby strengthening the role of prior beliefs and discussion. Evaluations of tax laws are most responsive to more politically-oriented influences.     

Informal Work in Nonmetropolitan Pennsylvania1

Abstract It is well recognized that the informal economy—unregulated economic activities that generate real or in-kind income—features prominently in the day-to-day lives of many in the developing world. Researchers have begun to explore the informal economy in developed countries but this work has focussed primarily on urban areas to the neglect of rural areas. In this paper the nature and correlates of informal work in nonmetropolitan Pennsylvania are described through an analysis of survey data on 505 families. Results indicate that participation in informal activities is widespread, is not more typical of the poor, does not contribute greatly to family income on average but does help many poor families weather difficult economic times, is both economically and noneconomically motivated, and, net of other sociodemographic variables, is positively related to rurality of residence and formal labor supply.