Gay youth and gay adults: bridging the generation gap

Recent discussion of lesbian, gay, bisexual, and trans (LGBT) youth has included two emphases: the burgeoning trend toward youth-supportive organizations and focus on risk factors experienced by these youth. In practice, the two are intertwined: the need for youth-supportive endeavors is typically demonstrated by appeals to the risks LGBT youth face. Relatively little attention has been given to relationships between youth and adults in LGBT communities. This article employs data from a long-term qualitative study with LGBT youth, supported by information from numerous other settings to suggest that a failure on the part of both groups fully to comprehend the experience of the other hampers the optimal functioning of everyone involved. In particular, we suggest that the discourse about the dangers faced by LGBT youth, despite its being thoroughly well-intentioned. may actually place these teens at greater risk.     

Evaluating risk: global fees and episodic care

In 1999, two articles in The Physician Executive -- "Part I: Global Theory and the Nature of Risk (July-August)." and "Part II: Towards a Choice-Based Model of Managed Care (October-November)" -- outlined the flaws of orthodox managed care theory and highlighted the unique advantages of moving to a genuinely market-based model, which included the concept of direct contracting for integrated episodes of care. This follow-up focuses on comparing an episode contracting system to a traditional capitated program and outlines the features that make this approach much more attractive to physicians, payers, and most importantly patients.     

A formulation of the concept of probability based on the use of experimental devices

This paper sets out to identify the abilities that a person needs to be able to successfully use an experimental device, such as a probability wheel or balls in an urn, for the elicitation of subjective probabilities. It is assumed that the successful use of the device requires that the person elicits unique probability values that obey the standard probability laws. This leads to a definition of probability based on the idea of the similarity between the likeliness of events and this concept is naturally extended to the idea that probabilities have strengths, which relates to information about the likeliness of an event that lies beyond a simple probability value. The latter notion is applied to the problem of explaining the Ellsberg paradox. To avoid the definition of probability being circular, probabilities are defined such that they depend on the choice of a reference set of events R which, in simple cases, corresponds to the raw outcomes produced by using an experimental device. However, it is shown that even when the events in R are considered as having an “equal chance” of occurring, the values and/or strengths of probabilities can still be affected by the choice of the set R.     

The Interpretation of Line of Regard by Prelingually Deaf Children

The ability of 5- to 12-year-old deaf children to utilise and interpret another person's visual line of regard (where the eyes are looking) was studied in four experiments using cartoon faces. The children had little difficulty in determining whether or not a face was looking directly at them. They had more difficulty, however, with more complex tasks requiring them to infer mental states of desire and intention from line of regard and to ignore line of regard when it was inappropriate to attend to this cue. Deaf children raised in a hearing environment appear to have more difficulty with these more complex tasks than hearing children. The results are discussed in terms of the special difficulties facing some deaf children in the development of skills involving utilisation of line of regard and the implications for the development of joint attentional behaviour, theory of mind and dyadic social interaction in deaf and hearing children.     

THE PROCESS OF CHANGE IN COUPLES THERAPY: A QUALITATIVE INVESTIGATION

Open-ended interviews with 24 couples therapy clients regarding their experience of the process of change revealed shifts in clusters of affect, communication, and cognition. Six additional contextual preconditions for change were also identified. The change process within couples was uniformly reported to be gradual.     

Subjective Health-Related Quality of Life in Homeless and Vulnerably Housed Individuals and Its Relationship with Self-Reported Physical and Mental Health Status

Although the association between homelessness and objective indicators of poor health is well-established, little research has focused on the subjective health-related quality of life of homeless and vulnerably housed (HVH) individuals. This study examined the subjective health-related quality of life of HVH individuals, using the Multiple Discrepancies Theory (MDT) Scale for Health of the Quality of Life for Homeless and Hard-to-House Individuals (QoLHHI) Inventory, and its association with self-reported functional health status, as measured by the SF-12, and self-reported physical and mental health conditions in a sample of 100 HVH individuals recruited in Vancouver, Toronto and Ottawa. Our findings indicate that physical and mental health conditions are highly prevalent among HVH individuals and that the SF-12 Physical and Mental Component Summary scores are substantially lower compared to US population norms. The MDT Health items were not statistically significantly associated with physical or mental health conditions and only showed correlations of small to moderate magnitude with the SF-12 Component Summary Scales. These findings suggest that the QoLHHI MDT Scale for Health can provide information about HVH individuals’ subjective health experiences that is different from, and can serve as a valuable complement to, health status information for use in research and evaluation studies, as well as for policy purposes to make informed decisions based on subjective health-related quality of life data from HVH individuals.     

How Does Relative Income and Variations in Short-Run Wellbeing Affect Wellbeing in the Long Run? Empirical Evidence From China’s Korean Minority

Cognitively appraised life satisfaction is relatively stable over time and can be considered as reflecting subjective wellbeing in the long run. Affect is transitory and can be considered as reflecting subjective wellbeing in the short run. Using the Personal Wellbeing Index to measure cognitively appraised life satisfaction and the Positive and Negative Affect Schedule to measure positive and negative affect we examine how income relative to one’s comparator group and variations in short run wellbeing impact upon wellbeing in the long run. We do so for China’s Korean ethnic minority. We find that affective state has an effect on wellbeing in the long run and that a negative shock to affectivity is more persistent than a positive shock. We also find that relative income, rather than absolute income, matters for wellbeing in the long run and that the results are consistent with a status effect.