Longitudinal cost of services in a homeless sample with cocaine use disorder

ABSTRACT

Homeless people with cocaine use disorder have multiple comorbidities and costly service needs. This study examined service costs associated with cocaine use and substance service use in substance, psychiatric, and medical service sectors. 127 homeless participants with cocaine use disorder were interviewed annually. Self-report and agency-report service use and cost data were combined. Pairwise comparisons were made with cocaine abstinence and substance service use in relation to mean and yearly proportional service costs in 3 service sectors. Among substance service users, the achievement of abstinence was not associated with decreased substance service costs. Cocaine abstinence was associated with proportional reduction of substance service costs over time. Substance service use was associated with proportional reduction of psychiatric service costs over time among the abstinent subgroup. Conversely, substance service use was associated with continuing higher medical service expenditures in the abstinent subgroup and higher psychiatric service expenditures in those not abstinent. Homeless individuals who achieved cocaine abstinence after using substance services had decreased substance service expenditures. Individuals with continued substance service use had greater medical and psychiatric service costs. Policy-based on maximizing benefits while minimizing costs appears insufficiently complex to incorporate the multiple needs and associated with the costs of treating homeless populations.     

Emergence of Nonsexual Crimes and Their Relationship to Sexual Crime Characteristics and the Deviant Arousal of Male Adolescent Sexual Offenders: An Exploratory Study

In this study, we explore nonsexual crimes committed by a sample of 437 incarcerated adolescent sexual offenders as well as deviant arousal and its relationships to nonsexual and sexual crimes. Over 50% of the juvenile sexual offenders in this sample have committed nonsexual offenses. In addition, nonsexual crimes, particularly general delinquency, were significantly correlated to a number of characteristics of sexual crimes committed by the youth. Previous research has shown that sexually abusive youth are more likely to recidivate nonsexual crimes, and among the implications of this study is the need for treatment providers and service delivery systems to address nonsexual as well as sexual crimes.     

Early Marriage,Rape, Child Prostitution,and Related Factors Determining the Psychosocial Effects Severity of Child Sexual Abuse in Ethiopia

This study was aimed at identifying factors that determine the psychosocial effects severity of child sexual abuse. Data were collected from 318 female children in Ethiopia using the Children's Impact of Traumatic Events Scale–Revised and the Rosenberg Self-Esteem Scale. The results revealed that respondents who survived rape and child prostitution were more symptomatic than those who were married early. Respondents for whom less time had elapsed since their first experience of abuse demonstrated a significantly higher level of post-traumatic stress disorder symptoms, negative reactions by others, self-blame, and guilt than those for whom more time had elapsed since such an experience. The respondents in an intact marital relationship were found to be less symptomatic than their never married and divorced counterparts. Implications for intervention and further investigations are discussed.     

Substance Use Patterns and Consequences Among Lesbians,Gays, and Bisexuals

Substance abuse among gays and lesbians may be considered a “neglected area” of drug use research in criminology and criminal justice. In the current study, we seek to address the lack of scientific inquiry on substance use among lesbians, gays, and bisexuals by drawing from an availability sample of 179 lesbian, gay, and bisexual (LGB) adults to examine substance use patterns as well as the relationship of self-esteem with problems associated with using alcohol and drugs. Results showed consistency in the frequency of tobacco, alcohol, marijuana, and cocaine use in the past year; however, more gay and bisexual men than gay and bisexual women reported problems stemming from substance use.     

Delivering LGBT-sensitive substance use treatment to sexual minority women

Abstract

Epidemiologic studies have consistently found elevated rates of alcohol and other substance use among sexual minority women (SMW), and despite calls for “lesbian, gay, bisexual, and transgender (LGBT)-specific” services and culturally tailored interventions, few such services exist. This study involved qualitative interviews with directors from substance use treatment programs (N?=?10) about how they addressed the needs of SMW. Strategies implemented primarily focused on creating a safe and welcoming environment for sexual minority clients. Findings highlight challenges involved in meeting the treatment needs of SMW and provide guidance to researchers and service providers on how to improve the quality of care for them.     

Psychosocial Correlates of Methamphetamine Use

Methamphetamine (MA) abuse is a devastating problem that has been sweeping the United States from west to east and has reached epidemic proportion in many areas. Literature on the drug itself, its history, and its effects are reviewed. The current project aimed to examine the psychosocial correlates of MA use using Hudson's Multi-Problem Screening Inventory (MPSI). The MPSI was given to a control group consisting of undergraduate social work students (n = 17) and a group of past-year MA users (n = 15). Differences between users and non-users were examined across the 27 domains of the MPSI, and subscales for which MA users exceeded the clinical cutting score were noted. In addition, the correlation between severity of craving for MA and MPSI scores was examined. MA users differed significantly from non-users on the depression, partner, child and neighbor problems, aggression, fearfulness, ideas of reference, phobias, guilt, disturbed thinking, memory loss, and drug abuse subscales. MA users exceeded clinical cutting scores on all of these scales except child problems; fearfulness; ideas of reference; self-esteem; sexual discord; personal stress; friend, school and coworker problems; and confused thinking. Severity of craving was correlated with MPSI score on all MPSI scales except self-esteem; sexual discord; mother, father, friend, coworker, school and family problems; suicide; non-physical abuse; and alcohol abuse. Interesting findings regarding the control group are also discussed.     

Linking Housing,Social Services and Family Well-Being

Abstract

Securing adequate housing is a key component in achieving family well-being and a decent quality of life. It is expected that as many as twenty percent of the families currently on welfare, many of whom are disproportionately female and African American, may not be employable by the end of their lifetime benefit. These families, classified as “hard-to-serve” or “hard-to-employ,” are headed by an adult who may be struggling with substance abuse, physical or mental health problems, as well as low literacy and social competency issues that inhibit achieving self-sufficiency. This author will examine existing literature on welfare-dependent households coping with substance abuse and mental health problems, and how the lack of affordable housing impacts their ability to achieve self-sufficiency. This article presents a case study     

A note on shtetl definitions and the dating of the first shtetl

Consideration of two different working definitions of a shtetl, and the two different datings of the first shtetl that they produce, leads to the following conclusions. (1) The definition of a shtetl is formed by a set of criteria, one of which distinguishes it from similar settlements by providing a characteristic termed “sufficient Jewishness.” Because “sufficient Jewishness” exists in multiple forms, such as “at least 40% Jewish population,” and “the presence of certain specified institutions of religious observance,” a number of valid definitions can coexist. (2) The dating of the earliest shtetl will vary from one study to another, because it is determined by the selected definition of a shtetl used to arrive at that dating, and ultimately by the selected form of that definition's distinguishing criterion. (3) Therefore, just as more than one definition of a shtetl can coexist, each with a different form of the distinguishing criterion, so more than one valid dating of the first shtetl can coexist.     

桐城派“因声求气”理论源流考辨

"因声求气"理论主要提出者是刘大櫆,它是桐城派文论的核心,也是中国传统文论的精粹。其理论渊源向上可以追溯到先秦,是对孟子、曹丕、刘勰、沈约、韩愈、朱熹等人的继承和发展;向下又是对后来理论的开拓与奠基,特别是在桐城派内部,从姚鼐到方东树、曾国藩,再到吴汝纶、张裕钊、贺涛等,对之更是推崇备至,世代承袭。五四以后,朱光潜用现代理论丰富和完善了这一理论,并赋予其以现代学术形态,为中国传统理论的现代化提供了一个极佳的范例。     

忧伤与绝望：詹姆斯·赖特诗歌中的英雄主义

在反思现代工业文明背景下从事体力劳动的工人的生活境遇等问题意识下,诗人和学者把眼光投向人物的内心世界.詹姆斯·赖特创作的诗歌“秋天在俄亥俄的马丁斯费里开始了”描绘了在他家乡,劳动工人们普遍低落的身心状态.在面对家庭责任时,他们愧疚不堪;在想到人生理想时,他们只能从孩子们身上重温少年时代的英雄梦.文章通过对劳动工人们内心世界的挖掘,对美国当时经济状况的分析以及对劳动工人英雄主义思想等问题的探究,阐述在美国现代工业高速发展的20世纪50年代,劳动工人消极的个人生活的根源与实质.