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.     

The specter of failure: rendering Afghan women as sites of precarity in empowerment regimes

This article analyzes how the category of “Afghan women” and discourses of precarity intersect within the women’s empowerment regime in Afghanistan. By examining an NGO that seeks to empower women through writing, I argue that staff members draw upon precarity as a go-to logic to describe the state of Afghan women writers’ successes under conditions of insecurity and limited communication. Specifically, it is writers’ desires to subvert their social orders and to carve out their own futures that staff members and writing coordinators frame as subject to potential destruction. While recent work has highlighted the importance of recognizing the precarious lifeworlds of vulnerable populations, this article points to the potential implications of a hyper-recognition of precarity – namely, the obscuring of the complexities of individual women’s past and present realities. Through analyzing the pedagogies of one empowerment NGO working with women in a post-9/11 Afghanistan, I show how the logic of precarity is concerned with the vulnerability of women’s desires and sentiments, rather than their material and political vulnerabilities. It is thus deeply inflected by a historically situated “common sense” about which potentialities and aspirations are inherent to Afghan women.     

Operative strategies of HLB's scouts of a citrus property within the State of Sao Paulo, Brazil

This research aimed to study the activity of the HLB's scouts, workers whose function is to identify symptomatic plants, in order to understand the physical constraints, cognitive and organizational involved in accomplishing the task, characterizing the operative approach used to identify diseased plants, and to elucidate what aspects hinder the identification of symptoms. The method adopted for the research was the Ergonomic Analysis of Work--EAW [6]. The results, after validation with the operators and management, allowed understanding the complex relationships between the physical, cognitive and organizational aspects present on activity. Major difficulties were observed mainly in relation to the disposal of the scouts on the platforms and in relation to working hours, at the beginning and end of the journey. Important findings have highlighted strategies, unknown by the organization, used by scouts to locate candidates' trees to the fine analysis of investigation of symptoms. In conclusion, the analysis enable to understand the constraints and find technical and organizational solutions to the survey work on citrus groves as well as it showed signs and symptoms not investigated yet or rarely considered by researchers involved on searches aimed at increasing the ability to diagnose the disease in the field.     

Childcare costs and the demand for children—evidence from a nationwide reform

Exploiting the exogenous variation in user fees caused by a Swedish childcare reform, we are able to identify the causal effect of childcare costs on fertility in a context in which childcare enrollment is almost universal, user fees are low, and labor force participation of mothers is very high. Anticipation of a reduction in childcare costs increased the number of first and higher-order births, but only seemed to affect the timing of second births. For families with many children we also find a marginally significant negative income effect on fertility.     

Leg-extension strength and chair-rise performance in elderly women with Parkinson's disease

The lower extremity performance in elderly female patients with mild to moderate Parkinson's disease (PD; n = 12) and controls (n = 16) was compared. Isometric dynamometry and force-plate measurements were used. PD patients had lower (p < .05) bilateral (BL) maximal isometric leg-extension force (MF), BL isometric MF relative to body mass, and maximal rate of isometric force development than control participants. BL strength deficit was greater (p < .05) in PD patients than in controls. A significantly longer chair-rise time and lower maximal rate of vertical-ground-reaction-force development while rising from a chair was found in PD patients than in controls. These findings suggest that elderly women with PD have lowered voluntary isometric force-generation capacity of the leg-extensor muscles. Reduced BL leg-extension strength might contribute to the difficulty of individuals with PD to rise from a chair.