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.     

Cowboys and Indians

This experimental, layered, mixed‐genre narrative folds my biographical experiences into a critical reading of a cultural performance involving cowboys and Indians in a small Montana town in summer 2000. Informed by critical race theory and poststructuralism, this narrative attempts to deconstruct racial stereotypes associated with Native Americans and their presence in America's movies and popular culture.     

Beyond ‘developmentalism’: A relational and embodied approach to young children's development

This article begins by discussing ‘developmentalism’, one of the key debates that has characterised the current theoretical impasse in the development of childhood studies. I use Norbert Elias's concept of the relation between love and learning as a foundation to develop the way in which young children's development is a non-linear, temporal and embodied process. I argue that we need to develop a relational approach that moves beyond some of the binary divisions between ‘nature’ and ‘biology’, drawing on concepts from particular theoretical traditions that have been under-utilised, particularly the relational school of psychoanalysis and the work of Maurice Merleau-Ponty.     

Parent–Adolescent Sexual Communication and Its Association With Adolescent Sexual Behaviors: A Nationally Representative Analysis in the Netherlands

Sexual communication is a principal means of transmitting sexual values, beliefs, expectations, and knowledge from parents to children. Although this area has received considerable research attention, more studies with representative samples are needed to assure that findings are reflective of populations of interest. A nationally representative sample of parent–adolescent dyads (N = 2,965; mean adolescent age = 13.8 years) in the Netherlands was employed to examine the frequency of parent–adolescent sexual communication and its association with adolescent sexual behaviors (defined as sexual initiation, condom use, and contraceptive pill use). Nine communication topics in the areas of anatomy, relationships and rights, and protection and contraception were examined. In all, 75%of parents reported having discussed at least one topic multiple times with their adolescents. Romantic relationships were discussed most frequently. Hierarchical logistic regression analyses indicated that parent–adolescent sexual communication on protection and contraception was positively associated with adolescent sexual initiation and contraceptive pill use but not condom use. This may reflect that adolescents, when they become sexually active, are more likely to discuss sexuality with their parents. Findings are interpreted within the context of Dutch culture, which is generally accepting of adolescent sexuality and characterized by open sexual communication.     

Was Cicourel’s critique in Methods and Measurement in Sociology too radical?

This article is a contribution to a mini symposium on the 50th anniversary of the publication of A V Cicourel’s Method and Measurement in Sociology (1964). The central theme of the book is reviewed – the problem of the relationship between everyday language and cultural meanings, and the language of measurement in social research – and the lack of an adequate ontology of social actors is identified as being the cause of the problem. The solution offered by Alfred Schütz – that social scientific language should be derived from everyday language – is discussed and it is argued that this was probably too radical at the time the book was published, and is still generally neglected in the social sciences.     

James - stein regression estimation in a prediction context

Two types of shrunken estimators of regression coefficients are studied in the context of stochastic predictor variables. Emphasis is placed on the choice of the shrinkage parameters, using a ‘deleted-observation’ concept which is motivated by predictive ability.