Computer-Assisted Diagnosis of Alcoholism

The use of computer-assisted interviews in the diagnosis of psychiatric conditions has increased since researchhas shown such interviews to have adequate psychometric properties and to be acceptable to patients. This study uses a computer-assisted format to assess drinking behaviors and alcohol-related symptoms in 50 veterans hospitalized for alcohol dependence. A computerized version of the Michigan Alcohol Screening Test (C-MAST) is compared to the standardized MAST, substantiating the earlier finding that individuals are more willing to reveal negatively-sanctioned behaviors to a computer than to an individual or on a questionnaire. The usefulness of such an assessment tool in general practice is discussed.     

Training Strategies for Elder Abuse/Inadequate Care

A key component in the efforts to deal with elder abuse/inadequate care is the development of educational programmes for both the public and responsible staff. This article explores the development of training programmes that address the needs of adult learners in the caring professions. Central to the success of the training was the programme design that entailed three methods of teaching in response to the three ways adults learn. Participants acquired a knowledge base that will enable them to work in an environment with few legal directives.     

Principles of Total Quality Management and Their Application to Employee Assistance Programs:

Total quality management (TQM) has been thrust into the psyche of corporate America. TQM is not a new phenomena. Introduced in the early fifties to Japanese managers by an American management expert, it served to make Japan an international economic leader. U.S. companies have generally had little international competition. They now recognize he formidable challenge that quality based companies represent and are striving to replicate these successes. To do so will be to remain competitive. To discount the impact of TQM initiatives could spell economic disaster. Employee assistance program (EAP) management is modeled after American management principles. EAPs are also now having to compete for market share in ways for which they were never prepared. The TQM initiatives currently being implemented in many companies may be applied equally well to EAPs. This article presents an overview of the TQM principles formulated by W. Edwards Derning. The article also attempts to critically analyze some of the areas that have been problematic in EAP management. Further, it examines how TQM initiatives could serve to ameliorate some of these problems and lend additional impetus to the competitiveness of employee assistance programs with other behavioral health care service delivery and cost management programs.     

1894-1914年俄国酒销售垄断政策目的与结果为何相悖(上)

从古至今酗酒问题一直困扰着俄国。国家垄断酒销售既是政府增加财政收入的举措,也是治理民众酗酒问题的手段。1894—1914年俄国实施了酒销售垄断政策,初衷是增加国家岁入,同时引导民众文明饮酒和减少酗酒,然而,减少民众酒消费和增加国库收入存在根本矛盾,二者很难兼顾,因此面临取舍的难题。而在俄国政府看来,国库利益永远高于戒酒利益,当国家财政紧张时就更是如此。这是酗酒问题难以根除的客观原因,民众的饮酒方式和习俗则是主观原因,俄国各阶层民众都有饮酒习惯。围绕对酒垄断的原则与目的、酒销售垄断的财政结果、影响烈性酒消费收入增加的若干因素、酒销售垄断与酒消费、民众饮酒方式和习俗的探讨,可以理解酒垄断时期俄国政府的两难处境与未能缓解民众酗酒的原因。     

Preenrollment Immunization Policies of American Colleges: An Assessment of the Need for Policy Implementation

Abstract

Alcohol abuse among college students is prevalent, yet few instruments with sound reliability and validity are available to assess these problems in this population. As part of a large, baseline assessment battery for a prospective study of offspring of alcoholics, the 27-item Young Adult Alcohol Problems Screening Test (YAAPST) was given to 490 freshmen at a large mid western university; approximately 9 months later, 482 subjects completed the scale again. In addition to asking about such traditional problems as experiencing blackouts and driving while intoxicated, the YAAPST included specific items relating to college experiences (eg, getting into sexual situations that were later regretted, missing classes, and receiving lower grades than usual). The YAAPST was designed to assess these drinking consequences over two different time frames, lifetime and past year, and also to indicate the frequency of occurrence during the past year. Results indicated that the YAAPST is a unidimensional scale with good psychometric properties (good internal consistency and test-retest reliability). Three different approaches were used to demonstrate the validity of the YAAPST. Findings supported criterion validity (with interview-based alcohol abuse/dependence diagnoses as the criterion), concurrent validity (comparing the YAAPST with other drinking measures), and construct validity (correlating the YAAPST with etiologically relevant personality, motivational, and peer influence variables). The YAAPST is a promising screening instrument for alcohol problems in college students. It has excellent psychometric properties and the potential to provide a range of useful information to the clinician or researcher.     

Lessons on social and health disparities from older lesbians with alcoholism and the role of interventions to promote culturally competent services

ABSTRACT

Older adults who are lesbian, gay, bisexual, or transgender (LGBT) face greater health risks and possibly more costly care because of their reluctance to seek out health and long-term care services because of limited cultural sensitivity of service providers. This is particularly evident in older lesbians who face substantial risk of health problems associated with alcoholism and are less likely to be open with health care providers because of stigma combined with feelings of alienation, stress, and depression. An estimated 4.4 million older adults are predicted to have problems with alcohol by 2020, and the rates of alcohol-related hospitalizations are similar to those for heart attacks, creating exorbitant medical costs. More culturally competent health and long-term care may reduce health care costs by effectively addressing the dynamics of alcoholism, aging, and lesbian culture. Training initiatives such as those developed by the National Resource Center on LGBT Aging have begun to address the need of a more culturally competent aging services network. This article provides exemplars from empirical data on older lesbians with alcoholism to highlight some of the health, economic, and social disparities experienced in the aging LGBT community. Current interventions in the form of cultural competence training for service providers are presented as a potential step toward addressing health disparities among LGBT older adults.     

Epistemology of the Bottle: The Social Construction of Alcoholism and Alcoholics in Social Work Literature in the United States Between 1950 and 1959

ABSTRACT

This article examines selected social work literature that has been published in mainstream social work journals in the United States from 1950 to 1959 in order to deconstruct how alcoholism and alcoholics have been historically constructed within the social work profession. The theoretical framework employed is that of social constructionism and deconstruction. The methodology is qualitative research, specifically historical analysis. The findings of this article are discussed for their relevance to social work practice and social work education.     

A Review of Alcoholism Screening Instruments and Their Appropriateness for Women

Abstract

The purpose of this paper is to review empirical data on currently used alcoholism screening instruments. It is the contention of this article that current established instruments have incorporated items significantly more characteristic of males' alcoholism or late stage problem drinking of women. They omit areas more germane to women's life course experiences, such as reproductive health issues and exposure to physical and sexual abuse. Indicators more appropriate for detecting problem drinking in women are proposed.