Latent variable assessment of outcomes in a nurse-managed intervention to increase latent tuberculosis treatment completion in homeless adults.

OBJECTIVE: To assess predictors of latent tuberculosis infection (LTBI) completion by using structural equation modeling (SEM) among homeless adults, a group at great risk for LTBI and active tuberculosis (TB). LTBI therapy is effective in stemming the progression to active TB, yet treatment adherence among homeless persons is difficult to attain. DESIGN: By using SEM, the authors assessed predictors of LTBI completion among a sample of 494 homeless adults in Los Angeles, CA, who received either a nurse case-managed program (NCM) or a usual care program. MAIN OUTCOME MEASURES: Latent variables were created with the baseline variables of site type, age, intervention status, dissatisfaction with health care, depression, TB risk assessment, alcohol use, heroin or cocaine use, and TB knowledge. Outcome variables included many of the same baseline variables as well as treatment completion. RESULTS: LTBI treatment completion (100% adherence) was significantly and positively associated with participation in NCM, older age, and less heroin or cocaine use. NCM also predicted greater TB knowledge, greater ease of treatment, and more satisfaction with treatment (NCM completion rate = 64%, control rate = 42%). CONCLUSION: The culturally competent NCM program, combined with active tracking and incentives, was successful in a difficult-to-treat and highly transient population.     

Book reviews

Weiskrantz, L. (1986). Blindsight: A case study and implications. Oxford University Press. Pp. 187. ISBN 0-19-852129-4. £19.50.

Humphreys, G. W. & Riddoch, M. J. (1987). to see but not to see: A case study of visual agnosia. Hove and London: Lawrence Erlbaum Associates Ltd. Pp. 124. ISBN 0-83677-064-9. £12.95.

Downing, J. A. (1988). Advances in psychology: Cognitive psychology and reading in the USSR. Amsterdam: North Holland; Elsevier Science Publishers. Pp. 471. ISBN 0-444-70374-8. $108.00.

John Beech & Ann Colley (Eds.) (1987). Cognitive approaches to reading. Chichester: John Wiley. Pp. xii + 315.

James Wertsch (Ed.) (1985). Culture, communication and cognition: Vygotskian perspectives. Cambridge: Cambridge University Press. Pp. 379. ISBN 0-521-25214-8. £27.50 (Hardback).

Fodor, J. A. (1987). Psychosemantics: The problem of meaning in the philosophy of mind. Cambridge, MA: M.I.T. Press. Pp. xiii, 1-171. ISBN 0-262-06106-6.

Richardson, K. (1988). Understanding Psychology. Milton Keynes: The Open University Press. Pp. 114. ISBN 0-335-09842-8. Paperback £7.95.

Stanovich, Keith E. (Ed.) (1988). Children's reading and the development of phonological awareness. Detroit: Wayne State University Press. Pp. 177. ISBN 0-8143-1909-2. $20.00.

Allport, A., MacKay, D.G., Prinz, W., & Scheerer, E. (Eds.), (1987). Language perception and production: Relationships between listening, speaking, reading, and writing. London: Academic Press. Pp. xiii + 497. ISBN 0-12-052750-2. £32.00

Light, L. L. & Burke, D. M. (eds.) (1988). Language, Memory and Aging. Cambridge: Cambridge University Press. Pp. 280. ISBN-0-521-32942-6. £27.50

Friedman, S.L., Scholnick, E.F., and Cocking, R. R. (1987). Bleuprints for thinking: The role of planing in cognitive development. Cambridge: Cambridge University Press. Pp. xv + 559. ISBN 0-521-25605-4. £40.00.     

THE SHIFT IN POWER WITH AGE Changes in Perception of the Power of Women and Men Over the Life Cycle

Previous research has described an apparent shift in perceived interpersonal power towards equality between men and women later in life. This study investigated (a) whether the "shift in power with age" would appear in the Israeli kibbutz, (b) the role of the "parental emergency" in the shift, and (c) whether changes in behaviors or attitudes best account for the shift. One hundred twenty younger and older Israeli women and men, half from the city and half from the kibbutz, wrote TAT stories, which were then rated for overall power of the female and male characters, their power strategies, and their motives. A shift in perceived power with age was found in both the city and the kibbutz. Parental status reduced the power of the woman and increased the power of the man only in the city, whereas the reverse was true in the kibbutz. These results counter the "parental emergency" explanation for the shift in power with age. Furthermore, older women used traditionally feminine power strategies, but their behavior was evaluated as more powerful than the same behavior in younger women. Thus, it is not the behaviors but rather people's evaluation of the behaviors that changes across the life span of the individual.     

SAMHSA philosophy and statement on ethical principles

As the major federal agency responsible for improving the delivery and effectiveness of substance abuse and mental health services to the American public, the Substance Abuse and Mental Health Services Administration (SAMHSA) is aware that its programs deal with especially sensitive issues. As a national leader in advancing effective services to persons with addictive and mental disorders, SAMHSA has stewardship over important interventions affecting personal, community, institutional, and social values. Inherent in SAMHSA's mission and goals is a commitment to protect and promote the human, civil, and legal rights and moral freedoms of those individuals and groups who participate in SAMHSA-funded activities and to demonstrate that Agency policies and procedures are congruent with publicly acceptable ethical principles and standards of conduct. A foundation of mutual trust between SAMHSA officials and participants as well as sensitivity to issues of public accountability will hasten and strengthen progress toward this shared vision.     

Brief Report: Safe at Home Base: Working Parents' Reasons for Choice of Home-Based Child Care

The current generation of working parents faces new challenges to the traditional family model. Despite this, they select forms of home-based child care more than any other type of care. Prior data also reveal that parents who use home-based care, center-based care, and family day care all cite quality as the primary reason for their choice. Given the similarity of reason and the difference in care actually used, working parents who use home-based care were interviewed on additional reasons for their choice. These parents lacked confidence in center-based care and preferred their children to receive one-to-one attention. Age of child, cost of care, and availability of centers did not affect choice. These adults seem to be selecting home-based care in an attempt to provide care as close as possible to parental care. They are making a statement on the importance of the home environment even as their participation in the workplace increases.     

Getting Out of the Way: A Strategy for Engaging Students in Collaborative Learning

The author describes what has been entailed in a shift from a teacher-centered approach — one which relied on her expertise in Chinese studies — to a more student-centered approach in which the teacher creates a learning environment and seeks to “get out of the way” of student learning. She describes concrete strategies for de-centering herself and empowering students, and discusses the roles and responsibilities of the teacher in this alternative model.