Predictors of Readiness to Exit Commercial Sexual Exploitation Among Women in India and the U.S.

Exiting commercial sexual exploitation (CSE) is a difficult and prolonged process. This study examines the predictors of readiness to exit CSE, using the stages of change model as an underlying framework, among women in India (n=163) and the U.S. (n=87). Constructs such as years of schooling, residence, unemployment, age of entry, causes of entry, types of exploitation, addictions, presence of perpetrator, culture – individualistic and collectivistic, stigma, social support, empowerment, and current involvement in CSE were assessed. Results of a multi-group analysis indicated significant differences in the relationships between readiness to change and the predictor measures. For the Indian sample, years of schooling, economic conditions/abuse/runaway behavior as reasons for entry, individualistic and collectivistic culture approaches, and stigma were associated with readiness to change. For the U.S. sample, living by oneself, abuse/runaway behavior as reasons for entry, indoor experiences of exploitation, substance abuse problems, collectivist cultural approach, social support, and current involvement in CSE were associated with readiness to change. However, some similarities were also found. The findings suggest that service provision must focus on addressing the constructs that increase the readiness to exit, while also being culturally competent

An Association Between Implementing Trauma-Informed Care and Staff Satisfaction

Despite its widespread adoption there is limited research on the influence of trauma-informed care (TIC). The current study examined the impact of implementing TIC on the satisfaction of agency staff by comparing the results of a satisfaction survey taken in January of 2014, a month prior to the agency\u27s implementation of TIC, and again twelve months later. As collaboration, empowerment, and self-care are primary components of a TIC organizational approach, its implementation was expected to increase staff satisfaction. Following the implementation of TIC, agency staff reported higher scores on all but one of the six satisfaction survey factors. Increases in staff satisfaction have been associated with better staff retention rates, increased organizational commitment and better performance. In consequence, TIC implementation is associated with increased staff satisfaction, and may positively influence organizational characteristics of significance to social service agencies.

The geographic distribution of nurse practitioners in the United States

This study analyzed the geographic distribution of nurse practitioners in the United States. Primary data on nurse practitioners were obtained from State Boards of Nursing and the District of Columbia in the spring of 1994. At the state level, nurse practitioners were more concentrated in urban areas than their physician counterparts. Of the 33,094 certified nurse practitioners, 85% were in metropolitan areas. Results from the dissimilarity indices between nurse practitioners and general populations showed that a greater supply of nurse practitioners in a state may not necessarily lead to an equitable distribution across counties. At both the state and county levels, the supply of nurse practitioners was positively associated with the supply of primary care physicians. Results from multivariate analyses show that nurse practitioners were more likely to locate in a county where state laws allowed independent practice. States that allow independent practice and direct third-party reimbursement will likely have greater availability and a larger supply of nurse practitioners in rural counties. © 1997 John Wiley & Sons, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/35206/1/5_ftp.pd

Examining Factors in the Research Institute on Addictions Self-Inventory (RIASI): Associations with Alcohol Use and Problems at Assessment and Follow-Up

Impaired driving is a leading cause of alcohol-related deaths and injuries. Rehabilitation or remedial programs, involving assessment and screening of convicted impaired drivers to determine problem severity and appropriate programs, are an important component of society’s response to this problem. Ontario’s remedial program, Back on Track (BOT), involves an assessment process that includes administration of the Research Institute on Addictions Self-Inventory (RIASI) to determine assignment to an education or treatment program. The purpose of this study is to identify factors within the RIASI and examine how factor scores are associated with alcohol use and problem indicators at assessment and six-month follow-up. The sample included 22,298 individuals who completed BOT from 2000 to 2005. Principal component factor analysis with varimax rotation was conducted on RIASI data and an eight factor solution was retained: (1) Negative Affect, (2) Sensation Seeking, (3) Alcohol-Quantity, (4) Social Conformity, (5) High Risk Lifestyle, (6) Alcohol Problems, (7) Interpersonal Competence, and (8) Family History. Regression analyses were conducted to examine associations between factors and alcohol and problem measures obtained at assessment and at follow-up. Most factors, except for Interpersonal Competence, were associated with more alcohol use and problems at assessment. A similar pattern was observed at 6-month follow-up, but interestingly some factors (Negative Affect, Sensation Seeking, Alcohol-Quantity and Family History) predicted fewer days of alcohol use. The Interpersonal Competence factor was associated with significantly lower levels of alcohol use and problems at both assessment and follow-up. This work suggests that the RIASI provides information on several domains that have important relationships with alcohol problem severity and outcomes

Beverage specific alcohol intake in a population-based study: Evidence for a positive association between pulmonary function and wine intake

BACKGROUND: Lung function is a strong predictor of cardiovascular and all-cause mortality. Previous studies suggest that alcohol exposure may be linked to impaired pulmonary function through oxidant-antioxidant mechanisms. Alcohol may be an important source of oxidants; however, wine contains several antioxidants. In this study we analyzed the relation of beverage specific alcohol intake with forced expiratory volume in one second (FEV(1)) and forced vital capacity (FVC) in a random sample of 1555 residents of Western New York, USA. METHODS: We expressed pulmonary function as percent of predicted normal FEV(1) (FEV(1)%) and FVC (FVC%) after adjustment for height, age, gender and race. To obtain information on alcohol intake we used a questionnaire that reliably queries total alcohol and beverage specific recent (past 30 days) and lifetime alcohol consumption. Results: Using multiple linear regression analysis after adjustment for covariates (pack-years of smoking, weight, smoking status, education, nutritional factors and for FEV(1)%, in addition, eosinophil count), we observed no significant correlation between total alcohol intake and lung function. However, we found positive associations of recent and lifetime wine intake with FEV(1)% and FVC%. When we analyzed white and red wine intake separately, the association of lung function with red wine was weaker than for white wine. CONCLUSION: While total alcohol intake was not related to lung function, wine intake showed a positive association with lung function. Although we cannot exclude residual confounding by healthier lifestyle in wine drinkers, differential effects of alcoholic beverages on lung health may exist

Rehabilitation and the International Classification of Functioning, Disability and Health: Past, Present, and Future Directions

This article provides a brief overview of the history of disability in the United States and discusses the three paradigms: rehabilitation, independent living, and support and empowerment that have guided rehabilitative services for persons with disabilities. Within the context of this historical background, the article also presents various models used to define and classify disability. The effect and influence of society's perceptions of people with disabilities on the evolution and refinement of disease and disability models is also discussed. The International Classification of Functioning, Disability and Health, which is a currently utilized disability model is discussed in detail and information is provided as to its applicability to rehabilitation.departmental bulletin pape