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This article depicts the changing demographic portrait of social work education in the United States from 1974 through 2000 and considers the demographic shifts in the profession of social work. During this period, BSW and joint MSW-BSW programs increased from 150 to 404, MSW programs increased from 79 to 139, and social work doctoral programs increased from 29 to 67. BSW graduates increased by 24 percent to almost 12,000, MSW graduates grew by almost 90 percent to over 15,000, and doctoral graduates increased by 44 percent to only 229. From 1974 to 2000, people of color represented increasing proportions of social work graduates to almost 30 percent of BSW graduates, 26 percent of MSW graduates, and 19 percent of social work PhD graduates. By 2000, the proportion of women earning social work degrees had grown to 88 percent at the BSW, 85 percent at the MSW, and 73 percent at the PhD levels, and women accounted for almost two-thirds of social work faculty. The most dynamic trends within the composition of the profession are the substantial increases in the proportion of women faculty, and among MSW graduates, a decrease in the proportion of men from 43 percent in 1960 to 15 percent in 2000. Findings suggest that issues of racial, ethnic, and gender representation in particular merit discussion within the profession.

This paper describes a life skills training intervention with 230 mothers of children with a variety of developmental disabilities. The study's design evaluated the effects of a skills-building method developed to improve coping and social support networks of mothers of handicapped children. In groups of 10-12, mothers of handicapped children participated in one of two intervention groups: a skills-building intervention or a comparison treatment intervention using traditional counseling methods. At posttest assessment participants in the skills-building sessions demonstrated improved coping and communication skills, greater satisfaction with social support networks, and a reduction in depression and stress levels.

Because anemic persons have lower cholesterol and whole blood viscosity than those who are not anemic, we hypothesized that subjects with hereditary spherocytosis who have not had the spleen removed should have fewer arteriosclerotic events than unaffected family members. We defined arteriosclerotic events as myocardial infarct, stroke, coronary artery surgery, and carotid artery surgery. We compared the rate of these events in affected-not splenectomized persons to the rate in unaffected family members. The relative risk of an arteriosclerotic event in hereditary spherocytosis patients with a spleen was one fifth that in unaffected family members. These data support the hypothesis that chronic anemia retards the development of arteriosclerosis. Spherocytosis is another example of an inherited condition that conveys an advantage in one system and a disadvantage in another.

This study examined the relationship between substance abuse treatment use, health services use, HIV status, and emergency room/hospital use for 507 injection drug users (IDUs). Logistic regression models showed that mental health status, severity of drug use and private health insurance were significantly associated with having used emergency room/hospital services in the past six months. History of substance abuse treatment use, positive HIV/AIDS diagnosis, mental health service use, ethnic/racial background, gender, age, education and homelessness were not significant at either the bivariate or the multivariate level. These results point to the need to improve mental health screening and referrals through emergency room medical systems. (Am J Addict 2005;14:268–280)

This study was designed to test the hypothesis that thalassemia trait diminishes the likelihood of myocardial infarction. If the hypothesis is true the prevalence of thalassemia trait should be less in myocardial infarct patients than in a control population. Blood counts and blood chemistry data from 500 men in Taiwan with a discharge diagnosis of myocardial infarction were recorded, and similar data were gathered on 500 men admitted to the same hospital for a routine check-up. Thalassemia trait was diagnosed via a discriminant function applied to the red blood cell count and indices. The study was done in a large modern hospital in Taipei; 14 of the 500 infarct patients and 33 of the 500 non-infarct subjects had thalassemia trait as defined here. The prevalence of thalassemia trait in myocardial infarct patients is significantly less than in the control subjects. This case control study supports the hypothesis that thalassemia trait lessens the risk of myocardial infarction.

This article examines patterns of methadone maintenance treatment entry among 9018 adult women injection drug users (IDUs), with special attention to parental-status differences. The data originate from a statewide drug-treatment database covering all women IDUs who entered drug treatment in the State of Massachusetts over a four-year period. Through the use of logistic regression analysis, the study found that among these women IDUs, those who resided with their children were significantly more likely to enter methadone maintenance than women who were mothers but did not reside with their children. Mothers residing with their children were 73% more likely to enter methadone maintenance than mothers who do not reside with their children. The authors discuss specific programmatic and policy implications including the need to determine whether methadone maintenance should be promoted as an alternative drug treatment option in order to preserve family unification or promote family reunification.

A woman’s drug and alcohol use has been found to increase her risk of experiencing intimate partner violence (IPV). Objective The study describes the rates of lifetime and current IPV among women awaiting care in an emergency department and explores the association between IPV and having a drug abuse problem, and IPV and having an alcohol abuse problem, after controlling for demographic factors and history of childhood victimization. Methods Face-to-face interviews were conducted with 143 low-level triaged women recruited from an inner-city emergency department. Results Nearly one-half reported ever experiencing IPV, and over 18% reported IPV during the year before the interview. A higher proportion of abused women reported a history of regular crack, cocaine, or heroin use and visiting shooting galleries or crack houses. Participants who were physically abused by their partner during the past year (15%, n = 21) were more likely than nonabused women (85%, n = 122) to report higher scores on the Alcohol Use Disorders Identification Test (AUDIT) (4.9 vs. 2.4), a measure of alcohol-related problems, and the Drug Abuse Severity Test (DAST) (3.0 vs. 1.3), a measure of drug-related problems. Sexually abused women (6%, n = 9) were more likely than their counterparts (94%, n = 134) to have significantly higher AUDIT scores (6.4 vs. 2.5). The findings have implications for how the intersecting public health problems of IPV and substance abuse should be taken into consideration in research and patient care protocols in emergency departments.

Urine screening is a potentially useful tool for detecting drugs of abuse in treatment, criminal justice, and other human service settings. This article examines the relative accuracy and other features of three drug screening assays sold by commercial laboratories: (1) Abbott Diagnostics ADx machine and reagents; (2) ONTRAK, manufactured by Roche Diagnostics; and (3) EZ-SCREEN, manufactured by Environmental Diagnostics. Urine samples (n=345) were collected from indigent men and women in a work and life skills program, and tested for cocaine and opiates with each of the kits. The ADx fluorescent immunoassay was presumed to be the most sensitive and specific screening method, and comparisons with the two visually-determined test kits supported this assumption. Of the two visual test kits, ONTRAK was the more specific assay, and was lower in cost and simplest to perform. Decision makers could employ similar evaluative methods in selecting drug testing materials.

This study expands upon coupon distribution strategies used to measure male condom acquisition in HIV/AIDS prevention by incorporating both female and male condoms and examining factors related to coupon redemption among urban STD clinic patients.In this study, condom coupon redemption (CR) rates were examined for male and female condoms. The study also explored the relationship between demographic and sexual behavior characteristics and CR and describes male and female participants requesting female condoms. The participants of this study were 100 patients, 55 male and 45 female, recruited from STD clinics by means of posted advertisements. Logistic regression analysis was used to explore the association between sexual risk factors, unprotected sexual intercourse, recent multiple sexual partners, STDs, and CR. Demographic screening revealed that 39% of the 100 participants redeemed coupons and females were more likely to redeem coupons than males. No association was found between sexual risk behavior and CR. Redeemers were slightly less sexually active than nonredeemers. Among coupon redeemers, 65% of women and 44% of men reported that they used the female condom at least once and 64% said that the device was easy to insert. Non-Latino women were the predominant users of female condoms, and more Latino men requested female condoms. This study found that there was no association between sexual risk behaviors and CR. CR, incorporating both condom types, would then provide a stronger measure of consumer preference of one type over the other.

The correlates of high-risk women's intentions to use the female condom were investigated in a descriptive study involving 148 sexually active women from 3 US methadone clinics. 51% of women were Latina and 38% were African-American; the mean age was 39 years. Male condoms, douching, sterilization, and withdrawal were the most frequently used contraceptive methods in the 90 days preceding the study. 56% had heard of the female condom, but only 6% had used it. Of the 139 women who had never used the female condom, 32% indicated they intended to use it in the future. Such intention was significantly, positively correlated with age under 39 years, African-American ethnicity, and the belief the female condom offers users a sense of personal control over their sexuality. Those who intended to use the female condom were more likely to have previously used male condoms, believe their partners would be supportive of the device, think female condom use could be erotic and fun, feel confident in their ability to negotiate safer sex, and to welcome an additional option for practicing safer sex. They were also less likely than their counterparts, who did not intend to use a female condom, to believe use of this method would imply they had a sexually transmitted disease or were too eager to have sex. Compared with women who did not intend to use the female condom, those who did were more likely to discuss the device with at least 1 member of their social network. These findings confirm the necessity of considering gender relations and social networks in the design of female condom promotion strategies.

Despite a slowing of the rates of human immunodeficiency virus (HIV) infection among intravenous drug users, this group remains at high risk for contracting acquired immune deficiency syndrome (AIDS). Promising reports of safer drug use patterns among addicts notwithstanding (Coleman, Lodico, Evans, & DiClemente, 1992; Sorensen, Batki, Coates, & Gibson, 1988; Watters et al., 1988), untreated drug users continue to share needles (Neaigus et al., 1992; Ortiz et al., 1992; Robles, Matos, Cancel, & Colon, 1992). Moreover, there is as yet little evidence of sustained safer sexual practices among drug users and their partners (Abdul-Quader et al., 1992; El-Bassel et al., 1992). In an ongoing series of studies, the authors are testing a small-group skills-training approach to reducing HIV-risk behavior among methadone patients. Earlier reports of these investigations have described the study methodology and preliminary outcomes (El-Bassel & Schilling, 1992; Schilling, El-Bassel, Schinke, Gordon, & Nichols, 1991). This article describes the conceptual components and strategies of a skills-building intervention model consisting of 13 weekly sessions followed by six monthly booster sessions. Social workers, many trained in group work and cognitive-behavioral approaches, would be positioned to initiate, and possibly carry out, such groups in chemical dependency treatment settings. Methadone Maintenance Methadone maintenance has been shown to be an effective approach to treating large numbers of heroin addicts, thereby reducing the risk of HIV infection associated with the sharing of intravenous drug paraphernalia (Ball & Ross, 1991; Murphy & Rosenbaum, 1988; Sorensen et al., 1988). Paradoxically, studies in the past several years have at once revealed both the protective effects and critical shortcomings of methadone maintenance treatment programs (MMTPs). Opiate relapse, alcohol and cocaine use, program attrition, and sexual risk-taking all present serious challenges to such programs (Obuchowsky & Zweben, 1987; Roszell, Calsyn, & Chaney, 1986; Schilling, El-Bassel, Gilbert, & Schinke, 1991). These challenges underscore the need for enhancing the nonpharmacological services of methadone clinics (Rounsaville & Kleber, 1985; Sorensen, 1991; Weddington, 1991). Most methadone patients receive medication several times per week. Their attendance is usually predictable. Counseling services would seem to be a natural extension of MMTP programs, and indeed federal regulations require programs to provide supportive services along with medication. Unfortunately, MMTPs have always had limited counseling components, and resources for supportive programs, including social work services, have eroded in recent years (Ball & Corty, 1988; Hubbard et al., 1989). Even if AIDS were not a consideration, MMTPs might benefit from sociobehavioral interventions that help clients to anticipate relapse, avoid high-risk situations, and recover from temporary lapses (Stark, 1989; Weddington, 1991). The AIDS crisis brings the need for MMTP program enhancements to the foreground. In response to this need, we developed and tested a set of theoretically and empirically derived intervention strategies designed to reduce drug use and high-risk sexual behavior among MMTP patients. Theoretical and Empirical Foundations of Training The underpinnings of the intervention are drawn from social learning theory (Bandura, 1977), health behavior models (Bandura, 1977; Cronkite & Moos, 1984; Wesson, Havassy, & Smith, 1986), theories of expectancy (Christiansen & Goldman, 1983; Marlatt & Roshenow, 1980) and self-efficacy (Baer, Holt, & Lichtenstein, 1986; Bandura, 1977; Donovan & Chaney, 1985; Heather, Rollnick, & Winton, 1983), relapse prevention (Marlatt & Gordon, 1985; Nurco, Stephenson, & Hanlon, 1991; Wesson et al., 1986), problem solving (Larson & Heppner, 1989; Nezu & D'Zurilla, 1981; Platt, Taube, Metzger, & Duome, 1988), skills training (Hawkins, Catalano, Gilmore, & Wells, 1989; Zackon, McAuliffe, & Ch'ien, 1985), self-regulation (Rehm & Rokke, 1988), social support (Fraser & Hawkins, 1984; Wesson et al. …

This study examines the predictors of alcoholism among 201 patients from three methadone maintenance treatment programs (MMTPs) in New York City. Using the Michigan Alcohol Screening Test, one-fifth of the sample met criteria for alcohol dependence. Few subjects were currently enrolled in any form of chemical dependency treatment other than MMTP. Alcoholics started to use alcohol at an early age, and almost every alcoholic subject admitted to alcohol abuse before entering MMTPs. More alcoholics than nonalcoholics reported symptoms of somatization, obsessive-compulsive behavior, depression, phobic anxiety, and psychosis. Logistic regression indicated that alcoholism among MMTP patients was associated with years drinking, years of sharing needles, utilization of drug abuse detoxification but not alcohol detoxification, smaller increases in methadone dosage over time, and psychiatric symptomatology. Findings are discussed in terms of their implications for designing more efficacious treatment approaches for dually addicted patients in MMTPs.

The black population is disproportionately affected by acquired immune deficiency syndrome (AIDS). Among those black people most at risk of becoming infected with the human immunodeficiency virus are black men who use intravenous drugs and black men who are gay. This article explores the complex cultural, economic, and social factors obstructing the reduction of the AIDS rate among these men. Implications and recommendations are made for developing effective AIDS prevention efforts by highlighting race-specific resources and supports for high-risk black men.

Untreated substance users remain beyond the reach of most acquired immune deficiency syndrome (AIDS) prevention efforts. In an effort to describe the risk behavior and attitudes of this population, the authors conducted interviews with 148 drug users in an urban soup kitchen. The study focused on subjects' risk-taking and risk-reduction behavior related to injection drug use, perceived changes in risk behavior, perceived risk for contracting AIDS, and socioeconomic and attitudinal correlates of injecting and sharing needles. Study findings underscore the need for community-based AIDS prevention strategies to intervene with high-risk populations beyond the reach of drug treatment and AIDS prevention programs.

African Americans and Latinos, respectively, account for 29% and 16% of persons with the acquired immunodeficiency syndrome, yet collectively represent less than 20% of the US population (Centers for Disease Control 1990) Although rates of human immunodeficiency virus (HIV) transmission have slowed among gay Anglo men there is less evidence to indicate that patterns of transmission have been altered among Black and Hispanic intravenous drug users. In this article, risk factors for HIV transmission among drug users are described, and sociocultural aspects of these risk behaviors are discussed Next, the advantages and disadvantages of various approaches to reducing the spread of HIV among drug users and their associates are considered, particularly as they apply to ethnic-racial minorities Finally, brief examples are provided of how existing theories of behavior change can be applied in Hispanic and African-American communities and suggestions are offered for further research

Excerpt To the Editors: The editorial by Schilling (1) was very stimulating. Chronic inflammation is very often the underlying mechanism of hypoferric anemia in patients. Chronic immune stimulation...

Purpose 1) To determine if there are significant differences in laboratory parameters and patient characteristics between patients with low erythrocyte (RBC) folate levels and those with normal RBC folate levels; 2) to determine the correlation between serum and RBC folate levels; 3) to determine if the RBC folate level changed the diagnosis, treatment, and outcome of these patients if the serum folate level was available. Patients and methods The study is a retrospective review of all inpatients and outpatients at a public teaching hospital who had an RBC folate level less than or equal to 175 ng/ml (N = 57) over the study period (69 months) and a blindly selected group of patients with RBC folate levels greater than 175 ng/ml (N = 53) during the same period. Results Patients with low RBC folate levels had higher mean corpuscular volume (MCV) and red cell distribution width (RDW) values and lower serum folate and B12 values than patients with normal RBC folate levels, but there was no difference in degree of anemia, presence of oval macrocytes and/or hypersegmented neutrophils on the peripheral blood smear, LDH, alcohol use, diet, or any other measured clinical parameter. Serum and RBC folate levels were highly correlated and a low RBC folate affected the clinical outcome of three patients (5% of the low RBC folate group). Conclusions Based upon these retrospective data and a review of the literature, we cannot define significant differences between patients with low RBC folate and randomly selected patients with normal RBC folate that could not have been equally well defined using serum folate values. The sensitivity and specificity of a low RBC folate level in the diagnosis of ill or healthy individuals are undefined, and until prospective studies utilizing some of the newer, more specific biochemical indicators of tissue folate are completed, the interpretation of low RBC folate levels will remain problematic.

The AIDS crisis, the increase in other sexually transmitted diseases (STDs), and the continuing problem of unwanted pregnancies, necessitate new methods of barrier protection. In 1988, Wisconsin Pharmacal began testing the safety and efficacy of a new female condom (Reality), a disposable, prelubricated, polyurethane device that is both a contraceptive and a barrier against STDs. The product requires no professional fitting and is inserted by the woman. Preliminary data from clinical and laboratory studies indicate that the female condom may be an effective barrier against STDs. A widespread use of the female condom, however, will depend on women's and men's initial attitudes, including culturally determined barriers to acceptance.

To the Editor. —Your cogent Editorial 1 about health care system reform has inspired a lighter analysis of this major problem I have entitled "The Verities From Alice in Nimbyland" (with apologies to L. Carroll). We have a moral obligation to provide universal access to high-quality health care, but thou shalt not raise my taxes. We absolutely must control health care costs, but thou shalt not ration care for my family. We must increase the number of primary care physicians, but thou shalt not restrict my free access to the specialists I choose. We must curtail the use of expensive, unproven new technology, but thou shalt not restrict my freedom to choose the tests and treatment my doctor and I want. We must reduce the cost of drugs, but thou shalt not question my choosing a new, expensive drug even though it has not been shown to be superior.

Conventional practice wisdom has long shielded alcohol treatment center clients from social and medical pressures to quit smoking. But, recent findings of increased cancer risk are forcing a re-examination of traditional practices. Detailed case histories of 14 recovering alcoholics who successfully quit smoking suggest the feasibility of cessation efforts even in the face of severe substance abuse histories.

Equipment and methodology for determining the effects of toxic substances on pilot performance were evaluated using ethyl alcohol as a reference substance, since its effects on flying performance in a flight simulator are well known. Four levels of ethyl alcohol were administered to eight instrument trained pilots in a Latin Square within subjects design. Significant performance decrements were found on instrument holding pattern, Instrument Landing System (ILS) approach, and Sternberg's choice reaction time tasks.

The relationship between hypocholesterolemia and anemia has been recognized in humans. However, no metabolic studies in humans have been reported, nor has an animal model been developed to investigate the effects of anemia on cholesterol metabolism. We have identified an animal model, the 'sex-linked anemic' (gene symbol, sla) mouse, characterized by iron deficiency anemia, to study the relationship between anemia and cholesterol metabolism. Results from our studies showed that the serum cholesterol was significantly lower in anemic male SLA mice compared to non-anemic littermates. The lower serum cholesterol observed in anemic SLA mice was related to a decreased in vivo hepatic cholesterol synthesis. However, the decreased hepatic cholesterol synthesis in anemic SLA mice was not due to a block at the primary regulatory site, the hydroxymethylglutaryl-CoA reductase, nor at one of the secondary regulatory sites: the acetoacetyl-CoA thiolase and hydroxymethylglutaryl-CoA synthase.

This study examined the relationship among cognitive functioning, social support networks, and risk for child abuse in a sample of 92 mothers of developmentally disabled children. Mothers found to be at highest risk for child abuse potential tended to score low on cognitive skills, social support networks, and life satisfaction. Beck Depression Inventory scores were found to explain 57% of the variance in the Child Abuse Potential Scores. Single mothers differed significantly from married mothers on child abuse potential, relationship satisfaction, community involvement, and loneliness. The authors discuss implications of the study and the need for future research with families of handicapped children.

A model enhancing child care worker training links needs assessment and training into six steps: data collection, data analysis and presentation, staff training design, training, evaluation, and needs reassessment. Applying the model in a day care center resulted in improved worker knowledge, attitudes, and performance, and in a continuing forum for subsequent program changes.

This paper reports an outcome study of coping skills intervention to help adolescents manage stress associated with the transition from elementary school to junior high. In a randomized design, sixth grade students from four elementary schools were pretested, then two schools each were assigned to an intervention condition and to a control condition. Intervention condition subjects received eight sessions of instruction and practice in coping skills intervention. Following intervention, all subjects were posttested. At posttest and relative to control condition subjects, intervention condition subjects scored more positively on measures of problem solving, assertive direct refusals, adequacy of information about junior high school, ability to handle stress, ability to deal with peer pressure, and general readiness for junior high school.

School health educators have devoted much attention to cigarette smoking. Recent years have seen the testing of interventions to prevent smoking. To date, controlled studies have not evaluated the added value of skills methods for preventing smoking. This article describes such an evaluation with sixth-grade students from two schools. Subjects were pretested and randomly assigned to receive conventional health education methods or to receive skills intervention. Both conditions included films, peer testimonials, discussions, and homework. Health education condition subjects additionally participated in oral quizzes, games, and debates. Skills condition subjects additionally learned problem-solving, self-instruction, and interpersonal communication methods. At postintervention, skills condition subjects, more than health education condition subjects, had better scores on measures of smoking-related knowledge, attitudes, and intentions. In addition, reported cigarette use, validated by biochemical data collection, was lower in the skills condition than in the health education condition at all postintervention measurements, including a 24-month follow-up. The article discusses the strengths, limits, and implications of the study for other smoking prevention efforts in schools.

Research on the prevention of substance abuse among American Indian and Alaska Native youth offers challenges and demands careful methods. This paper describes such challenges in terms of philosophical, political, and cultural issues surmundiig substance abuse prevention research with American Indian and Alaska Native people. The authors suggest how social work researchers can address these issues through strategies of community 'collaboration, goal sening, and cultural sensitivity. The paper discusses the limits, implications, and future applications of the described strategies for research on the prevention of alcohol and drug abuse among American Indian and Alaska Native youth.

This study evaluated cigarette smoking prevention methods with a sample of adolescent females and males. Arranged by school, 331 informed and consenting sixth graders were randomly divided into four groups: 1) pretest, skills-building methods, posttest; 2) pretest, discussion methods, posttest; 3) pretest and posttest; and 4) posttest only. All subjects were followed for 6 and 15 months after the posttest. Outcome results on measures of non-smoking intentions, attitudes, predictions, problem-solving abilities, and peer interactions favored subjects in the skills-building group when compared with subjects in the discussion and pretest-posttest control groups. Smoking rates at posttest and at both follow-ups were lower in the skills-building group than in the other three groups. Results from posttest-only subjects did not support pretest reactivity. The study's strengths and limits are discussed along with directions for future smoking prevention research.

This paper considers coping styles of mothers and fathers of handicapped children. Cautioning against stereotyping, the authors find that mothers and fathers differ in how they appraise and cope with the stress of rearing a developmentally disabled child. The need for systematic investigation of gender-related coping styles in families with handicapped children is discussed.

This paper proposes a new definitional model and improved methods for human services prevention research with youth and families. The proposed model defines prevention as knowledge-based, group intervention aimed at helping at-risk youth and families build skills and social supports to enhance interpersonal and environmental competence and to manage stress. Based on this definition, the authors suggest methods for improving prevention research. Those methods begin with risk assessment. Risk assessment, in turn, provides a basis for three levels of preventive intervention: universal, selective, and indicated. Each intervention level is discussed, with particular attention given to selective and indicated interventions because of their relevance for human services with youth and families. Finally, the paper notes the implications and future research directions for new models and levels of human services prevention with youth and families.

Hispanic adolescents are the fastest growing ethnic-minority age group in America. They are also at high risk for drug, alcohol, and tobacco use. In this paper, the authors discuss the etiology of Hispanic adolescents' substance abuse, as explained in part by psychological stress. Based on the authors' research and on other data, a model for preventing substance abuse among Hispanic youths is presented. The model draws from coping, acculturation, social learning, and informal network theories. Concluding with a research agenda, the paper calls for descriptive, correlative, and intervention outcome studies to scientifically understand and prevent substance use among Hispanic adolescents.

Substance abuse is one of the worst problems experienced by American Indian people. In this article, methods to prevent substance abuse among Indian young people are described and the future implications of drug and alcohol abuse prevention efforts with Indian youth are discussed.

This study examined snuff and chewing tobacco use among Alaska Native and American Indian adolescents. Results show frequent and early use of smokeless tobacco products. Almost one fifth of all females and close to one half of all males had used snuff or chewing tobacco on more than 20 occasions. Weekly smokeless tobacco use was reported by 34% of all females and by 42.6% of all males. By product type, 32.6% of all subjects had used snuff and 27.8% had chewed tobacco in the past week. Among females, over one half of all subjects had used snuff or chewing tobacco before age 10 years. Among males, nearly one half of the subjects first used smokeless tobacco prior to 8 years of age. Few subjects had used cigarettes or other smoked tobacco products.

The entrance into junior high school is a critical but seldom studied event in the life of the adolescent. Little has been done to prepare youths for the transition. This study evaluated a skills building approach to prepare sixth graders for the entry to junior high. The curriculum was administered to two grade schools (n = 138) with two additional grade schools (n= 140) serving as controls. At the conclusion of post testing, youths in the skills training condition were more informed about junior high school, percieved themselves to be more prepared, and were better able to handle stress and peer pressure than the youths in the control condition. They used more direct refusals as a tactic in handling peer pressure, and were able to generate more options for dealing with tough situations. Generally, results of the study support claims of program effectiveness.

Stress and its management influence the nature of family interactions. Harmful family interactions, including violent interactions, are likely affected by mismanaged stress. This paper reviews scientific evidence on stress concepts, sources, and treatment strategies. Particular emphasis is given to the potential of stress-management preventive intervention for reducing the risk of family violence. Based on a study with teenage parents, the authors describe procedures and results from clinical stress-management preventive intervention. Study findings noted post-test and 3- month follow-up improvements in favor of preventive intervention subjects relative to test-only control subjects on measures of personal and social support, cognitive problem solving, self-reinforcement, parenting competence and care, and interpersonal performance. Consumer satisfaction from teenage parents who received intervention lent additional support to the value of stress-management preventive methods. The paper discusses the implications, limitations, and future directions of stress-management preventive intervention to lower risks of family violence.

Normal sexual functioning has only recently become a prerogative of mentally retarded persons. More often, the sexuality of women and men with mental handicaps has been viewed as deviant and as cause for concern, restrictive policies, and clinical intervention. This paper critically evaluates scientific evidence for and against mentally retarded persons' increased risk of committing sexual offenses. Etiological theories of sexual offenses among the target population are discussed in detail. In addition, the authors describe treatment strategies for mentally retarded sexual offenders. Finally, the paper gives directions for future behavioral and social science research on issues concerning sexual offenses among mentally retarded persons.

Summary This paper describes an intervention programme, evaluation procedures, and results from a study of skills training for reducing stress with parents of handicapped children. Four mothers of developmentally disabled children participated in an 8-week training programme designed to teach parents ways to enhance their coping skills, increase their social support networks, and collectively make changes in their environment. Post-test data indicate that the programme shows promise for teaching coping and social support enhancement skills to parents.