Medication adherence among Latino and non-Latino white children with asthma.

OBJECTIVE: Latino children of Caribbean descent remain at high risk for poorly controlled asthma. Controller medications improve asthma control; however, medication adherence remains suboptimal, particularly among minorities. This study assessed socioeconomic, family-based, and parent factors in medication adherence among children with asthma from Rhode Island (RI; Latino and non-Latino white [NLW]) and Puerto Rico. METHODS: Data collection occurred as part of a multicenter study of asthma disparities. Our sample included children (ages 7-16) prescribed objectively monitored controller medications (n = 277; 80 island Puerto Rico, 114 RI Latino, 83 RI NLW). Parents completed questionnaires regarding family background and beliefs about medications. Families participated in an interview regarding asthma management. Multilevel analyses (maximum likelihood estimates) accounting for children being nested within site and ethnic group assessed the contribution of social context, family, and parent variables to medication adherence. RESULTS: Medication adherence differed by ethnic group (F(2, 271) = 7.46, P < .01), with NLW families demonstrating the highest levels of adherence. Multilevel models indicated that parental beliefs about medication necessity and family organization regarding medication use were significant predictors of adherence, even for families below the poverty threshold. With family factors in the model, a substantial improvement in model fit occurred (Akaike Information Criterion change of 103.45). CONCLUSIONS: Adherence to controller medications was lower among Latino children in our sample. Targeted interventions that capitalize on existing family resources, emphasize structure, and address parental beliefs about the importance of medications may be of benefit to families from different cultural backgrounds.

Normative collective behavior in the Station building fire.

Objective. This article offers a test of the normative explanation of collective behavior by examining the fire at the Station nightclub in Rhode Island that killed 100 and injured nearly 200 persons.Methods. Information on all persons at the club comes from content analysis of documents from the Rhode Island Police Department, the Rhode Island Office of the Attorney General, and The Providence Journal. We use negative binomial regression to test hypotheses about the effects of group-level predictors of the counts of dead and injured in 179 groups at the nightclub.Results. Results indicate that group-level factors such as distance of group members at the start of the fire, the number of intimate relations among them, the extent to which they had visited the nightclub prior to the incident, and the average length of the evacuation route they used predict counts of injured and dead. The research also looks at what behavioral differences exist between survivors and victims, ascertains the existence of role extension among employees of the nightclub, and provides support for the affirmation that dangerous contexts negate the protective influence of intimate relations in groups.Conclusion. We argue for the abandonment of current emphasis on irrationality and herd-like imitative behavior in studies of evacuation from structural fires in buildings and for the inclusion of group-level processes in social psychological explanations of these incidents.

"Killed by its mother": infanticide in Providence County, Rhode Island, 1870 to 1938.

This article analyzes infanticide based on the Coroners' Records for Providence County, Rhode Island, from the 1870s to 1938 to determine doctors' and coroners' attitudes toward mothers who killed. The nineteenth century witnessed a medical discourse on the possibility of postpartum insanity as a cause of infanticide. While some women claimed temporary insanity, and some doctors and coroners legitimated this defense, its application to mothers who killed was arbitrary. They determined who deserved this diagnosis based on the woman's character, her forthrightness, and extenuating circumstances. Infanticide divided the profession nationally and at the local level and prevented doctors or coroners from speaking in a united voice on the issue. This article does not attempt to follow cases of infanticide through to jury verdicts. Instead, it provides an opportunity to analyze the circumstances women faced that led them to kill their newborns, and to analyze the responses of doctors and coroners to these mothers who killed. Unlike the findings of other studies, neither physicians nor coroners in Rhode Island were united in a claim of ignorance to save these women from guilty verdicts.

Multiple program participation and exits from food stamps among elders.

This article uses population-level administrative data from Rhode Island's Food Stamp Program to examine exits from the Food Stamp Program by elders. Multivariate event history models estimate the relations of multiple program participation and the timing of eligibility reviews to the probability of exiting food stamps. Results suggest that elders who are age 65 or older and who receive both Supplemental Security Income and food stamps have a higher probability of exiting the Food Stamp Program than do elders who receive only food stamps. The timing of eligibility reviews is also found to be positively associated with the probability of exit from food stamps. This article is argued to extend conceptual models of the determinants of food stamp exits.