Stages of change and smoking cessation: a computer-administered intervention program for young adults.

Sixty-five college-student smokers were randomly assigned to a four-week computer-administered, stage-based smoking control program or a four-week computer-administered general health education control condition. At post-test, the percentage of students advancing to a higher stage of readiness to change was slightly higher among those in the stage-based program compared to the control condition. At seven month follow-up, both groups reported abstinence rates of approximately 30%. Continuous abstinence for 6 months was 19% for the stage-based group and 14% for the control group at the final follow-up.

Repairing broken rules: care-seeking narratives for menstrual problems in rural Mali.

Narratives play an important role in the organization of therapeutic action in rural Mali. This article provides structural and interpretive analyses of a young, French-speaking Dogon woman's accounts of her efforts to manage her menstrual bleeding and threatened infertility. Through her personal narratives she creates social arenas to recruit support, negotiate changes in her family relationships, and enhance her standing as a member of the community. Beginning with the accounts of her fear and helplessness, the narrator integrates past events into her unfolding present and achieves a meaningful resolution of her problem. Her narratives weave together encounters with family members, friends, and healers to describe a therapeutic itinerary that acquires significance as a transformative experience.

The dilemma of seeking urgent care: asthma episodes and emergency service use.

Asthma is an invisible and unpredictable chronic illness characterized by recurrent episodes of airflow obstruction and airway inflammation. Until recently, psychological factors were thought to play a major role in this condition. The notion of an emotionally-based illness serves to discredit asthma as a 'real' illness among health professionals and patients alike, contributes to the sense of stigma that persons who have asthma experience, and impedes effective management. Findings from research with a sample of 95 adults with physician diagnosed and documented asthma indicate that persons who have asthma walk a tightrope between delaying formal medical intervention and seeking treatment too soon. Uncertainty about the quality and speed of care available in an emergency department shapes, in part, the nature of the lived experience of asthma and affects feelings of control over the illness. These concerns create a push-pull dynamic, as individuals struggle to make decisions about emergency department use that will provide relief, ensure autonomy, deter the experience of stigma, and diminish the threat of death.