On May 17, 2004, Massachusetts became the first state to legalize same-gender marriage. From California to Missouri, nearly all states now face legislative challenges to the once firmly entrenched notion that marriage can only exist between a man and a woman. Public opinion polls conducted from 1977 to 2004 found that Americans' attitudes toward gay men and lesbians and marriages or civil unions for same-gender couples have evolved. Opposition persists, however. The most recent data indicate support for some legal recognition of gay and lesbian couples, but most Americans favor civil unions over same-gender marriages. Although the future of civil unions and same-gender marriages remains uncertain, social workers can serve gay and lesbian clients and their families best by staying informed of the attendant legal, social, and policy issues.

In a study to assess the natural history of giant-cell arteritis, 90 patients with proved disease were followed up from the time of diagnosis. Early mortality was low and most commonly due to vertebral arteritis, but cerebral infarction did not appear to be a late complication. High maintenance dose steroids and visual loss were associated significantly with a shortened life span (p =00003 and p=0-0024). One-third of the patients developed chronic relapsing disease, but serious late complications were not encountered.After the initial attack has been controlled steroid dosage should be reduced to the minimum needed to alleviate symptoms.

Objectives-Mark/recapture (or capturerecapture) is a simple technique commonly applied to estimate the hypothetical total (including undercount) in a register composed of cases from two or more independent and separately incomplete case lists. This paper seeks to illustrate serious drawbacks in the use of the mark/recapture technique when applied to injuries. Setting and subjects-Northumbrian children under 15 years of age who were seriously injured in motor vehicle accidents (MVAs) over a five year period ascertained from two data sources: police reports and hospital inpatient records. Methods-Individuals (n) appearing in both police (S) and hospital (H) case lists are identified using various matching criteria. The separate and combined influence of age, sex, and casualty class (cyclist, passengers, pedestrians) on the probability of such matching is estimated using multivariate techniques. The hypothetical total incidence of child MVA victims (N) is calculated from N = (S × H)/n. Main outcomes-Estimates of the incidences of "serious" injuries in MVAs under various conditions of stratification and matching. The overall procedure is tested for conformity with accepted criteria for valid use of mark/recapture. Results-About one third of the 1009 police and 836 hospital records could be exactly matched. There were significant variations in matching proportions by class of accident (pedestrian v passenger v cyclist). This selective recapture or "heterogeneity" was not aVected by sex, but was independently influenced by the age of the child. Further uncertainty was introduced when matching criteria were slightly relaxed. Estimates of the total population of children with serious injuries vary accordingly from 1729 to 2743. A number of plausible reasons why these two data sources might not be unbiased or mutually independent samples of the total target population are proposed as explanations for this heterogeneity.Conclusion-This typical example of two sample mark/recapture estimation in an epidemiological setting can be shown to violate virtually all the requirements for valid use of the technique. Very little can be deduced accurately about the scale or characteristics of an unobserved group by the use of mark/recapture applied to two overlapping health event registers. (Injury Prevention 2000;6:46-50)

A new chart was designed to aid accurate identification of weight faltering and failure to thrive. It provides guidance on the lower limits of expected weight gain for children, whatever their initial centile position. The chart's theoretical basis, the process of its construction, and its evaluation are described in this paper.Evaluation was by a self completion questionnaire, where respondents answered questions about a range of standardised growth patterns, plotted on old and new charts. Forty five health visitors, 28 general practitioner principals and registrars, and nine community paediatricians provided 328 chart ratings. These showed that the new format significantly increased the proportion of correctly rated charts (old: 45 (28%); new: 82 (51%)), with the greatest impact in severe cases. This suggests that the new chart improves the precision of judgments made about weight gain in infancy. (Arch Dis Child 1998;78:40-43)