AUD researcher and pharma CEO develops new medication

Bankole Johnson, D.Sc., M.D., is the chairman of Adial Pharmaceuticals, which is developing a medication—AD04, a very low‐dose formulation of ondansetron—for the treatment of alcohol use disorders (AUDs). Johnson has long studied medications – ondansetron in particular ‐‐ to treat AUDs (see ADAW, Oct. 15, 2007, Feb. 11, 2008, June 16, 2008, Nov. 3, 2008, June 7, 2010, August 16, 2010, Jan. 31, 2011, Feb. 24, 2014), and most recently has been named the 2019 recipient of the American Society of Addiction Medicine's (ASAM's) R. Brinkley Smithers Distinguished Scientist Award, which will be presented, along with the accompanying lecture, at ASAM's annual conference in Orlando next month.     

AUD medications and postsurgery opioids: The latest

Topiramate's use as a treatment for alcohol use disorder (AUD) is not a new idea, Bankole Johnson, M.D. (now of ondansetron fame; see ADAW, March 25, April 1), reviewed it many times (see ADAW, Oct. 15, 2007; Feb. 11, 2008; June 16, 2008; Nov. 3, 2008; June 7, 2010; Jan. 31, 2011; Feb. 24, 2014). But a comprehensive review published recently in the Journal of Addiction Medicine is concise. While not approved by the Food and Drug Administration for AUD, topiramate can be prescribed off‐label, and should be considered as a treatment for the condition, according to Ajay Manhapra, M.D., and colleagues in the article, “Topiramate Pharmacotherapy for Alcohol Use Disorder and Other Addictions: A Narrative Review.” Like ondansetron and other possible AUD medications, including those that are approved (like acamprosate and naltrexone), topiramate doesn't work for everyone. But pharmacogenetic testing may help identify those who are likely to respond, according to the review. In addition, there are early studies indicating it could be used to treat cocaine and nicotine use disorder, as well as behavioral addictions.     

Using HIT to deliver integrated care for the frail elderly in the UK: current barriers and future challenges

In this paper we briefly describe the results of a 3 year project examining the use of Health Information Technologies (e.g., electronic patient record systems) to deliver integrated care. In particular, we focus on one group of patient (the frail elderly) and efforts to design an e-health supported healthcare pathway (the frail elderly pathway--FEP). The aim of FEP is to bring together clinicians and staff from health and social care and allow them to share patient information. Our findings show that progress in delivering a fully-supported and working FEP has been slow, not least because of the difficulties experienced by healthcare staff in using current IT systems. In addition, there are many strategic and technical issues which remain unresolved (e.g., systems interoperability).     

The distinct role of group-central and group-peripheral norms in taxpaying behaviour

In recent years, a social identity approach has been used to help understand why people do or do not pay tax [see Taylor, 2003; Wenzel, M., 2002. The impact of outcome orientation and justice concerns on tax compliance: the role of taxpayers’ identity. Journal of Applied Psychology 87, 629–645; Wenzel, M., 2004. An analysis of norm processes in tax compliance. Journal of Economic Psychology 25, 213–228; Wenzel, M., 2005. Misperception of social norms about tax compliance: from theory to intervention. Journal of Economic Psychology 26, 862–883; Wenzel, M., 2007. The multiplicity of taxpayer identities and their implications for tax ethics. Law & Policy 29, 31–50]. This research, which has focused almost exclusively on national identity, indicates that the more people identify with a group, the more likely they are to adhere to its tax norms and values. However, conformity to group norms may be more nuanced than this, and depend on (a) the meaning or content of the identity in question [e.g., Turner, J.C., 1999. Some current themes in research on social identity and self-categorization theories. In: Ellemers, N., Spears, R., Doojse, B. (Eds.), Social Identity: Context, Commitment, Content. Blackwell, Oxford, pp. 6–34] and (b) whether the norms and values are central or peripheral to the content of that identity. In line with this idea, two studies explored whether the concept and act of taxpaying are more central to what it means to be a member of one's nation than of one's occupational group. Both studies confirm this expectation. Importantly, the findings also suggest that although occupational groups have different norms and values in relation to pre-tax behaviours (e.g., how to deal with extra income), these too can be peripheral to what it means to a group member. If norms are peripheral to identity content, conformity to such norms may be independent of group identification.     

Nursing Home Deficiency Citations for Safety

Deficiency citations for safety violations in U.S. nursing homes from 2000 to 2007 are examined (representing a panel of 119,472 observations). Internal (i.e., operating characteristics of the facility), organizational factors (i.e., characteristics of the facility itself), and external factors (i.e., characteristics outside of the influence of the organization) associated with these deficiency citations are examined. The findings show that nursing homes increasingly receive deficiency citations for resident safety issues. Low staffing levels, poor quality of care, and an unfavorable Medicaid mix (occupancy and reimbursement) are associated with the likelihood of receiving deficiency citations for safety violations. In many cases, this likely influences the quality of life and quality of care of residents.     

Nursing home deficiency citations for safety

Deficiency citations for safety violations in U.S. nursing homes from 2000 to 2007 are examined (representing a panel of 119,472 observations). Internal (i.e., operating characteristics of the facility), organizational factors (i.e., characteristics of the facility itself), and external factors (i.e., characteristics outside of the influence of the organization) associated with these deficiency citations are examined. The findings show that nursing homes increasingly receive deficiency citations for resident safety issues. Low staffing levels, poor quality of care, and an unfavorable Medicaid mix (occupancy and reimbursement) are associated with the likelihood of receiving deficiency citations for safety violations. In many cases, this likely influences the quality of life and quality of care of residents.     

Domestic Violence

ABSTRACT

As our communities and families are faced with the growing problem of violence, more information is needed as to what women in abusive relationships see as challenges that prevent or delay leaving. To address the issue in the brief therapeutic environment, 14 women in counseling for abuse agreed to participate in three task groups and were asked to identify and rank-order the challenges they faced that could prevent them from leaving. Group one included women who had a desire to leave but were not sure they could. Group two consisted of women working on a case plan but who still had concerns; and, the third group contained women who had left the relationship and were expecting not to return. Overall, when analyzing and comparing these groups, all women (regardless of the stage of leaving) expressed similar challenges and concerns. Major themes presented in all groups included: limited resources (e.g., money, shelter, day-care and medical expenses), fears (e.g., fear of being killed, retaliation, being alone, making the wrong choices, the unknown), commitment to the relationship, concern for children, love for the abuser and other emotional issues. These challenges are discussed and specific applications to facilitate practice are made.     

The ugly scholar: Neocolonialism and ethical issues in international research

As a discipline, sociology has had to confront criticism of the nature and ends of sociological research and ethnical dilemmas in the study of social problems and people. Over time guidelines have appeared to aid in protecting subjects and colleagues (e.g., the ASA Code of Ethics) and to guarantee research standards (e.g., the peer-reviewed proposal process, human subjects committees). However, guidelines tend not to address the challenges sociologists face in international research. This results in unpleasant experiences and potentially endangers research and researcher alike. This articles responds to the gap in the literature on ethical issues in international research. It draws on writings by social scientists and from the author’s experience in Latin America.     

The impact of the 2007-2009 recession on workers' health coverage

IMPACT OF THE RECESSION: The 2007-2009 recession has taken its toll on the percentage of the population with employment-based health coverage. While, since 2000, there has been a slow erosion in the percentage of individuals under age 65 with employment-based health coverage, 2009 was the first year in which the percentage fell below 60 percent, and marked the largest one-year decline in coverage. FEWER WORKERS WITH COVERAGE: The percentage of workers with coverage through their own job fell from 53.2 percent in 2008 to 52 percent in 2009, a 2.4 percent decline in the likelihood that a worker has coverage through his or her own job. The percentage of workers with coverage as a dependent fell from 17 percent in 2008 to 16.3 percent in 2009, a 4.5 percent drop in the likelihood that a worker has coverage as a dependent. These declines occurred as the unemployment rate increased from an average of 5.8 percent in 2008 to 9.3 percent in 2009 (and reached a high of 10.1 percent during 2009). FIRM SIZE/INDUSTRY: The decline in the percentage of workers with coverage from their own job affected workers in private-sector firms of all sizes. Among public-sector workers, the decline from 73.4 percent to 73 percent was not statistically significant. Workers in all private-sector industries experienced a statistically significant decline in coverage between 2008 and 2009. HOURS WORKED: Full-time workers experienced a decline in coverage that was statistically significant while part-time workers did not. Among full-time workers, those employed full year experienced a statistically significant decline in coverage from their own job. Those employed full time but for only part of the year did not experience a statistically significant change in coverage. Among part-time workers, those employed full year experienced a statistically significant increase in the likelihood of having coverage in their own name, as did part-time workers employed for only part of the year. ANNUAL EARNINGS: The decline in the percentage of workers with coverage through their own job was limited to workers with lower annual earnings. Statistically significant declines were not found among any group of workers with annual earnings of at least $40,000. DEMOGRAPHICS: Workers with a high school education or less experienced a statistically significant decline in the likelihood of having coverage. Neither workers with a college degree nor those with a graduate degree experienced a statistically significant decline in coverage through their own job. Workers of all races experienced statistically significant declines in coverage between 2008 and 2009. Both men and women experienced a statistically significant decline in the percentage with health coverage through their own job. IMPACT OF STRUCTURAL CHANGES TO THE WORK FORCE: The movement of workers from the manufacturing industry to the service sector continued between 2008 and 2009. The percentage of workers employed on a full-time basis decreased while the percentage working part time increased. While there was an overall decline in the percentage of full-time workers, that decline was limited to workers employed full year. The percentage of workers employed on a full-time, part-year basis increased between 2008 and 2009. The distribution of workers by annual earnings shifted from middle-income workers to lower-income workers between 2008 and 2009.     

Altruism and envy in contests: An evolutionarily stable symbiosis

Altruists and envious people who meet in contests are symbionts. They do better than a population of narrowly rational individuals. If there are only altruists and envious individuals, a particular mixture of altruists and envious individuals is evolutionarily stable.I thank Helmut Bester, Friedel Bolle, Werner Güth and an anonymous referee for very helpful comments. The usual caveat applies. For a broader discussion of the economics of envy and a brief literature survey see, e.g., Mui (1995). Altruism has been discussed even more widely. Key references are Becker (1974, 1976), Lindbeck and Weibull (1988) and Bruce and Waldman (1990).     

Process evaluation of “Girls on the Run”: Exploring implementation in a physical activity-based positive youth development program

Many positive youth development programs rely on physical activity as a primary program component. Referred to as physical activity-based youth development programs, these program designs have great potential for promoting healthy youth development. This study examined how one such physical activity-based positive youth development program was implemented in order to identify design features critical to maximizing positive youth outcomes. This mixed method, multi-site process evaluation of Girls on the Run (GOTR) utilized focus groups, site visits, and self-report implementation checklists. Implementation scores were calculated to assess implementation fidelity across twenty-nine sites, and qualitative data were inductively analyzed to identify factors influential for implementation. Results reveal variability in how GOTR was implemented. Five themes emerged from the data that represented factors serving as facilitators or barriers to programmatic implementation. These included contextual/environmental factors (e.g., parental involvement, relationships with school personnel), organizational factors (e.g., implementation support and responsiveness of staff), program-specific factors (e.g., curriculum design), coach factors (e.g., existing relationships with participants, responsiveness to participant's needs), and youth factors (e.g., behavioral and discipline issues). Study findings have implications for improving the design of physical activity-based and other positive youth development programs, with relevance to evaluators, program planners, youth development leaders, and others working with children and youth.     

Can a workbook work? Examining whether a practitioner evaluation toolkit can promote instrumental use

In large-scale, multi-site contexts, developing and disseminating practitioner-oriented evaluation toolkits are an increasingly common strategy for building evaluation capacity. Toolkits explain the evaluation process, present evaluation design choices, and offer step-by-step guidance to practitioners. To date, there has been limited research on whether such resources truly foster the successful design, implementation, and use of evaluation findings. In this paper, we describe a multi-site project in which we developed a practitioner evaluation toolkit and then studied the extent to which the toolkit and accompanying technical assistance was effective in promoting successful completion of local-level evaluations and fostering instrumental use of the findings (i.e., whether programs directly used their findings to improve practice, see Patton, 2008). Forensic nurse practitioners from six geographically dispersed service programs completed methodologically rigorous evaluations; furthermore, all six programs used the findings to create programmatic and community-level changes to improve local practice. Implications for evaluation capacity building are discussed.     

Challenges,Changes, and Impact of the Council on Social Work Education Women’s Council: An Update

This article highlights the contributions of the Council on the Role and Status of Women in Social Work Education (Women’s Council) as well as the role and status of women in social work education. For this historical analysis update, the authors drew on several primary and secondary data sources. The first major theme was organizational development (e.g., organizational commitment, strategic planning, and sustainability). The second major theme was contributions to social work education (e.g., furthering the knowledge base, influencing accreditation standards, and monitoring equity). These major themes and subthemes remained constant from the previous publication on the history of the WC (Alvarez et al., 2008), underscoring the resilience, commitment and persistence of the WC to keep a sharp focus on infusing feminist perspectives into social work education.     

‘So I Feel Like I'm Getting It and Then Sometimes I Think OK,No I'm Not’: Couple and Family Therapists Learning an Evidence‐Based Practice

This research concerns itself with the experiences of couple and family therapists (CFTs) learning about and using an evidence‐based practice (EBP). The engagement with EBP is growing across many aspects of the mental health and health care systems. The EBP model is now being applied in a broad range of health and human service systems, including mental and behavioural health care, social work, education, and criminal justice (Hunsley, 2007). The dialogue about the role of evidence‐based approaches in the practice of CFT and research literature is also evolving (Sexton et al., 2011; Sprenkle 2012 ). Interestingly, while the research delves into what are the best approaches with different populations and presenting issues, little research has explored the experience of CFTs themselves, particularly while learning an EBP. Using a phenomenological approach called interpretive phenomenological analysis (Smith, Flowers & Larkin, 2009), this research explores the experiences of CFTs learning and using an EBP. The paper reports on key issues, challenges, and areas for CFTs, educators, and supervisors. As researchers, educators, administrators, policy makers, and CFTs struggle with what works best with which populations and how best to allocate resources, this research contributes to dialogues about how best to educate and support CFTs, and the complexity of doing research in real‐life settings.     

Animal Rights Talk: Moral Debate over the Internet

Messages sent over Animal Rights-Talk, an electronic mail network devoted to the discussion of issues related to the animal rights movement, were analyzed. Messages typically fell into the following categories: questions and information, discussions of philosophical issues, ethical problems associated with the treatment of particular species, the politics of the animal rights movement, problems of moral consistency, the ethics of particular uses of non-human species (e.g., meat consumption, biomedical research with animal subjects), and matters pertaining to the internal life of the network (e.g., efforts at control of perceived norm violations). Debates between animal activists and animal researchers over the network often reflected the conflicting cosmologies of scientists and animal protectionists. We argue that computer bulletin boards offer a potentially important avenue for qualitative research.     

African American Gay Family Networks: An Entry Point for HIV Prevention

Gay families are constructed support networks that gay, bisexual, and transgender individuals of color form, often in response to societal marginalization and rejection from biological families. Research on these family structures has been scarce, with little focus on the experience of African American gay family networks in the South. The current grounded theory qualitative study focused on the experiences of 10 African American male and transgender individuals between the ages of 18 and 29 from gay families in the Mid-South, and explored the ways these families addressed safe-sex issues and human immunodeficiency virus (HIV) risk prevention. Results revealed that families can play a role in either increasing HIV risk (e.g., ignoring HIV issues, encouraging such unsafe behaviors as exchanging sex for money or drugs, stigmatizing HIV-positive people) or decreasing it (e.g., intensive, family-level prevention efforts at safe-sex practices and family support for HIV treatment adherence). The potential of these family networks for HIV prevention and adherence efforts is considered.     

Exploring the abortion problem in Canada

A scale designed to measure attraction to sexual aggression is described, based on earlier work assessing self‐reported likelihood of committing rape. This scale's associations with measures of theoretically relevant attitudes, perceptions, and behavioral inclinations are examined in comparison with briefer measures, and with a number of other scales measuring attraction to various types of sexual interactions. These include conventional sex (e.g., heterosexual intercourse), homosexuality, bondage, unconventional sex (e.g., group sex), and deviant sex (e.g., pedophilia). Data supporting the longer and shorter versions of the attraction to sexual aggression scale are presented, showing internal consistency, test‐retest reliability, and discriminant and construct validity. As well, a number of issues raised by critiques of research in this area are addressed empirically.     

The Involvement of Spanish Older People in Nondegree Educational Programs: Reasons for and Barriers to Participation

This article examines the reasons older Spanish people participate in nondegree educational programs and the barriers they may face when they want to do so. Data were drawn from the 2007 Survey on Adults’ Involvement in Learning Activities (Encuesta sobre la Participación de la Población Adulta en Actividades de Aprendizaje: EADA) and correspond to a nationally representative sample of Spanish people aged between 60 and 74 years old (n = 4,559). Overall, only 8.7% of the sample participated in a nondegree educational program. Predictors of participation were being a woman, being younger, having a higher educational level, and being employed. The most frequent reason given for participation was of an intrinsic nature (e.g., interest in the topic), although instrumental motives (e.g., utility of the content for daily life) were more common than suggested by previous research. As for barriers to participation, the vast majority of older people (95.6% of those who did not participate) did not even express a desire to participate. The most frequent barriers were internal (e.g., age/health restrictions). This kind of barrier was ascribed a greater importance by older and less educated groups as well as by those who participate less in cultural activities. Policies to promote older people’s participation in nonformal educational activities are discussed in light of the data.     

Local rural product as a ‘relic’ spatial strategy in globalised rural spaces: Evidence from County Clare (Ireland)

Using a case study from County Clare (Ireland), this study critically analyses notions of ‘local’ rural production. It investigates where rural businesses source the different components of their products and how these interrelate with the locality, how local businesses use the notion of ‘local’ in their product branding, and what the socio-economic and political constraints and opportunities are for businesses seeking to foreground the ‘local’ in their business marketing. Echoing critical studies on the notion and use of ‘local’ in rural product branding (e.g. Burnett and Danson, 2004; Ilbery and Maye's; Feagan, 2007; Darby et al., 2008; Giovannucci et al., 2010), we argue that even remote rural areas such as County Clare in western Ireland have become so embedded in globalised economic and decision-making pathways that the ‘local’ in rural product branding only remains ‘local’ as a relic process associated with past localized rural production activities.