Exploring the ethics of treatments for depression: The ethics of care perspective

This article explores the ethics of current treatments for depression through the lenses of social work values and ethics. As a vehicle for analysis, the approach associated with ethics of care will be utilized. Particular attention is paid to ethical dilemmas in the treatment of depression under the auspices of managed care companies. A case example is presented to help social workers understand these dilemmas in the context of practice. Adopting an ethics of care perspective would mandate that social workers become more politically active, and work toward integrating direct and indirect practice approaches in treating people who suffer from depression and similar problems.     

The Helpfulness of Holistic Arts–Based Group Work with Children Living in Foster Care

This article discusses practice-based research that is exploring the helpfulness of holistic arts–based group work for the development of self-awareness and self-esteem in children living in foster care. The group program is arts based and encourages children to explore their beliefs, feelings, and behaviors. Examples of group exercises are provided, challenges in developing this group program are discussed, and qualitative research findings are presented, which are based on the analysis of fifteen 6-week groups. Findings indicate that children learned new skills, improved coping abilities, connected with feelings, and felt more positive. Practitioners are encouraged to consider how arts-based group work can help children in care.     

Regional cultures and health outcomes: Implications for performance measurement,public health and policy

The U.S. Medicare program now ties payment to health care providers based on their patients’ outcomes. This change comes as compilations of data on geographic variations in health outcomes and quality of care indicate patterns that appear to be deeply ingrained. This study explores whether cultural characteristics correlate with health outcomes such that quality indicators may be measuring something other than quality of care, and whether regional subcultures have a significant impact on public health. It concludes that two cultural dimensions, social capital and traditional/rational-secularism, which explain a sufficient proportion of outcome variations to cast doubt as to whether outcome measures capture provider quality. Correlations are explored between American regional subcultures identified by Joel Lieske and the variation in health outcomes. In a multidimensional analysis of Lieske's typology, results indicate that certain U.S. subpopulations have cultural advantages or disadvantages relating to health.     

Cracking the Code: Race,Class, and Access to Nightclubs in Urban America

Using ethnographic data collected in the downtown nightlife of Athens, Georgia, we explore black males’ responses to being rejected from nightclubs via dress code enforcement in predominately white settings. We contrast these responses to the general experiences of other black males who gained access. Although race is a factor in the enforcement of dress codes, we find a fluid relationship between race, class, and taste that influences black males’ responses and experiences. We illustrate how the nuanced reality of lived racial and class experiences for many young black males problematize the narrow interpretation of a black cultural essence.

Increasing walking in college students using a pedometer intervention: differences according to body mass index

Objective: The researchers assessed the effectiveness of a pedometer intervention and differences in walking behaviors according to body mass index (BMI). Participants: Two hundred ninety college students completed the intervention from January to February 2005. Methods: Participants wore pedometers 5 days per week for 12 weeks and completed questionnaires assessing demographic information. The authors calculated daily step averages for weeks 1, 6, and 12. They then classified students as underweight (UW), normal weight (NW), or overweight/obese, by BMI. The authors analyzed data using repeated-measures analysis of variance. Results: The average number of daily steps increased from week 1 to week 6 (p < .001) and week 12 (p = .002). UW participants reported the fewest steps at each time point, but the difference was significant only when compared with NW participants (p = .03). Conclusions: These results support the effectiveness of a pedometer intervention to increase walking in college students. Health benefits other than weight management should be emphasized to maximize the effects for all students.     

Gender differences in cardiovascular disease prevention

Risk factors are generally shared between men and women with the major differences being hormonal. Nine modifiable risk factors account for over 90% of the risk of a coronary event in men and women--smoking, hypertension, hyperlipidaemia, diabetes, abdominal obesity, lack of exercise, alcohol excess, reduced intake of fruit and vegetables, and psychosocial issues. Approximately half the decline in deaths from coronary heart disease (CHD), between 1980 and 2000, can be attributed to a reduction in the major risk factors and the other half to the use of evidence-based management. As educational efforts to increase awareness of cardiovascular disease (not cancer) to be the leading cause of death and disability in women are also associated with preventative action, it is important that health-care professionals educate themselves about CHD in women and communicate with women themselves, so that women can come forward for advice and evaluation.     

Competitive and Collaborative Quality and Warranty Management in Supply Chains

Product quality and product warranty coverage are two important and closely related operational decisions. A longer warranty protection period can boost sales, but it may also result in dramatically increased warranty cost, if product quality is poor. To investigate how these two decisions interact with each other and influence supply chain performance, we develop a single‐period model with a supplier that provides a product to an original equipment manufacturer, which in turn sells it to customers. Customer demand is random and affected by the length of the product warranty period. Warranty costs are incurred by both the supplier and the manufacturer. We analyze two different scenarios based on which party sets the warranty period: manufacturer warranty and supplier warranty. Product quality is controlled by the supplier, and the manufacturer determines the ordering quantity. We analyze these decentralized systems and provide the structural properties of the equilibrium strategies. We also compare the results of centralized and decentralized systems and identify the conditions under which one system provides a longer warranty and better product quality than the other. Our numerical study further shows that, in decentralized settings, when the warranty period is determined by the firm sharing the larger proportion of total warranty costs, the supply chain can achieve greater system‐wide profit. Both parties can therefore benefit from properly delegating the warranty decision and sharing the resulting additional profit. We further design a supplier‐development and buy‐back contract for coordinating decentralized supply chains. Several extensions are also discussed.     

How do risk attitudes affect pro-social behavior? Theory and experiment

Theory and Decision - We explore how risk preferences affect pro-social behavior under uncertainty. We analyze a modified dictator game in which the dictator can, by reducing her own sure payoff,...     

Changes in psychosocial well-being during stages of gay identity development

The current study evaluated the stage theory of Homosexual Identity Formation (HIF) developed by Cass (1979), in terms of the relationship between stage of gay identity development and psychosocial well-being. Four hundred twenty-five males (12 to 64 years, M = 29.2) reporting sexual attraction to other men provided demographic information and completed psychosocial measures: the Happiness-Sadness Scale (McGreal & Joseph, 1993), the Satisfaction with Life Scale (Diener, Emmons, Larsen & Griffin, 1985), the UCLA Loneliness Scale (Russell, Peplau & Ferguson, 1978), the Index of Self-Esteem (Hudson, 1982), and the Gay Identity Questionnaire (Brady & Busse, 1994). Correlation analysis and ANCOVAs controlling for age and nationality demonstrated that the 6 sequential stages of HIF were associated with a U-shaped function for the psychosocial variables. Well-being was high during the initial Confusion and Comparison stages of HIF, was reduced during the middle Tolerance and Acceptance stages, and was again high in the later Pride and Synthesis stages. Each of the psychosocial variables was significantly different according to stage of development (p <.001). Qualitative analysis of subjects' comments also revealed support for the U-shaped pattern.     

Parent-adolescent concordance on perceived need for mental health services and its impact on service use

Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent-adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n = 108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed.