Public attitudes toward the use of psychiatric medications for children

Psychiatric medication use for children has increased dramatically over the past three decades. Despite substantial media attention to the issue, little is known about how the lay public feels about the use of psychiatric medications for children. Drawing on theories of medicalization, we describe and analyze Americans' attitudes towards the use of psychiatric medications generally and Prozac specifically for children described as having three types of behavioral problems. Using data from the 1998 General Social Survey's Pressing Issues in Health and Medical Care Module, we find that more Americans (57%) are willing to use psychiatric medications for children who have expressed suicidal statements than for "oppositional" behaviors (34.2%) or for hyperactivity (29.5%). Across the board, respondents are less willing to give Prozac than the general class of psychiatric medications. While socio-demographics do little to identify Americans with differing positions, the strongest and most consistent correlates of willingness to give psychiatric medications to children are trust in personal physicians, general attitudes towards psychiatric medications, and the respondent's expressed willingness to take psychiatric medications herself or himself.     

Accountability to Welfare Service Users: Challenges and Responses of Service Providers

Influenced by the consumerist sentiment in New Public Management,the last decades have witnessed a revival of the call for accountabilityto service users in the public service sector. As an act ofaccountability, social care and health care professionals areincreasingly obliged to involve their service users in the serviceplanning and monitoring process. Despite the popularity of thisaccountability and user involvement rhetoric, critics have,however, been skeptical of the prevailing user involvement initiativesas an effective measure of accountability to service users (Barnes and Wistow, 1994a,1994b; Bowl, 1996; Peck et al., 2002; Rea, 2004). Based on astudy of user involvement in the welfare sector of Hong Kong,this paper argues that the discourse of accountability to theservice users can be a source of unrest for welfare professionals,in the manifestation of accountability as a power relationship.Their ensuing response is to accommodate the ensuing challengearising from the demand for accountability to service usersby manoeuvring the accountability discourse. It is the contentionof this paper that the institutional inclusion of welfare serviceusers into a discursive space is a necessary but not sufficientcondition for the realization of a mandate of accountabilityto welfare service users.     

An EM Algorithm for Smoothing the Self-consistent Estimator of Survival Functions with Interval-censored Data

Interval-censored data arise in a wide variety of application and research areas such as, for example, AIDS studies (Kim et al ., 1993) and cancer research (Finkelstein, 1986; Becker & Melbye, 1991). Peto (1973) proposed a Newton–Raphson algorithm for obtaining a generalized maximum likelihood estimate (GMLE) of the survival function with interval-cen sored observations. Turnbull (1976) proposed a self-consistent algorithm for interval-censored data and obtained the same GMLE. Groeneboom & Wellner (1992) used the convex minorant algorithm for constructing an estimator of the survival function with "case 2" interval-censored data. However, as is known, the GMLE is not uniquely defined on the interval [0, ∞]. In addition, Turnbull's algorithm leads to a self-consistent equation which is not in the form of an integral equation. Large sample properties of the GMLE have not been previously examined because of, we believe, among other things, the lack of such an integral equation. In this paper, we present an EM algorithm for constructing a GMLE on [0, ∞]. The GMLE is expressed as a solution of an integral equation. More recently, with the help of this integral equation, Yu et al . (1997a, b) have shown that the GMLE is consistent and asymptotically normally distributed. An application of the proposed GMLE is presented     

The role of the gerontological social worker in assisted living

This qualitative study reports on thirteen assisted living (AL) administrators' perspectives of the role and the importance of the AL social worker in addressing the unmet needs of older adults as they move and transition into AL. Participant interviews were analyzed using the constant comparative method. Administrators described 5 AL social work roles: (a) decision-making and adjustment coordinator; (b) resident advocate; (c) mental health assessor and counselor; (d) family social worker; and (e) care planner. Implications include directly examining AL social workers' views, analyzing costs and benefits of employing AL social workers, and developing social work practicum sites within AL.     

Warehouses or Welfare?: Legislative Dispositions for Alcoholics

Skid row alcoholic offenders and the various legislative responses to this social problem are examined. Recent United States case law is discussed in the context of sociological explanations of societal intervention against this group. The validity of the medical model of alcoholism as a basis for planning social policy in respect of alcoholic offenders is questioned. Traditional justifications for civil commitment programmes are rejected as an infringement of civil liberty and human dignity. The effectiveness of criminal sanction on a cost benefit basis is analysed. Finally,. alternative policies are discussed and recommendations are made as to possible long-term solutions.     

Palliative sedation: an essential place for clinical excellence

The complexities that converge around palliative sedation invite clinicians to work together to differentiate the issues and come to recommendations and decisions that are humane, ethical, legal, and clinically sound. Whether a crisis or long-term situation exists, the work is essentially the same. It must include critical thinking, clinical expertise, multidimensional assessment, and an array of interventions to assist patients and families in situations where symptoms and suffering are sufficiently intense to warrant exploration of sedation. The many issues inherent in the discussion of sedation at end of life require not that we have the answers but rather that we work with our colleagues to raise relevant questions and integrate both expertise and compassion into end-of-life decisions and care.