Liability in child welfare

Child welfare workers and agencies are vulnerable to lawsuits. Recent court rulings have more clearly defined the liability of workers. The distinguishing variable is custody. Children injured while in the custody of the state are entitled to sue for damages. Children injured by their parent, even if under the supervision of a child welfare agency, are not entitled to claim a violation of their 14th Amendment rights. These cases are reviewed and strategies designed to minimize vulnerability are offered.     

Rates of pathological gambling in publicly funded outpatient substance abuse treatment

Rates of problem or probable pathological gambling were assessed in substance abusers seeking outpatient treatment in a publicly funded outpatient substance abuse treatment program. The South Oaks Gambling Screen (SOGS) was administered to 467 consecutive admissions at three different sites. Problem gamblers comprised 6.2 percent of the total (n=29), and 4.5 percent scored as probable pathological gamblers (n=21). These rates are two and one-half times greater than would be expected according to a recent state survey using the SOGS. Implications for assessment and treatment of problem gambling are discussed.The author expresses his appreciation to John Ramsay and the staff of Epoch Counseling Center for data collection; to Les Franklin for computational analysis; and Dr. Rachel Volberg for providing supplemental data from her Maryland State Gambling Survey.     

Exposure Reconstruction for the TCDD-Exposed NIOSH Cohort Using a Concentration- and Age-Dependent Model of Elimination

Recent studies demonstrating a concentration dependence of elimination of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) suggest that previous estimates of exposure for occupationally exposed cohorts may have underestimated actual exposure, resulting in a potential overestimate of the carcinogenic potency of TCDD in humans based on the mortality data for these cohorts. Using a database on U.S. chemical manufacturing workers potentially exposed to TCDD compiled by the National Institute for Occupational Safety and Health (NIOSH), we evaluated the impact of using a concentration- and age-dependent elimination model (CADM) (Aylward et al., 2005) on estimates of serum lipid area under the curve (AUC) for the NIOSH cohort. These data were used previously by Steenland et al. (2001) in combination with a first-order elimination model with an 8.7-year half-life to estimate cumulative serum lipid concentration (equivalent to AUC) for these workers for use in cancer dose-response assessment. Serum lipid TCDD measurements taken in 1988 for a subset of the cohort were combined with the NIOSH job exposure matrix and work histories to estimate dose rates per unit of exposure score. We evaluated the effect of choices in regression model (regression on untransformed vs. ln-transformed data and inclusion of a nonzero regression intercept) as well as the impact of choices of elimination models and parameters on estimated AUCs for the cohort. Central estimates for dose rate parameters derived from the serum-sampled subcohort were applied with the elimination models to time-specific exposure scores for the entire cohort to generate AUC estimates for all cohort members. Use of the CADM resulted in improved model fits to the serum sampling data compared to the first-order models. Dose rates varied by a factor of 50 among different combinations of elimination model, parameter sets, and regression models. Use of a CADM results in increases of up to five-fold in AUC estimates for the more highly exposed members of the cohort compared to estimates obtained using the first-order model with 8.7-year half-life. This degree of variation in the AUC estimates for this cohort would affect substantially the cancer potency estimates derived from the mortality data from this cohort. Such variability and uncertainty in the reconstructed serum lipid AUC estimates for this cohort, depending on elimination model, parameter set, and regression model, have not been described previously and are critical components in evaluating the dose-response data from the occupationally exposed populations.     

A sea change on the island continent: frameworks for risk assessment,prevention and intervention in child health in Australia

This article overviews prevention and early intervention approaches focusing specifically on their relevance to the health of children and young people in Australia. Australian public health has a sound track record although concealed within the aggregate profile are a number of sub-populations with poorer health indicators. Recognition of this has increased efforts to improve the health of children and young people especially in exploring the impact of social environments within the communities where children are raised. This paper examines emerging research in this area drawing out key lessons and learning from Australian experience in the field of early intervention and prevention in community settings.     

Alternative institutional responses to asbestos

The level of asbestos risk varies widely, with insulation workers facing risks many orders of magnitude greater than other groups, such as school children. After a period of regulatory neglect, asbestos risks are now among the mos stringently regulated risks, with costs per case of cancer prevented on the order of $100 million. Asbestos litigation triggered much of the public action against asbestos, as asbestos cases constituted the majority of all product liability cases in the federal courts from 1988 to 1991. The litigation costs have, however, been substantial, almost three times as great as the amounts transferred to asbestos disease victims. Risk communication potentially could promote efficient risk levels and victim compensation.     

Training with o (observing) and T (treatment) teams in live supervision: reflections in the looking glass*

Working with a treatment and observing team at the same time, behind the oneway mirror, offers a variety of ways to: (a) generate multiple realities; (b) work with two different models of family therapy simultaneously; and (c) provide feedback on the teams' own roles, rules and group process. The process that 6 trainees and two supervisors used with T and O teams to examine their own coevolution as a therapeutic system using the Milan model of family therapy and Ericksonian hypnotherapy is described. The article concludes with a discussion of the advantages and pitfalls of this type of dual supervision.     

The prevalence rates of pathological gambling: A look at methods

Planning the gambling environment requires protection of the public's health, safety and welfare. Whereas most public gaming provisions and statutes address the public's fears of organized crime as well as some welfare needs, rarely do they safeguard the public's health regarding the spread of the mental disease known as pathological gambling. Measurement of the prevalence and incidence of this disease would enable policy planners to evaluate both the state's responsibility for an epidemic and the adequacy of publicly funded treatment programs. The purpose of this paper is to examine the methods which underlie three different estimates of the prevalence rate of pathological gambling and to critique them in the light of sound epidemiological procedure. In 1975, the Institute for Social Research (ISR) of the University of Michigan conducted a national survey and a survey of the state of Nevada on behalf of the U.S. Commission on a National Policy Toward Gambling. Using discriminant function analysis coupled with subjective inspection of cases in the at-risk pool, the researchers estimated rates of probable and potential pathological gamblers. In 1984 and 1985, this author surveyed residents in the Delaware Valley and the state of Ohio using the cumulative clinical signs method which also posited rates of probable and potential pathological gamblers. In 1986, researchers at the Office of Mental Health for the State of New York employed a formal screening device to survey residents and proposed a rate of probable pathological gamblers and a rate of problem — although not pathological — gamblers. All three approaches produced different estimates. The utility of prevalence and incidence rate research in this field is threatened by a lack of consensus about the proper epidemiological procedure to be employed in arriving at these estimates. There is also confusion about the distinction between a probable and a potential pathological gambler. The planning purpose, method, validity and reliability of prevalence rate research about pathological gambling are addressed in this paper.     

A review of research on the happiness measures: A sixty second index of happiness and mental health

Eighteen years of research using the Happiness Measures (HM) is reviewed in relation to the general progress of well-being measurement efforts. The accumulated findings on this remarkably quick instrument, show good reliability, exceptional stability, and a record of convergent, construct, and discriminative validity unparalleled in the field. Because of this, the HM is offered as a potential touchstone of measurement consistency in a field which generally lacks it.     

On "being a prostitute"

The book "On Being a Prostitute" (Perkins & Bennett, 1985) is a valuable contribution to the sociology of deviance and sexual ideologies. However, comprehensive as it is, the book presents certain omissions and flaws, with implications for both is empirical data and theoretical underpinnings. In focusing on male (homoerotic) prostitution, and drawing upon Bennett's (1983) "Twenty-Ten" survey (which forms the main empirical base of that aspect of the book), I argue that certain categories of male prostitutes have been excluded. These omissions, I suggest, were necessary to allow Bennett's hypothesis that most male prostitution derives from economic necessity--a recurrent economic determinism reminiscent of Havelock Ellis (1906/1936), and somewhat contrary to a broader structural approach (see Mathews, 1983).     

Demographics: people and markets

The basics of demography are now basic to us business as well. Demographics combine demographic data with socioeconomic and geographic factors to help business and other managers know the market for their goods and services. This pamphlet explains market, product, and site analyses, discusses data sources and resources, and includes case studies involving major corporations. Post-war population trends have had an enormous impact on consumer and labor markets, bringing home to business the importance of taking advantage of demographic shifts. Advances in computerized access to data describing changes and increased consciousness of their economic significance has spurred the application of demographic knowledge by managers and the growth of the demographics information industry. The pamphlet describes the resources and methods of demographics including the creation and use of demographic data products.