Moving Toward Medicare Home Health Coverage for Persons with Alzheimer's Disease

ABSTRACT

Medicare home health care policy does not incorporate research evidence of effective palliative home care interventions for Alzheimer's disease and dementia patients and caregivers. This article examines the dissonance between the needs and burdens of Alzheimer's disease patients and caregivers, research results on medical and palliative care interventions, and medicalized public policy in the Medicare home health benefit. The article asserts existing research establishes a prima facie case exists for the federal government to fund a Medicare Palliative Home Care for Alzheimer's disease demonstration project. The article cites the success of the Medicare Hospice Demonstration project and Hospice Medicare Benefit in reducing costs and improving client quality of life as precedent and a model for Alzheimer's disease. Other research implications are identified.     

Pelvic muscle strength of female ejaculators: Evidence in support of a new theory of orgasm

After a pilot study of two male teams at two different universities suggested that some athletes apparently had participated in homosexual activities which they would reliable answer questions about, the researchers surveyed three additional teams at three other universities. The data indicated that a fairly substantial minority of collegiate male athletes had engaged in gay actions. The results did not appear to be due to sample bias, ambiguity in defining what is “gay,” deception, or other artifacts.     

Using Social Work Theory for the Facilitation of Friendships

Positive friendships are essential to human development and resilience. In spite of the importance of friendships, few social work models have been developed to help clients establish or maintain friendships. This article explores how clinical theories of social work, and their associated practice interventions, can guide social workers in helping their clients improve their friendship relationships.     

A la Recherche du Temps Perdu: Case-study Evidence from Off-site and Pupil Referral Units

Recent changes in provision for children who have been excluded from school have involved the establishment of Pupil Referral Units (PRUs). This paper proposes that many of the difficulties which face both teachers and young people working in PRUs are replicating problems that have traditionally existed in segregated education. Using the views of young people who have been excluded from school and those of their teachers it notes the similarities between current provision and the ‘off-site units’ for so-called disruptive children of the 1970s and 1980s. What results, it is argued, represents an often well-meaning but hopelessly inadequate response to the needs of these children.     

Towards a Philosophy of Containment: Reading Goffman in the 21st Century

On the occasion of the re-publication of Erving Goffman’s Relations in Public: Microstudies of the Public Order, including the remarkable appendix, “Insanity of Place,” the authors propose new ways of reading Goffman’s work in order to highlight his attention to havoc and containment. Goffman’s “Insanity of Place,” explores the phenomenon of mental illness by asserting that it is an instance of havoc, a symbolic and practical condition that disrupts the social order of life, and one that must be contained. By situating this essay at the center of Goffman’s oeuvre they examine Goffman’s “philosophy of containment,” and trace its trajectory from Asylums, Stigma and “The Insanity of Place” to its full crystallization in Frame Analysis. The authors offer a generative reading of havoc and containment in order to understand the incoherence, irrationality, unreason, incomprehensibility and unbearableness of social life and the imperative to preserve social order from collapsing, dissolving or imploding. This reading enables us to see the cracks in the social order and understand containment as the constant effort exerted to recuperate transgressions and deviations back into that order. Goffman’s analysis becomes an opening into engagements with the work of Judith Butler and Michel Foucault around the notion of the normative order and the issues of containment and transgression. Thinking through Goffman’s philosophy of containment as the framework for an analysis of socialization, normalization, and social ordering affords an approach to thinking macro-micro linkages of order and instability that confront both our contemporary society and the discipline of sociology.     

Alprazolam (Xanax) use among southern youth: beliefs and social norms concerning dangerous rides on "handlebars"

While the epidemiologic trends concerning alprazolam (Xanax) are unknown, the use of benzodiazepines, in general, has increased in popularity among youth within recent years. To shed light on the drug problem, the current pilot study used a qualitative approach to investigate relevant beliefs, norms, and perceived addiction associated with alprazolam initiation among 46 youth who were attending an inpatient drug treatment program during the spring of 2004. Overwhelmingly, most participants stated that addiction to alprazolam occurs as early as initial consumption. Most youth in the study stated that their friends felt it was normal to use alprazolam. In addition, their control beliefs revealed that if someone wanted to stop it would be difficult because of the widespread use in their communities and family social reinforcement involved with its use. In this study, a majority of students stated that medical professionals such as doctors and pharmacists were the greatest facilitator of alprazolam acquisition. Implications for these results are discussed.