The downside of managed mental health care

This article provides and analysis of the diffuculties caused by an attempt to combine professional and corporate cultural values in managed mental health care. It encourages the reader to think critically about the ethical, administrative, clinical, and practical issues which invevitably arise when these two cultures collide. It further suggests that although utilization review claims to provide cost-containment and consumer protection, in actuality is exists to protect profit, for the managed care company by providing disincentives for seeking and accessing necessary treatment. Finally, there is an exploration of the manner in which managed care companies manipulate virous segments of the healthcare system against one another in order to maximize profit. An alternative model is suggested.     

Incarcerated Dutch juvenile sex offenders compared with non-sex offenders

There is some debate about whether or not sex offenders are similar to non-sex offenders with regard to family background (parental characteristics), personality, and psychopathology. The central aim of this study focused on the comparison of juvenile sex offenders and non-sex offenders. The sample consisted of incarcerated juvenile male sex (n = 30) and non-sex (n = 368) offenders. It appeared that sex offenders resembled non-sex offenders with respect to most of the offender and parental characteristics. Results demonstrated some differences between both groups, while the majority of characteristics were similar. Limitations of the study are discussed, especially the low number of sex offenders, followed by suggestions for further research.     

Management of premature menopause

There has been some confusion among women and health professionals since the publication of the Women's Health Initiative and Million Women studies about the management of premature ovarian failure (POF). Both studies were undertaken in women aged 50 and over, and cannot be extrapolated to their younger counterparts, who would normally be producing their endogenous estrogen, since they have functioning ovaries. Estrogen-based replacement therapy is the main stay of treatment for women with POF and is recommended at least until the average age of natural menopause (52 years in the UK). This view is endorsed by regulatory bodies such as the Committee on Safety of Medicines (now the Commission on Human Medicines) in the UK. No evidence shows that estrogen replacement increases the risk of breast cancer to a level greater than that found in normally menstruating women, and women with POF do not need to start mammographic screening early unless other risk factors are present, such as family history.     

An American Dream Unfulfilled: The Limited Mobility of Mexican Americans

Objective . We build on past research regarding immigrant group adaptation by examining the wages of first–, second–, and third–generation Mexican–American men and women and empirically evaluating if past theories of immigrant incorporation apply to the Mexican–American case. Methods . We use the 1989 Latino National Political Study and the 1990/1991 Panel Studies of Income Dynamics and OLS regressions to estimate the effects of generation and human capital on wages. Results . Immigrant men and women report lower wages than their second– and third–generation counterparts, but once human capital controls are added, the wage pattern becomes one of steady decline across generations for men, and stagnation or marginal decline across generations for women. Conclusions . Our results generally contest the applicability of linear assimilation hypotheses to the Mexican–American experience, while lending some credence to the selectivity and immigrant optimism hypotheses. Results also indicate the importance of developing more contextualized immigrant adaptation frameworks.     

Restorative Practices and Child Welfare: Toward an Inclusive Civil Society

Child welfare systems in the United States are failing to include families in making plans, and this reduces their success in stabilizing children's placements and promoting children's well-being. A North Carolina study demonstrates how one restorative practice—family group conferencing (FGC)—advances family participation in child welfare planning. A sample of 27 conferences showed that the 221 family group members outnumbered the 115 service providers at the meetings. Family group members were usually satisfied with the conference process and decision and saw the plans as primarily reached through consensus, following a trusted leader, and bargaining. Satisfaction with the decision was reduced when bargaining was employed. Manipulation was more likely to occur when conference preparations were inadequate.     

Defining Community Care: realities and myths

This article looks critically at the concept of community care and argues that it is unhelpful and redundant. It makes three main points: first, that many care settings have elements of institutional and so-called community care and that there is no clear dichotomy between the two. Second, it is argued that the real distinction is not between the institution and the community but is between the institution and home. Community care is not provided by anonymous, altruistic others but comes from specific individuals (usually women) in domiciliary settings. The concept and definition of “home” are briefly discussed and it is suggested that most care is delivered either in a home , from home or at home. The third argument is that careful individual assessment is required to ensure that dependent people are not offered housing or residential solutions when what they need (and want) is care and services.     

Intergenerational patterns of teenage fertility

One of the frequently cited consequences of teen childbearing is the repetition of early births across generations, which thereby perpetuates a cycle of poverty and disadvantage. We use data from the 1988 National Survey of Family Growth (NSFG), Cycle IV, to examine trends and determinants of the intergenerational teen fertility link for women who reached adolescence between the 1950s and the 1980s. We find that daughters of both white and black teen mothers face significantly higher risks of teen childbearing than daughters of older mothers. We also find, more generally, that patterns of teenage family formation (i.e., both marriage and childbearing behaviors) tend to be repeated intergenerationally. The results suggest that the intrafamily propensity for early childbearing is not inherited biologically, at least not through factors related to the timing of puberty. Rather, the intergenerational patterns appear to operate at least in part through the socioeconomic and family context in which children grow up.     

Intensified inequities: Young people's experiences of Covid-19 and school closures in Uganda

Uganda had the longest period of school closures worldwide as a response measure during the Covid-19 pandemic. Drawing on longitudinal qualitative data from the Contexts of Violence in Adolescence Cohort Study (CoVAC) (2018–2023), we examine how this has affected the lives of adolescents in Uganda. Our analysis showcases how intersecting inequities based on socioeconomic circumstances, gender and location have intensified, with detrimental effects on young people's educational paths and life circumstances. Strategies that take the intersections of these inequities into account are urgently needed to help the most disadvantaged and marginalized young people return to school.