Patient Compliance and the Role of the Expert

The failure of patients to follow recommendations made to them by health experts usually represents a hazard to the patient's health, a waste of health resources, and a source of frustration to the health expert. Many studies of such failure lead to the conclusion that every patient should be considered as potentially "non-compliant." The most promising site for intervention is in the expert-patient interaction. Viewing compliance as a property of the transaction between expert and client, it is appropriate to see the responsibility for establishing compliance as shared between expert and client. From this viewpoint, several models of the expert-client relationship are reviewed. Three areas of responsibility can be assigned to experts—exploring the individual patient's situation fully; anticipating the patient's difficulties in following recommendations; and communicating information in a way that will maximize its effectiveness. Recognition of these responsibilities will have numerous consequences for those who teach health professionals and for psychologists engaged in the study of communication processes.     

Teaching Note—Incorporating Journal Clubs Into Social Work Education: An Exploratory Model

This article outlines the implementation of a journal club for master's and doctoral social work students interested in mental health practice. It defines educational journal clubs and discusses the history of journal clubs in medical education and the applicability of the model to social work education. The feasibility of implementing journal clubs in a school of social welfare is highlighted. The journal club received high ratings on student evaluations indicating participants thought it was a valuable addition to their education. Journal clubs align with the program mission and goals of the Educational Policy and Accreditation Standards (EPAS) set forth by the Council of Social Work Education (CSWE), and they can be an affordable, easily implemented, and sustainable supplement to traditional research curricula.     

Establishing the Validity of the Affirmative Training Inventory: Assessing the Relationship between Lesbian,Gay, and Bisexual Affirmative Training and Students’ Clinical Competence

This study established the validity and factor structure of the Affirmative Training Inventory (ATI; T. S. Carlson, C. R. McGeorge & M. Rock, unpublished) as a measure of lesbian, gay, and bisexual (LGB) affirmative clinical training. Additionally, this study examined the latent associations among the subscales of the ATI and the Sexual Orientation Counselor Competency Scale ( Bidell, 2005 ) utilizing a sample of 248 master’s and doctoral couple and family therapy students. The findings from this study provide empirical support for the relationship between specific classroom‐related content associated with LGB affirmative therapy and students’ perceptions of their own ability to work competently with LGB clients. This study also found a positive association between the degree to which couple and family therapy programs adopt a LGB‐affirmative stance and students’ beliefs, knowledge, and skills associated with competent therapy with LGB clients.     

Mental Disorders Among Non-Elderly Nursing Home Residents

Many Medicaid beneficiaries aged 22 to 64 with serious mental illness may be admitted to nursing facilities rather than psychiatric facilities as a result of Medicaid policies prohibiting coverage of inpatient psychiatric care in institutions of mental disease while requiring states to cover nursing facility care. Using nationwide Medicaid Analytic Extract claims from 2002, we found that nearly 16% of nursing home residents aged 22 to 64 had a diagnosed mental disorder, while 45.5% received antipsychotic medication, but these rates varied widely across states. Further research is necessary to determine whether, among the nation's youngest nursing home residents, care in nursing homes is potentially substituting for care in institutions for mental disease or community-based settings.     

The Blind Paper Cutter: Teaching about Variation,Bias, Stability,and Process Control

The intention of this article is to provide teachers with a student activity to help reinforce learning about variation, bias, stability, and other statistical quality control concepts. Blind paper cutting is an effective way of generating tangible sequences of a product, which students can use to address many levels of questions. No special apparatus is required.     

DISTRIBUTION FREE MULTIPLE COMPARISONS FOR MONOTONICALLY ORDERED TREATMENT EFFECTS

A method of calculating simultaneous one-sided confidence intervals for all ordered pairwise differences of the treatment effects_j–_i, 1 i < j k, in a one-way model without any distributional assumptions is discussed. When it is known a priori that the treatment effects satisfy the simple ordering_1k, these simultaneous confidence intervals offer the experimenter a simple way of determining which treatment effects may be declared to be unequal, and is more powerful than the usual two-sided Steel-Dwass procedure. Some exact critical points required by the confidence intervals are presented for k= 3 and small sample sizes, and other methods of critical point determination such as asymptotic approximation and simulation are discussed.     

Evaluating the relative accuracy and significance of net migration estimates

This paper presents the elements of a theory for evaluating the quality of a set of net migration estimates. The total error in a net migration estimate is decomposed into total bias and total variation. The bias is further decomposed into three bias elements-selection bias, estimator bias, and measurement bias. Tables of bounds for measurement and estimator biases in the vital statistics and the forward survival ratio estimates of net intercensal migration are presented. Both net migration levels and net migration ratios are treated, and provision is made for both life table and census survival ratio estimates. Some of the statistical tables are applied illustratively to net migration data for Canadian counties or census divisions during the 1951-61 decade. Tests of significance and confidence intervals are indicated for net migration estimates, and the basic technical notes are presented in appendices.     

Epidemiologic network inference

Statistics and Computing - In many epidemiologic models, a disease is assumed to spread along a contact network. We aim to infer this network, in addition to the epidemiologic model parameters,...     

The Evolution of Culture and Sociology

Orthodox neo-Darwinians have typically sought to explain human pro-social behavior by invoking kin altruism and reciprocal altruism, principles that explain the pro-social behavior of non-human species. These principles, however, do not account for those features of our species that are most unique and of greatest importance to sociologists—our group identities and behavior, our cognitive and behavioral plasticity, our capacity for social learning and cumulative culture, among other things. This article describes the efforts of “dual inheritance” theorists to overcome the deficiencies of orthodox neo-Darwinism by developing an evolutionary theory of culture, a theory that also seeks to account for human “groupishness,” intelligence, language use, empathy, morality and religion. The article asserts that dual inheritance theory accommodates most of the traditional research interests of sociologists while proving a robust explanatory framework and that sociologists are positioned especially well to contribute to the study of the evolution of culture.