Are Hearing Voices Networks Compatible with Cognitive Behavioural Therapy for Psychosis?

The most extensively evaluated intervention for auditory hallucinations is Cognitive Behavioural Therapy for Psychosis (CBTp), which is usually delivered in statutory settings by experienced clinicians. In contrast, peer support networks, such as the Hearing Voices Network (HVN), operate informally using peers to normalise and manage voices. This article compares these two approaches to identify points of synergy and difference. Its analysis suggests the two approaches share many features, but also deviate in important ways that could compensate for each other. Instead of competing with each other as might first be thought, they may actually be complementary. Further, HVN may align comfortably with the values and principles of social work. Social workers seeking to engage with voice hearers may be advised to study the underlying principles of each approach to guide the way in which they can capitalise on intervention opportunities to better assist voice hearers.     

The effects of school desegregation on mixed-race births

We find a strong positive raw correlation between black exposure to whites in their school district and the prevalence of later mixed-race (black-white) births, consistent with the literature on residential segregation and endogamy. However, that relationship is significantly attenuated by the addition of a few control variables, suggesting that individuals with higher propensities to have mixed-race births are more likely to live in desegregated school districts. We exploit quasi-random variation from court-ordered school desegregation to estimate causal effects of school desegregation on mixed-race childbearing, finding small to moderate effects that are largely statistically insignificant. Because the upward trend across cohorts in mixed-race childbearing was substantial, separating the effects of desegregation plans from secular cohort trends is difficult; results are sensitive to how we specify the cohort trends and to the inclusion of Chicago/Cook County in the sample. The fact that the addition of a few control variables substantially weakens the cross-sectional relationship between lower levels of school segregation and higher rates of mixed-race childbearing suggests that a substantial portion of the observed correlation is likely due to who chooses to live in places with desegregated schools. Researchers should be cautious about interpreting raw correlations between segregation—whether residential or school—and other outcomes as causal. Our results also point to the need to carefully explore specification of cohort effects in quasi-experimental designs for treatments where cumulative exposure is important.     

Is Chinese National Health Insurance Effective in the Face of Severe Illness? A Perspective from Health Service Utilization and Economic Burden

Over the past decade, health insurance coverage has expanded dramatically in China. Health insurance benefits, however, remain shallow or ambiguous. This study examines the effect of Chinese national health insurance policy on health service utilization and economic burden in urban settings using the Urban Resident Basic Medical Insurance Household Survey. We employ the Heckman selection model to correct for selection bias among hospital inpatients, and find that compared to individuals without health insurance, those with health insurance are more likely to be admitted to the hospital when their physicians recommended them to enter the hospital as inpatients. Health insurance is also associated with about 45.6 % decrease in out-of-pocket inpatient expenditures. Individuals with urban employee basic medical insurance see the largest decrease in economic burden, followed by individuals with urban resident basic medical Insurance, and those with new rural cooperative medical insurance.     

Using institutional ethnography's ideological circle to portray how textually mediated disability discourse paralysed a Supreme Court of Canada ruling

Persons with disabilities created through texts as damaged goods are being ‘cured’ by workplace accommodation, a textually mediated work process. Prior to 1999, workplace accommodation in the Canadian federal public service signified the adjustments necessary to enable a disabled worker to fit into a workplace designed for able-bodied workers. In 1999, a Supreme Court of Canada (SCC) ruling known as Meiorin turned this accommodation provision on its head. Instead of being focused on individual-level fixes so that a disabled worker could be accommodated in an existing workplace, this legislation required employers to transform their workplaces so as to make them ready to receive as many different types of workers as reasonably possible from the outset. Using Dorothy E. Smith's institutional ethnography, I use my experiences as a disability rights activist employed in the Canadian federal public service to explicate how textually mediated disability discourse paralysed this groundbreaking SCC ruling.     

Anabolic-Androgenic Steroids and Condom Use: Potential Mechanisms in Adolescent Males

Previous research has revealed a significant bivariate relationship between anabolic-androgenic steroid (AAS) use and reduced condom use among adolescent boys. However, to date, no known studies have explored the psychological mechanisms that may explain this relationship. Thus, the current study sought to examine two possible mediators in the association between AAS and condom use: depressive symptoms and substance use. Data were extracted from a nationally representative sample of U.S. adolescents. Participants were 3,780 U.S. high school boys who responded to self-report items assessing a number of health behaviors, including symptoms of depression, substance use, AAS use, and use of condoms during their most recent act of intercourse. Both depression and substance use were significant mediators in the relationship between AAS and condom use. However, when these effects were contrasted, the indirect effect of substance use was significantly stronger in magnitude than the effect of depression. Although AAS use was associated with sexual risk behaviors among adolescent boys, significant variance in this relationship was accounted for by elevated levels of depression and substance use, with substance use demonstrating a particularly salient pathway.     

Preference intensity representation: strategic overstating in large elections

If voters vote strategically, is it useful to offer them the possibility of expressing nuanced opinions, or would they always overstate the intensity of their preferences? For additive voting rules, say that a ballot is extremal if it is neither abstention-like nor can be expressed as a mixture of the available ballots. We give a sufficient condition for strategic equivalence: if two rules share the same set of extremal ballots (up to an homothetic transformation), they are strategically equivalent in large elections. This condition is also necessary for the strategic equivalence of positional rules. These results do not hold for small electorates.     

The Global Alliance for Public Relations and Communication Management: Origins,influences, issues and prospects

This paper chronicles the formation and development of the Global Alliance for Public Relations and Communication Management (GA) up to 2002. It sets the GA's genesis within the context of other internationalisation initiatives undertaken by the wider public relations practitioner community and draws links between the formation of the GA and the emerging phenomenon of globalisation. The paper's intent is to describe the formation of the GA from a historical perspective, to understand the forces that led to its creation and to appreciate the different drivers and motivation of founding members. These factors provide a springboard to consider some of the issues that currently challenge GA, some of which were inherent in the governance model it chose at its inception.     

Gender and Supportive Co‐Worker Relations in the Medical Profession

Women's growing numerical representation in the professions has not necessarily translated into women being truly integrated in these occupations. Questionnaire data are used to examine whether female physicians are socially integrated in the male‐dominated profession of medicine in terms of the support they receive from their medical colleagues compared to male physicians. The literature on tokenism and homophily suggests that women in male‐dominated professions receive less support than their male colleagues, whereas the social support literature predicts that women typically receive more emotional support than men but less informational and instrumental support. The results of this study shed light on the complex and multi‐layered ways in which gender is relevant to our understanding of the extent to which co‐workers provide empathy, information and assistance to one another.     

Predictors of treatment outcome in a child and adolescent psychiatry clinic: A naturalistic exploration

We present data on predictors of treatment outcome for 3200 consecutive referrals to a child and adolescent psychiatry clinic. Using Reliable Change Index (RCI) methodology, we divided children into those who, between intake and discharge, improved, stayed the same, or got worse according to clinician-rated impairment. Most predictors of improvement were related to parent variables (marital status, maternal anxiety, and ethnicity), while those associated with deterioration were tied to child status (extent of psychiatric comorbidity, history of placement in a self-contained classroom, and a prior trial of psychotropic medications). The implications of these findings for data-driven program development, clinic management, treatment planning, and systems of care are discussed.     

Delirium: a very common problem you may not recognize

Older adults with multiple pre-existing conditions are admitted to hospitals with acute illnesses and injuries every day. Delirium is not recognized by clinicians across health care settings. With awareness of risk factors and knowledge of delirium, nurses can play a pivotal role in the early identification, treatment, and, most important, prevention of delirium in older adults. Nurses often display a lack of knowledge related to delirium and the complex symptoms that appear differently in the presence of other complicating co-morbid conditions in aging adults. Nurses play a crucial role in keeping patients safe and ensuring optimal outcomes, regardless of the setting. With the growing population of older adults and the expected increases in chronic illness and dementia, delirium is a problem nurses are likely to experience in all practice settings. Knowing what to look for facilitates recognizing the risk and acting early to minimize (or even prevent) delirium.