Overcoming medication refusal using a patient-centered approach

The refusal of psychotropic medication is a challenge faced by many healthcare providers when treating patients with mental illness. Controversy surrounds medication refusal because some mental health professionals believe that psychiatric patients should be forced to take medications for the safety of the general public, while patients are often acutely aware of potential lifelong adverse side effects and are sometimes reluctant to comply. The proposed alternative to this problem begins with developing the patient-provider relationship through a patient-centered approach. This approach emphasizes the individual needs of patients and creates opportunities for input from patients about their care, which helps form relationships of mutual trust and respect between patients and providers. This article explores the literature to: (1) understand some of the challenges and controversies involved in patient medication refusal from a clinical and societal level; (2) identify some issues in a patient-centered approach; and (3) make some brief clinical and policy recommendations that might help to bring about an increase in the use of patient-centered care. Hopefully, as efforts are made toward a patient-centered approach, increased psychotropic medication adherence and decreased medication coercion will result as providers listen and act upon the needs of their patients.     

The disinterested state: negative diasporic policy as an expression of state inclusion and national exclusion

ABSTRACT

This article engages with the understudied phenomenon of the ‘disinterested, denouncing’ diaspora state (Levitt, P., and N. G. Schiller. 2004. “Conceptualizing Simultaneity: A Transnational Social Field Perspective on Society.” International Migration Review 38 (3): 1002–1039. doi:10.1111/j.1747-7379.2004.tb00227.x) or ‘indifferent’ diaspora state (Ragazzi, F. 2009. “Governing Diasporas.” International Political Sociology 3 (4): 378–397. doi:10.1111/j.1749-5687.2009.00082.x). Focusing on U.S. citizens abroad, the article argues that there is negative diasporic outreach on the part of the state – ‘disinterested’ from the state's perspective, but ‘denouncing’ from that of the diaspora. Negative diasporic outreach is exemplified by the 2010 FATCA legislation, which sought to root out tax evaders resident in the U.S., but has, instead, affected millions of American emigrants through increased financial control and the repercussions of those policies, and has resulted in sharply higher citizenship renunciation figures. Impact on an American diaspora was not considered in the law's proposal, debate and passage into law. Second, the article argues that this negative diasporic outreach, in combination with the continued facilitation of the right to vote, is a reflection of the inclusion of these American emigrants in the American state, but their simultaneous exclusion from the American nation.     

Becoming cosmopolitan: encountering difference in a city of mobile labour

ABSTRACT

Many who move countries today do so for work, and labour mobility – both temporary and permanent – is the mechanism by which countless people (both movers and stayers) come into contact with cultural difference. The domain of mobile labour is thus an important context through which to consider the transformative possibilities of encounters with racial and cultural difference. Situated within debates on everyday multi-culture and vernacular cosmopolitanisms, this essay considers the question of intercultural encounter at work in relation to the layered histories of race and variegated citizenships of mobile labour in Singapore. Exploring the micro-nature of cosmopolitan practices, the paper considers under what labour conditions might an outward-looking cosmopolitan sensibility and a convivial openness to otherness emerge among migrant workers, as against a set of survival-based intercultural capacities. I reflect specifically upon two cases of ‘incongruous encounter’ in workplaces reliant on precariously employed migrant labour: a mainland Chinese man and a Filipina woman who, because of Singapore’s racialised system of work visas, find themselves working in South Asian restaurants in Singapore’s Little India. They both engage ‘cosmopolitan practices’, yet their sensibilities differ sharply. Their stories highlight how, in a place like Singapore, the ‘encounter’ needs to be understood within a regime of mobile labour, situated racial hierarchies, and a highly stratified system of work visas. I further suggest that situational factors such as the nature of work including its spatial and temporal qualities, the mixture of co-workers, and recognition relations with superiors all mattered in framing the affective atmospheres of encounter. In a context of forced encounter, I argue that learnt capacities to function and interact across difference should not necessarily be romanticised as a cosmopolitan sensibility.     

College and university compliance with a required meningococcal vaccination law

OBJECTIVE: Maryland became the first state to pass a vaccination law requiring college and university students living on campus to obtain a meningococcal vaccination or to sign a waiver refusing vaccination because college students are at increased risk for disease. The authors sought to identify how Maryland colleges addressed the law and determine whether schools were in full compliance. PARTICIPANTS: The authors surveyed 32 college/university administrators via a self-administered questionnaire. METHODS: The authors calculated vaccination and waiver rates and assessed compliance with the law overall and with specific law components. RESULTS: Among 28 participating schools, annual vaccination rates and waiver rates among students during 2000-2004 ranged from 66%-76% and 12%-17%, respectively. Two (7%) schools were compliant with all components of the law. CONCLUSIONS: Mandatory vaccination laws do not ensure compliance at the college and university level. Mandatory reporting, increased education, and collaboration between colleges and universities and public health agencies are needed.     

Names and naming in adoption: Birth heritage and family‐making

In this article, we consider the significance and practices of names and naming in adoption to develop understanding of the issue amongst scholars, policymakers, adoption practitioners, and adoption communities. Research on the topic of names and adoption is scarce and focused mostly on international and domestic adoptions in the United States. We draw on the research literature to critically explore names and naming in adoption through two recurrent and related themes. The first is “birth heritage,” where names, forenames especially, are shown to be important in the approach taken by adopters to their child's birth family and cultural identity. The second theme is “family‐making,” where namesaking and homogeneity of surname emerge, amongst others, as strategies to create, sustain, and display “family.” In gathering together for the first time an otherwise scattered, disparate body of research, our article showcases names and naming as illuminating distillations of key contemporary challenges experienced by families formed through adoption. We conclude our article by considering emergent gaps in existing knowledge and understanding about names, naming, and adoption that might usefully be addressed, to inform professional advice and familial decisions about names, and enhance outcomes for adoptees and their families.     

The effect of media sexism on women’s political ambition: evidence from a worldwide study

This paper presents results from one of the first global studies on the relationship between media sexism and the share of candidates for the lower chamber of national parliaments who are women. Data on media sexism come from the Global Media Monitoring Project, the most reliable worldwide source for media coverage from a gender perspective. The data on share of female political candidates come from the Inter-Parliamentary Union. The results show that that there is, even when controlling for the number of women in parliament, electoral system, gender quotas, level of human development, level of women’s rights, freedom from corruption, and media access, a significant relationship between media sexism—measured as (i) the share of all news subjects that are women and (ii) the share of all news subjects portrayed in the function of experts who are women—and the share of women candidates for parliament: the higher the level of media sexism, the lower the share of women candidates. The theory discussed zooms in on a bystander effect: We hypothesize that sexist portrayals of women in the media stifle ambition among women who, in a less sexist media environment, would be willing to stand as political candidates.     

Issuing and Responding to Unusual Questions: A Conversation Analytic Account of Tom Andersen's Therapeutic Practice

Tom Andersen is considered one of the key contributors to the development of postmodern practice. Little is known, however, about the ways in which his ideas and practices are routinely carried out in situ. We used Conversation Analysis (CA) to investigate a session of couple therapy facilitated by Andersen. We show how Andersen and client participants oriented to and addressed problems of understanding that occurred between them. The source of this trouble was Andersen's use of unusual question formulations. We offer preliminary evidence that such unusual formulations served particular interactional and institutional (i.e., therapeutic) functions in their local contexts of use. We conclude by considering some implications of this analysis—and of conversation analytic inquiry more generally—for the practice of family therapy.     

Class participation as a pedagogical tool in social work education

Class participation is an essential part of the social work pedagogy. However, active student engagement in classes is inconsistent and varies based on factors such as social backgrounds, educational background, and individual characteristics. Instructors often evaluate participation based on frequency of verbal contributions. Evaluation criteria are often unarticulated or difficult to measure, presenting numerous challenges for instructors and students alike. A model of reflective self-assessment of participation by students, paired with timely instructor feedback is put forth in this paper to mitigate these concerns. The steps in this model include initial self-assessment, goal setting, midterm review, and a final review. The process of continuous self-evaluation and problem-solving is discussed as strategies that aid the process of class participation. Three instructor touch points are suggested: at the goal-setting stage, the midterm review, and the final grade. Throughout the paper, connections to social work practice and social work pedagogy are highlighted. This model has yet to be implemented in a social work school’s curriculum. Challenges in the implementation and resolution of those challenges are also presented. This model suggests ways to enhance opportunities for student engagement and integration into graduate programs, in addition to fostering valuable skills for future practice in the field.     

Evaluating the effect of a campus-wide social norms marketing intervention on alcohol-use perceptions,consumption, and blackouts

Objective: To evaluate the effect of a campus-wide social norms marketing intervention on alcohol-use perceptions, consumption, and blackouts at a large, urban, public university. Participants: 4,172 college students (1,208 freshmen, 1,159 sophomores, 953 juniors, and 852 seniors) who completed surveys in Spring 2015 for the Spit for Science Study, a longitudinal study of students' substance use and emotional health. Methods: Participants were e-mailed an online survey that queried campaign readership, perception of peer alcohol use, alcohol consumption, frequency of consumption, and frequency of blackouts. Associations between variables were evaluated using path analysis. Results: We found that campaign readership was associated with more accurate perceptions of peer alcohol use, which, in turn, was associated with self-reported lower number of drinks per sitting and experiencing fewer blackouts. Conclusions: This evaluation supports the use of social norms marketing as a population-level intervention to correct alcohol-use misperceptions and reduce blackouts.