Parent-adolescent concordance on perceived need for mental health services and its impact on service use

Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent-adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n = 108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed.     

The Effects of Evaluating Video Examples of Staffs' Own Versus Others' Performance on Discrete-Trial Training Skills in a Human Service Setting

Many studies have been conducted evaluating the use of feedback in staff training in organizational settings. Central to this literature has been the use of a variety of forms of feedback, including videotaped feedback. A distinction is outlined between video modeling and a variety of possible video feedback procedures. Previous studies have indicated a possible positive training effect on staff skills from simply being exposed to relevant videotaped performances of those skills or as a result of evaluating video modeled performances. This study evaluated the effectiveness for training teaching skills of having staff evaluate videotaped teaching skills as performed by themselves versus others. The current study results replicate earlier research on the effectiveness of evaluating video models as a training method and do not suggest a difference between observing oneself as opposed to observing someone else. Future research suggestions for the general use of video in training are provided.     

Playground Accessibility and Neighbourhood Social Interaction Among Parents

While the positive association between social interaction and access to green space is well accepted, little research has sought to understand the role of children??s playgrounds in facilitating social interaction within a community. Playgrounds are spaces designed to facilitate play and the interaction of children, but may also be important places of interaction between parents. In this paper we examine how access to playground spaces is related to social interaction between parents. We use two measures of accessibility (1) walking distance to the closest playground and (2) playground service area, a measure of the number of potential users of a playground based on population density. We use generalized estimating equations, an extension of generalized linear models, to control for the confounding effects of socio-economic status (income, education), neighbourhood dynamics (neighbourhood location, years in neighbourhood) and free time (daily outdoor activity, marital status, number of children) on the independent relationship between social interaction and access to playground spaces. Our results suggest that while accessibility to playgrounds is associated with social interaction among parents, the direction of the effect is opposite to existing literature on green space and social interaction; parents with low accessibility to playgrounds are more likely to interact socially with their neighbours than parents with high accessibility. Our results suggest a pattern of spatial behaviour in which the burden of poor access to some resources may actually encourage greater neighbourhood engagement. Future research studying the relationship between health and green space may benefit from studying the specific role of playground spaces.     

The Age Difference Between Spouses: Variations among Developing Countries

Sub-national and cross-national variations in the age difference between spouses are investigated with data from the World Fertility Survey relating to 29 developing countries. Substantial variation within and between countries is evident. Analysis suggests that the relative age of prospective spouses is a factor taken into account in the marriage market. Observed variation in the age difference, within and between countries, cannot be explained as the simple by-product of the random matching of independently determined distributions of men's and women's ages at marriage. Certain age differences are avoided, others chosen more frequently. Preferred age differences appear to differ in the societies studied, however, and this variation can be directly interpreted in terms of two sets of factors: kinship structure and women's roles. The analysis also suggests that demographic determinants of the age difference, in particular age constraints on the pool of possible matches, are of less importance in explaining societal variations than are social structural factors.     

Knowledge, Consequences, and Experience: The Social Construction of Environmental Problems

Perhaps one of the most obvious yet difficult questions confronting sociologists concerned with large-scale environmental problems is an epistemological one: How do we know what we know about the state of the environment? This paper explores the realist and constructionist approaches to environmental-social problems and finds both inadequate as currently formulated. A case is made for a phenomenological constructionism that moves beyond relativism and simple definitional constructionism by exploring how we actually experience the world. This approach recognizes the existence of a natural world independent of our constructions, yet suggests that our knowledge of it is always mediated, indirect, and pragmatically motivated.     

Minimum wage effects by gender

Recent criticisms have led some to dismiss time-series analyses in the debate over the minimum wage. We investigate previous time-series studies showing that raising the minimum wage has a smaller impact on females than males. We reanalyze the data in light of recent developments in time-series methods and find that the minimum wage has a similar significant negative impact on both males and females. We conclude that, following a 10 percent increase in the minimum wage, both male and female employment drops from between 2 and 4 percent over a two-year period. This employment decrease slowly erodes as economic growth and inflation cause the minimum wage to fall below the market-clearing wage. We thank David Card and Alan Krueger for generously providing the data.     

Changing the Palace Guard: Analysing the Impact of Women's Entry into Medicine

Women's rapid entry into medicine raises important questions about change in this historically male-dominated profession. In addition to shifting the gender balance, do increasing numbers of women signal a more fundamental change in the way in which medicine is organized and practised? A growing body of research suggests such change. Yet there is continuing controversy about the meaning of observed gender differences in practice, whether they reflect an essentially pragmatic response to women's dual workload of family and career, or whether they are the result of underlying differences in attitudes, values and orientations. This article uses data from a survey of a recent cohort of family physicians in Ontario, Canada, to document the extent of gender differences and similarities in medical practice, and their interrelationships to family situation, political attitudes and patient care attitudes. The results show that seemingly related differences in practice are accounted for in different ways: while some are associated with differences in family situation, others are tied to attitudes, while others are a function of gender alone. The results also reveal gender similarities which do not suggest that women are becoming more like men, but that men, and the profession as a whole are changing. We would emphasize the importance of interpreting gender differences and similarities within a broader conceptual understanding of change in the profession.     

Casino self‐exclusion programmes: A review of the issues 1

Abstract

Casino self‐exclusion is a procedure by which individuals can have themselves banned from entering a casino. One of the purposes of this paper is to present information about the availability and features of these programmes. A second purpose is to make recommendations about how to best operate them based on cross‐jurisdictional analysis and lessons from the addiction literature. The first section of the paper describes the typical casino self‐exclusion programme, outlining the features common to most policies. The second section provides a detailed overview of the programmes operating in Canada in order to give the reader an appreciation of the procedural variations that exist. The third section discusses the effectiveness of self‐exclusion programmes. Finally, the fourth section contains recommendations on ways to improve effectiveness. When properly implemented, self‐exclusion can be a valuable tool in helping to curb problem gambling.     

The classification accuracy of four problem gambling assessment instruments in population research

Improved methodology was used to re-examine the weak correspondence between problem and pathological gamblers identified in population surveys and subsequent classification of these individuals in clinical interviews. The SOGS-R, the CPGI, the NODS and the Problem and Pathological Gambling Measure (PPGM), as well as questions about gambling participation and expenditures, were administered to a total of 7272 adults. Two clinicians then assessed each person's status, based on comprehensive written profiles derived from these questionnaire responses. Instrument classification was then compared to clinical classification. All four instruments correctly classified most non-problem gamblers (i.e. had good to excellent sensitivity, specificity and negative predictive power). However, the PPGM was the only instrument with good classification of problem gamblers (i.e. excellent sensitivity and positive predictive power). The CPGI and SOGS-R had weak positive predictive power and the NODS had only adequate sensitivity and positive predictive power. Improvement in the classification accuracy of the CPGI occurred when a 5+ cut-off was used and when a 4+ cut-off was used with the SOGS. In general, the classification accuracy of the NODS, SOGS and CPGI is better than prior research suggested but overall accuracy is still modest. With adjusted cut-offs, all three instruments are reasonably congruent with clinical ratings.