Personal empowerment program: addressing health concerns in people with schizophrenia

Three staff nurses in the Outpatient Schizophrenia Service of the Foothills Medical Centre in Calgary, Alberta, Canada, became concerned about the weight gain of their patients. Patients and their family members were also concerned and asking for help. Before integrating a program to address these concerns, staff first had to demonstrate that a program of this nature would be beneficial for clinic patients. Of the 75 clients screened, many presented with problems in the areas of weight, blood pressure, and fasting blood sugar and lipid levels. Although not a research study, an 8-month pilot project was implemented to address these concerns. It was hypothesized that integrating all dimensions of wellness in patient programming would have a positive effect on various defined indicators (e.g., weight, body mass index, blood pressure, and fasting blood sugar and lipid levels). Screening tests before, during, and after the 8-month project provided the physical outcome measurements. Social and psychological outcomes were described through observation and group member feedback. The positive results are significant in terms of empowering patients in the long-term management of their health.     

Integrating a family-centered approach into social work practice with families of children and adolescents with disabilities

This article identifies a family-centered practice construct for working with children and adolescents with disabilities and their families. The experiences of these families have shifted considerably over the past 30 years. A legislative and historical context provides the basis for an understanding of present policies and practices that influence current approaches to service delivery. Though family-centered practice is emphasized in various practice settings, there is still a need to integrate this philosophy into social work practice with children and adolescents with disabilities and their families. In order to enhance the ability of the social worker to integrate this construct into practice, a framework for exploring the experiences of children, adolescents and families is provided. This framework provides an overview of factors related to the individual child, the family and siblings for the social worker to consider when working with these families. The social worker's role as collaborator, advocate, team member and family resource is highlighted.     

Sexual functioning in women with chronic pelvic pain: the impact of depression, support, and abuse

Many studies have documented associations between sexual functioning, depression, experiences of childhood sexual abuse, relationship support, and chronic pelvic pain, but none have addressed the interrelationships among all of these variables in a unified model. The aim of this preliminary study was to construct an integrative model predicting sexual functioning for women with chronic pelvic pain. Sixty-three women with chronic pelvic pain completed measures of sexual functioning for use as the criterion variable, and measures of the impact of chronic pain, depression, experiences of sexual abuse, and relationship support as predictors. The primary finding was that depression mediated the effects of child sexual abuse and partially mediated the effects of relationship support on sexual behavior and satisfaction with the sexual relationship. In addition to its indirect relationship through depression, relationship support also independently predicted sexual function. Thus, in this nonclinical sample, the effects of child sexual abuse on sexual function depended on the extent of depressive symptoms, while the influence of relationship support depended in part on depression.     

Marriage Following Adolescent Parenthood: Relationship to Adult Well‐being

Research suggests that adult marriages confer benefits. Does marriage following a teenage birth confer benefits similar to those observed for adults? Longitudinal data from a community sample of 235 young women who gave birth as unmarried adolescents were used to examine this question. Controlling for socioeconomic status and preexisting “benefits,” we found that marriage conferred small, though statistically significant, benefits with regard to less economic adversity and less marijuana and polydrug use but no observable benefits with regard to alcohol or other drug use, poverty, psychological well‐being, or high school completion, in contrast to prior findings. We conclude that in addition to the marriage benefits observed, stable intimate relationships, whether marital or not, appear to confer psychological benefits in this sample.     

The economic costs of childhood poverty in the United States

This paper attempts to estimate the aggregate annual costs of child poverty to the US economy. It begins with a review of rigorous research studies that estimate the statistical association between children growing up in poverty and their earnings, propensity to commit crime, and quality of health later in life. We also review estimates of the costs that crime and poor health impose on the economy. Then we aggregate all of these average costs per poor child across the total number of children growing up in poverty in the United States to obtain our estimate of the aggregate costs of the conditions associated with childhood poverty to the US economy. Our results suggest that these costs total about $500 billion per year, or the equivalent of nearly 4% of gross domestic product (GDP). More specifically, we estimate that childhood poverty each year: (1) reduces productivity and economic output by an amount equal to 1.3% of GDP, (2) raises the costs of crime by 1.3% of GDP, and (3) raises health expenditures and reduces the value of health by 1.2% of GDP.     

Analysis and Management of Periodic Review,Order‐Up‐To Level Inventory Systems with Order Crossover

In this article, we investigate the (R, S) periodic review, order‐up‐to level inventory control system with stochastic demand and variable leadtimes. Variable leadtimes can lead to order crossover, in which some orders arrive out of sequence. Most theoretical studies of order‐up‐to inventory systems under variable leadtimes assume that crossovers do not occur and, in so doing, overestimate the standard deviation of the realized leadtime distribution and prescribe policies that can inflate inventory costs. We develop a new analytic model of the expected costs associated with this system, making use of a novel approximation of the realized (reduced) leadtime standard deviation resulting from order crossovers. Extensive experimentation through simulation shows that our model closely approximates the true expected cost and can be used to find values of R and S that provide an expected cost close to the minimum cost. Taking account of, as opposed to ignoring, crossovers leads, on average, to substantial improvements in accuracy and significant cost reductions. Our results are particularly useful for managers seeking to reduce inventory costs in supply chains with variable leadtimes.