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.     

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.     

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.     

Documenting Pornography Use in America: A Comparative Analysis of Methodological Approaches

Estimates of pornography use in the United States range widely. We explore the reasons for the variation in such estimates among U.S. adults using data from four different recent nationally representative samples—each of which asked a different type of question about pornography use. We attribute the notable variation in estimates to differences in question wording and answer options, and assert that a survey question asking respondents about their most recent use of pornography minimizes recall bias and is better poised to assess the overall prevalence of pornography in a population than is the more common approach of asking respondents about their historical general-use pattern. When we privileged the most-recent-use approach, survey data from 2014 reveal that 46% of men and 16% of women between the ages of 18 and 39 intentionally viewed pornography in a given week. These numbers are notably higher than most previous population estimates employing different types of questions. The results have ramifications for methods of surveying sensitive self-reported behaviors and for contextualizing scholars’ claims as well as popular conversations about the reach and implications of pornography use in the United States.     

Immigration policies that include or exclude: a South African public opinion study of immigration policy preferences

South Africa is a regional hub for migration on the African continent and is home to a growing documented international migrant community. Foreigners in the country, however, often face violations of their established rights and are the victims of abuse. This paper examines public support for policies that would exclude international migrants from the country. Data from the 2013 South African Social Attitudes Survey, a nationally representative opinion poll (N = 2739) of all adults in the country, are used. This poll found that many South Africans favoured restrictive immigration policies and opposed granting foreigners the same rights as citizens. Multivariate analysis is employed to discern determinants of this opposition. Respondents’ perceptions of the population sizes of foreigners in their communities did not affect support for inclusion. It can be inferred, therefore, that the growth of the immigrant population has not provoked exclusionary attitudes in the country. Rather, results revealed, it is national pride (cultural versus political) and fears about the consequences of immigration that drive such attitudes. Programmes and policies designed to improve public perceptions of how foreigner impact society and the promotion of a nationalism characterised by inclusive multicultural civic patriotism may improve public support for the inclusion of international immigrants.     

Czechoslovakia’s Interrupted Revolution

Russia’s transition to a market economy has been accompanied by serious, and in some ways unanticipated, disruptions of the existing social welfare system. The social policy dilemma has become a contentious issue in the national political arena. This paper examines the debate on the relationship between social welfare and democratization in post-communist Russia, exploring the case of pensions for the elderly. Although the causes of the pension crisis are complex and rooted in institutional difficulties, the state’s fiscal weakness alone does not explain the difficulties and controversies associated with Russia’s pension crisis. Analysis of the assumptions and principles of pension policy during the Soviet era and perestroika reveals that Russia today is caught between contradictory and competing discourses over citizens’ entitlement to pensions: Is an old-age pension to be considered a reward distributed by a prosperous society, or a basic and inviolable human right? Although the Russian government has used an argument that in effect makes pensions conditional on government resources, citizen and opposition protest has to some extent compelled the Russian government to be increasingly sensitive to demands for guaranteed pensions.