Mental Health Policy in South Australia: A Job Half Done

Though the emphasis in South Australian mental health policy on deinstitutionalisation is based on sound principles of civil liberties and psychiatric treatment, serious social problems have followed in the wake of the new initiatives. This paper attributes many of the problems to the simultaneous pursuit of deinstitutionalisation and centralisation of resources within psychiatric hospitals. It is argued that the policy of deinstitutionalisation demands a commensurate decentralisation of resources to enable the development of community-based residential and nonresidential alternatives to hospital.     

Bulgaria's non-profit sector: the search for form,purpose, and legitimacy

Bulgaria, like other East European nations since the collapse of communism, has moved rapidly to form private, self-directed non-profit and voluntary organisations. Like those nations too, Bulgaria faces a number of challenges in its pursuit of forming a strong non-profit sector. Chief among those challenges are establishing a sound legal foundation, defining the social purposes and functions of the non-profit sector, and establishing the legitimacy of these organisations in the minds of the Bulgarian people. These three challenges are analysed in the essay, following an overview of the current make-up and characteristics of the emerging non-profit sector.     

Actual and perceived emotional sending and personality correlates

To ascertain whether actual and perceived emotional sending are distinct constructs, the present study investigated the relationship between subjects' ability to facially express six basic emotions and their perceived success at expressing these emotions. Sixty-eight subjects completed a number of standardized personality scales and were videotaped while attempting to portray six basic emotions. Immediately following the videotaping subjects were asked to rate their perceived success in the emotional-sending task. Observers then judged the emotional-sending videotapes to determine subjects' actual sending abilities. A confirmatory factor analytic model indicated that actual and perceived emotional-sending were distinct factors. Zero-order correlations between the traditional personality measures and the actual and perceived sending factors also supported this distinction. These findings have important implications for the construction of standardized measures of individual differences in nonverbal communication skills.This research was supported by a UCR intramural research grant and a UCR NIH Biomedical Support Equipment grant. The authors would like to thank Richard Lippa and Louise Prince.     

Comparing the health status of low-income children in and out of foster care

Children in foster care face poverty, family dysfunction, neglect, and abuse, with high rates of chronic health, emotional, and developmental problems. This study compared the overall health status of a group of children entering foster care with a group of Medicaid-eligible children living with their parents, matched for age and gender. It identified significantly more health and developmental problems in children in foster care than in the comparison group. Possible contributors to the higher percentage of problems among foster care children may be that the foster children have more problems related to the underlying risk factors resulting in placement, or that the foster care physicians conducted a more comprehensive assessment or had lower clinical thresholds. Further research is necessary to identify and treat the problems of this high-risk group.     

Young adolescents, tobacco advertising, and smoking

BACKGROUND: In adolescents aged 12-14, we measured attitudes to tobacco advertising. Our purpose is to understand the relation of these attitudes to tobacco use and identify the groups most influenced by the advertising. METHODS: Survey of adolescents on Gran Canaria Island, Spain, about aspects of family, school, peers, tobacco consumption, and tobacco advertising. The subjects of the double-stratified cluster sample were 1910 students at the same grade level in 33 schools; 86.6% were 13 or 14 years old, and 51.2% were boys. We generated measures for attitudes to tobacco advertising from replies to seven questions with ordinal scales by an analysis of categorical principal components. To relate attitude to tobacco advertising and the profiles of these adolescents, we used multiple regression and logistic regression models. RESULTS: Attitudes to tobacco advertising are related to some home and school factors, but most significantly to tobacco and alcohol consumption, to amount of time at home without adults, and to peer influence. CONCLUSIONS: It is possible to draw up profiles of the students most vulnerable to tobacco advertising, and to cluster them in two groups, the "vitalists" and the "credulous." The effect of cigarette ads is different between these groups. This study can help to orientate smoking prevention.     

Appraising financial performance for financial institutions

The author is an investment analyst whose area of specialization is financial shares, especially in banking. The prime responsibility of the investment analyst is to the investment institutions. However, the information available to the analyst is no more than that available to shareholders in the institution being monitored. The expertise of the analyst is in seeking out the information and interpreting it for the client. There has been a considerable improvement in investor relations in the U.K. in the past few years. The author suggests that more information could be provided by the U.K. Clearing Banks—information which is readily available within the banks—which would enable the investment analyst to make important comparisons from data which is not at present available to him.     

Multiple imputation of a randomly censored covariate improves logistic regression analysis

Randomly censored covariates arise frequently in epidemiologic studies. The most commonly used methods, including complete case and single imputation or substitution, suffer from inefficiency and bias. They make strong parametric assumptions or they consider limit of detection censoring only. We employ multiple imputation, in conjunction with semi-parametric modeling of the censored covariate, to overcome these shortcomings and to facilitate robust estimation. We develop a multiple imputation approach for randomly censored covariates within the framework of a logistic regression model. We use the non-parametric estimate of the covariate distribution or the semi-parametric Cox model estimate in the presence of additional covariates in the model. We evaluate this procedure in simulations, and compare its operating characteristics to those from the complete case analysis and a survival regression approach. We apply the procedures to an Alzheimer's study of the association between amyloid positivity and maternal age of onset of dementia. Multiple imputation achieves lower standard errors and higher power than the complete case approach under heavy and moderate censoring and is comparable under light censoring. The survival regression approach achieves the highest power among all procedures, but does not produce interpretable estimates of association. Multiple imputation offers a favorable alternative to complete case analysis and ad hoc substitution methods in the presence of randomly censored covariates within the framework of logistic regression.