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.     

Exploring the nonverbal facet of ethnic discrimination: a field experiment on anti-Roma racism in the Paris métro

A field experiment on the discrimination of Roma migrants from Eastern Europe was conducted in two stations of the Paris metro to explore the behaviors that may communicate misrecognition in everyday encounters. An actress asked for help to randomly chosen passengers on a metro platform, wearing a glaringly Romani skirt in the treatment condition but an unconspicuous middle-class style in the control condition. In interaction with the actress wearing the Romani skirt, passengers were found to enact the so-called “visual dominance pattern”, and male passengers in particular were found to keep greater distances. Reverse discrimination also occurred as women kept shorter distances from the actress bearing the ethnic stigma. Last, passengers helped less the stigmatized actress, but only in one of the two metro stations where trials were conducted.     

Weiterbilden und Weiterkommen? Non-formale berufliche Weiterbildung und Arbeitsmarktmobilität in Deutschland

Politicians and the business leaders regularly stress the importance of (further) education for individual life chances. Still, it is far from clear whether non-formal further training, i.?e. short training courses, which are the most common forms of further education in Germany, lead to career advancement. In this study, we analyze the impact of non-formal further training on labor market mobility using data from the German National Educational Panel Study (NEPS) over the period from 2009 to 2016. Event history models for discrete time intervals show that employer-provided courses reduce mobility and promote career stability, which contradicts hypotheses derived from human capital theory, which is commonly used in the literature. More concretely, employer-provided courses prevent downward mobility (safety net function), but also reduce upward mobility and firm changes. Based on these findings, we suggest that future research should consider transaction costs and the firm context as well as the distinction between employer-provided and non-employer-provided training.     

PROVIDING GLOBAL PUBLIC GOODS: ELECTORAL DELEGATION AND COOPERATION

This study experimentally examines the effect of electoral delegation on providing global public goods shared by several groups. Each group elects one delegate who can freely decide on each group member's contribution to the global public goods. Our results show that people mostly vote for delegates who assign equal contributions for every group member. However, in contrast to standard theoretical predictions for our delegation mechanism, unequal contributions across groups drive cooperation down over time, and it decreases efficiency by almost 50% compared to the selfish benchmark. This pattern is not driven by delegates trying to exploit their fellow group members, as indicated by theory. It is driven by conditional cooperation of delegates across groups. Since one of the potential sources of the resulting inefficiency is the polycentric nature of global public goods provision together with other‐regarding preferences, we use the term P‐inefficiency to describe our finding. (JEL C92, D72, H41)     

Resettlement challenges faced by refugee claimant families in Montreal: lack of access to child care

Adult refugee claimants experience several well‐documented post‐migratory challenges. Little is known about the resettlement process for refugee claimant families with children. This study reports on 75 open‐ended, in‐depth interviews with refugee claimant families in Montreal about their resettlement challenges and their proposed solutions to them. These interviews were conducted with 33 dyads and triads of children and parents attending a paediatric hospital. Experiences accessing formal and informal child care in Montreal were addressed. Subsequently, a comparative policy analysis was conducted on residency eligibility criteria for child care subsidization. Twenty‐eight out of 39 parents (73%) report a lack of informal or formal child care and 15 out of 33 families (39%) propose improving access to formal child care services. They describe a lack of informal child care as a result of reduced social networks, and affordability as a barrier to formal child care services. Refugee claimants are not eligible for subsidized child care in Quebec. A comparative policy analysis within Canada and comparable countries reveals that this situation is not unique to Quebec. However, most provinces and European countries offer child care subsidies to refugee claimants. Refugee claimants should qualify for child care subsidies. Social workers and community organizations should consider their clients' child care needs in designing programmes and services.     

Mood and Audience Effects on Video Lottery Terminal Gambling

Little is known about the situational factors associated with gambling behavior. We induced 180 male participants (mean age: 21.6) into a positive, negative, or neutral mood prior to gambling on a video lottery terminal (VLT). While gambling, participants were observed by either a male peer, female peer, or no one. Induced mood had no effect on gambling behavior. Participants induced into a negative mood prior to gambling, however, reported more positive moods after gambling, whereas those with positive and neutral moods reported more negative moods after gambling. Participants observed by either a male or female peer spent less time gambling on the VLT compared to those not observed. Participants observed by a female peer lost less money relative to the other observer conditions. Degree of problem gambling in the last year had little influence on these effects. Some practical implications of these findings are discussed.