Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.     

Boundary Spaces

While shows like The X-Files and 24 have merged conspiracy theories with popular science (fictions), some video games have been pushing the narrative even further. Electronic Art's Majestic game was released in July 2001 and quickly generated media buzz with its unusual multi-modal gameplay. Mixing phone calls, faxes, instant messaging, real and "fake' websites, and email, the game provides a fascinating case of an attempt at new directions for gaming communities. Through story, mode of playing, and use of technology, Majestic highlights the uncertain status of knowledge, community and self in a digital age; at the same time, it allows examination of alternative ways of understanding games' role and purpose in the larger culture. Drawing on intricate storylines involving government conspiracies, techno-bio warfare, murder and global terror, players were asked to solve mysteries in the hopes of preventing a devastating future of domination. Because the game drew in both actual and Majestic-owned/-designed websites, it constantly pushed those playing the game right to borders where simulation collides with " factuality'. Given the wide variety of "legitimate' conspiracy theory, alien encounters and alternative science web pages, users often could not distinguish when they were leaving the game's pages and venturing into " real' World Wide Web sites. Its further use of AOL's instant messenger system, in which gamers spoke not only to bots but to other players, pushed users to evaluate constantly both the status of those they were talking to and the information being provided. Additionally, the game required players to occupy unfamiliar subject positions, ones where agency was attenuated, and which subsequently generated a multi-layered sense of unease among players. This mix of authentic and staged information in conjunction with technologically mediated roles highlights what are often seen as phenomenon endemic to the Internet itself; that is, the destabilization of categories of knowing, relating, and being.     

Ideas versus ideology: The origins of modern labor economics

Starting with its early twentieth century origins, the development of Labor Economics is traced to the present. We describe an intellectual revolution in which an earlier tra-dition that focused primarily on the institution of the labor union has been replaced by a perspective that emphasizes the various roles played by labor markets in an eco-nomic system. That earlier tradition contained very significant ideological elements, whereas its successor deals much more with the world of ideas. In the course of the debate, which still continues, ideas triumphed over ideology and created modern Labor Economics.     

Flipping and ex post aggregation

We show that Bayesian ex post aggregation is unstable with respect to refinements. Suppose a group of Bayesians use ex post aggregation. Since it is a joint problem, each agent's problem is captured by the same model, but probabilities and utilities may vary. If they analyze the same situation in more detail, their refined analysis should preserve their preferences among acts. However, ex post aggregation could bring about a preference reversal on the group level. Ex post aggregation thus depends on how much information is used and may keep oscillating (“flipping”) as one keeps adding more information. Received: 16 April 2002/Accepted: 27 May 2002     

Socioeconomic Status and Early Adolescent Self-Esteem*

This study is a replication of a recent assessment of the relationship between social class and self-esteem, and the variables that intervene on this relationship. The purpose is to replicate the methods used to explore further this relationship by attempting to replicate the findings reported by Demo and Savin-Williams (1983) in another population. Only one of the four hypotheses tested received support thereby indirectly supporting the null relationship theory of no relationship between socioeconomic status and self-esteem. Implications of the findings also are addressed.