Diagnostic and treatment issues with childhood bipolar disorders

With biologically based mood disorders, early identification and treatment may prevent or ameliorate serious dysfunction in later life. Although there is less diagnostic certainty about early manifestations of bipolar disorder in children than about unipolar depression, certain potential indicators do appear in the literature. This article describes these indicators, and also presents the cases of two youngsters with bipolar disorders, discussing symptomatology and treatment issues with the children and their families.     

Time allocation of one- and two-parent mothers

Using data from one- and two-parent households with two children in rural and urban areas of California, this study analyzes time allocation decisions in market work, household work, and leisure activities among single and married mothers. Results of the seemingly unrelated regression procedures indicate that family structure affects time in household work but not market work or leisure activities. Of the socio-demographic variables, only day of the week explains time allocation to household work, market work, and leisure activities among single and married mothers.This research has been supported by the United States Department of Agriculture through the Georgia Agricultural Experiment Station under Southern Regional Project S-206.Teresa Mauldin is an Assistant Professor and Carol B. Meeks is an Associate Professor in the Department of Housing and Consumer Economics, the University of Georgia, Athens, GA 30602. Dr. Mauldin received her Ph.D. from The Ohio State University and is interested in time use, economic well-being of individuals and families, and family structure. Dr. Meeks also received her Ph.D. from The Ohio State University and her research interests include time use, family structure, and economic aspects of housing.     

Understanding Career Plateauing: Implications for Counseling

The pyramidal shape of most organizations dictates that virtually all careers will level out before an employee reaches the top of the institution, agency, or corporation. How to maintain or enhance worker productivity and job satisfaction when an employee remains at a career level that discourages one's aspirations are concerns for career counselors, their clients, and organizational executives. This article defines career plateauing, explains types and sources of plateauing, and suggests counseling interventions that can help individuals to recognize and adjust to plateauing. In addition, we recommend proactive measures that will perpetuate the work motivation of effectively-performing plateaued workers as well as remediate the work behavior of the ineffective, plateaued worker. One of life's maxims is that all careers reach a level after which no higher achievement can be expected. From night watchguard to chief executive officer, each person's career has its apex. Thus, career plateauing is inevitable for all who strive and struggle in the work world (Bardwick, 1986). The point in time when an individual will experience, if not recognize, career plateauing is difficult to predict as is the extent to which that person can influence the timing or impact of this phenomenon.     

The Rise and Fall of a Risk-Based Priority System: Lessons from DOE's Environmental Restoration Priority System

This paper presents the history of the Environmental Restoration Priority System (ERPS), a decision aid developed by the U.S. Department of Energy (DOE) to help determine how to allocate funds for cleaning up hazardous waste sites. Although praised in technical peer review, the system was strongly criticized by stakeholders external to the DOE. Ultimately, and in the midst of a National Academy of Sciences review, DOE shelved the system. The rise and fall of ERPS provides useful lessons for analysts hoping to improve risk management in the public sector.     

Subgroup analyses in cost‐effectiveness analyses to support health technology assessments

‘Success’ in drug development is bringing to patients a new medicine that has an acceptable benefit–risk profile and that is also cost‐effective. Cost‐effectiveness means that the incremental clinical benefit is deemed worth paying for by a healthcare system, and it has an important role in enabling manufacturers to obtain new medicines to patients as soon as possible following regulatory approval. Subgroup analyses are increasingly being utilised by decision‐makers in the determination of the cost‐effectiveness of new medicines when making recommendations. This paper highlights the statistical considerations when using subgroup analyses to support cost‐effectiveness for a health technology assessment. The key principles recommended for subgroup analyses supporting clinical effectiveness published by Paget et al. are evaluated with respect to subgroup analyses supporting cost‐effectiveness. A health technology assessment case study is included to highlight the importance of subgroup analyses when incorporated into cost‐effectiveness analyses. In summary, we recommend planning subgroup analyses for cost‐effectiveness analyses early in the drug development process and adhering to good statistical principles when using subgroup analyses in this context. In particular, we consider it important to provide transparency in how subgroups are defined, be able to demonstrate the robustness of the subgroup results and be able to quantify the uncertainty in the subgroup analyses of cost‐effectiveness. Copyright © 2014 John Wiley & Sons, Ltd.     

Lost lessons?: the Experience of a time-limited home-school support project

This article reports on an evaluation of an innovative, but time-limited, home-school support project, designed to improve the behaviour of young children in danger of school exclusion. It concludes that, although valued by the families and schools involved, the effective operation of the initiative was hampered by problems of communication, by its single agency location and by the short-term nature of its funding. Copyright © 1999 John Wiley & Sons, Ltd.     

Beyond Parallel Process: Relational Perspectives on Field Instruction

This article explores the implications of contemporary relational perspectives for transforming our understanding and use of the concept of parallel process in supervisory relationships in social work field instruction. We review the history of the concept of parallel process, summarize current relational views in psychodynamic supervision, and critique the social work literature in light of the paradigmatic shift to a relational, constructivist viewpoint. We present two vignettes illustrating how relational sensibilities enrich our understanding and increase the effectiveness of the field instruction relationship. We relocate parallel process, which up to now has been a primary, organizing framework in psychodynamic supervision, in a larger relational matrix, where it is one element in a complex, interactive process and serves as a marker for further exploration in reflective social work practice.     

What rights for disabled children? Home enteral tube feeding in the community

The growing number of disabled children who are tube fed at home has important implications both for families and the professionals who support them. This paper reports on the preliminary findings of a project which aims to assess the practical, social and emotional impact of home enteral tube feeding (HETF) on the lives of disabled children and their families. The evidence presented here suggests that guidance and training on HETF for non-parent carers is both inadequate and inconsistent. Consequently access to education and social services may be restricted or even denied for disabled children on HETF as a direct result of their perceived need for nursing or medical care. Copyright © 1999 John Wiley & Sons, Ltd.