Treatment of the emotionally disturbed,mildly retarded youngster in the foster care system

This paper demonstrates the need for a broad array of clinical services in treating the emotionally disturbed, mildly retarded youngster in the foster care system. A hypothesis suggests that cognitive deficits and borderline pathology are interrelated, and that treatment involves modifications of traditional therapeutic techniques. The definition of clinical is expanded to include seemingly concrete and environmental services, in addition to the office therapy session. Finally, some systemic impediments to effective treatment of the population are explored.This paper was completed as a requirement of the Post-Master's Program in Advanced Clinical Social Work of Hunter College School of Social Work.     

The medical examiner and deaths in the hospital setting

There has been a perceived increase in the number of medical negligence claims in recent years. The modern metropolitan medical examiner is increasingly called upon to deal with numerous medical, legal, social, and ethical issues. Nowhere is the role of the medical examiner more important than in the investigation of deaths related to surgical, diagnostic, anesthetic, or therapeutic procedures. Medical examiners have an important role in the investigative process. Through utilization of the offices and services of the medical examiner, questions raised by families, physicians, and other hospital employees may be satisfactorily answered a priori, and litigation may therefore be averted.     

Rural development and women: what are the best approaches to communicating information?

The project reported in this article aimed to discover how well the needs of women were being met with respect to rural development and to identify the best approaches to communicating information to farmers in Tanzania. Semi-structured interviews of male and female respondents in selected 200 households in Shinyanga, northwestern Tanzania, were conducted. The interviews were conducted in order to record data on gender differences in farming and herding with the aim of determining how to communicate information on development. Findings showed that women continued to be the poorest group in the community. Use of introduced technology was mostly associated with men's work. The activities of Hifadhi Ardhi Shinyanga conducted through communication channels were also more accessible to men than women. The improved stoves specifically aimed at women also failed because of ineffective communication strategies. It is difficult to approach women because they tend to be tied far more closely to the area of their homes. Thus, training through village workshops would encourage the active participation of women. This would enable information to be shared with, and between, as many women as possible.     

Branch banking in the year 2000

The topic of branch banking in the United States in the year 2000 is obviously one that has been in the minds of California bankers for some time because California is the largest state in the United States to permit virtually unlimited statewide branch banking. It is a topic that must also be in the minds of a large number of European and Asian bankers as well because several non-U.S. banking systems have already established large branch networks in the United States. It is a difficult topic because no one knows precisely what will be the status of branch banking in the year 1990, let alone the year 2000. This article makes some predictions.     

Systems analysts and the politics of organizational control

The introduction of major information systems into organizations can be fraught with difficulties. The negative effects of such systems can, for many important organizational members, be too great a price to pay for the supposed benefits. The advent of computerised information systems has served not merely to deskill the clerical ‘craft’ but can also be used as a strategy by top management to reduce the management control gap. However, by undercutting the organizational ‘rules of the game’, information systems innovation can produce severe strains and stresses in the political system. The proposals in the literature to combat the effects of innovation are examined. A broader, political perspective is used to reveal some of the inadequacies of these proposals and supporting data, gathered from interviews in several Canadian organizations, are presented to illustrate this. The paper ends with a discussion of the implications of this broader approach.     

Evidence-based Medicine and Child Mental Health Services

There is increased focus on using research evidence to guide clinical practice in the provision of child mental health services, to allocate resources and to make policy decisions. Emphasis has been placed on randomised controlled trials, which are clearly vital. However, given the complexity of children's lives and the multiple systems relevant to their care, it is important to consider alternative research designs and to think creatively about outcomes. In the context of difficulties with random allocation a number of quasi-experimental designs are described that may more closely reflect actual clinical work. In the context of ecological theory, the importance of taking a systems level approach to evaluation is highlighted, with examples from the US. Finally, the ways in which qualitative outcomes measures can be used to sensitively describe the effects of treatment are outlined, and their potential for giving voice to children and families as consumers of mental health services. These suggestions aim to lessen the tension between the requirements of the scientific investigations of treatment effectiveness and the realities of clinicians' daily experiences.