On the Local Polynomial Estimators of the Counting Process Intensity Function and its Derivatives

Abstract. We consider the properties of the local polynomial estimators of a counting process intensity function and its derivatives. By expressing the local polynomial estimators in a kernel smoothing form via effective kernels, we show that the bias and variance of the estimators at boundary points are of the same magnitude as at interior points and therefore the local polynomial estimators in the context of intensity estimation also enjoy the automatic boundary correction property as they do in other contexts such as regression. The asymptotically optimal bandwidths and optimal kernel functions are obtained through the asymptotic expressions of the mean square error of the estimators. For practical purpose, we suggest an effective and easy‐to‐calculate data‐driven bandwidth selector. Simulation studies are carried out to assess the performance of the local polynomial estimators and the proposed bandwidth selector. The estimators and the bandwidth selector are applied to estimate the rate of aftershocks of the Sichuan earthquake and the rate of the Personal Emergency Link calls in Hong Kong.     

A Strengths Perspective in Working with an Adolescent with Dual Diagnosis

Dual diagnosis has gradually become a problem among adolescents in Hong Kong. In working with persons with dual diagnosis, professionals are accustomed to use a disease model in diagnosis, treatment, and rehabilitation. By means of a case illustration, the writer tries to contrast a disease orientation and a strengths perspective in working with persons with dual diagnosis. The disease orientation stresses: addiction and mental illness; intoxication and dependence; symptoms and diagnosis; detoxification and treatment; confusion and control as well as resistance and labeling. The strengths perspective focuses on: decoding frustration and emptiness from addiction; searching for strengths to satisfy normal needs; establishing social support and encouraging participation in a healthy environment; re-anchoring self-confidence and capability development as well as maintaining empathetic trust. In this case, with the strengths perspective, the writer successfully helped an adolescent to re-build his self-confidence and re-establish a healthy social support system to live a normal life.     

Estimating the Basic Reproductive Number in the General Epidemic Model with an Unknown Initial Number of Susceptible Individuals

Abstract. In any epidemic, there may exist an unidentified subpopulation which might be naturally immune or isolated and who will not be involved in the transmission of the disease. Estimation of key parameters, for example, the basic reproductive number, without accounting for this possibility would underestimate the severity of the epidemics. Here, we propose a procedure to estimate the basic reproductive number ( R ₀ ) in an epidemic model with an unknown initial number of susceptibles. The infection process is usually not completely observed, but is reconstructed by a kernel‐smoothing method under a counting process framework. Simulation is used to evaluate the performance of the estimators for major epidemics. We illustrate the procedure using the Abakaliki smallpox data.     

A Natural Locally-Based Networking Approach for Singleton Disabled Elderly: Implementation and Case Illustration

Correspondence to Dr. Yip Kam-shing, Associate Professor, Department of Applied Social Studies, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. E-mail: SSKSYIP{at}POLYU.EDU.HK Summary Hong Kong is a high industralized and commercialized city-sizedregion. Within such a business-orientated and competitive lifestyle,the elderly usually are the ones who have poor social supportand social networks. Many singleton elderly lead lonely liveswithin the community. The Good Neighbour Centre of the UnitedChristian Nethersole Community Health Service in Hong Kong hasimplemented a natural locality-based supportive networking approachfor disabled singleton elderly in a public estate (1991-2000).As part of this approach, various psycho-social interventionswere developed over nine years to strengthen mutual supportamong neighbours, able-bodied elderly, outpatients sufferingfrom mental illness and volunteers who were matched and integratedwith the disabled singleton elderly person to form a locality-basednaturally supporting community. Different stages of developinga natural, supportive community by networking were identifiedin this project: network assessment, network matching, networkformation and network strengthening. The concepts of stableand constant mutual support, mutual development and mutual concernwere stressed. Feedback from stakeholders was encouraging andthe demonstrated improvement in the functional and psycho-socialwell-being of disabled singleton elderly and mental health outpatientswas impressive and clear. Also, according to the principlesof the strengths perspective, the approach was strength oriented,that is it cultivated the potential strengths within a locally-basedcommunity: challenging the care and concern of members withinthe community through the loneliness of singleton elderly; developingthe mutual support and nurturing new supportive resources withina locally-based community. Further research may help to consolidatethe effectiveness of this approach through new strategies.     

Sullivan's Approach to Inner Psychotic Experiences: A Case Illustration

Harry Stack Sullivan's concept of interpersonal psychiatry has been recognized as a landmark in the American psychoanalytic movement, in particular his influence on the development of object-relations theory. He is an influential figure in interpreting the inner experiences of persons with schizophrenia. Psychotic experiences represent a failure of one's self-system and the dissociation dynamism. Delusions and hallucinations are experiences in lost control of self-awareness. The person regresses to dreams or experiences from infancy and childhood in facing spontaneous conflicts and anxiety in interpersonal transaction. As a result, the tripartite self-system is fractured. In this paper, the writer applies Sullivan's concept in interpreting the inner psychotic experiences of a client with schizophrenia. Its implication for clinical social work practice is also discussed.     

Self-reflection in Reflective Practice: A Note of Caution

In reflective practice, social work students are encouragedto undergo self-reflection. It is a process of self-analysis,self-evaluation, self-dialogue and self-observation. Under appropriateconditions, social workers’ self-reflection can be veryconstructive, resulting in self-enhancement. However, underinappropriate conditions, social workers’ self-reflectionin reflective practice can be destructive and create problemsfor their professional and self-development.     

A Strengths Perspective in Working with an Adolescent with Self-cutting Behaviors

This paper describes the use of a strengths perspective in working with an adolescent with self-cutting behavior. While a disease model stresses diagnosis, labeling, medication, control, and manipulation; a strengths perspective advocates understanding of feelings and meaningfulness behind symptoms, identifying needs, and developing abilities, facilitating interpersonal communication, and building a better social environment for the adolescent client with self-cutting behaviors. A case example demonstrates this approach.Prof. Kam-shing Yip is a Professor, Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.     

Medicalization of Social Workers in Mental Health Services in Hong Kong

Correspondence to Dr Kam-shing Yip, Associate Professor, Department of Applied Social Studies, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. E-mail: ssksyip{at}polyu.edu.hk Summary Medical dominance is a crucial problem in social work practicein mental health services. This paper is an examination of theresponse of social workers to medical dominance in mental healthservices in Hong Kong. To explore the process and the effectsof medicalization of social workers, sixty-three social workersin various areas of mental health service settings were interviewed.Their reaction and daily performance in facing medical dominancewere analysed and evaluated. The findings show that facing medicaldominance was a common occurrence for social workers in variousmental health services in Hong Kong. Conflict existed betweenthe rationalization of medical knowledge by medical professionals,and social work rationalization of social work knowledge bysocial workers. The process of medicalization consisted of fivestages: ignorance of medical dominance, confronting medicaldominance, compromise with medical dominance, acceptance ofmedical dominance and internalization of medical dominance.The findings also show that medicalization was influenced bythe organizational and team context.