Exempting casinos from the Smoke-free Illinois Act will not bring patrons back: they never left.

OBJECTIVE: The Smoke-free Illinois Act was implemented in January 2008, one month after the beginning of a national recession. In December 2010, the Illinois legislature proposed new legislation that would provide an exemption for casinos from the act until neighbouring states also implement smoke-free casino policies. Lobbyists and gaming commission representatives argued that Illinois casinos were losing patrons to casinos in neighbouring states that allow smoking. This study examined the influence of the act on casino admissions in Illinois and neighbouring states in light of the economy. METHODS: A multilevel model was developed to examine monthly casino admissions from January 2007 to December 2008. RESULTS: There was no difference in changes in admissions across the four states over time after accounting for the economic downturn. CONCLUSIONS: The Smoke-Free Illinois Act did not have a detectable effect on Illinois casino admissions.

An Exploration of Human Rights and Social Work Education in the United States.

Social work, with its commitment to social justice, knowledge about cultural diversity, and respect for the dignity and worth of the individual, has much to contribute to the modern-day human rights debate. Many international social work scholars have articulated the view of social work as a human rights profession. The profession's presence in this arena, however, has not always been apparent. Amid increasing global tensions and domestic challenges, equipping social work students with human rights knowledge and skills is critical. The limited attention given to human rights in social work education, particularly in the United States, provides a unique opportunity to explore the human rights discourse occurring in academic circles. This paper presents a review of scholarly journal articles that explore the human rights discourse related to social work education in the United States. Upon reviewing the literature, the following categories emerged: (1) general articles on integrating human rights into social work education; (2) pedagogical frameworks, models, and examples of incorporating human rights into social work education; and (3) measures and perceptions related to assessing the integration of human rights in social work education. Findings indicate that the inclusion of human rights into social work education in the United States is in its infancy. It is recommended that social work programs in the United States be more intentional about integrating human rights content into the curricula to train culturally competent and globally minded social workers.

Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda.

An unresolved issue in the field of implementation research is how to conceptualize and evaluate successful implementation. This paper advances the concept of "implementation outcomes" distinct from service system and clinical treatment outcomes. This paper proposes a heuristic, working "taxonomy" of eight conceptually distinct implementation outcomes-acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability-along with their nominal definitions. We propose a two-pronged agenda for research on implementation outcomes. Conceptualizing and measuring implementation outcomes will advance understanding of implementation processes, enhance efficiency in implementation research, and pave the way for studies of the comparative effectiveness of implementation strategies.

From early to late adolescence: American Indian youths' behavioral trajectories and their major influences.

OBJECTIVE: This article identifies behavioral trajectories of American Indian adolescents and examines their predictors. METHOD: A total of 401 urban and reservation American Indian adolescents were interviewed yearly from 2001 to 2004 (with 341 youths, or 85%, retained to 2004, and 385 completing at least two interviews). The Youth Self-Report total problem score is used to model behavior change trajectories, with psychological (addictions and mental health) and environmental (family, peer, community, and services) variables as independent variables. Analyses were based on PROC TRAJ, an SAS macro. RESULTS: Five trajectory groups were found. Youths who started with a Youth Self-Report score less than the clinical cutoff were low stable (n = 142) or low improving (n = 175). Youths with initial scores over the cutoff were very high chronic (n = 5), high improving (n = 30), or high chronic (n = 33). High improvers scored close to the low improving group by 2004. At baseline, the high improving group was more likely than the high chronic group to be from the reservation (odds ratio 5.94), have greater family satisfaction (1.14), and have fewer school problems (0.84). Over time, the high improving group had substance use and depression drop, family satisfaction increase, fewer parents with mental health or addictions problems, fewer peers using substances, and a decrease in neighborhood problems and stressors. CONCLUSIONS: A significant majority (more than 82%) of the youths exhibited relatively low levels of problem behaviors over all 4 years, and 42% of those with clinically significant problems improved over time.

The role of providers in mental health services offered to American-Indian youths.

OBJECTIVE: American-Indian adolescents have high rates of addiction and mental health problems but low rates of service use. The gap between service need and use appears to be even larger than the known gap for the general population, and few of the services are provided by specialists. This study examined receipt of treatment by American-Indian youths for addictions or mental health problems, the service provider who first identified a problem and sent a youth to treatment, and the extent to which the provider's knowledge and assessment predicted variance in service actions. METHODS: A sample of 401 American-Indian youths (196 from an urban area and 205 from a reservation) aged 12 to 19 years was first interviewed in person in 2001. A total of 188 of the youths' treatment providers were then interviewed. RESULTS: Structural equation modeling showed that 30 percent of the variance in addictions or mental health services provided to youths was predicted by the provider's assessment of the youth's mental health, the provider's resource knowledge, and provider type. CONCLUSIONS: The results demonstrate that professional, informal, and traditional providers play a pivotal role in providing treatment services offered to American-Indian youths and that these providers were more likely to identify a youth's problems and to offer and refer services when the provider knew more about community resources for the youth and about the youth's personal and environmental problems.

Factors associated with successful functioning in American Indian youths.

This study examines environmental and cultural factors related to successful functioning in a stratified random sample of 401 American Indian youths. The success index included seven indicators: good mental health, being alcohol- and drug-free, absence of serious misbehavior, clean police record, good grades, positive psychosocial functioning, and positive behavior and emotions. Family satisfaction was positively related to overall successful functioning, whereas misbehaving peers, living in a dysfunctional neighborhood, and experiencing child abuse had an inverse relationship with success.