Changes in Health,Mortality, and Disability and Their Impact on Long-Term Care Needs

The need for long-term care is driven both by the growth of the elderly population and changes in the age relations of morbidity, disability, and mortality. Data show these relations changed in the U.S. elderly population from 1982 to 1989. Chronic disability prevalence declined between the 1982 and 1989 U.S. National Long Term Care Surveys. knong those impaired, many persons using personal assistance to meet their needs shifted to the use of assisted housing and special equipment. The relation of these trends to other changes-such as the increasing educational level of thc elderly population-is examined to estimate how future changes in disability and morbidity may affect the demand for long-term care. Disabilities at specific times as well as their transition rates were examined to determine how long individuals need long-term care. The analyses suggest that, while the amount of long-term care services needed will increase rapidly, the types and amounts of services used by the U.S. elderly population will undergo significant change.     

An Innovative Behavioral Health Workforce Initiative: Keeping Pace with an Emerging Model of Care

ABSTRACT

Recent policy shifts in health care have created opportunities for social workers to provide services in integrated primary care and behavioral health settings. However, traditionally prepared social workers may not have the skill set necessary to meet practice demands. This article describes a behavioral health workforce initiative that trains master’s of social work students for work in integrated primary care settings with children, adolescents, and transition-age youths. The training model includes field placements in integrated care settings, co-curricular seminars, and advanced clinical electives. This article identifies challenges of creating new field placements and developing new curricula to support students’ acquisition of knowledge and skills required in integrated care settings. Additionally, it presents data on changes in students’ knowledge and confidence.     

Extending Symmetry: Toward a Convergence of Professionalism,Practice, and Pragmatics in Public Relations

The professional values, practice, and pragmatics (3Ps) model is a framework to evaluate professional values and the practice of public relations within the context of situational pragmatics. In essence, this is a move from the two-way symmetrical model to a three-dimensional space anchored by professional values, practice, and pragmatics. The pragmatics dimension is developed from three subdimensions: threat versus opportunity, uncertainty, and perceived control. In addition, symmetry and skills have been reorganized into core professional values and professional practice, each with three subdimensions of their own.     

Health care innovations for homeless families: Emerging opportunities under Medicaid and the Affordable Care Act

Prior to the Patient Protection and Affordable Care Act of 2010 (the ACA), the US health care system left many low-income families facing limited access to medical care, struggling with high-health costs, or lacking health insurance altogether. The ACA aims to increase access to care, improve the quality of care, and lower total health care costs. While the ACA can benefit all individuals and families, it has significant potential for expanding and improving services for those experiencing homelessness. This paper describes specific opportunities under the ACA and Medicaid that can be used to strengthen services for homeless families and provides examples of efforts under way. It also offers guidance for how homeless service agencies can effect change in their respective states. The examples described here are promising approaches to strengthening homeless services. Pursuing these ideas for homeless families will require initiative, creativity, and perseverance, but recent progress is encouraging.     

International Funding of NGOs in India: Bringing the State Back In

This article seeks to understand how the Indian state exercises control over transnational ties between foreign and domestic actors by examining the national legislative practices that determine receipt of foreign funds and the data on foreign funding flows to NGOs (a database of more than 18,000 associations). The article shows how legislative practices of democratic states serve to reduce foreign influence. Issue characteristics are also shown to determine state response to externalization, blocking transnational ties in “high politics” areas such as minority claims. Finally, within state imposed restrictions, religious rather than secular organizations remain dominant transnational actors in India. The study contributes evidence to suggest that contrary to the arguments of world polity theory and many transnational social movement scholars, states continue to remain powerful actors limiting transnationalization.

The Changing Roles of NGOs in Nepal: Promoting Emerging Rights-Holder Organizations for Inclusive Aid

This article examines the unique roles of NGOs with special attention to the changing socio-political contexts of NGOs in terms of their partnerships with Rights-Holder Organizations (RHOs), which claim the rights of particular groups of excluded population. It reviews an example of the NGO working with RHOs in Nepal. NGO relationships with RHOs are delicate and not always equitable due to their different backgrounds and expertise. NGOs, comprising mostly people who are not members of the rights-holding groups, use their expertise to work for others over fixed periods, whilst RHOs work for their own constituencies through movements. Until the 1990s, NGOs supported so-called ‘beneficiaries’ who were members of excluded groups whose rights were being denied. Today, RHOs are formed directly by excluded groups. Some NGOs are trying to change their role to become promoters for RHOs, whilst others remain as their proxies, which merely creates an extra layer between RHOs and donors. The article attempts to prove that building equitable relationships between NGOs and RHOs is possible if NGOs have professionalism, expertise in capacity development and a readiness to become more inclusive. Though there are still several challenges ahead, such efforts by NGOs make it possible to change funding flows for RHOs and contribute to inclusive aid.     

Infusing Integrated Behavioral Health in an MSW Program: Curricula,Field, and Interprofessional Educational Activities

ABSTRACT

An essential aspect of integrated care is the coordination of medical and behavioral health needs concurrently. This has sparked renewed emphasis on interprofessional (IP) education and practice. The impetus for IP efforts was crystalized in large part because of health care reforms, and federal funding to expand the behavioral health work force. Using an ecological systems perspective, this article describes how one school is preparing a new generation of MSW students to work in integrated behavioral health care using a three-pronged approach involving curricula, field education, and IP activities. Social work education must ensure that new and experienced professionals can (a) understand the profession’s role in IP health care settings, and (b) navigate an evolving and complex health care environment.     

Genealogy of an Emerging Field: Foundations for the Study of Media and Religion

This study triangulated research methods to analyze how the public debate on a controversial issue was framed, and by whom, as a means of understanding the process and outcome of that debate. Its findings support the idea that public debates are framed by all involved parties, not just the news media. It also considered how the relative power position held by each side in this debate may have affected their interactions with the news media.     

Scissors, Surveys, And Psycho-Prophylactics: Prenatal Health Care Campaigns And State Building In China, 1949–1954

This paper examines how the Chinese state's prenatal health care campaigns of the early 1950s attempted to redefine women's social and political roles. The replacement of local midwifing practices with a uniform birthing method in order to radically reduce infant and mother mortality entailed complex ramifications regarding the relationship of women vis-a-vis the state. Campaigns involved demonizing "traditional" midwifing, promoting a statistical vision of female reproductivity and children as national resources, and the isolation of individual mothers as directly responsible to the state for managing reproduction for the national interest. In sum, a physiological definition of gender was used to open women's bodies to state management. Utopic visions of painless childbirth and of the socialist nation as a giant new family were used to promote participation in grassroots campaigns, but the sources also point to forms of local resistance to the micro-level reorganization of power these campaigns intended.     

The Crafting of Care: Rationality,Gender and Social Relations in Educational Decision-Making

This article examines discourses on care and the way they operate within four education case conferences. It examines the multiple subject positions afforded to participants in the meetings, and the constitutive aspects of language associated with discourses on care. The paper covers the following domains. Firstly, caring is explored as a specific form of gendered activity within dominant constructions of the family and organizations in contemporary Western (white, heterosexual) society. Secondly, caring is examined as a relationship and a discursive category rather than as an individual attribute. The implications this has for the participants’ identities and roles in the context of the education case conferences are explored. Thirdly, some examples of the way caring operates in specific case conferences are discussed. I conclude by suggesting that caring is employed by women professionals in the meetings discussed, as a way of mystifying differences. In some instances, it seems to function as a coping rhetorical strategy (see Davis 1994), which places a burden of responsibility onto women professionals and may project failure onto mothers and pupils within the meetings.     

Rural Families and Health Care:

No abstract available for this article.     

CHAPTER 2: Background Forces in Policies for Care and Treatment of Disability

No abstract available for this article.     

Disability and Attitudes to Family Care in Britain: Towards a Sociological Perspective

Attitudes to family care are critical to the quality of community support offered to people with physical and mental handicaps. Yet despite their importance, they have attracted comparatively little social research. This paper examines the 'hotchpotch' of material which is available through the eyes of psychology and sociology. The potential of the psychologist's four-part anatomy of attitudes is recognised: the perceptual, evaluative, affective and behavioural components. However, attention is drawn to the narrow, consensual framework within which these components are often placed, and an alternative sociological or structural model is developed for family care, where the attitudes of disabled people and their relatives are seen as products of the family's socio-economic role. The conclusion discusses some of the policy implications.     

Health, Illness, Disability and Black Minorities: A Speculative Critique of Present Day Discourse

The idea of incorporating a user perspective was central to the design of a study looking at services for, and the needs of, Black minorities. The initial assumption of this work was that health, illness and disability are intimately connected to the way people construct their social realities. The ideas and attitudes individuals hold about their health and disability, however, are also organised within a particular discourse. This discourse is not neutral, and a critical understanding that unravels it is necessary. This is the intent of the article, which includes an exploration of the construction of health, illness and disability in western societies and how this is subsequently discussed in relation to Black minorities. At a general level this is addressed with reference to the humanist philosophy which pervades the entire discourse and provides the dominant framework of power in society.