The International Migration of Nurses in Long-Term Care

This article describes five major factors that are affecting patterns of international migration among nurses who work in long-term care settings:

• Demographic drivers–The aging of the populations in developed countries and the low to negative growth in the working-age population will increase the demand for international workers to provide long-term care services.

• Gender and race–A dual labor market of long-term care workers, increasingly made up of women of color, is becoming internationalized by the employment of migrating nurses from developing countries.

• Credentialing–The process of credentialing skilled workers creates barriers to entry for migrating nurses and leads to “decredentialing” where registered nurses work as licensed practical nurses or aides.

• Colonial history and geography–The colonial histories of many European countries and the United States have increased migration from former colonies in developing countries to former colonial powers.

• Worker recruitment–Efforts to limit the recruitment of health care workers from some developing countries have had little effect on migration, in part because much of the recruitment comes through informal channels of family and friends.

     

关键时刻的语境大串联——关于文化研究的对话

这里刊出的是两位著名文化研究学者的一篇对话,主题自然是文化研究。劳伦斯.格罗斯伯格早年学习历史与哲学,后在英国伯明翰大学当代文化研究中心做研究,师从文化研究领军人斯图尔特.霍尔。他撰写和主编的大量论著在文化研究领域具有广泛影响,许多成为经典性论著。他主编的《文化研究》杂志,创刊于1987年。20年来,该杂志发表了近千篇学术论文,对文化研究领域的形成和发展有举足轻重的意义。刘康现担任美国杜克大学公共政策学院中国传媒中心主任、教授,南京大学兼职教授。照对话者的看法,文化研究的要旨在于如何“讲好故事”,路径之一乃是“串联”(articulation,又译作“接合”)。“串联”概念源出于斯图尔特.霍尔,旨在将不同事物联系起来构成新东西。对话者首先提出了跨学科的“串联”,以问题为中心,将不同学科的视角、方法、观念和理论相互碰撞,必然会产生各种新的观念。以问题为核心,就是强调回到问题本身是研究之宗旨所在。这就触及到所谓的“激进的语境主义”,也就是将特定问题带回到它们出现的那个特定社会、政治、经济和文化背景之中。提倡从问题出发、反对理论先行,这就击中了当前一些文化研究普遍存在的弊端。“关键时刻”概念特指社会矛盾激化的重要时刻,是语境的另一种描述,中国和西方目前都处在这一时刻。劳动的贬值,共同价值的衰落,文化的经济化,消费社会的崛起,传媒的影响等,都作为关键时刻的问题凸现出来,向文化研究提出了挑战。理论如何与大众“串联”,是对话又一重要主题,将文化研究变成公共知识,而非学院派的密语,看来是今后文化研究所面临的难题。在这方面右派比左派做得更好,也更有效,倒是一个发人深省的问题。于是,文化研究议程的创新,特别是在中国,如何从理论消费转向理论生产,乃是一个不容忽视的重大问题。     

Knowledge,Attitudes, and Informational Behaviors of College Students in Regard to the Human Papillomavirus

Abstract

Objective: To assess students’ human papillomavirus (HPV) knowledge, attitudes, and behaviors. Participants/ Methods: Students (N = 1,282) at a large, public university in the Northeast United States completed a questionnaire during February 2008 assessing HPV knowledge, prevalence, transmission, cervical cancer risk and stigma; sexual behavior, vaccination status, as well as past and preferred sources of information about HPV and sexual health. Results: A majority of respondents know of HPV. However, understanding was insufficient in several important areas. Overwhelmingly, respondents heard about HPV via television commercials yet preferred to obtain sexual health information from physicians. Hearing about HPV on a TV commercial was associated with increased knowledge. More knowledge of HPV was associated with less stigma. Men exhibit a higher level of stigma and less knowledge than women. Conclusions: Publicly funded health campaigns aimed at increasing knowledge about HPV are overdue and necessary. This is especially true for efforts targeting young adults about this extremely common sexually transmitted infection (STI).     

Feasibility of a Telephone Follow-Up on Use of Emergency Contraceptive Pills in a College Health Center

Abstract

The authors examined the feasibility and effectiveness of a telephone follow-up procedure on use of emergency contraceptive pills (ECP) at a college health center. They made 264 telephone calls to the 97 women who had received ECPs during one 16-week academic semester and were successful in reaching 65 (67%) of the women, who responded with information about their experiences with ECPs. The women demonstrated a high rate of adherence to the medical regimen and reported very few side effects from ECPs; a majority said that ECPs did not affect their ability to carry out daily activities. On weighing the relative absence of problems following ECP distribution against the time, effort, and cost required to reach just over two thirds of the women, the researchers concluded that an ECP telephone follow-up procedure was neither cost-effective nor particularly useful.     

Fingerprint-based background checks for personal care workers: Stakeholder views of policy criteria

Decision makers face difficult choices when tasked with identifying and implementing appropriate mechanisms for protecting the elderly and other vulnerable adults from abuse. A pilot project involving fingerprint-based criminal history background checks for personal care workers in Michigan has supplied an opportunity to examine one such mechanism. In conjunction with the pilot project, we have conducted a stakeholder analysis with the aim of informing decision makers about stakeholder perceptions of standard policy criteria like effectiveness, efficiency, and equity. We employed focus groups and a Web-based survey to collect data from stakeholders. While stakeholders generally see fingerprint-based background checks for personal care workers as potentially effective and as a net benefit, they also point to a variety of contingencies. They also recognize difficulties and constraints for government involvement. This preliminary analysis provides solid foundational information for decision makers and for more extensive benefit–cost analysis.     

Quantifying Littered Cigarette Butts to Measure Effectiveness of Smoking Bans to Building Perimeters

Abstract

Objective: The authors estimated the number of violations of a university policy that prohibited smoking within 25 ft of all campus buildings. Participants: The project was conducted by 13 student researchers from the university and a member of the local public health department. Methods: Students quantified cigarette butts that were littered in a 30-day period inside the prohibited smoking area of 7 campus buildings (large residential hall, small residential hall, administrative building, 2 academic buildings, campus cafeteria, and student union). Results: Investigators found a total of 7,861 cigarette butts (large residential hall: 1,198; small residential hall: 344; administrative building: 107; 2 academic buildings: 1,123 and 806; campus cafeteria: 2,651; and student union: 1,632). Conclusions: Findings suggest that there is low compliance with the university's smoking policy. The described project may be repeated by students at other universities as a method to advocate for policy change.     

Mandatory Testing of Drivers on the Basis of Age and Degenerative Diseases: Stakeholder Opinions

Concerns about the driving competence of older drivers have led to policy discussions about mandatory aged-based and disorder-based assessments. This study explored the attitudes, beliefs, and preferences of older adults, law enforcement officers, and licensing authorities toward reexamination of driving skills for persons with Alzheimer's disease (AD) and Parkinson's disease (PD) and at varying ages. With few exceptions, participants across all groups supported retesting drivers with AD. Moderate support was given for further evaluation of 90-year-olds and those with PD. Least endorsement was given for reassessment of 70-year-old drivers. Findings have implications for legislative changes to address drivers with AD and PD and at older ages.     

Elder Abuse:

Perpetrator and incident characteristics were studied in regard to incidents of emotional, physical, and sexual mistreatment of older adults (age 60+) in a national sample of older men and women. Random digit dialing across geographic strata was used to compile a nationally representative sample; computer assisted telephone interviewing was used to standardize collection of demographic, mistreatment, and perpetrator and incident characteristics data. The final sample size consisted of 5,777 older adults. Approximately one in ten adults reported at least one form of mistreatment, and the majority of incidents were not reported to authorities. Perpetrators of physical mistreatment against men had more “pathological” characteristics compared to perpetrators of physical mistreatment against women. Perpetrators of physical mistreatment (compared to emotional and sexual mistreatment) also evidenced increased likelihood of legal problems, psychological treatment, substance use during incident, living with the victim, and being related to the victim. Implications for future research and social policy are discussed.