Social Networks and Unobserved Heterogeneity in Risk for AIDS

As a sexually transmitted disease, AIDS spreads along social networks; consequently,it is reasonable to propose to utilize these networks in teaching people to avoid practices that put them at increased risk of contracting AIDS. Most obviously, homosexual men are both at relatively high risk of contracting AIDS, and in many urban areas have well crystallized community structures and high social connectivity. We present evidence suggesting that using such social networks can have the unanticipated consequence of reaching a set of men who are at relatively low risk. Evidently, there is great unobserved heterogeneity among the population in terms of risk, and while this heterogeneity is not captured by conventional measures of risk behavior, it is closely linked to network processes.     

AgJOBS: New Solution or New Problem?

Over half of the workers employed on U.S. farms are not authorized to work in the United States. An historic compromise between employer and worker advocates in September 2003 would legalize some currently unauthorized workers and make it easier for farmers to obtain guest workers, but is unlikely to change the farm labor market, so that the percentage of unauthorized workers is likely to climb again.     

Depression and elder abuse and neglect among a community-dwelling Chinese elderly population

Our recent survey of an elderly cohort in mainland China suggests that elder abuse and neglect are common. Unfortunately, there is minimal knowledge about the risk factors for elder abuse and neglect among this population. We aimed to examine depression as a risk factor for elder abuse and neglect among Chinese elderly. A cross-sectional study was performed in a major urban medical center in NanJing, China. Depression was assessed using the Geriatric Depression Scale and direct questions were asked regarding abuse and neglect experienced by the elderly since the age of 60; 412 patients completed the survey. The mean age of the participants was 70 and 34% were female. Depression was found in 12% of the participants and elder abuse and neglect was found in 35% of the participants. After multiple logistical regression, feeling of dissatisfaction with life (OR, 2.92; 95% CI, 1.51-5.68, p < 0.001), often being bored (OR, 2.91; CI, 1.53-5.55, p < 0.001), often feeling helpless (OR, 2.79; CI, 1.35-5.76, p < 0.001), and feeling worthless (OR, 2.16; CI, 1.10-4.22, p < 0.001) were associated with increased risk of elder abuse and neglect. Multiple logistic regression modeling showed that depression is independently associated with elder abuse and neglect (OR, 3.26; CI, 1.49-7.10, p < 0.003). These findings suggest that depression is a significant risk factor associated with elder abuse and neglect among Chinese elderly.     

Paid personal assistance services:an exploratory study of working-age consumers' perspectives

This study examined the experiences of individuals who use paid personal assistance services (PAS). Structured interview data were collected from a convenience sample of 24 working-age individuals from diverse backgrounds recruited from Centers for Independent Living in nine states. Respondents described their general satisfaction with current paid PAS, but many reported previous experiences with poor care related to the low wages, lack of training of PAS providers, and an inadequate supply of providers. Respondents reported many unmet needs because of a shortage of hours provided by state programs and the lack of help with daily living activities, transportation, childcare, and social activities. The respondents strongly preferred consumer-directed care.     

Using evaluation to improve program quality based on the BELL model

Building Educated Leaders for Life (BELL) is a national not-for-profit organization whose mission is to increase the educational achievements, self-esteem, and life opportunities of elementary school children living in low-income urban communities. BELL has been engaged in formal evaluation, internally and externally, for more than five years and has built internal evaluation capacity by investing in a specialized full-time evaluation team. As part of a continuous program improvement model of evaluation, BELL uses the data to refine program implementation and replicate successful elements of the services and operations. In this chapter, the authors highlight best practices from the field by outlining BELL's approach to using evaluation data for continuous program improvement. Key strategies include (1) carefully identifying intended users of the evaluation throughout the organization and among its external stakeholders, then working closely with intended users throughout the evaluation process, ensuring full engagement at every step of the process; (2) reporting findings in a readable, user-friendly format and timing the reporting so that it is aligned with programmatic decision making and planning cycles; and (3) making and supporting explicit recommendations for the next program cycle, where intended users have agreed to recommendations and ownership is assigned. BELL's successful use of data for improvement is evidenced by the consistently strong outcomes for the students it serves as well as increased efficiency and satisfaction related to service delivery that has supported the replication of BELL's programs nationally.     

Migration and retirement in the life course: an event history approach

Migration at older ages is commonly explained by reference to the search for greater amenity, and subsequently by the onset of greater dependency, but the links between mobility and specific life course transitions have rarely been articulated. We aim to establish the timing of migration in relation to retirement from the labour force, and to determine how its intensity varies around the retirement event. We also seek to identify how household and individual characteristics shape the propensity and timing of migration, differentiating moves according to distance and with particular attention to the characteristics of the spouse. Data are drawn from the first six waves of the Household, Income and Labour Dynamics in Australia survey, a nationally representative panel study covering the period 2001–2006. Migration events are identified relative to retirement and event history methods are employed to establish the characteristics predisposing households to relocate around retirement. Results demonstrate that retirement acts as a trigger to migration but the propensity to move falls as retirement age rises and the hazard is increasingly concentrated in the year retirement occurs. Within this framework the presence, health, education and retirement status of a spouse exert a significant influence on the likelihood of migration, though with different effects for long and short distance moves. Results highlight the importance of variations in underlying life-course trajectories in shaping retirement migration and demonstrate that only a minority of moves at ages 55–69 are directly associated with retirement, underlining the need for caution when identifying retirement migration using age as a proxy measure.