The State of Care Management in Learning Disability and Mental Health Services 12 Years into Community Care

This paper reports on the organization of care management froma longitudinal study of community care for people resettledfrom long-stay learning disability and psychiatric hospitals.The findings from a 12-year follow-up of care management arrangementsin 12 learning disability and eight mental health study siteservices are described. The diversity of care management arrangementsfound at earlier points in the evaluation remained evident.Also, many of the former ‘care in the community’service users were excluded from mainstream care managementarrangements in their localities. The difficulty of developingperson-centred arrangements in learning disability and the lackof integration of the Care Programme Approach and care managementwere evident. The findings and observations are placed in thewider policy and practice context, with suggestions for takingcare management forward nationally and locally.     

WHOSE GAY COMMUNITY? SOCIAL CLASS,SEXUAL SELF‐EXPRESSION,AND GAY COMMUNITY INVOLVEMENT

The visible and political gay community has been characterized as an increasingly middle-class, white institution. It is hypothesized that this middle-class nature requires economic and psychosocial resources that are not available to the working class and, thus, may limit the expression of sexual orientation for the working class. An analysis of data from the multicity Urban Men's Health Study supports this hypothesis. Nine of 14 hypothesized effects are statistically significant and indicate that working-class men who are homosexually active are less likely to describe themselves as gay, are more likely to have heterosexual experience, and are less likely to be involved in the gay community. Thus, it is important to incorporate class differences when addressing the social and the political dynamics of sexual orientation.     

Four‐Month Attentional Regulation and Its Prediction of Three‐Year Compliance

The extent to which 4‐month attentional regulation during an infant‐mother still‐face situation and 12‐month attachment security during the Strange Situation predicted rates of compliance and noncompliance during a cleanup task at 36 months was examined longitudinally in 70 infant‐mother dyads. Hierarchical multiple regression analyses indicated that infants who showed more attentional regulation during the still‐face situation with mothers later showed a higher rate of committed compliance and a lower rate of situational compliance during cleanup with mothers. Furthermore, lower levels of attentional regulation were later associated with higher rates of assertive behavior, but only for infants in an insecure attachment relationship.     

THE ANSWERING MACHINE POSES MANY QUESTIONS FOR TELEPHONE SURVEY RESEARCHERS

The proliferation of the telephone answering machine raisesa number of questions about the continued efficiency of thetelephone as a data-gathering mechanism. The most critical ofthese is what effect the use of these machines might have onestablishing contact with potential respondents. If individualsroutinely use these machines to screen calls, then their accessibilityto telephone survey researchers will be restricted. A secondquestion is the degree to which respondents who own answeringmachines and are reachable are likely to participate in a survey.A third question is the extent to which the incidence of theanswering machine as a response disposition might vary by thetime of calling and the respondent's place of residence. Thefindings of this study, based on a nationwide survey, pointto a significant proportion of answering machine owners beingreachable and willing to participate. Furthermore, the answeringmachine appears to be in use more on weekends than on weekdayevenings and in more urbanized areas than in areas with fewerinhabitants.     

Measuring the non-profit sector cross-nationally: a comparative methodology

As a result in part of the way non-profit institutions are defined and treated in the United Nations System of National Accounts (SNA), little is known about the size, scope, financial base and role of this set of institutions at the international level, even though their importance is increasingly being recognised throughout the world. To remedy this significant lack of systematic information on non-profit institutions cross-nationally, the Johns Hopkins Comparative Nonprofit Sector Project has undertaken a major analysis of the economic role of this sector in twelve countries throughout the world, utilising a more meaningful definition of the sector and an approach that is otherwise consistent with the overall thrust of the SNA system. This paper outlines the basis of the more inclusive definition of the non-profit sector embodied in this project, the classification system formulated to structure data-gathering on this more broadly-defined sector and the data assembly strategy developed to build up key estimates of the scale, structure and revenue sources of the non-profit sector in the project countries. The article concludes with a recommendation to incorporate a similar approach to the assembly of data on the non-profit sector into the ongoing SNA system on a regular basis.Professor Lester Salamon is Director of the Institute for Policy Studies and Director of the Comparative Nonprofit Sector Project at the Johns Hopkins University, Baltimore, Maryland, 21218.Helmut Anheier is Research Scientist at the Institute for Policy Studies at the Johns Hopkins University and Assistant Professor of Sociology at Rutgers University, New Brunswick, New Jersey, 08903. He is co-editor ofVoluntas.     

Stress at work and psychological and immunological parameters in a group of Norwegian female bank employees

This study concerned the immunological correlates of stress and work. Self reported stress, emotional state, ego-strength, and defensiveness were examined in relation to measures of cellular immunity (T-cell response to Con A and number of T4 and T8 cells) and humoral immunity (concentrations of immunoglobulins and complement components in plasma) in a group of 96 Norwegian female bank employees. The analyses showed that workload, the stress factor with the highest group mean, was associated with number of T-cells, while strain due to body posture during work was related to concentrations of IgM and C3. Further, depression was significantly correlated with IgM concentration and T-cell number, and anxiety with C3 concentration. T-cell activity was the immunological parameter most consistently associated with psychological well-being, showing positive correlations with defensiveness and ego-strength and negative correlations with anxiety and depression. In conclusion, T-cell number and concentrations of IgM and C3 were sensitive to both work-related stress experience and emotional distress. Coping abilities, indicated by the MMPI Ego-strength scale and emotional distress, were reflected in T-cell activity; insufficient coping was associated with low T-cell activity.     

Factors Affecting Children’s Adjustment to the Death of a Parent: The Social Work Professional’s Viewpoint

This study investigated factors affecting the adjustment of parentally bereaved children by reviewing existing literature and comparing it to observations made by professional social workers. Interviewees had between 1 1/2 and 22 years of experience in counseling bereaved children. The specific factors examined were age and sex of the bereaved child, circumstances of the death, and adjustment of remaining caregiver. Participants (n = 5) responded to an interview instrument specifically designed for this study which contained seven in-depth, open-ended questions. Participants’ replies were mostly in accordance with the literature, but also generated some new perspectives that had not been previously considered for this study and had not appeared in the literature. This study has implications for practice with parentally bereaved children and their surviving caregivers.Rebecca M. Hope, LCSW, Outpatient Clinician, New River Valley Community Services, 700 University City Boulevard, Blacksburg, VA 24060.Diane M. Hodge, Ph.D. is an Associate Professor of Social Work, Radford University, P.O. Box 6958, Radford, VA 24141; e-mail: dmhodge@radford.eduAddress correspondence to Rebecca M. Hope, LCSW, Outpatient Clinician, New River Valley Community Services, 700 University City Boulevard, Blacksburg, VA 24060; e-mail: rmhope@verizon.net