Pilot study results: the psychiatric RN case manager.

1. It is important to examine client and staff satisfaction with the RN case management (RNCM) model to enhance the quality of care in psychiatric settings. 2. Ninety-two percent of clients surveyed ranked the RNCM care as "excellent" or "above average." Clients valued most the humanistic role of the RNCM and repeatedly commented on the importance of the nurse being caring, genuine, and supportive. 3. RNCMs expressed high satisfaction with their role, which they described as collaborative with the psychiatrist, yet also professional and independent. Psychiatrists expressed a high degree of confidence that clients were receiving excellent care by competent nurse professionals.     

A peer supervision group: put countertransference to work.

1. As the nurse-patient relationship evolves through a series of ongoing interactions, both participants become "known" and stir in each other a range of positive and negative emotional reactions. 2. When working with severely psychologically disturbed patients, the nurse's affective and behavioral response can be valuable clues to understanding the patient's early experiences that contribute to the pattern of relatedness and to the formulation of change, enhancing therapeutic interactions. 3. The goals of the countertransference peer supervision group were to recognize unconscious countertransference reactions; unravel the origin and meaning of those countertransference reactions; and collaboratively develop therapeutic nursing interventions.     

Elective single mothers and their children: The missing fathers

Elective single mothers are adult, unmarried women who intentionally become mothers. This study utilized longitudinal data about 17 Caucasian, elective single mothers and their children to identify fathers' roles in these families, and to understand children's views of their fathers. These single mothers and their children resided for the first six years of the children's lives in father-absent households. By age six, most of the children had ghost fathers, whom they had never met or knew little about. The data suggest that the father often becomes a family secret, and that children may blame themselves for their fathers' absence.     

Demography and ageing -- a truism highlighted

Since the aging of populations, with its extensive consequences, requires ample planning, demography is the soothsayer of gerontology. The realization that aging is the main demographic event of this century has generated an interdependence among demography, gerontology, and geriatrics, and created a base from which to extrapolate socio-political consequences from population changes. Demography transforms the personal unidimensional experience of aging to a dynamic one which traverses time and geography. Chronological age is not an exclusive criterion; this presents an opportunity to explore avenues grounded in the realms of economics, politics, policy, and culture. The inclusion of demography in international training courses of the International Institute on Aging (United Nations-Malta) has made possible an easier progression toward discussing policy, planning, funding, and social services within a broader context. The dependency of aging upon demography established the collaborative development between the Committee for International Cooperation in National Research in Demography (CICRED) and INIA and the joint hosting of a synthesis meeting on Population Ageing Research Project. In this collection of papers, Don Rowland creates the concept of the Gerontological Transition which interprets aging as a process of cohort flow; Raul Hernandez, through an evaluation of regional data, provides a classic analysis of changing age ratios within the population as a whole; Anthony Warnes, through use of mortality rates, provides a demographic analysis to expose the age-dependent variability in health and welfare payments; Paul Paillat transposes demographic numbers into social consequences; Miroslav Macura focuses on the youth in these population shifts; and the emerging elderly in the never ending cycle of events are viewed. Planning beyond the individual lifetime will become a necessity for mankind.     

Helping oneself by helping others: evaluation of a service credit banking demonstration

Between 1987 and 1990, the Robert Wood Johnson Foundation funded six service credit banking demonstration programs among the elderly in which participants delivered services in return for credits, entitling them to later service. This evaluation of the demonstrations found that these six sites successfully attracted elders for the delivery of household support services to a relatively old, frail population with potentially limited social networks. Evidence on the significance of the "credit" in attracting volunteers was mixed, but the programs have attracted new volunteers, and have not substituted for other volunteer activities. Program development has entailed considerable staff investment in volunteer support; programs are better understood as community membership organizations than as mechanical exchanges.     

Sucker bet or sure thing: A critical analysis of sports lotteries

A paradox currently exists regarding legal sports gambling in North America: various forms are flourishing in Nevada, Oregon, and several Canadian provinces, while at the same time the United States Congress is conducting hearings on two bills that would prohibit any new state-sponsored sports gambling initiatives. This study examines the issue of why some jurisdictions are enthusiastic about legal sports gambling while others strongly resist the concept. In reviewing these divergent viewpoints, a case study of the newfledged Canadian Sport Select gambling format is presented. This example is used to highly the perils and payoffs of a typical state-sponsored sports gambling scheme, with a view toward broadening our understanding of how they work and how they might be fairer to the public.     

Multistate life-tables and regression models

"A survey is given of the use of modern statistical techniques in event history analysis, and in particular in the study of multi-state life-tables in demography. Emphasis is placed on the interplay between partial likelihood and nonparametric maximum likelihood based methods, a) when analysing semi-Markov models or models with repeated spells, and b) in frailty models for unobservable heterogeneity."