Transforming national health policy: The significance of the stratification system

Policy formulation and decision-making occur within a continually changing sociopolitical environment. Presently, our national health policy lacks coherence and direction. It also is in a state of transition as evidenced by the recent restricted proposal to expand Medicare coverage to catastrophic illness. A comprehensive strategy for balancing escalating medical, hospital, and insurance costs as well as those associated with long-term care while extending access has not been devised. One of the most salient reasons for this is the failure of policy makers to grasp the complexities of the multifaceted stratification system. Its diverse, interrelated strata based on age, sex, economic status, and race are not incorporated in the process of shaping vitally needed and rational health policy. Doris Y. Wilkinson, a professor of sociology at the University of Kentucky, is a co-principal investigator on an intervention project funded by the National Cancer Institute. She recently received the Master of Public Health in Health Policy and Management from Johns Hopkins University.     

Social Advocacy for Equal Marriage: The Politics of "Rights" and the Psychology of "Mental Health"

Using the contemporary issue of equal access to marriage for same-sex couples as a case study, we examine two distinctive frameworks within which social advocacy may be pursued. We argue that when we speak as psychologists, we use a discourse of mental health; when we speak as social activists, we use a discourse of human rights and justice. Although these two frameworks may converge in supporting equal access to marriage, they represent radically different ways of understanding inequality and advocating for social change. A discourse of mental health focuses on psychological damage or deficit (caused, for example, by the social exclusion of particular groups or individuals. A discourse of rights asserts universally-applicable principles of equality, justice, freedom, and dignity. Further, the paradigmatic framework of psychology as an approach to understanding human beings in the world seems fundamentally antithetical to the conceptual framework of human rights, as a basis for social justice.     

Summer learning and its implications: insights from the Beginning School Study

There is perhaps no more pressing issue in school policy today than the achievement gap across social lines. Achievement differences between well-to-do children and poor children and between disadvantaged racial and ethnic minorities and majority whites are large when children first begin school, and they increase over time. Despite years of study and an abundance of good intentions, these patterned achievement differences persist, but who is responsible, and how are schools implicated? The increasing gap seems to suggest that schools are unable to equalize educational opportunity or, worse still, that they actively handicap disadvantaged children. But a seasonal perspective on learning yields a rather different impression. Comparing achievement gains separately over the school year and the summer months reveals that much of the achievement gap originates over the summer period, when children are not in school. The authors review Beginning School Study research on differential summer learning across social lines (that is, by family socioeconomic level) and its implications for later schooling outcomes, including high school curriculum placements, high school dropout, and college attendance. These studies document the extent to which these large summer learning differences impede the later educational progress of children of low socioeconomic status. Practical implications are discussed, including the need for early and sustained interventions to prevent the achievement gap from opening wide in the first place and for high-quality summer programming focused on preventing differential summer learning loss.     

Age discrimination and working life: Perspectives and contestations – a review of the contemporary literature

This review highlights some of the principal issues and debates surrounding age discrimination at the workplace. Essentially, the existing research in this area can be divided into three broad, although somewhat overlapping, categories. The first explores the underlying causes and consequences of age discrimination at the workplace from one or other theoretical tradition. The second broad body of literature encompasses empirical studies which document the nature and extent of age discrimination, based on the use of official statistics, and/or firm‐level survey evidence. The third explores the effects of various governmental initiatives to reduce the incidence of age discrimination and policy options in this area. Even though age discrimination is widely accepted to be prevalent, its causes are rather more contentious. Age discrimination has variously been ascribed to market imperfections, the product of rational choices and the effects of long‐term changes in the nature of the economy. Policy interventions may be prompted by economic pressure, demographic changes or cultural shifts, and have involved voluntary codes as well as legislation. Although voluntary codes have generally proved ineffective, the literature indicates that more formal regulations may still have only limited efficacy, underscoring the deeply rooted nature of age discrimination in society.     

A review of interventions to prevent Type 2 Diabetes after Gestational Diabetes

BackgroundGestational Diabetes Mellitus (GDM) during pregnancy is a risk factor for the development of Type 2 Diabetes (T2DM) within 15 years, and prevention programmes have been problematic.QuestionThe aim of the study is to identify effective strategies and programmes to decrease the risk of T2DM in women who experience GDM, the barriers to participation, and the opportunities for midwives to assist women in prevention.MethodsEnglish language, peer reviewed and professional literature published between 1998 and 2013 were searched. A systematic review of the literature was undertaken, included studies were then appraised for quality and finally findings of the studies were thematically analysed.FindingsThis review identified that there are interventions that are effective, however most lifestyle changes are difficult to translate into everyday life. As the incidence of GDM is expected to rise, midwives’ role in promoting long-term health behaviours requires further review.ConclusionsWomen need to overcome barriers and be supported in making the behavioural changes necessary to prevent T2DM following GDM. Midwives as the primary carers for women in pregnancy and childbirth are ideally positioned to educate women and engage them in lifestyle and behaviour programmes that prevent the onset of Type 2 Diabetes.     

Legitimizing Security in the Ivory Tower: Canadian University Corporate Security Services’ Public Quest for Legitimacy

This article examines how university corporate security (UCS) services engage in legitimation work in their attempts to make their university communities (i.e., faculty, staff, students) and political masters (i.e., university administrators, boards of governors, senators) believe that they are honest, trustworthy, and caring and have authority that should be deferred to. This is accomplished through the analysis of interview and observational data collected as part of a research project exploring UCS services at five Canadian universities and an examination of how UCS services at 14 Canadian universities communicate using the social media service Twitter. These UCS services were found to primarily use Twitter for the purposes of soliciting or requesting information and for networking. In communicating through Twitter, UCS services engage in public legitimation work in which they make claims about and attempt to demonstrate their expertise, authority, and accountability. This article argues that both UCS services’ particular legitimacy problem (i.e., their possession of both private and public attributes) and the interactive nature of public legitimation work create tensions that may serve to disrupt UCS services’ ability to attain legitimacy. Cet article examine la manière dont les services de sécurité d'entreprise à l'université (SEU) s'engagent à légitimer leurs tentatives de persuader leurs communautés universitaires (c'est‐à‐dire le corps professoral, le personnel et les étudiants) ainsi que la haute administration (c'est‐à‐dire les administrateurs de l'université, le conseil des gouverneurs et les sénateurs) qu'ils sont honnêtes, attentifs, dignes de confiance, et qu'ils possèdent un niveau d'autorité auquel quiconque devrait se référer. Ceci sera accompli en analysant un corpus d'entrevues et d'observations dans le cadre d'un projet de recherche examinant les services de type SEU dans cinq universités canadiennes, ainsi qu'une étude sur la manière dont les services de SEU dans quatorze universités canadiennes gèrent leurs communications sur le réseau de médias sociaux Twitter. Il a été établi que ces services de SEU utilisent principalement Twitter pour la sollicitation ou la demande d'informations, et pour le réseautage. En communiquant par Twitter, les services de SEU s'engagent dans un processus de légitimation par lequel ils revendiquent et tentent de démontrer leur expertise, autorité, transparence et responsabilité. Cet article propose l'argument suivant: la question de la légitimité particulière des services de SEU (c'est‐à‐dire leur possession d'attributs à la fois privés et publics) combinée avec la nature interactive du processus de légitimation publique crée des tensions qui peuvent en fin de compte perturber la capacité des services de SEU à atteindre réellement cette légitimité.     

A collaborative model: ambulatory pharmacotherapy for chronic psychiatric patients.

1. Increases in patient acuity and diagnosis related groups limiting hospital lengths of stay have contributed to the heightened demand for structured outpatient programs. 2. The Medication Clinic and Medication Group, a daily functioning outpatient program, is designed to shift the responsibility for medication management from the health-care provider to the patient and family through education and participation. 3. Within the framework of a collaborative practice model, the patient, clinical nurse specialist, and psychiatrist share equal power and responsibility. A phenomenologically oriented approach whereby the health-care provider attempts to understand the patient's illness from the patient's perspective is a crucial component. 4. The Medication Program combines the expertise of nursing and medicine in a complementary fashion, conducive to both revenue-generating activity and cost-effective role use.