Child welfare reform in the United States: findings from a local agency survey

Efforts to improve the public welfare and child welfare system sparked an unprecedented amount of federal legislation in the 1990s, including the Adoption and Safe Families Act of 1997 (ASFA), the Multiethnic Placement Act of 1994 and Interethnic Adoption Provisions of 1996 (MEPA-IEP), and welfare reform. Such reforms allow an unprecedented degree of flexibility, but little is known about their implementation. Researchers administered the Local Agency Survey to the first national probability sample of public child welfare agencies from 1999 to 2000. Findings indicate that ASFA has had the most effect on child welfare service delivery. Welfare reform has had less effect, and MEPA-IEP seems to have had little effect at all.     

Meeting communication needs: topics of talk in the nursing home

Nursing home residents primarily rely on staff for communication and interpersonal relationships. Challenged by staffing shortages and increasingly complex care, staff who provide the most communication with residents lack awareness and skills to effectively communicate with older adults. This study, a secondary analysis of staff-resident interactions from one nursing home, explores communication topics and the effects of an intervention. Staff from one unit were recorded during 2 hours of caregiving to provide a representative sample of their communication with residents. Staff then attended an educational program targeting improved awareness of communication needs and reducing "elderspeak". Recording was repeated post-intervention. Baseline conversations focused on activities of daily living (ADLs), personal-social, technical care, and health assessment. Post-intervention ADL talk decreased in staff-resident interactions, while personal-social topics increased. These findings suggest that residents' limited opportunities for communication with staff are primarily focused on care tasks. With increased communication awareness, staff can learn to modify conversational topics to better meet older adults' psychosocial needs.     

Assuring the quality of long-term care insurance benefits through care management: the California partnership for long-term care

Despite recent improvements in long-term care insurance (LTCI) policies, concerns have been raised regarding just how well LTCI benefits actually meet elderly consumers' health and financial needs. In this case study, we examined the quality assurance (QA) provisions in a state-sponsored LTCI program, the California Partnership for Long-Term Care (CPLTC). CPLTC invests the primary responsibility for QA with care management networks, which assure quality services through care monitoring, quarterly service record reviews, and annual documentation of care manager clinical competence. Study findings suggest a number of limitations in existing QA policies and procedures, which can undermine the ability of care managers and other third parties to identify and rectify potential unmet needs among LTCI policyholders. These findings, while based on an intensive analysis of QA provisions in a particular, state-sponsored LTCI program, are likely to have implications for other LTCI programs and policies, most of which have less well-developed QA provisions.     

Psychologists' judgments of psychologically aggressive actions when perpetrated by a husband versus a wife

Research literature suggests that clinical judgments of men's versus women's behavior and symptoms typically rate the men as more pathological and dangerous. To determine whether this view would extend to assessments of psychologically aggressive actions, two separate versions of a survey listing potentially psychologically abusive behaviors perpetrated by either a wife toward her husband or the identical actions perpetrated by a husband toward his wife were sent to a nationwide sampling of practicing psychologists. Results indicated that psychologists, irrespective of demographics, rated the husband's behavior as more likely to be psychologically abusive and more severe in nature than the wife's use of the same actions. Psychologists did not differentially rely on any of the three contextual factors (i.e., frequency/duration, intent of the perpetrator, and perception of the recipient) to influence their determination that a behavior was "psychological abuse" dependent upon whether the initiator of the psychological actions was the husband or the wife. Future research could assess more directly the rationale for the psychologists' differing views of male versus female behavior. In addition, more normative information is needed to inform mental health professionals as to the prevalence and severity of psychologically aggressive actions in the general population.     

Polish Households During the Economic Transformation

Two topics are presented in this paper: a short history of the Polish economic transformation, begun in 1989, and analyses of aggregate data describing the life conditions of Polish households in the period immediately following the transformation.     

What to do while things are changing

No longer able to support an entitlement culture, the business of health care is rapidly giving way to a culture of marketability. However, effective career management within a changing professional landscape doesn't have to be nightmare. Physician executives can learn to work with the dynamics and principles of change management to significantly reduce their error rate and increase their chances for success. Using change management strategies and tools effectively is the best way to transform any sense of urgency you may feel into energy, information, and action. This is the optimal time to create a better work environment for yourself, and become a better resource for the community you serve.     

The British Community Development Project: Lessons for today

This paper looks back at the experience of the first Britishpoverty programme, the national Community Development Project(CDP), which operated from 1969 to 1978. The "radical" projectswithin CDP comprehensively rejected the official governmentview of the nature and causes of, and solutions to, povertyand urban deprivation. The roots of the radical CDP perspectiveare to be located within the political character of the periodamong other factors. The paper offers a retrospective accountof the strengths and limitations of CDP.     

Migrant adjustment in Seoul,Korea: employment and housing

To examine the role of the migrants in the job and housing markets, a sample survey of 1000 households in Seoul, Korea was conducted. For each sample household chosen, in an area probability sample based on the city registration lists, 1 household member, aged 15-45, was interviewed about employment, housing, migration and family histories, and the social and psychological adjustment in Seoul City of the respondent and his family members. Interveiws were completed for 978 cases in 2 rounds in 1974-75. An important feature of the sample was the inclusion of the control group of lifetime urban residents who were used as the standard by which migrants' adjustment was examined. This group comprised 27% of the sample. Additionally, the migrant group was subdivided according to length of residence in Seoul City. Those who resided there for fewer than 5 years were classified as recent migrants and comprised 20% of the sample. Longterm migrants, those with residence greater than 5 years, comprised 53% of the sample. Recent migrants were concentrated in the blue collar occupations, but there was virtually no difference between the occupational distributions of longterm migrants and lifetime urban residents. Lifetime urban residents showed higher unemployment rates and higher educational enrollment rates than either the recent or longterm migrants groups. There was a 10% differential favoring employment in modern industries (secondary and tertiary) among the lifetime urban residents; fewer than 40% of the recent migrants fell into the modern categories compared to 44% for longterm migrants, and over 50% for lifetime urban residents. Lifetime urban residents were significantly less likely to be employed in traditional service occupations than were recent migrants. Longer term migrants were intermediate for the tertiary traditional sector, but they were significantly less likely to be employed in the manufacturing or secondary sector, especially the modern secondary sector, possibly reflecting the job market upon their arrival in Seoul. Younger respondents were concentrated in blue collar occupations, but for those 25 years old and older more than half were employed in white collar occupations. The quality of dwellings for migrants and natives was measured in 3 areas: housing quality; neighborhood quality, and tenure status. To a certain extent migrants were in lower quality housing compared to urban natives, but this appeared to be due not to recency of migration itself but to other characteristics of the migrants. The relative position of recent, versus longterm migrants, was opposite to the expected pattern. The quality of the neighborhood of residence differed somewhat more for migrants and nonmigrants. The relative positions were as hypothesized: neighborhood quality increased with duration of residence. The range of differences was narrowed considerably when the effects of age, education, and income were removed. Owning or not owning one's house seemed related much more closely to the formation of attachments in the urban area, that is, commitment. Migrants through time do come to approximate the economic and housing patterns of lifetime urban residents.