Urban and Rural Variations in the Characteristics Associated With Elder Mistreatment in a Community-Dwelling Chinese Population

This study compares the urban and rural differences in characteristics associated with elder mistreatment (EM) in a Chinese population. A cross-sectional study of 269 urban and 135 rural participants aged 60 years or greater was performed. Among those with EM, rural participants were more likely to be women, have lower levels of education and income, have lower levels of health status and quality of life, have worse change in recent health, and have lower levels of psychosocial well-being. Both higher levels of depressive symptoms and lower levels of social support were associated with increased risk of EM.     

Mapping the Elder Mistreatment Iceberg: U.S. Hospitalizations With Elder Abuse and Neglect Diagnoses

Purpose: This study describes U.S. hospitalizations with diagnostic codes indicating elder mistreatment (EM). Method: Using the 2003 Nationwide Inpatient Sample (NIS) of the Healthcare Costs and Utilization Project (HCUP), inpatient stays coded with diagnoses of adult abuse and/or neglect are compared with stays of other hospitalized adults age 60 and older. Results: Few hospitalizations (< 0.02%) were coded with EM diagnoses in 2003. Compared to other hospitalizations of older adults, patients with EM codes were twice as likely to be women (OR = 2.12, 95% CI = 1.63–2.75), significantly more likely to be emergency department admissions (78.0% vs. 56.8%, p < .0001), and, on average, more likely to have longer stays (7.0 vs. 5.6 days, p = 0.01). Patients with EM codes were also three to four times more likely to be discharged to a facility such as a nursing home rather than “routinely” discharged (i.e., to home or self-care) (OR = 3.66, 95% CI = 2.92–4.59). Elder mistreatment–coded hospitalizations compared to all other hospitalizations had on average lower total charges ($21,479 vs. $25,127, p < .001), with neglect cases having the highest charges in 2003 ($29,389). Implications: Knowledge about EM is often likened to the “tip of the iceberg.” Our study contributes to “mapping the EM iceberg”; however, findings based on diagnostic codes are limited and should not be used to minimize the problem of EM. With the so-called graying of America, training is needed in recognizing EM along with research to improve our nation's response to the mistreatment of our elderly population.     

Multifamily therapy in the community mental health network: A pragmatic randomized and controlled study

Multifamily therapy (MFT) is a psychotherapeutic group intervention for patients with severe mental disorders (SMDs) and their families. The present study is a multicenter, randomized, and controlled trial that analyzes the benefit of MFT during outpatient treatment. The recruited patients were randomly assigned to the experimental group (n = 26), which received 24 MFT sessions in addition to their treatment as usual (TAU), or to the control group (n = 29), which received only TAU (individual and family sessions). Six months after the inclusion in the MFT, the experimental group showed a significant decrease in number of visits to the psychiatric emergency services, number of psychiatric admissions, and the days of admission. The need for hospital care 6 months after recruitment was also lower in the experimental group compared to the control group. These results suggest that the implementation of MFT during outpatient treatment facilitates community management of people diagnosed with mental health problems.     

Occupational influences on retirement,disability, and death

This research examines the alternative mechanisms by which occupations influence the nature and timing of older men's labor force withdrawal. We specifically assess the extent to which occupational factors operate directly and indirectly on exiting events and whether occupations constrain traditional determinants of labor force participation. Based on a discrete-time hazard modeling approach, the results substantiate that the occupational task activities--substantive complexity and physical demands--are key elements of the work environment that are evaluated against nonwork alternatives. In the case of retirement, these aspects of occupational attractiveness function as a dominant and direct force in retirement decision making. With regard to disability, the occupational attribute of substantive complexity operates as an indirect advantage (through higher wages) by reducing the risk of disability. Indicators of career continuity also influence retirement among older workers. Finally, the results suggest that financial characteristics and health problems are central to the distribution of older workers across the alternative destination statuses of retirement, disability, and death.     

“She foreswore her womanhood”: Psychoanalytic views of female homosexuality

Just as in early psychoanalytic views of female sexual development women's sexual anatomy, psychic development, and object relations were seen relative to male norms and found wanting, in much of psychoanalytic thinking the sexual and psychic development of women in lesbian relationships are seen relative to heterosexual women and found lacking. Various etiological explanations of female homosexuality attempt to isolate a particular developmental arrest or disorder characteristic of female homosexual relations. This paper reviews the major psychoanalytic formulations of female homosexuality and discusses them in terms of two phallocentric assumptions: 1.) A woman who loves a woman must be a man, or be like a man, or must want to be a man; and 2.) A relationship between two women must always remain incomplete compared to the complementarity assumed in a heterosexual relationship. Increased understanding of the sexual desires and experience of women in lesbian relationships would contribute to expanded perspectives about female sexuality and development. The paper offers two paradigms for thinking about homosexual object choice which are not based on analogies to pathological conditions.If you don't know the kind of person I am and I don't know the kind of person you are a pattern that others made may prevail in the world and following the wrong god home we may miss our star. from A Ritual to Read to Each Other, William Stafford     

From Silos to Scaffolding: Engaging and Effective Social Work Practice

In this final article of the special issue Beyond the Manual: Using Data and Judgment in Clinical Social Work Practice, we extend the discussion regarding the use of data and judgment. We discuss the multiple sources of data used in practice, including research evidence, client perspectives and experience, moment-by-moment process observation, and client feedback regarding progress towards specific, desired outcomes. We move beyond current debates purporting one framework over another to propose a synthesizing framework that situates evidence-based practice, empirically supported interventions and common elements/mapping and adapting practice within a common factors scaffolding framework. This framework provides a way for social workers to effectively make sound judgments using research and client data within the demands of contemporary practice. The article provides a brief overview of the four practice approaches followed by the proposed scaffolding framework and rationale, and concludes with implications for practice, professional education, and research.     

College Health Service and the Fast-Food Value System

Abstract

Objective: To estimate and compare the prevalence of overweight and obesity among self-identified lesbian, bisexual, and heterosexual college age women. Methods: A secondary analysis of the Spring 2006 National College Health Assessment was conducted with 31,500 female college students (aged 18 to 25 years) to compare body mass index (calculated from self-reported height and weight) among lesbian, bisexual and heterosexual college women. Results: Compared to heterosexuals female college students, lesbians and bisexual women were both significantly more likely to be overweight or obese. Lesbians were also less likely to be underweight compared to heterosexual college women. Conclusions: Self-identified lesbian and bisexual college women were more likely to be overweight or obese than their heterosexual counterparts. Health care professionals and educators should target these high-risk populations for obesity prevention programs. This study highlights the need for additional research examining the potential risk factors for overweight and obesity among young sexual minority women.