Older people's experiences of community life: patterns of neighbouring in three urban areas

This paper examines changes to the community life of older people living in three urban areas of England: Bethnal Green, Wolverhampton and Woodford. All three were the subject of classic community studies in the 1940s and 1950s, these providing rich material about the lives of groups such as elderly people. Using this earlier research as a baseline, the paper presents data on how the experience of living in urban neighbourhoods has changed for older people in the intervening years. The article reviews the relationship between elderly people and their neighbours, drawing on quantitative as well as qualitative data. In conclusion, the paper identifies a number of general arguments pointing to the value of a community and locality perspective for understanding the impact of social changes on later life.     

Social Work Gerontological Practice: The Need for Faculty Development in the New Millennium

There is a pressing need to upgrade the gerontological knowledge and skills of practicing social workers. Geriatrics and gerontology, as specialized fields of knowledge, have not been sufficiently integrated into formal academic training programs. There are major trends in the health care environment which impact on social work education, including technological advances, a shift from inpatient to outpatient and community care settings, increasing diversity of the older population, and client and family participation in decisionmaking. These trends necessitate social work education to emphasize new content areas in gerontology and the development of new skills in clinical, case management, care coordination, and teamwork. A significant obstacle to the preparation of future social workers to deliver the complex services needed by older adults and their families is a serious shortage of social work faculty in gerontology. Sustained and broad initiatives, such as the John A. Hartford Foundation funded Geriatric Social Work Faculty Scholars Program, are needed to develop academic and practice-based faculty in gerontology. This is crucial if social work is to maintain an important service role in the new millennium.     

Improving health care delivery to aging adults with disabilities: social work with dual eligibles in a climate of health care reform

Adults aging with disabilities comprise a diverse group. In this article, we identify the prevalence and characteristics of this target population, focusing on adults who are dually eligible for Medicare and Medicaid. We articulate challenges in the delivery of health, social, and support services to adults aging with disabilities, particularly how existing health care policy and financing contributes to fragmentation of care. Finally, we identify opportunities for social workers to advocate for and promote system improvements in the delivery of care for aging adults with disabilities in the current climate of health care reform.     

The "X component" in Shanghai's social security reforms

In 2003, the Shanghai Bureau of Labour and Social Security launched the zhenbao (town insurance) programme, now widely known as 25 plus X. This scheme is regarded as an important experiment in social security reform and has been lauded for extending social security to areas where previously only segments of the population had mandatory coverage. Using data from 103,000 individuals enrolled in 25 plus X, we examine the extent to which the scheme represents an extension in social security coverage. Our analysis suggests that while it does represent an extension of benefits for some, for many it represents a considerable dilution in benefits.     

An introduction to methodological challenges in the evaluation of eHealth research: Perspectives from the Health e-Technologies Initiative

In February 2002 the Health e-Technologies Initiative (HETI), a program office of the Robert Wood Johnson Foundation^®, was created to advance discovery of scientific knowledge regarding the effectiveness of interactive eHealth applications. This article is the introduction to a series of seven articles written by grantees of HETI which address challenges, lessons learned, and proposed solutions as researchers implement eHealth projects. From this body of work it is clear that the overall process of conducting evaluation research in eHealth requires careful and detailed planning, recognition of the heightened sensitivity of IRBs, and institutions around the electronic collection and communication of personal health information, and a combination of tenacity and creativity to address the inevitable thorny methodological challenges to eHealth research. Use of established guidelines to help standardize the evaluation process, where feasible, is recommended.     

The grieving child: Manifest and hidden losses in childhood and adolescence

The loss of parents through abandonment has specific traumatic features. This paper discusses the variety of losses children and adolescents may experience and the psychological implications and manifestations in relation to the loss. Specific reactions of children and suggestions for therapeutic prevention through psychotherapy are discussed.Coordinator, Ph.D. Specialization in treatment of children and adolescents and is in private practice     

MEN, WOMEN, AND THE CULTURE OF ENGINEERING

This study focuses on women's position in engineering. A conflict model that emphasizes the interplay of structural and interactional resources is developed to explain the occupational positions of women engineers. A central feature of this model is the "culture of engineering"—the socially defined standard of behavior and interaction among engineers. This model is used to explain the occupational experiences of a cohort of male and female engineers. Males and females with virtually identical qualifications and occupational attitudes show dissimilar current job status. It is argued that the culture of engineering, strongly identified with the male gender role, works against women. Where that culture is strongest, women do most poorly in occupational status and mobility.     

Managing risk under the children act 1989: Diversion in child care?

The idea of diversion has dominated the theory and practice of juvenile justice for some time. Developments in child care practice in the 1980s mirror those which produced diversion. Diversion provides an alternative conceptual framework within which the changes to child care law introduced by the Children Act 1989 can be analysed, particularly the interrelation of s.1(5), the so-called non-intervention principle, and Part III, which establishes the duty of local authorities to provide services for children in need. These provisions and current child care practices may be seen to promote four distinct forms of diversion: (1) diversion from court; (2) diversion from care or residential provision; (3) diversion from procedures; and (4) diversion from social work. Examining the law and practice in terms of diversion focuses on the potential gains and losses resulting from the Children Act's emphasis on partnership, planning and bureaucracy without presuming that losses will be compensated for by the provision of services. It also suggests the need to consider child care in terms of net widening and tariff raising.     

A Simulation Study of the Influence of Study Design on the Estimation of Benchmark Doses for Developmental Toxicity1

The benchmark dose (BMD)⁴ approach is emerging as replacement to determination of the No Observed Adverse Effect Level (NOAEL) in noncancer risk assessment. This possibility raises the issue as to whether current study designs for endpoints such as developmental toxicity, optimized for detecting pair wise comparisons, could be improved for the purpose of calculating BMDs. In this paper, we examine various aspects of study design (number of dose groups, dose spacing, dose placement, and sample size per dose group) on BMDs for two endpoints of developmental toxicity (the incidence of abnormalities and of reduced fetal weight). Design performance was judged by the mean-squared error (reflective of the variance and bias) of the maximum likelihood estimate (MLE) from the log-logistic model of the 5% added risk level (the likely target risk for a benchmark calculation), as well as by the length of its 95% confidence interval (the lower value of which is the BMD). We found that of the designs evaluated, the best results were obtained when two dose levels had response rates above the background level, one of which was near the ED₀₅, were present. This situation is more likely to occur with more, rather than fewer dose levels per experiment. In this instance, there was virtually no advantage in increasing the sample size from 10 to 20 litters per dose group. If neither of the two dose groups with response rates above the background level was near the ED₀₅, satisfactory results were also obtained, but the BMDs tended to be more conservative (i.e., lower). If only one dose level with a response rate above the background level was present, and it was near the ED₀₅, reasonable results for the MLE and BMD were obtained, but here we observed benefits of larger dose group sizes. The poorest results were obtained when only a single group with an elevated response rate was present, and the response rate was much greater than the ED₀₅. The results indicate that while the benchmark dose approach is readily applicable to the standard study designs and generally observed dose-responses in developmental assays, some minor design modifications would increase the accuracy and precision of the BMD.     

Cultural issues in the intellectual assessment of children from diverse cultural backgrounds

Cultural factors impact on the intellectual assessment of children from diverse backgrounds. Given this fact, psychologists and educators should become culturally competent. In this article, a modified format for culturally competent intellectual assessment is discussed. The interaction between culture and language, and their impact on the development of specific cognitive competencies is explored. Practical suggestions for testing children of color are provided.