The expansion of religious affiliation: An explanation of the growth of church participation in the United States 1850–1930

This paper focuses on the period in U.S. history that experienced the most rapid rate of increase of church membership—the decades between 1850 and 1930—in order to explain synchronic and diachronic variation in those rates. Using pooled cross-sectional time series analysis, different predictions are derived and tested from theories of secularization/social control, comparative disadvantage, resource mobilization, and pluralism. The effects of spatial diffusion and the momentum of religious tradition also are estimated. Our conclusion is that religious monopoly—not diversity—fuels religious expansion. This finding is bolstered by the complementary result that ethnic homogeneity is also conducive to religious expansion. Together these results highlight the importance for mobilization of religious and ethnocultural dominance in a particular niche.     

POLICY PARADOXES: THE DISEMPOWERMENT OF YOUNG PEOPLE UNDER THE LABOR GOVERNMENT, 1983–91

This paper explores the restructuring of the experience of young people's lives. It examines Federal Labor Government youth and education policy apparently developed as a response to the high levels of youth unemployment in place since 1976–77. It argues that these policies have dramatically altered the experience of being young by creating greater dependence and further disempowerment. It argues that young people have become the objects of punitive exercises that deny them their basic rights, disenfranchise them and extend the socially constructed features of adolescence into early ‘adulthood’.     

The Social Power of Health-Care Practitioners as Agents of Change

This paper examines dominant sources of social power and influence that affect the degree to which patients adhere to recommended regimens for prevention or treatment and their rate of recovery. Referent power of health-care practitioners, as contrasted with their expert, coercive, reward and legitimate power, is expected to be most effective when internalization of medical recommendations by the patients is essential. The paper explores specific ways that a health-care professional can gain referent power, using weight control treatment as an example. It presents a conceptual framework that provides a rationale for a number of relationship-building techniques and offers evidence that referent power is effective in promoting adherence to treatment and more healthful behavior, and in influencing critical outcome measures such as weight loss. Analysis of the relative efficacy of various methods of building and using referent power and the possible limiting conditions on its effectiveness are also discussed.     

英国医疗卫生体系问题与医疗卫生政策改革研究

健康是人们福利的重要组成部分,因此医疗卫生政策和体系是社会政策的重要领域。该项研究从贫穷、低收入和健康之间的关联中评估人们对医疗保健的需要;指出英国存在全科医生、医院医生及公共卫生医生是医疗卫生服务提供的主体;英国在医疗卫生政策改革方面的内容包括:(1)对英国全民医疗体系(NHS)多渠道的财政支持,(2)提高服务质量的机构管理改革,(3)实施提高服务质量的安全、有效、病人中心、及时、效率、和平的原则;英国存在的强大政治集团及其利益影响着改革;政府需要在减少医疗服务中不平等和提供及时有效的服务方面努力。     

A different kind of holding environment: a case study of group work with pediatric staff

This paper reports a nearly two-year intervention with staff at a major urban pediatric facility. The authors worked as trainers and consultants for two groups-the Emergency Department (ED) and Chronic Care units (CC). Following two days of training about grief and loss, highlighting skill building for work with traumatized and grieving children and parents, the consultants worked to develop teams which could provide a Winnicottian holding environment for staff. The efficacy of this staff training is analyzed and support needs of staff members are identified. Findings include varied willingness to make use of group support. Chronic care participants are more likely to express willingness to engage in on-going support for one another, while ED staff members seem to prefer structured, educational training and episodic support. The holding environment of the processing groups must be adapted to fit the needs of the medical sub-culture.     

Practice challenges at the intersection of child protection and mental health

This paper examines the complexity of collaboration between child protection and mental health services, where a parent has a mental illness and there are protection concerns for children. The paper reports on data from focused in‐depth interviews with 36 child protection workers, adult mental health workers and child and youth mental health workers. Data were analysed thematically, using NVivo to facilitate data management and analysis. Two dimensions were identified. The first, the process of collaboration, relates to four factors that assisted the collaborative process: communication, knowledge, role clarity and resources. The second dimension considers the challenges presented to collaborative work when a parent has a mental illness and a child is in need of protection, and identifies issues that are inherent in cases of this kind. Two types of challenge were identified. The first related to characteristics of mental illness, and included the episodic and/or unpredictable nature of mental illness, incorporating information from psychiatric and parenting capacity assessments, and the provision of ongoing support. The second type of challenge concerned the tension between the conflicting needs of parents and their children, and how this was viewed from both the adult mental health and the child protection perspective. Implications for policy and practice are identified in relation to the need for service models that provide ongoing, flexible support that can be intensified or held back as needed.     

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.