Assessing Perceptions of Synergistic Health Risk: A Comparison of Two Scales

Two approaches to measuring perceptions of synergistic risk were compared, one using the traditional Likert scale, the other using an anchored, relative scale. Perception of synergistic risk was defined as rating the combined hazard as more risky than each of its constituent single hazards. In a within-subjects design, a convenience sample from the community (N= 604) rated three hazard combinations and their constituents: Driving while Intoxicated (familiar, high synergy), Radon and Smoking (unfamiliar, high synergy), and Smoking and Driving (familiar, low synergy), on both scales. The relative scale was expected to be a more sensitive measure of synergy than the Likert scale. The effects of item order (single hazards rated first versus combined hazards rated first) were examined between subjects. Driving while Intoxicated was perceived by the large majority of participants as a synergistic risk on both scales, but neither of the other two combined hazards were rated synergistically on either scale. The relative scale demonstrated a slight advantage over the Likert scale, and presenting the single hazards first for the relative scale produced more synergistic ratings. It is recommended that anchored, relative scales be used to measure synergy and that single hazards be presented prior to the combined hazards when using relative scales.     

The “Good Enough” Fit: Psychoanalytic Psychotherapy and Psychoanalysis as Culturally Sensitive Practice

This paper examines the impact of the gender, race, class, and culture of the three participants in the patient-therapist dyad and the patient-therapist-supervisor triad, and how these similarities and differences reflect the unconscious cultivation of transferences and internalizations. The analyst's skills, art, experience, and relative freedom from conventional assumptions are important, and the main problem for analyst and supervisor is to meet the challenge to our analytic selves posed by conventional assumptions, which are compromises regarding culturally sensitive issues that derive from the ever-present dominant culture and its ideologies.     

The Onset of Working Memory in Infants

We used an optimized configuration of the delayed‐response task to explore the ability of young infants to remember which of 2 locations was correct across 12 trials after a 1‐ to 2‐sec delay. Performance improved with age, particularly after 5.5 months. These findings suggest an onset of appreciable working memory for many infants in the middle of their 6th month.     

Local Voices in an Internal Market: The Case of Community Health Services*

This paper presents findings from a study of contract specification and implementation in community health services (CHS). In this paper, we focus on one aspect of that study: the role of local people in informing the assessment of health needs and in determining the provision of community health services in the context of the NHS “internal market”. The paper is based on fieldwork undertaken in three districts within one region. Analysis of data obtained from these localities suggests that while there appears to be a genuine commitment to the principle of local involvement, ideas about how that involvement can be built into the activities of either purchasers or providers are less transparent.     

Markets,contingency and preferences: contemporary managers’ narrative identities1

We explore work identity amongst managers, a key group in the ‘new’ capitalism. Some existing accounts of such workplace identities emphasize new ‘cultures of control’, others focus on new requirements and possibilities of individual autonomy through reflective identity formation, while others identify a crisis in workplace identity formation. Focusing on these issues, we analyse the career narratives of 136 managers and show that our empirical data do not neatly fit any existing models. Managers’ career stories were dominated by a ‘market’ narrative, in which they placed themselves as strategic actors making choices in a social world constituted by market‐like interactions. We show that the market narrative frames how managers understand risks to their careers arising from the contingent actions of firms, and how it provides a space for managers to reflectively identify their preferences and pleasures. We consider the consequences of this analysis for contemporary understandings of work and identity.     

Governmentality by Network in English Primary Healthcare

In England, the quality of clinical work is being regulated in new ways following recent developments in “clinical governance” policy and apparent failures in the previous system of medical self‐regulation. Using multiple case studies, this paper examines how these changes are affecting professional governmentality and discipline in general practice. Formal organizational structures play little role in clinical governance there. Clinical quality is managed largely through semi‐formal networks, relying on medical self‐surveillance. Compliance is achieved largely by discursive appeals to the legitimacy of clinical governance, but local GPs’ leaders also argue that governments might otherwise regulate medical practice more actively. As yet the effects of clinical governance activity on service delivery are slight. Professional self‐regulation is replacing permissive exception management with more collegial, directive methods.     

Taking the class to the community with service-learning: gerontological macro social work practice

In an effort to infuse gerontological content throughout a BSW curriculum, the College of Mount St. Joseph developed community partnerships with agencies that serve older adults. These partnerships led to specific "out-of-class" assignments in a macro social work practice class using a service-learning approach. The development and implementation of those assignments in the agency settings are described using Polvika's Conceptual Model for Community Interagency Collaboration. The successful outcomes are described in terms of the community partnership, services and benefits provided, and the degree of satisfaction by the agencies, students, and faculty with this pedagogical method.     

Anticipating relocation: concerns about moving among NORC residents

Most older adults prefer to live at home as long as possible, requiring supports and services to help them age in place. This study examines the relocation concerns of a group of older adults in a suburban naturally-occurring retirement community (NORC). Twenty-six percent of the 324 residents interviewed expressed concern about having to move in the next few years. Residents who were worried differed from those who did not worry on a number of demographic and biopsychosocial characteristics. Overall, residents present a profile of vulnerability that calls for preemptive action to help them stay in their homes. A NORC is an ideal setting in which to provide supportive services.