Child health

In "Child Health," Lorraine V. Klerman, a professor at Brandeis University's Heller School for Social Policy and Management, describes the difficulty of measuring welfare reform's impact on children's physical and mental health by using existing data sources and suggests additional approaches to consider. She relies on the following data sources: the Behavior and Risk Factor Surveillance System (BRFSS); the Current Population Survey (CPS); the Medical Expenditure Panel Survey (MEPS); the National Health Interview Survey (NHIS); the National Health and Nutritional Examination Survey (NHANES); the National Hospital Discharge Survey (NHDS); the National Household Survey of Drug Abuse (NHSDA); the National Immunization Survey; the State and Local Area Integrated Telephone Survey (SLAITS); the VSCP; and the Youth Risk Behavior Surveillance System (YRBSS).     

Healthcare System Types: A Conceptual Framework for Comparison

This article addresses the need to establish a comprehensive conceptual framework for analysing healthcare systems and their transformations. It begins by offering an overview of the current state of the art in the field, pointing to the literature's absence of conceptual robustness in the definition of system types. By exploring the dimensions 'financing', 'provision' and 'regulation' of healthcare, the article then proceeds deductively in line with the 'Weberian method of ideal-types' to establish a taxonomy of 27 healthcare systems, of which three can be identified as 'ideal-types'. When applying this concept, not only can differences between healthcare systems be analysed, but also changes over time. The article concludes by identifying three forms of healthcare system transformation.     

Mental disorders among non-elderly nursing home residents

Many Medicaid beneficiaries aged 22 to 64 with serious mental illness may be admitted to nursing facilities rather than psychiatric facilities as a result of Medicaid policies prohibiting coverage of inpatient psychiatric care in institutions of mental disease while requiring states to cover nursing facility care. Using nationwide Medicaid Analytic Extract claims from 2002, we found that nearly 16% of nursing home residents aged 22 to 64 had a diagnosed mental disorder, while 45.5% received antipsychotic medication, but these rates varied widely across states. Further research is necessary to determine whether, among the nation's youngest nursing home residents, care in nursing homes is potentially substituting for care in institutions for mental disease or community-based settings.     

Public Perceptions of Risk and Preference-Based Values of Safety

This article reports the results of two studies aimed at estimating preference-based values of safety in three contexts—namely rail, domestic fires and fires in public places—relative to the corresponding value for roads using matching (or equivalence) questions. In addition, both studies included a variety of questions intended to shed light on respondents' perceptions of risk and attitudes to safety in the various contexts. While the two studies were, to all intents and purposes, identical in the procedure that they employed, the essential difference between them was that the first study took place in late 1998, whereas the second study was carried out in early 2000 in the aftermath of a major rail accident at Ladbroke Grove near London's Paddington station which occurred in October 1999 and in which 29 passengers and 2 train drivers died. In addition, the second study sample was deliberately weighted to contain an above-average proportion of regular rail users. These studies demonstrated how certain factors which have been shown to affect people's perception of risk (see Slovic, P. (1992). In S. Krimsky and D. Golding (eds.), Social Theories of Risk, Westport, CT: Praeger, pp. 117–152) also affected our respondents' priorities over safety programs. The results also showed however, that the impact of these perceptions upon the trade-offs between preventing deaths in different hazard contexts was a good deal less pronounced than has been suggested by the value differentials that are currently implicit—and in some cases, explicit—in public policy making.     

“I Want to Feel Like a Full Man”: Conceptualizing Gay,Bisexual, and Heterosexual Men’s Sexual Difficulties

Current understandings of sexual difficulties originate from a model that is based on the study of heterosexual men and women. Most research has focused on sexual difficulties experienced by heterosexual men incapable of engaging in vaginal penetration. To better understand men’s perceptions and experiences of sexual difficulties, seven focus groups and 29 individual interviews were conducted with gay (n = 22), bisexual (n = 5), and heterosexual (n = 25) men. In addition, the extent to which difficulties reported by gay and bisexual men differ from heterosexual men was explored. Data were analyzed using thematic analysis applying an inductive approach. Two intercorrelated conceptualizations were identified: penis function (themes: medicalization, masculine identity, psychological consequences, coping mechanisms) and pain (themes: penile pain, pain during receptive anal sex). For the most part, gay, bisexual, and heterosexual men reported similar sexual difficulties; differences were evident regarding alternative masculinity, penis size competition, and pain during receptive anal sex. The results of this study demonstrate the complexity of men’s sexual difficulties and the important role of sociocultural, interpersonal, and psychological factors. Limitations and suggested directions for future research are outlined.     

Field education in crisis: experiences of field education coordinators in Canada

Significant multi-layered challenges with delivering quality practicum experiences to social work students have led field education coordinators to release a joint statement that social work field education in Canada is in a state of crisis. This article presents the results of a two-year mixed methods study that sought to investigate and describe the challenges in order to enhance understanding of the crisis from the perspective of Canadian social work field education coordinators. The results indicate that social work education programs in Canada face four key challenges in regard to field education that can be further divided into two sections: (a) the social work practice field and (b) social work field education administration. The two key challenges associated with the social work practice field are: (a) social work practice contexts and realities and (b) practicum shortages and saturation. The two key challenges associated with social work field education administration are: (a) practicum procurement and field instructor recruitment and retention; and (b) expectations and workloads of field education coordinators. To address these challenges, collaborative development of a multi-level strategy aimed at moving beyond the current state of crisis toward a sustainable model of social work field education in Canada is recommended.     

The expression of mourning in an eight-year-old girl

This is a case of a just-turned eight-year-old girl whose mother was murdered on September 18, 1983. Since the child was already in treatment, the mourning process started immediately and continued until the end of June 1984. The case is distinctive because of the relative ease with which this child was engaged in the process and educated to it. Unconscious feelings readily emerged because they had been so recently repressed. The mourning was accomplished mainly through the process of interpretation of her play and behavior, although at times she would bring things up directly. The focus of therapy remained on the mourning during the entire nine months of treatment.