Relational Autonomy in Assisted Living: A Focus on Diverse Care Settings for Older Adults

Consistent with Western cultural values, the traditional liberal theory of autonomy, which places emphasis on self-determination, liberty of choice, and freedom from interference by others, has been a leading principle in health care discourse for several decades. In context to aging, chronic illness, disability, and long-term care, increasingly there has been a call for a relational conception of autonomy that acknowledges issues of dependency, interdependence, and care relationships. Although autonomy is a core philosophy of assisted living (AL) and a growing number of studies focus on this issue, theory development in this area is lagging and little research has considered race, class, or cultural differences, despite the growing diversity of AL. We present a conceptual model of autonomy in AL based on over a decade of research conducted in diverse facility settings. This relational model provides an important conceptual lens for understanding the dynamic linkages between varieties of factors at multiple levels of social structure that shape residents' ability to maintain a sense of autonomy in this often socially challenging care environment. Social and institutional change, which is ongoing, as well as the multiple and ever-changing cultural contexts within which residents are embedded, are important factors that shape residents' experiences over time and impact resident-facility fit and residents' ability to age in place.     

The Effects of Childhood Sexual Abuse and Other Trauma on Drug Court Participants

Within the context of a larger study of drug court participants, this study examined the impact of traumatic experiences on psychiatric distress and on court outcomes. In the analyses, the participants (n = 229) were separated into 3 groups: childhood sexual abuse (CSA; n = 18), other trauma (n = 134), and no trauma (n = 77). The CSA group had higher mean scores on depression, anxiety, panic disorder, social phobia, somatization, and posttraumatic stress disorder than the other trauma group. Path analyses suggest that a history of trauma is a positive predictor of psychiatric distress and negative court events (positive urine screens, sanctions, etc.), with indirect effects on substance abuse severity, and failure in the drug court. These results suggest a need for the initial assessment procedure in drug courts to include a screening for trauma history, including CSA. They also suggest a need for trauma-informed care within drug courts.     

Building on the life-span perspective: a model for infusing geriatric social work

The growth in the older adult population and the demand for better trained geriatric social workers challenge the existing curricula of social work programs. The Geriatric Enrichment Grant funded by the John A. Hartford foundation has provided financial support for curricular reform. Curriculum reform is a challenging undertaking at any level. Each program and educational institution experiences the process of curriculum reform in unique ways. This paper describes one program's experience of curriculum reform for the purpose of infusing geriatric content.     

Getting to Yes or Bailing on No: The Site Selection Process of Ethanol Plants in Wisconsin

Prior studies of ethanol location rest on the assumption that ethanol producers are economic free agents—evaluating sites as if all counties are contenders for their business, weighing the availability of feedstocks along with their infrastructure needs, operating without ties to localities, and being subject to enticement from policy incentives. We analyze the political‐economic process through which ethanol plants come into communities by examining plant location decisions, plant financing, community receptivity toward the plant, local government incentives, and the dynamics of the approval process. We use case studies of ethanol plants in Wisconsin to explore the economic, social, and political dynamics of ethanol plant location. Our case studies provide evidence in support of some findings in the ethanol location literature—such as the importance of access to corn; however, they also suggest site selection criteria not adequately addressed by the literature. Furthermore, our data suggest that capital may not be as mobile as location theory assumes it to be and that location decisions are not primarily determined by consideration of profit maximization. Instead, the location of ethanol plants is greatly influenced by the extent to which the original initiators of the plant are locally embedded in its host community. Our research answers Barkley and McNamara's ( 1994 :45) call for a return to a case studies approach in order to develop “reliable insights into the location process.”     

Perceptions of Academic Achievement and Educational Opportunities Among Black and African American Youth

Research focusing on disparities in academic achievement among Black, African American, and other youth has largely examined differences in quantitative risk and protective factors associated with levels of achievement. Few interpretive studies of academic achievement by race or ethnicity have considered how the context of young people’s lives impact their perceptions of academic performance. Furthermore, the lived experiences of Black and African American youth have rarely been considered. This study examined perceptions of academic achievement among a sample of Black and African American elementary and middle school students living in four public housing neighborhoods in a Western US city. Twenty-five Black and African American youth participated in the study. Fourteen youth were in grades 4 and 5, and 11 youth were in grades 6, 7, or 8. Sixty-four percent of participants (n?=?16) were male and 36% (n?=?9) were female. Four themes emerged regarding participants’ perceptions of academic achievement: (1) (in)equity and the internalization of messages; (2) teachers as gatekeepers; (3) family and community factors promoting and inhibiting academic success; and (4) cultural considerations—language, stereotypes, and difference. Implications for improving academic outcomes and reducing the achievement gap among Black, African American, and other students are noted.     

Stakeholder perspectives on integrated services for people who experience chronic homelessness

This article concerns a SAMHSA-funded service intervention, Pathways to Independence, that combined the use of SAMHSA’s SSI/SSDI Outreach, Access, and Recovery approach to facilitating disability entitlement claims with financial management classes, mental health assessment and referral, and access to employment and housing for people experiencing chronic homelessness. The purpose of this study was to explore perceptions of this form of service delivery and the benefits and challenges of the program model from the perspective of those who experienced it. Focus groups were conducted with a total of 17 program stakeholders, including program participants, program staff, collaborating case management staff of the parent agency, and a landlord and an employer, with questions to each regarding the program and its impact. Focus groups were analyzed through independent coding followed by discussion to reach consensus on key themes. Five themes were identified across the groups: (a) the importance of relationships, (b) staff specialization and provision of individualized services, (c) an orientation to outcomes, (d) comprehensiveness of services and facilitation of connections to community resources, and (e) systems challenges. The Pathways to Independence program provides a working model for integrated employment, entitlement assessment and application, housing, and behavioral health treatment for persons experiencing chronic homelessness.     

Exposing School Employee Sexual Abuse and Misconduct: Shedding Light on a Sensitive Issue

ABSTRACT

While the media continue to report incidents of school employee sexual misconduct, few empirical studies focus on this issue. To address this gap in the literature, expand knowledge and awareness around the problem, and inform future research and programs, this research intends to document and analyze the characteristics of school employee sexual misconduct cases reported in the media. The authors conducted a landscape analysis of 361 published school employee sexual misconduct cases in the United States from 2014, documenting factors such as offender and victim characteristics, type of incident, technology use, location of offense, and resulting disciplinary actions by schools and law enforcement. These analyses showed that offenders were most often male and general education teachers, with approximately a quarter identified as athletic coaches. Offenders’ average age was 36 years, while the average age of victims was 15. More than half of incidents took place at school or school-related events. Results also showed that school employee sexual misconduct incidents most often involved physical contact; however, technology (i.e., cell phones, computers, cameras/video recorders, and storage devices) played an important role in three out of four cases. Finally, analyses of the criminal and school-related consequences showed that over half of offenders were placed on administrative leave or resigned immediately following their arrest and almost all were convicted of their crimes. Additional findings concerning this topic are also reported in this article.     

Client Experiences of Trauma-Informed Care in Social Service Agencies

This paper describes a qualitative study of individual client interviews (n?=?26) from four social service agencies to understand how clients experience trauma-informed care services and implementation challenges. We used the Fallot and Harris framework to explore client experiences of the five core concepts of trauma-informed care (safety, trustworthiness, choice, collaboration, and empowerment) using semi-structured interview questions with each client. The four agencies consisted of: refugees (n?=?4), substance abuse (n?=?8), older adults (n?=?12), and maternal/child health (n?=?2), and the agencies varied in size, service goals, and clientele. The results of the study suggest that clients’ experience of these concepts was shaped by the actions of other clients, and these experiences were either mitigated or hindered by actions of the agency employees. Agency policies either supported or enhanced their experiences as well. The results also suggest that it was challenging for agencies to provide for all of the trauma-informed care (TIC) concepts at the same time. We discuss the implications of these findings for social service delivery in a range of agency types. Future research should examine the effects of trauma-informed policies on client experiences of each TIC domain.     

Hunger,nutrition, and precipitation: evidence from Ghana and Bangladesh

Population and Environment - Changing precipitation patterns caused by climate change are expected to have major impacts on food security and nutrition in agrarian areas in developing countries....     

Health-Promoting Influences of the Family on Late Adolescent Functioning

This study examined whether potentially modifiable health-promoting family factors during mid-adolescence (age 15) predicted adaptive functioning in late adolescence (age 18) among members of a working-class community cohort. Family factors included feeling valued in the family, cohesion, and social support. Late adolescent outcomes covered developmentally salient areas: academic functioning; mental health; suicidal behavior; and social, psychological, and behavioral functioning. Our findings demonstrate that a positive adolescent family milieu is related to both adaptive outcomes and a reduced likelihood of serious difficulties, including mental and behavior problems. Although each hypothesized health-promoting factor was significantly associated with multiple areas of age 18 functioning, the patterns of association differed by type of family factor. Taken together, results suggest that the family remains an important social context during mid-adolescence and that to be most effective programs designed by practitioners aimed at strengthening families should target multiple features of the family environment.