The increasing racial disparity in infant mortality: Respiratory distress syndrome and other causes

Although substantial declines in infant mortality rates have occurred across racial/ethnic groups, there has been a marked increase in relative black-white disparity in the risk of infant death over the past two decades. The objective of our analysis was to gain insight into the reasons for this growing inequality on the basis of data from linked cohort files for 1989-1990 and 1995-1998. We found a nationwide reversal from a survival advantage to a survival disadvantage for blacks with respect to respiratory distress syndrome over this period. The results are consistent with the view that the potential for a widening of the relative racial gap in infant mortality is high when innovations in health care occur in a continuing context of social inequality. As expected, the results for other causes of infant mortality, although similar, are less striking. Models of absolute change demonstrate that among low-weight births, absolute declines in mortality were greater for white infants than for black infants.     

A New Privacy Paradox? Youth Agentic Practices of Privacy Management Despite “Nothing to Hide” Online

Focus groups conducted with Canadian teenagers examining their perceptions and experiences with cyber risk, center on various privacy strategies geared for impression management across popular social network sites (SNS). We highlight privacy concerns as a primary reason for a gravitation away from Facebook toward newer, more popular sites such as Instagram and Snapchat, as well as debates about the permeability of privacy on Snapchat in particular. The privacy paradox identifies a disjuncture between what is said about privacy and what is done in practice. It refers to declarations from youth that they are highly concerned for privacy, yet frequently disregard privacy online through “oversharing” and neglecting privacy management. However, our participants, especially older teens, invoked a different mindset: that they have “nothing to hide” online and therefore do not consider privacy relevant for them. Despite this mindset, the strategies we highlight suggest a new permutation of the privacy paradox, rooted in a pragmatic adaptation to the technological affordances of SNS, and wider societal acquiescence to the debasement of privacy online.     

Hoarding cases involving older adults: the transition from a private matter to the public sector

Hoarding interventions with older adults require significant resources from multiple public agencies, yet recidivism occurs frequently. To improve services through better coordination, some communities have formed multiagency hoarding teams (MAHT), which include aging services. MAHTs requested this mixed methods study to understand the progression of cases through the public sector. Quantitative data collected on 52 cases involving adults ages 60+ identified steps in this process. Qualitative data collected from MAHT members were the basis for case studies illustrating the progression of cases through the public sector. Findings have implications for social workers involved in local service coordination, training, and policy.     

African Students in America: Reconstructing new meanings of "African American" in urban education

The presence of newly arrived students from countries on the continent of Africa poses specific challenges for inner-city schools, but their presence also provides the unprecedented opportunity to bring African and African American students together around their shared heritage and to restore connections that were severed long ago by slavery. In many school settings with African and African American students, strained relations are the norm. Myths, misperceptions and negative stereotypes keep these two groups of students apart. Regrettably, negative stereotypes about Africans and about African Americans are reinforced, rather than acknowledged as pernicious, at school, at home and by the media. Afrocentricity, a theory that situates people of African descent as subjects, not objects, promotes the importance of knowing one's history and culture, and delineates the elements of the African worldview, can be an effective tool for building positive relationships between these two groups. Afrocentric activities were used to help students develop a shared understanding of their common heritage and values. Results of this study indicate that, by providing positive images of Africa, Africans and African Americans, and by giving the students the opportunity to develop a new understanding of their shared history and culture, both groups of students benefited and their relations improved. Some of the benefits the students mentioned include respect for self and others of African descent, new friendships, a new interest in Africa, and the courage to learn more about Africa, Africans and African Americans.     

Show Me the Way to go Home: A Narrative Review of the Literature on Delayed Hospital Discharges and Older People

Correspondence to Jon Glasby, Health Services Management Centre, University of Birmingham, Park House, 40 Edgbaston Park Road, Edgbaston, Birmingham B15 2RT, UK. E-mail J.Glasby{at}bham.ac.uk Summary This Research Note reports findings from a narrative reviewof the literature on the rate and cause of delayed hospitaldischarge in the UK. In addition to summarizing our knowledgeto date in this important area, the Research Note raises a seriesof questions about aspects of current hospital discharge policyand practice (and in particular, the recent reimbursement policyto charge social services departments for delayed discharges).     

Approaches to worker rehabilitation by occupational and physical therapists in the United States: factors impacting practice

Work-related rehabilitation services have changed in nature and scope since their inception in the late 1970s. A review of the literature reveals a large body of published data concerning the various approaches used by therapists in this practice area, but a limited number of comparison studies documenting the value of one approach over the other. This national survey of physical and occupational therapists in the US was conducted in 2002, and examined the prevailing trends in service provision, and factors that determine the nature of services provided to clients. Results indicate that services continue the move to onsite service provision and an emphasis on prevention, but that select services, such as onsite job analysis and comprehensive, inter-disciplinary programs are being used to a limited degree. Research that examines the relative contributions of selected work-related services to successful and efficient return to work outcomes is necessary to identify best practice approaches. Therapists and insurance providers should work more closely in exchange of data that will ensure optimal program design and funding.     

Engaging with a Mental Health Service: Perspectives of At-Risk Youth

Studies suggest that only a small number of young people with diagnosable mental health difficulties are referred for treatment. Of these a significant proportion fail to engage in treatment or terminate prematurely. This situation is exacerbated when the young people are homeless or at risk of homelessness, and considered to be at-risk. With this at-risk population the process of engagement is likely to be a critical aspect of successful interventions. Using qualitative methodology, at-risk clients of a mental health service (n = sixteen) were interviewed, and four primary themes crucial to the engagement process were identified. The data indicated the importance of considering the young person and their multifarious life-experiences; the attractiveness and accessibility of the service; and the follow-up offered by the service provider. The implications for mental health services that provide counseling for young people are discussed.     

Missed Opportunities in the Patient-Focused Drug Development Public Meeting and Scientific Workshop on Female Sexual Dysfunction Held at the FDA,October 2014

There were numerous missed opportunities at the October 2014 U.S. Food and Drug Administration (FDA) meeting on female sexual dysfunction (FSD). They included opportunities to hear from a diverse range of patients and to engage in evidence-based discussions of unmet medical needs, diagnostic instruments, trial end points, and inclusion criteria for clinical trials. Contributions of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) nomenclature, based on extensive research, were dismissed in favor of language favoring a seemingly clear but scientifically unsupportable distinction between women's sexual desire and arousal. Numerous participants, including patients recruited by their physicians, acknowledged travel expenses paid for by interested pharmaceutical companies. Conflicts of interest were manifold. The meeting did not advance the FDA's understanding of women's sexual distress and represents a setback for our field.