Group therapists' countertransference reactions to multiple deaths from aids

Group therapists for those with HIV Related Diseases are becoming the “professional” survivors of this world-wide epidemic. From their experiences we may learn a great deal more about the effects of multiple deaths on mental health care professionals. As therapists they are constantly eliciting and listening to the fears, hopes, agonies and terrors of those with this disease. They become the bereaved. Witnesses to the deaths of many of their group members, they struggle with a wide range of emotional responses while at the same time assisting surviving group members in their struggle to live with these deaths. Mourning reactions and countertransference phenomena are in abundance as these therapists grapple with these group processes. This article identifies and examines these therapists' responses by focusing on clinical illustrations drawn from their bi-weekly supervision sessions.     

A research note on Keyfitz's ‘The demographics of unfunded pensions’

Keyfitz (1985), The demographics of unfunded pensions, discusses the performance of pay-as-you-go old age insurance plans under different financial structures. One arrangement is to pay a fixed pension to retirees and collect the necessary contributions from the working population. Another is to fix the contribution per worker and distribute whatever monies are collected to the retirees. Unfortunately, equity problems arise in a pay-as-you-go plan when the population is not stable. Generally, large cohorts will receive greater rates of return than small cohorts when the pension is fixed, while small cohorts will receive greater rates of return when the contribution is fixed. Social security analysts in the U.S. have been concerned with minimizing inequities in cohort rates of return. In considering the US population in 1980, Keyfitz shows that disparities in cohort rates of return are less under a fixed contribution scheme than under a fixed pension scheme. This research note points out that Keyfitz's finding is limited to the specific situation in 1980. When analyzing in a broader framework the mechanics of unfunded pensions and their interaction with nonstable populations, the reverse is true: fixing the pension yields less disparity in cohort rates of return than fixing the contribution.Keyfitz (1985) a déjà discuté dans cette revue des résultats d'un système de répartition pour le financement des pensions de retraite sous diverses conditions financières. Une solution consiste à payer une pension fixée aux retraités et à collecter les fonds nécessaires auprès de la population active. Une autre solution est de fixer la contribution par actif et de distribuer ce qui a été ainsi collecté aux retraités. Malheureusement des problèmes d'équité surviennent dans ces systèmes de répartition lorsque la population n'est pas stable. Généralement, les cohortes nombreuses bénéficieront de plus forts taux de rendement que des cohortes moins nombreuses lorsque la pension est fixée, tandis que l'inverse se produit lorsque la contribution par actif est fixée. Aux Etats-Unis les analystes des systèmes de sécurité sociale ont cherché à minimiser les inégalités dans les taux de rendement. Lorsque Keyfitz considérait la population des Etats-Unis en 1980, il avait montré que les disparités dans les taux de rendement des cohortes étaient moindres sous la condition d'une contribution par actif fixée que sous celle d'une pension par retraité fixée. Cette note the recherche indique que le résultat obtenu par Keyfitz est propre à la situation spécifique de l'année 1980. Lorsque l'on analyse d'un point de vue général le fonctionnement des pensions de retraite et leurs interactions avec des populations non-stables, l'inverse est vérifié : le fait de fixer la pension conduit à moins de disparités dans les taux de rendement des cohortes que le fait de fixer la contribution des actifs.

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This research was undertaken when the author was completing her dissertation at the Graduate Group in Demography at the University of California, Berkeley. The author now operates Lapkoff Demographic Research, a private research consulting firm.     

Patient assertiveness in ethnically diverse older women with breast cancer: Challenging stereotypes of the elderly

Patients' views of patient-physician interactions—particularly the perspectives of older, ethnically diverse women—are poorly understood. The older patient's attitude toward and understanding of the medical encounter, however, are essential to the design of strategies to improve patient-physician communication. To date, investigations have primarily emphasised the ways in which the therapeutic relationship is influenced by immutable patient characteristics. This qualitative study extends previous research findings by looking beyond the effect of ascribed categories (such as age, race, and gender) and focusing on aspects of patient behavior, specifically assertiveness. Focus groups were conducted with older African-, Chinese-, European-, and Hispanic American breast cancer patients from sites in the eastern and western United States. The study explores the potential of a form of patient activation for challenging stereotypes of the elderly and changing health care practitioners' behavior.     

GM Foods and the Misperception of Risk Perception

Public opposition to genetically modified (GM) food and crops is widely interpreted as the result of the public's misperception of the risks. With scientific assessment pointing to no unique risks from GM crops and foods, a strategy of accurate risk communication from trusted sources has been advocated. This is based on the assumption that the benefits of GM crops and foods are self-evident. Informed by the interpretation of some qualitative interviews with lay people, we use data from the Eurobarometer survey on biotechnology to explore the hypothesis that it is not so much the perception of risks as the absence of benefits that is the basis of the widespread rejection of GM foods and crops by the European public. Some respondents perceive both risks and benefits, and may be trading off these attributes along the lines of a rational choice model. However, for others, one attribute-benefit-appears to dominate their judgments: the lexicographic heuristic. For these respondents, their perception of risk is of limited importance in the formation of attitudes toward GM food and crops. The implication is that the absence of perceived benefits from GM foods and crops calls into question the relevance of risk communication strategies for bringing about change in public opinion.     

Gambling Among Prison Inmates: Patterns and Implications

There is an absence of research on gambling among prison inmates during their incarceration. Little is known about how prisoners organize gambling activities or the potential risks they face from gambling. Similarly, no empirical attention has been given to how correctional institutions respond to inmate gambling. This study employed interviews with 55 male prisoners and self-administered surveys with 159 correctional officers and staff, at two medium security prisons in Ohio. Data were gathered on prevalence and patterns of inmate gambling, perceived hazards of gambling, and perceived institutional responses to prisoner gambling. Findings suggest that inmate gambling is common and constitutes an important feature of the underground economy of prisons, yet little is done to deter or prevent this activity. Suggestions are made for more effective institutional responses.     

Developing Age-Friendly Cities: Case Studies From Brussels and Manchester and Implications for Policy and Practice

Developing environments responsive to the aspirations of older people has become a major concern for social and public policy. Policies and programs directed at achieving “age-friendly” communities are considered to require a wide range of interventions, including actions at the level of the social and physical environment. This article compares the age-friendly approaches of two European cities, Brussels and Manchester, with a particular focus on policies and initiatives that promote active aging in an urban context. The article examines, first, the demographic, social, and multicultural contexts of Brussels and Manchester; second, the way in which both cities became members of the World Health Organization Global Network of Age-Friendly Cities and Communities; third, similarities and differences in the age-friendly approaches and actions adopted by both cities; and fourth, opportunities and barriers to the implementation of age-friendly policies. The article concludes by discussing the key elements and resources needed to develop age-friendly cities.     

Substance use disorders and referral to treatment in substantiated cases of child maltreatment

Parents with substance use disorders (SUD) require treatment and support in order to provide children with appropriate care and protection. Using the 2012 National Child Abuse and Neglect Data System (NCANDS), this paper analysed 464 313 substantiated child maltreatment reports to determine (i) the proportion and characteristics of reports involving substance abuse; and (ii) the child and caregiver/perpetrator (C/P) characteristics that predicted referral to treatment as recorded in service plans. Findings indicate that 12% (N = 53 234) of maltreatment reports involved C/P SUD. Yet, of those reports, only (19%) (N = 10 088) were referred to substance abuse treatment as part of their service plan, indicating a large gap between those who need treatment and those who receive it. This finding is important given that parental SUD is consistently linked to poorer child outcomes. Amongst other variables, reports indicate that C/P with co‐occurring emotional disturbance were three times more likely to be referred to treatment for SUD as part of service plans. Additional research is needed regarding the characteristics that distinguish C/P who receive referrals for SUD treatment in substantiated cases of child maltreatment.     

Incomes after Job‐loss in the United States: From Programme Rules to Panel Data

Welfare state studies are usually motivated by one or both of two concerns: programme effects on the incidence of poverty, and the possibility of perverse incentive effects. Most research has been comparative, using cross‐national indicators from the Organisation for Economic Co‐operation and Development and other international organizations. That research often contrasts the generosity of programmes in a number of European countries and the lack of it in the USA. Focusing on income transfers after job‐loss, in this article we critically examine the comparative evidence on US welfare state generosity and then use the Panel Study of Income Dynamics (PSID) to estimate what happens to job‐losers' incomes. The comparative analysis suggests conclusions more nuanced than found in much of the literature. The PSID analysis shows how the income effects of job‐loss vary across job‐losers and suggests that the role of unemployment compensation programmes in supporting incomes may be overstated.