The life-course origins of mastery among older people

In this article, we aim to identify the sources of mastery--the understanding that individuals hold about their ability to control the circumstances of their lives. The sample for our inquiry was drawn from the Medicare beneficiary files of people 65 and older living in Washington, DC, and two adjoining Maryland counties. We find that past circumstances, particularly those reflecting status attainment and early exposure to intractable hardships, converge with stressors experienced in late life to influence elders' level of mastery. The impact of past conditions, however, does not necessarily directly affect the current mastery of older people. Instead, the effect of prior experiences on current mastery is mediated by what we refer to as life-course mastery: one's belief that one has directed and managed the trajectories that connect one's past to the present. Our analyses show that life-course mastery largely serves as the mediating channel through which individuals connect their past to their present.     

Community-managed water supplies in Africa: sustainable or dispensable?

Over the past two decades, community management has become theprevalent model for management of rural water supplies throughoutsub-Saharan Africa. Despite its widespread popularity amongdonors and implementing agencies, low water supply sustainabilitylevels throughout the sub-continent indicate that it is notthe panacea it is often presented to be. There is a strong needto distinguish between ‘community participation’which is a prerequisite for sustainability and ‘communitymanagement’ which is not. If community management systemsare to be sustainable, they require ongoing support from anoverseeing institution to provide encouragement and motivation,monitoring, participatory planning, capacity building, and specialisttechnical assistance. If such support is not available, alternativessuch as household water supplies and private sector servicedelivery should be considered.     

Fatigue and sleep quality in nurses

Fatigue is a critical issue for nurses that may lead to medical errors, degradation in performance, decreased mental acuity, and social problems. Poor sleep quality is also a contributing factor in fatigue that nurses experience. Therefore, the purpose of this study was to examine the differences in perceptions of fatigue between night-shift and day-shift nurses, as measured by scores on the Brief Fatigue Inventory (BFI) and to examine differences in sleep quality between the two groups, as measured by responses on the Pittsburgh Sleep Quality Index (PSQI). Univariate analysis of variance showed significant differences between the two groups on the BFI, with the night-shift cohort reporting higher mean scores on the BFI. Significant differences were also found between the two groups on PSQI mean scores, with the night-shift cohort reporting higher mean scores. Findings from this study suggest that night-shift nurses, compared with day-shift nurses, perceived a much higher level of fatigue and had poorer sleep quality. Further research is needed to evaluate interventions that might decrease fatigue in nurses and improve their sleep quality.     

The production of therapy:the social process of construction of the mother of a sexually abused child

This study qualitatively examined the perspectives of clinical social workers on non-offending mothers of sexually abused children. The study examined whether clinicians still used collusion to explain mothers' behavior, despite research refuting collusion. Findings revealed that, although workers did not use collusion, they still constructed mothers negatively. Multiple contexts of agency practice influenced constructions. Administrative use of authority to implement external constraints led to workers' resistance, which involved humor with gender and ethnic components. The agency's role as a graduate social work teaching site contributed the following: Field instructors transmitted the belief that incest typified severe family difficulties and posed complex assessment and intervention problems. Implications for effective practice are discussed.     

Bridging the divide in urban sustainability: from human exemptionalism to the new ecological paradigm

This paper reviews the main bodies of contemporary urban sustainability theory. From this analysis, two underpinning paradigms of urban sustainability are identified: (1) The ‘Human Exemptionalism Paradigm’ (HEP), which emphasizes the ability of humans to overcome environmental problems—see Urban Sociology, Urban Ecology, Urban Geography, Urban Psychology and Political Economy; and (2) The ‘New Ecological Paradigm’ (NEP), which emphasizes the criticality of ecological limits to human progress—see Urban Metabolism, Energy/Emergy Analysis and Ecological Footprinting. Each of these approaches is critically reviewed, highlighting their main assumptions, theoretical and practical foci. It is argued in the paper that if the related issues of urban sustainability and development are to be progressed, there needs to be: (1) a greater maturation of the NEP approaches, which are ‘relative newcomers’ to the area of urban theory; and (2) greater integration and dialogue between the HEP and NEP approaches to urban sustainability than has hitherto been the case.

Systemic lupus erythematosus and hormone replacement therapy

The indications for hormone replacement therapy (HRT) in postmenopausal women is the treatment of climacteric symptoms and the prevention of osteoporosis. Women with systemic lupus erythematosus (SLE) are more likely to have a premature menopause, osteoporosis and cardiovascular disease. HRT can induce SLE flares and cardiovascular or venous thromboembolic events. Therefore it should not be used in women with active disease or those with antiphospholipid (aPL) antibodies. In general, it should be used only for patients without active disease, a history of thrombosis or aPL antibodies. Non-oral administration of estrogen is recommended because of its lesser effect on coagulation. With regard to the progestogen, progesterone or pregnane derivatives are preferred. Otherwise, non-estrogen-based strategies should be used.     

A family systems-based model of organizational intervention

Employee assistance professionals are expected to be proficient at intervening in organizations and creating meaningful behavioral change in interpersonal functioning. Because of their training in family systems theories and concepts, marriage and family therapists (MFTs) are well suited to serve organizations as "systems consultants." Unfortunately, the authors were unable to identify any family systems-based models for organizational intervention that have been empirically tested and supported. In this article, the authors present a family systems-based model of intervention that they developed while working in an employee assistance program (EAP). They also present research that was used to refine the model and to provide initial support for its effectiveness.