Trends in the Relationship between Infant Mortality and Socioeconomic Status

Abstract

This paper reports some of the results of an ecological analysis of the relationship between infant mortality and economic status in metropolitan Ohio at three points in time (1959–1961, 1969–1971 and 1979–1981). The data presented clearly reveal the adverse mortality consequences of alow economic status. In spite of some remarkable declines in the infant death rate since 1960, most notably in neonatal mortality, the inverse socioeconomic differential in 1980 is as wide as it ever was, and it characterizes both whites and nonwhites and both the neonatal and postneonatal components of infant mortality. Moreover, in sharp contrast to the situation a generation ago, the neonatal death rate has emerged as a major contributor to the overall relationship between socioeconomic status and infant mortality. It is suggested that this situation reflects the failure of recent advances in maternal and infant care programs to reach those lower status members of the society that are most in need of them.     

The mental health dimension in the new social work degree: starting a debate

The Mental Health in Higher Education Project (mhhe) aims to increase networking and debate about the learning and teaching of mental health, both within and across the disciplines and professions in higher education. Despite the recent prominence that has been given to mental health in terms of policy development and new practice models, there has so far been little discussion as to what should constitute the mental health component of the new social work degree that is currently being introduced in England. This paper sets the context for the debate and reports on the outcome of an mhhe workshop on this theme held at the 2003 Social Work Education Conference in Warwick.     

Cancer Knowledge and Examination Frequency in College Students

Abstract

College students are now being considered an appropriate target for cancer education programs. However, research has demonstrated that only a fraction of those individuals knowledgeable about the importance of cancer examinations actually practice these examinations. This study investigated whether the personality construct of repression-sensitization could identify which individuals would or would not practice regular examinations for breast, cervical, and testicular cancer. College students were identified as repressors, neutral, or sensitizers and tested as to their knowledge and examination frequency for breast, cervical, and testicular cancer. After a cancer lecture, this information was reasessed. No differences were found among repressors, neutrals, or sensitizers in cancer knowledge or examination frequency, either prelecture or postlecture. Cancer knowledge significantly increased after the lecture for both males and females. No change was found in the frequency of breast self-examination, while frequency of pap smears declined after the lecture. In contrast, testicular self-examination frequency increased. The implications of these results for future research are discussed.     

Recovery capital: what enables a sustainable recovery from mental health difficulties?

There is increasing international interest in recovery approaches in mental health—and this connects with an emerging focus within European social work around promoting capability and sustainability. Research at a population level would suggest that social factors rather than medical interventions are the main determinants of recovery from mental health difficulties—but this is not yet reflected in social work practice, which can still be dominated by biomedical perspectives and a focus on risk management. Drawing upon and extending analyses of social and other forms of capital, this paper outlines the basis for a new paradigm for mental health social work that is specifically oriented towards enabling the development of personal efficacy and social capability—an approach that is explicitly focused on achieving longer-term sustainability rather than shorter-term problem solving.     

Hours of Paid Work in Dual-Earner Couples: The United States in Cross-National Perspective

Abstract

In this paper we examine the hours of paid work of husbands and wives in 10 industrialized countries, using data from the Luxembourg Income Study. We present results on the average hours of paid work put in jointly by couples, on the proportion working very long weekly hours, and on gender equality in working time within families. The United States ranks at or near the top on most indicators of working time for couples, because of (1) a high proportion of dual-earner couples; (2) long average work weeks, especially among women; and (3) a high proportion of individuals who work very long hours. In terms of gender equality, the United States ranks above average in paid working time among dual-earner couples with no children but fares less well among working parents. Finally, we discuss policies and institutions that may help explain the distinctive United States results, namely the long hours and moderate levels of gender equality, including the regulation of maximum hours, the demand for part-time work, and the public provision of child care.     

Reconsidering Therapeutic Neutrality

In recent decades, with the emergence of postmodern philosophies and of relational psychoanalysis, therapeutic neutrality has come under challenge as being both an impossible and an undesirable analytic stance. This article explores recent understandings of transference and of therapeutic neutrality; the position of those relational psychoanalysts who posit that explicit use of intersubjectivity is the central treatment vehicle of psychoanalysis; and presents material from the treatment of an individual with a borderline personality disorder, using the developmental, self, and object relations approach of James Masterson, to illustrate some potential dangers of abandoning a neutral stance when treating such clients.     

Developing Brokered Community Transportation for Seniors and People With Disabilities

Communities are exploring ways to increase transportation coordination to improve access for seniors. One such effort is a brokered transportation system in which one agency serves as the central point of contact for ride information or actually arranging transportation for clients of multiple programs by use of a combination of transportation services. A team of social work faculty and students from the University of New Hampshire (UNH) Social Work Outreach Center, a center that provides service learning opportunities to students, collaborated with a local coalition to investigate the specific transportation needs of the region's senior citizens. A total of 641 people participated in the survey. Results indicate that the study population experiences problems reliably meeting daily living needs due to inconsistent or unavailable private and public transportation options. Study findings also indicate the promising potential of brokered transportation systems, particularly for isolated seniors in rural and suburban areas with relatively limited public and private transportation options.     

Dialogue and Challenge: Involving Service Users and Carers in Small Group Learning with Social Work and Nursing Students

This paper examines the rationale for service user and carer involvement in professional education and reflects on an initiative in which social work and nursing students undertook a sequence of joint learning in relation to mental health theory and practice. Central to this initiative was the promotion of opportunities for dialogue, both between students from different professional disciplines and between students, service users and carers. To enable this, much of the learning took place in small groups facilitated by either a service user or a carer.

Evaluation of this initiative indicated that, for the majority of social work and nursing students, learning from this shared experience had a major impact on their professional development. However, a small but significant minority found it hard to enter into a dialogue with others on a basis of equality and a sharing of their human as well as their professional experience. Some students indicated that they would have preferred a focus on acquiring more specialist professional knowledge and skills. This raises important issues in relation to the changing expectations of professionalism and professional education—and what really makes someone ‘fit for practice’.     

MSW Student Perceptions of the Efficacy and Ethics of Internet-Based Therapy

This study reports on the results of a survey of 378 MSW students that asked about their attitudes regarding the efficacy and the ethics of online psychotherapeutic services (e-therapy).The students’ perceptions varied considerably, but there was a moderately strong association between the belief that the ethical requirements of practice can be met online and positive attitudes about the efficacy of e-therapy. Students had little direct experience with e-therapy and generally did not discuss the issue in practice classes. Implications for social work education are discussed and suggestions are made for incorporating e-therapy content into the practice curriculum.