Well balanced: 8 steps to wellness for adults with mental illness and diabetes

Serious mental illness places a tremendous burden on clients, their families, and behavioral and medical health care providers. The co-occurrence of diabetes with mental illness may further compromise daily functioning. Psychiatric nurses can make a significant difference in improving the health and medical outcomes of this client population. A partnership was developed between the University of Rochester School of Nursing and the Western New York Care Coordination Program to evaluate a novel nursing model for adults with both serious mental illness and diabetes mellitus. The Well Balanced program incorporated health promotion, disease management, nursing care management, and evidence-based practice guidelines into 8 Steps to Wellness for a community-based mental health population. During a 16-visit intervention period, psychiatric nurses interacted with 74 clients. As a result of the program, clients experienced improvements in health risk status and in their hemoglobin A1C and reported high satisfaction with the Well Balanced program.     

Abuse of elderly male client: efforts and experiences in rural and urban adult protective services

Elder abuse has not been viewed as seriously as child abuse because of the emotional sensibilities attached to child abuse. Although elder abuse is experienced disproportionately by women, men also are in need of protection and engagement. An important factor for understanding the work with elderly men is the social construction of manhood. Both urban and rural settings recognize this as a significant starting point to engage men in services. This paper describes the efforts in both rural and urban Adult Protective Service agencies to identify and work with abused elderly men from a strengths and solution-focused perspective.     

Fractured relationships and the potential for abuse of older men

Elderly men are an understudied population in the area of abuse and neglect. The typical elder abuse or neglect victim is described as a frail woman. The National Elder Abuse Incidence Study shows men to be victims as well and at higher risk than women for abandonment, the most extreme form of neglect. A qualitative study of older widowed men did not specifically explore issues of abuse and neglect, but found several of the men experiencing alienation from one or more of their adult children. This paper explores the dynamics of these "fractured relationships" and finds several patterns that may increase an older man's risk of being neglected when his needs for support increase. Many men are not functioning in a kinkeeper role and are not attempting to repair fractured relationships. Minimizing their own feelings may prevent men from understanding the extent of alienation felt by an adult child.     

Making Sense of Organizational Change: Voices of Older Volunteers

The role of voluntary and community sector organizations in the delivery of public services is increasing and these changes bring new responsibilities and benefits to organizations that have the capacity to participate. There are concerns within the sector about the implications for citizenship and participation. The sector is highly dependent on volunteers yet little is known about how organizational change in response to new relationships with the statutory sector impact upon the commitment and well-being of people who volunteer. This paper addresses that gap in knowledge for older volunteers. Drawing upon collaborative research with a voluntary organization in the north of England, the authors explore the meanings and aspirations of volunteering for older people, and explain how and why changes associated with closer engagement with public service delivery and less grant dependency can be disempowering for them.

Strengths-Based Approach and Coping Strategies used by Parents Whose Young Children Exhibit Violent Behaviour: Collaboration Between Schools and Parents

This research study explores the strategies adopted by 60 parents of children between 3 and 9 years of age considered to have engaged in violent behaviour, within the meaning of the Safe Schools Act (Ontario Ministry of Education, Canada, 2000). This legal framework requires parents to be involved in the decisions concerning their children. Parents’ perceptions of their involvement lead them to develop coping strategies enabling them to play a more active role in such decision making. This article analyzes their perceptions according to a strengths-based approach and seeks to provide a mediation perspective to social work practice with families.

Prevalence and characteristics of sexual violence victimization among U.S. adults, 2001-2003

This article provides the most recent U.S. prevalence estimates of forced sex and unwanted sexual activity. Results of a national telephone survey conducted in 2001-2003 indicate that 1 in 59 U.S. adults (2.7 million women and 978,000 men) experienced unwanted sexual activity in the 12 months preceding the survey and that 1 in 15 U.S. adults (11.7 million women and 2.1 million men) have been forced to have sex during their lifetime. There were 60.4% of females and 69.2% of males who were 17 years old or younger at the time the first forced sex occurred. This study provides an update to the National Violence Against Women Survey with more recent national data. Findings suggest that victimization rates have remained consistent since the 1990s. These findings suggest that a continued effort toward primary prevention of sexual violence, particularly rape of children and adolescents, is needed.     

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.     

The making of US monetary policy: Central bank transparency and the neoliberal dilemma

This article explores the implications of the Federal Reserve’s shift to transparency for recent debates about neoliberalism and neoliberal policymaking. I argue that the evolution of US monetary policy represents a specific instance of what I term the “neoliberal dilemma.” In the context of generally deteriorating economic conditions, policymakers are anxious to escape responsibility for economic outcomes, and yet markets require regulation to function in capitalist economies (Polanyi 2001). How policymakers negotiate these contradictory imperatives involves a continual process of institutional innovation in which functions are transferred to markets, but under the close control of the state. Thus, under transparency, Federal Reserve officials discovered innovations in the policy process that enabled “markets to do the Fed’s work for it.” These innovations enlisted market mechanisms, but did not represent a retreat from the state’s active role in managing the economy.

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The critique of intelligent design: Epicurus,Marx, Darwin,and Freud and the materialist defense of science

A new version of the age-old controversy between religion and science has been launched by today’s intelligent design movement. Although ostensibly concerned simply with combating Darwinism, this new creationism seeks to drive a “wedge” into the materialist view of the world, originating with the ancient Greek philosopher Epicurus and manifested in modern times by Darwin, Marx, and Freud. Intelligent design proponents thus can be seen as challenging not only natural and physical science but social science as well. In this article, we attempt to explain the long history of this controversy, stretching over millennia, and to defend science (especially social science) against the criticisms of intelligent design proponents – by defending science’s materialist roots.

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