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.     

Severely Traumatized Siblings: A Treatment Strategy

Siblings who have suffered severe trauma and disrupted attachment relate to one another in ways that interfere with individual development, the chance to benefit from connections with adults, the establishment of healthy sibling relationships, and the working through of traumatic experiences. The authors use case examples to illustrate four distinct sibling patterns: absent, adult lockout, half and half, and trauma shield. The authors highlight the importance of recognizing these types and then varying the therapist's treatment stance to pursue five goals. These include suspending problematic sibling relationships to create room for bonding with caring adults, transferring attachment behaviors and impulses to a receptive adult, resuming healthy individual development, forming more adaptive sibling connections, and expressing shared traumatic content.     

The NTEE classification system: tests of reliability/validity in the field of higher education

An analysis of the field of higher education reveals a surprisingly large number of classification errors within the (US) National Taxonomy of Exempt Entities database. Of the nearly 4,000 non-profit entities coded within the universe of institutions of higher education, we estimate that approximately 60 per cent were incorrectly included (Type II errors). Institutions incorrectly excluded from the higher education universe (Type I errors) represent roughly 10 per cent of the institutions coded correctly. These errors result primarily from assigning codes on the basis of the names of organisations (for example, College Park Towers is classified as a college, when it is in fact a housing complex for senior citizens) and from trying too hard to assign codes in ambiguous situations. The consequences can be significant for the users of these data, and we recommend raising bright warning flags while simultaneously enlisting the help of the entire non-profit sector in improving the classification coding process.The authors are with The Andrew W. Mellon Foundation. In addition to our colleagues on the staff of the Foundation, we wish to thank Helmut Anheier, Ted Bozovich, Harvey Dale, Virginia Hodgkinson, Stephen Noga and Christopher Toppe for helpful suggestions.     

Identity,security and the nation: understanding the South Korean response to North Korean defectors

From the Cold War era of the ‘veteran heroes’ to the present view of escaped North Koreans in terms more akin to ‘refugees’ and sometimes even just ‘migrants’, perceptions of North Korean defectors in South Korea have changed as swiftly as the number and origins of Northerners entering the South have expanded. At the same time, government policy for these ethnic ‘brethren’ has evolved considerably, particularly as South Korea has seen fundamental shifts in its independent identity, with important repercussions for the way its citizens view themselves as a collective. This article explores some of the key influences behind changes to policy and perceptions regarding North Korean people in South Korea over the period from 1997 to 2012, by applying international relations theory on national identity and its role in policy formation and change through the need to secure different parameters within that identity.     

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.     

Snake parasitism in an urban old-growth forest

Urban-associated changes can have immediate or long-term consequences on animal populations. Such changes may be assessed through parasite prevalence and abundance in wildlife hosts, as urbanization can influence parasitism and disease transmission in wildlife. Snakes are widespread and diverse vertebrates that often persist in urban environments; however, parasitism of snakes in urban environments has yet to be studied, leaving the roles of snakes in parasite transmission uncharacterized. Field ecology, microscopy, molecular techniques, and geographic information science (GIS) were integrated to characterize parasitism of snakes in an urban old-growth forest park. The species, sex, mass, length, location, and prevalence of ecto-, hemo-, and fecal parasites were determined for 34 snakes of 6 species. Ectoparasites (mite), hemoparasites (Hepatozoon spp.), and fecal parasites (Entamoeba spp., Trichomonas spp., Strongloides spp., and an unidentified helminth) were detected in snakes and 64.7?% of snakes were infected by at least one of these parasites. Parasite infections were generally not related to the sex, age, or body condition of snakes. The locations of infected snakes were used to produce risk maps indicating where parasite prevalence is predicted to be greatest. The analysis of these maps indicated that snakes with fecal parasites were closer than non-infected snakes to the edge of the forest. This study confirms that snakes may be important parasite hosts or reservoirs in parasite transmission pathways in urban environments and it provides an integrative multidisciplinary approach that may be used to monitor parasitism dynamics in other urban wildlife areas.