Trust and the Dilemmas of Suicide Risk Assessment in Non-government Mental Health Services

Reducing suicide rates is a national mental health priority as over 2,200 people die from suicide each year in Australia. Increasingly, nongovernment organisations (NGOs) provide services to people experiencing severe and persistent mental illnesses—a significant cohort at risk of suicide. While clinical services are generally seen as the arbiters of risk, little is known of how suicide risk assessments are undertaken in NGOs. This article reports the findings of a survey-based pilot study of 44 frontline workers in mental health-focused NGOs in Tasmania, Australia, with the aim of sketching a preliminary picture of this under-studied terrain. We identified the assessment practices utilised by workers, and the challenges and dilemmas they experienced in navigating issues of trust in suicide risk assessment in contexts where they often felt vulnerable and under-prepared. We argue that these early findings demonstrate the need for organisations to foster cultures of trust to facilitate both the activities of relationship building between practitioners and clients, and those of monitoring risk.     

湖南省学前教育普及现状调查与对策建议

湖南省实施发展学前教育三年行动计划效果明显，学前教育机构总数、在园幼儿数、学前三年毛入学率显著增加。与经济发达省份对比，湖南省学前教育普及水平还比较落后，城镇学前教育普及水平明显高于农村地区，县域之间学前教育普及水平差距明显。湖南省普及学前教育面临的主要问题是：政府主导作用发挥不够、农村学前教育普及水平落后、学前教育基础建设不足、普及学前教育路径不畅。推进湖南学前教育持续普及，需要构建学前教育公共服务体系，大力扶持农村学前教育，建立学前教育的保障体系，优化学前教育普及模式。     

Changes in the labour market and health inequalities during the years of the recent economic downturn in Italy

There is widespread concern that episodes of unemployment and unstable working conditions adversely affect health. We add to the debate by focusing on the relationship between work trajectory and the self-reported health of Italian men and women during the present economic downturn. Relying on Italian data in the EU-SILC project (from 2007 to 2010), our sample includes all individuals aged 30 to 60 in 2010, and uses multivariate binomial regression models for preliminary analyses and the Structural Equations modelling (SEM) to observe the cumulative effects of health status according to different job trajectories. Our main findings show similar pictures for men and women. Individuals who are unemployed, ejected or in precarious occupational positions have a higher risk of worsening their health status during these years.     

Leaving my religion: Understanding the relationship between religious disaffiliation,health, and well-being

Religious disaffiliation—leaving the religious tradition in which one was raised for no religious affiliation in adulthood—has become more common in recent years, though few studies have examined its consequences for the health and well-being of individuals. We use an innovative approach, comparing the health and subjective well-being of religious disaffiliates to those who remain affiliated using pooled General Social Survey samples from 1973 through 2012. We find that religious disaffiliates experience poorer health and lower well-being than those consistently affiliated and those who are consistently unaffiliated. We also demonstrate that the disadvantage for those who leave religious traditions is completely mediated by the frequency of church attendance, as disaffiliates attend church less often. Our results point to the importance of the social processes surrounding religious disaffiliation and emphasize the role of dynamics in the relationship between religious affiliation and health.     

黄山市音乐考级的现状调查与研究

音乐考级是对音乐能力进行的分级考试。黄山市作为皖南山城,具有浓厚的徽州文化底蕴,在当地老百姓的观念中学习艺术是旁门左道,自从十年前第一个音乐考级点建立起,至今已有三个考级单位,参与培训并获得考级证书的学员近万人。极大程度上推动了黄山市素质教育的发展,更新了老百姓的传统观念。本文通过对黄山市音乐考级现状的调查与分析,了解本市音乐考级这一机制的运行情况,总结音乐考级带来的成效以及存在的不良发展趋向,提出解决弊端的方法并对黄山市音乐考级未来发展提出建设性的建议。     

Deriving Behavior Model Parameters from Survey Data: Self‐Protective Behavior Adoption During the 2009–2010 Influenza A(H1N1) Pandemic

In this paper, we demonstrate how public opinion surveys can be designed to collect information pertinent to computational behavior modeling, and we present the results of a public opinion and behavior survey conducted during the 2009–2010 H1N1 influenza pandemic. The results are used to parameterize the Health Belief Model of individual health‐protective decision making. Survey subjects were asked questions about their perceptions of the then‐circulating influenza and attitudes towards two personal protective behaviors: vaccination and avoidance of crowds. We empirically address two important issues in applying the Health Belief Model of behavior to computational infectious disease simulation: (1) the factors dynamically influencing the states of the Health Belief Model variables and (2) the appropriateness of the Health Belief Model in describing self‐protective behavior in the context of pandemic influenza.     

Thriving Older African American Women: Aging After Jim Crow

ABSTRACT

This paper is based on the findings of small group discussions with self-defined successful African American women age 60+ in Charlotte, North Carolina. These women, who lived through the Jim Crow era and thrived in spite of the obstacles, continue to seek meaning in their lives through the roles they play in their families, churches, and communities. They feel strongly that there is a core of key values that continue to hold meaning and struggle to impart these values to those whose lives they touch. The key values identified include education, religion, work, and giving back to the community, and illustrate the integration of both traditional and nontraditional definitions of success. Mentoring is proposed as an important concept for understanding the lives of African American women in later life.     

清末政治思想中的民论探析

民论是清末政治改革思潮中的重要内容。在清末这一变动剧烈的时代中,人们对于民的认识发生了诸多变化,对当时及其后的政治发展产生了重要影响。清末的民论包括对民之地位与民之权利的论述等内容。清末民初思想家普遍认识到了民的重要性,对民的地位、民的权利进行了不同于传统民论的新的阐释。但对于民的能力却大多抱以悲观的态度,因此在是否给予民以充分的自由权利、提高普通民的政治地位问题上显现出迟疑和保守。     

Examining Outpatient Health Care Utilization Among Adults with Severe or Profound Intellectual Disabilities Living in an Urban Setting

Abstract

The present study examined the health status and outpatient health care utilization among 52 adults with severe or profound intellectual disabilities (IDs) living with their families or in group homes in New York City. Bivariate and regression analyses among demographic variables, medical conditions, health care utilization, and type of living situation were conducted. Findings indicate that demographic factors andhealth statuses were similar regardless of living situation, except for ageand the presence of Down Syndrome, that is, younger people and people with Down Syndrome were more likely to live with family than in group homes. The results indicated that regardless of where they lived, individuals had high rates (70%) of overweight/obesity. The mean number of internal medicine, specialty medicine, nursing, and total clinic visits were significantly higher for those living in group homes compared to those living with their families. The findings and their implications are discussed with respect to social work policy and practice.     

Efficacy of Statistical Outlier Analysis for Monitoring Quality of Care

Researchers have proposed that hospitals with excessive statistically unexplained mortality rates are more likely to have quality-of-care problems. The U.S. Health Care Financing Administration currently uses this statistical “outlier” approach to screen for poor quality in hospitals. Little is known, however, about the validity of this technique, since direct measures of quality are difficult to obtain. We use Monte Carlo methods to evaluate the performance of the outlier technique as parameters of the true mortality process are varied. Results indicate that the screening ability of the technique may be very sensitive to how widespread quality-related mortality is among hospitals but insensitive to other factors generally thought to be important.