The complexity of roles in community action projects: The example of the evaluation of ‘alternatives’

Evaluation of community interventions is a special form of evaluation involving many roles that are key to accomplishing both the intervention and the accompanying research. The present paper describes the roles involved in the evaluation of a community intervention (‘Alternatives’) aimed at safer use of alcohol and depressant medications by seniors.The three core roles were the community developer who provided leadership in the implementation of the project, the researcher/evaluator, and the community committee that sanctioned and facilitated the project. Other roles on the project included: the project coordinator, the nurse-interviewers who collected the survey data for the evaluation, volunteers from seniors groups, local health service providers, the media, the funders, and others on the project team who provided specific technical expertise.The paper describes the competing interests among these roles as well as conflicts that arose and how these conflicts were handled. Although specific roles are described, the types of roles and the potential for competing interests and conflict are generally relevant to community level evaluations.     

社会组织参与养老服务的逻辑框架：制度环境·主体类型·实践方式

社会组织参与养老服务是推动养老服务多元化发展的必由之路,也是推进国家治理体系和国家治理能力现代化的题中之义。基于参与式治理理念,可从制度环境、主体类型、实践方式三个方面构建社会组织参与养老服务的基本逻辑框架。从制度环境看,社会组织参与养老服务具有宏观制度环境开放鼓励、微观制度环境渐趋宽松、制度执行环境模糊约束的含混性特征,需要进一步优化制度环境才能更好地激发社会组织活力。从主体类型看,参与养老服务的社会组织主体类型可以划分为养老服务供给型社会组织和支持型社会组织,分别强调其专业服务优势和多元资源支持。从实践方式看,社会组织主要通过承办社区居家养老服务、运营机构养老服务、开展志愿养老服务、组织互助养老服务等直接方式,以及政策参与、资源动员、行业自律等间接方式参与养老服务建设。     

社会资本对城乡老年人健康影响的实证研究——基于CGSS混合截面数据

利用2013年、2015年中国综合社会调查(CGSS)的混合截面数据,采用二元logistic回归、OLS回归模型,从生理健康和心理健康二个维度,综合考察了社会资本对城乡老年人健康的影响,并检验了社会融合学说及网络关系学说两个理论.研究发现:个体社会资本与集体社会资本均对老年人的生理与心理健康产生显著正向作用,社会经济地位、收入和教育都对老年人身心健康有正向影响,性别和年龄会影响老年人的生理健康,而婚姻会影响老年人的心理健康,家庭规模的影响作用不显著.但在考虑城乡二元结构差异时,个体社会资本对城市老年人的生理与心理健康影响不显著,而家庭规模对农村老年人的心理健康产生显著正向作用.因此,需要促进城市老年人社会交往,提高老年人的社会经济地位,鼓励农村孩子常回家看看,共同营造一个“健康老龄化”的社会.     

Substitution in statutory and voluntary support for relatives of older people

This study investigates the relationship between statutory and voluntary activity in the field of support to family carers of older people in Sweden. The relationship is considered in regard to substitution theory. A survey was conducted comprising 80 local authorities and 358 voluntary organisations. All the local authorities and about a third of the voluntary organisations arranged support activities. The number of activities varied substantially across the municipalities. However, correlation analysis found no significant relationship between local authority and voluntary activity, even though both sometimes arranged the same kinds of activities. In other words, this study finds no support for substitution theory. On the contrary, it shows that a higher level of voluntary activity is found in municipalities where the local authority cooperates with or supports voluntary organisations.     

老年胆道结石症微创手术的疗效评价

目的探讨联合应用腹腔镜及十二指肠镜与开腹手术治疗老年胆道结石并胆囊炎胆囊结石患者的治疗效果。方法 18例老年胆道结石并胆囊炎胆囊结石患者行内镜下十二指肠乳头切开取石术+腹腔镜胆囊切除术(EST+LC)与同期25例常规开腹胆道探查、取石、T 型管引流术(CCHTD 组)同类患者进行对比,观察术后各项恢复指标。结果微创组术后各项恢复指标明显优于开腹组。结论联合应用腹腔镜及十二指肠镜对老年胆道结石并慢性胆囊炎胆囊结石患者的治疗效果满意,值得推广应用。     

PAI-1、t-PA/PAI-1比值与急性血管事件的相关性研究

目的了解血浆t-PA、PAI-1和t-PA/PAI-1比值在急性血管事件中的变化和意义。方法对于健康对照组、陈旧性和急性血管事件组分别采用ELISA法检测t-PA和PAI-1活性,计算t-PA/PAI-1比值。结果急性血管事件组血浆t-PA、PAI-1明显增高、t-PA/PAI-1比值明显降低,与其它两组相比P<0.01;陈旧性血管事件组血浆PAI-1增高,与对照组相比P<0.05;t-PA升高和t-PA/PAI-1比值降低,与对照组相比无显著差异。结论血浆t-PA和PAI-1水平与血管内皮稳定性密切相关。PAI-1增高和t-PA/PAI-1比值降低的程度在急性血管事件发生中起着重要的作用。监测PAI-1和t-PA/PAI-1比值这两项指标,在心脑血管事件的预防和治疗方面具有重要意义。     

The residential home – what difference does it make?: Comparing the public systems of care for the elderly and disabled in two Swedish municipalities

Two municipalities in Sweden – Solna and Sigtuna – have taken part in a project (the ASIM project) aimed at developing a system for monitoring and analysing the public system of long-term care and assistance for elderly and disabled people. The two municipalities have chosen different alternatives in the question of residential homes. In Solna they have been retained and in Sigtuna they have been converted into sheltered housing. By separating the clients into different classes of dependence using the ASIM assessment, it is shown that in Solna, compared with Sigtuna, fewer of the most dependent clients are in long-term hospital care and fewer of the high-medium category are in domiciliary care. The data were used to calculate the distribution of the clients and the average dependence on the different levels of care if Solna were to apply the care pattern of Sigtuna and vice versa.     

Gambling and the Older Chinese in Canada

In Canada, there is a lack of research on gambling among the older adults from ethnic minority groups, especially the older Chinese. In this study, two research questions were used to examine gambling among the older Chinese: (1) What is the pattern of gambling among the older Chinese in Canada? (2) What are the predictors associated with gambling among the older Chinese in Canada? The data for this study were collected as part of a multi-site study on health and well-being of 2272 older Chinese in Canada. Four main questions related to gambling were used in this study. Among the 2257 participants who answered the questions on gambling, 26.6% of them reported that they gambled. Results of the hierarchical logistic regression analysis showed that being male, having lived in Canada longer, having a higher level of social support, having more service barriers, and having a stronger level of Chinese ethnic identity would increase the probability for an older Chinese to participate in gambling. Conversely, having a post-secondary and above level of education and having a higher level of life satisfaction would reduce one’s probability of gambling. Although city of residency was also significant in predicting gambling, further analysis showed that its effect was actually caused by other factors including services barriers, social support, life satisfaction, Chinese ethnic identity, and education.     

社会转型时期江苏农村新型养老保障模式刍议

笔者对江苏太仓、启东、赣榆三地的农村养老保障制度以及社会保险试点情况开展了深入细致的调查分析。通过调查发现在社会转型的大背景下,江苏农村传统家庭养老支持力呈现持续不断弱化的态势。在调查的基础上,对江苏农村的家庭养老支持、农村社区养老以及社会养老保险等社会支持方式进行分析,结合江苏经济发展情况提出相适应的农村社会养老保障制度构思及政策建议：力争消除城镇与农村的二元养老保障制度,突出政府在农村养老保障工作方面的主导地位,加强农村养老保障的法制建设,推进农村土地制度改革,并从多方面切实增加农民的经济纯收入,从根本上使广大的农村居民真正实现老有所养。     

随迁老人的城市适应问题研究

随迁老人在城市适应中面临着子女家的"局外人"身份和城市社区的"陌生人"身份的双重尴尬。本文调查表明随迁老人在城市适应中存在着适应程度的个体差异,同时家庭关系、随迁老人夫妇有无一起随迁和参与社区活动频率是影响随迁老人城市适应的因素。现阶段解决随迁老人城市适应问题应以家庭为主、社区为辅;以个体性为主、共同性为辅;以主动适应为主、外力推动适应为辅。