Structuring Mental Health Within Senior Services: A Case Study of an Outpatient Mental Health Clinic Serving Latinos

The article presents a case study of an outpatient mental health clinic serving Latino older adults. The study explored staff perceptions on the clinic development and the context within an immigrant multicultural community. The study used in-depth, semistructured interviews with support staff, clinical social workers, and administrators. Interviews were analyzed using a thematic content analysis. The mental health clinic formation was perceived by staff as an ecological process stemming from the needs of the Latino immigrant senior clients. A close knit and interdependent culture allowed the clinic to adjust to diversity and changing cultural contexts.     

Screening for Geriatric Depression in Residential Care Facilities: A Systematic Narrative Review

Studies in residential care facilities suggest that routine screening can assist in the early detection of geriatric depression. However, the effectiveness of screening instruments in residential care in the US and Canada has not been adequately evaluated. We conducted a systematic narrative review of the English-language literature published between 2000 and 2010 on screening instruments used for depression detection in older adults living in residential care facilities. The review yielded nine scales and their modifications tested in residential care, which we evaluated. We provide specific recommendations for the use of effective scales and discuss implications for practice, policy and research.     

Depression in Older Adults: A Meta-Synthesis

Depression in older adults is often overlooked and dismissed as a part of aging. A body of knowledge—both quantitative and qualitative—has developed on the topic of depression in older adults. Meta-analyses and systematic reviews have been used to synthesize the quantitative findings of studies, and our research seeks to synthesize the qualitative studies that have been conducted on elders' experience with depression. Thirteen studies met inclusion criteria, and 4 major themes were extracted: experiences, causes, recovery, and barriers to treatment. These themes are detailed and their implications for practice are explored.     

An intervention strategy for improving social adaptation among female North Korean refugees

This study investigated the effect of TSL (Thank you, Sorry, Love) family therapy on social adaptation and health among female North Korean refugees in South Korean society. A quasi-experimental design was used to test the programme's effects as measured by changes in female North Korean refugees' scores on a test of social adaptation and in SDNN (Standard Deviation of heart rate Normal-to-Normals) scores. Results suggest that the programme intervention for the treatment group caused a significant increase in social adaptation, relative to a comparison group. Health improvements were also observed as changes in SDNN scores were significant.     

Unemployment,Medicaid provisions,the mental health industry,and suicide

This study examines the association between unemployment, Medicaid provisions, the mental health industry, and adult suicides in nine US northeastern states from 1999 to 2009. Results show that increased unemployment is associated with more Medicaid beneficiaries and higher health care spending per beneficiary with no significant relationship with Medicaid mental health spending. The Medicaid beneficiary rate is positively associated with the number of mental health clinics, mental health and substance abuse social workers, mental health counselors, and psychiatrists, with no significant association with mental health physician offices or psychologists. Unemployment is also related with increasing suicide rates for the overall population and White non-Hispanics, aged 16–64, with the worst association for White non-Hispanic males. The composition of the mental health industry is also associated with suicide rates. Maintaining an appropriate mix of mental health facilities and professionals to prevent, diagnose, and treat mental health disorders remains a critical public health challenge.     

Examining Reports and Policies on Cognitive Enhancement: Approaches,Rationale, and Recommendations

The phenomenon of cognitive enhancement is attracting attention in bioethics literature and beyond, in public policy. In response, three bodies—the British Medical Association (BMA); the Commission de l'éthique de la Science et de la technologie (CEST) du Québec; the American Academy of Neurology (AAN)—have produced reports and guidance on this topic. To gain insights into different public policy approaches, rationales, and recommendations on the topic, we analyzed these reports in depth. We found convergence on the definition (with the exception of the CEST) of cognitive enhancement. However, we noted a lack of critical reflection with respect to the underlying rationale for developing these reports, i.e., that cognitive enhancement practices are rampant and represent major social changes. As it currently stands, cognitive enhancement is constituted in a way that challenges the creation of coherent and effective policy recommendations. However, policy makers should not simply wait for definitional consensus and hope that on balance the benefits turn out to be greater than the risks. Some components of cognitive enhancement could be reduced down to clearly identified policy targets to be further examined. Then, if appropriate, policy should be created that is, amongst other criteria, beneficial to the majority of the population.     

When Everyone Is an Orphan: Against Adopting a U.S.-Styled Orphan Drug Policy in Canada

Putting aside whether diseases that affect only small numbers of people (“rare diseases”) should be prioritized over diseases that are otherwise orphaned, in this article I argue that a new approach to rare, orphan diseases is needed. The current model, first signaled by the United States' Orphan Drug Act and subsequently emulated by several other jurisdictions, relies on a set of open-ended criteria and market-based incentives in order to define and encourage drug therapies for rare, orphan diseases. Given a) the biopharmaceutical industries' growing interest in orphan diseases, b) progress in the sphere of personalized medicines enabling more and more common diseases to be reclassified as rare, and c) empirical evidence suggesting that the most orphan drugs target only a limited, lucrative subset of rare diseases, I argue that Canada, which recently announced plans to develop its own “orphan drug framework” should not follow the United States' orphan drug model.     

女性教工健康状况调查——以安徽农业大学为例

随着社会的发展,女性地位的提高,女性的很多相关问题引起人们的关注。本次调查以安徽农业大学现在职的全体女性教工为研究对象。目的是通过这次调查了解安徽农业大学目前在职的女性教工的健康状况与女性以及学校对女性教工健康关注状况之间的相关性,提出相应意见以期为女性教工的事业发展搭建良好的平台。     

(Net)Working out: social capital in a private health club

In Bowling Alone Robert Putnam considers the possibility that the growth of private health clubs and the rising rates of membership to such clubs might represent a counter-trend to his thesis on the decline in social capital. In this paper I explore this idea using ethnographic data and social network analysis. I show both that and how networks form in health clubs and I discuss the ways in which these networks constitute social capital for their members. In addition, however, I explore the 'dark side' of this form of social capital. I argue that high integration amongst some members of a fitness class can generate a power differential between those members and other, less integrated members who experience this negatively. Furthermore, with an eye on Burt's (2005 ) important thesis on brokerage and closure, I argue that brokerage between relatively closed clusters of agents can lead to inter-group rivalry and conflict, which, in turn, is experienced negatively by those involved.     

Lessons from a project to create performance measures for public health

This paper uses a specific example to illustrate complications that arise in formulating and implementing performance measures. The context of this demonstration is a Centers for Disease Control and Prevention (CDC)-funded project to explore the feasibility of performance measures developed at the national level for local sexually transmitted disease (STD) prevention and control programs. Grantees provided local data and reported on their experience in eliciting the data and using the results for program development. The experience of this project suggests that measures can be made operationally feasible and programmatically useful only if terminologies are subjected to extensive definition and clarification activities. These activities must include development of common language, mapping of workflows, and clarification of spheres of influence. Finally, performance measures must be used with some caution, as they often unintentionally capture extraneous program elements.