American Indian/Alaska Native Elders: A Growing Demographic that Is Changing How We View Aging

Today, AIAN Elders are more actively engaged in their families and communities, encouraging the development of intergenerational programs, language and cultural revitalization, being stewards in research conducted in their communities, as well passing on their knowledge and experiences on how to live as healthy Native people. Elders have traditionally been quiet and observant of their environment, but the current and future cohorts of Elders are advocates, leaders, and culture bearers for their families and communities and they are now in positions of leadership. Western society acknowledges the value of traditional knowledge and AIAN Elders are viewed as exemplars of healthy aging and their lessons and experiences can be attributed to our own lives. This commentary highlights the paradigm shift in how society views older adults, specifically AIAN Elders and their role in health and wellbeing.     

Narrating Sustainability in Canadian Health Care Reform Discourse

In Canada, as in other industrialized welfare states, definitions of health system sustainability reflect different goals and correspondingly diverse ways of understanding exactly what is to be sustained and how. In this article, we report on results from a survey of documents and groups involved in and/or concerned about sustainability of the healthcare system. We identify four broad narratives of sustainability in Canadian healthcare reform discourse, and explore what these different sustainability narratives tell us about the character and contours of these often‐fractious debates. We argue that sustainability itself may not be a paradigm shift, as has been suggested, but a plot device that helps to steer the story in a particular direction, ‘black‐boxing’ certain aspects of context and emphasizing others.     

Vision and state health department public relations practitioners: Prepared to lead?

Visions are important to organizational effectiveness. Although providing vision has been identified as one of the behaviors that best captures organization-wide public relations leadership, little public relations research has focused on vision. Similarly, state health departments have drawn little interest among public relations scholars even though states are a central part of the nation's public health system. This study addressed the perceptions of the top public relations professionals at state health departments concerning vision and their involvement in the visioning process. The practitioners were nearly unanimous in their belief that organizational visions are important. However, results indicate that some top public relations practitioners at state health departments are not prepared to make optimal contributions to the visioning process. In order to take full advantage of opportunities to serve as organization-wide leaders, public relations practitioners should seek out information about visioning in order help chart their organization's future and enhance their careers.     

Demographic and Social Factors Associated with Homophobia and Fear of AIDS in a Community Sample

Examinations of demographic and social factors associated with homophobia and fear of AIDS are limited by the frequent use of homogeneous, college student samples and limited examination of interrelationships among variables. The present study examined community attitudes toward homosexuality and fear of HIV/AIDS as a function of age, education, race/ethnicity, religious affiliation, political party affiliation, and personal contact with homosexual individuals and persons living with HIV/AIDS. A community sample of 463 adults completed standardized measures of homophobia and fear of AIDS as well as demographic and social background items. When examined separately, each demographic and social factor assessed, with the exception of race/ethnicity, was associated with homophobia and all but race/ethnicity and political party affiliation were associated with fear of AIDS. However, when entered into multiple regression analyses, 24% of the variance in homophobia was predicted by a single variable, including only personal contact with homosexual individuals, while 18% of the variance in fear of AIDS was accounted for by five variables, including personal contact with homosexual individuals, religious affiliation, political affiliation, education, and personal contact with someone living with HIV/AIDS. Findings suggest that it is important to consider intercorrelations among social and demographic factors, particularly when considering homophobia.     

Family Background and the Process of Ability Formation*

This paper takes a sociometric approach to the process of skills formation in children as they mature into adults. Honda suggests that meaningful communication with family as a child is the determining factor that raises those abilities (ability β ¹ ) that fall outside of scholastic aptitude – motivation, personal relations skills, personality, and emotions. Along with considering the results of Honda's thesis, I have constructed an operating hypothetic model that includes two additional factors: the financial state of the family during childhood, and the transition of the communication target from within the family to a target outside the family. The data for this investigation were then verified. From the results, the direct effect of the observed family communication, when isolated from other influencing variables in the formation of abilities β, is not as decisive a factor as Honda emphasized. It was clear that the financial status of the family played a role, as did the indirect results of the intermediary shift from communication within the family to outside the family (the process of children becoming socially independent). The results of this analysis show that we should not necessarily be looking for the decisive factors of abilities β within the family; if anything, it reflects the existence of a formative route for abilities β that capitalizes on the resources outside the family. Based on the above, the results also show the potential for the introduction of social intervention to address the disparity and inequality in skills formation, and the possible anticipation of more rationality in the overblown discourse surrounding the role of the family in facilitating educational ability.     

The cost‐effectiveness of UK parenting programmes for preventing children's behaviour problems – a review of the evidence

Parenting programmes are widely used in the UK, promoted in policy documents as a cost‐effective way for children's services to address behaviour problems and thereby the longer‐term costs associated with conduct disorders, particularly antisocial behaviour and criminality. To explore whether these programmes are a cost‐effective component of family intervention, this paper examines evidence from cost‐effectiveness studies based on randomized controlled trials, modelling studies estimating longer‐term costs and outcomes, and studies estimating costs of UK parenting programmes, including evidence from routine practice. Findings indicate that parenting programmes have the potential to be cost‐saving in the long term; however, gaps in the evidence include: lack of follow‐up of families who drop out of programmes, absence of control groups in longer‐term follow‐ups, and little information about costs and effects of programmes in routine practice. The size of savings resulting from implementation of effective parenting programmes will depend on the extent to which families likely to be most costly to society attend and experience lasting benefit.     

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.     

Using a participatory evaluation design to create an online data collection and monitoring system for New Mexico's Community Health Councils

We present the collaborative development of a web-based data collection and monitoring plan for thirty-two county councils within New Mexico's health council system. The monitoring plan, a key component in our multiyear participatory statewide evaluation process, was co-developed with the end users: representatives of the health councils. Guided by the Institute of Medicine's Community, Health Improvement Process framework, we first developed a logic model that delineated processes and intermediate systems-level outcomes in council development, planning, and community action. Through the online system, health councils reported data on intermediate outcomes, including policy changes and funds leveraged. The system captured data that were common across the health council system, yet was also flexible so that councils could report their unique accomplishments at the county level. A main benefit of the online system was that it provided the ability to assess intermediate, outcomes across the health council system. Developing the system was not without challenges, including creating processes to ensure participation across a large rural state; creating shared understanding of intermediate outcomes and indicators; and overcoming technological issues. Even through the challenges, however, the benefits of committing to using participatory processes far outweighed the challenges.     

Thinking about biology and culture: can the natural and human sciences be integrated?

Genomic analyses have shown that only 1.2 per cent of the genome is devoted to protein coding sequences (the most commonly invoked definition of genes), and that much of the remaining sequences are employed in regulation – that is, in responding to signals, first, from the immediate environment of the DNA, but ultimately from the distal environment – from the cytoplasm, from the environment outside the cell, and finally, from the environment beyond the organism. Such signals are not restricted to the simple physical and chemical stimuli that impinge directly on the DNA, on the surface of the cell, or even on the body as a whole: organisms with central nervous systems have receptors for forms of perception that are not only more complex but far longer range. Humans have especially sophisticated perceptual capacities, enabling them to respond to a wide range of complex visual, auditory, linguistic and behavioural/emotional signals in their extended environment. Research has recently begun to show that responses to such signals can extend all the way down to the level of gene expression. The question is this: to what extent are we witnessing (at last) a rapprochement between the natural science of biology and the human sciences of sociology and anthropology, and to what extent do the new promises of synthesis merely reflect an expansion of older reductionist aims, threatening once again to marginalize rather than incorporate the insights of cultural analysis? As in my earlier discussion of the nature/nurture debate (2010), my focus will be restricted to the Anglo-American context.     

Religion in the Lives of Older Women Serving Life in Prison

This exploratory qualitative study examined the roles of religiousness in the lives of 21 older women (mean age = 63) serving life sentences in one southern state. Based on survey and focus group methodology, several themes emerged as important focal points, including early religious experiences prior to incarceration, imprisonment and religious doubt, participation in formal and informal religious activities, and use of religion in coping with stressors such as interpersonal relationships, trauma, and health statuses. Irrespective of their religious upbringing, all participants agreed that religiosity/spirituality played a key role in their ability to cope with their prison experience as well as for maintaining hope and the opportunity for release.