Changes in the age dependence of mortality and disability: Cohort and other determinants

Though the general trend in the United States has been toward increasing life expectancy both at birth and at age 65, the temporal rate of change in life expectancy since 1900 has been variable and often restricted to specific population groups. There have been periods during which the age- and gender-specific risks of particular causes of death have either increased or decreased. These periods partly reflect the persistent effects of population health factors on specific birth cohorts. It is important to understand the ebbs and flows of cause-specific mortality rates because general life expectancy trends are the product of interactions of multiple dynamic period and cohort factors. Consequently, we first review factors potentially affecting cohort health back to 1880 and explore how that history might affect the current and future cohort mortality risks of major chronic diseases. We then examine how those factors affect the age-specific linkage of disability and mortality in three sets of birth cohorts assessed using the 1982, 1984, and 1989 National Long Term Care Surveys and Medicare mortality data collected from 1982 to 1991. We find large changes in both mortality and disability in those cohorts. providing insights into what changes might have occurred and into what future changes might be expected.     

Veteran's health care: time for a change?

The Department of Veterans Affairs' mission is "to care for him who are shall have borne the battle for his widow and orphan." The Veterans Health Administration comprises 172 hospitals that are the hub of the health care delivery system. It is the largest provider of graduate medical education, and one of the major research organizations in the United States. The medical care budget exceeds $17 billion annually. Most of the persons cared for are not legally entitled to this health care based on service connected disability. The utilization of acute care hospital beds appears excessive when compared to that obtainable with managed care for Medicare or commercial insurance beneficiaries--the cost per member per month is three times higher. There may also be exploitation of the Veterans Administration hospitals by university medical schools. The Veterans Health Administration is a very expensive way to deliver care to entitled service connected veterans. Therefore, it is suggested that privatization be considered as an alternative vehicle for delivering health care.     

Legal issues affecting residential child care workers

Most respondents felt that child care workers' legal concerns should be addressed by requiring (1) thorough, legally approved written procedures and guidelines for all day-to-day procedures and responsibilities; (2) legally approved comprehensive record-keeping systems; and (3) access to legal support and counsel. When child care workers follow legal guidelines and a facility's procedure manuals carefully, documenting their activities in an approved record-keeping system, they can expect to be in a positive situation in any legal contest and to have behavior measured from a legal standpoint by a standard described as what a "reasonable person" would be expected to do in a similar situation and circumstance.     

The Reconstruction and Development Programme: Success Or Failure?

The Reconstruction and Development Programme (RDP) of the Government of National Unity (GNU) represents a major initiative to redress the imbalances of the past. The RDP consists of six principles and five key programmes which are outlined in this paper. It addresses, to a degree, the position of youth and women. It also stresses the importance of education and training. Various research studies that provide measurements of poverty against which the RDP can be evaluated have already been completed. They show the gross disparities in quality of life, before the April 1994 election, between people of different racial groups and urban and rural dwellers. The RDP can be assessed in both physical and psychological terms; and results of a longitudinal study measuring awareness, perceived delivery and expectations of the RDP among urban adults are given. A successful outcome for the RDP is seen as essential, if a stable South African society is to materialise. This paper sets out to examine whether this is feasible.     

Female Labor Force Participation and the Organizational Experiences of Male Workers*

Using a sample of 387 male federal employees who responded to a questionnaire, this study tests two theoretical perspectives concerning the effect of women's labor force participation on men's work experiences. One theory, with roots in the external-conflict/intenial-cohesion and minority-group size/discrimination literature, predicts that the greater the representation of women in work groups, the greater the social solidarity among male workers and the less the social support for males from female coworkers. A second theory, derived primarily from Blau's exploration into the quantitative properties of social structure, suggests that the higher the proportional representation of females, the lower of social solidarity among male workers and the greater the social support for males from female coworkers. The findings support the latter, not the former, theoretical perspective.     

Encountering and dealing with difference: second life and intercultural competence

With increasing cultural diversity as a result of globalization, intercultural competence (IC) to interact and co-exist in multicultural environments is recognized as being very important. Research indicates that cultural knowledge alone, or even being immersed in a different cultural environment does not necessarily lead to the development of IC necessary to deal with differences in behaviour, communication styles, and values and beliefs. Rather, it requires intentional development particularly of critical awareness of an individual’s cultural identity, and the values and beliefs that underpin one’s attitude and behaviour. Providing effective learning and teaching approaches to facilitate development of these affective and behavioural dimensions, challenges traditional pedagogical practices. Second life (SL), a multi-user virtual environment, potentially provides effective intercultural experiential learning opportunities to develop the desired IC by challenging personal beliefs and assumptions underpinning cultural frameworks and identity. This paper evaluates SL as one of the approaches used to develop IC in a first year IC module in a New Zealand university. Based on data from two case studies, it presents and discusses significant findings in terms of using SL and the development of students’ IC.