Health investment, saving, and public policy

This paper develops an overlapping-generations model in which agents invest in health to prolong life in both working and retirement periods. It explores how unfunded social security with or without health subsidies affects life expectancy, economic growth, and welfare. In particular, by extending life at a possible cost of capital accumulation, health subsidies and a pay-as-you-go pension can improve welfare, especially in the short run.

A phenomenology of crack abuse

The aim of this dissertation is to identify, describe, and explain the common experiences defining the crack abuser's life-world. Its method is phenomenological. Using basic cybernetic premises, a neurophysiologically oriented phenomenological framework concerning the constitution of thoughts, memories, and perceptions is first written. The framework is designed to hypothetically represent the neuropathology of crack abuse within a perspective that prescinds and describes the constitution, flow, and interdependence of experience. After the framework is written, the dissertation outlines the neuro-psychopharmacology of crack abuse and delimits crack abusers as a specific group within the more general population of cocaine users. It then represents the neuropathology of crack abuse within its phenomenological framework and uses the first-person accounts of forty-two crack dependents to actualize a phenomenological sketch of the crack abuser's life-world. The ethnographies afford the possibility of writing a “thick” description of the crack abuser's daily life—one that communicates the substance, order, and subjective and cultural dimensions of the dependent's defining experiences. ^ The dissertation's goals are successfully realized. The framework written and the ethnographies recorded and transcribed, the dissertation is able to identify, describe, and to a certain extent explain some of the common experiences defining the crack abusers life-world. The dissertation concludes that the crack abuser's life-world is organized around three primary and four secondary experiences. His primary experiences include: (1) an almost complete, yet fleeting, satisfaction of the ego's innate insufficiency and sublime, erotic-like stimulation of its core, (2) a fundamental inclination and expansion of the uniquely oriented euphoria-dysphoria dynamic that vivifies and orients the flow of consciousness, and (3) a change in the ego's innate structure. His secondary experiences include: (a) a characteristic aiming of projects, actions, and conduct toward the procurement and consumption of crack, (b) a denigration in the hold of legitimations and institutionalizations on the thematic field, (c) a strict alignment and a contraction in the scope of logical types pointing to the salient experiences within the stock of knowledge, and (d) for some crack abusers, ontological insecurity, despair, and exhaustion. ^

Substance use and sexual risk behaviors among adolescent detainees

There is a commonly presumed link among sexual risk behavior, substance use, and other psychosocial factors among adolescents. However, these relationships have been relatively understudied in detained, low-income, minority, substance abusing adolescents. This study addresses this gap in the literature with a secondary data analysis based on a sample of adolescent offenders in two detention and treatment centers in Miami-Dade County. Univariate, bivariate statistical analysis and multivariate logistic regressions were conducted on baseline data from structured interviews with 455 adolescents participating in an NIH funded prevention intervention. Data were analyzed to assess relationships among self-reported substance use, STD history, HIV/AIDS knowledge, condom use, condom use attitudes, and skills, peer and parental approval to use condoms, and race/ethnicity. The adolescent sample was 74.1% male, and 25.9% female and 35.4% African American, 25.1% non-African American Latino, 11.2% White, and 28.4% of other race/ethnicity categories. The mean age was 15.6 years. Results suggested that alcohol use (p < 0.001) and use of marijuana, cocaine and other drugs (p < 0.001) are significant variables when explaining the variability in sexual risk behaviors. Results also suggested that unprotected vaginal, anal, and oral sex increased with higher alcohol and drug use (p < 0.001) and that positive attitudes about personally using condoms (p < 0.001) were also significantly related to condom use. Logistic regressions showed that race/ethnicity was a significant control variable when explaining the variability of condom use. Being White and Latino were significantly associated with less condom use during oral and anal sex when compared to other racial/ethnic groups. These results indicated that risky sexual behavior and HIV infection risk are significantly associated with substance use, particularly alcohol use. Therefore, proper screening and identification of alcohol use, and condom use attitudes could maximize the efficacy of referrals to programs targeting both issues and increase the potential for appropriate primary and secondary prevention and treatment among adolescent detainees.

The relationship of fear of intimacy, body image avoidance and body mass index

Issues of body image and ability to achieve intimacy are connected to body weight, yet remain largely unexplored and have not been evaluated by gender. The underlying purpose of this research was to determine if avoidant attitudes and perceptions of one's body may hold implications toward its use in intimate interactions, and if an above average body weight would tend to increase this avoidance. The National Health and Nutrition Examination Survey (NHANES, 1999-2002) finds that 64.5% of US adults are overweight, with 61.9% of women and 67.2% of men. The increasing prevalence of overweight and obesity in men and women shows no reverse trend, nor have prevention and treatment proven effective in the long term. The researcher gathered self-reported age, gender, height and weight data from 55 male and 58 female subjects (determined by a prospective power analysis with a desired medium effect size (r=.30) to determine body mass index (BMI), determining a mean age of 21.6 years and mean BMI of 25.6. Survey instruments consisted of two scales that are germane to the variables being examined. They were (1) Descutner and Thelen of the University of Missouri‘s (1991) Fear-of-Intimacy scale; and (2) Rosen, Srebnik, Saltzberg, and Wendt's (1991) Body Image Avoidance Questionnaire. Results indicated that as body mass index increases, fear of intimacy increases (p<0.05) and that as body mass index increases, body image avoidance increases (p<0.05). The relationship that as body image avoidance increases, fear of intimacy increases was not supported, but approached significance at (p<0.07). No differences in these relationships were determined between gender groups. For age, the only observed relationship was that of a difference between scores for age groups [18 to 22 (group 1) and ages 23 to 34 (group 2)] for the relationship of body image avoidance and fear of intimacy (p<0.02). The results suggest that the relationship of body image avoidance and fear of intimacy, as well as age, bear consideration toward the escalating prevalence of overweight and obesity. An integrative approach to body weight that addresses issues of body image and intimacy may prove effective in prevention and treatment.

The influence of spirituality, race/ethnicity and religion on parent grief and mental health at one and three months after their infant's/child's death in the neonatal or pediatric intensive care unit

The death of an infant/child is one of the most devastating experiences for parents and immediately throws them into crisis. Spiritual and religious coping strategies may help parents with their loss. The purposes of this longitudinal study were to: (1) describe differences in bereaved parents' use of spiritual coping strategies across racial/ethnic and religious groups, mother/father dyads, and time—one (T1) and three (T2) months after the infant's/child's death in the neonatal (NICU) or pediatric intensive care unit (PICU), and (2) test the relationship between spiritual coping strategies and grief, mental health, and personal growth for mothers and fathers at T1 and T2. A sample of 126 Hispanic, Black/African American, and White parents of 119 deceased children completed the Spiritual Coping Strategies scale, Beck Depression Inventory-II, Impact of Events-Revised, Hogan Grief Reaction Checklist, and a demographic form at T1 and T2. Controlling for race and religion, spiritual coping was a strong predictor of lower grief, better mental health, and greater personal growth for mothers at T1 and T2 and lower grief for fathers at T1. The findings of this study will guide bereaved parents to effective strategies to help them cope with their early grief.

Quality of life and application of the transtheoretical model to diabetes self -management behaviors in older adults with type 2 diabetes

One in five adults 65 years and older has diabetes. Coping with diabetes is a lifelong task, and much of the responsibility for managing the disease falls upon the individual. Reports of non-adherence to recommended treatments are high. Understanding the additive impact of diabetes on quality of life issues is important. The purpose of this study was to investigate the quality of life and diabetes self-management behaviors in ethnically diverse older adults with type 2 diabetes. The SF-12v2 was used to measure physical and mental health quality of life. Scores were compared to general, age sub-groups, and diabetes-specific norms. The Transtheoretical Model (TTM) was applied to assess perceived versus actual behavior for three diabetes self-management tasks: dietary management, medication management, and blood glucose self-monitoring. Dietary intake and hemoglobin A1c values were measured as outcome variables. Utilizing a cross-sectional research design, participants were recruited from Elderly Nutrition Program congregate meal sites (n = 148, mean age 75). ^ Results showed that mean scores of the SF-12v2 were significantly lower in the study sample than the general norms for physical health (p < .001), mental health (p < .01), age sub-group norms (p < .05), and diabetes-specific norms for physical health (p < .001). A multiple regression analysis found that adherence to an exercise plan was significantly associated with better physical health (p < .001). Transtheoretical Model multiple regression analyses explained 68% of the variance for % Kcal from fat, 41% for fiber, 70% for % Kcal from carbohydrate, and 7% for hemoglobin A 1c values. Significant associations were found between TTM stage of change and dietary fiber intake (p < .01). Other significant associations related to diet included gender (p < .01), ethnicity (p < .05), employment (p < .05), type of insurance (p < .05), adherence to an exercise plan (p < .05), number of doctor visits/year ( p < .01), and physical health (p < .05). Significant associations were found between hemoglobin A1c values and age ( p < .05), being non-Hispanic Black (p < .01), income (p < .01), and eye problems (p < .05). ^ The study highlights the importance of the beneficial effects of exercise on quality of life issues. Furthermore, application of the Transtheoretical Model in conjunction with an assessment of dietary intake may be valuable in helping individuals make lifestyle changes. ^

The Public Health of Cubans and Cuban Americans: A Symposium [Program]

This is the program for "The Public Health of Cubans and Cuban Americans: A Symposium".

The Public Health of Cubans and Cuban Americans: A Symposium

The flyer promotes the event"The Public Health of Cubans and Cuban Americans: A Symposium" cosponsored by the FlU Herbert Wertheim College of Medicine, the Robert Stempel College of Public Health & Social Work, the Latin American and Caribbean Center, and the Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA) and part of the CRI/LACC Cuba and the Professions Lecture Series.

The Public Health of Cubans and Cuban Americans: A Symposium

This flyer promotes the event "The Public Health of Cubans and Cuban Americans: A Symposium" cosponsored by the FlU Herbert Wertheim College of Medicine, the Robert Stempel College of Public Health & Social Work, the Latin American and Caribbean Center, and the Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA). Part of the CRI/LACC Cuba and the Professions Lecture Series

Professional development programs in health promotion : tools and processes to favor new practices

Developing innovative interventions that are in sync with a health promotion paradigm often represents a challenge for professionals working in local public health organizations. Thus, it is critical to have both professional development programs that favor new practices and tools to examine these practices. In this case study, we analyze the health promotion approach used in a pilot intervention addressing children’s vulnerability that was developed and carried out by participants enrolled in a public health professional development program. More specifically, we use a modified version of Guichard and Ridde’s (Une grille d’analyse des actions pour lutter contre les inégalités sociales de santé. In Potvin, L., Moquet, M.-J. and Jones, C. M. (eds), Réduire les Inégalités Sociales en Santé. INPES, Saint-Denis Cedex, pp. 297– 312, 2010) analytical grid to assess deductively the program participants’ use of health promotion practices in the analysis and planning, implementation, evaluation, sustainability and empowerment phases of the pilot intervention. We also seek evidence of practices involving (empowerment, participation, equity, holism, an ecological approach, intersectorality and sustainability) in the intervention. The results are mixed: our findings reveal evidence of the application of several dimensions of health promotion (equity, holism, an ecological approach, intersectorality and sustainability), but also a lack of integration of two key dimensions; that is, empowerment and participation, during various phases of the pilot intervention. These results show that the professional development program is associated with the adoption of a pilot intervention integrating multiple but not all dimensions of health promotion. We make recommendations to facilitate a more complete integration. This research also shows that the Guichard and Ridde grid proves to be a thorough instrument to document the practices of participants.

Psychology and Social Work: Applied Perspectives

Successful social work practice is underpinned by knowledge, theories and research findings from a range of related disciplines, key amongst which is psychology. This timely book offers a grounded and engaging guide to psychology s vital role at the heart of contemporary social work practice. The book skilfully addresses some of the central theoretical developments in psychology from an applied perspective, and explains how these make essential contributions to the methods and theory base of social work in ways that foster critical evaluation and promote best practice. Written by two authors with extensive backgrounds in psychology and social work respectively as well as a deep understanding of the intersections of the two this book delivers a unique synthesis of perspectives and approaches, focusing on their application to the lives of individuals and families. Each chapter contains reflective points and case studies based on contemporary practice realities which are related to the Professional Capabilities Framework for Social Workers and also to the Health and Care Professions Council s Standards of Proficiency. Times have never been more challenging for social work and this book will be an invaluable source of professional support within the ever-more complex psychological worlds where social work takes place. Table of Contents 1. Introduction: The place of psychological knowledge and research in social work training and practice 2. Signposts from Developmental Psychology on Human Development over the Life Course 3. Perspectives from Clinical and Counselling Psychology on Mental Health and Illness 4. Perspectives from Social and Community Psychology: Understanding values, attitudes, diversity and community change 5. Health Psychology: Understanding health, illness, stress and addiction 6. Organizational Psychology: Understanding the individual and the organization in the social work structure 7. Forensic Psychology: Understanding criminal behaviour and working with victims of crime 8. Conclusion References Index

Professional development programs in health promotion : tools and processes to favor new practices

Developing innovative interventions that are in sync with a health promotion paradigm often represents a challenge for professionals working in local public health organizations. Thus, it is critical to have both professional development programs that favor new practices and tools to examine these practices. In this case study, we analyze the health promotion approach used in a pilot intervention addressing children’s vulnerability that was developed and carried out by participants enrolled in a public health professional development program. More specifically, we use a modified version of Guichard and Ridde’s (Une grille d’analyse des actions pour lutter contre les inégalités sociales de santé. In Potvin, L., Moquet, M.-J. and Jones, C. M. (eds), Réduire les Inégalités Sociales en Santé. INPES, Saint-Denis Cedex, pp. 297– 312, 2010) analytical grid to assess deductively the program participants’ use of health promotion practices in the analysis and planning, implementation, evaluation, sustainability and empowerment phases of the pilot intervention. We also seek evidence of practices involving (empowerment, participation, equity, holism, an ecological approach, intersectorality and sustainability) in the intervention. The results are mixed: our findings reveal evidence of the application of several dimensions of health promotion (equity, holism, an ecological approach, intersectorality and sustainability), but also a lack of integration of two key dimensions; that is, empowerment and participation, during various phases of the pilot intervention. These results show that the professional development program is associated with the adoption of a pilot intervention integrating multiple but not all dimensions of health promotion. We make recommendations to facilitate a more complete integration. This research also shows that the Guichard and Ridde grid proves to be a thorough instrument to document the practices of participants.

The role of social support in protecting mental health when employed and unemployed: a longitudinal fixed-effects analysis using 12 annual waves of the HILDA cohort

Perceived social support is associated with overall better mental health. There is also evidence that unemployed workers with higher social support cope better psychologically than those without such support. However, there has been limited research about the effect of social support among people who have experienced both unemployment and employment. We assessed this topic using 12 years of annually collected cohort data. The sample included 3190 people who had experienced both unemployment and employment. We used longitudinal fixed-effects modelling to investigate within-person changes in mental health comparing the role of social support when a person was unemployed to when they were employed. Compared to when a person reported low social support, a change to medium (6.35, 95% 5.66 to 7.04, p < 0.001) or high social support (11.58, 95%, 95% CI 10.81 to 12.36, p < 0.001) was associated with a large increase in mental health (measured on an 100 point scale, with higher scores representing better mental health). When a person was unemployed but had high levels of social support, their mental health was 2.89 points (95% CI 1.67 to 4.11, p < 0.001) higher than when they were employed but had lower social support. The buffering effect of social support was confirmed in stratified analysis. There was a strong direct effect of social support on mental health. The magnitude of these differences could be considered clinically meaningful. Our results also suggest that social support has a significant buffering effect on mental health when a person is unemployed.