<p> African American older adults have historically been identified as vital members of the African American family and community (Hill, 1972; Cox, 2002; Waites, 2008). Unfortunately, research has shown an increasing number of older African Americans are being admitted into nursing facilities (Paul, 2004; Feng et al., 2011). Between the years of 1998-2008, it was projected African Americans living in nursing homes increased by 10.8% (Feng et al., 2011). This study explores the intergenerational relationships of older African American adults with their grandchildren, family, and community through the lens of Intergenerational Family Systems Theory. By viewing this qualitative study through the lens of Intergenerational Family Systems Theory, changes in the older adults&rsquo; kinscripts were analyzed to obtain a greater understanding of affects associated with nursing home relocation and the older adults&rsquo; relationship with their grandchildren, family, and communities since being admitted. By utilizing a grounded theory approach, this study has found key areas to influence future social work practice and research.</p>

<p>Healthcare provider practices around older adult sexuality are increasingly the focus of scholarship. Researchers use available scales to study health worker knowledge and behavior in their research. This dissertation argues the need for a new scale, because the available measures are dated and do not account for changes in attitudes and medical advances over three decades. After a review of the increasing role of physicians, social workers, and other health workers providing care for sexual issues throughout history, I describe available scales for measuring knowledge and behaviors about older adult sexuality and review research that employs them. The purpose of the dissertation was to develop a contemporary measure regarding older adult sexuality practices among health workers. I utilized a two-phase plan following Bowen and Guo&rsquo;s 12-step mixed-method approach for scale development (2012). Phase I included a literature review and qualitative interviews with experts on older adult sexuality regarding the construct. Then I created a universe of items, reviewed them with the experts, and revised items. In Phase II, I tested the items with 155 healthcare providers and conducted analysis for reliability and validity. Based on the analysis, I culled items to create a shortened scale. I proposed a scale consisting of 52 items with three subscales: a 25-item Knowledge subscale, a 13-item Attitude subscale, and a 14-item Behavior subscale. The Knowledge subscale showed poor internal reliability (<i>KR-20</i> = .625). The Attitudes (&alpha; = .825), and Behavior (&alpha; = .837) subscales showed good internal reliability. I also evaluated content validity and criterion-related validity for the subscales. Flaws in the methods and analysis make the 52-item proposed scale conceptually unsound. Limitations in generating the pool of items, evaluating the items, and testing reliability and validity did not produce a viable scale. I analyze problems with the methodological approach and propose a redesign that corrects for flaws in the approach employed here. I will use an inductive, social justice model that expands scale development to include interviews with practitioners and older adults. I conclude with a number of research, practice, and policy implications that will result from a redesigned scale. </p>

<p> The experience of anxiety and depression can have detrimental effects on the body, especially that of a developing fetus. Depression and anxiety have been linked to the experience of greater pregnancy symptoms, miscarriage, poorer birth outcomes and difficult deliveries. Despite their detrimental effects, depression and anxiety may be common during the prenatal period. A history of miscarriage may heighten normally occurring symptoms, adding a layer of difficulty to an already stressful time period.</p><p> Mind-body practices have been linked to a number of health benefits, including attenuation of psychiatric symptoms and improved pregnancy outcomes. While many of these practices have received increasing attention in popular literature, lacking are studies utilizing large, randomized clinical trials empirically validating the efficacy of these interventions.</p><p> The purpose of the original study was to examine whether miscarriage status and the engagement in mind-body practices were associated with lower levels of depression and anxiety in pregnant women. Forty-three (N=43) pregnant women in the second and third trimesters were recruited and questioned about their pregnancy, their engagement in mind-body practices (past and present) and were asked to complete the Center for Epidemiological Studies Depression Scale (CES-D) and the State Trait Anxiety Inventory (STAI). It was anticipated that women with a miscarriage history would report higher levels of anxiety and depression and that women engaging in mind-body practice, past or present, would report lower levels of depression and anxiety. When statistical analyses failed to yield significant results, this author chose to explore the process of generating new knowledge through autoethnography. This dissertation moved from an empirical study to a qualitative, autoethnographic exploration of pregnancy loss in which the themes of meaning making, personhood and the expression of feelings were explored through the literature, the author's personal experience and through participation in an online pregnancy loss support group.</p>

Online social support is reported to be used by a number of people to obtain social interaction and exchange communication as a way to buffer stressful situations. Breastfeeding women experience a significant change in their lives and routine which a number of women find it stressful for various reasons. Research shows that breastfeeding women use the Internet to obtain support, however little is known about how breastfeeding women use online social support and their perceptions, concerns and expectations about using it. An interpretive approach using qualitative methods was adopted in this research to obtain and analyse the data acquired through interviews and observations. The framework proposed by the Social Cognitive theory was used to conduct this research and to provide insights into online social support in a breastfeeding peer support context. The results in this research indicate that in spite of face-to-face interventions being favoured, online social support is perceived as a helpful alternative support with the potential to positively influence breastfeeding self-efficacy. A number of similar characteristics of face-to-face support were found to be present in online social support, such as emotional and informational support, empathy and empowerment. Online social support was perceived as offering additional features to traditional support including convenience of use, connection with peers and supporters at any time of the day, and the opportunity to express emotions and issues textually. Certain concerns were also associated to using online social support to support breastfeeding women, which need to be taken into consideration by providers of online social support. These included the need for training volunteers in this type of media, confidentiality and trustworthiness of the information available online and issues related to digital divide. These findings are useful to further the understanding of the implications of online social support in self-efficacy and the associated outcomes. Policy makers, social scientists and breastfeeding support organisations can use the findings in this research to develop future breastfeeding promotion strategies and interventions. Ultimately, breastfeeding women benefit from the findings of this research, through the implementation of online social support interventions addressing the issues raised in this research. These women will consequently have access to more services and applications, as well as engage with volunteers or clinicians trained to fulfil their needs over an alternative channel.

<p> As the number of older adults with dementia in nursing facilities grows, so does the need for holistic dementia training for nursing home staff. This curriculum was designed as a training tool for all nursing facility staff in order to provide practical education on how to develop individualized, psychosocial interventions for residents that have dementia. The curriculum is presented in two parts. Part I is a simulation activity and discussion to create empathy among staff members by demonstrating the perspective of an older adult with dementia. Part II is a guided practice activity on how to identify important interests and characteristics of an individual resident and apply this knowledge to create effective interventions. The training is a total of approximately 4 hours and focuses on teaching staff skills that will allow them to continue to target dementia symptoms with psychosocial interventions. The curriculum also includes a trainer&rsquo;s guide, handouts, and a survey tool for evaluation.</p>

This thesis examines patterns of mortality in interwar south Wales and assesses the relative influences of various social factors in determining those patterns. Chapters on income, expenditure, housing, environment, diet and medical services describe and evaluate the material conditions of life for working-class families in the different communities of interwar south Wales. A consideration of the effects of economic depression on these material aspects of people’s lives is an integral aspect of these chapters. The impact of unemployment and poverty is assessed so as to understand their significance in the everyday lives of working-class people. In this way, the thesis addresses the shortcomings in the historiography of the ‘healthy or hungry’ nature of the interwar period by anchoring the consequences of unemployment in the realities of everyday experience. The second section of the thesis consists of demographic studies of mortality and infant mortality. Various mortality indicators are examined so as to identify patterns of mortality in the different communities of south Wales. These mortality indicators are disaggregated according to age, sex, social class, occupation and location. The specific patterns revealed by this analysis are examined in the light of the material aspects of working-class life outlined in the first section of the thesis so as to determine the social determinants of mortality and the precise effects of economic depression on patterns of mortality. This detailed and systematic examination of mortality in interwar south Wales addresses the weaknesses in the Welsh historiography that has consisted of impressionistic interpretations of the effects of economic depression on standards of health. Therefore, the thesis examines the levels and trends of mortality in interwar south Wales and considers the factors that determined them. Secondly, it assesses the extent to which the economic depression of the interwar period affected these patterns of mortality.

A qualitative analysis of aftercare service provision for survivors of sex trafficking in North Carolina

Thesis (Ph.D.)--University of California, San Francisco, 2009. / Source: Dissertation Abstracts International, Volume: 70-06, Section: A, page: . Advisers: Charlene Harrington; Craig R. Cohen.

Thesis (Ph. D.)--Syracuse University, 2009. / "Publication number: AAT 3385099."

<p> The purpose of the study was to conduct a community risk assessment of the city of Huntington Park, California by utilizing the Communities That Care model to identify the most concerning risk factors for delinquency and school dropout. Forty-seven indicators measuring 18 risk factors were gathered from public sources. Data from Huntington Park was compared to data from Los Angeles County and California. The risk factors of main concern for the community appeared to be transition and mobility, low neighborhood attachment and community disorganization, extreme economic deprivation, family management problems, academic failure beginning in elementary school, early and persistent antisocial behavior, friends who engage in the problem behavior and early initiation of the problem behavior. Efforts to reduce involvement in delinquency and school dropout should target the community, school and peer and individual domains. Suggestions for evidence-based programs and approaches to reduce the most salient risk factors are provided.</p>