Suchergebnisse

All 50 States have passed legislation to protect elderly victims of domestic abuse and neglect. Forty-two States have mandatory reporting laws, with health care providers considered the major professional referral service.This exploratory study of State health departments had as its goals (a) the identification of administrative awareness regarding the State law, (b) the perception of difficulties encountered in the reporting process, and (c) the development of procedures, such as written materials or training curriculum, to assist health personnel with the reporting responsibilities. The study was carried out between April and October 1989. A brief questionnaire was mailed to State health department directors. All 50 States responded, although the respondents represented varying disciplines and staff responsibilities within the health departments or were from agencies that the State had designated to investigate elder abuse. These data should be considered preliminary and suggestive of service needs. The results demonstrated an inverse relationship between awareness of the laws or regulations and specific activities to support the reporting process. Ninety-four percent of respondents were aware of the State law, but only 20 to 28 percent reported the use of written procedures or training materials specifically designed for health personnel. At the same time, approximately one-third were aware of reporting issues that needed to be addressed, including staff unfamiliarity with the regulations, concerns of confidentiality, and uneasiness about reporting in general. Part of the reason for what appears to be inactivity on the part of the State departments of health may lie in the fact that elder abuse reporting laws tend to place implementing authority with human service, aging, or law enforcement agencies rather than with health departments.(ABSTRACT TRUNCATED AT 250 WORDS)

This is the final version. Available on open access from he National Academy of Sciences via the DOI in this record ; Data Availability: All data associated with the manuscript are provided within the manuscript. ; We consider two aspects of the human enterprise that profoundly affect the global environment: population and consumption. We show that fertility and consumption behavior harbor a class of externalities that have not been much noted in the literature. Both are driven in part by attitudes and preferences that are not egoistic but socially embedded; that is, each household's decisions are influenced by the decisions made by others. In a famous paper, Garrett Hardin [G. Hardin, Science 162, 1243-1248 (1968)] drew attention to overpopulation and concluded that the solution lay in people "abandoning the freedom to breed." That human attitudes and practices are socially embedded suggests that it is possible for people to reduce their fertility rates and consumption demands without experiencing a loss in wellbeing. We focus on fertility in sub-Saharan Africa and consumption in the rich world and argue that bottom-up social mechanisms rather than top-down government interventions are better placed to bring about those ecologically desirable changes.