Planning for a statewide network of dementia assessment services: A survey of geriatric assessment services in Michigan

All 38 geriatric assessment service units identified in Michigan were surveyed and responded as a component of planning a statewide network of diagnostic and assessment services for patients with dementia. Most units were outpatient (71 percent), urban (71 percent), and hospital-based (82 percent). Some provided primarily geropsychiatric services (21 percent), while the rest provided general geriatric services. The staff included physicians (95 percent), nurses (100 percent), social workers (95 percent) and other professionals (SO percent) such as nutritionists, neuro psychologists or clinical pharmacists. Assessments performed by most units included physical (92 percent), psychosocial (95 percent), functional (95 percent), neurological (71 percent) mental (95 percent), and financial (89 percent). Patient referral sources were most frequently self/family, followed by physician, community agencies, and community mental health. Reasons for referral were most often confusion! memory loss, followed by behavior change, caregiver stress, depression, and evaluation for placement. Most patients seen were between 65 and 84 years of age (72 percent), lived within 25 miles of the unit (87 percent), and had dementia (62 percent). Urban sites assessed significantly more persons per month (19 percent) than non-urban sites (4 percent). Community-based services spent significantly more time per month on geriatric assessments (68 hours) than did hospital-based services (26 hours). These survey results will aid the development of a statewide network of dementia diagnostic and assessment services.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67004/2/10.1177_153331759200700606.pd

Shanty towns around the Global Village?: Reducing distance, but widening gaps with ICT

For at least 25 years, prophecies and predictions have been made about the power of communications technologies to reduce the effects of geographical distance. Advances in satellite communications and supranational broadcasting, together with the dramatic growth in the availability and capability of information and communication technologies (ICTs), have revolutionised both the speed and the nature of global communications. However, technological determinist predictions have failed to take account of the pre-existing social contexts and relationships that shape the uptake and use of new technologies at both national and international levels. In Western countries, the impact of ICT upon different groups in society has been varied, tending to reinforce rather than ameliorate existing inequalities. On an international scale, the Internet has now reached most parts of the world, but anglophone countries have dominated information sources and services. Inequalities exist not only in access to the technological means of communication, but also in respect of what is conveyed by those means