bluuebunny/crossref_metadata_2025 huggingface dataset:
Rites of Passage: Constructing Quality in a Commodity Subsector
Authors: Busch Lawrence , Tanaka Keiko
Published: March 2007

This article extends the concept of symmetry to ethics. Using the case of canola in Canada, the authors argue that grades and standards simultaneously subject humans and nonhumans to rites of passage that test their "goodness. " Then, they further develop a tentative typology of standards. The authors argue that these standards allow something resembling the neoclassical market to be established, create the conditions for economic analysis, and allocate power among human actors.
Effective Cardiovascular Health Education in the Young
Authors: White Carl W. , Albanese Mark A. , Anderson Elizabeth , Caplan Richard M.
Published: March 2007

The study was designed to assess the efficacy of one national health education effort, the School Health Curriculum Project ("Berkeley Project"), in increasing the level of cardiovascular health knowl edge of sixth-grade students. Using a recently developed test of cardiovascular health knowledge, the Iowa Cardiovascular Health Test (ICVHT), 577 sixth-grade and 358 seventh-grade students from six Iowa school districts participating in the Berkeley Project were compared to two control groups. Significant differences in knowledge were present following comple tion of the cardiovascular unit when sixth-grade students in the experimental group weere compared to those in the control groups. However, differences in knowledge levels were transient, lacking practical significance when seventh-grade students were tested one year following completion of the instruction. The results of this investigation have implicationsforfuture health education curricular design and imple mentation.
Competency Verification in the Health Professions Via Limited Focus Measurement
Authors: Popham W. James
Published: March 2007

As American health professionals attempt to create assessment mechanisms to verify the competencies of practitioners, they are discovering that traditional norm-refer enced measurement strategtes are inappro priate. However , in their subsequent adoption of criterion-referenced measure ment strategies they have learned that these highly descriptive measures more clearly reveal not only what is being measured, but also what is not being measured. To create reliable assessment procedures for competency verification, a limited focus conception of measurement is proposed wherein manageable numbers of high-import competencies are validly assessed.
Rating Dental Students
Authors: Seefeldt Michael , Blumberg Phyllis
Published: March 2007

This study compares supervisor and patient perceptions of dental students' clinical performance. Postvisit questionnaires were competed by 52 patients and by the respective supervisors overseeing the student dentists who treated the patients. Evaluated areas inchlded interpersonal skills, empathic behavior, efficiency and ability to npre confidence, credibility of knowedge bae, andotherattributes-relted toprofessionalperfirmance. Patients were found to rate students significantly more highly on 17 of 24 Likert type items. Reasonsfor thesedtifferences are dscssed, including dierential expectations of students betweenpatentsandsupervisors, the noncritical nature of the patient pool composed largely oflower socioeconomicleves, the varied vahe positions of patients and supervisors regarding "professional detachment, "and the different experiential perspectives vis-a-vis student performance.
A Comparison of Knowledge, Synthesis, and Clinical Judgment
Authors: Norcini John J. , Swanson David B. , Grosso Louis J. , Shea Judy A. , Webster George D.
Published: March 2007

This study compares the reliability, validity, and efficiency of three multiple-choice question (MCQs) ability scales with patient management problems (PMPs). Data are from the 1980, 1981, and 1982 American Board of Internal Medicine Certifying Examinations. The MCQ ability scales were constructed by classifying the one best answer and multiple-true/false questions in each examination as measuring predominantly clinical judgment, synthesis, or knowledge. Clinical judgment items require prioritizing or weighing management decisions; synthesis items require the integration of findings into a diagnostic decision; and knowledge items stress recall of factual information. Analyses indicate that the MCQ ability scales are more reliable and valid per unit of testing time than are PMPs and that clinical judgment and synthesis scales are slightly more correlated with PMPs than is the knowledge scale. Additionally, all MCQ ability scales seem to be measuring the same aspects of competence as PMPs.
Use of Time Budgets in a Preventive Program
Authors: Smith Trina Plakosh , Jason Leonard A.
Published: March 2007

Time budgets provide cost-efficient methods of collecting daily behaviors occurring during the natural course ofpeople's lives. The present study illustrates the use of time budgets in evaluating preventive exercise programs. In the intervention, children were assigned randomly to either an aerobic, nonaerobic, or control condition. The aerobic condition featured jogging, whereas the nonaerobic condition taught yoga exercises. Following participation in the aerobic intervention program, time budgets indicated increased aerobic activities. Time budgets were effective in documenting behavioral changes in the children as a function of the preventive intervention.
On the Meaning of Scores Derived from Patient Management Problems
Authors: Giannini Gemma , Engel John D.
Published: March 2007

Patient Management Problem (PMP) test scores have been questioned by many for their interpretability and validity. Despite these measurement problems, PMPs remain popular evaluation and research instruments. A paired-comparisons study was undertaken to investigate the relationship between performance and corresponding scores (proficiency andpathway). The scale values for the performances do not reflect the same relative quality ofperformance as the proficiency and pathway scores. Even more remarkable is the emergence of a different standard when performance is assessed as a whole. The findings of this study suggest that assigning points at the "option level" culminates in scores that cannot easily be interpreted and cannot readily be linked to the behavior they are supposed to represent. These conclusions have implications for construct validity and educational decisions.
A Path Analysis of Medical School and Residency Performance
Authors: Curry Raymond H. , Yarnold Paul R. , Bryant Fred B. , Martin Gary J. , Hughes Richard L.
Published: March 2007

The selection and subsequent performance of 212 internal medicine residents was examined byfactor analysis andpath analysis. A three-factor solution accountedfor most of the variance among the nine selection variables. These three factors, labeled Board Scores, Faculty Evaluations, and Academic Distinction, were then combined with in-training residencyperformance evaluations and composite scores on the ABIM certifying examination to produce a comprehensive path model of house staff selection and performance. The Academic Distinction factor emerged as the strongest predictor of residency performance,; the Faculty Evaluationsfactor was also a significant component of the model. Standardized test scores correlatedpoorly with clinicalperformance. The data suggest that increased attention to the content of letters of reference could substantially improve their predictive validity. Other means of reporting subjective evaluations may also be needed to increase the stature of noncognitive attributes in house staff selection decisions.
The Use of Qualitative Evaluation Methods to Test Internal Validity
Authors: Steckler Allan
Published: March 2007

Since the late 1970s, qualitative research methods have gained recognition for their potential contribution to the evaluation of health promotion and educationprograms. Today, the issue is no longer whether to use quantitative or qualitative methods, but rather, how they can be combined to provide more complete assessments of the impact of a program. Each method is based on different yet complementary assumptions and each method has certain strengths that can be used to compensate for the limitations of the other. This article illustrates how qualitative and quantitative methods were combined in the evaluation of a health promotion program conducted in 23 rubber-producing plants in the United States. The qualitative case study and monitoring data were used to complement the quantitative study through the testing of threats to internal validity, and through the detection of a Type III error, that is, the inadequate implementation of the primary program intervention. In experimental and quasi-experimental evaluations it is recommended that selected in-depth case studies of both experimental and control sites be conducted Such case studies are essential for answering the question of why program activities were or were not carried out.
Moving from "Small Qa" to "Large Qa"
Authors: Williamson John W. , Moore Donald E. , Sanazaro Paul J.
Published: March 2007

In this article we describe an "outcomes framework" for planning and analyzing quality management systems in relation to their ultimate purpose, enhancing the wide range of health care benefits. "Small qa" includes those methods that focus on structure or process and induce improvement of outcomes. These methods are essential but, predictably, often involve minimal improvement of health care. "LARGE QA " is defined as those methods that focus on unacceptable outcomes and deduce processes and structures to be changed to enhance outcomes. These methods focus on either "problems" or "opportunities" that predict substantial improvement in health care benefits. We briefly describe and analyze this outcomes framework for quality management in terms of its conceptual factors and its current and future emphasis. We then describe several major nationalprogram developments and resources that will facilitate moving the balance of quality management effort from small qa to LARGE QA.
Changes in Rates of Unscheduled Hospital Readmissions and Changes in Efficiency Following the Introduction of the Medicare Prospective Payment System
Authors: DesHarnais Susan , Hogan Andrew J. , McMahon Laurence F. , Fleming Steven
Published: March 2007

The purpose of this study was to analyze changes in rates of unscheduled readmissions and changes in technical efficiency following the introduction of the Medicare Prospective Payment System (PPS). We developed the RiskAdjusted Readmissions Index (RARI), which allowed us to make comparisons in rates of unanticipated readmissions across hospitals and over time. Data envelopment analysis (DEA), a linear programming technique, was used to measure changes in technical efficiency by comparing the inputs used and the outputs produced across a cohort of hospitals, while adjusting for changes over time in case mix and case complexity. Rates of unscheduled readmissions and efficiency scores were computed for a sample of 245 hospitals for each year. Although both readmission rates and efficiency scores increased for most hospitals, there was no evidence that those hospitals that experienced the greatest increases in efficiency had the largest increases in their rates of unscheduled readmissions.
Computer-Based Instruction and Health Professions Education
Authors: Cohen Peter A. , Dacanay Lakshmi S.
Published: March 2007

Although several dozen studies on computer-based instruction (CBI) in health professions education have been conducted over the past 20 years, little has been done to quantitatively summarize these studies. The present investigation used Glass's techniques of meta-analysis (Glass, McGaw, &Smith, 1981) to statistically integratefindingsfrom 47comparative studies on CBI. A clear majority of these studies favored CBI over conventional methods of instruction. The overall achievement effect size for 37 studies that quantified outcomes was 0.41, a medium-sized effect. Two studyfeature variables-type of CBE and publication source -related to effect size. Computer-enriched applications of CBI produced larger effects than computer-assisted instruction (CAI) and computer-managed instruction (CMI) applications, and published reports showed larger effects than did dissertations and theses. Few studies reported outcomes of retention, achievement categorized by ability, attitudes, and time to learn. The results show higherorder applications of computers to be especially effective, although more and better-reported research isneeded to identify instructional qualities that lead to positive student outcomes.
Research on Standards for Professional Licensure and Certification Examinations
Authors: Norcini John J.
Published: March 2007

The purpose of this article is to outline an agenda for research on standards for professional licensure and certification examinations. To avoid confusion, scores are defined as content-based decisions about the correctness of responses, and standards refer to the educational/social decisions about how many questions need to be answered correctly to pass. Standards are the focus of this article. The two major types of standards, relative and absolute, are described and the major standardsetting methods for each are presented. Some of the published results in four different areas are reviewed: (a) basis of the judgments, (b) efficiency of the process, (c) group effects, and (d) content and expertise effects. Topics forfuture research in allfour areas are identified.
Understanding and using Meta-Analysis
Authors: Preiss Raymond W. , Allen Mike
Published: March 2007

Meta-analysis represents a technique with almost limitless potential to improve the practice ofpersons in the health professions. However, the technique is not without limitations that deserve careful consideration when going over any meta-analyticfinding. The essayprovides some perspectives on the possible uses of meta-analyses and standards that permit the evaluation of the worth of any particular meta-analysis. As with primary research, the meta-analytic reviewer must make a decision, and the consumer (reader) must evaluate those choices. This article offers an exploration of those choices and some of the potential consequences of those choices.
A National Assessment of the Service, Support, and Housing Preferences by Persons with Chronic Fatigue Syndrome
Authors: Jason Leonard A. , Ferrari Joseph R. , Taylor Renee R. , Slavich Susan P. , Stenzel Cheryl L.
Published: March 2007

Persons with Chronic Fatigue Syndrome (PWCs) completed and returned by mail a brief survey of openand closed-ended items designed to assess their utilization and preferences for a variety of services. A total of 984 middle-aged adults diagnosed with Chronic Fatique Syndrome (CFS) from across North America returned the survey. During the past 12 months, many of these PWCs reported utilization of a primary care physician, gynecologist, CFS specialist, and self-help group to assist in their recoveryfrom CFS. Most PWCs believed it was important to educate both health-care practitioners and the general public about CFS. In terms of their desire for specific recovery needs, factor analysis of responses indicated that these PWCs preferred self-help/social support services and general advocacy services in the treatment of their illness. The implications of these results for developing rehabilitation programsforPWCs are discussed.
Producing Credible Evaluations of Federal Health Programs
Authors: Chelimsky Eleanor
Published: March 2007

Based on extensive experience as a reviewer of evaluations offederal health programs, the author distinguishes and discusses two sources of evidence for the credibility of an evaluation. Substantive credibility is indicated by the quality of the literature review; the evaluative understanding manifest in the description of the program or treatment; the relation between the study questions and the study design; the expertise and candor displayed in the methods discussion; and the degree to which stated findings and recommendations are supported by methods and data. Presentational credibility is undermined by language that reveals subjectivity or advocacy, but it is supported by the competent organization and readability of the report.
Evaluation of Public Health Service Programs Under the Government Performance and Results Act
Authors: Straw Roger B.
Published: March 2007

The Public Health Service (PHS) is made up of a number of agencies whose collective mission has traditionally been to protect and improve the mental and physical health of the American people and to close the gaps in the health status of disadvantaged populations. However, the ClintonAdministration 's National Performance Review and its associated "reinventing government" initiatives are beginning to show promise of substantially reshaping the structure andfunctions of the federal government. Regardless of the final shape that the reinvented government takes, the Government Performance and Results Act (GPRA) will provide the framework within which that government plans, implements, and evaluates its programs. Whereas some have argued that GPRA will strengthen the role of evaluation within federal agencies, GPRA has been seen primarily as a management and budget issue, and limited attention has been paid to important issues of measurement, attribution of outcomes, and reporting time lines. Nevertheless, GPRA provides the opportunity to make the government more effective and efficient and restore the faith of the American people in government.
The Effect of a Monetary Incentive in Increasing the Return Rate of a Survey to Family Physicians
Authors: Everett Sherry A. , Price James H. , Bedell Archie W. , Telljohann Susan K.
Published: March 2007

The barrage of requests family physicians receive to complete mail surveys often results in physicians who are unwilling, or unable due to time constraints, to complete each survey they receive. Thus, to obtain an acceptable response rate, state-of-the-art mail survey techniques must be used. This article reports the results of the use of a modest($1) monetary incentive to increase a survey response rate. A random sample of 600 American Academy of Family Physicians members were mailed a survey of firearm safety counseling; half received a $1 incentive whereas the remaining half served as a control group. The response rate in the incentive group was 63% compared to 45% in the control group [X2 (1, N = 251) = 16.0, p < .0011. Further, the use of the incentive appears to be more cost-effective than a thirdfollow-up (postcard reminder) mailing.
Changes in Surrogate Laboratory Markers, Clinical Endpoints, and Health-Related Quality of Life in Patients Infected with the Human Immunodeficiency Virus
Authors: Chan Kitty S. , Revicki Dennis A.
Published: March 2007

Objective: To evaluate the relationship between laboratory markers of HIV, AIDS- defining events, study discontinuation, and summaryscoresftom theMOS-HWVHealthSurvey. Methods: Secondary analysis of data from a clinical trial of antiretroviral therapies in advanced HIV-infected patients (N = 940). Clinical and health-related quality-of-life data were collected over 48 weeks. Linear regression, logistic regression and survival analyses were performed to evaluate the relationships between MOS-HlVsummary scores, clinical events, and laboratory markers. Results: Each point increase in PHS resulted in a 3.0% decrease in the likelihood of developing an AIDS-defining event (p<.05) and a 2.7% decrease in likelihood of study discontinuation (p<.05). MHS did not significantly predict clinical events, but did predict study discontinuation (p<.05). From the linear regression analyses, the change in CD4 counts was a significant predictor of the change in MHS (p<.01).

Conclusion: The MOS-HIV summary scores predict clinical events and study discontinuation in advanced HIV-infected patients.
`Understanding media': theories of the press in Britain, 1850-1914
Authors: Hampton Mark
Published: March 2007

This article examines the theories of the press that circulated in the late 19th and early 20th centuries, relating them to their economic, political and intellectual contexts. It argues that elite discussions of the press often stood in for discussions of the changing relationship between the elite and popular classes. In the mid-19th century, and ideal of the press as an `educational' agency predominated; the press should involve readers in a public discussion that contributed to self-government. As the electorate and reading public expanded, this ideal began to decline and give way to an ideal of the press as `representing' the people. In this formulation, the ordinary reader was not credited with rational thinking, and instead of involving readers in a public discussion, this theory proposed that newspapers should speak for the readers.
Near and far: banal national identity and the press in Scotland
Authors: Law Alex
Published: March 2007

Too often study of communicative and cultural processes makes `gratuitous assumptions' about media and collective identities like national identity. This article is a critical engagement with Michael Billig's notion of `banal nationalism', a rare analysis of everyday media rhetoric and nationalism. It does this through a survey of daily newspapers sold in Scotland. Newspapers are plotted according to an index of semantic assumptions they make about where the spatial centre of national communication lies. The newspapers surveyed cluster into three broad national types, ranging from an indigenous Scottish press, Scottish editions of English-based papers, `tabloid interlopers' and the English-based broadsheets. The article argues that Billig's emphasis on the `big state' nationalism of the USA and the UK restricts the analytical scope of `banal nationalism' when studying newspaper rhetoric in a `stateless nation' like Scotland.
Symbiosis: mass media and the Truth and Reconciliation Commission of South Africa
Authors: Krabill Ron
Published: March 2007

One of the most important and visible elements of South Africa's transition to democracy has been the Truth and Reconciliation Commission (TRC). Without mass media - particularly broadcast media - the TRC's much-heralded process of providing a public platform for victims of gross violations of human rights and forging a new national history would have been severely limited. This article teases out the relationship between mass media and the TRC, focusing primarily but not exclusively on broadcast media. It draws on two analytical frameworks from the field of media studies: Dayan and Katz's Media Events (1992) and Hayman and Tomaselli's `Broadcasting Technology as an Ideological Terrain' (1987). Particular attention is paid to the TRC's institutional hearings on the media. These explorations help us to better conceptualize how and why mass media have played such a unique and crucial role in South Africa, both under apartheid and throughout the TRC process.
From media audience to media public: a study of letters written in reaction to FDR's fireside chats
Authors: Ryfe David Michael
Published: March 2007

This article investigates the process by which media audiences become media publics in an analysis of Franklin D. Roosevelt's (FDR) fireside chats. Data for this analysis includes 380 randomly selected letters written in reaction to the first ten chats delivered by FDR during his first term of office. I show that FDR borrowed the `for-anyone-as-someone' structure of broadcasting to address listeners as particular individuals and as members of a mass public. In response, listeners adopted this structure to speak for themselves and for a mass public. In this manner, listeners associated themselves with a larger collectivity, but on the basis of collective rather than personal feelings. These feelings inspired bouts of sociability - serial conversations with family, friends, neighbors, and strangers - that look very much like an instance of collective reflexivity. Thus I conclude that the mass public which formed around FDR's fireside chats represents an instance in which a media audience transformed itself into a media public.
Cultural imperialism and resistance in media theory and literary theory
Authors: Roach Colleen
Published: March 2007

This article places particular emphasis on the criticism of cultural imperialism that began in the mid-1980s and that is now subsumed under the rubric of `cultural studies' and its key concepts: the active audience, audience `resistance' to media messages, and polysemy. It contrasts the political economy school with cultural studies. The positions of Herbert Schiller and Armand Mattelart on the `resistance debate' are outlined, with the author concluding that while Schiller still asserts the validity of cultural imperialism thinking, Mattelart has moved in a slightly different direction. Nonetheless, while the latter has welcomed the departure from monolithic research models, he by no means endorses cultural studies positions, particularly their political implications. The article also contrasts the way `resistance' has been used by postmodernists in the field of communications with its meaning as articulated by two prominent writers in the field of comparative literature: Edward Said and Ngugi Wa Thiong'o. Both writers still validate the notion of cultural imperialism and use the term `resistance' to refer to the struggles against colonialism and imperialism in the countries of the South.
Inherent dependence on power: the Hong Kong press in political transition
Authors: Lee Paul S.N. , Chu Leonard L.
Published: March 2007

This article examines the changes in the press in Hong Kong during its political transition. The practical consequences of ideological differences between China and Hong Kong for the press might be limited to only three taboos — no advocacy of Hong Kong, Taiwanese or Tibetan independence; no subversion of central government; and no personal attacks on Chinese leaders. The ownership structure of the press is still diverse. In actual operation, however, the Chinese authorities have already exerted their pressure through punishment, rewards and public relations. Covert and overt self-censorship are increasing. In the selection of the Chief Executive of the post-1997 government, the press showed a dramatic turn towards legitimating the Chinese authorities and appears to be inherently power dependent. After 1997, it is suggested that the press will take up a public relations role, serving mainly as a conveyor of positive messages for government.
The construction of gendered national identities in the television advertisements of Japan and Australia
Authors: Hogan Jackie
Published: March 2007

This article examines the relationship between globalization and the construction of gendered national identities in Japanese and Australian television advertisements. The article analyses how `Japaneseness' and `Australianness' are established in a sample of television ads, and asserts that these representations of national identity are gendered. It suggests that these gendered representations are tied to increasing globalization. Specifically, it argues that the gendering of discourses of national identity serves to anchor in traditionalism identities that are destabilized by the pressures of the Japanese programme of `internationalization' and the Australian programme of `multiculturalism'. These findings represent the preliminary results of ongoing research into the relationship between globalization, gender and national identity in contemporary Japan and Australia.
Reciprocity Beyond Dyadic Relationships
Authors: Lawrence Abigail R. , Schigelone Amy R. Schiller
Published: March 2007

Residing in a long-term care community can provide numerous opportunities for collective identification and cooperative action to address the chronic stressors of aging, including issues of health and well-being. Communal coping, a process that entails the identification of a stressor as “our” issue and “our” responsibility, has traditionally been examined in the context of large-scale natural disasters or war or of family systems. This study examines communal coping behavior among 11 elderly residents of a continuing-care retirement community. Using grounded theory and semistructured interviews, the authors found that respondents engaged in mutually beneficial and supportive behavior toward their peers through reciprocal assistance between roommates, the “buddy system” among neighbors, and the expression of solidarity in aging through “we” talk. Aging stressors often viewed as “individual” in nature can instead be both viewed and addressed in the context of a collectively shared experience.
Intergenerational Social Support and the Psychological Well-Being of Older Parents in China
Authors: Chen Xuan , Silverstein Merril
Published: March 2007

This study explores the relationship between intergenerational social support and the psychological well-being of older Chinese parents. Effects of structural, functional, emotional, and appraisal social support on older Chinese parents’ well-being were tested by analyzing data collected from a random sample of 3,039 persons aged 55 and over who participated in the 1992 baseline survey of the Beijing Multidimensional Longitudinal Study on Aging (BMLSOA). Multiple regression is used to determine whether intergenerational exchanges of social support influence older parents’ morale. Findings reveal that providing instrumental support to children and satisfaction with children directly improve parents’well-being. The benefits of receiving support from children are fully mediated by parents’satisfaction with their children. The positive effects of providing functional support are magnified among parents who adhere to more traditional norms regarding family support. The results suggest that the psychological benefits of intergenerational support exchanges should not be ignored when developing elder care policy in China.
Satisfaction with Care among Elderly African American and White Residents of Adult Care Facilities
Authors: Mutran Elizabeth J. , Sudha S. , Desai Tejas , Long Kristie
Published: March 2007

Satisfaction with long-term care has received the attention of academics, policymakers, and the general public. However, little attention has been paid to ethnic differences in satisfaction, despite the increasing proliferation of long-term care options and minority representation in such facilities. The authors find that ethnic differences exist in satisfaction with adult care homes. Dependency, satisfaction with health, resident involvement in placement decisions, home type, and percentage of private rooms vary in their impact on satisfaction by ethnicity. Predictors of satisfaction within groups are primarily intra/interpersonal versus organizational characteristics. African Americans are more affected than Whites by organizational factors. Different predictors of satisfaction by ethnicity may indicate that elders bring different life experiences, cultural beliefs, and expectations with regard to long-term care that may influence their degree of satisfaction. Service delivery in long-term care institutions should be aware of the unique experiences of their residents and implement services to ensure optimal satisfaction and care.
Instability in the Retirement Transition
Authors: Marshall Victor W. , Clarke Philippa J. , Ballantyne Peri J.
Published: March 2007

The relationship between employment and retirement is changing dramatically in industrialized societies, with a decreasing proportion of working life being spent in stable career progression. Many who retire from long-service career jobs now seek paid employment in bridge jobs before completely exiting the labor force. There is little research about the effects of employment transitions and instability in later life on health, but limited research on instability early in the working life does show a strong and significant relationship. In this article, the authors investigate the relationship between instability in the retirement transition and health in a sample of early retirees from a major Canadian telecommunications company. Instability is found to be associated with adverse health effects, with variability by gender and type of health measure. In addition, both objective and subjective transition characteristics were related to variability in health.
Adult Children Helping Older Parents
Authors: Laditka James N. , Laditka Sarah B.
Published: March 2007

Using the 1993 Panel Study of Income Dynamics, the authors examine help given to older parents in typical American families. Daughters and sons not in couples were more likely to help than those in couples, and gave substantially more hours. In couples, daughters were less likely to help than sons, but they helped for considerably more hours. Black daughters helped at least as commonly as White daughters, and did so for substantially more hours than either White daughters or sons of either race. Results suggest that Black sons may help less commonly than White sons. Black sons who help, however, do so for at least as many hours as White sons. Findings suggest that changes in the Black American family have not produced the notable intergenerational relations breakdown anticipated by some researchers. Results also illuminate the important role of sons in family help and suggest that changing marriage patterns may not reduce help to older parents.
The Life-Course Trajectory toward Living Alone
Authors: Hays Judith C. , George Linda K.
Published: March 2007

Objectives: Dramatic increases in living alone in late life have been associated with higher incomes and better health, obscuring the risk to subgroups living alone with diminished health and socioeconomic resources. This study describes race differences in the stability and life-course antecedents of living alone. Method: The prospective cohort study used data from the Established Populations for Epidemiologic Studies of the Elderly at Duke University ( n = 4,132) to estimate 10-yearprevalence, incidence, and predictors of living alone among Black and White elders. Results: New episodes of living alone were equally likely. Black elders’lower prevalence of living alone was a function of their 80 percent greater probability of a new coresident episode. Home ownership, residential tenure, and perceived good health were lower among Blacks living alone, compared to Whites, who had fewer living children. Stressful life events had similar effects on household size. Discussion: Race differences in late life household size were primarily dependent on decisions embedded in midlife.
Who Uses Service Directories?
Authors: Cherry Ralph
Published: March 2007

Because access to service information can be a crucial contingency for service use, this research uses the behavioral model of predisposing, enabling, and need factors to examine who used an information directory of health and human services that was distributed by mass mail. Data were collected from surveys mailed to 657 people aged 60 and older before and after service directory dissemination, and multiple logistic regression analyses examined the likelihood of different types of directory use. Respondents who were African American, were caregivers, or had transportation or personal assistance needs were most likely to seek information about community-based services. Enabling variables (directory packaging, prior service use, and awareness) and media-scanning predispositions also influenced remembering the directory and directory use for discretionary or nondiscretionary services. Although more research is necessary regarding why information is ignored or overlooked, older people are stimulated by the distribution of service directories to acquire information and to call agencies.
Perceptions of Development
Authors: Fitzgerald Joseph M. , Hyland Diane T.
Published: March 2007

A group of 144 college students expressed attitudes about the competencies of self, average peer, average middle-aged person, and average old-aged person for abstract thinking, everyday problem solving, and moral reasoning. An additional three groups of 48 college students role played one area of competence by completing Cattell's Culture-Fair Test, the Means-Ends Problem Solving Test, or the Defining Issues Test for each of the four target groups. The aim of this study was to assess the agreement between the two methods. The attitudinal results reflect that general self and middle-age ratings are significantly higher than peer and old-age ratings, except for moral reasoning where the old-age ratings are highest. The role-playing results for abstract thinking and moral reasoning indicate a perceived decline between college age and old age. The disagreements between the attitudinal and role-playing results indicate that there are substantial limitations on the equivalence of the two methods.
Sibling Interaction and Morale
Authors: Lee Gary R. , Ihinger-Tallman Marilyn
Published: March 2007

Previous research has found no relationship between the morale of the elderly and frequency of interaction with children. This is often explained in terms of cohort differences in attitudes, values, and interests between parents and children. This study examines the relationship between morale and interaction with siblings among the elderly and finds no relationship. The indicated conclusion is that, at least in terms of interaction frequency, relations with kin do not affect the morale of the elderly. Furthermore, age differences are not relevant to the explanation of this fact.
Preferred Timing of Female Life Events
Authors: Fallo-Mitchell Linda , Ryff Carol D.
Published: March 2007

The present research examines cohort differences in the preferred timing of events in the female life cycle. A modified and extended version of the Age Constraint Scale was administered to three groups of women: a young adult group (N = 80; mean age 20.7), a middle-aged group (N = 80; mean age 44.3), and an old age group (N = 80; mean age 66.1). Each woman answered the scale in terms of her personal timing preferences and in terms of her perceptions of the preferences of women of the other two groups. The results revealed that young adult women preferred later ages for family life events and earlier ages for general life events than either middle- or old-aged women. The most pronounced differences existed between young adult and old-aged women. In addition, the different cohorts misperceived each others' preferences by attributing their own ideals to women of other ages. The findings are discussed in terms of the changing nature of social clocks among contemporary American women.
Differential Use of Health Services among Disabled Elderly
Authors: Wan Thomas T.H. , Arling Greg
Published: March 2007

In order to facilitate program planning for the chronically ill, it is essential to understand their propensity to use health and social services. This study has systematically examined the use of ambulatory services among the noninstitutionalized elderly (N = 772) who reported with one or more activity-limiting chronic conditions in a statewide survey of older Virginians in 1979. The determinants of differential use of physician services are investigated. The independent variables included in the analysis are: (1) personal attributes that may predispose individuals to seek care; (2) need for care factors as evidenced by the number of health disorders, physical functioning limitations, and perceived health; and (3) enabling factors such as income, insurance status, regular source of care, perceived service needs, and transportation barriers. Findings show that a significantly large number of physician visits may be generated in response to the psychological needs of disabled elderly. The eighteen predictors accounted for a relatively larger amount of variance (39%o) in use of social services than in physican visits (14%o). Furthermore, there is a strong complementary relationship between physician visits and use of social services.
Issues in Elderly Patient-Provider Interactions
Authors: Haug Marie R. , Ory Marcia G.
Published: March 2007

The current state of knowledge concerning relationships between elderly patients and their health care providers is reviewed in this article, chiefly in terms of physicians as providers. Characteristics of physicians, including age, gender, practice styles, and psychological attitudes, are shown to be relevant to the course and content of interactions. Equally critical are characteristics of the elderly patients, such as cohort membership, health status, gender, race, and health-related attitudes and beliefs. Also significant are the organizational settings in which interactions occur. Implications for elderly patient compliance and satisfaction, as well as health services utilization, are discussed in light of communication issues. The need for according elderly patients respect and dignity is stressed, particularly in light of ageist attitudes still prevalent among health practitioners and the society at large.
Texas Snowbirds
Authors: Martin Harry W. , Hoppe Sue Keir , Larson C. Lyn , Leon Robert L.
Published: March 2007

This article compares the results of a 1985 survey of elderly seasonal migrants to the Rio Grande Valley of Texas with those of five earlier studies to provide a more comprehensive profile of such migrants than is currently available. Sociodemographic, life-style, and health characteristics are reviewed. Based on apparent similarities among elderly seasonal migrants in the six studies, suggestions are made for the direction of future research.
Personalization of Formal Social Relationships by the Elderly
Authors: Wolfsen Connie R. , Barker Judith C. , Mitfeness Linda S.
Published: March 2007

This article examines the role of formal support services in the lives of elderly residents of HUD-subsidized buildings. Tenants identified a variety of formal roles as important in their lives. The three most central roles were physician (79%), apartment manager (58%), and social worker (51%). Formal roles were an important source of both instrumental and affective support in a wide variety of circumstances. Many individuals in formal roles were considered friends and the highly personalized nature of these relationships was a surprising finding.
Demoralization among Sons, Daughters, Spouses, and Other Relatives of Nursing Home Residents
Authors: Grau Lois , Teresi Jeanne , Chandler Barbara
Published: March 2007

This study examines demoralization among a sample of sons, daughters, spouses, and other relatives of nursing home residents. Various aspects of the caregiving situation-caregiver burden and family members' feelings of guilt and worry about the placement-as well as social support, were significantly related to morale for the sample as a whole. However, when each group of family members was analyzed separately, the predictors of demoralization were found to vary. Spouses were the most vulnerable group, experiencing the highest demoralization. Caregiving-related factors had the greatest impact on demoralization among spouses and relatives other than spouses and adult children.
Rural/Urban Differences in Adult Day Care
Authors: Conrad Kendon J. , Hultman Cheryl I. , Hughes Susan L. , Hanrahan Patricia
Published: March 2007

A review of the literature indicated that rural areas tended to be disadvantaged relative to urban areas in community-based health services, but no studies had been done on adult day care (ADC). Using data from a national survey of 822 ADC centers, this study found significant differences between urban and rural ADC centers on 23 of 42 structure, process, and client measures. Rural ADC centers tended to have lower enrollments, with a client population that was significantly less impaired. These findings were further reflected in services and activities provided in rural centers that were less clinical, a finding that is consistent with a less impaired clientele. Rural centers also reported less involvement of the family and community in activities. Rural ADC was clearly different from urban and deserves further study as a distinct entity.
Assisted-Living and Nursing Unit Use among Continuing Care Retirement Community Residents
Authors: Newcomer Robert , Preston Steven , Roderick Sue Schock
Published: March 2007

Using the lifetime experience of residents in seven continuing care retirement communities, we examine the probability of moving from independent living to assisted-living and nursing unit beds, and calculate the length of stay within each level of care. Between 50% to 70% of entering residents can be expected to use either (or both) assisted-living or nursing units during their tenure. Length of stay in independent living is increased and the length of stay in assisted living is reduced within high-rise facilities. There is a minor substitution effect between assisted-living and nursing unit use, especially among women. The nursing unit results are not affected by high rise or garden apartment design of the facility, or the percentage of nursing beds to total beds.
Effects of Hardiness and Appraisal on the Psychological Distress and Physical Health of Caregivers to Elderly Relatives
Authors: Clark Laura M. , Hartman Marilyn
Published: March 2007

The goal of this study was to identify characteristics of caregivers that contribute to differences in psychological distress and physical health in family caregivers to elderly relatives. It was hypothesized that hardiness would predict caregiver's distress and physical health beyond what could be accounted for by the demands of caregiving (relative's cognitive impairment and functional/behavioral impairment, and caregiver's level of responsibility for needed care); that hardiness would decrease distress and increase physical health; and that the effect of hardiness would be mediated by appraisals of caregiving. In a sample of 53 caregivers to relatives age 65 or older, results indicated that both hardiness and appraisals predicted psychological distress (depression and life satisfaction). Neither predicted physical health. Appraisals partially explained the relationship between hardiness and psychological distress, but it appears that both general personality characteristics and situation-specific perceptions determine the impact on the caregiver.
The Professions and Public Policy: Expanding the Third Sector
Authors: Candler Gaylord George
Published: March 2007

Professional associations are often seen as wholly self-interested actors, and/or as an integral, indistinguishable part of the privileged elite. As a result, the international third sector literature has tended to focus on the activities of social movements and NGOs. This article uses field research and the rich Brazilian third sector literature to assess these assumptions. The first part shows that numerous policy-relevant groups have long existed in Brazil, beyond the NGO/social movement ambit. The article then demonstrates the autonomy and policy relevance of professional associations. The final section shifts to the local level, using the activities of these groups in the state of Santa Catarina to show that the Brazilian third sector is best seen not in opposition to the state, but as part of dense policy networks including the state, business, and other nonprofit groups.
Scandinavian Feminist Debates on Citizenship
Authors: Skjeie Hege , Siim Birte
Published: March 2007

The Scandinavian notion of citizenship is based upon a strong participatory tradition. A broad notion of democracy includes not only formal political institutions but also the activities of social movements and voluntary associations in civil society. In social democratic citizenship, tension thus persists between traditions of governance where consensus-building is mediated through centralized corporate negotiations between major economic organizations, and an egalitarian, participatory tradition based on movement activism.