bluuebunny/crossref_metadata_2025 huggingface dataset:
Expert Enhancement and Replacement in Computerized Mental Labor
Authors: Perrolle Judith A.
Published: March 2007

What happens to professional and technical work when it is computerized? Exploratory analysis of case studies indicates that when expert systems are used to enhance the work of professionals, some tasks of medium- and low-skilled support personnel are integrated into the work of highly skilled experts. Technical workers are thus at risk of having their jobs automated as part of the computer enhancement of professionals. When computerization replaces expertise, job opportunities for medium-skilled personnel shrink and barriers to upward mobility through on-the-job experience are reduced Entry-level professionals or even technicians with computers can perform tasks formerly done by experienced professionals. But working conditions do not promote the development of expertise and professional judgment among these workers. Thus it appears that routinization, deskilling, and automation are not only the problems of manual laborers in the information age; professional workers are also at risk, in complex ways.
Ethics, Public Policy, and Global Warming
Authors: Jamieson Dale
Published: March 2007

There are many uncertainties concerning climate change, but a rough international consensus has emerged that a doubling of atmospheric carbon dioxide from its pre-industrial baseline is likely to lead to a 2.5 degree centigrade increase in the earth's mean surface temperature by the middle of the next century. Such a warming would have diverse impacts on human activities and would likely be catastrophic for many plants and nonhuman animals. The author's contention is that the problems engendered by the possibility of climate change are not purely scientific but also concern how we ought to live and how humans should relate to each other and to the rest of nature; and these are problems of ethics and politics.
Technology, Science, and Obstetric Practice: The Origins and Transformation of Cephalopelvimetry
Authors: Hiddinga Anja , Blume Stuart S.
Published: March 2007

The process of technological change in obstetrics must be understood as contingent on the exigencies of the professional project, rather than in terms simply of improvement or dehumanization of care. Transformation in the procedures by which the female pelvis and the fetal head have been measured illustrate this point. The development of new measurement techniques was profoundly influenced by the shifting locus of obstetric care and by changing professional concerns, including the initial demarcation of a professional practice and subsequent debates about preferred modes of intervention.
The Seamless Web and Communications Equity: The Shaping of a Community Network
Authors: Virnoche Mary E.
Published: March 2007

Drawing on field data gathered from 1994 to 1996, this article considers tensions in the development of community networks and highlights the decisions that shape particular types of networks. Four key decision points include interface choice, content, interaction, and outreach. Discourse about decision making is often dichotomized around civic and consumer social currents. Civic currents demand text-only interfaces, exclusively non- profit content, full electronic interaction capabilities for everyone, and deep outreach efforts. In contrast, consumer currents push graphical interfaces, the inclusion of profit-making content, limited interaction options, and meso to shallow outreach. While considering the influences of these currents, the article problematizes the dichotomy and considers more specific social influences on decision making. It also suggests specific network decisions that may contribute to greater communications equity.
Teaching Technologic Restraint
Authors: Nelson Rodney B.
Published: March 2007

An excessive number of serum determinations of vitamin B-12 and fohc acid was being ordered from the Medical Service. During 1976 the estimated laboratory costs for detecting five cases of pernicious ane mia were about $45,000 or $9,000 per case. It was felt that an educational program stressing the limitations of this use of the laboratory, the cost of the strategies in use, and the proposal of alternate, less costly strategies might lead to a reductm in utihzation of the laboratory. It has been the feeling that voluntary technologic restraint could not be practiced by physicians and that economic rationing might become necessary to control costs. It was found that physicians could be taught restraint but that constant reinforcement and emphasis would be necessary to make voluntary technologic restraint useful. Monitor ing use of the clinical laboratory is a useful technique for assessing the effectiveness of programs aimed at cost containment.
Evaluating Student Multiple-Choice Responses
Authors: Harasym P.H. , Norris D.A. , Lorscheider F.L.
Published: March 2007

The effects of coded (type K) and free (type X) formats on student responses to identical multiple-choice items were com pared. Two subtests (A and B) each of 20 multiple-response items were emplo ved The items of the two subtests were placed in both K and X response formats pro ducing two examinations (i.e., exam I subtest A in type K format and subtest B in type X format; exam II. subtest A in type X format and subtest B in type K format) which were randomly distributed to 155 premedical students enrolled in an advanced human physiology course. Analyses of student performance led to four observanons. (1) the type K items significantly elevated student achievement scores due to a cueing effect inherent in the format, (2) the "poorer" students' scores were elevated more than the "better" students' scores, as evidence by a signifi cant negative relationship between the degree of cueing and examinee perfor mance; (3) the item format and scoring system (dichotomous or semicontinuous scales) affected the mean and variance of examinee scores; (4) the reliability (alpha coefficient) of items in the type X format tended to be statistically higher than that of items in the type K format. It was con cluded that an examination constructed in the type X format is a superior evalua tion instrument when compared to its parallel type K format
The Clinical Skills Assessment Form:
Authors: Skakun E.N.
Published: March 2007

A 12-item rating scale, the Clinical Skills Assessment Form, used for assessing the clinical skills of pediatric candidates during their final clinical examination is described. In addition to the description, a measure of internal consistency as well as a factor analysis of the scale to validate the structure of the scale are also reported. The results of the concurrent validity of the form are presented. Results indicate that the form is internally consistent, measures three global aspects, and correlates modestly with other certification measures. Further research using the form is discussed.
Evaluating Decentralized Basic Science Medical Education:
Authors: Cullen Thomas J. , Dohner Charles W. , Schwarz Roy
Published: March 2007

The Washington, Alaska, Montana, and Idaho Program in Decentralized Medical Education began in 1971. Since that time, more than 400 students have participated in the University Phase of the program. This article presents a modelfor evaluating the basic science portion of the program in which the first year of medical school is taught at sites remote from the medical center in Seattle, Washington. The article describes a methodology for assessing student performance and student and faculty satisfaction with the program. The results indicate (1) that students at remote sites are indistinguishable from those students who study at the University of Washington School of Medicine and (2) that they choose primary care pathways and residencies at a greater rate than their classmates at the School of Medicine.
An Evaluation of a Cancer Control Outreach Program in Radiation Therapy
Authors: Diamond James J. , Rominger C. Jules , Kramer Simon
Published: March 2007

Using the methodology of retrospective chart review, this study in radiation therapy compared workup and treatment scores for two groups of community hospitals. The group that participated in clinical trials with a radiation therapy cooperative consortium was superior in several respects to a matched comparison set of hospitals. However, the superiority appears to have been in evidence before theprogram began. There are presumed to be selection mechanisms that operate to bring certainfacilities into the clinical research effort, while excluding others.
Evaluation of a Medical Interviewing Course
Authors: Harris Ilene B. , Eckert Elke D. , Petzel Robert A. , Westermeyer Joseph
Published: March 2007

Changes in beginning medical students' preferred interview responses appear attributable to a course that emphasizes communication techniques for developing patient rapport. For each offive successive classes, pre /postcourse preferences were obtained for alternative response modes (categorized as understanding, probing, interpretive, supportive, and evaluative. Analysis indicated significant increases in students' preferences for understanding responses and decreases in preferences for evaluative responses (p < .001). Changes are in the desired direction with respect to course goals, since rapport is generally enhanced by conveying understanding and refraining from premature evaluation. Effects on response preferences of some instructor characteristics are analyzed. Implications for health professions education and research are discussed.
Needs Assessment and Hospice Planning in a Rural Setting
Authors: Byrne Colene M.
Published: March 2007

A needs assessment is a research and planning activity designed to determine a community's service needs and utilization patterns. One of the most practical ways to plan services is to gather information accurately about a definedpopulation and use that information to revise existing programs or develop new ones. Unfortunately, needs assessment findings often go unused. This article describes how a needs assessment was designed to assess the need for hospice services in a rural Pennsylvania county and how the results of this assessment were useful in determining priorities for program planning and service development. The implications of a model needs assessment such as the one proposed are discussed.
Structural Equation Models of Moral Reasoning and Physician Performance
Authors: Sheehan T. Joseph , Candee Daniel , Willms Janice , Donnelly Julie C. , Husted Susan D.R.
Published: March 2007

In order to identify and explain those aspects of clinical performance related to moral reasoning, 39 family medicine residents were studied as they interacted with each of two simulated patients. Residents were interviewed to assess their performance with each patient, elicit their general philosophy of being a doctor, and measure their moral reasoning. General performance as residents was rated by three faculty supervisors. Scoringprotocols were developedfor each measure to ensure objectivity. Factor analysis of each measure guided selection of the most meaningful variablefrom each instrument. Based upon general models relating attitude to behavior, structural equations were used to explicate the relationship between moral reasoning, performance on the simulated cases, performance as a resident, attitude, and intention. Chi-square goodness offit indicates that the general attitude-behavior models adequatelyfit the data. These models would suggest that moral reasoning and physician attitudes have more of an influence on behavior than physician intentions.
Perceived Quality of Hospital Care
Authors: Bausell R. Barker
Published: March 2007

Physicians, nurses, and consumers in the New York City area were asked to indicate which of 76 acute-care hospitals they would be willing to be patients in if they became seriously ill. Percentages offavorablejudgments rangedfrom a high of 95% for one university hospital to a low of less than 10% for a community hospital. Over haylof all responding physicians, nurses, and consumers indicated that they would not wish to be a patient in the majority of the 76 hospitals sampled. Although a high degree of consistency (r = .93) was observed among all three types of respondents, physicians were on the average significantly more pessimistic (X percentage of favorable judgments = 34) than nurses and consumers. A 11 three groups indicated a statistically significant (p < .001) preference for larger hospitals as well as institutions that were affiliated with a medical school in some way.
Quality of Care
Authors: Levine Harold G.
Published: March 2007

Educational research and development in health professions education has suffered in recent years in regard to federal support as concerns about health manpower have declined. This article expresses the belief that educational research and development has the potential to influence the quality of health care, but that the public perception of its influence is weak. Some of the literature on quality of care implies that cognitive factors in educating health professionals may be less important than the personal qualities of the professionals and the appropriateness of their practice experience to present needs. The implications of this perspective on thefuture agenda of health professions education research and development are discussed.
Dealing with Nonrespondents in a Mail Survey of Professionals
Authors: Ogborne Alan C. , Rush Brian , Fondacaro Rocco
Published: March 2007

In an experimental study involving health and social service professionals, a second mailing of a questionnaire to initial nonrespondents in a mail survey wasfound more cost-effective as a means of increasing returns than attempts to conduct telephone interviews, although telephone contacts suggested several reasonsfor nonresponse.
The Application of Strength of Association Statistics to the Item Analysis of an In-Training Examination in Diagnostic Radiology
Authors: Diamond James J. , McCormick Janet
Published: March 2007

Using item responses from an intraining examination in diagnostic radiology, the application of a strength of association statistic to the general problem of item analysis is illustrated. Comparisons are made between the use of the omegasquared and the pointbiserial as criteria for item selection. General issues of reliability and errors of measurement are discussed.
Randomized Response Methodology in Health Research
Authors: Soeken Karen L.
Published: March 2007

Randomized response measurement techniques have been proposed to overcome subject unwillingness to answer embarrassing or threatening questions truthfully. Many of the applications to date have dealt with health-related issues. This article demonstrates the application of the unrelated question randomized response design with one such question. Although the techniques are currently underused, they are to be recommended for use in evaluating programs designed to deal with potentially sensitive behaviors orfor research involving attitudes toward sensitive issues.
The Prevention of Adolescent Smoking
Authors: Harken Laurel S.
Published: March 2007

The multiple increased health risks that are associated with smoking make primary prevention of the adoption of the habit by adolescents crucial. Smoking is a behavior that is fostered by environments in which peers and family members smoke and by large scale media campaigns advertising tobacco products. There are also well-defined psychological, behavioral and developmental characteristics that place adolescents at risk of experimenting with smoking. In order to foster nonsmoking, prevention programs have traditionally focused on education about the health risk of the habit. To enhance the effectiveness of these efforts, new programs have incorporated social inoculation strategies, which identify and analyze the pressures to smoke that adolescents face. They demonstrate and practice resistance techniques that enable students to withstand these pressures. In addition, general coping and social skills training have been added. These focus on problem-solving and decision-making skills, assertiveness training, relaxation techniques, and communication strategies. By preparing adolescents to deal with nonspecific problem situations, it is felt that they will be more competent and capable of resisting allforms of substance abuse. In addition, prevention programs have been reinforced by community and legislative efforts to decrease the rate of smoking in the general population.
Preventive Health Behavior Advice
Authors: Young Rosalie , Kahana Eva , Rubenfire Melvyn
Published: March 2007

Preventive health behavior on the part of heart patients is essential to reduce cardiac risk, improve the opportunity for recovery after myocardial infarction (MI), and enhance the patient's likelihood of survival. Since physicians often manage older patients differently than younger ones, it is important to determine whether preventive health advice differs by age. This study of 246 recovering MIpatients has shown that important areas of differences emerge that appear to favor younger patients. These involve preventive behavior information, advice, and physician referrals. Also indicated by the data was that older patients were offered significantlyfewer opportunitiesfor enrollment in cardiac rehabilitation programs and received significantly less instruction in practices that are beneficial to cardiac health. Discriminant function analyses performed on the data identified specif ic referral patterns in which age of patient was a majorfactor. Reasonsfor the discrepant patterns are offered, including the possibility of age-related stereotyping of older heart patients.
A Follow-Up Study of "Dangerous Answers" in Four Medical Specialties
Authors: Kremer Barbara K. , Mankin Henry J.
Published: March 2007

We undertook this study to obtain further validation of a latent trait for dangerousness, identified by Mankin, Lloyd, and Rovinelli (1987), on certification examinations for medical specialists. "Dangerousness " was defined as any act of omission, or commission, in treatment which could result in a patient's death or injury. The method we employed involved asking panels of experts to retrospectively evaluate items on specilty examinationsfor dangerous answers. We then analyzed candidates' choices of dangerous answers. Four specialties participated in the study, and data from each were analyzed separately. Our results failed to support a latent trait for dangerousness. Nevertheless, we suggest that future studies employing alternative evaluation methods could yield support for a dangerousness trait, but consideration must be given to the potential costs of these studies.
Methods of Determining the Cost of Health Care in the Department of Veterans Affairs Medical Centers and Other Nonpriced Settings
Authors: Chapko Michael K. , Ehreth Jenifer L. , Hedrick Susan
Published: March 2007

Cost is increasingly important in the evaluation of health care. Though charges are often used as a proxy for cos4 some health care systems such as the Veterans Administration do little or no billing. This article describes, presents examples of and evaluates four options for determining the cost of care within the Department of Veterans Affairs: measuring input costs, the Departmen t's cost accounting system, the reimbursement system, and use of charges from a surrogate health care facility. Each approach is evaluated for accuracy, ability to compare the costs of different treatments, and effort required to estimate cost.
Work Patterns of Male and Female Pharmacists
Authors: Knapp Katherine K. , Koch Marianne J. , Norton Linda , Mergener Michael A.
Published: March 2007

A demandfor betterdata about pharmacists as working health professionals led the authors to study the work patterns of 1,146 pharmacists over a 30-year period from 1959 to 1989. Work history data were used to determine gender-specific participation rates as a function of age, years in the work force, and date. Percent full-time (as opposed to part-time) work as a gender-specific function of age was also determined. Participation rates for males and females, widely disparate in the 1960s, have converged and are not significantly different. Graduates of the 1980s, both male and female, are remaining with pharmacy as an occupation at a significantly higher rate than earlier graduates. Percent full-time rates for women pharmacists are significantly lower than those for male pharmacists, although women have registeredsignificant increases in percentfull-time work in each decade from the 1960s to the 1980s. An unexpectedfinding was the overall reduced participation by graduates of the years 1970 to 1979. The findings of the study are helpful in explaining recent controversies about the adequacy of the supply of pharmacists. The form of the data bases constructed for this study could be used as a model for the study of other health professionals.
Assessing Cigarette Sales Rates to Minors
Authors: Jason Leonard A. , Ji Peter Yun , Anes Michael , Xaverious Pamela
Published: March 2007

Minors were asked questions regarding their cigarette-purchasing behavior and a group of volunteer minors were sent into stores to purchase cigarettes in a large Midwestern city. Results show that cigarette sales rates for two sampling data taken one year apart were 80% and 82%. In addition, minors reported they can easily purchase cigarettes from stores and vending machines. The results indicate that minors have easy access to cigarettes in a large Midwestern city.
Is the Public being Protected? Prevention of Suboptimalmedical Practice Through Training Programs and Credentialing Examinations
Authors: Tamblyn Robyn
Published: March 2007

Governments have traditionally looked to the medical profession for leadership in health planning and have charged the profession with the responsibility of establishing and monitoring standards of medical practice. Training program accreditation and licensure/certification exams have been used as the primary methods of preventing unqualified individuals from entering medical practice. Despite the critical nature of the decision made at the time of licensure/certification, there is no information about the validity of these examinations for predicting subsequent practice and health outcome. In this article, the assumptions implicit in the current use of licensing/certifying examinations are identified, the relevant evidence is reviewed, and the implications of this evidence for current methods of measurement are discussed.
Reliability and Validity of A Breast Self-Examination Proficiency Rating Instrument
Authors: Wood Robin Y.
Published: March 2007

A college laboratory was used as the setting to test the reliability and validity of a newly designed Breast Self-Examination Proficiency Rating Instrument (BSEPRI). The instrument was tested on two groups of nursing students, one instructed prior to testing and one not. BSE proficiency was scored individually for each subject as she demonstrated the procedure on a breast simulation model. Independent sample t tests were used to compare the groups. Mean scores of the instructed group were significantly higher than mean scores of the uninstructed group on the total test and on subscales of palpation and inspection. Criterion-referenced concurrent validity was assessed by correlating palpation scores with lump detection in a silicone model. Interrater reliability using percentage agreement between raters was high on 19 out of 23 criteria. Kuder-Richardson internal reliability coefficients ranged from .67 to .74.
Methodological Issues for Health-Related Surveys of Multicultural Older Women
Authors: Zapka Jane G. , Chasan-Taber Lisa , Bigelow Carol , Hurley Thomas
Published: March 2007

Given concerns about survey nonresponse bias as well as the need to plan resources for participant recruitment, this study tracked each step of the recruitment process (location, response, consent, and completion) of sociodemographically diverse older women for a survey concerning mammography experience. Younger, less educated poor women were likely to be lost due to inability to locate them, while older middle and upper-economic-group women were more likely to be lost due to refusal to participate. Hispanic and Black women were significantly more likely to respond on successive attempts to recruit them than were White, non-Hispanic women. There was no significant difference in refusal rates by minority women over the successive contacts, as contrasted with White women, who refused at significantly higher rates with each attempt.
Using a Set-Aside to Encourage the Evaluation of Public Health Service Programs
Authors: Riggin Leslie J. C. , Shipman Stephanie L. , York Robert L.
Published: March 2007

For over 20years, the secretary of the Department of Health and Human Services (HHS) has had the authority to use up to 1% of the annual Public Health Service (PHS) appropriations for the evaluation of federal health programs. However, recent changes to the Public Health Service Act put not only a ceiling (1%) but also afloor (0.2%) on the funds that the secretary can set asidefor evaluation. The changes to the legislation are intended to encourage HHS to dedicate more funds to evaluation, focus the funds set aside for evaluation on studies of PHS program implementation and effectiveness, and regularly report the findings of the evaluations to Congress. These changes respond to concerns raised by the U.S. General Accounting Office in a study of the PHS evaluation set-aside conducted for Congress.
The Limits of Medicaid Reimbursement Incentives
Authors: Cruise Peter L.
Published: March 2007

Provider incentive payments in the Medicaid program have been in operation nationally since the early 1980s. Although initially indicating favorable results, recently the ability of such incentives to produce the desired action has been questioned. This study examined the Florida Medicaid AIDS Nursing Home Admission Incentive Program to determine the reasons behind the program's apparent inability to increase Medicaid-covered persons with AIDS (PWAs) admissions to nursing homes. A survey of 308 nursing homes in the 10 Florida counties with the highest cumulative AIDS cases in the state was conducted. The results reveal that (a) the level of incentive reimbursement received, (b) the financial classification of existing (non-AIDS) residents, and (c) the level of technological sophistication of the facility are all significantly related to the number of PWAs admitted. Based on these results, the author discusses implications for the future of Medicaid incentive programs for PWAs.
Cuing Effect of "All of the above" on the Reliability and Validity of Multiple-Choice Test Items
Authors: Harasym P. H. , Leong E. J. , Violato C. , Brant R. , Lorscheider F. L.
Published: March 2007

It is generally acknowledged that alternatives such as none of the above and all of the above should be used sparingly in multiple-choice (MC) items. But the effect that all of the above has on the reliability and validity of an MC item is unclear This study compared the results of a single-response (SRa) item format that included all of the above as the correct response to a multiple-response (MR) item format that required examinees to select all of the available alternatives for a correct response. A crossover design was used to compare the effect of formats on student performance while item content, scoring method, and student ability levels remained constant. Results indicated that the SRa format greatly distorted examinee performance by elevating their scores because examinees who recognized two or more alternatives as being correct were cued to select all of the above. In addition, the SRafornat significantly reduced the reliability and concurrent validity of examinee scores. In summary, the MR format was found to be superior Based upon new empirical evidence, this study recommends that whenever an educator wishes to evaluate student understanding of an issue that has multiple facts, the SRa format should be avoided and the MR format should be used instead.
The international telenovela debate and the contra-flow argument: a reappraisal
Authors: Biltereyst Daniël , Meers Philippe
Published: March 2007

Latin American telenovelas are often considered an interesting case in international communication theory and research, illustrating the potential of Third World cultural industries for resistance, alternatives and even contra-flow. In this article we first shed some light on the main theoretical frameworks and empirical arguments in the international telenovela debate. In the second part we focus on the contra-flow argument in relation to the worldwide exports of telenovelas. In the case study we concentrate on the telenovela flow to Europe. Both theory and case study stress the weakness of the contra-flow argument.
Supper with the devil — a case study in private/public collaboration in broadcasting: the genesis of Eurosport
Authors: Collins Richard
Published: March 2007

Time-honoured distinctions between public service and commercial broadcasters are eroding. A chief driver of these changes is a rise in the prices of programmes and of the cost of television sports rights in particular. Many contemporary instances of these trends were foreshadowed in an early example of cooperation between European public service broadcasters and their commercial rivals in the 1980s. The EBU-sponsored satellite television channel Eurosport was a notable example. Eurosport was established in partnership with News International's Sky Channel in the late 1980s, a partnership that was brokered by the BBC. The history of Eurosport exemplifies the erosion of long-established distinctions between public service and commercial broadcasters in Europe. This process of `convergence' between public and commercial broadcasters will make special arrangements to protect and foster public service broadcasting difficult to sustain.
Taiwan's film importation from China: a political economy analysis of changes and implications
Authors: Hong Junhao , Sun Jungkuang
Published: March 2007

For 40 years, Taiwan observed a strict `closed door' policy with China, concerning not only political and economic relations but also cultural relations. This study examines the changes in Taiwan's importation of China's media and cultural products from 1987, when the two societies resumed contact, to 1997, when both governments announced the most significant policy change. This article reviews the evolution of changes in Taiwan's policies on film importation from China, discusses the motivations for the policy changes and analyzes the implications of these changes. The purpose of this study is to explore relationships between the two Chinese societies' cultural relations and political and socioeconomic relations.
From `historic compromise' to `telecratic compromise': notes for a history of political communication in Italy between the First and Second Republic
Authors: Zolo Danilo
Published: March 2007

The author analyses the development of the mass communication system in Italy during the 1990s. The central thesis is that television's hegemony over political communication has profoundly transformed Italian politics. The mass political parties have been marginalized and their representative structure has lost its traditional significance. The new subjects of politics no longer belong properly speaking to parties: they are the elites belonging to electoral machines which, via television, offer the mass of citizen-consumers their own symbolic products, engaging in publicity battles according to precise marketing strategies. At the normative level Parliament and the government have systematically legalized the existing public-private duopoly in the media sector and today a new constitutional paradigm appears on the horizon, that of the `telecratic compromise'. On one side is a party system based on control of the three channels of public television (RAI) and on the other the private market monopoly of Fininvest owned by the multimedia manager and political leader Silvio Berlusconi.
Antecedents and Effects of Wisdom in Old Age
Authors: Ardelt Monika
Published: March 2007

Using longitudinal data on 82 White, California women from the Berkeley Guidance Study, this study examines the relationship between wisdom (defined as a combination of cognitive, reflective, and affective personality qualities) and aging well and explores the early antecedents of wisdom. In structural equation models with latent variables, the social environment of early adulthood has a significant positive influence on wisdom over 40 years later, whereas mature personality characteristics during the early years of life and the quality of one’s childhood exert no enduring effects. Wisdom in the later years has a positive effect on women’s life satisfaction, physical health, and the quality of their family relationships. Hence, wisdom appears to be an important predictor of aging well.
Physician-Patient Racial Matching, Effectiveness of Care, Use of Services, and Patient Satisfaction
Authors: Howard Daniel L. , Konrad Thomas R. , Stevens Catherine , Porter Carol Q.
Published: March 2007

The authors examined how racial matching between older patients and physicians relates to effectiveness of care, use of services, and satisfaction with care. In this cross-sectional, community-based cohort study, 2,867 elderly African American and White North Carolina residents with regular physicians were interviewed and screened for hypertension (HBP). African Americans were more likely than Whites to be told they had HBP, to receive HBP medication, and to take it regardless of their physician’s race. White elders with African American physicians were more likely to report that they delayed care quite often. African American elders were less likely to delay care quite often, regardless of their physicians’ race. These results did not support the position that African Americans require treatment by African American physicians to achieve better care. Although elders of both races who had African American physicians were less satisfied with care received, interpretation of this finding is difficult without better measurement of patient satisfaction.
Work and Retirement among the Elderly in Vietnam
Authors: Friedman Jed , Goodkind Daniel , Cuong Bui The , Anh Truong Si
Published: March 2007

This article examines patterns of work and retirement in Vietnam based on two recent surveys of the elderly. Vietnam provides a unique context for addressing elderly labor force participation due to its transition from a socialist to a market economy. As expected, elderly persons are less likely to be working to the extent that they are older or sick, although there is little variation by socioeconomic status. There are, however, distinct patterns of work stoppage across employment sectors (agricultural, state, and nonstate), due in part to the nature of work in these sectors. The data permit measurements across time, including job switches from one sector to another, or to retirement. Most notably, the data demonstrate the strong outflow of elderly employees from the state sector. We discuss explanations for these findings, paying particular attention to Vietnam’s recent history and social policies designed to facilitate the transition toward a market-based economy.
Public Pensions for Nonworking Wives
Authors: Holden Karen C.
Published: March 2007

One of the most controversial issues which must be solved by any national pension program insuring against earnings loss on retirement is if and how nonworking persons should be covered. In deciding to provide old-age income to nonworking wives, the United States and Japan have adopted different program options. OASI in the United States covers nonworking wives as noncontributing dependents of covered workers. The receipt and size of benefits are dependent on the behavior of the worker. Kokumin Nenkin in Japan allows contributions by nonworking wives, who are thus able to build up credits toward retirement income independent of marriage duration or the husband's work behavior. Both these approaches will result in the inequitable treatment of some covered groups. How completely nonworking women are protected against income loss in old age by national pension programs in the United States (OASI) and in Japan (Kosei Nenkin and Kokumin Nenkin) is examined. Also discussed are the inequities in the treatment of covered groups and of the beneficiary population generated by the particular method of nonworker coverage adopted, and policy modifications are suggested.
Feeling "Useless"
Authors: Mutran Elizabeth , Burke Peter J.
Published: March 2007

The purpose of this research is twofold: (1) to investigate a dimension of the self-concept which appears to be shared by both young and old adults, and (2) to develop a causal model analyzing both determinants and consequences of this identity. Using data from a national probability sample of 1,500 adults, the Burke-Tully (1977) procedure for measuring self-in-role (identity) indicates that on one dimension "old" persons have identities which, while different from middle-aged persons, are similar to young adults: they see themselves as less useful and less powerful than middle-age individuals. Independent variables in the causal analysis include age, education income, health, and marital and occupational statuses. In addition to showing that uselessness was experienced by both old and young, the results indicate that the sense of the self as useless is caused by feelings of loneliness for older people and by lack of labor force participation for younger persons. Poor health is also associated with the sense of self for older persons. These results are integrated with earlier work on age identity.
Social Integration, Health, and Choice
Authors: Harel Zev , Noelker Linda
Published: March 2007

This research examined the importance of social integration, compared with self-rated health and feelings about entry and residence in an institution, for the subjective well-being of aged in long-term care settings. Additionally, various measures of social integration were investigated and several appeared as more salient predictors of resident morale, life satisfaction, and satisfaction with treatment. These measures, which were directed to the nature rather than the quantity of social interaction, included being visited by a preferred family member or friend, receiving assistance from others, giving assistance to others, and participating in organized social activities.
A Cultural Analysis of the Grandmother
Authors: Johnson Colleen Leahy
Published: March 2007

This article analyzes the role of the contemporary American grandmother, exploring the meanings of the role for 58 grandmothers who are responding to the divorces of their children. Although the literature suggests that the grandparenting role is unpatterned and relatively normless, these respondents retain uniform conceptions of the traditional grandmother although they have been modified in congruence with their own middle-age norms. The role is primarily regulated by explicit proscriptive norms rather than by prescriptive norms that are vague and diffuse.
A Health Profile of Older Women with Comparisons to Older Men
Authors: Verbrugge Lois M.
Published: March 2007

This article discusses the physical health status of contemporary older women (aged 65 and over) in comparison to older men, using data from ongoing national health surveys and vital statistics. The article reviews older women's and men's life expectancy after 65 and recent trends in their mortality rates. It then looks extensively at data on physical health, especially the prevalence of chronic conditions and long-term disabilities. Leading ailments at different "stages" are discussed: health problems in daily life, the presence of chronic conditions (whether symptomatic or not), ambulatory care visits, hospital stays, and causes of death. The data show that older women are more frequently ill than older men, with both acute and chronic conditions, but that their problems are less life-threatening than men's. The article concludes with thoughts about the health of future older cohorts.
A Health Services Research Agenda for Geriatric Care
Authors: Pearlman Robert A. , Hedrick Susan C.
Published: March 2007

To facilitate efficient and effective modifications in the delivery of care to the elderly, an empirically based agenda was developed within the Veterans Administration to guide health services research. The agenda includes studying methods to augment providers' geriatric expertise, facilitate maximal independence for older persons, and identify effective strategies, target groups, and appropriate outcomes for long-term care.
Stability of Perceived Personal Control for Older Black and White Men
Authors: Pitcher Brian L. , Spykerman Bryan R. , Gazi-Tabatabaie Mahmood
Published: March 2007

The recent emergence of the life-span perspective in sociopsychological research has increased attention to the issue of stability versus change in adult personality and behavior. This study uses data on older men from the National Longitudinal Surveys and LISREL statistical procedures to investigate the structural invariance over time, the level stability, and normative stability of perceived personal control within subsamples of blacks and whites.
The Elderly Mobility Transition
Authors: Rogers Andrei
Published: March 2007

The redistribution of the elderly population in the United States is receiving increased attention as the sociodemographic consequences of the uneven geography of the aged are becoming more evident to state and local policymakers. Prospects for the future may be illuminated with the development of a conceptual framework for analyzing such redistribution processes. This article suggests that the notion of an Elderly Mobility Transition may be useful in such analyses, and it sets out three measures that could be used to depict the evolution of the transition: growth, concentration, and tempo.
Age, Interpersonal Attraction, and Social Interaction
Authors: Webb Lynne , Delaney Judith Jopling , Young Lorraine R.
Published: March 2007

This essay reviews over 40 extant research reports on attraction and aging. The review indicated that (a) perceived agreement in attitude tends to neutralize young adults' general perception of older adults as unattractive, (b) elders prefer to associate with middle-aged and older adults more than they desire to associate with younger adults, regardless of the relative physical attraction of the target individuals, and (c) elders' marital satisfaction appears to be related to perceived physical attractiveness of the husband, not the wife. The authors provide critique and analysis of the research methods employed in the reviewed studies. Avenues for further research are identified.
Seeing Gray: School Bond Issues and the Aging in Florida
Authors: Button James W. , Rosenbaum Walter A.
Published: March 2007

Conventional wisdom and previous studies strongly suggest that aging citizens oppose local school bond issues because the issues represent increased taxes without direct benefit to the aging. This article tests this assumption through an aggregate level analysis of voting in all Florida school bond referenda since 1969 (n = 56). Among the independent variables in the regression equations were three associated with the aging: percentage 65+, growth rate of population 65+, and an indicator of the degree of political organization among the aging in the election districts. Results showed that one or more characteristics of the aging population were significantly (statistically) and positively related to the percentage of "yes" votes, particularly for the years 1976-1988 and for summer referenda when more resident retirees are politically active. The study indicates that the presence of an organized, relatively affluent, and educated aging population can lead to increased support for local educational referenda.
Social Relations and the Self-Esteem of Older Persons
Authors: Lee Gary R. , Shehan Constance L.
Published: March 2007

This study employs survey data from a sample of persons 55 years of age and older to examine the antecedents of self-esteem. Hypotheses are derived from a theoretical orientation that hinges on the ability of the individual to terminate relations that might be productive of negative reflected appraisals. Consistent with hypotheses, friendship interaction is positively related to self-esteem, whereas kinship interaction is not. Marital satisfaction also affects self-esteem positively; among men, this effect is stronger for the retired than for the employed. Finally, never-married and nonemployed older women have lower self-esteem than other women have. Implications are drawn regarding the importance and role of self-esteem in theories of psychological well-being among older persons.
Perceptions of Respite Services as Predictors of Utilization
Authors: Kosloski Karl , Montgomery Rhonda J. V.
Published: March 2007

The purpose of this study was to investigate the factors that influence the extent to which family caregivers of Alzheimer's patients use publicly subsidized respite programs. A model linking caregivers' attitudes concerning the convenience, quality of care, and perceived usefulness of a particular respite program to levels of respite use is hypothesized and tested. One hundred fourteen caregivers throughout Michigan who were eligible for respite services under the auspices of the Michigan Model Respite Program and caring for a noninstitutionalized elder with Alzheimer's disease participated in the study. Controlling for functional limitations of the elder, health of the caregiver, use of other support services, perceptions concerning the usefulness of respite, and the convenience of respite use were found to have significant direct effects on the level of actual respite use. Perceptions of program convenience affected service use indirectly by influencing caregivers' perceptions of program usefulness.
Patients' Views of Family Involvement in Medical Care Decisions and Encounters
Authors: Prohaska Thomas R. , Glasser Michael
Published: March 2007

This study was designed to examine the role of the third person in the doctor-older patient-companion triad at three points in the medical care decision process of older patients: before the medical encounter, during the medical visit, and subsequent to the medical encounter. Older patients accompanied on the medical visit were compared with older patients who came alone regarding the roles and activities of family and others leading to the older patients' medical visit as well as immediate outcomes upon completion of the medical visit and short-term outcomes 2 months after the initial medical visit. Older patients accompanied to the medical visit also assessed roles and assistance provided by the third-person companion during the medical encounter. Older patients accompanied on the medical visit were usually accompanied by the same person across medical visits. The third person was likely to be a spouse and was viewed as an asset during and after the medical encounter. Older accompanied persons were more likely to have assistance both before and after the medical visit, although there were few differences between groups in terms of immediate and short-term outcomes. Findings suggest that the presence of the third person in the doctor-older patient medical encounter should be viewed as an opportunity for patient education and support for the companion who provides an ongoing role in care of the older patient.