bluuebunny/crossref_metadata_2025 huggingface dataset:
Adjusting Confidence Tests for Realism
Authors: Rippey Robert M. , Voytovich Anthony E.
Published: March 2007

Confidence tests were administered three times during a course in physical diagnosis. Conventional measures of knowledge and written case studies were examined in order to determine acceptability, reliability, and strength of association between confidence measures and other reflections of performance. Confidence testing wasfound to be acceptable, in fact, even enjoyable, to the students. Reliability was significantly improved and realism was stable across test halves and independent of knowledge, suggesting the presence of separate, measurable attributes in clinical thinking. Although statistical significance was not reached, confidence testing seemed qualitatively better atpredictingperformance on written case histories. Students, in general, improved their performance over the year in realism assessment. Educational implications and directionsforfuture research are discussed.
Evaluation of Continuing Education in the Health Professions
Authors: Abrahamson Stephen
Published: March 2007

In this article the author discusses three "levels" of the state of the art: the "ideal," for program evaluation; the " practical," with political limitations; and the "actual," for current practices. Starting with a review of the developmental stages of effectiveness variables (from attendance and "happiness" through professional performance and patient outcomes), the article updates a review by Lloyd and Abrahamson (1979) and then discusses current practices. Evaluation as a potential contamination factor leads into consideration of evaluation versus research. Finally a review of "lessons learned" over the last twenty years introduces a look ahead into exploitation of the state of the art.
Scores Based on Dangerous Responses to Multiple-Choice Items
Authors: Grosse Martin E.
Published: March 2007

Scores based on the number of correct answers were compared with scores based on dangerous responses to items in the same multiple-choice test. The dangerous options were identified by content experts as representing responses to items that could cause significant harm to a physician's patients. The results of the study showed evidence for construct validity of both sets of scores. However, the total test scores and the dangerous option scores were completely redundant measures when evaluated by a correlation coefficient, corrected for unreliability. Therefore, unless more reliable dangerous options scores can be developed from afuture test, and unless these scores can be shown not to be redundant with the total test scores, the total test scores must remain the preferred choice for evaluating certification candidates.
Using Routine Documentation of Medical Care to Observe Physician Behavior
Authors: Howland Jonathan , Meier Frederick A. , Barlow Peter B. , Landman Danielle
Published: March 2007

This observational study compared the utilization of pulmonary function tests (PFTs)for outpatients at community hospitals in New Hampshire in 1975 and 1980. It was hypothesized that if preliminary care physicians were shifting toward using PFTs for early detection of chronic obstructive airway disease (COAD), (1) an increase in the number of tests ordered, (2) a decrease in the mean age ofpatients tested, and (3) an increase in the mean lung functions (FEVJ/FVC)wouldbeobserved. Forhospitals providing datafor 1975 and 1980, (1) 85% showed an increase in the number of outpatient tests ordered (p = 0.002), (2) the mean age of outpatients tested decreased at 75% of the hospitals (p = 0.019), and (3) the mean FEVI/FVC increased at 67% of the hospitals (p = 0.014). The hypotheses thus confirmed, it is concluded that New Hampshire physicians are using PFTs for early detection of COAD.
Teaching Skill Improvement for Graduate Medical Trainees
Authors: Sheets Kent J. , Schwenk Thomas L.
Published: March 2007

The medical education literature concerned with the teaching role fulfilled by house officers was reviewed by the authors. Articles were presented in three categories: (1) studies of house officer effort, (2) perceptions of the house officer's teaching role, and (3) assessing and improving house officer teaching skills. House officers are involved in a large amount of teaching, greatly influence students, and fulfill a unique teaching role in medical education that is complementary to thefaculty teaching role. An agendafor research and development in the area of research teaching skills was proposed based on three broad research questions: (1) What types of teaching skills are most appropriate for residents? (2) How do faculty and student expectations of resident teaching influence resident teaching? (3) What type of intervention is most successful in improving resident teaching skills?
A Criterion-Referenced Examination of Physician Competence
Authors: Norcini John J. , Hancock E. William , Webster George D. , Grosso Louis J. , Shea Judy A.
Published: March 2007

Despite the growing popularity of performance tests, scores on such measures have rarely been interpreted from a criterionreferenced perspective. This paper describes a test of skill in reading electrocardiographs (ECGs). Using generalizability theory, the errors of measurement and standard setting were estimated both alone and together from a criterionreferenced perspective. Performance on this test was also compared with a measure of the quality of training plus the multiplechoice questions and patient-management problems used in a medical certifying examination. Generalizabilityanalysesproduced positive results for the standard setting procedure and the ECGs, both separately and together. The preliminary validity evidence for scores was encouraging. The criterion-referenced ECGs ranked groups of examinees as expected based on prior education and examination experience. The criterion-referenced ECGs also had modest correlations with traditional measures of physician competence.
Cost Differences between Hospice and Nonhospice Care
Authors: Brooks Charles H.
Published: March 2007

Although it has been postulated that hospice care savings are "biased" when costs are measured in terms of insurerpayments instead of provider charges, this claim has not been documented by research. This article examines cost differences between hospice and nonhospice care, first, by analyzing Medicare Part A payments and, second, by studying provider charges for services rendered to a population of 24 cancer patients during their last 24 weeks of life. The exploratory results of the study showed that although the cost savings derived from analyzing provider charges were about double those based on Medicare Part A payments, both approaches to the measurement of cost strongly indicated that hospice home care was less costly than nonhospice care. Further analysis showed that variations in the rates of Medicare reimbursement accounted for 22 to 42% of the differences in the derived cost savings between the two approaches to measuring cost, and that payments to hospitals played a major role in determining this outcome.
Evaluation of an Intervention for Staff in a Long-Term Care Facility Using a Retrospective Pretest Design
Authors: Hyman Ruth Bernstein
Published: March 2007

It has been previously established that human service workers often suffer from emotional exhaustion, which has been conceptualized by Maslach and Jackson as burnout. Burnout may be a particularly great risk in workers providing long-term geriatric care. The current study evaluated the effects of a series of three 3-hour sessions designed to address team building, communication skills, self-esteem, and stress management on a random sample of 51 of the 188 long-term care staff who participated. Using a retrospective pretest design, a statistically significant improvement from "then" to "today" was found for the three components of burnout: Depersonalization, Emotional Exhaustion, and Personal Accomplishment. Responses to an open-ended question about workshop effects corroborated the quantitative data, and effects noted were highly related to the defined objectives of the workshops.
Tobacco Control Activities of Primary Care Physicians in California
Authors: Crooks Catherine E. , Kenney Erin , Elder John P. , Levitz Michael D. , Johnson Michael , Bal Dileep G.
Published: March 2007

The primary purpose of this study was to ascertain tobacco control attitudes, practices, and level of involvement in tobacco activities funded by the California Tobacco Tax Initiative prior to and after implementation of statewide programs aimed at primary health care providers. In addition, the study compared the statewide results with a county where there has been widespread tobacco control activity aimed at health care providers. A 32-item questionnaire, developed to ascertain attitudes, practices, and policies related to tobacco contrml, was completed by 581 (35%) of the 1,680 statewide physicians contacted and 460 (31%) of the 1,500 county physicians contacted. Both cohorts who responded to the pretest questionnaire were resurveyed 1 year later Results of the two-way MANOVA revealed statistical significance on both main effects (county vs. state and pretest vs. post-test). Subsequent univariate F tests revealed statistically significant differences between groups on the set of variables measuring involvement in programs funded by Proposition 99. Results indicate that statewide tobacco control programs aimed at providers might be having an impact on physicians 'practices and level of involvement in tobacco programs.
Access to Health Care
Authors: Khan Abdullah A. , Bhardwaj Surinder M.
Published: March 2007

Despite some serious past efforts to clarify its multiple dimensions and meanings, access to health care has remained a rather elusive concept, hampering the work of health care policymakers and professionals as they endeavor to effect meaningful health care reform. This article provides perhaps the most detailed clarification of the access concept, especially the crucial linkages among the various access dimensions, and presents a comprehensive conceptual framework for evaluation and planning activities as they relate to people's access to health care services. The proposed conceptual model recognizes access as the outcome of a process involving the interplay between the characteristics of the health care service system and of potential users in a specified area, and moderated by health care related public policy and planning efforts. An elaborate typology of access, incorporating four pairs of access dimensions, is also derived. This atomization of the concept allows us to focus on specific aspects of the access to health care problem, and to develop precise outcome indicators of health system performance for evaluative purposes. Further, it enables the access concept and its pertinent dimensions to be put into proper perspective when assessing the health care access situation in a specific national or regional context. The relevance of the proposed access model and the typology to health care planning in general, and to spatial planning of health care service systems in particular; is also discussed.
Evaluating Physician Impact Analysis
Authors: Charles Cathy , Roberts Jacqueline
Published: March 2007

Physician impact analysis (PIA) is a planning tool intended to bring greater predictability to hospital medical staff resource planning by providing a means to predict the impact of a new or replacement physician's practice profile on a hospital's clinical program priorities, staffing resources, and costs. Two key methods advocated to undertake PIAs are the Department Survey Method and the Hospital Medical Records Institute Case-Mix Groups/Resource Intensity Weights Method developed by the Hospital Medical Records Institute. This article discusses issues related to the methods, results, and uses of PIA information in Ontario hospitals. Further evaluation of the PIA process is recommended to increase our understanding of both the strengths and limitations of this planning tool.
Peer Coachng in Clinical Teaching
Authors: Hekelman Francine P. , Flynn Stephen P. , Glover Pamela B. , Galazka Sim S. , Phillips J. Arch
Published: March 2007

Increasingly, medical education, and family medicine in particular, is focusing on improving clinical teaching. Peer coaching represents one alternative for improving and enhancing instruction. It enhances clinicians' understanding and use of new skills by demonstration, practice, and nonevaluativefeedback from their colleagues. This article introduces the idea of peer coaching as an approach to faculty development. It uses a l'/2-yearformative assessment of one family physician's teaching practices and beliefs to describe the process.
Effect of Audiovisual Enhancement on Problem-Solving and Decision-Making Activities During a Computerized Clinical Simulation Test (CSTtm) of Nursing Competence
Authors: Bersky Anna K.
Published: March 2007

The purpose of this study was to explore the effects of interactive audiovisual (AV) enhancement on examinee problem-solving and decision-making activities during a Computerized Clinical Simulation Test (CST) of nursing competence and to determine which activities were most affected by AV inclusion. Two forms of CST and a questionnaire requesting examinee opinions about CST were administered to two different groups. Findings suggest that no reliability was lost by a change in format. An analysis of the item difficulty calibrations under the different administration conditions revealed that some items (particularly data-gathering items) functioned differently when cases were presented in an AV format. Those exposed to an AVformat presentation took significantly longer to complete the AV-enhanced cases but committed significantly fewer risky and inappropriate actions. Examinees exposed to AV format reported feeling more involved with the patients and better able to identify patient problems.
Evaluating HIV Prevention Community Planning
Authors: Rogers Susan J. , Doino-Ingersoll Joann , Hayes-Cozier Ravinia , Weisfuse Isaac
Published: March 2007

To improve human immunodeficiency virus (HIV) prevention efforts nationwide, the Centers for Disease Control and Prevention (CDC) has funded HIV Prevention Community Planning, an initiative that promotes parity, representativeness, and inclusion of community and the application of scientific principles for decision making. This initiative was welcomed enthusiastically in New York City, an AIDS epicenter with limited prevention resources. In thefirst year of implementation, the New York City Department of Health (NYCDOH) supported a comprehensive evaluation of the planning initiative. This article reviews the evaluation design, including its process and outcome components, the study findings, and its strengths and limitations. It provides overall guidance for those who are assessing prevention planning in HIV as well as other health areas.
An Instrument for Measurement of Outcomes of Care for Schizophrenia
Authors: Cuffel Brian J. , Fischer Ellen P. , Owen Richard R. , Smith G. Richard
Published: March 2007

To advance effectiveness research in mental health, we need common, standardized, validated instruments that can be used easily in routine practice settings. The Schizophrenia Outcomes Module is a relatively brief, comprehensive instrumentfor monitoring and assessing the outcomes of treatment for schizophrenia in clinical care settings. The module was developed with the guidance of a multiinstitutional, multidisciplinary expert panel; the clinical and theoretical considerations that framed the expert panel's deliberations and determined the module's content and characteristics are described Initialfield testing of the instrument involved longitudinal observation of 100 individuals with schizophrenia over a 6-month period. To our knowledge, it is the only brief and easily administered instrument that encompasses the four major outcome domains defined by the National Institute of Mental Health's Plan for Research on the Severely Mentally Ill. As such, it is a promising toolfor effectiveness research in schizophrenia.
Primary Care Physicians and Barriers to Providing Care to Persons with HIV/AIDS
Authors: Shi Leiyu , Samuels Michael E. , Richter Donna L. , Stoskopf Carleen H. , Baker Samuel L. , Sy Francisco
Published: March 2007

Primary care physicians play an increasingly important role in the care of persons with HIVIAIDS due to the rising number and changing geographic distribution of persons infected with HIV/AIDS. The study explored the relationship between barriers to health services and the experience and willingness of primary care physicians to care for persons with HIV/AIDS. The study was based on a random survey of primary care physicians in South Carolina. The results indicate that although primary care physicians' willingness to treat persons with HIV/AIDS is significantly associated with many self-reported barriers (i.e., financial, structural, knowledge, and attitudinal), their HIV/AID care experience was most significantly correlated with self-reported knowledge that overrides financial and structural barriers. The results emphasize the importance of programs and policy initiatives aimed at enhancing the primary care physicians' knowledge level and improving their attitudes related to HIV/AIDS.
The Design of Evaluations for Continuous Quality Improvement
Authors: Colton David
Published: March 2007

Many health care organizations are modeling continuous quality improvement activities after designs used in business and industry. This has resulted in a somewhat standardized and possibly limited approach to conducting quality improvement activities. In contrast, the evaluation paradigm provides a broader approach because the design of an evaluation may be based on the questions to be examined, or the design may emerge during the process of conducting the evaluation. This article examines the design of evaluations usedforcontinuous quality improvement activities in health care and human service organizations. Through a case example, the benefits of using alternative evaluation designs are explored. In particular; use of alternative approaches to gather and evaluate information about restrictive treatment interventions in a mental health setting are presented.
Health-Related Quality of Life
Authors: Nanda Upasana , Andresen Elena M.
Published: March 2007

The importance of evaluating health care in terms of patients' quality of life has only recently been acknowledged in the context of outcomes research and the measurement of quality of care. Asa health professional, trying to choose the appropriate health status or health-related quality of life (HRQOL) measure can be daunting, as one is faced with a bewildering array of choices. The purpose of this article is to describe the process by which professionals might make a choice about measures in outcomes research. The article includes examples and rationale for using generic or disease-specific HRQOL measures. In addition, examples are provided of HRQOL assessment in two adult chronic disease applications: asthma and congestive heartfailure.
The Empowering Potential of Quality Improvement Data
Authors: Fitzgerald Matthew E. , Molinari Gaetano F. , Bausell R. Barker
Published: March 2007

Data are being used to redefine, transform, and empower the roles of providers, payers, and patients. The empowering potential of data on these three groups, and theirchanging roles are reviewed The use of data to transform care and increase equality is not new, yet the comprehensive application ofprinciples of continuous quality improvement to the delivery processes is just beginning. The approach to the quality improvement processes employed by peer review organizations includes idea capture, development of intuitively appealing quality indicators, formulating the intervention, formalizing the research architecture, and quantifying the impact of the interventions. The multifaceted interventions for improvement are discussed. Thefuture of medicine includes a greater use of data and the quantitative sciences to inspire improvement across the health care delivery continuum.
A Congestive Heart Failure Project with Measured Improvements in Care
Authors: Delong James F. , Allman Richard M. , Sherrill Robert G. , Schiesz Nadine
Published: March 2007

This project was designed to improve the in-hospital management ofMedicare beneficiaries with congestive heart failure (CHF). Eleven hospitals were studied using two indicators: (a) assessment of left ventricular (LV) function, and (b) use of angiotensin converting enzyme (ACE) inhibitors in patients with systolic dysfunction. Baseline performance rates were obtainedfor 990 cases with the Diagnosis Related Group (DRG) 127 for CHF discharged January 1994 to December 1994. Baseline data feedback presentations in 1995 spurred quality improvement plans with interventions such as physician education, critical care maps, and standing orders. Follow-up abstractions were performed on 612 discharges October 199S through April 1997. The study demonstrated 12% improvement (53% to65%, p <.01) inassessingLVfunction and 20% improvement (54% to 74%, p < .01) in appropriate ACE inhibitor use. Projects emphasizing Health Care Quality Improvement Program (HCQIP) principles can successfully affect health care management for the Medicare population.
Information, storytelling and attractions: TV journalism in three modes of communication
Authors: Ekström Mats
Published: March 2007

The competition for the attention of potential audiences, and the problem of audience appeal, has become an increasingly important aspect of TV journalism. The aim of this article is to present a conceptual framework for studies of TV journalism as communication; including different intentions, strategies applied to appeal to viewers, processes of production, bases for audience involvement, roles and relations. I differentiate three modes of communication: information, storytelling and attractions, and argue that this trichotomy is more fruitful and analytically developed, compared to other conceptualizations such as the dichotomy: information and entertainment. The article describes and conceptualizes the specific characteristics of information, storytelling and attractions; and presents empirical examples of TV journalism communicating within these modes of communication.
A new kind of newspaper? Understanding a popularization process
Authors: Eide Martin
Published: March 2007

A social history of a popularization process of major importance for a national press structure forms the basis of this article. Today's largest circulation newspaper in Norway is the case in point. Vardens Gang (now known under the acronym VG) grew out of the resistance movement during the Second World War, and set out with the ambition of being `a new kind of newspaper'. However, economic problems soon fuelled a popularization process, and gradually the ground was cleared for a sensational growth in circulation numbers. What happened to the original ideals, and to the new kind of newspaper? Answers are indicated by focusing on changes in the newspaper's modes of addressing its readers and their everyday roles, and by paying particular attention to a `service and campaign journalism' and to a certain kind of `newspaper schizophrenia'. On this basis, the author warns against a crude essentialism in the understanding of popular journalism.
Drugs and the media in the era of postmodernity: an archaeological analysis
Authors: Giulianotti Richard
Published: March 2007

This article addresses the vast heterogeneity of UK media reports on illicit drugs by applying Michel Foucault's archaeological methodology. Accordingly, the media reports are classified to reflect their connections within a discursive formation that is itself situated within the milieu of postmodernity. By using the binary oppositions of private-public and societal-subcultural as classificatory axes, the author identifies four categories of media statements on drugs, which possess particular discursive vantage points. The variations of statements within these categories are explored at length, as are their contradictions. The paper concludes by advancing Foucault's archaeology as a valuable contemporary methodology for understanding the nature of the moral and epistemological claims which discourses make.
Politics in the fine meshes: young citizens, power and media
Authors: Barnhurst Kevin G.
Published: March 2007

Surveys exposing an uninformed public, journalism emphasizing interpretations, and news focused on showmanship have combined to change public life. As young adults abandon news, what do they substitute to become informed citizens? Life history narratives offer some answers. Young citizens form their political identities within personal networks, responding first to fiction television in the family and with peers. Their stories take place in small jurisdictions — home, school, church — where through media they confront the state as a force empowered to risk life. Politics principally involves forming opinions. In that process, young adults refer to news among many other sources: pop songs, TV commercials, documentaries, personal discussions. Because they cannot escape the media surround, their sense of power corresponds not to democratic theory but to the ideas of Foucault and Nietzsche, where citizens use the media to design their own bodies as political outposts.
Doing it my way — broadcasting regulation in capitalist cultures: the case of `fairness' and `impartiality'
Authors: Harvey Sylvia
Published: March 2007

This article considers the suspension of the Fairness Doctrine in the USA and the legal instatement of the professional practice of impartiality in Britain as examples of two very different approaches to the regulation of broadcasting. These developments are located within the context of the shifts and changes of the post-Cold War period and are considered in terms of the highly differentiated unfolding of the bourgeois revolution in these two countries. It is also suggested that the practices of impartiality on the one hand, and of broadcaster advocacy or editorializing on the other, may be key factors for the outcome of a democratic process which seeks to identify the public interest and to foster the expression of public opinion.
French youth talk radio: the free market and free speech
Authors: Dauncey Hugh , Hare Geoff
Published: March 2007

French talk radio emerged in the mid-1990s as a form of programming which challenged accepted practices of French radio, especially when catering for youthful audiences who were attracted to cult radio programmes whose star presenters vied with each other to increase audience ratings. French youth talk radio has come into conflict with regulators over good taste and quality in programming, creating a wider debate over issues of censorship, culture and political correctness. This article analyses French youth talk radio through a number of scandals involving the radio stations Skyrock and Fun Radio, whose programmes elicited sanctions from the French regulatory body the Conseil supérieur de l'audiovisuel.
Religious Activity, Alcohol Use, and Depression in a Sample of Elderly Baptists
Authors: Musick Marc A. , Blazer Dana G. , Hays Judith C.
Published: March 2007

Recent research has shown the beneficial effects of religious activity for individual health and well-being among older adults. The purpose of this article is to determine whether breaking the norms of the religious group can have deleterious consequences for individual mental health and whether this effect is exacerbated by frequent service attendance. To test these ideas, the authors used two waves of data collected from a sample of older adults (age 65 and over) living in central North Carolina. Using only sample members who reported an affiliation with a Baptist denomination, the authors tested whether attending services more often and living in rural areas were associated with a smaller likelihood of alcohol use. The authors further tested whether the use of alcohol in this sample was associated with higher counts of depressive symptoms. The results indicate that older Baptists who lived in rural areas and who attended services more often were less likely to use alcohol. It was also found that alcohol use had no effect on depressive symptoms. One exception to this latter finding was that among rural Baptists who rarely attended religious services, using alcohol was associated with more depressive symptoms.
Kinship Ties and Solitary Living among Unmarried Elderly Women in Chile and Mexico
Authors: de Vos Susan
Published: March 2007

Using census microdata, the article describes living arrangements among unmarried elderly women in Chile and Mexico around 1990, two rather different Latin American countries. In both countries, most unmarried elderly women lived with kin. Even those without children still usually lived with relatives, often nephews, nieces, or siblings. Elderly women who never married nor had any children had a higher likelihood of co-residence than counterparts who never married but did have children or who married but did not have children. Residence with relatives may well decline notably in Chile and Mexico in the next 25 to 50 years among unmarried elderly people. That certainly has been the case in more developed countries. The question could become how to retain valuable kin ties while respecting increased autonomy.
Age, Education, and the Sense of Control
Authors: Schieman Scott
Published: March 2007

Recent U.S. surveys indicate that older people report a lower sense of control. Moreover, education and impairment explain some of that association. What explains the rest? The author proposes that education, marital and employment statuses, health, financial satisfaction, and religious involvement influence the age differences in control. Using data from a 1996 sample of 1,421 U.S. residents, the author documents an inverted U-shaped association between age and control. Lower education and higher rates of widowhood and retirement account for about 67 percent of older adults’ lower control. Greater financial satisfaction and religious involvement suppresses part of that effect. Similarly, education, marital status, and employment status explain about 54 percent of the linear age effect. Were it not for lower financial satisfaction and declining self-reported health during young and middle adulthood, the age effect would be even stronger. Results support the Cumulative Advantage hypothesis: Education buffers against erosion in control during the later years.
Informal Groups and the Elderly
Authors: Wagner Donna L. , Keast Frederick
Published: March 2007

The function of the contemporary family has been of interest to researchers since the advent of the nuclear family structure. Likewise researchers have been exploring the role of other informal group sectors such as friends and neighbors. This article examines one such function, mediation between elderly individuals and bureaucratic organizations. Findings suggest that the elderly are not relying on informal group members to negotiate bureaucratic structures, and questions regarding the theoretical and research implications are discussed.
The Ideal Residential Area
Authors: Carp Frances M. , Carp Abraham
Published: March 2007

This article reports two studies of the "ideal" residential environment, the first of which analyzes responses of a large sample of residents of the San Francisco Bay Area, aged 25 and older, regarding how important each of 15 environmental characteristics would be to them if they were to consider moving, and assesses relative importance for the group in general, as well as correlations with age. The second uses an extended question-and-response format to determine how 90 women, aged 60 and older, living alone, would describe the ideal environmental situation with regard to facilities and services within walking distance of their homes and within their own blocks. The response options of inclusion, exclusion, irrelevance, or no opinion clarified the negative-concomitant aspects of proximity, complementing previous research on proximity and utilization.
Analyzing Panel Data in Studies of Aging
Authors: Campbell Richard T. , Mutran Elizabeth
Published: March 2007

The LISREL model, recently developed by Jöreskog and his colleagues, is of great importance to students of aging and human development. Essentially, LISREL unites factor analysis and structural equation modeling. It is extremely general, permitting a wide variety of nonrecursive structural equation models while also permitting complex models involving measurement error. Thus, LISREL speaks to the psychometric concerns of those who measure the same variable over time and to the modeling concerns of those who wish to allow for lagged effects, feedback loops, and the like. This article describes the LISREL model in nontechnical terms, points the reader to the more technical literature, and provides an extended example of a three-wave, two-variable model, with and without additional exegenous and endogenous variables. The example shows how causal effects can be estimated and how these estimates are affected by assumptions regarding measurement error.
The Elderly Respondent
Authors: Gibson Diane M. , Aitkenhead Wendy
Published: March 2007

This article examines the particular advantages and disadvantages associated with interviewing older people. Expected problems included those relating to the physical and mental health status of the elderly, repondent fatigue, the acceptability of particular questions, and the suitability of certain formats. Overall, physical and mental frailty and respondent fatique led to few interviewing difficulties. Elderly respondents were found to be somewhat reticent on traditionally "difficult" questions such as income, but no particular problems were encountered with potentially emotional or threatening topics. The main advantages were those associated with high levels of cooperation and interest and few limitations on the time available to respondents to complete the interview.
Anthropological "Community" Studies in Aging Research
Authors: Eckert J. Kevin
Published: March 2007

This article focuses on the application of the community case study approach in gerontological research. It presents the systematic, developmental process of this approach, as developed by the author during the conduct of an eight-year longitudinal case study of older hotel dwellers.
The Hospice Ideology and Success of Hospice Care
Authors: Bass David M.
Published: March 2007

Hospice is a concept of terminal care based on an ideology that specifies a particular way for patients and families to deal with death and dying. This article describes this ideology and attempts to assess its success for hospice patients. Findings show that hospice care is more successful for patients who are more aware of their terminal status, who are older, and who have a primary caregiver who experiences fewer difficulties with the caregiver role.
Measuring Intergenerational Family Relations
Authors: Mangen David J.
Published: March 2007

Conceptual and empirical issues involved in the measurement of intergenerational relations constitute a significant challenge for aging research. This manuscript reviews several of these issues, including: (1) levels of analysis, (2) conceptualization, and (3) empirical assessment of measurement adequacy, with special attention to issues of correlated measurement error. Suggestions for addressing these issues are provided, with illustrations drawn from the Southern California Study of Three Generations.
Evaluation Research in Long-Term Care
Authors: Wan Thomas T.H.
Published: March 2007

Several policy issues pertaining to long-term care (LTC) were assessed, and they include (1) What are the cost-effective alternatives in long-term care? (2) What are the major societal and individual factors that are amenable to program interventions for reducing unnecessary and inappropriate institutionalization of the chronically ill? (3) What are the critical elements of a successful evaluation research design in long-term care? (4) How can LTC research findings be transmitted into policy relevant guides for program planning and development? The strengths and weaknesses of a variety of evaluation designs in long-term care research were discussed.
Homesharing and Congregate Housing
Authors: Muller Charlotte
Published: March 2007

Activities of states to develop alternative living arrangements for the elderly to avert expensive institutionalization and improve conditions of the community-dwelling elderly have become numerous. Both housemate matching programs and congregate housing have been supported as federal construction for the low-income elderly has waned. The varied initiatives of the most active states are reviewed. But the pace of development has been uncertain because of problems of generating demand, financial limitations, and targeting.
The Economic Impact of Elderly Winter Residents in the Phoenix Area
Authors: Happel Stephen K. , Hogan Timothy D. , Pflanz Elmer
Published: March 2007

This article adds to the emerging literature on the seasonal migration of the elderly by considering the economic benefits and costs to a large receiving area. Estimates of the number of "snowbird" households are derived from an annual mobile home and travel trailer park census and a local savings company sample. These estimates are then combined with individual park resident survey results to generate expenditure totals for park snowbirds and all snowbirds during the 1986-1987 season. Conflicts between permanent and seasonal residents are considered after expenditure totals are derived, and the article concludes with views about future research needs.
Trends in Elderly Criminal Victimization from 1973 to 1984
Authors: Covey Herbert C. , Menard Scott
Published: March 2007

Trends in elderly victimization are analyzed for the years 1973-1984. Criminal victimization rates are declining for all types of crime, including those committed against the elderly. The elderly experienced greater declines over time than the general population. Crimes involving a combination of personal contact and economic motivation declined faster than other crimes committed against the elderly. It is possible that the observed declines may be attributable more to changes in the demographic structure of the American population than to public policy.
Remarriage of Older Canadians
Authors: Burch Thomas K.
Published: March 2007

The remarriage experience of Canadian men and women aged 55 and over at time of survey are described using data from the Canadian Family History Survey, carried out in 1984 by Statistics Canada. Data pertain to approximately 1,300 women and 1,100 men. Remarriage is put in the context of total life cycle experience by means of a simple decomposition of the lifetime probability of remarriage. The analysis highlights the greater exposure of women to remarriage (due to high rates of widowhood) but their lower remarriage rates compared to men. The sex differential in remarriage remains when age at dissolution is controlled. A major regional differential is found in remarriage patterns in Canada, with residents of Quebec showing appreciably lower remarriage rates following divorce than the rest of the country. An interpretation of the observed patterns suggests the need for more attention to motivation in the study of remarriage behavior.
The Nature and Functions of Dating in Later Life
Authors: Bulcroft Richard A. , Bulcroft Kris A.
Published: March 2007

Using the National Survey of Families and Households, logistic regression analyses were conducted to identify factors that are significant predictors of dating for persons aged 60 years and older. Stepwise regressions were also conducted to determine the effects of dating on the psychological well-being of older daters. The strongest predictor of the propensity to date in later life is gender, with men significantly more likely to engage in dating. A number of gender differences were noted as they relate to the likelihood of dating. In particular, age and social role involvement tend to influence older men's likelihood of dating, while health and mobility were significantly associated with dating among older women.
The Prevalence of Elder Care Responsibilities among the Work Force Population
Authors: Gorey Kevin M. , Rice Robert W. , Brice Gary C.
Published: March 2007

This review synthesizes the findings of 17 independent studies dealing with the prevalence of elder care responsibilities among the work force population. Across-study, summative findings were: (a) approximately one fifth (M = 21.1%) to one quarter (Md = 23.1%) of employees provide care for an elderly dependent; primary study findings varied by a factor of nearly 25, ranging from a high estimate of 46.0% to a low of 1.9%; (b) the average response rate was fairly low (M = 45.0% and Md = 41. 1%), indicating that the studies captured only slightly more than one third, but less than half of all eligible in-sample assignments; (c) the correlation of prevalence and response rates was found to be r = -.69, p < .01; (d) the partial correlation of prevalence with response rate, adjusted for the breadth of the elder care operational definition, remained significant, r = -.50, p < .05; and (e) these two methodological characteristics together accounted for half (R2 = .505) of the variability in reported prevalence, response rate accounting for nearly all (95.4%) of this explained criterion variation. Bias due to nonresponse thus represents a potent threat to the validity of the mean prevalence estimate found in this body of research (21.1%). The implementation of statistical controls for nonresponse and definitional inconsistencies resulted in an estimated prevalence of 7.4% to 11.8%; however, this review outcome is tentative at best and must be tested with future, better controlled primary studies.
The Gender of Poverty in an Aging Population
Authors: Hardy Melissa A. , Hazelrigg Lawrence E.
Published: March 2007

Recent studies have documented an increasing feminization of poverty, especially among households with children and among elderly households. Because those studies have been based mainly on aggregate data, they do not provide a clear picture of the conditions of gender differences in the risk of poverty. Using individual-level data from a 1986 survey of Florida's resident population aged 55 and older, the authors analyze the gender differential relative to several correlates of poverty-for example, race/ethnicity, education, income sources, and living arrangements. In addition to specifying conditions under which older women have faced greatest risks of poverty, the analyses provide an estimate of the extent to which poverty is gendered in later stages of the life course, net of other "determinants" or correlates of poverty.
Representations of Caregiving by Margaret Forster; Mary Gordon, and Doris Lessing
Authors: Abel Emily K.
Published: March 2007

This article examines three novels in order to provide a new perspective on traditional gerontological studies of caregiving and the public policies they generate. All three novels challenge the model of caregivers as rational calculators and the fixed, static notion of caregiving that underlies cross-sectional research. The novels also highlight the importance of paying greater attention to the particularities of individual experience.
Sampling in Qualitative Research
Authors: Luborsky Mark R. , Rubinstein Robert L.
Published: March 2007

In gerontology the most recognized and elaborate discourse about sampling is generally thought to be in quantitative research associated with survey research and medical research. But sampling has long been a central concern in the social and humanistic inquiry, albeit in a different guise suited to the different goals. There is a need for more explicit discussion of qualitative sampling issues. This article will outline the guiding principles and rationales, features, and practices of sampling in qualitative research. It then describes common questions about sampling in qualitative research. In conclusion it proposes the concept of qualitative clarity as a set of principles (analogous to statistical power) to guide assessments of qualitative sampling in a particular study or proposal.
Older Persons 'Medical Encounters and their Outcomes
Authors: Beisecker Analee E.
Published: March 2007

This article reviews research on older patients and their doctors, with particular attention to the medical encounter between an elderly patient and his or her physician. Major categories of variables affecting the medical encounter include provider and patient characteristics (age, gender, ethnicity, education, values) and the context or setting of the encounter (site, presence of a patient's companion, and whether the visit is an initial one for the physician-patient pair). The process and content of medical encounters are affected by participant characteristics and context variables, and these in turn affect outcome variables such as participant satisfaction, adherence to treatment regimens, and medical outcome. Process issues include transfer of information, medical decision making, and interpersonal relations. Methodological issues are discussed, including problems with theory generation, lack of standardized methodology, gaps in research knowledge, and prior emphasis on descriptive studies as opposed to testing of interventions to improve elderly patient-physician communication.
Beyond the Dichotomy
Authors: Grant Leslie A.
Published: March 2007

Unit-level data describing dementia care attributes in 390 units in 123 Minnesota nursing facilities were used in a two-stage analytic procedure (1) to derive a typology of unit clusters and (2) to describe similarities and differences across unit clusters in terms of dementia care attributes and other unit characteristics not used to derive the typology. Nursing units were classified with combinations of environmental, programmatic, and staff attributes into six unit clusters. Most special care units (SCUs) were in a single unit cluster (dementia units) with the most dementia care attributes and serving mostly residents with dementia. Two unit clusters (small custodial units and rehabilitation units) were composed exclusively of non-SCUs, whereas remaining unit clusters (conventional units, large undifferentiated units, and heavy care units) consisted predominantly of non-SCUs with roughly equal proportions of residents with and without dementia. The typology offers a potentially useful way of classifying dementia care in nursing homes.
Transformation of International Relations—between Change and Continuity: Introduction
Authors: Sindjoun Luc
Published: March 2007

International relations, as every other scientific discipline, tries to be autonomous; however, that depends on its relationship with time and space. The current situation characterized by post-cold war and globalization realities constitutes an opportunity for the heuristic reinvention of international relations (IR). The reformulation of IR is neither a rejection of the old, nor a worship of the new; it is a reflection of the dynamics affecting international relations through both process and relational analyses.
Changing Power Cycles and Foreign Policy Role-power Realignments: Asia, Europe, and North America
Authors: Lahneman William J.
Published: March 2007

By documenting types of foreign policy role empirically, a calculus is presented for ascertaining the nature of power-role gaps (misalignment) in contemporary world politics. As states rise or decline on their power cycles, power-role gaps emerge because of an inherent inertia in adjusting roles and responsibilities. Such gaps often remain a non-issue until squeezed to the surface of statecraft at critical points where expectations regarding future security change massively and abruptly. Power cycle theory requires mitigation of role-power gaps before they intensify (power-role equilibrium) as part of a broader conception of “dynamic equilibrium” to ensure security amidst structural change.