bluuebunny/crossref_metadata_2025 huggingface dataset:
Locating Genetic Knowledge: Picturing Marfan Syndrome and Its Traveling Constituencies
Authors: Heath Deborah
Published: March 2007

This article draws attention to the production and circulation of genetic knowledge among three constituencies—laboratory researchers, clinicians, and health advocates— all of whom have a stake in research on a heritable connective tissue condition known as Marfan syndrome. National and international conferences provide a context that brings members of these groups together. Such meetings are performance settings, which include the display of visual images depicting various aspects of Marfan syndrome and of the bodies and lived experience of those who have it. The article examines how these images are interpreted, appropriated, and exchanged and how their circulation is both grounded in local knowledge and the grounds for transformative translocal practice.
Utilization of Behavioral Knowledge From Short-Term Workshops
Authors: Marr John N. , Greenwood Reed
Published: March 2007

Workshops on new methods in the health professions have often been evaluated for participant reaction and understanding of the material. But behavior change on the job following workshops has seldom been assessed. Rehabilitation professionals in seven states were survered to determine use of behavior management procedures after three-day training workshops. Those trained within the previous 15 months reported more frequent use of specific procedures than those trained 16 to 30 months before the survey. Positive verhal reinforcement for appropriate behaviors and for behaviors incompatible with inappropriate behaviors were the specific procedures used most frequently by respondents. Group token economies were more frequently used by trainees who worked with homogeneous client populations than those who had clients with different types of disabilities. The need for consultants and additional training were the most frequently cited reasons for not using procedures more frequently.
Evaluations of Patient Education Programs
Authors: Posavac Emil J.
Published: March 2007

A literature search located 23 evaluations of patient education programs that utilized a randomly selected control group (i.e., an experimental design) or a non- equivalent control group (i.e., a quast experimental design). Meta-analysis pro cedures were used to combine the findings of these studies The effect size for each of 102 dependent variables was derived from the mean of an experimental group and the mean and standard deviation of an untaught control group. The effect size is a z-score that can be converted into the mean percentile rank of taught pattents relative to the untaught controls The mean effect size for all studies was .74, which is equivalent to improving the average taught patient from the fiftieth to the seventy-seventh percentile relative to the untaught patient group Suggestions for improving the usefulness of patient education research design and report content are discussed
House Staff Knowledge of Blood Component Therapy
Authors: Kasprisin Duke O. , Kasprisin Lorraine
Published: March 2007

It has been documented that most transfusion errors are either administrative or clerical. It is necessary to ascertain if those responsible for transfusing patients have the knowledge to do it properly. Since house staff are responsible for the proper administration of blood components at many teaching hospitals, a group of pediatric Interns and residents were given a short examination to measure their knowledge of transfusion practices and to iden trfy when, during their training, this knowledge is obtained. Transfusion techniques, inspection of blood bag labels, compatibility, and transfusion reactions were covered in the exam. It was found that the knowledge of transrusion therapy is learned by experience and that many house staff members have an adequate knowledge of present-day transfusion practices.
A Simulation Method Measuring Psychomotor Nursing Skills
Authors: McBride Helena , Littlefield John , Garman Russell E.
Published: March 2007

A simulated clinical setting was developed to measure proficiency in performing 18 psychomotor nursing skills in an under graduate baccalaureate program. Criterion-refereneed checklists were developed and dependability coefficients based upon generalizability theory are reported. The resulting scores are moderately dependable for making decisions regarding individual mastery of psychomotor nursing skills at the 70%proficiency level. A relatively large Applicant x Skill interaction implies that proficiency on one skill is not highly related to performance on another skill; therefore, the skills selected for testing must be carefully chosen to be representative of the total domain of skills.
Economic Evaluation Methods and Health Policy
Authors: Stoddart Greg L.
Published: March 2007

Economic evaluation of health services may take many forms, depending on the range of costs and consequences included in the analysis and the methods employed to measure and value them. In order to clarify the sometimes confusing array of economic analyses for users and evaluations, an analytic overview of costs and consequences to be considered for inclusion in such evaluations is presented. This allows the techniques of cost-effectiveness, cost-benefit, and cost utility analysis to be differentiated. Two often neglected methodologic issues are also discussed. First, it is suggested that the significance of the analytic viewpoint for economic evaluations should not be underestimated. Second, it is recognized that economic evaluations that demonstrate cost savings from a program or policy change implicitly assume that resources can be removed from the health sector. In fact, this is seldom true, consequently strategies for incorporating this knowledge into evaluations are discussed.
Scoring Multiple True/False Tests
Authors: Gross Leon J.
Published: March 2007

A chievement tests in the health professions that utilize the multiple true-false (MTF) format apply variousformula scoring techniques to minimize the probability of inflated scores that result from guessing and the accompans'ing side effects of reduced score variability and attenuated discrimination between examinees. Despite the 50%i probability of a correctly guessed response, this article suggests that an MTF examination should provide sufficient score variabilit i'for adequate discrimination without formula scoring. Furthermore, since formula scoring may introduce factors that lower test validity, the scoring system advocated here is to direct examinees to respond to each item, with their scores based simply on the number of correct responses.
Assessment of the Clinical Quality of Health Care
Authors: Ryge Gunnar , Devincenzi Ronald G.
Published: March 2007

Rating systems and criteria, developedfor peer review, were used for evaluation of dental care as part of a study to determine the feasibility of using computers as a first level screening mechanism for quality assurance. Ten dentists were trained and standardized in the use of the system, and 646 patients receivedfull-mouth examinations by two examiners. Disagreements were resolved by joint examination. More than 22,000 individual judgments were recorded. Of all dental services evaluated, 91.5% were rated satisfactory. Data on subratings, Range of Excellence versus Range of Acceptability and Replace for Prevention (future damage likely) versus Replace Statim (damage now occurring) are also presented, together with interexaminer agreement levels. The rating system permitted full-mouth examination by two trained examiners, including resolution of disagreements, to be carried out in an average of 24 minutes. The system is suitablefor verification of computer screening of treatment records for quality assurance.
Setting Program Standards for New York State's Periodic Medical Review
Authors: Hannan Edward L.
Published: March 2007

This article describes the methodology used to develop program standardsfor a new periodic medical review/independent professional review (PMR/IPR) in New York State nursing homes. The new program consists of two stages: a first, cursory stage for the purpose of identifying patients to be subjected to a more thorough process review in the second stage. Program standards consist of(1) norms for the percentage of patients failing Stage I before a second stage is undertaken in a nursing home and (2) norms for the percentage of patients failing the second stage before the home is subject to corrective action. The actual standards that were developed are also presented.
Primary Medical Care and Health Outcome
Authors: Smith William G. , Buesching Don
Published: March 2007

In order to examine the relationship between primary medical care and health outcome, a systematic sample of 485 persons in a typical metropolitan Midwest county was surveyed. Primary care was defined in functional terms including concepts of ready access, continuity over time, comprehensiveness, coordination, and personalized care. Health outcome encompassed self-reported health status, disability, patient satisfaction, and medical costs. Persons who had high levels of primary care tended to have more chronic medical problems and saw physicians more frequently, especially their own principal physician. They clearly were more satisfied with their medical care, but incurred higher medical costs. They did not differ from persons with a low level of primary care in current health status or disability. It was not possible to demonstrate that quality primary care led to better health outcome except on the parameter of patient satisfaction.
Behavioral Approaches in Increasing Blood Donations
Authors: Jason Leonard A. , Jackson Karen , Obradovic Joyce L.
Published: March 2007

In the United States, as well as other countries, there is a constant and pressing need for increasing the number of people who donate blood. Medical procedures require donated blood, and when shortages occur in different regions, the lives of numerous patients are endangered. Behavioral strategies, which include use of incentives, competition, and raffles, and the like, might be effective methodsfor motivating individuals to donate blood. This study examined the use of a variety of these types of strategies used by workers at United Blood Services. Organizations that had employed behavioral strategies were compared with other organizations that had not used these approaches. Significantly higher rates of donations were obtained in organizations that had used behavioral strategies. The implications of these findings are discussed.
Confidence in Pass/Fail Decisions for Computer Adaptive and Paper and Pencil Examinations
Authors: Bergstrom Betity A. , Lunz Mary E.
Published: March 2007

The purpose of this study is to compare the level of confidence in pass/fail decisions obtained with computer adaptive tests and pencil and paper tests. Examinees took a variablelength computer adaptive test and two fixedlength pencil and paper tests. The computer adaptive test was stopped when the examinee ability estimate was either 1.3 times the standard error of measurement above or below the pass/fail point (one-tailed 90% confidence interval) or when a maximum test length was reached. Results show that greater confidence in the accuracy of the pass/fail decisions is obtained for more examinees when the computer adaptive test implements a 90% confidence stopping rule than with paper and pencil tests of comparable test length.
Assessment of Uniqueness of Information Provided by Postencounter Written Scores on Standardized-Patient Examinations
Authors: Colliver Jerry A. , Travis Terry A. , Robbs Randall S. , Vu Nu V. , Marcy Michelle L. , Barrows Howard S.
Published: March 2007

The complete clinical encounter station uses two testing methods in the assessment of clinical competence: checklists completed by standardized patients (SPs) who record actions students performed on history and physical examination and written responses by students to a series of written questions designed to elicit findings they see as pertinent to the problem, their working hypotheses, their plans for laboratory findings, and their diagnoses and management plans. Given that the critical part of any SP station is the standardizedpatient encounter and that the postencounter session needed for the student to answer the written questions increases the time required to administer an already lengthy examination, questions have been raised about the need for written questions in addition to SP checklists in the clinical encounter station. Thus it is important to determine if the written scores are providing additional, nonredundant information over and above that provided by the checklist scores. The results of this study showed only moderate overlap between the checklist and written scores. The mean checklist-written correlation across 83 SP cases was .13, and the mean correlation between the average checklist and written scores across six classes of medical students was .32. The mean of the correlations across the six classes, disattenuated for measurement error, was only .57. The results provide strong evidence that the written scores provide unique information, in addition to that provided by checklist scores.
Surgery Resident Selection and Evaluation
Authors: Edwards Janine C. , Currie Marianne L. , Wade Terence P. , Kaminski Donald L.
Published: March 2007

This article reports a study of the process of selecting and evaluating general surgery residents. In personnel psychology terms, a job analysis of general surgery was conducted using the Critical Incident Technique (CIT). The researchers collected 235 critical incidents through structured interviews with 10 general surgery faculty members andfour senior residents. The researchers then directed the surgeons in a two-step process of sorting the incidents into categories and naming the categories. The final essential categories of behavior to define surgical competence were derived through discussion among the surgeons until a consensus was formed. Those categories are knowledge/self-education, clinical performance, diagnostic skills, surgical skills, communication skills, reliability, integrity, compassion, organization skills, motivation, emotional control, and personal appearance. These categories were then used to develop an interview evaluation form for selection purposes and a performance evaluation form to be used throughout residency training. Thus a continuum of evaluation was established. The categories and critical incidents were also used to structure the interview process, which has demonstrated increased interview validity and reliability in many other studies. A handbook for structuring the interviews faculty members conduct with applicants was written, and an interview training session was held with the faculty. The process of implementation of the structured selection interviews is being documented currently through qualitative research.
Development of a Measure of Attitude toward Pulmonary Disease Prevention
Authors: Mcgaghie William C. , Boehlecke Brian , Devellis Brenda M. , Contreras Alfonso , Becker Megan
Published: March 2007

This developmental study aimed to produce a measure of attitude toward pulmonary disease prevention that yields reliable data from health professionals and students. Systematic scale development procedures, reliability analyses on three samples of 2,852 medical students, and factor analysis were used to develop and refine the attitude scale. Internal consistency (a = .83) and test-retest (r = .57) reliabilities are high. These and otheranalyses indicate that the scale is unidimensional. The resulting Pulmonary Disease Prevention Survey (PDPS) holds promise in educational and health services research as an outcome measure or as a mediating variable that may correlate with preventive behavior
Guidelines for using Standardized Outcome Measures Following Addictions Treatment
Authors: Graham Kathryn
Published: March 2007

Increasingly, program managers are incorporating existing standardized tests as part of outcome evaluation. This article identifies guidelines for selecting and using standardized measuresfollowing addictions treatment. The principles identified in this context, however, are not only applicable to addictions treatment evaluation but also to the use of standardized measures in outcome evaluation of health programs generally. These guidelines cover eight basic criteria for selecting outcome measures: validity, sensitivity to measuring change, suitabilityfor type of clients in the program, acceptability, clinical usefulness, ease of administration, scoring, and low cost. The article also discusses uses of outcome data, comparison of monitoring client outcomes to other forms of evaluation, and some practical issues related to using standardized outcome measures, including selecting what to measure and interpreting results.
The Interpersonal Relationship in Clinical Practice
Authors: Simmons Julia , Roberge Len , Kendrick S. Bryant , Richards Boyd
Published: March 2007

The biomedical model that has long been central to medical practice is gradually being expanded to a broader biopsychosocial model. Relationship-building skills commensurate with the new paradigm need to be understood by educators and taught to medical practitioners. The person-centered, or humanistic, model of psychologist Carl Rogers provides a theoretical approachfor the development of effective biopsychosocial relationships. The Barrett-Lennard Relationship Inventory (BLRI) was developed in 1962 as an assessment instrument for the person-centered model. In this article, the person-centered model and the use of the BLRI as an assessment instrument of this model are discussed. Current and potential uses of the BLRI are explored.
Assessing the Effectiveness of Mental Health Care in Routine Clinical Practice
Authors: Smith G. Richard , Rost Kathryn M. , Fischer Ellen P. , Burnam M. Audrey , Burns Barbara J.
Published: March 2007

The health care delivery systemfaces continually increasing pressure to be accountable for the historically unparalleled amount of resources it utilizes. This article discusses one set of recently developed tools known as outcomes modules that are used to assess how treatment affects outcomes in patients with a given disorder These tools currently are being used to inform administrative decisions about how to improve the quality of care, and can potentially influence decisions by patients, providers, and payers of care as well. The critical components of outcomes modules, as well as their administration and applications are described, using modules for psychiatric conditions as examples.
Cooperative Cardiovascular Project (CCP) Quality Improvement in Maine, New Hampshire, and Vermont
Authors: Ramunno Lawrence D. , Dodds T. Andrew , Traven Neal D.
Published: March 2007

The Cooperative Cardiovascular Project (CCP) is a nationwide quality improvement project (quality indicator measurement, feedback, remeasurement) in Medicare acute myocardial infarction (AMI) patients sponsored by the Health Care Financing Administration (HCFA). In Maine, New Hampshire, and Vermont, 3,472 baseline records were abstracted from 76 hospitals from January 1994 to February 1995. After feedback, 2,270 remeasurements were collected from October 1996 to May 1997. At remeasurement, performance improved significantly for "ideal" candidates (defined by the CCP) on five quality indicators-aspirin during hospitalization 88% to 93% (p < .001), thrombolytic timing 60% to 69% (p <.01), discharge aspirin 83% to 90% (p < .001), discharge beta-blockers 69% to 82% (p < .01), and calcium channel blocker avoidance 83% to 93% (p < .05). Reperfusion, angiotensin converting enzyme inhibitors, and smoking cessation advice did not improve significantly. This study demonstrates that evidence-based indicators, nationally designed data collection, and locally based interventions can significantly improve AMI care.
Election night
Authors: Marriott Stephanie
Published: March 2007

This article discusses live two-way interviews between television presenters in the studio and programme participants at outside broadcast locations. It concerns itself in particular with the relationship between the television event and the event-in-itself, outlining the way in which one programme, Election 97, brings spatially dispersed individuals and places together in a dialectical relationship and suggesting that the television event in such instances is generated not by the reconstruction of events at some discrete remote location but rather via the penetration of a multiplicity of remote sites into one another in the live space of the broadcast. It concludes by arguing for a view of the event as complex, self-referential and multiply-mediated when seen from the perspective of its spatio-temporal dynamics.
The Malaysian dilemma: advertising's catalytic and cataclysmic role in social development
Authors: Holden Todd Joseph Miles
Published: March 2007

This article is concerned with how ethnic harmony, national identity and political ideology are delivered, then disrupted by advertising, consumption and a globalizing world. Working with a sample of over 250 television commercials culled from the (then) three commercial networks in Malaysia in 1997, I show how ads are used by government as an intentional tool to manage the multiethnic, stratified social relations that comprise Malaysian society. This, in turn, produces three dilemmas. (1) potentially greater racial segmentation where the government was seeking to eliminate it entirely; (2) in part, because the nation is being united under the traditions and beliefs of only one (the dominant) ethnic group; (3) an attempt to repudiate the very exo-cultural system which is serving to remediate these perceived dysfunctions. In a concluding section the author introduces the concept of `semiotic literacy' to argue that ideological domination by the Malaysian government is possible given the relatively low level of symbolic fluency held by the consumers of television advertising. However, such control will be increasingly difficult to maintain as the audience becomes more symbolically fluent, in part because of the increasing number of signs entering the context from an increasing number of external sources.
Lost expectations? Women journalists and the fall-out from the `Toronto newspaper war'
Authors: Aldridge Meryl
Published: March 2007

Newspapers, like all forms of communication, play an unusually important rôle in Canadian society. Correspondingly, newspaper journalism is a respected occupation. This, taken together with the commitment to equal opportunities embodied in the country's Charter of Rights and Freedoms, might suggest that women face fewer barriers to advancement in Canadian newspapers than elsewhere. Drawing on interviews with women working for newspapers in Greater Toronto and in Montréal, and discussions with academic observers, the article suggests that, until the early 1990s, this optimism about an evolutionary movement into positions of real organizational power was reasonably well-founded. It goes on to argue, however, that the rapid change in the commercial environment brought about by the launch of the National Post in 1998 illustrates how quickly attitudinal and cultural change can be stalled, or even reversed, by changes in management priorities triggered by a threat to profits.
Media, religion and democratic participation: community communication in Zimbabwe and Norway
Authors: Lundby Knut
Published: March 2007

How do people's references to religion and media shape democratic participation in small-scale communities? This research question is applied to pilot case studies across two continents, namely the growth point of Tsanzaguru in Zimbabwe and the municipality of Sør-Aurdal in Norway. In each community, ten `general influential opinion leaders' were interviewed ahead of the 1995 elections. `Religious belonging' (i.e. affiliation to various Christian groups) was applied as a main variable. Sør-Aurdal offers an opportunity to study the contrast between `church' and `sect', while Tsanzaguru displays a more pluralistic pattern of `denominations' and African `charismatic collectivities'. In these cases, it appears that religious belonging does have a bearing on how people do or do not engage with the processes of democratic participation and on the ways that people use the media for such purposes.
Telecommunications policy in the new South Africa: participatory politics and sectoral reform
Authors: Horwitz Robert B.
Published: March 2007

This article examines the process of telecommunications reform in the `new' South Africa. In many, if not most countries, telecommunications reform has been pushed by political and economic elites, whose ability to bring about policy transformations derives largely from the insulation of `reform' from normal political decision-making channels and distributive claims. In marked contrast, telecommunications reform in South Africa was conducted within a democratizing context and was itself a democratic process of a unique, participatory kind. The tension between participatory and electoral democracy was, for the most part, productive of a viable and legitimate reform policy.
Needs and wants: the case of broadcasting policy
Authors: Pratten Stephen
Published: March 2007

In this article I identify two broad perspectives on broadcasting policy, each deploying very different assumptions regarding the role of policy in facilitating human well-being. I argue that in increasingly influential wants-based position draws upon an impoverished social ontology which is unable to sustain the distinction between wants and underlying needs. I also argue that the previously dominant beyond-wants perspective failed to elaborate its own contrasting presuppositions sufficiently. Drawing upon a perspective developed within economics under the heading of critical realism, I emphasize that needs can be formulated as goals only under definite historical conditions. As such, they may be poorly and even misleadingly formulated. Specifically, real needs can be manifest in a variety of historically contingent wants, which may then be met by any of a multitude of potential satisfiers. The point insisted upon here is that the two, real needs and expressed wants, should not be conflated. By maintaining this distinction it is possible to evaluate broadcasting systems not simply in terms of their ability to match outputs to wants but in terms of criteria beyond wants.
Euronews: the first European news channel as a case study for media industry development in Europe and for spectra of transnational journalism research
Authors: Machill Marcel
Published: March 2007

The European news channel, Euronews, can be regarded as a model case from the point of view of transnational, critical journalism research in two respects: first, it is to be demonstrated, on the basis of theoretical considerations relating to the course taken by communications policy, how a rationalized media operation is positioning itself in the European context of media industry development. Second, it can be viewed against the background of transnational journalism concepts. The rationalized mode of working in the multinational form found at Euronews is suitable for the integration of journalistic product and media industry development strategy at the European level, since Euronews is capable of providing contents for the new communication systems (highways).
Deterritorializing radio: deregulation and the continuing triumph of the corporatist perspective in the USA
Authors: Fairchild Charles
Published: March 2007

The deregulation of commercial radio in the USA has had important consequences in two specific cases: the concentration of ownership and the removal of public interest requirements. A `corporatist' perspective has driven deregulation and has now achieved complete dominance over radio broadcasting in the USA. The most significant consequence of deregulation has been that `local' radio stations are completely insulated from any form of direct community influence that is not contained within channels created and controlled by industry. In the USA, the idea of `public interest' in radio broadcasting is now defined entirely in the terms of private industry.
Money, persuasion and American values
Authors: Mayhew Leon
Published: March 2007

This article reviews the relationship between money and influence in civic life. It looks at the contemporary conditions of civic speech and discussion and explores how far these are based on spending power. The question of the regulation of the relationship between money and communicative opportunity is raised and some of the norms and assumptions underlying present regulatory measures explored. The issues are placed in the context of the author's ideas about the character of `the new public', transformed by the economic and cultural terms of television, and the way in which the USA differs from other countries in its civic culture is briefly discussed.
The Role of Community Context in Immigrant Elderly Living Arrangements
Authors: Kim Jibum , Lauderdale Diane S.
Published: March 2007

Previous studies of the determinants of living arrangements for immigrant elderly have focused on cultural tradition or individual characteristics, without addressing community-level structural factors. This study examined the living arrangements of Korean American elderly. The authors hypothesized that the probability of Korean American elderly living independently is associated with community characteristics, specifically the availability of subsidized housing near Korean ethnic communities. Using the U.S. Census Bureau 1990 Public Use Microdata Sample, the authors compared the living arrangements of Korean Americans aged 60 and over in Los Angeles, Chicago, and New York City. After adjusting for demographic, socioeconomic, cultural, and health factors, Korean American elderly in New York City are less likely to live independently compared to those in Los Angeles or Chicago. Using Korean business directories and public housing lists, the authors found that the availability of subsidized housing and the concentration of Korean businesses are jointly associated with residential autonomy.
Explaining Race Differences in Health among Older Adults
Authors: Robert Stephanie A. , Lee Kum Yi
Published: March 2007

Research demonstrates that race disparities in health often persist after controlling for individual socioeconomic status (SES). Yet little is known about the contribution of community socioeconomic context to race disparities in health among older adults. The authors hypothesized that Black older adults’ disadvantaged health status is partly explained by individual SES but further explained by their greater likelihood of living in more socioeconomically disadvantaged communities. The results of multilevel analyses demonstrate that living in such communities helps explain Black older adults’higher number of chronic conditions and worse self-rated health compared to non-Black older adults. Moreover, Black older adults may even have slightly better self-rated health than non-Black older adults once individual SES and community socioeconomic context are controlled. Understanding race and socioeconomic inequalities in health over the life course will require attention to the complex relationships between race, individual SES, and the socioeconomic and racial community contexts in which people interact and live their lives.
A Life-Course Perspective on Housing Expectations and Shifts in Late Midlife
Authors: Robison Julie T. , Moen Phyllis
Published: March 2007

This study applies a life-course approach and retirement migration theory to develop a model of future housing expectations and actual moves for a random sample of men and women in late midlife. Results suggest that late-midlife workers and retirees expect to age in place; expectations to live in highly supportive environments are uniformly low. Older, nonmetropolitan respondents with less education and more years in their homes express the strongest expectations that they will age in place. Those people who rent their homes, have weaker ties to their communities, and have more symptoms of depression tend to foresee a move in the future. However, physical health of respondents and their spouses do not predict future housing expectations. Prior expectations about aging in place, residential history, and life-course changes in marriage and retirement predict actual moves within the next two years, with differing patterns for men and women.
Racial Differences in Mortality among Elderly Patients Admitted for Heart Failure
Authors: Ibrahim Said A. , Cook C. Francis , Kwoh C. Kent , Rosenthal Gary E. , Snow Richard J. , Harper Dwain L. , Baker David W.
Published: March 2007

Several studies have examined predictors of mortality among elderly patients hospitalized with heart failure. In some, elderly African American patients hospitalized for heart failure were reported to have lower risk-adjusted in-hospital mortality compared with Whites. Whether this difference is sustained in the long term and what factors account for this difference remain poorly understood. The objective of this study was to compare risk-adjusted short-term and long-term mortality of a cohort of elderly African American and White patients hospitalized for heart failure to all 30 hospitals in northeast Ohio. The database used for this analysis includes information on demographics and detailed clinical information abstracted from patients’ hospital records. Crude and adjusted 30-day and 18-month survival were compared using Kaplan-Meier method and logistic regression models for multivariate analysis. African American patients had significantly lower 30-day mortality compared with Whites. However, this difference diminished over time and when adjusted for important explanatory covariates, including “do not resuscitate” orders.
Medicaid Reimbursement Rates and Access to Nursing Homes
Authors: Meyer Madonna Harrington
Published: March 2007

Medicaid reimbursement rates vary widely around the country and at times are just 70 to 80 percent of prevailing private pay rates. These differences may create economic incentives for nursing homes to discriminate against Medicaid applicants. The 1997 National Nursing Home Survey of Current Residents provides the opportunity to develop a ratio of Medicaid to private pay rates for a nationally representative sample of 6,081 residents. Logistic regression modeling shows that even when controlling for sex, race, marital status, and functional level, residents are less likely to be on Medicaid at admission when the ratio is small than when it is close to 1.0. Older Blacks and Hispanics, and older unmarried persons, are more likely to be on Medicaid; therefore, they are more likely to face delay or denial of admission. A possible policy resolution comes from Minnesota, where an equalization law requires nursing home and welfare state officials to work together to set rates, making discriminatory practices against vulnerable groups illegal.
Dispositional Optimism, Role-Specific Stress, and the Well-Being of Adult Daughter Caregivers
Authors: Atienza Audie A. , Stephens Mary Ann Parris , Townsend Aloen L.
Published: March 2007

The present investigation examined the effects of role stress and dispositional optimism on the well-being of 296 adult daughter caregivers who simultaneously occupied mother, wife, and employee roles. It was predicted that dispositional optimism would buffer the effects of stress in each of the fourroles on psychological well-being (depressive symptoms and life satisfaction). Results provided some evidence to support the stress-buffering hypothesis. Dispositional optimism buffered (i.e., moderated) the effects of wife stress on depressive symptoms and life satisfaction. In addition, main effects of dispositional optimism on the psychological well-being were found, even after considering stressful experiences in particular social roles (e.g., caregiver). Findings suggest that dispositional optimism can serve as a beneficial resource that reduces the negative effects of wife stress on psychological well-being and contributes to adult daughter caregiver’s well-being, irrespective of stress experienced in specific social roles, including caregiving.
Place Characteristics and Later-Life Migration
Authors: Walters William H.
Published: March 2007

This article examines the impact of origin and destination characteristics on the internal migration of retired migrant groups that have been defined on the basis of their life-course attributes. Separate regression analyses of in-migration, out-migration, and local mobility were conducted for each of three groups: amenity migrants, assistance migrants, and severely disabled migrants not living with a spouse. The results are generally consistent with the life-course model of migration. Amenity migrants are strongly attracted by pleasant climates and favorable economic conditions but tend to avoid large metropolitan areas. Assistance migrants, notable for their tendency to live in low-cost housing, do not choose the counties or metropolitan areas with the lowest average rents but appear to select low-cost housing within particular areas after choosing those areas on the basis of other criteria. Migrants with severe disabilities are especially likely to leave those places where nursing home facilities are inadequate.
Relocation Desires and Outcomes among the Elderly
Authors: Ferraro Kenneth F.
Published: March 2007

The factors that affect relocation desires and outcomes among the elderly are analyzed using longitudinal data from a national survey of the low-income aged (N = 3402). The analysis indicates that only a small proportion of respondents desired to move in 1973 and even fewer were able to fulfill their residential preferences within the following year. The desire to move and actual relocation are examined in relation to a number of personal and environmental factors. Of particular interest is the finding that among those who relocated, individuals who desired to move in the 1973 interview were more satisfied with their new dwelling than those who did not express such a desire in the previous year.
A Review of Aging and Cognitive Processes
Authors: Woodruff Diana S.
Published: March 2007

An overview of the literature of aging and cognitive processes is presented, with emphasis on the areas of psychometric measurement of intelligence, qualitative interpretations of adult thinking, and the speed and timing of behavior. It is argued that the study of psychometric intelligence has gone through four distinct phases, reflecting an expanding data base and an evolving theoretical orientation and methodology. Contemporary research on aging and intelligence continues to be undertaken from at least three of the four perspectives. Qualitative and quantitative approaches to cognition have both provided evidence for increased integration in the thinking of older people, although the two approaches have different conceptualizations of integration. There is extensive evidence to support the contention that the speed of behavior slows with age, and the slowing affects efficiency of behavior rather than simply causing the response to occur more slowly. Cognition in aging includes great diversity, ranging from senility to wisdom.
Age, Ethnicity, and Well-Being
Authors: Janson Philip , Mueller Karen Frisbie
Published: March 2007

In this article we reexamine the issue of age differences in well-being, focusing on ethnic variations in this relationship. Data are from 1269 Los Angeles residents (407 Anglos, 413 blacks, and 449 Mexican Americans) between the ages of 45 and 74. Two measures of well-being were analyzed: Lawton's Philadelphia Geriatric Morale Scale and a single-item indicator of happiness. Results suggest that: (1) The overall relationship between age and well-being is strongly positive for Anglos, once controls are introduced for sex, marital status, income, health, and schooling; and (2) the slope of the relationship between age and well-being is similar for blacks and Anglos, but much smaller for Mexican Americans. Results suggest clear ethnic differences in the net advantage that advancing age offers to well-being. The relevance of the findings for the double-jeopardy hypothesis is discussed.
Isolation of Older Persons
Authors: Weeks John R. , Cuellar Jose B.
Published: March 2007

Current theories suggest that migration tends to exacerbate isolation of older people, although such isolation should be mitigated by length of residence. Propositions derived from these theories were tested using data collected in San Diego, California, from 1139 older people representing ten different ethnic groups (Black, Hispanic, Pilipino, Guamanian, Samoan, Japanese, Chinese, Korean, American Indian, and nonminority). The findings suggest that recent older immigrants are, in fact, more isolated than elders in other migration/residence statuses. However, immigration seems to exert an overall low level of influence on isolation, whereas ethnicity independently appears to exert a greater influence.
The Decision to Leave Work
Authors: Durbin Nancy E. , Gross Edward , Borgatta Edgar F.
Published: March 2007

This study examines the explanations offered by faculty at a major university regarding their decisions to accept or reject an attractive early-retirement option. A survey of faculty eligible for this option was administered soon after the end of the decision period for accepting the option. Two models are developed to describe the findings: The first includes only factors expected to enter into explaining for the decision to accept or reject the early-retirement option; the second adds time spent obtaining information and "considering" the decision. Both rational explanations and role-taking explanations are found to be involved in the retirement/nonretirement decisions. In addition, the second model indicates that the amount of time spent examining the option is a crucial link in the decision-making process. Demographic characteristics, health, and scholarly productivity all fail to show significant effects on the decision to take the attractive option to retire early.
Health of the Chinese Elderly in America
Authors: Yu Elena S.H.
Published: March 2007

This article examines the mortality and morbidity patterns of Chinese elderly in America by using two established data sources: (1) the most recent vital statistics maintained by the National Center for Health Statistics, and (2) the cancer registry program called SEER (Surveillance, Epidemiology, and End Results) maintained by the National Cancer Institute at the National Institute of Health. The results suggest that Chinese Americans are relatively healthier than white Americans, the average age-adjusted death rate being lower for Chinese than for white Americans. Likewise, the age-specific death rates for all causes of death are lower for Chinese than for the majority white population. Details of statistics on rates of suicide, heart disease, neoplasms, and various forms of cancer are presented.
Delivering Health Care to the Elderly
Authors: White Diana L. , Pearlman Robert A.
Published: March 2007

This article reports on a project to identify and describe systematically problems encountered in providing health care to elderly veterans. A modified Delphi approach was used to survey a wide range of health professionals. A typology of problems was developed in Stage 1 of the Delphi. Problems represented by the typology were then rated by importance in Stage 2. Analysis of Stage 2 data indicates that the typology is conceptually sound. As such, it is a useful tool for describing problems and guiding future research.
Living Arrangements and Family Networks of Older Women in Italy
Authors: Wolf Douglas A. , Pinnelli Antonella
Published: March 2007

As in many other industrialized countries, population aging in Italy is disproportionately a phenomenon associated with unmarried women, mainly widows. This article examines the extent to which older unmarried women live alone, and the extent to which they receive help in everyday tasks from others outside their households, using data from a large Italian household sample survey conducted in 1983. Older women can either live alone or with others, and may or may not receive external help in either case; thus there are four distinct combinations of outcomes analyzed. In both descriptive bivariate analysis. and a multivariate model of the outcomes, we find pronounced differences in behavior according to region of residence, educational level, age, degree of disability, work experience, and pension receipt. The findings indicate the importance of family as a source of help and/or co-residence in situations of need.
The Effects of Help Patterns on the Mental Health of Spouse Caregivers
Authors: Pruchno Rachel A.
Published: March 2007

Investigated were the patterns of task assistance and social support received by 315 people who were the primary caregivers to spouses suffering from Alzheimer's Disease. Despite the fact that spouse caregivers themselves are old and frail, they continue to provide the bulk of care required by their impaired partner. When help is forthcoming from any source, it is minimal. Contrary to the hypothesis that back-up sources of support or confidants should buffer the primary caregiver from negative mental health effects, there was no relationship between existence of either task support or social support and mental health.
Caregiver Burden and the Continuum of Care
Authors: Miller Baila , McFall Stephanie
Published: March 2007

This article integrates the results of a series of prospective studies that used data from the 1982-1984 National Long Term Care Survey to (a) provide a comprehensive view of the effects of caregiver burden over a two-year period, (b) suggest ways in which caregiver burden intersects with the continuum of care, and (c) explore the implications for long-term care research and policy. Each dimension of caregiver burden had different consequences for each long-term care outcome. Neither personal nor inter-personal burden had an independent effect on changes in the informal task support network. Personal burden, but not interpersonal burden, influenced changes in the use of formal services. Interpersonal burden, but not personal burden, influenced nursing home admissions.
The Effects of Stress, Vulnerability, and Appraisals on the Psychological Well-Being of the Elderly
Authors: Kahana Eva , Redmond Cleve , Hill Gretchen J. , Kercher Kyle , Kahana Boaz , Johnson J. Randal , Young Rosalie F.
Published: March 2007

A conceptual model was developed and tested that examined the relationships between respondent characteristics, stressors, psychological well-being measures, and intervening life domain appraisals. The model was tested using data from elderly members of a Detroit area HMO. An innovative focus of the study was comprehensive consideration of the array of stressors impinging on the elderly. Stressors examined included recent negative life events, cumulative life crises, living with an ill family member, and social isolation. Domain appraisals in the model concerned satisfaction with activities, relationships, health, and income. Support was found for the hypothesis that stressors affect well-being indirectly through domain satisfactions.
Determinants of Elderly Interstate Migration in the United States, 1985-1990
Authors: Newbold K. Bruce
Published: March 2007

This article applies a three-level nested logit model to the microdata of the 1990 U.S. census to explain the 1985 to 1990 return and onward interstate migration patterns of the elderly aged 65+ by personal factors and state attributes. The elderly were split into three groups defined by age: 65 to 69, 70 to 74, and 75+. Analysis reveals that both return and onward migrants were sensitive to amenity factors, racial similarity, and the distance decay effect, although return migrants were less affected by the distance decay effect than onward migrants. The motivations for a return or onward migration were also observed to vary with respect to age groups, with amenity effects more important for the young elderly. Several personal characteristics also were found to systematically influence the migration choice process, including level of education and marital status.