bluuebunny/crossref_metadata_2025 huggingface dataset:
A Sexual Health Workshop for Health Care Professionals
Authors: Richardson Glenn E.
Published: March 2007

The purpose of the study was to evaluate a three-day workshop in human sexuality for health care professionals using identified and described systematic development and evaluation components. The problem was to determine if the use of a systematic development approach obtains the desired outcomes of an educational experience. The desired outcomes include cognitive gains, attitude shifts toward more openness, and behavioral changes leading to an improvement of the quality ofsexual coun seling and therapy. The main sponsoring agency for the workshop was the Interwest Regional Medical Education Center of the Veterans Administration Hospital system. The 126 participants included physicians, psychologists, social workers, nurses, clergy, and students. The results showed that participants (1) gained significantly on cognitive scores from the pretest to the posttest, (2) shifted toward more open attitudes from pretest to posttest, and (3) incorporated many desired behaviors into their practices 10 to 11 weeks following the workshop.
Assuring Quality of Health Care
Authors: Demlo Linda K.
Published: March 2007

This article reviews currently used quality assurance techniques. It assumes a broad definition of quality that includes attention to the content and professional judgment exercised in the provision of health services, as well as the appropriateness of resource utilization. Emphasis is on more or less generic approaches to review that can be applied regardless of the specific health profession involved. After describing and contrasting various quality assurance techniques, the article concludes with a general discussion of effectiveness, problems in initiating behavior change, and opportunities for further research and evaluation.
User-Centered Evaluation
Authors: Bland Carole J. , Ullian John A. , Froberg Debra G.
Published: March 2007

Much has been written on graduate medical education and its evaluation. Seldom, however, are mentioned the uses made or the benefits of such evaluations. Drawing on current models for increasing the use of information from external evaluations, the authors offer a usercentered approach for increasing the use of results from internal evaluations, the more typical form of evaluation in graduate medical education. The overriding emphasis of the user-centered approach to evaluation is the utility of the resultant data. Three features characterize user-centered evaluation: an ordered set of steps with usefulness as the primary concern at each step; delineation of evaluator and decision-maker roles; and attention to the general communication aspects of evaluation. This article describes these three characteristics, concluding with two fundamental points: (1) A user-centered approach to evaluation will help evaluation do what it is supposed to do: provide information that gets used to increase the effectiveness of everyday decisions. (2) A user-centered evaluation accomplishes this, first, by having a pervasive attitude of utility and, second, by carefully attending to the three characteristic features of this approach to evaluation.
Cost-Benefit Studies of Health Care Programs
Authors: Joglekar Prafulla N.
Published: March 2007

This article summarizes the results of a critical review of several cost benefit analyses (CBA) of health care programs. With pertinent examples, it is demonstrated that the results and conclusions of a study depend upon the assumptions and methods underlying the measurement of costs and benefits in a CBA. Given the incentives for an analyst to comply with desires of his sponsor, and given the scope of the choice available to an analyst among alternative assumptions and methods, it seems quite possible that desired results often dictate the assumptions and methods chosen. It is recommended that apolicy maker should suspect an advocacy in the results and conclusions of every CBA. If CBAs are to be a true decision aid, a policy maker ought to obtain several of them, each of which assesses the costs and benefits of a given action plan using assumptions and methods substantially different from the other.
Anomalous Responses on Confidence-Scored Tests
Authors: Rippey Robert M. , Voytovich Anthony E.
Published: March 2007

Confidence testing allows subjects to respond to each option of a multiple-choice question with their perceived likelihood that it is the correct one. Scoring procedures subsequently provide measures not only of knowledge, but of the individual's "confidence" or realism in the assessment of whether the response is correct. There is an underlying assumption, however, of a significant correlation between assigned probabilities and actual likelihood for choosing a correct response, for we would naturally assume that subjects would, in general, be more certain when correct and less certain when wrong. Significant negative correlation or correlation not different from zero suggests bizarre responses in which the subject becomes more certain of the answer as mastery declines. Such anomalous responses were isolated from 530 tests of clinical knowledge administered to highly motivated medical students. These were rare (less than 3%0). Thus a crucial assumption underlying the theory of confidence testing is validated and a useful method of identifying outliers is devised.
Conducting Qualitative Studies Using Theory and Previous Research
Authors: Weinholtz Donn , Friedman Charles P.
Published: March 2007

Interpreting qualitative data in the context of existing theories is a process frequently alluded to, but rarely discussed in detail. This article is a case study illustrating how existing theories and researchfindings were used to enrich a qualitative, preassessment study examining effective teaching by at tending physicians. The investigators advocate an approach in which preliminary theoretical assumptions and orienting concepts are explicitly statedprior to conducting fieldwork. These assumptions and concepts are then modified during an initial pilot phase of study from which more focused theoretical perspectives and key orientingprinciples emerge. The remainder of thefield experience is usedfor refinement of these perspectives and principles, which serve as the final results of the study.
Test Equating and Credentialing Examinations
Authors: Holmes Susan E.
Published: March 2007

The advent of open testing and test disclosure legislation has fostered a renewed interest in the problems and issues associated with test equating. This article focuses on a specific application of test equating, namely that of credentialing examination programs in the health professions. First, the role of test equating in the credentialing process is considered. Its usefulness for maintaining consistent standards and monitoring performance trends across time is discussed. Second, the issues that must be considered when implementing test equating in a credentialing examination program are described. Issues are considered as either test development concerns or as technical concerns. The audience for the article includes credentialing board members and other individuals who hold the major responsibilityfor preparing, administering, and scoring credentialing examinations as well as all other persons interested and/or involved in credentialing health professionals.
Is Nursing a Profession?
Authors: Brown William , Knight Jack , Patel Kant , Pilant Denny
Published: March 2007

This article examines the question of whether or not nursing is or should be a profession. The conclusion is based primarily on an analysis of what constitutes a profession and an empirical study of some nursingpractices and attitudes. The analysis of professions recognizes three prominent models in sociology: trait, functional, and power or control. It bypasses these infavor of a "cluster concept," which asserts that the public has a number of expectations of an occupation before it will bestow the status of profession upon it. We then give an analysis of some of the results of the survey of a sample of Missouri registered nurses. The gist of the data is said to reflect the facts that these nurses think nursing is or should be a profession, but that other factors tend to show that nursing lacks the requisite cluster to substantiate the claim to be a profession. We conclude that nursing should perhaps not be a profession since it has been a bastion of the "ethics of compassion" in a world that is increasingly beset by an "ethics of competence. "
Medical Schools in Crisis
Authors: Brown J. H. U.
Published: March 2007

The medical schools of the United States are in crisis because of poor teaching methods, misdirected training of medical students, and failure to respond to the needs of the population. Much of the increased cost of medical care can be blamed on high technology and the type of training provided in the medical school. Students are trained in hospital care and use of technology toforward treatment rather than in the ambulatory and family practice care they will use later in their careers. Medical schools are to be blamedfor teaching specialty medicine and thus providing large numbers of unneeded surgeons and other specialists. In addition, too many physicians of all sorts are being trained, this raises the cost of medical care to the population as a whole. Proposals are made to limit the number and kind of specialties, to restrict medicalschoolenrollments, to train medical students in ambulatory environments, and to reorient medical care from the hospital to less costly environments. With the DRG regulations and pressure from government, medical schools must alter their curriculum in order to meet the challenges of the future.
Issues in the Evaluation of AIDS Education Programs
Authors: Forst Martin , Moore Melinda , Jang Michael
Published: March 2007

Health education is currently considered the most important factor in the prevention of HIV infection. Many AIDS education programs have started within the past several years, but few have undergone rigorous evaluation. This article presents findings from an outcome evaluation of the state of California AIDS Education and Prevention Program, the largest AIDS public education program in the country. The data suggest that the specific educational intervention programs suffered from many design defects which made it impossible to determine accurately the effectiveness of the programs. The programs did not use standard pre/post design, for example, or use standardized testing procedures. Moreover, only cognitive knowledge about AIDS transmission and prevention was stressed in the educational interventions and measures of effectiveness. The Education and Prevention Program must now move to promoting and measuring attitude and behavior change in addition to cognitive knowledge. The article concludes that AIDS education and prevention programs must place greater emphasis on conducting thorough evaluations, if the goals of attitude and behavior change are to be achieved.
Psychosocial Factors and Aids-Related Behavior of Homosexual Men
Authors: Zapka Jane G. , Mccusker Jane , Stoddard Anne M. , Morrison Charles S. , Mayer Kenneth H.
Published: March 2007

The primary objective of this study was to conduct measurement and data-reduction procedures of selected psychosocial measures used in AIDS-related behavioral research. Secondly, we investigated the associations of the psychosocial scales relative to other personal and health serviceslinformation factors with one selected AIDS protective behavior among asymptomatic homosexual/bisexual mern Data were collected using a self-administered questionnaire. Factor analysis and regression modeling were used to address the study objectives. Factor analyses validated the relationships between 53 survey items and 12 hypothesized constructs suggested by several theories of behavior change. These constructs included perceptions of susceptibility, beliefs of social network members, opinions about HPV testing, medical efficacy, related health habits and barriers to behavior change. Regression modeling demonstrated the relative importance of psychosocial scales to other variables in understanding associations with total number of sexual partners.
Testing A Model of Diabetes Self-Care Management
Authors: Nowacek George A. , O'Malley Patrick M. , Anderson Robert A. , Richards Fredrick E.
Published: March 2007

The daily management of diabetes involves a complex interaction of metabolic variables, self-care behaviors, andpsychological and social adjustments to having the disease. Diabetes patient-education programs usually focus on the self-care aspects of managing the disease with emphasis on specific cognitive knowledge and performance of daily diet, medication and exercise routines. This study presents a model of diabetes management which includes an attitudinal element -the personal meaning of having diabetes. This expanded model allows for testing of hypothesized relationships between all elements, rather than a single linear cause and effect model Data were obtained from 115 Type I and 105 type II people from three states who hadhaddiabetesforatleastoneyear. Thedata were analyzed using a structural equation analysis (LISREL VI). While the results showed that the data did not fit the proposed model well enough to allow for definitive conclusions, the results are generally supportive of the original hypothesis that the personal meaning of diabetes is an important element in the daily management of diabetes and the psychosocial adjustment to the disease.
Correcting Performance-Rating Errors in Oral Examinations
Authors: Raymond Mark R. , Webb Lynn C. , Houston Walter M.
Published: March 2007

Although oral examinations are widely used for making decisions regarding an individual s level of competence, they are frequently of limited reliability. A significant part of the error in oral performance ratings is due to the tendency for some evaluators to be lenient and others to be stringent in their assignment of ratings. This article describes and evaluates a simple method to identify and correct for errors of leniency and stringency. The method, which is based on a regression model recommended by Wilson (1988), extends and simplifies the procedures recommended by Cason and Cason (1984, 1985). The method provides an estimate of each individual's performance that has been corrected for errors of leniency and stringency. In addition, it produces for each rater an index of leniency or stringency and several other statistics useful in evaluating the properties of rating data. The regression method is applied to performance ratings from three separate administrations of an oral examination in a medical specialty. The results indicate modest but significant levels of leniency and stringency error; correcting for such errors would change the pass/fail decisions for about 6% of the examinees. Limitations of the procedure, as well as the need for additional research, ore discussed.
Faculty Perspectives of a Valid and Reliable Clinical Tutor Evaluation Program
Authors: McLeod P. J.
Published: March 2007

Evaluation of clinical tutors by students is potentially useful for tutor feedback and to assist administrators in decisions about tenure and promotion. At most universities, there has been inadequate attention paid to clinical tutor evaluation. McGill University in Canada designed an evaluation system adhering rigidly to accepted psychometric standards of reliability and validity and has used it successfully for the past 5 years. When researchers investigated its credibility with McGill tutors, they found significant ambivalence and some hostility toward the process. Apparently, these tutors are suspicious of the credibility of student ratings of their teaching skills. Part of the explanation for this lies in their own selfdoubts as reflected in lower self-ratings. Much of the ambivalence relates to lack of recognition of clinical teaching by administrators and lack of impact of teaching evaluations on promotion and tenure decisions.
The Role of the Medical Care Advisory Committee in the Administration of State Medicaid Programs
Authors: Ciesla James R. , Samuels Michael E. , Stoskopf Carleen H.
Published: March 2007

Every state Medicaid program has a Medical Care Advisory Committee (MCAC). MCACs are required by federal regulations to have representation from state human service agencies, healthcare providers, and Medicaid consumers. Survey data presented in this study show the make-up ofMCACs by representative group. Other data presented show meeting frequencies, subcommittee structure, and information about MCAC activities. Comparisons are made from historical MCAC data showing long-term trends of their composition and structure. It is argued thatMCACs can be useful to state Medicaid agencies in policy development but have not been structured to do so. Recommendations are given to make MCACs more useful.
Reliability of Katz's Activities of Daily Living Scale When Used in Telephone Interviews
Authors: Ciesla James R. , Shi Leiyu , Stoskopf Carleen H. , Samuels Michael E.
Published: March 2007

The reliability of afive-item Katz's Activities of Daily Living (ADL) scale collected by selfreport telephone interview is presented. A random sample of 6,472 South Carolina residents over 55 years of age selected from a statewide population is used. Factor structure, Guttman properties, internal consistency reliability, Mokken's index of test homogeneity, and Spearman's coefficient of rank-order correlation are used to show that ADL data gathered by telephone interview are reliable. Because telephone interviewing methods are faster, cheaper, and safertheyare recommended as a viable wayfor researchers, policymnakers, and practitioners to gather ADL information.
A Measure of Perceived Burden among Caregivers
Authors: Macera Caroline A. , Eaker Elaine D. , Jannarone Robert J. , Davis Dorothy R. , Stoskopf Carleen H.
Published: March 2007

This, report describes an easily administered scale for measuring perceived burden among caregivers offamily members with dementia. During home interviews conducted in 1991, 82 caregivers rated theirfamily member with dementia on several items related to functional ability, the type of care provided, and associated stress. The resulting measure ofperceived burden, based on 15 internally consistent items (alpha = 0.87), is significantly correlated with depressive symptomatology (r = 0.38, p = 0.0004). This measure is useful in assessing perceived stress associated with specific caregiving responsibilities. It can be used, along with other measures of patientfunctional status, to assess overall caregiver burden and to target intervention strategies.
Changes in Cluster Analysis Subtypes among Alcoholic Personalities after Treatment
Authors: Dush David M. , Keen Joyce
Published: March 2007

The authors examined the use of cluster analysis to evaluate the changes in personality subtypes of alcoholics across 30days of inpatient treatmentfor 137females and 388 males. Results at retesting 30 days later showed dramatic overall reduction inpathology, plus general erosion of the distinguishing features of subtypes found at initial testing on the 13 scales of the Minnesota Multiphasic Personality Inventory-1. A single, enduring Psychopathy scale emerged as the distinguishingfeature of nearly all subgroups at retesting, regardless of initial configuration. Implications for treatment evaluation, classification, and outcome prediction are discussed.
The Consistency and Uncertainty in Examiners' Definitions of Pass/Fail Performance on Osce Stations
Authors: Rothman Arthur I. , Blackmore David , Cohen Robert , Reznick Richard
Published: March 2007

The Medical Council of Canada has made use of examiners'pass/fail classifications of candidates' behaviors in objective structured clinical examination (OSCE) stations in defining cutting scores for these stations. This process assumes that there is consistency in the judgments of examiners employed in the same stations at different testing sites and in the cutting scores derived from these judgments. These assumptions were tested using the results of the fall 1993 administration of part 2 of the Medical Council of Canada's Evaluating Examination to 744 candidates. The results of this study provided evidence of the consistency of the pass/fail and cutting score definitions for the stations used across examiners.
Evaluation in the Health Resources and Services Administration
Authors: Crane Anabel Burgh , Ginsburg Susanna
Published: March 2007

The mission of the Health Resources and Services Administration (HRSA) in the U.S. Department of Health and Human Services is to improve the health of the nation by assuring quality health care to underserved and vulnerable populations and by promoting a primary care and public health workforce. This article provides an overview of HRSA 's prior work in performance measurement and highlights a current initiative designed to help the agency improve its performance measurement efforts in the context of the Government Perfornance and Results Act. This initiative began with an agencywide assessment of capacity to measure performance at program, bureau, and agency levels. Based on thefindings, HRSA is moving forward both with technical assistance to individual bureaus in developing performance indicators and data sources and with activities to coordinate performance measurement for the agency as a whole.
An Examination of Variation in Long-Term Community Tenure after Psychiatric Hospitalization in Eight States
Authors: Pandiani John A. , Banks Steven M. , Schacht Lucille M.
Published: March 2007

The influence of seven personal and clinical characteristics on the community tenure of discharged state hospital patients in eight states is analyzed and discussed. Previous admission to a state hospital and a diagnosis of schizophrenia were associated with shorter community tenure. Older patients had longer community tenure than younger. These findings were consistent across the states and are consistent with previous work thatfocused on much narrower populations. The relationship of these risk factors to community tenure are discussedfrom an individualistic perspective, a treatment oriented perspective, and a community integrationist perspective, and implicationsforfurther research are explored.
The Use of Formative Evaluation to Assess Integrated Services for Children
Authors: Brindis Claire , Hughes Dana C. , Halfon Neal , Newacheck Paul W.
Published: March 2007

This article describes the use of formative evaluation in assessing the feasibility of implementing a new service integration effort. The Child Health Initiative, a nine-site, national demonstration project funded in 1991 by the Robert Wood Johnson Foundation, sought to implement systemic change through the creation of new mechanisms for spending service dollars more flexibly at the local site. The Child Health Initiative calledfor developing local child health-monitoring systems, a care coordination mechanism, and a program for decategorizing the myriad of restrictive categorical public programs serving children. Most demonstration communities experienced some degree of success in achieving the first two components, but none was able to implement decategorization during the 3to 5-year funding period. Key lessons for evaluators include the need for (a) a flexible evaluation design that can sequentially adapt to changes in program implementation, (b) repeated longitudinal data collection measures to document changes over time, (c) avoidance of a premature focus on program outcomes, and (d) methods to establish attribution of outcomes.
Using Outcomes to Make Inferences about Nursing Home Quality
Authors: Spector William D. , Mukamel Dana B.
Published: March 2007

Recent concerns about containing the growth of public expenditures on nursing home care and the development of prospective and casemix reimbursement systems with incentives for cost containment have increased the importance of monitoring quality in nursing homes. The current view is that quality assurance systems should include more outcome measures to improve quality. This article discusses why it is difficult to develop facilitylevel outcome measures that can be used to evaluate and compare the quality of care of nursing homes. The article places the current interest in outcomes measures in its historical policy context and reviews important conceptual and methodological issues associated with outcome-based quality assessment. The authors discuss the difficulty in isolating the facility effect when studying nursing home outcomes and implications of using different estimation approaches. In conclusion, they discuss the need to integrate research with outcome-based quality assurance systems to allow ongoing evaluation and quality improvement.
Public relations, news production and changing patterns of source access in the British national media
Authors: Davis Aeron
Published: March 2007

This article aims to draw attention to the rising influence of professional public relations on the process of national news production in Britain and to discuss how this influence is affecting existing media-source relations. It notes that a wide range of organizations have begun adopting public relations as a means of achieving particular goals through media coverage. At the same time media institutions, operating under tighter editorial budgets, have become more dependent on information supplied by external sources. The two trends have resulted in the sudden growth of the professional public relations sector and changes to existing patterns of source access. How such trends are affecting various sources in their attempts to gain and manage media access is the debate that therefore takes up most of this piece. Is public relations simply another means by which institutional and corporate organizations are managing to secure access advantages, or is it providing new means whereby non-official sources can gain media access which was hitherto denied them?
Media templates: patterns of association and the (re)construction of meaning over time
Authors: Kitzinger Jenny
Published: March 2007

This article introduces the concept of `media templates' and explores how these templates operate in relation to existing theories around key events and news icons. Drawing on focus group discussions, content analysis and interviews with media personnel, I demonstrate how templates help to shape news narratives and guide thinking not only about the past, but also about the present and the future. The argument is illustrated by examining the position of the `Cleveland scandal' (and the subsequent `Orkney crisis') in discussions of child sexual abuse. The discussion explores how templates such as Cleveland are established and maintained by source strategies, social power relations and journalistic/audience reception processes. The article concludes by outlining the implications of templates for media production practice, media studies theory and audience reception research.
Entitlement and sincerity in broadcast interviews about Princess Diana
Authors: Myers Greg
Published: March 2007

Vox pop interviews were used extensively in British broadcast coverage of the death and funeral of Princess Diana. They were one of several ways that public expression of emotion was defined as an important part of the events of the week. Some commentators criticized this attention to the public response, rather than on new information and formal events, as an excessive and sentimental part of a loss of proper perspective. This criticism raises two issues in the relation of media events to everyday experience - entitlement of members of the public to feel overpowering emotion at the loss of someone they knew only through media, and the sincerity of expressions of emotion when ordinary people are faced with microphones and a camera. I argue here that such criticisms miss the ways interviewees packaged their responses with an awareness of just such criticisms. Interviewees showed entitlement by presenting themselves as speaking for ordinary people, linking their responses to the place and time, and tying their stories into their everyday activities or to historic events. They showed sincerity by presenting their feelings as atypical for them, by acknowledging apparent clichés, and by emphasizing Diana's own sincerity. Analysis of interviewees' reflexive sense of performance shows how `intimacy at a distance' can make public involvement a component of media events.
Broadcasting policy, creative compliance and the myth of civil society in China
Authors: Keane Michael
Published: March 2007

This article looks at arguments framing civil society debates and questions the usefulness of civil society models in understanding how media policy is made and implemented in China. The key argument is that viewing the state-society relationship in China through a Western optic obviates the distinctive differences between the autonomous civil society of liberal democracies and Chinese social relations. This does not mean that civil society is a redundant concept. It can be usefully applied to describe economically driven political and social change in China. However, its capacity to explain how cultural and media policy is formulated is limited.
From the margins to mainstream: the political power of hip-hop
Authors: Stapleton Katina R.
Published: March 2007

Uniquely situated at the heart of African-American youth culture, hip-hop is about music, style and voice. In many ways hip-hop is also about political action. Any discussion of hip-hop culture and rap music lends itself to examinations of rap as a means of protest among inner-city African-American youth. But the resistive benefits of rap music are not limited to its African-American listeners as can be seen by its widespread popularity among youth of all different races, classes and nationalities. As the cultural and political voice of an entire generation of youth, hip-hop has become a means of political action for its artists and fans. In addition to its prominent resistive role, political action in the hip-hop community includes political deliberation and direct uses of hip-hop to increase political awareness and to organize collaborative action.
The Impact of a New Phased Retirement Option on Faculty Retirement Decisions
Authors: Ghent Linda S. , Allen Steven G. , Clark Robert L.
Published: March 2007

Life-cycle theory suggests that workers would prefer to gradually enter retirement from their career jobs. Using data from 15 campuses of the University of North Carolina system, this study provides a first look at the effects of the introduction of a phased retirement program on faculty retirement decisions. The authors’ analysis indicates that most of the faculty members choosing phased retirement would have likely remained full-time at their universities if the phased retirement option had not been available.
The Self-Concepts of Older Women
Authors: Turner Barbara F.
Published: March 2007

This article reviews the research literature on the self-concepts of older women, tracing the antecedents, consequences, and correlates of gender-and age-related differences in four commonly studied dimensions of self-concepts: (1) self-esteem, (2) internal control, (3) age identification, and (4) the content of self-concepts, or identity. It is concluded that cultural prescriptions for "femininity" have a significant effect upon the self-esteem, internal control, age identification, and the content of self-concepts of women throughout life. Women in late middle age appear to derive benefit, in enhanced self-esteem, from apparent shifts toward a more "masculine" and less "feminine" self-concept.
Job Deprivation in Retirement
Authors: Skoglund John
Published: March 2007

This paper examines various previous findings and explores factors related to feelings of "missing work" after retiring by means of stepwise, multiple-regression analyses run separately among 262 preretirees and 341 retirees aged 60-75 in a Swedish sample. It was found that 55% of preretirees anticipated job deprivation, whereas 36% of retirees actually reported such feelings. In both groups, "missing work" was significantly related to favorable work orientation and reluctance to retire, a pattern found among both blue-and white-collar workers, and job deprivation was also positively associated with work orientation independently of the retirement attitude; no associations were found with age, sex, education, and residence.
Aged Migration
Authors: Lee Anne S.
Published: March 2007

Elderly migration was measured indirectly on the basis of the proportionate increase in the population aged 65 and older between 1970 and 1975. Using this measure, 173 "high impact counties" were identified. Characteristics of the health care delivery system (medical underservice, physicians, hospital beds) were then examined, as were selected demographic data for these counties. In general, high impact counties were found to have adequate (or better) supplies of physicians and hospital beds to meet national standards. Moreover, there was some evidence that those counties with the greatest impacts were the best served. This research underscores the need for studies focusing on individual areas rather than on grouped data.
The Process of Caretaker Selection
Authors: Ikels Charlotte
Published: March 2007

The genealogy is widely recognized as a valuable tool in the study of nonindustrial societies. Its value in the study of industrial societies is often overlooked. This article demonstrates the utility of the genealogy in helping to understand the meaning of kinship resources to the elderly in two ethnic groups in greater Boston.
Life Expectancy and the Older Population
Authors: Crimmins Eileen M.
Published: March 2007

In this article recent trends in old-age mortality are first reviewed. Then the effect that these developments have had on mortality projections for both the short-range and long-range future are analyzed. Next the assumptions underlying the most recent official mortality projections are detailed and evaluated. Following this, the implications of the varying mortality projections for the future size and composition of the older population are examined. Finally, the proposition is addressed that projected mortality is approaching or exceeding maximum average human life span.
The Types of Social Relations Predicting Elderly Well-Being
Authors: Baldassare Mark , Rosenfield Sarah , Rook Karen
Published: March 2007

It is widely believed that supportive social networks are especially important resources for older adults. Previous work has lacked attention to the specific types of social relations, subjective evaluations of social relations, and social network characteristics that affect well-being. This study uses a representative sample of Northern California elderly respondents to examine the effects of social relations on self-reported happiness. Social relations are important predictors of happiness, even after accounting for the effects of several demographic and health characteristics. Perceived companionship is the best predictor of happiness among all the social relations variables. It is argued that further research should concentrate on the specific social relations factors that significantly affect specific domains of personal well-being.
Social Networks, Stress, Adaptation, and Health
Authors: Cohen Carl I. , Teresi Jeanne , Holmes Douglas
Published: March 2007

In this study, utilizing 19 social network variables and 3 outcome measures (need fulfillment, psychological symptoms, and physical symptoms), we follow 133 elderly residents of mid-Manhatten hotels for one year. The findings indicate that social networks exert a direct effect on reducing subsequent symptoms and enhancing ability to meet needs. Moreover, social networks trigger a buffering response to stressors in that their ability to reduce symptoms and to promote need fulfillment was greatest among high-stress individuals.
Intervention Research Approaches
Authors: Smyer Michael A. , Gatz Margaret
Published: March 2007

This article reviews the process of intervention research, with particular emphasis on interventions with and for older adults. First, we consider the context of intervention research: What are the resources and constraints that shape the process of intervention and research? Second, we outline a taxonomy of interventions, reflecting different combinations of level and timing of interventions. Third, we consider the types of research designs that are most appropriate in the different contexts of applied research.
Provision of Care to Old Parents
Authors: Matthews Sarah H.
Published: March 2007

Unlike research on parent care in which a primary caregiver is the focus, this research begins with the assumption that filial responsibility is shared in older families that comprise more than one child. Results of the analysis indicate that structural variables are significant. More important, they support the argument that conceptualizing filial responsibility as shared is important for future research.
The Threshold for Aging in the Workplace
Authors: Ashbaugh Donald L. , Fay Charles H.
Published: March 2007

The literature was reviewed for studies in which "older worker" was operationalized using some chronological age as a threshold. An analysis of 105 studies shows little agreement on when a worker becomes an older worker. A variety of methods, mostly arbitrary, were used in setting threshold age. Implications are discussed.
Parent Care and Geographically Distant Children
Authors: Schoonover Claire B. , Brody Elaine M. , Hoffman Christine , Kleban Morton H.
Published: March 2007

Interviews were conducted with geographically distant adult children whose female siblings were primary caregivers for elderly widowed mothers. Female distant siblings were more likely than males to express guilt, strain, and other emotional effects deriving from the mother's situation, as well as certain intersibling tensions relative to the mother's care.
Disability and Living Arrangements among Elderly American Men
Authors: Stinner William F. , Byun Yongchan , Paita Luis
Published: March 2007

The living arrangements of disabled elderly people are an important policy-related issue. This investigation focused on testing four models which posit alternative ways in which disability might affect coresidence with adult relatives. The models were tested for a pooled sample of elderly men drawn from the 1976 and 1981 rounds of the National Longitudinal Survey of Mature Men. The methodological strategies for model assessment included descriptive and logistic regression techniques. Men with multiple disabling conditions, but not a single disability, were more likely to be coresiding with adult relatives than were nondisabled men, independent of a set of selected background characteristics. These results provided general support for a model focused on assistance norms. There was some suggestion that the absence of a spouse reinforces this pattern.
Characteristics of Alzheimer's Versus Non-Alzheimer's Adult Day Care Centers
Authors: Conrad Kendon J. , Gutfman Rosalie
Published: March 2007

This study distinguished the unique characteristics of adult day care (ADC) centers serving victims of Alzheimer's disease (ALZ) as compared to centers without a substantial proportion of Alzheimer's victims (non-ALZ). A set of hypotheses regarding expected differences in the characteristics of ALZ versus non-ALZ centers along with the rationale for these hypotheses are presented. The measures of ADC characteristics are then described. The results of two types of analyses are presented: t tests and discriminant function analyses. The results indicate that the major discriminating factor was increased support for families in ALZ centers. Alzheimer's programming also placed more emphasis on therapeutic recreation, personal care assistance and training, and entertainment rather than on the provision of clinical and personal services. ALZ centers tended to have higher morale with the perception of being more caring and pleasant. They had longer hours, greater provision of transportation, and more amenities for the disabled. Implications are drawn for practice and research in ADC.
Employment after Retirement
Authors: Hardy Melissa A.
Published: March 2007

This study deals with one piece of the more general topic of job termination and responses to job terminations by focusing on the retirement and reentry behavior of older men and women. Using survey data from a representative sample of Florida residents aged 55 and older, multinomial logit models distinguishing reentrants, available workers, and retirees are estimated. Results are supportive of a status maintenance perspective on inequality in old age, showing that many of the factors associated with an insufficient demand for labor at younger ages are reproduced as predictors of unsuccessful reentry into the labor force after an initial retirement. Women, in particular, appear to be disadvantaged in their ability to maintain a desired attachment to the labor force, and evidence of this disadvantage persists even when preretirement job status and educational achievement are controlled.
Household Status and Headship among Unmarried Asian Indian Women in Later Life
Authors: Burr Jeffrey A.
Published: March 2007

This study applies a conceptual framework to the living arrangements of older unmarried Asian Indian women in the United States that allows for the evaluation of cultural diversity. The model holds that living arrangements at the end of the life cycle are determined by three sets of factors: availability of kin, feasibility as related to economic and health status, and desirability of living arrangements as related to cultural identity and adaptation. The multinomial logistic regression results show that despite the strong family norms of Asian Indians and their minority group status, older unmarried Asian Indian females are more likely than their White counterparts to live alone. In a separate analysis of Asian Indian women, the evidence shows that acculturated Asian Indian females are more likely than less acculturated members of this ethnic group to live alone as compared to living as part of a larger household without headship.
From Executive Suite to Production Line
Authors: Mutschler Phyllis H.
Published: March 2007

It is now widely accepted that employee caregivers-in the main, women-need to make adjustments in or take time from their jobs in order to provide or oversee assistance required by elderly relatives. The absenteeism, lowered productivity, and job turnover noted by many employers in business group surveys have motivated a number of firms to seek ways to address the needs of this group of employees. To date, researchers studying work disruption among employee caregivers have given little attention to the ways in which employees in different types of jobs respond to their dual responsibilities toward employers and elders who require their assistance. Those investigating the ways in which caregivers accommodate these competing demands have speculated that blue- or pink-collar workers may differ from their white-collar counterparts in the kinds or intensity of work disruptions they face, but few studies have contained information on workers' jobs that would permit systematic analysis of this question. This article analyzes patterns of work accommodations among caregivers in the Survey of Informal Caregivers of the 1982 National Long Term Care Survey. Caregivers' occupations are classified as: (a) executive, professional, technical jobs (18%); (b) sales (8%) or service (23%) positions; (c) clerical jobs (19%); or (d) production line and other blue-collar positions (32%). The study concludes that because the approaches caregivers take to address the demands of elder care are quite diverse and vary with membership in occupational group, employers who wish to aid these employees will need to design a set of flexible policies and benefit packages.
Toward an Understanding of Elderly Seasonal Migration Using Origin-Based Household Data
Authors: Hogan Timothy D. , Steinnes Donald N.
Published: March 2007

Analyses of data from a statewide household survey of older Minnesotans provide estimates of seasonal migration activity that are substantially higher than previous census-based estimates. More important, the data allow for comparisons between the migrant and nonmigrant populations of the same origin state (Minnesota). The findings show distinct differences between the two populations for many socioeconomic household characteristics.
Postretirement Increases in Pensions in the 1980s
Authors: Allen Steven G. , Clark Robert L. , McDermed Ann A.
Published: March 2007

Many firms give postretirement increases in pension benefits to retirees even though the formal pension contract does not require them. A leading explanation for the existence of postretirement increases is that they are part of an implicit employment contract that requires the firm to award postretirement increases when the financial performance of the pension fund is better than expected. Data from the 1986 Employee Benefit Survey is combined with financial information from the Form 5500 tax reporting forms for 1985 to estimate the determinants of postretirement increases in pension benefits between 1980 and 1985. The results indicate that financial factors are not closely related to the incidence of postretirement benefit increases but are important determinants of the magnitude of benefit increases. Other results reveal that proxies for the presence of an implicit contract are positively associated with the probability that a firm will award a postretirement benefit increase.
Older Adult Migration to the Sunbelt
Authors: Hazelrigg Lawrence E. , Hardy Melissa A.
Published: March 2007

Previous research has documented that, in the aggregate, older adult migrants to the Sunbelt tend to have higher average incomes than age-peer native residents. Using individual-level data on older Florida residents, the present study examines the extent to which this difference is due to compositional differences in factors that correlate with income, rather than to differences in income, per se. To compare specifically the income characteristics of the in-migrant and native portions of a place's older population, it is necessary to standardize the two groups on other relevant characteristics. The analyses suggest that the income advantage of migrants occurs principally among those older adults who migrate in conjunction with the retirement decision, and that it results mainly from a self-selection process.
Psychosocial Factors in Older Patients 'Medical Encounters
Authors: Greene Michele G. , Adelman Ronald D.
Published: March 2007

This article reviews the literature and presents some new preliminary findings on physician-older patient communication about psychosocial issues in primary care medical visits. The authors examine the importance of psychosocial talk in medical encounters, the barriers to these discussions, and the prevalence and specific content of psychosocial discussions in primary care medical encounters. The research suggests that the preponderance of talk in the medical encounter is biomedical, with little attention to psychosocial topics. The differential attention to the biomedical sphere may be more common and more problematic with the elderly. A research agenda in three areas is proposed. Investigations are needed on: (a) the determinants, outcomes, and nature of physician-older patient communication about psychosocial issues; (b) the psychosocial factors that are problematic in older patients' lives and have relevance for their medical care; and (c) the psychosocial issues that arise when the older patient is sick or disabled.
Assessing Environments in Alzheimer Special Care Units
Authors: Grant Leslie A.
Published: March 2007

The Nursing Unit Rating Scale (NURS) was developed to compare dementia special care units (SCUs) in nursing facilities to their non-SCU counterparts across six environmental dimensions: (1) separation, (2) stability, (3) stimulation, (4) complexity, (5) control/tolerance, and (6) continuity. The NUJRS was tested in 390 units in 123 nursing facilities in Minnesota. Statistically significant differences were found on all measures except continuity. The NURS is a potentially useful tool for assessing policy and program features of SCUs.