Trade-Offs Between Formal Home Health Care and Informal Family CareGiving

Using 1994 National Long Term Care Survey data, we estimated logistic regressions of formal and informal home health care use and hours. Home health care use and intensity were differentially impacted by chronic conditions, are higher for Medicaid enrollees and rural or small town residents, but lower for HMO enrollees. Decreases in the probability of home health care use increased informal instrumental activities of daily living (IADL) support four hours and decreased informal activities of daily living (ADL) support eight hours weekly. IADL caregiving substituted for formal care, but ADL caregiving declined with reductions in formal care. Public policy reducing formal home health care access may reduce informal ADL caregiving and increase informal IADL caregiving, producing net declines in support.     

Re-evaluating the Community Question from a German perspective

The far-reaching effects of the social systemic division of labor on the organization and contents of primary ties make the Community Question an important issue for many sociologists. This paper looks at the personal embeddedness of families in three German cities (Berlin, Hamburg, and Stuttgart) and examines the Community Question with data collected at the end of 2003. It is based on the theoretical views of Wellman [Wellman, B., 1979. The community question. The intimate networks of East Yorkers. American Journal of Sociology 84, 1201–1231], who used a network analysis perspective to conceptualize “the Community Question”. The results of this German study generally support the results of Wellman's second East York Study. However, the network structures analyzed in my study vary from the three ideal-type models. Cluster analysis shows that Wellman's typology can be replicated relatively well in Germany. In contrast to traditional discourse related to the Community Question, particular network types are not associated with low levels of social relations. Moreover, structural factors do not explain the existence of different network types. Thus, the networks are not a product of only one community model. They suggest that it is less helpful to talk about “Saved”, “Lost”, or “Liberated” communities than it is to regard communities as a mixture of strongly-knit nuclear clusters and of broader, sparsely-knit relations that provide access to different groups and their resources.     

FAMILY THERAPISTS' RESPONSE TO AIDS: AN EXAMINATION OF ATTITUDES,KNOWLEDGE, AND CONTACT*

As the number of individuals and families impacted by AIDS continue to multiply, family therapists will increasingly be asked to become engaged in the challenge of caring for those affected. To date, little has been written in family therpy journals regarding the response of family therapists to this crisis. This paper represents an initial attempt to examine the atitudes of clinical members of the American Association for Marriage and Family Therapy toward AIDS and persons with AIDS. Included in the study are data regarding the therapists' contact with persons with AIDS, gays, and lesbians, and the impact of such contact on attitudes. Implications for future research, training, and treatment of those affected by AIDS are also provided.     

A research note on Keyfitz's ‘The demographics of unfunded pensions’

Keyfitz (1985), The demographics of unfunded pensions, discusses the performance of pay-as-you-go old age insurance plans under different financial structures. One arrangement is to pay a fixed pension to retirees and collect the necessary contributions from the working population. Another is to fix the contribution per worker and distribute whatever monies are collected to the retirees. Unfortunately, equity problems arise in a pay-as-you-go plan when the population is not stable. Generally, large cohorts will receive greater rates of return than small cohorts when the pension is fixed, while small cohorts will receive greater rates of return when the contribution is fixed. Social security analysts in the U.S. have been concerned with minimizing inequities in cohort rates of return. In considering the US population in 1980, Keyfitz shows that disparities in cohort rates of return are less under a fixed contribution scheme than under a fixed pension scheme. This research note points out that Keyfitz's finding is limited to the specific situation in 1980. When analyzing in a broader framework the mechanics of unfunded pensions and their interaction with nonstable populations, the reverse is true: fixing the pension yields less disparity in cohort rates of return than fixing the contribution.Keyfitz (1985) a déjà discuté dans cette revue des résultats d'un système de répartition pour le financement des pensions de retraite sous diverses conditions financières. Une solution consiste à payer une pension fixée aux retraités et à collecter les fonds nécessaires auprès de la population active. Une autre solution est de fixer la contribution par actif et de distribuer ce qui a été ainsi collecté aux retraités. Malheureusement des problèmes d'équité surviennent dans ces systèmes de répartition lorsque la population n'est pas stable. Généralement, les cohortes nombreuses bénéficieront de plus forts taux de rendement que des cohortes moins nombreuses lorsque la pension est fixée, tandis que l'inverse se produit lorsque la contribution par actif est fixée. Aux Etats-Unis les analystes des systèmes de sécurité sociale ont cherché à minimiser les inégalités dans les taux de rendement. Lorsque Keyfitz considérait la population des Etats-Unis en 1980, il avait montré que les disparités dans les taux de rendement des cohortes étaient moindres sous la condition d'une contribution par actif fixée que sous celle d'une pension par retraité fixée. Cette note the recherche indique que le résultat obtenu par Keyfitz est propre à la situation spécifique de l'année 1980. Lorsque l'on analyse d'un point de vue général le fonctionnement des pensions de retraite et leurs interactions avec des populations non-stables, l'inverse est vérifié : le fait de fixer la pension conduit à moins de disparités dans les taux de rendement des cohortes que le fait de fixer la contribution des actifs.

---

This research was undertaken when the author was completing her dissertation at the Graduate Group in Demography at the University of California, Berkeley. The author now operates Lapkoff Demographic Research, a private research consulting firm.     

Patient assertiveness in ethnically diverse older women with breast cancer: Challenging stereotypes of the elderly

Patients' views of patient-physician interactions—particularly the perspectives of older, ethnically diverse women—are poorly understood. The older patient's attitude toward and understanding of the medical encounter, however, are essential to the design of strategies to improve patient-physician communication. To date, investigations have primarily emphasised the ways in which the therapeutic relationship is influenced by immutable patient characteristics. This qualitative study extends previous research findings by looking beyond the effect of ascribed categories (such as age, race, and gender) and focusing on aspects of patient behavior, specifically assertiveness. Focus groups were conducted with older African-, Chinese-, European-, and Hispanic American breast cancer patients from sites in the eastern and western United States. The study explores the potential of a form of patient activation for challenging stereotypes of the elderly and changing health care practitioners' behavior.     

Substance use disorders and referral to treatment in substantiated cases of child maltreatment

Parents with substance use disorders (SUD) require treatment and support in order to provide children with appropriate care and protection. Using the 2012 National Child Abuse and Neglect Data System (NCANDS), this paper analysed 464 313 substantiated child maltreatment reports to determine (i) the proportion and characteristics of reports involving substance abuse; and (ii) the child and caregiver/perpetrator (C/P) characteristics that predicted referral to treatment as recorded in service plans. Findings indicate that 12% (N = 53 234) of maltreatment reports involved C/P SUD. Yet, of those reports, only (19%) (N = 10 088) were referred to substance abuse treatment as part of their service plan, indicating a large gap between those who need treatment and those who receive it. This finding is important given that parental SUD is consistently linked to poorer child outcomes. Amongst other variables, reports indicate that C/P with co‐occurring emotional disturbance were three times more likely to be referred to treatment for SUD as part of service plans. Additional research is needed regarding the characteristics that distinguish C/P who receive referrals for SUD treatment in substantiated cases of child maltreatment.     

Probabilistic solutions to ordinary differential equations as nonlinear Bayesian filtering: a new perspective

Statistics and Computing - We formulate probabilistic numerical approximations to solutions of ordinary differential equations (ODEs) as problems in Gaussian process (GP) regression with nonlinear...     

The inner circle: Building bridges or boundaries between researchers and practitioners

An epistemological and methodological approach, The Change Laboratory, is analysed to determine which forms of distributing knowledge are apparent during cross-cultural research. Distributing knowledge is intricately related to methodological design, to researchers’ and practitioners’ life experiences and to roles of power. The article concludes that research conducted across cultures necessitates careful analysis of the power found within forms of distributing knowledge. This power is derived from a tacit belief that certain knowledge is only available to those within a given circle or that it is available to those outside a given circle without alteration.     

Does compassion go viral? Social media,caring, and the Fort McMurray wildfire

ABSTRACT

In May 2016, an enormous wildfire threatened the city of Fort McMurray, Alberta and forced the evacuation of all of the city’s residents. Outpourings of support teemed in from all across Canada and over the world, prompting the largest charitable response in Canadian Red Cross history. This paper examines Albertans’ response to the wildfire by exploring caring and helping behaviors as well as the role of social media in facilitating these remarkable charitable efforts. The paper uses mixed methods including an analysis of the most popular Tweets related to the wildfire and an Alberta survey collected months after the disaster. The analysis of tweets reveals that care, concern, and invitations to help were prominent in social media discourse about the wildfire. The analysis of survey data demonstrates that those who followed news about the wildfire on social media express higher overall levels of care and concern for those affected, which led to helping those impacted by the wildfire. The findings provide important insights about the role of social media in disaster relief and recovery as well as citizens’ civic engagement.