Fingerprint-based background checks for personal care workers: Stakeholder views of policy criteria

Decision makers face difficult choices when tasked with identifying and implementing appropriate mechanisms for protecting the elderly and other vulnerable adults from abuse. A pilot project involving fingerprint-based criminal history background checks for personal care workers in Michigan has supplied an opportunity to examine one such mechanism. In conjunction with the pilot project, we have conducted a stakeholder analysis with the aim of informing decision makers about stakeholder perceptions of standard policy criteria like effectiveness, efficiency, and equity. We employed focus groups and a Web-based survey to collect data from stakeholders. While stakeholders generally see fingerprint-based background checks for personal care workers as potentially effective and as a net benefit, they also point to a variety of contingencies. They also recognize difficulties and constraints for government involvement. This preliminary analysis provides solid foundational information for decision makers and for more extensive benefit–cost analysis.     

Quantifying Littered Cigarette Butts to Measure Effectiveness of Smoking Bans to Building Perimeters

Abstract

Objective: The authors estimated the number of violations of a university policy that prohibited smoking within 25 ft of all campus buildings. Participants: The project was conducted by 13 student researchers from the university and a member of the local public health department. Methods: Students quantified cigarette butts that were littered in a 30-day period inside the prohibited smoking area of 7 campus buildings (large residential hall, small residential hall, administrative building, 2 academic buildings, campus cafeteria, and student union). Results: Investigators found a total of 7,861 cigarette butts (large residential hall: 1,198; small residential hall: 344; administrative building: 107; 2 academic buildings: 1,123 and 806; campus cafeteria: 2,651; and student union: 1,632). Conclusions: Findings suggest that there is low compliance with the university's smoking policy. The described project may be repeated by students at other universities as a method to advocate for policy change.     

Mandatory Testing of Drivers on the Basis of Age and Degenerative Diseases: Stakeholder Opinions

Concerns about the driving competence of older drivers have led to policy discussions about mandatory aged-based and disorder-based assessments. This study explored the attitudes, beliefs, and preferences of older adults, law enforcement officers, and licensing authorities toward reexamination of driving skills for persons with Alzheimer's disease (AD) and Parkinson's disease (PD) and at varying ages. With few exceptions, participants across all groups supported retesting drivers with AD. Moderate support was given for further evaluation of 90-year-olds and those with PD. Least endorsement was given for reassessment of 70-year-old drivers. Findings have implications for legislative changes to address drivers with AD and PD and at older ages.     

Elder Abuse:

Perpetrator and incident characteristics were studied in regard to incidents of emotional, physical, and sexual mistreatment of older adults (age 60+) in a national sample of older men and women. Random digit dialing across geographic strata was used to compile a nationally representative sample; computer assisted telephone interviewing was used to standardize collection of demographic, mistreatment, and perpetrator and incident characteristics data. The final sample size consisted of 5,777 older adults. Approximately one in ten adults reported at least one form of mistreatment, and the majority of incidents were not reported to authorities. Perpetrators of physical mistreatment against men had more “pathological” characteristics compared to perpetrators of physical mistreatment against women. Perpetrators of physical mistreatment (compared to emotional and sexual mistreatment) also evidenced increased likelihood of legal problems, psychological treatment, substance use during incident, living with the victim, and being related to the victim. Implications for future research and social policy are discussed.     

Self-tracking as communication

Self-tracking has attracted a lot of attention from researchers and public opinion makers owing to its potential for improving life conditions through preemptive action on health, and as a tool of user empowerment vis-à-vis health-care professionals and private and public institutions. Nevertheless, the ‘stuff’ that is typically tracked – exercise and diet being the dominant tracking activities – refers to cultural and social practices that, for the individual user, are utterly mundane and reside in an experiential realm of everyday life. Self-tracking has to be understood in relation to behavior that is predominantly about getting things done in ways that are possible, suitable and meaningful for the individual. To account for this, we propose to conceptualize self-tracking as a communicative phenomenon along three dimensions: communication with the system, the self and social networks of peers. We develop the theoretical framework, drawing upon empirical findings from a qualitative study on how self-tracking is practiced and experienced in the context of exercise by different categories of empirical users. We demonstrate that the meanings of self-tracking practices are, at once, shaped by the motivation of an individual user who is situated in a broader web of everyday activities, and stimulated and augmented by communicative features provided by the technology.     

Comparison of Conflict of Interest Policies and Reported Practices in Academic Medical Centers in the United States

The authors reviewed the conflict of interest policies of 9 academic medical centers in the United States and interviewed members of the Institutional Review Boards (IRBs) and Conflict of Interest Committees (COICs) at those institutions. They found that many institutions used processes for reporting and managing conflicts of interest that were more decentralized than the processes described in their policies. Also, most institutions had no clear and comprehensive policy to guide investigators regarding disclosure of conflicts of interest to potential research participants. Considerable differences in understanding of conflict of interest policies were observed between IRB and COIC officials.     

Abstinence and Relapse Rates Following a College Campus-Based Quit & Win Contest

Abstract

Objective: To conduct and evaluate Quit & Win contests at 2 2-year college and 2 4-year university campuses. Participants: During Spring semester, 2006, undergraduates (N = 588) interested in quitting smoking signed up for a Quit & Win 30-day cessation contest for a chance to win a lottery prize. Methods: Participants (N = 588) completed a baseline survey, provided a urine sample to verify smoking status before joining the contest, and completed a follow-up survey at contest end to assess abstinence. Participants reporting continuous 30-day abstinence were surveyed again 2 weeks post contest to assess relapse. Results: Participants smoked an average of 9.8 ± 6.7 cigarettes/day on 26.7 ± 5.7 days/month. Among participants completing a follow-up survey (74%), 72.1% reported abstinence during the entire contest period (Intent-to-Treat Analysis = 53.2%). 55.3% of those abstinent at the end of contest had resumed smoking 2 weeks post contest. Conclusions: Campus Quit & Win contests appear feasible, acceptable, and effective at facilitating short-term abstinence. Further research is needed to identify strategies to prevent postcontest relapse.     

Suicide Ideation Among College Students Evidencing Subclinical Depression

Abstract

Identifying elevated suicide ideation in college students is a critical step in preventing suicide attempts and deaths by suicide on college campuses. Although suicide ideation may be most prominent in students with severe depression, this should not suggest that only students with severe depression experience significant risk factors for suicide. Objective: The purpose of these 3 studies was to explore the relation between suicide ideation and severity of depressive symptoms in college students. Participants: In each study a sample of college students were recruited for participation. Methods: Participants completed self-report assessments of depressive symptoms and suicide ideation. Results: The results of these studies suggest that although the greatest elevation in suicide ideation occurs at the highest depressive symptoms, significant suicide ideation is also experienced by college students with mild and moderate depressive symptoms. Conclusions: The implications of these findings for the assessment of suicide ideation are discussed.     

Testing Censoring Point Independence

Identification in censored regression analysis and hazard models of duration outcomes relies on the condition that censoring points are conditionally independent of latent outcomes, an assumption which may be questionable in many settings. This article proposes a test for this assumption based on a Cramer–von-Mises-like test statistic comparing two different nonparametric estimators for the latent outcome cdf: the Kaplan–Meier estimator, and the empirical cdf conditional on the censoring point exceeding (for right-censored data) the cdf evaluation point. The test is consistent and has power against a wide variety of alternatives. Applying the test to unemployment duration data from the NLSY, the SIPP, and the PSID suggests the assumption is frequently suspect.     

College Smoking Policies and Smoking Cessation Programs: Results of a Survey of College Health Center Directors

Abstract

College students' cigarette smoking rose dramatically during the 1990s. Little is known about what colleges do to address the problem. Health center directors at 393 4-year US colleges provided information (response rate: 65.1%) about college policies addressing smoking and the availability of smoking cessation programs. Of the health center directors surveyed, 85% considered students' smoking a problem; yet only 81% of colleges prohibit smoking in all public areas and only 27% ban smoking in all indoor areas, including students' rooms in dormitories and in private offices. More than 40% of the respondents reported that their schools did not offer smoking cessation programs and that the demand for existing program was low. Colleges need to do more to discourage student tobacco use. Recommended actions include campus-wide no-smoking policies that apply to student residences and identification of new ways of providing smoking prevention and cessation services.