Multilevel Factors Related to Psychosocial Care Outcomes in Washington State Skilled Nursing Facilities

As the primary providers of psychosocial services in skilled nursing facilities, social services professionals report barriers interfering with their ability to meet residents' needs. This study utilizes a 3-category quality assessment framework and a cross-sectional survey design to assess factors impacting the provision of effective psychosocial services in Washington State facilities. Hierarchical linear regression results indicate that the 3-factor model explains 26.4% of the variance in psychosocial outcomes; 4 variables exert the most influence: ownership turnover, practitioner experience, practitioner role identity, and the importance of individualizing care. Findings have implications for developing necessary supports for quality psychosocial care delivery.     

Gerontological Social Workers' Perceived Efficacy for Influencing Client Outcomes

Using a sample of practitioners (n = 269) from the 2004 National Study of Licensed Social Workers, this article employs a quality assurance structure–process–outcome model to examine factors at the practitioner, workplace, and service delivery levels that influence the perceived efficacy of licensed gerontological social workers to affect client outcomes in the context of a highly challenging health care environment. A regression model accounted for 33.9% of the variance (adjusted R ² = .291) in perceived efficacy with 3 aspects of service delivery satisfaction having significant effects: ability to address complex/chronic care, to influence the design of services, and to help clients navigate the system.     

Retrospective Reflections of a Whistleblower: Opinions on Misconduct Responses

Almost 10 years ago, when I was in my fourth year of graduate school, my fellow graduate students discovered that our thesis advisor had engaged in misconduct by falsifying and fabricating data in two grant applications. We informed the university and my advisor resigned. This event was a turning point in my life. Years later, I have gathered my thoughts and reflections on the experience. I believe we must first prevent what misconduct we can. But unfortunately some misconduct will still occur and in those circumstances we must respond to protect those affected by the misconduct and to progress beyond the event. In so doing, we get the most value out of scientific research.     

Introduction: Accountability in Neuroethics

Pharmaceutical sponsored clinical trials, formerly conducted predominantly in the United States and Europe, have expanded to emerging regions, including the Middle East. Our study explores factors influencing clinical trial privacy and confidentiality in the United Arab Emirates. Factors including concept familiarity, informed consent compliance, data access, and preservation, were analyzed to assess current practices in the Arab world. As the UAE is an emerging region for clinical trials, there is a growing need for regulations related to data confidentiality and subject privacy. Informational and decisional privacy should be viewed within the realms of Arab culture and religious background.     

Streetwise sales and the social order of city streets

This paper analyses how a Big Issue vendor approached passers-by and how they responded, how recognizable courses of social and economic activity were interactionally produced from initiation through to some conclusion. The paper recovers how the vendor's work was contextually embedded in the urban landscape, how it was constrained by, and actively shaped, the social order of the street. Drawing on video-audio recordings the paper contributes to a growing body of ethnographic and ethnomethodological research which has emphasized the embodied, contingent and interactional character of economic activity. By examining such materials, the paper is well positioned to describe how the vendor found his market on the street, social interventions that propelled passers-by into buying behaviour. The paper sheds light on now familiar encounters which occur millions of times each week in the UK and beyond.     

Using alcohol to sell cigarettes to young adults: a content analysis of cigarette advertisements

OBJECTIVE: Advertising influences the health-related behaviors of college-aged individuals. Cigarette manufacturers aggressively market to young adults and may exploit their affinity for alcohol when creating advertisements designed to increase cigarettes' appeal. Internal tobacco industry documents reveal that cigarette manufacturers understood the popularity of alcohol among young adults and sought to produce pertinent marketing strategies. METHODS: The authors conducted a content analysis of cigarette and alcohol advertisements in young adult-oriented magazines to investigate portrayed associations between cigarettes and alcohol. RESULTS: The content analysis revealed that 32 of 114 cigarette advertisements referenced alcohol and that those advertisements were more likely than others to portray active smoking. Conversely, 0 of 317 alcohol advertisements referenced cigarettes, and alcohol advertisements were only slightly more likely than cigarette advertisements to feature alcohol-related settings. CONCLUSIONS: Such advertising may detrimentally affect smoking patterns of college students. An understanding of these strategies can benefit on-campus tobacco control efforts.     

Comparability of the 6-min walk test using different test configurations

The 6-min walk test (6MWT) is a common component of fitness assessments of older adults; however, differing course configurations might affect 6MWT performance. It is unclear how comparable 2 different configurations are. To determine the comparability of 2 courses, 35 adults >65 years of age completed two 6MWT, once walking around a 20- by 5-yd outdoor rectangle and once on an indoor oval track (circumference 144.3 yd). Scores for the 2 tests were internally consistent (intraclass correlation coefficient = .95). The participants walked farther on the oval track than around the rectangle (639 +/- 19 vs. 582 +/- 16 yd; p < .0001), but responses to the rectangular configuration could be readily estimated using the equation 66.7 yd + 0.807 x (oval walking distance), R2 = .85. Thus, within-participant responses are similar across both 6MWT, but the course configuration affects the distance walked.     

AN INTERNATIONAL COMPARISON OF LIFETIME INEQUALITY: HOW CONTINENTAL EUROPE RESEMBLES NORTH AMERICA

We compare earnings inequality and mobility across the United States, Canada, France, Germany and the United Kingdom during the late 1990s. A flexible model of earnings dynamics that isolates positional mobility within a stable earnings distribution is estimated. Earnings trajectories are then simulated, and lifetime annuity value distributions are constructed. Earnings mobility and employment risk are found to be positively correlated with base‐year inequality. Taken together they produce more equalization in countries with high cross‐section inequality such that the countries in our sample have more similar lifetime inequality levels than cross‐section measures suggest.     

Age-Specific Death Rates With Tobacco Smoking and Occupational Activity: Sensitivity to Sample Length,Functional Form,and Unobserved Frailty

In this article, we estimate accelerated time-to-failure and proportional-hazard functions with about 100,000 members of the Dorn sample, finding greater hazards associated with smoking and some dependence on occupational variables that measure risk and physical activity. We answer three questions: (1) How sensitive are the estimates to sample length, using monthly data for the periods 1954–1969 and 1954–1980? The results differ somewhat between these sample periods. (2) How sensitive are the estimates to alternative functions for the hazard? Within a given time period, the estimates are fairly robust to specification changes in the distribution of the hazard in the accelerated time-to-failure models. (3) How sensitive are the estimates to alternative controls for unobserved frailty? Within a given sample period, the estimates are fairly robust to the allowance for parametric or nonparametric heterogeneity in the proportional-hazard models.     

Valuation of education and crime neighborhood characteristics through hedonic housing prices

This article studies households' valuation of neighborhood amenities through analysis of housing as a bundle of structural and neighborhood characteristics. Using statistical techniques, hedonic prices, or incremental values in the market, can be imputed to each element of the bundle. Twelve variables describe neighborhood crime; twenty-one variables describe neighborhood schools. Together with structural variables, they significantly and substantially explain house prices in the Baltimore metropolitan area. The technique is also shown to provide a market framework for approximating the benefits of localized neighborhood improvements.The authors wish to thank David Puryear, Ralph Taylor, and the two anonymous referees for their helpful comments on earlier drafts of this paper. We also thank Central Maryland Multiple Listing Service, the Baltimore City and Baltimore County Police Departments, and the Johns Hopkins Center for the Social Organization of Schools for house price, crime, and education data. None of the people or organizations listed is in any way responsible for the analyses or conclusions presented. Requests for reprints should be addressed to Dr. Allen C. Goodman, Center for Metropolitan Planning and Research, The Johns Hopkins University, Baltimore, MD 21218.