Evidence-based risk factors for adverse health outcomes in older patients after discharge home and assessment tools: a systematic review

The current health care system is discharging elderly patients "quicker" and "sicker" from acute care facilities. Consequently, hospital readmission is common; however, readmission may be only one aspect of adverse outcomes of importance to social work discharge planners. The early recognition of risk factors might ensure a successful transition from the hospital to the home. A systematic review was conducted to identify factors associated with adverse outcomes in older patients discharged from hospital to home. Using a content analysis, factors were characterized in five domains: demographic factors, patient characteristics, medical and biological factors, social factors, and discharge factors. The most frequently reported risks were depression, poor cognition, comorbidities, length of hospital stay, prior hospital admission, functional status, patient age, multiple medications, and lack of social support. A systematic search identified four discharge assessment tools for use with the general population of elderly patients. Practice and research implications are offered.     

Intervention fidelity in psychosocial oncology

Intervention fidelity refers to strategies that practitioners and researchers use to monitor, enhance, or evaluate the accuracy and consistency of the delivery of an intervention to ensure that it is implemented according to how it was planned. The purpose of the authors in this article was to evaluate intervention fidelity in the psychosocial oncology intervention effectiveness research. Twenty-eight studies located in a previous systematic review on psychosocial oncology intervention effectiveness comprised the sample for this research. A treatment fidelity checklist was applied to each study independently by each author (MP & PB). Percent agreement between raters ranged from 68% to 100% (M = 89%). Overall, the mean proportion of adherence was 0.57 (SD 0.12), which may be considered to be moderate fidelity. Critical examination and applicability of the checklist in examining and assessing intervention fidelity were highlighted and discussed. Overall, intervention fidelity was adequately addressed in the psychosocial oncology intervention effectiveness research, and integrity was confirmed in the majority of studies reviewed. Suggestions for future psychosocial oncology effectiveness research were made.     

One-Year Prospective Study on Passion and Gambling Problems in Poker Players

The concept of passion is relevant to understanding gambling behaviours and gambling problems. Longitudinal studies are useful to better understand the absence and development of gambling problems; however, only one study has specifically considered poker players. Using a longitudinal design, this study aims to determine the influence, 1 year later, of two forms of passion—harmonious and obsessive—on gambling problems in poker players. A total of 116 poker players was recruited from across Quebec, Canada. The outcome variable of interest was participants’ category on the Canadian Pathological Gambling Index, and the predictive variable was the Gambling Passion Scale. Multiple logistic regression analyses were conducted to identify independent risk factors of at-risk poker players 1 year later. Obsessive passion at baseline doubled the risk of gambling problems 1 year later (p < 0.01); for harmonious passion, there was no association. Number of gambling activities, drug problems, and impulsivity were also associated with at-risk gambling. This study highlights the links between obsessive passion and at-risk behaviours among poker players. It is therefore important to prevent the development of obsessive passion among poker players.     

Passion for gambling: a scoping review

Investigating factors that influence a person’s ability to control gambling behaviour is important. The Dualistic Model of Passion, which includes both harmonious and obsessive passion, has proposed an original framework for studying these factors. However, the concept of passion as it pertains to the gambling experience remains relatively new and uncharted territory. This study entails a scoping review undertaken to determine the current state of knowledge concerning passion for gambling, and to provide recommendations for future research directions. The majority of studies included report a positive association between obsessive passion and gambling problems, whereas results related to harmonious passion were less consistent. Recommendations stemming from this scoping review include refining understanding of the relationship between obsessive passion and gambling problems, and broadening research aims to include more diverse sampling, methods and variables of interest when examining the overall contribution of passion to gamblers’ lived experiences. A final recommendation is to initiate research to test the utility of the Gambling Passion Scale in prevention and intervention programming.     

The Impact of Forced Migration on Marital Life in Chad

Civil war in Chad in the 1990shad a major impact on the family life of large numbers of people who were internally displaced or sought refuge in exile. This article examines the effect of these forced migrations on marriage, in particular the transition from monogamy to divorce or bigamy. It analyses data collected in N'Djamena in 1993–1994. The higher risk of divorce among internally displaced persons compared to that of refugees suggests that they were more vulnerable from a demographic perspective, and that their marital survival strategies may have been less successful. It is suggested that aid agencies should increase assistance given to internally displaced people because they are more at risk. This revised version was published online in July 2006 with corrections to the Cover Date.     

De la gestion technique du risque à celle du travail : l'accouchement en hôpital public

Since the 1998 perinatal reform, pregnancies and births have to be handled as a function of the estimated level of risk for the pregnant woman and fetus. Through a survey based on observations of, and interviews with, personnel in obstetrics, we see how managing risks and using techniques arise in interaction out of the tension between two forms of rationalization, the one formal, the other material. Four techniques are examined for assisting childbirth: the induction of labor, “directed work”, peridural analgesia and preventive Caesarian sections.     

Leaving Home in Europe: The Role of Parents’ and Children’s Incomes

This paper examines the role of parents’ and children’s incomes in the ‘leaving home’ decisions of young adults in Europe. Using the ECHP data on 11 European countries, results from random and fixed-effects models suggest that the leaving home decision is positively related to the child’s income. The effect of parents’ income is less clear and of lower magnitude. These patterns are broadly similar among European countries, in spite of significant differences in the institutional contexts.     

Prevalence and Correlates of Problem Gambling in a Representative Sample of Norwegian 17-Year-Olds

We report data collected in a representative sample of 17-year-old Norwegians to investigate prevalence rates of non-problem, risk, and problem gambling, as measured by the Problem Gambling Severity Index (PGSI). In addition, we explored the importance of demographic, personality, motivational, social, and health variables explaining variance in adolescent gambling. Prevalence rates of risk and problem gambling were low but similar to those found in previous studies outside of Norway using the PGSI in adolescent samples. With regard to the relative importance of the various covariates, we found that motivational variables (future gambling intentions, attitudes toward gambling, and gambling-related knowledge) distinguished best between those who did not gamble, non-problem gamblers, and risk and problem gamblers. Furthermore, social variables were important covariates of adolescent gambling; significant associations were found for family and friends’ approval of gambling, parental monitoring, father’s level of education, and having relatives or friends with a history of a gambling disorder. We discuss possible reasons for differences between the covariates with regard to their importance for explaining adolescent gambling and address implications for future research.     

Risk Perception,Risk Attitude,and Decision: A Rank-Dependent Analysis

The classical expected utility model of decision under risk has been criticized from an experimental point of view (Allais’ paradox) as well as for its restrictive lack of explanatory power. The Rank-Dependent Expected Utility model answers some of these criticisms. The decision maker is characterized by two functions: a utility function on consequences measuring preferences over sure outcomes and a probability weighting function measuring the subjective weighting of probabilities. The model allows for more diversified types of behavior: it is consistent with the behavior revealed by the Allais paradox; the decision maker could dislike risk (prefer its expectation to any lottery) without necessarily avoiding any increase in risk; diminishing marginal utility may coexist with “weak” risk-seeking attitudes; decision makers with the same utility function may differ in their choices between lotteries when they have different probability weighting functions; furthermore, the same decision maker may have different, context-dependent, subjective beliefs on events.     

Some Structural Effects of Migration on Receiving and Sending Countries

Traditionally, the question of migration has been compartmentalized analytically between, on the one hand, the causes of international migration which in the main have been studied by economists and geographers and, on the other hand, the consequences of migration primarily on the receiving countries, which has mostly been an area of concern for sociologists, demographers and geographers who have looked into theories and processes of settlement/integration. The twain rarely met. As a consequence, for heuristic purposes a separation based on discipline, geographical areas and objects of study has taken place, an approach challenged recently by some scholars. This article brings together the threads of international migration in its causes and consequences affecting both sending and receiving countries as well as the migrants. The close interaction between causes and consequences is enhanced by the role of migrants themselves. Indeed, migrants are not only objects whose moves are deterministically conditioned by structural factors, they are social actors who formulate their own strategies and life projects within given settings and conflicts in their society of origin and society of reception, which they in turn contribute to modify.