State Variations in Nursing Home Social Worker Qualifications

ABSTRACT

This is the first published account of state administrative code variations in nursing home social worker qualifications. It is important to review state codes because the majority of nursing homes in the U.S. have fewer than 121 beds and therefore are not required by the federal government to employ at least one full-time qualified social worker. States have the option of extending the federal regulations to homes with 120 or fewer beds, or strengthening the federal requirements in other ways. Findings indicate enormous variation in state requirements for qualifications of nursing home social workers, and even when states define a qualified nursing home social worker (not all do), they often exempt facilities from employing one. Seven states were found to be out of federal compliance. Research describing the qualifications of people employed in nursing home social services is called for, as well as research documenting effective psychosocial interventions, especially as they relate to resident quality of life. Ten recommendations for enhancing nursing home social work services are included.     

Expanding the Role of Long-Term Care Social Workers: Assessment and Intervention Related to Urinary Incontinence

Urinary incontinence (UI) is a common and stigmatizing problem faced by long-term care (LTC) residents. It is typically addressed by medical professionals, with social work rarely involved. The purpose of this article is to illustrate how social workers can address the psychosocial implications of UI while working with residents and their family members as part of an interdisciplinary team. Using a case example and the NASW objectives for LTC, recommendations on how the role of the LTC social workers can be expanded to better address both the needs of residents, families, and the larger LTC system are provided.     

BAYESIAN ESTIMATION OF RUIN PROBABILITIES WITH A HETEROGENEOUS AND HEAVY-TAILED INSURANCE CLAIM-SIZE DISTRIBUTION

This paper describes a Bayesian approach to make inference for risk reserve processes with an unknown claim‐size distribution. A flexible model based on mixtures of Erlang distributions is proposed to approximate the special features frequently observed in insurance claim sizes, such as long tails and heterogeneity. A Bayesian density estimation approach for the claim sizes is implemented using reversible jump Markov chain Monte Carlo methods. An advantage of the considered mixture model is that it belongs to the class of phase‐type distributions, and thus explicit evaluations of the ruin probabilities are possible. Furthermore, from a statistical point of view, the parametric structure of the mixtures of the Erlang distribution offers some advantages compared with the whole over‐parametrized family of phase‐type distributions. Given the observed claim arrivals and claim sizes, we show how to estimate the ruin probabilities, as a function of the initial capital, and predictive intervals that give a measure of the uncertainty in the estimations.     

Casting a Wide Net for Innovation: Mediating Effect of R&D Human and Social Capital to Unlock the Value from Alliance Portfolio Diversity

This paper examines the performance effects associated with different alliance portfolio configurations in terms of geographical location and partner type. Based on these distinctions, the authors hypothesize that more diverse alliance portfolios enable firms to gain and exploit innovation opportunities. Additionally, the mediating effects of R&D human and social capital on the R&D alliance portfolio diversity–innovation performance relationship are explored. The authors reason that the absorptive capacity of R&D intellectual capital determines a firm's potential gains from highly diverse alliance portfolios. From panel data of manufacturing firms in Spain for the period 2008–2013, the results confirm the inverted U‐shaped relationship between alliance portfolio diversity and firm innovation performance, implying that both insufficient and excessive alliance portfolio diversity may be detrimental to firm innovativeness. Additionally, R&D human and social capital partially mediates the R&D alliance diversity–innovation performance relationship, emphasizing the importance of internal capabilities to leverage the benefits of highly diverse alliance portfolios. These findings add a dynamic dimension to the conceptualization of alliance portfolios and how firms create value by balancing explorative and exploitative alliances.     

Female labour force participation and fertility

The levels of labor force participation by women in selected Asian countries were recorded in a series of censuses taken over a period of years. These levels were less influenced than male employment levels by economic conditions and more influenced by cultural traits of the country. Postwar trends seem to have fallen in Korea, risen in Singapore and the Philippines, and remained steady in Japan, Malaya, and Thailand. The limitations of these data are mentioned. In Thailand and West Malaysia greater percentages of women worked in agricultural than non-agricultural employment; in the Philippines, where women did not work so much in agricultural pursuits, their jobs were still in traditional rather than in development industries. In the cities of Bangkok, Manila, and Kuala Lumpur, fertility was lower for working than for non-working women. In rural agricultural areas, the fertility of working women was minimally higher, probably due to economic need of lar ger families. It is concluded that urban life separates the employment and the family roles of working women, leading to lowered fertility; this does not occur in rural areas. The creation of new roles for women alternative or supplementary to marriage and motherhood would result in lowered fertility. In high fertility Asian countries, policies directed toward greater participation of women in non-agricultural work and great er exposure to an urban lifestyle might achieve fertility reductions.     

The Class Politics of Alternative Food: Informing Public Health Policy and Remedying Health Inequality

The past decade has witnessed an interesting coupling between alternative ways to produce and consume food (farmers' markets, Consumer Supported Agriculture (CSA) shares, and urban gardens to name a few) and individual health‐seeking. While much of this activity rests on an ideological rhetoric of individual choice and “lifestyleism” strongly correlated with social class, there have also been a host of very different government and policy efforts aimed at improving poor food environments and the vulnerable populations that inhabit them in the name of public health. Efforts such as zoning against fast food franchises, placing stipulations on what benefit programs like Supplemental Nutrition Assistance Program (SNAP) can be used for, and taxing foods deemed unhealthy are sparking public debate because they cut to the heart of many American socio‐political debates: the tension between individual liberties and government intervention. Based on existing scholarship of alternative food, health, and bodies, and the author's insights gleaned from ethnographic research, this article sheds light on the potential ineffectiveness of such public health efforts despite positive – and often times class‐conscious – intentions. Such an acknowledgement raises critical questions about who benefits and who misses out in alternative food projects. While this article situates these questions squarely in the American context, it also highlights the need for other situated studies that emphasize other countries' particular political, cultural, and economic contexts that shape contemporary food systems, and their accompanying moral politics.     

Responding to the 2015 CMS Proposed Rule Changes for LTC Facilities: A Call to Redouble Efforts to Prepare Students and Practitioners for Nursing Homes

In July of 2015, the Federal Register published for public comment proposed rule changes for nursing homes certified to receive Medicare and/or Medicaid. If the final rules are similar to the proposed rules, they will represent the largest change in federal rules governing nursing homes since the Nursing Home Reform Act which was part of OBRA 1987. The proposed changes have the potential to enhance the quality of care and quality of life of nursing home residents. Many of the proposed changes would directly affect the practice of social work and would likely expand the role for nursing home social workers. This article discusses the role that members of the National Nursing Home Social Work Network (NNHSW Network) played in developing and submitting a response to CMS. The article provides the context for the publication of the proposed rules, describes the process used by the NNHSW Network to develop and build support for comments on these rules, and also includes the actual comments submitted to CMS. Social work education programs and continuing education programs throughout the country will continue to have an important role to play in helping to prepare social work students and practitioners for a career in long-term care.     

It's His Right,It's Her Duty: Benevolent Sexism and the Justification of Traditional Sexual Roles

This study tested the effects on social perceptions of sexual marital rights and duties of ambivalent sexist ideology and information about the benevolent sexist ideology of a husband, portrayed in a hypothetical marital vignette. In addition, the perception of whether hypothetical forced sex between husband and wife is considered rape was explored. For one half of the participants (college students), the husband was presented as high in benevolent sexism (BS); and for the other half, no information about his ideology was given. Results showed that participants in the first group ranked sexual marital rights (for him) and duties (for her) more highly, and regarded forced sex as rape to a lesser extent. Positive relationships were also found between participants’ BS and these ratings. Moreover, participants’ perceptions of marital rights and duties played a mediating role in the relationship between their BS and their perception of forced penetration as rape. Finally, an interaction was found between participants’ and husbands’ BS in the perception of marital rights and duties: The influence of participants’ BS was higher when the husband was presented as a benevolent sexist man. Results highlight the role of sexist attitudes in the interpretation of marital rape.