Nursing home deficiency citations for safety

Deficiency citations for safety violations in U.S. nursing homes from 2000 to 2007 are examined (representing a panel of 119,472 observations). Internal (i.e., operating characteristics of the facility), organizational factors (i.e., characteristics of the facility itself), and external factors (i.e., characteristics outside of the influence of the organization) associated with these deficiency citations are examined. The findings show that nursing homes increasingly receive deficiency citations for resident safety issues. Low staffing levels, poor quality of care, and an unfavorable Medicaid mix (occupancy and reimbursement) are associated with the likelihood of receiving deficiency citations for safety violations. In many cases, this likely influences the quality of life and quality of care of residents.     

The Cost of Doing Femininity: Gendered Disparities in Pricing of Personal Care Products and Services

Economic discrimination has been a major focus of gender research for the past several decades and such studies reveal a persistent gender wage gap. This study examines another aspect of the interaction between gender and the economy that has been largely ignored by social scientists—gender-based disparities in the cost of goods and services in the personal care industry. We examine prices charged for personal care products and services that are targeted toward women or men and find that women pay more than men for certain items and services. Our research suggests that although the differences are not uniform across types of services or products, women do tend to pay more than men for items such as deodorant, haircuts, and dry-cleaning. We suggest that such practices contribute to gender inequality by increasing women’s economic burden and reinforcing essentialist thinking about gender (i.e., that women and men are biologically different).     

Working for Patients? The Right Approach?

This paper is a slightly revised version of a Memorandum requested by the House of Commons Social Services Select Committee to assist the Committee in its analysis of the White Paper Working for Patients (Cm 555). It was submitted to the Committee on 28 February 1989. The paper follows up the authors'earlier study of the reform of the NHS (Barr, Glennerster and Le Grand, 1988), prepared at the request of the Select Committee prior to the publication of the White Paper.
The success or failure of the White Paper depends crucially on the precise details of the way in which its proposals are implemented. The Working Papers, although providing some more information as to how the White Paper's proposals will be implemented, do not in the main address the issues that concern us here.
Given the inescapable tension between cost and quality, quality control will be absolutely critical if the incentives to economize on the use of resources are not on occasion to lead to unacceptable reductions in quality — reductions which might well apply differentially by socioeconomic group.     

Pediatric Emergency Department Visits for Mental Health Crisis: Prevalence of Cyber-Bullying in Suicidal Youth

The objective of this work is to (1) study the prevalence of cyber-bullying amongst adolescents referred by Pediatric Emergency Department (PED) for urgent psychiatric assessment and (2) to examine the association between cyber-bullying and suicidal behavior to assist emergency department professionals in screening for risk and triage. This is a retrospective study of patients referred by PED to an urgent psychiatric clinic. Data was extracted for those with bullying victimization. Clinical variables included demographics, reason for referral, type of bullying, substance use, abuse, past psychiatric history, diagnosis and outcome. The cyber-bullying group was compared to those with traditional bullying and a group with no-bullying. Data analysis was conducted using Chi squares, multinomial and bimodal logistic regression. The urgent psychiatric clinic assessed 805 patients in 24 months, the prevalence of bullying was 26.9 % (n = 217). The prevalence of Cyber-bullying was 13.5 % (n = 109) and traditional bullying was 13.4 % (n = 108). Cyber-bullying victims have more suicidal ideation (χ² = 7.82, p = .005; 85.3  vs. 69.4 %), more sexual abuse (χ² = 5.75, p = .02; 29.4  vs. 15.7 %), more emotional abuse (χ² = 10.8, p = .01; 30.3  vs. 12.0 %) and physical abuse (χ² = 6.13, p = .01; 27.5  vs. 13.9 %) and a higher inpatient admission rate. Suicidal ideation is the presenting problem in more than two-thirds of patients, especially females, with history of cyber-bullying who present to the PED. Screening questions about cyber-bullying could assist emergency room professionals in establishing risk and making triage decisions.     

From Separate Corners to Dialogue and Action

How can higher education programs engage students in building a shared commons to address inequalities and foster commitment to intergroup collaboration? Intergroup dialogue is one such possibility to provide forums for meaningful engagement among students from diverse backgrounds. Findings from field experiments at nine colleges and universities show that students in intergroup dialogues increased significantly more than counterparts in control groups and social science comparison groups in their critiques of inequality and their commitments to post-college action to redress inequalities. Further, students in intergroup dialogues rated the frequency of the core communication processes more highly than the social science comparison students. The communication processes help account for the greater increase in students’ critiques of inequality and commitment to post-college actions.     

Underprotection of Unpredictable Statistical Lives Compared to Predictable Ones

Existing ethical discussion considers the differences in care for identified versus statistical lives. However, there has been little attention to the different degrees of care that are taken for different kinds of statistical lives. Here we argue that for a given number of statistical lives at stake, there will sometimes be different, and usually greater, care taken to protect predictable statistical lives, in which the number of lives that will be lost can be predicted fairly accurately, than for unpredictable statistical lives, where the lives are at stake because of a low‐probability event, such that most likely no one will be affected by the decision but with low probability some lives will be at stake. One reason for this difference is the statistical challenge of estimating low probabilities, and in particular the tendency of common approaches to underestimate these probabilities. Another is the existence of rational incentives to treat unpredictable risks as if the probabilities were lower than they are. Some of these factors apply outside the pure economic context, to institutions, individuals, and governments. We argue that there is no ethical reason to treat unpredictable statistical lives differently from predictable statistical lives. Moreover, lives that are unpredictable from the perspective of an individual agent may become predictable when aggregated to the level of a societal decision. Underprotection of unpredictable statistical lives is a form of market failure that may need to be corrected by altering regulation, introducing compulsory liability insurance, or other social policies.     

Perceptions of charisma from thin slices of behavior predict leadership prototypicality judgments

Signaling theory suggests that people use cues transmitted by leaders to form impressions of charisma but the validity of these impressions remains unexplored. Here, we examined whether perceptions of charisma from thin slices of nonverbal behavior relate to inferences based on more information. We tested whether ratings of charisma from 5-, 15-, and 30-s clips (with no audio) of speakers delivering a message predicted evaluations of vision articulation and leadership prototypicality made from 60-s multimedia clips (with audio). The results indicated that thin-slice charisma judgments predicted the criterion scores for leadership prototypicality but not vision articulation from all of the 5-, 15-, and 30-s silent clips. The current data therefore suggest that thin slices of charisma can be valid indicators of leadership.     

Evaluating Potential Distribution of High‐Risk Aquatic Invasive Species in the Water Garden and Aquarium Trade at a Global Scale Based on Current Established Populations

Aquatic non‐native invasive species are commonly traded in the worldwide water garden and aquarium markets, and some of these species pose major threats to the economy, the environment, and human health. Understanding the potential suitable habitat for these species at a global scale and at regional scales can inform risk assessments and predict future potential establishment. Typically, global habitat suitability models are fit for freshwater species with only climate variables, which provides little information about suitable terrestrial conditions for aquatic species. Remotely sensed data including topography and land cover data have the potential to improve our understanding of suitable habitat for aquatic species. In this study, we fit species distribution models using five different model algorithms for three non‐native aquatic invasive species with bioclimatic, topographic, and remotely sensed covariates to evaluate potential suitable habitat beyond simple climate matches. The species examined included a frog (Xenopus laevis), toad (Bombina orientalis), and snail (Pomacea spp.). Using a unique modeling approach for each species including background point selection based on known established populations resulted in robust ensemble habitat suitability models. All models for all species had test area under the receiver operating characteristic curve values greater than 0.70 and percent correctly classified values greater than 0.65. Importantly, we employed multivariate environmental similarity surface maps to evaluate potential extrapolation beyond observed conditions when applying models globally. These global models provide necessary forecasts of where these aquatic invasive species have the potential for establishment outside their native range, a key component in risk analyses.     

Wives and ex-wives: A new test for homogamy bias in the widowhood effect

Increased mortality following the death of a spouse (the “widowhood effect”) may be due to (1) causation, (2) bias from spousal similarity (homogamy), or (3) bias from shared environmental exposures. This article proposes new tests for bias in the widowhood effect by examining husbands, wives, and ex-wives in a longitudinal sample of over 1 million elderly Americans. If the death of an ex-wife has no causal effect on the mortality of her husband, then an observed association between the mortality of an ex-wife and her husband may indicate bias, while the absence of an effect of an ex-wife’s death on her husband’s mortality would discount the possibility of homogamy bias (and also of one type of shared-exposure bias). Results from three empirical tests provide strong evidence for an effect of a current wife’s death on her husband’s mortality yet no statistically signifi cant evidence for an effect of an ex-wife’s death on her husband’s mortality. These results strengthen the causal interpretation of the widowhood effect by suggesting that the widowhood effect is not due to homogamy bias to any substantial degree.