Social Work and Complex Care Systems: The Case of People Hospitalised with a Disability

Health and hospital system reforms prioritise efficiency. However, initiatives can impact on people with new or existing disabilities who require time to maximise functional independence. With greater demands for shorter hospital stays social workers face increasing pressure to facilitate discharge. This paper reports findings from research identifying factors contributing to extended stays for adults with disabilities. We sought to better understand patient characteristics and discharge planning challenges by analysing a clinical dataset of 80 patients and qualitative interviews with five experienced hospital social workers. Three key factors are identified: issues around rehabilitation services; assessment and planning for community care; and availability of and access to discharge options. Strategies to reduce length of stay are reported. We argue that building collaborative partnerships and working across multiple, complex systems and disciplines are vital to ensure these patients access appropriate community-based resources within the current health reform environment.     

Doubling up when times are tough: A study of obligations to share a home in response to economic hardship

This study uses a factorial vignette design embedded in an Internet survey to investigate attitudes toward an adult child and parent living together in response to economic hardship. Over half of Americans said the desirability of intergenerational co-residence depends on particularistic aspects of the family, notably the quality of family relationships. Support for co-residence is greatest when the adult child is single rather than partnered. Support is weaker if the adult child is cohabiting rather than married to the partner, although groups with greater exposure to cohabitation make less of a distinction between cohabitation and marriage. Presence of a grandchild does not affect views about co-residence. There is more support for sharing a home when a mother needs a place to live than when the adult child does. Responses to open-ended questions show that individuals invoke both universalistic family obligations and particularistic qualities of family relationships to explain their attitudes.     

Combined multiple testing of multivariate survival times by censored empirical likelihood

In each study testing the survival experience of one or more populations, one must not only choose an appropriate class of tests, but further an appropriate weight function. As the optimal choice depends on the true shape of the hazard ratio, one is often not capable of getting the best results with respect to a specific dataset. For the univariate case several methods were proposed to conquer this problem. However, most of the interesting datasets contain multivariate observations nowadays. In this work we propose a multivariate version of a method based on multiple constrained censored empirical likelihood where the constraints are formulated as linear functionals of the cumulative hazard functions. By considering the conditional hazards, we take the correlation between the components into account with the goal of obtaining a test that exhibits a high power irrespective of the shape of the hazard ratio under the alternative hypothesis.     

Engaging with Comparative Risk Appraisals: Public Views on Policy Priorities for Environmental Risk Governance

Communicating the rationale for allocating resources to manage policy priorities and their risks is challenging. Here, we demonstrate that environmental risks have diverse attributes and locales in their effects that may drive disproportionate responses among citizens. When 2,065 survey participants deployed summary information and their own understanding to assess 12 policy‐level environmental risks singularly, their assessment differed from a prior expert assessment. However, participants provided rankings similar to those of experts when these same 12 risks were considered as a group, allowing comparison between the different risks. Following this, when individuals were shown the prior expert assessment of this portfolio, they expressed a moderate level of confidence with the combined expert analysis. These are important findings for the comprehension of policy risks that may be subject to augmentation by climate change, their representation alongside other threats within national risk assessments, and interpretations of agency for public risk management by citizens and others.     

Morality and Nuclear Energy: Perceptions of Risks and Benefits,Personal Norms,and Willingness to Take Action Related to Nuclear Energy

We examined factors underlying people's willingness to take action in favor of or against nuclear energy from a moral perspective. We conducted a questionnaire study among a sample of the Dutch population (N = 123). As expected, perceptions of risks and benefits were related to personal norms (PN), that is, feelings of moral obligation toward taking action in favor of or against nuclear energy. In turn, PN predicted willingness to take action. Furthermore, PN mediated the relationships between perceptions of risk and benefits and willingness to take action. In line with our hypothesis, beliefs about the risks and benefits of nuclear energy were less powerful in explaining PN for supporters compared to PN of opponents. Also, beliefs on risks and benefits and PN explained significantly more variance in willingness to take action of opponents than of supporters. Our results suggest that a moral framework is useful to explain willingness to take action in favor of and against nuclear energy, and that people are more likely to protest in favor of or against nuclear energy when PN are strong.     

Cooperative innovation through a talent management pool: A qualitative study on coopetition in healthcare

In recent years, the Dutch healthcare sector has been confronted with increased competition. Not only are financial resources scarce, Dutch hospitals also need to compete with other hospitals in the same geographic area to attract and retain talented employees due to considerable labour shortages. However, four hospitals operating in the same region are cooperating to cope with these shortages by developing a joint Talent Management Pool. ‘Coopetiton’ is a concept used for simultaneous cooperation and competition. In this paper, a case study is performed in order to enhance our understanding of coopetition. Among other things, the findings suggest that perceptions of organizational actors on competition differ and might hinder cooperative innovation with competitors, while perceived shared problems and resource constraints stimulate coopetition. We reflect on the current coopetition literature in light of the research findings, which have implications for future research on this topic.     

Ethical Comportment in Organizations: A Synthesis of The Feminist Ethic of Care and the Buddhist Ethic of Compassion

This article describes a mode of ethical behavior in organizations called ethical comportment that is the enactment of the principles of elements common to the feminist ethic of care and the Buddhist ethic of compassion. The paper outlines the main tenets of care and The Eightfold Path of Buddhism, a mode of practicing compassion, demonstrating the similarities in values and practices that embody what the author considers to be ethical comportment in organizations. This revised version was published online in July 2006 with corrections to the Cover Date.     

Why smart people believe that schools shortchange girls: What you see when you live in a tail

Why do so many smart people believe that schools shortchange girls when girls do so much better in school? Girls get better grades in every subject, go to college and graduate from college more often, and surpass boys on standardized tests of writing skills and reading comprehension. Boys do surpass girls in mathematics and science achievement and get a disproportionate number of doctorates in mathematics and the physical sciences. But more boys also end up at the bottom of the barrel, labeled impaired and assigned to special education classes. A fair judge might call the school gender wars a draw. The reason that this charge rings true is conspicuous male success in the unrepresentative universe that the policy elite inhabits. Highly visible male success in a field comes in part from a pattern few people know about—greater male variability in many human characteristics that puts more males at the very top (but also at the very bottom) of a distribution. The schools are shortchanging students, but the shortchanged group is African-American males, not girls. *** DIRECT SUPPORT *** A03BB001 00005     

Scholarly Communication 2.0: Exploring Researchers' Opinions on Web 2.0 for Scientific Knowledge Creation, Evaluation and Dissemination

This paper presents the results of a survey aimed at gauging the potential acceptance of a collaborative and Web 2.0 inspired scholarly communication sector. While this sector has seen the birth of a multitude of innovative initiatives, there is still little empirical evidence of the acceptance of such initiatives by researchers. We received 349 completed questionnaires from researchers of many different disciplines. The results of the survey show that there is a strong positive attitude towards Web 2.0 and open publishing approaches. However, the major challenge still resides in combining free dissemination of results with robust and reliable quality control mechanisms.     

Reclassifying causes of death to study the epidemiological transition in The Netherlands, 1875–1992

This article describes a method for reclassifying causes of death in the Netherlands for the period 1875–1992. Two criteria should be met to obtain a useful classification to study the epidemiological transition. First, the categories should be nosologically continuous over the period under study and second, there should be enough detail in causes which are important in the context of the epidemiological transition viz. communicable diseases, non-communicable diseases and external causes of death. A method developed by Vallin and Meslé (1988), which involves ‘dual correspondence tables’ and ‘fundamental associations’, was used to create nosologically continuous categories. These categories were tested for statistical continuity during the transition years of one ICD-revision to the next, using ordinary least squares regression analysis. The reclassification procedure resulted in a nested classification consisting of three levels of refinement of causes of death: 27 causes, 1875–1992; 65 causes, 1901–1992; and 92 causes, 1931–1992. On the basis of this classification, 43% of all deaths in 1875–79 and 98% of all deaths in 1992 could be allocated to either communicable diseases, non-communicable diseases or external causes.