Using HIT to deliver integrated care for the frail elderly in the UK: current barriers and future challenges

In this paper we briefly describe the results of a 3 year project examining the use of Health Information Technologies (e.g., electronic patient record systems) to deliver integrated care. In particular, we focus on one group of patient (the frail elderly) and efforts to design an e-health supported healthcare pathway (the frail elderly pathway--FEP). The aim of FEP is to bring together clinicians and staff from health and social care and allow them to share patient information. Our findings show that progress in delivering a fully-supported and working FEP has been slow, not least because of the difficulties experienced by healthcare staff in using current IT systems. In addition, there are many strategic and technical issues which remain unresolved (e.g., systems interoperability).     

A usability gap between older adults and younger adults on interface design of an Internet-based telemedicine system

Internet-based telemedicine is becoming an effective tool to deliver home-healthcare services and health information on demand, especially in rural areas, where there is often a large elderly population with greater rates of preventable chronic diseases. However, the designs of current interfaces for these internet-based telemedicine systems do not take elderly user characteristics into consideration. This study conducted usability testing on the interface of an internet-based telemedicine system using two different age groups, young adults and older adults. Differences in overall performance and satisfaction between the two groups were identified. Based on these results, a future direction is suggested for the interfaces of Internet-based telemedicine systems.     

Family structure and child outcomes: a high definition, wide angle “snapshot”

Using data from the National Survey of America??s Families (NSAF), this research investigates the relationships between a highly defined set of family structures and a broad set of child outcomes at a particular point in time in a child??s life. A detailed classification of family structures is constructed that clarifies key differences among various types of diverse families, and facilitates equivalencies testing and pairwise comparisons across nontraditional family structures. The NSAF contains a large number of observations for less common, but growing, family structures such as single-father families, grandparent-headed households and cohabiters, which makes such detailed analyses feasible and allows further stratification by child age, gender and race. The data also contains information on child behavioral, educational and physical health outcomes, as well as extensive household characteristics, economic resources and parental behaviors and inputs. Results suggest that differences across nontraditional family structures are particularly prominent for child health outcomes and that the gender of the resident parent is empirically important, more so than the presence of a cohabiting or married step-parent. Children in single father families have lesser access to health care yet enjoy better health outcomes than those in other families, even after controlling for economic resources (and inputs). In contrast, few differences are found between grandparent-headed families and other non-parent families. While we explore alternative explanations for these results, our cross-sectional data and complex set of family structure variables preclude isolating causal relationships; instead, our analyses yield empirically important distinctions that point to promising avenues for future research.     

Labor Unions and Life Satisfaction: Evidence from New Data

While a growing literature demonstrates the impact of socio-political factors on citizens’ quality of life, scholars have paid comparatively little attention to the role political organizations such as labor unions play in this regard. We examine labor organization as a determinant of cross-national variation in life satisfaction across a sample of advanced industrial polities. Our findings strongly suggest that unions increase the life satisfaction of citizens, and that that this effect holds for non-union members as well. Moreover, we also find that labor organization has the strongest impact on the subjective well-being of citizens with lower incomes. We confirm these hypotheses using both individual and aggregate-level data from fourteen nations. We show these relationships to have an independent and separable impact from other economic, political, and cultural determinants. The implications for the study of life satisfaction and of labor unions as political actors in general are discussed.     

Temperament and the Development of Conscience: The Moderating Role of Effortful Control

In this longitudinal study we examined whether two components of effortful control, behavioral control, and executive function moderated the relation between temperament and conscience development. Temperament was assessed when participants were two years of age, and three temperament groups were formed: inhibited, exuberant, and low reactive. At 4.5 years of age, children's behavioral control and executive function were assessed. Moral behavior, emotionality during an empathy film, and false-belief understanding were measured at 5.5 years of age as components of conscience. Results indicate that inhibited children may benefit most from higher levels of effortful control. Inhibited children with higher levels of behavioral control performed better on false-belief understanding tasks whereas inhibited children who scored higher on executive function tests reported less emotional response to the evocative film. Finally, as a group, inhibited children exhibited more moral behavior than exuberant and low reactive children.     

Good Job,Good Life? Working Conditions and Quality of Life in Europe

Cross-national comparisons generally show large differences in life satisfaction of individuals within and between European countries. This paper addresses the question of whether and how job quality and working conditions contribute to the quality of life of employed populations in nine strategically selected EU countries: Finland, Sweden, the UK, the Netherlands, Germany, Portugal, Spain, Hungary, and Bulgaria. Using data from the European Quality of Life Survey 2003, we examine relationships between working conditions and satisfaction with life, as well as whether spillover or segmentation mechanisms better explain the link between work domain and overall life satisfaction. Results show that the level of life satisfaction varies significantly across countries, with higher quality of life in more affluent societies. However, the impact of working conditions on life satisfaction is stronger in Southern and Eastern European countries. Our study suggests that the issue of security, such as security of employment and pay which provides economic security, is the key element that in a straightforward manner affects people’s quality of life. Other working conditions, such as autonomy at work, good career prospects and an interesting job seem to translate into high job satisfaction, which in turn increases life satisfaction indirectly. In general, bad-quality jobs tend to be more ‘effective’ in worsening workers’ perception of their life conditions than good jobs are in improving their quality of life. We discuss the differences in job-related determinants of life satisfaction between the countries and consider theoretical and practical implications of these findings.     

Visual Sequence Learning in Infancy: Domain-General and Domain-Specific Associations with Language

Research suggests that non-linguistic sequence learning abilities are an important contributor to language development (Conway, Bauernschmidt, Huang, & Pisoni, 2010). The current study investigated visual sequence learning as a possible predictor of vocabulary development in infants. Fifty-eight 8.5-month-old infants were presented with a three-location spatiotemporal sequence of multi-colored geometric shapes. Early language skills were assessed using the MacArthur-Bates CDI. Analyses of children's reaction times to the stimuli suggest that the extent to which infants demonstrated learning was significantly correlated with their vocabulary comprehension at the time of test and with their gestural comprehension abilities 5 months later. These findings suggest that visual sequence learning may have both domain-general and domain-specific associations with language learning.     

The De/Repoliticization of Cooperation and the Discourse of Conversion1

Abstract In recent years, several agricultural cooperatives have undergone significant restructuring. Some have been taken through a conversion process and have been reorganized as “investor-oriented firms” (IOFs). This phenomenon has attracted the interest of agricultural economists, but it has not been analyzed by sociologists. This article examines the discourse with which agricultural economists have approached the conversion issue. Drawing upon Fraser's discussion of “needs talk,” and inspired by Kloppenburg's analysis of the agricultural scientific complex, an argument is made that a reprivatization discourse of neoclassical economics has effectively depoliticized discussion about the future of cooperative enterprise. It is further argued that a repoliticization of cooperation is necessary in order to assure the protection of extra-economic values and oppositional discourse that is embedded in the historical development of cooperative practices and institutions. We focus here on the role of expert discourse as it relates to the reinvention of cooperative institutions in the agricultural economy. It is argued that this discourse would be improved by greater attention to historical and sociological forces, rather than remaining narrowly focused on economism.