Challenges to care coordination posed by the use of multiple health IT applications

Coordinating care for hospitalized patients requires the use of multiple sources of information. Using a macroergonomic framework (i.e. the work system model), we conducted interviews and observations of care managers involved in care coordination across transitions of care. When information is distributed across multiple health IT applications, care managers experience a range of challenges, including organizational barriers, technology design problems, skills and knowledge issues, and task performance demands (i.e. issues related to individual information processing and management and sharing of information). These challenges can be used as a checklist to evaluate the proposed IT infrastructure that will allow the integration of multiple health IT applications and, therefore, support coordination across transitions of care.     

Old and New Forms of Giving: Understanding Corporate Philanthropy in India

Corporate philanthropy in India is burgeoning due to a fast growing economy, rise in the number of billionaires, and the recent introduction of legislation that mandates spending 2 % of company profits on corporate social responsibility. Through analysis of key historical and anthropological texts, we argue that ‘business philanthropy has a long and honorable history in India’ (Sidel, Voluntas: International Journal of Voluntary and Nonprofit Organizations 12(2):171–180, 172, 2001), and explain this with reference to Indian giving practices from Hindu, Mughal (Muslim), British Raj, and Gandhian traditions. We then move into a review of the emerging field of literature on corporate philanthropy, to explore how these traditions synthesized with contemporary global business and economic practices to create a distinct form of Indian corporate philanthropy. We necessarily also include an overview of its salient critiques. This will be of interest to those concerned with Indian philanthropy and of culturally specific scholarship of philanthropy.     

Adversity and children experiencing family homelessness: implications for health

This study tests links between adversity and health problems among children in family emergency housing. Children who experience family homelessness are at risk to also experience high levels of stress, health problems, and need for pediatric care. Understanding the connection between stress and health holds the potential to reduce persistent health disparities. Analyses tested whether experiencing a greater number of stressful life events during the early years of life was related to worse health conditions, emergency health-care utilization, and hospitalizations. Parents noted children’s experience of negative stressful life events, health problems, emergency room (ER) use, and hospitalization. Two cohorts of kindergarten-aged children staying in emergency family housing participated in the study in 2006–2007 (n?=?104) and in 2008–2009 (n?=?138), with the results examined separately. In both cohorts, more health problems were acknowledged for children exposed to more negative stressful life events. Stressful life events were not related to ER use but did relate to hospitalization for the 2006–2007 cohort. Results affirm links between stress in early childhood and health problems among children living in emergency housing. Findings are consistent with the hypothesis that adversity in early childhood contributes to income and racial disparities in health.     

Firearm presence and storage practices in North Carolina homes

Firearms injuries are a leading cause of injury and death in North Carolina, including suicide, homicide, intentional assault, and unintentional injuries. Research has demonstrated that the presence of a firearm in a household increases the risk for homicide and suicide. This study examined two firearms-related risk factors, the presence of a firearm in the household and risky storage practices (loaded and unlocked), using the 2011 North Carolina Behavioral Risk Factor Surveillance System (BRFSS). We hypothesized that among household firearm owners, those who keep unlocked loaded firearms would be varied by demographic variables and also by tendencies for more risk-taking behaviors such as smoking and drinking. Results showed that those who were more likely to keep firearms in or around the home were male, older age, White race, married, with some post high school education, and with higher income. There were no differences by region, age, race, education, or income among those who kept firearms loaded and unlocked. Risky storage practices were related to social conditions such as marital status and number of adults and children in the household. The presence of firearms was lower among those who lived alone; however, among those with a firearm in the household, 42% of single adult households keep a loaded and/or unlocked firearm in the house, and up to 30% of households with children do as well. Behavioral risk factors such as smoking, binge drinking, and not using a seatbelt when driving a car were also related to firearms possession and storage conditions.     

Effect of mortgage indebtedness on health of U.S. homeowners

This paper examines the effect of excessive mortgage indebtedness on health among homeowners using nine waves of the Health and Retirement Study from 1992 to 2008. Health status is measured by subjective well-being, number of depressive symptoms, and incidence of hypertension. Using average annual state-level home prices as an instrument, we attempt to identify the causal effect in an panel IV framework. Results from the panel IV estimations suggest that having a high mortgage loan to home value (LTV), defined as LTV at or above 80 %, leads to more depressive symptoms and a higher incidence of hypertension, but has no effect on subjective well-being. Since the results from panel estimations did not show that debt affects health, whether the panel IV results demonstrate a causal relationship depends critically on the exclusion assumption.     

Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations

Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice.     

Unmet health care needs of people with disabilities: population level evidence

The present study examined population level data on unmet needs for adults with physical, sensory and cognitive disabilities, using the National Population Health Survey. The study revealed that disabled adults (aged 20–64) reported more than three times as many unmet health care needs as their non‐disabled counterparts. Even after controlling for the effects of age, gender and poor health, disability had a significant effect on the perception of unmet needs, particularly disabilities associated with pain, hearing impairment and emotional problems. The greatest deterrent to receiving needed services among individuals with disabilities was cost. Despite being publicly funded and thereby presumably equally accessible to all, the health care system in Canada fails to meet the needs of some of its most vulnerable constituents – adults with disabilities.     

Masculinity and Men’s Choice of College Major

Gender Issues - We investigate whether adherence to dominant masculine norms and choice of college major are related among undergraduate men in the United States. Our results indicate that...     

Voices of youths on engagement in community life: a theoretical framework of belonging

Little is known from the perspectives of youths with intellectual and developmental disabilities themselves about their experiences related to inclusion, engagement in community life and friendship, and their quality of life. The Voices of Youths research project used an inclusive approach to learn from youths about these experiences. Twenty-four youths (age 13–24 years) with a range of intellectual and developmental disabilities diagnostic ‘labels’ participated in three video-recorded, community-based interviews. Constructivist grounded theory data analysis revealed a theoretical framework comprising the core concept of belonging and four associated concepts: engaging with similar people, having social relationships, negotiating meaningful roles, and navigating norms and expectations – finding a good fit. The findings contribute new knowledge about the ways in which these youths experience a sense of belonging from their own perspectives and can inform development/enrichment of policies, programmes, and services for these youths.     

Study abroad and cultural immersion: an alumni retrospect

ABSTRACT

This paper draws on an analysis of 2600 study abroad alumni responding to a survey that spans more than 25 years. Our inquiry focuses on evaluating how programme length, housing arrangements, number, and type of co-curricular activities impact alumni’s attributions of personal growth and their attitudes towards global engagement and future social relationships. This paper is also informed by a 5-year alumni follow-up study. Our study finds that the type of housing and participation in co-curricular activities have a significant moderating effect on alumni attributions. With rare exception, programme length does not have a significant impact on reported outcome measures. We conclude the paper with a discussion of how these findings can help guide future research and administrative programming.