Unmet needs at the end of life: perceptions of hospice social workers

Among persons at the end of life, it is important to understand whether the needs of patients are being adequately addressed. In particular, in hospice settings where the emphasis is on comfort care and quality of life, we know little about the presence of unmet needs. The purpose of this study was to examine the experiences of hospice social workers in working with hospice patients who had unmet needs at the end of life. Surveys were mailed to hospice social workers (N = 212) in two Southeastern states with a response rate of 36%. Results revealed that hospice social workers perceived patients to experience a wide variety of unmet needs-more commonly at the time of admission than during subsequent patient interactions. The most common unmet need reported at both times was a decreased ability to participate in activities that make life enjoyable. In situations where unmet needs exist, social workers reported that the most common perceived reasons were patient- related psychosocial issues and family conflict/issues. Additionally, a variety of interventions were used to address unmet needs, but a large number of barriers appear to impact outcomes in the cases. Results suggest that hospice patients experience a number of unmet needs, many of which are potentially treatable problems and concerns. Hospice professionals must continue to seek ways to assess and intervene effectively with patients who have unmet needs.     

Policy Learning for Flood Mitigation: A Longitudinal Assessment of the Community Rating System in Florida

Floods continue to inflict the most damage upon human communities among all natural hazards in the United States. Because localized flooding tends to be spatially repetitive over time, local decisionmakers often have an opportunity to learn from previous events and make proactive policy adjustments to reduce the adverse effects of a subsequent storm. Despite the importance of understanding the degree to which local jurisdictions learn from flood risks and under what circumstances, little if any empirical, longitudinal research has been conducted along these lines. This article addresses the research gap by examining the change in local flood mitigation policies in Florida from 1999 to 2005. We track 18 different mitigation activities organized into four series of activities under the Federal Emergency Management Agency's (FEMA) Community Rating System (CRS) for every local jurisdiction in Florida participating in the FEMA program on a yearly time step. We then identify the major factors contributing to policy changes based on CRS scores over the seven-year study period. Using multivariate statistical models to analyze both natural and social science data, we isolate the effects of several variables categorized into the following groups: hydrologic conditions, flood disaster history, socioeconomic and human capital controls. Results indicate that local jurisdictions do in fact learn from histories of flood risk and this process is expedited under specific conditions.     

Underwriting and Calls of Convertible Bonds*

We model convertible bond calls under asymmetric information where, unlike Harris and Raviv (1985), we consider a nonzero call price and a call notice period. In the model, the use of underwriters conveys negative information. Consequently, the stock price decline is greater for underwritten calls than for nonunderwritten calls. Furthermore, underwritten calls are made earlier and when the conversion option is less deep in the money. Underwriting commissions and the stock price decline associated with a call are negatively related to the extent that the conversion option is in the money before the call. Empirical evidence in this paper and Singh, Cowan, and Nayar (1991) are consistent with the model's predictions.     

Hierarchical Bayes modelling of penalty conversion rates of Bundesliga players

AStA Advances in Statistical Analysis - Judging by its significant potential to affect the outcome of a game in one single action, the penalty kick is arguably the most important set piece in...     

JOINT PRODUCT COST ALLOCATION IN THE CONTEXT OF COST-PLUS PRICING DETERMINATIONS WITH NON-UNIFORM MARKUPS

Companies that use cost-based pricing sometimes manufacture products that involve joint cost allocation. A problem with this is that, while product prices are a function of the full cost, joint cost allocation methods using net realizable values depend on the product prices. This paper demonstrates that when all costs and production quantities are known or can be budgeted, it is possible to simultaneously determine unique product prices (having non-uniform markup rates) and cost allocations using the net realizable value method.