Family Caregiver Communication in the ICU: Toward a Relational View of Health Literacy

We interviewed 18 family caregivers about their communication experiences in the ICUs at an urban hospital. Analysis of their narratives suggests health literacy is important in family caregiver/healthcare provider communication, especially as complicated illnesses move the caregiver deeper into decision making. Using the domains of Yuen et al.’s conceptual model of caregiver health literacy (2015), we identified three themes within the context of ICU communication: agency, coordinated communication, and caregiver’s evolving role. We saw family caregivers negotiating domains of health literacy as they built upon knowledge of the patient’s needs, their rights as family caregivers, and the hierarchy of the professional staff. We found that these narratives represent co-created, or relational communication, rather than individual health literacy skills. Conceptualized in the transaction of relationship, health literacy is enacted; it is socially constructed and is the scaffolding upon which family caregivers make decisions, care for their loved one, and care for themselves.     

Structured Voluntary Youth Activities and Positive Outcomes in Adulthood: An Exploratory Study of Involvement in Scouting and Subjective Well-Being

This study explores whether youth involvement in Scouting has positive consequences later in life. We examine whether the number of years of participation in Scouting is positively associated with human and social capital and recreational lifestyles in adulthood, and whether these are linked to subjective well-being: relational, emotional, and physical health. To explore this potential relationship, we estimated a structural equation model, analyzing data from a national sample of adult males. We found that youth involvement in Scouting is positively related to subjective well-being indirectly via the positive adult outcomes.     

The Development of a Reliable Change Index and Cutoff for the Revised Dyadic Adjustment Scale

The Revised Dyadic Adjustment Scale (RDAS; Busby, Crane, Larson, & Christensen, 1995) is a measure of couple relationship adjustment that is often used to differentiate between distressed and non‐distressed couples. While the measure currently allows for a determination of whether group mean scores change significantly across administrations, it lacks the ability to determine whether an individual's change in dyadic adjustment is clinically significant. This study addresses this limitation by establishing a cutoff of 47.31 and reliable change index of 11.58 for the RDAS by pooling data across multiple community and clinical samples. An individual whose score on the RDAS moves across the cutoff changes by 12 or more points can be classified as experiencing clinically significant change.     

Family Roles as Moderators of the Relationship Between Schedule Flexibility and Stress

Employer initiatives that address the spillover of work strain onto family life include flexible work schedules. This study explored the mediating role of negative work–family spillover in the relationship between schedule flexibility and employee stress and the moderating roles of gender, family workload, and single‐parent status. Data were drawn from the 2008 National Study of the Changing Workforce, a nationally representative sample of working adults (N = 2,769). The results indicated that schedule flexibility was associated with less employee stress and that these associations were mediated by perceptions of negative work–family spillover. This study found the moderating relationships of gender, family workload, and single parenting in the relationships between schedule flexibility and negative work–family spillover and stress. Schedule flexibility had stronger relationships in reducing negative work–family spillover and stress among women, single parents, and employees with heavier family workloads. The findings provide empirical support for intervention efforts involving schedule flexibility to reduce workplace stress among employees with family responsibilities.     

Gaining by giving? Peer research into service user and carer perceptions of inclusivity in Higher Education

Abstract

Service users and carers (SUAC) have made significant contributions to professional training in social work courses in Higher Education (HE) over the past decade in the UK. Such participation has been championed by government, academics and SUAC groups from a range of theoretical and political perspectives. Most research into the effectiveness of SUAC involvement at HE has come from the perspectives of academics and very little SUAC-led research exists. This qualitative peer research was led by two members of the University of Worcester’s SUAC group. Findings were that SUAC perceived their involvement brought benefits to students, staff, the University and the local community. Significant personal benefits such as finding a new support network, increased self-development and greater confidence to manage their own care were identified in ways that suggested that the benefits that can flow from SUAC involvement at HE are perhaps more far-reaching than previously recognised. Barriers to inclusion were less than previously reported in the literature and the humanising effects of SUAC involvement are presented as a partial antidote to an increasingly marketised HE culture.     

Relationships between Economics,Welfare, Social Network Factors,and Net Migration in the United States

By using economics, welfare and social network factors as frames of reference, this study aims to explore the relationship between these three factors and net migration to various US states. Adopting related variables collected from official aggregate data, this study first utilizes Logit Regression analysis to draw out seven variables that best explain net migration to the various states, then employs these variables in LISREL analyses to build a model explaining the factors influencing net migration to the various US states. Concretely, this research obtained the following findings: (1) the seven variables ‐‐ the average rate of net migrants of 2002–2005, Medicaid, federal aid, employment rate, non‐poverty population rate, and SSI subsidy ‐‐ all significantly affected (p < 0.01 or p < 0.05) net migration in 2006; (2) the main influences on net migration for the various states are, from highest to lowest, social network, economic, and welfare factors. More specifically, a better explanation is that, through the social network factor, economic and welfare factors exert an increased influence on the net number of migrants; and (3) as for the influence of social network factors on the number of net migrants, the social network factor for the previous year was found to best explain domestic migration flows, while the social network factor for the previous three‐to‐four years best explained international migration flows.     

Lesbian Identity Management at Various Stages of the Coming Out Process: A Qualitative Study

This qualitative study is designed to explore how women at various stages of lesbian identity development make decisions about managing their identities. Management of identity was studied in terms of how women came out or stayed hidden and how they made decisions both to disclose and to conceal. The Cass (1984) Stage Allocation Measure was used as a means to categorize women at various stages of lesbian identity development. Twenty-five adult women were individually interviewed using a semi-structured interview schedule. A journal was kept by each woman for one month. The major findings indicated that women at different stages of lesbian identity development use both disparate and similar identity-management and decision-making strategies. Underlying and connecting lesbian identity management and development was the need to maintain self-esteem and safety.     

A graphical method for evaluating mixture designs with respect to the slope

Good estimation of the slopes of the mixture response function may be important as well as estimation of mean mixture response. It is possible to evaluate and compare several mixture designs with respect to the slope. A graphical method is proposed that allows us to evaluate a given design's support for the fitted model in terms of slope variance. We can plot variances of slopes along Cox direction or axial direction according to existence of restriction of simplex region or not when comparing several different mixture designs.     

Managing urban wetlands for multiple use: research,restoration, and recreation

Conservation of urban wetland habitat is challenging, because multiple uses must coexist. We use examples from California and Wisconsin to describe potential synergies among recreation, restoration and research activities (the 3 R's). Allowing passive recreation is often essential to garner public support for habitat protection, restoration, and research. In turn, restoration activities can improve the appearance of degraded sites, and designing the work as a research experiment can serve the scientific community. Two projects at Tijuana Estuary support the 3 R's. (1) Oneonta Tidal Linkage is a 0.7-ha tidal channel and salt marsh that was excavated from disturbed upland to bring wetland habitat closer to the Visitor Center (thereby reducing visitor intrusion into natural marsh habitat, where endangered species would be disturbed). It supports an ambitious field experiment that is testing the importance of species diversity in restoration; it also includes a bridge that serves the interpretive program, and it adds 0.7 ha of wetland habitat that helps restore regional biodiversity. (2) A larger excavation (8 ha) of former tidal wetland will soon add wetland habitat, while testing the importance of tidal creek networks in ecosystem functioning and offering views and interpretive opportunities. A third situation, at the 485-ha University of Wisconsin–Madison Arboretum, concerns restored wet prairies, which provide habitat for native species and serve many hikers. Urban stormwater flows into and degrades the Henry Greene Prairie, allowing aggressive plants to invade. Research and restoration efforts are planned to sustain the habitat and recreation functions. These three models suggest that recreation, restoration, and research are compatible uses of urban wetland habitats.