Variability in measures of health and health behavior among emerging adults 1 year after high school according to college status

Objective: To examine changes in health behaviors among US emerging adults 1 year after high school. Participants: The national sample of participants (N = 1,927), including those attending 4-year college/university (n = 884), 2-year colleges/technical schools (n = 588), and no college (n = 455), participated in annual spring surveys 2013–2014. Methods: Health behaviors were assessed the last year of high school and first year of college; differences by college status controlling for previous-year values were estimated using regression analyses. Results: Relative to 4-year college attendees, those attending technical school/community college were less likely to binge drink (odds ratio [OR] = 0.57, confidence interval [CI] = 0.38–0.86) but more likely to speed (OR = 1.26, CI = 1.0–2.84), consume sodas (OR = 1.57, CI = 1.0–2.47), and report lower family satisfaction (p < .01), with marginally more physical and depressive symptoms. College nonattendees reported more DWI (driving while intoxicated; OR = 1.60, CI = 1.05–2.47), soda drinking (OR = 2.51, CI = 1.76–3.59), oversleeping (OR = 4.78, CI = 3.65–8.63), and less family satisfaction (p < .04). Conclusions: Health risk behaviors among emerging adults varied by college status.     

Academic Undermatch: How General and Specific Cultural Capital Structure Inequality

Recent literature has added another dimension to the well‐documented patterns of social class inequality in education: academic undermatch. Undermatch (which occurs when students attend institutions of lower selectivity than they are academically qualified to attend) is both widespread and unequal, with students from less advantaged families more likely to undermatch. Although proliferating, the research on undermatch has focused primarily on documenting the extent of, and less on exploring the mechanisms underlying, undermatch. Moreover, this literature has developed largely independent of the sociological research on cultural capital. Therefore, when scholars consider underlying mechanisms, they often focus narrowly on college‐specific information, without considering the broader cultural context in which students are embedded. Drawing on the literature on undermatch, as well as the sociological research on cultural capital, I differentiate between general and specific cultural capital. Moreover, instead of simply estimating whether students undermatch or not, I consider different types of undermatch. Results from the Educational Longitudinal Survey reveal that the effects of cultural capital are indeed heterogeneous, both with respect to its relationship to undermatch and its contribution to social class inequality. Findings have important implications for understanding undermatch and the role of cultural capital in reducing and reproducing social inequality.     

A Model for Aging in Place in Apartment Communities

The purpose of this article is to introduce a theoretical model for an aging-in-place housing specialist for those living in congregate housing facilities. A “needs assessment” tool is outlined to help facilitate the successful implementation of a Health and Aging Residential Service Coordinator (HARSC), both from a research perspective and from implementation of training curriculum for this specialized population. A model that provides both on- and off-site services is hypothesized to be most effective.     

Collaborative care for individuals with bipolar disorder or schizophrenia and co-occurring physical health conditions: A systematic review

While rates of chronic physical health conditions are increasing for the general population, individuals with severe mental illness are at greater risk. Co-occurring mental and physical health conditions are associated with poor health care utilization, socioeconomic, and patient-reported health status outcomes. This study used systematic review procedures to investigate the effectiveness of collaborative care models for improving the health of adults with bipolar disorder or schizophrenia and co-occurring chronic physical health conditions. Six studies met inclusion criteria, and included outcomes related to quality of life, physical health, and mental health. Collective and study-level results are reported and discussed, including implications for social work practice and research.     

Ice‐Breaker vs. Standalone: Comparing Alternative Workflow Modes of Mid‐level Care Providers

Capitalizing on the operational concept of division‐of‐labor, clinics often reduce physician service time by off‐loading some of his/her clinical activities to lower‐cost personnel. These personnel, such as nurse practitioners and physician assistants, are often collectively referred to as “mid‐level providers” (MLPs) and can perform many patient‐consultation tasks. The common rationale is that using an MLP allows the physician to serve more patients, increase patients’ access to care, and, due to MLPs’ lower salaries, improve the clinic's financial performance. An MLP is typically integrated into the outpatient clinic process in one of two modes: as an “ice‐breaker,” seeing each patient before the physician, or as a “standalone” provider, a substitute for the physician for the entirety of some patients’ visits. Despite both of these modes being widely used in practice, we find no research that identifies the circumstances under which either one is preferable. This study examines these two modes’ effects on operational performance, such as patient flow and throughput, as well as on financial measures. Using queueing and bottleneck analysis, discrete‐event simulation, and profit modeling, we compare these two deployment modes and identify the optimal policies for deploying MLPs as either ice‐breakers or as standalone providers. Interestingly, we also find there exists a range of scenarios where not hiring an MLP at all (i.e., the physician works alone) is likely to be most profitable for the clinic. Implications for practice are discussed.     

The asymptotic behaviour of the residual sum of squares in models with multiple break points

ABSTRACT

Models with multiple discrete breaks in parameters are usually estimated via least squares. This paper, first, derives the asymptotic expectation of the residual sum of squares and shows that the number of estimated break points and the number of regression parameters affect the expectation differently. Second, we propose a statistic for testing the joint hypothesis that the breaks occur at specified points in the sample. Our analytical results cover models estimated by the ordinary, nonlinear, and two-stage least squares. An application to U.S. monetary policy rejects the assumption that breaks are associated with changes in the chair of the Fed.     

Modeling binary responses with stochastic covariates

In a traditional binary regression model, covariates are assumed to be fixed by design. In practice, however, they are most likely to be stochastic and non-normally distributed. We develop modified maximum likelihood estimators for such situations. We show that these estimators are more efficient than the traditional binary regression estimators and robust to data anomalies. We illustrate our results using a real life example.     

Women's desire for the kaleidoscope of authenticity,balance and challenge: A multi‐method study of female health workers’ careers

Improved health care and increased life expectancy have extended working lives and changed the nature of work for many women. The aim of this research is to explore women's kaleidoscope career intentions of authenticity, balance and challenge, and understand the impact of life roles on their career choices. The research comprises two studies. In Study 1, interviews with 14 female hospital pharmacists demonstrate how their desire to increase non‐work life roles while caring for ageing parents has influence over their career choices. In Study 2, a survey of 178 female direct care workers confirms life roles’ impact on their kaleidoscope career intentions. Findings demonstrate that different life roles strongly influence women's career choices in a number of ways, primarily their desire to increase their leisure and engagement with activities outside work. In later life, carer responsibilities play an influential role in female career choices, particularly those related to eldercare. Finally, kaleidoscope career intentions may be influenced by life roles. These findings have considerable implications for both the expansion of careers and gender theory, and development of public and business policies aimed at attracting and retaining human resources.     

Pathways to pleasure: Older adult women’s reflections on being sexual beings

Older adult women make up a growing part of the population, and yet literature on the sexual activity over their life spans is lacking. This qualitative interview study explored the experience of 16 women aged 57–91 to better understand sexual pleasure over a lifetime. The participants described having to challenge cultural rules to create a supportive environment for sexual expression. Having access to Novel contexts in which to learn, cultivating Intimacy with partners and with oneself, being Creative with sexual activities, and Extending one’s sense of sexual possibility into advanced age (NICE) supported sexual pleasure as women aged.