Item validity of the physical demands from the Dictionary of Occupational Titles for functional capacity evaluation of clients with chronic back pain

This study assessed the item validity of 15 of the physical demands from the Dictionary of Occupational Titles (DOT), as evaluated in a new approach to functional capacity evaluation (FCE) for clients with chronic back pain, the Gibson Approach to FCE (GAPP FCE). Fifty-two occupational therapists were sent the specifications of the items in the GAPP FCE procedures and were asked to rate the items in terms of item-objective congruence, relevance and difficulty. A response rate of 59.2% was obtained. The majority of the therapists agreed that most of the items were congruent with the objectives based on the definition of the physical demands from the DOT. The items evaluating Balancing and Pushing and Pulling had the lowest item-objective congruence. The evaluation of Balancing and the Lifting, Carrying and Pushing and Pulling of loads greater than light-medium weight (10-16 kg) were not considered significantly relevant. Concerns were raised about the difficulty and safety of the evaluation of Lifting, Carrying and Pushing and Pulling with clients with chronic back pain, particularly if the therapist evaluates the manual handling of medium to heavy loads. These results may have implications for other FCEs, particularly those which are based on the DOT, or when assessing clients with chronic back pain.     

Dying patients' thoughts of ending their lives: a pilot study of rural New Mexico

Forty-nine hospice patients in rural New Mexico were directly interviewed concerning their thoughts about ending their lives. Thirty-one patients (63%) did not have thoughts of ending their lives, whereas 18 patients (37%) reported having suicidal thoughts. There were no differences between patients with and without thoughts of suicide related to gender; ethnicity; age; education; disease; religion; importance of religion; location of hospice agency; remaining financial, family, or spiritual issues; satisfaction with hospice care; sum of hospice personnel seen; or sum of medical equipment used. There were significant differences between patients with and without thoughts of suicide related to the number of household members (p = .02); the symptoms of trouble sleeping (p = .04) and nervousness (p =.03); and Medicare insurance coverage for hospice care (p =.01). No other symptom, including pain and hopelessness, was significant. Seven (39%) of the 18 patients who thought of ending their lives told someone about these thoughts. There were no variable differences between patients who did and did not tell someone about these thoughts.     

"Nothing about me without me": leading the way to collaborative relationships with families

This article discusses the National Center on Addiction and Substance Abuse's CASA Safe Haven, an evidence-based, community-driven intervention program for children and families in child welfare whose lives have been adversely affected by substance abuse, and for staff in the agencies that work with them. CASA Safe Haven builds collaborative relationships that feature a blend of multidisciplinary teams that share responsibility for helping families; family group conferencing, in which families are equal and welcome participants in designing and driving a service plan; and the influence of family court to hold families and service providers accountable for progress. CASA Safe Haven is a framework for collaboration.     

Key variables in technology transfer: A field-study based empirical analysis

Research and development (R&D) consortia represent a new organizational form which highlights barriers and clarifies solutions to efficient and timely technology transfer. Using interview, archival, and survey data collected on one of the nation's oldest and most prominent R&D consortia, the MCC (Microelectronics and Computer Technology Corporation), this study refines and contributes to established technology transfer theory by suggesting that four variables—communication interactivity, cultural and geographical distance, technology equivocality, and personal motivation—are central to technology transfer processes within and between organizations. Research hypotheses are presented in terms of a Technology Transfer Grid which depicts different combinations and managerial implications of the four variables.     

The importance of end-of-life care in nursing home settings is not diminished by a disaster

The emphasis in disaster situations is on preserving life, and this goal is both appropriate and laudable. There is a risk, however, that the needs of people who are dying can become lost when there is a sudden surge of people needing acute intervention. There are significant ethical considerations inherent in society's prioritization of care needs across the acute, rehabilitative, and palliative spectrum in general, let alone in a disaster situation. These ethical conundrums are not the focus of this article. Rather, we anchor our discussion on the assumption that care needs are equally valid, and our purpose is to explore the issues that impact the provision of quality end-of-life care in nursing home settings for those who require this care when a disaster occurs. Nursing home residents, in particular, are at heightened risk for experiencing negative disaster-related outcomes due to compromised physical or mental health that requires skilled nursing care. Moreover, within the already vulnerable nursing home population are many people who are receiving palliative end-of-life services when a disaster strikes. Education and training in end-of-life services for nursing home staff, disaster emergency responders, and other lay people is vital to build capacity for adapting the delivery of these services in disaster situations in the interest of equity and human rights. Given the present lack of guidance in the literature as to what end-of-life care looks like when adapted to the context of disaster response, there is also a pressing need for research to inform this discussion. The purpose of this article is to draw attention to this topic and highlight some of the critical issues, gaps, and opportunities.     

Cohort disaggregation analysis of fertility data from a sample survey

Social differentials in cumulative fertility revealed by field surveys in a number of countries typically have been interpreted with the implicit assumption that the timing of childbearing within the reproductive period remains constant. However, the reproductive histories that have been collected in such surveys provide a largely unexploited source of data for the analysis of trends in timing. An analysis by birth cohort of the fertility experience of 592 ever-married women surveyed in San Juan, Puerto Rico, in 1966 shows that significant changes in timing have occurred. Women in the more recent birth cohorts are distinguished by earlier childbearing and sustained higher fertility in consecutive age periods. The inter-cohort differences remain when adjustments are made for duration of time in legal and consensual unions.     

An analysis of Jordan's 2013 policy regarding Iraqi refugees

The Iraqi refugee population in Jordan has become a sustained humanitarian emergency, and Jordan must take new action to respond. The inability of Jordan to address the needs of Iraqi refugees causes not only the suffering of those refugees, but also that of the larger native populations, as needy Iraqis depend upon Jordan's already strained resources. In addition, non-governmental organizations cannot keep up with Iraqi refugee needs due to funding restrictions. Moreover, the UNHCR and other aid agencies may not be suited to performing the task of addressing the Iraqi refugee crisis as a majority of this response relates to humanitarian aid, not addressing the political roots of the problem. There are also fundamental statistical issues relating to Iraqi refugees in Jordan. Numerical discrepancies and political connections make it difficult to determine whether the currently purported number of 450,000 Iraqi refugees in Jordan is accurate. The clear benefits Jordan receives from aid might give rise to suspicions of inflated reported numbers of Iraqi refugees. Also, reports make contrary claims about the average social level of Iraqi refugees, making it difficult to determine what type of aid is needed. Jordan should alter internal policy regarding Iraqi refugees to initiate a political solution for the crisis. It must also carry out up-to-date surveys of the numbers and needs of Iraqi refugees to address the significant gaps in current data, and additionally should push for increased social integration of Iraqis within society.