Needs and Perceptions of LGBTQ Caregivers: The Challenges of Services and Support

Increasing attention has been paid to the lack of services and support afforded older lesbian, gay, bisexual, transgender, and queer (LGBTQ) women in same-sex relationships, including caregivers. This study was designed to investigate the needs and perceptions of LGBTQ women from ages 35 to 91, including informal caregivers and older adults regarding services and support from health care providers. Questionnaires were completed by older LGBTQ women (N = 76), and follow-up interviews were conducted with 25% of caregiver respondents. The majority of subjects indicated a fear of future challenges and discrimination. Four main themes emerged when analyzing the open-ended responses: the need for health care workers who were both supportive and knowledgeable about LGBTQ issues; better and consistent recognition of same-sex partners and their rights to make decisions as primary caregivers; increased sensitivity training regarding the needs of LGBTQ patients and caregivers; and more open and accepting environments where LGBTQ patients and caregivers could feel comfortable discussing issues with the staff.     

Conditioning on Auxiliary Variable Means in Finite Population Inference

This paper reviews conditional properties of the mean and total estimators of a finite population when auxiliary information is available. An exact design-based conditional analysis for complex sampling designs is intractable, but an asymptotic conditional framework can be developed. Within such a framework the paper establishes sufficient conditions for conditional unbiasedness and explores conditional properties of various types of regression estimators. A sample statistic capable of indicating the presence of substantial conditional biases is proposed, and illustrated by a simulation study.     

Building the next generation of leaders in the disabilities movement

The results from this study highlight ways that the disabilities community within the USA can begin to further promote the numbers and qualities of its leaders. Twenty-one grassroots and statewide leaders of the disabilities movement in one state described how they became a leader and identified ways that the disabilities movement can more effectively promote leadership within its ranks. Overall, our informants highlighted the need for the disabilities movement to re-examine its current definitions of and approaches to leadership development. They described the need for a more collective, versus individualistic, approach to leadership within the disabilities movement and the adoption of a more integrated, action learning approach to leadership development. Implications for the disabilities movement are discussed.     

Evaluation of long-term health care services through a latent Markov model with covariates

We focus on the evaluation of the long-term health care services provided to elderly patients by nursing homes of four different health districts in the Umbria region (Italy). To this end, we analyze data coming from a longitudinal survey aimed at assessing several aspects of patient health conditions and develop an extended version of the latent Markov model with covariates, which allows us to deal with dropout and intermittent missing data patterns that are common in longitudinal studies. Maximum likelihood estimates are obtained by a two-step approach that allows for fast estimation of model parameters and prevents some drawbacks of the standard maximum likelihood method encountered in the presence of many response variables and covariates. In the application to the observed data, we show how to obtain indicators of the effectiveness of the health care services delivered by each health district, by means of a resampling procedure.     

The need to improve communication about scope changes: frustration as an indicator of operational inefficiencies

Early and timely sharing of information can provide a sustainable competitive advantage. However, even if lean information management aims to improve this information flow, it has mainly been investigated in ‘operations-based’ companies. This paper fills this gap, drawing upon the experience of the authors working within a large project-based company engaged in the ‘engineer and manufacture to order’ of a complex piece of equipment costing millions of dollars, for its strategic long-term client, both working in the same industrial field, i.e. nuclear decommissioning. This research investigates the information flow regarding scope changes between the project-based company and the long-term client adapting and applying a five-step framework to highlight operational inefficiencies, reduce the corresponding transaction costs and increase the overall company’s competitiveness. This is exemplified through a particular case, but can be applied to other project-based companies dealing with strategic clients involved in long-term relationships.     

Mechanisms for Building Working Alliances in Clinical Supervision

While social workers and researchers acknowledge the importance of a positive working alliance between service providers and clients, less is known about mechanisms for developing working alliances between supervisors and supervisees. The Alliance Building: Learning to Engage (ABLE) model was developed to measure and enhance the supervisory relationship. The ABLE model consists of a tool for continuous measurement of the supervisory working alliance as well as several research supported resources. This two part study assessed the reliability and validity of the ABLE supervision tool (ABLE-S), and then a randomized control trial pilot study was conducted to determine if the use of ABLE in supervision improves the professional quality of life and occupational self-efficacy for supervisees. Analyses revealed the ABLE-S tool is a reliable and valid form for measuring supervisory working alliance, but the use of ABLE in supervision did not have a significant effect on supervisee outcomes compared to the control group. The findings suggest additional training on proper implementation of ABLE and expanded measurements to capture several confounds inherent in the supervisory context are needed in future studies. Practical implications of using ABLE include effective strategies for promoting positive supervisee development and reducing negative effects of stressful work environments that often exist in the social service field.