Child outcome measures in the study of child care quality

This article assesses whether there are methodological problems with child outcome measures that may contribute to the small associations between child care quality and child outcomes found in the literature. Outcome measures used in 65 studies of child care quality published between 1979 and December 2005 were examined, taking the previous review by Vandell and Wolfe (2000) as the starting point. Serious methodological problems were not pervasive for child outcome measures. However, methodological concerns were most prevalent among measures of socioemotional development. Furthermore, psychometric information on outcome measures was often missing from published reports, and health outcomes and approaches to learning were infrequently studied. Future research should address alignment issues between aspects of quality and the specific child outcomes chosen for study.     

Vital Conversations with Family in the Nursing Home: Preparation for End-Stage Dementia Care

Family members of persons with advanced dementia may be asked to make complex treatment decisions without having adequate knowledge regarding the risks and benefits. This 6-month, prospective, randomized trial tested the effect of an intervention consisting of a face-to-face, structured conversation about end-of-life care options with family members of nursing home residents with advanced dementia. A comparison group received only social contact via telephone. Structured conversations between a palliative care team and intervention group family members included goals of care and how best to achieve those goals, and provision of psychosocial support. Psychosocial support was also provided via telephone at three 2-month intervals. Family members participated in three telephone interviews: baseline, 3, and 6 months. Specific advance directives for persons with dementia were extracted from medical records. Results showed that intervention families had higher satisfaction with care than comparison families at the 6-month time point, and they were more likely to have decided on medical options listed in residents' advance directives (Do Not Resuscitate, Intubate, Hospitalize) over time. Study findings reinforce the need for increased education and support for families around issues of end-of-life care decisions for advanced dementia.     

Ethical problems with infertility treatments: Attitudes and explanations

Although media coverage of infertility treatments has increased markedly over the past decade, there is a dearth of empirical information about public perceptions of the ethics of infertility procedures (e.g. artificial insemination, in vitro fertilization, donor eggs, surrogate mothering, and gestational carriers) and about the factors that shape them. Two representative telephone survey samples (930 adults in a Midwestern state, and 580 adult women aged 25–50 in the North Central region) are analyzed to gauge public views on the ethics of infertility treatments and estimate the effects of social structure and exposure on these views. Ethical concerns were viewed as more serious for techniques that could result in a child who may not be biologically related to the woman or her partner than for those yielding a child biologically related to both parents. Social structural factors such as age and education were the strongest predictors of attitudes towards the ethics of infertility treatments. Neither parenthood nor experiencing infertility was related to ethical concerns, although women reporting the use of infertility services had fewer ethical concerns than their counterparts.     

Supervision and Supervision of Supervision,One Perspective

This paper provides one perspective on the theory, structure and process of supervision and supervision of supervision. A case study is provided of the supervision process with one trainee over a six month period of training during which the supervisor also received live supervision of supervision. Three further examples illustrate the use of supervision of supervision in resolving training difficulties.     

Turning Social Return on Investment on Its Head

This article undertakes a critique of social return on investment (SROI), combining the existing research literature with an analysis of six case studies of supported social enterprises employing people with disabilities and other challenges that affect their access to the conventional labor market. The critique of SROI focuses on its positivist roots and its emphasis on one number, the SROI ratio. It also discusses the technical challenges in producing that number, including concerns about its reliability. The article presents the stakeholder impact statement, an approach that is rooted in interpretivism and attempts to understand the impact of enterprises through the eyes of multiple stakeholders. Unlike SROI, which is a supplement to conventional accounting statements, the stakeholder impact statement integrates financial and social impact data, thereby placing them on the same level of importance.     

“We're in this together”: Attachment insecurities,dyadic coping strategies,and relationship satisfaction in couples involved in medically assisted reproduction

Attachment is an important predictor of relationship satisfaction and attachment insecurities are a risk factor for couples under stress. Drawing from the Vulnerability–Stress–Adaptation model, we investigated whether dyadic coping strategies (DCS) would explain the links between attachment insecurities and relationship satisfaction in 97 couples involved in medically assisted reproduction (MAR). Path analyses revealed that for women and men, attachment insecurities (anxiety, avoidance) were associated with their own lower relationship satisfaction through their lower use of positive DCS. Attachment avoidance was also associated with participants' own lower relationship satisfaction through their own lower use of negative DCS. Men's attachment avoidance was also related to their partner's lower relationship satisfaction via their own and their partner's lower use of positive DCS. The findings suggest that promoting the use of positive DCS may be important to preserve relationship satisfaction in couples involved in MAR.     

Measuring the Benefit of Offering Auxiliary Services: Do Bag‐Checkers Differ in Their Sensitivities to Airline Itinerary Attributes?

When firms evaluate their service system design choices, there is typically more uncertainty surrounding the value that a particular auxiliary service provides than there is on the cost of providing that service. To help inform this decision, we propose an approach where we compare the relative value of the segment of passengers who use an auxiliary service to the relative value of the segment that does not use it. We demonstrate this approach for a typical auxiliary service common to the airline industry. In 2008, most US airlines implemented checked baggage fee policies to decrease their costs by reducing the number of customer service agents needed in the check‐in and baggage handling processes. The success of this change has led to a current debate at many of these airlines on whether to make further staffing cuts in these areas, essentially making it even less attractive for passengers to check their baggage. Our proposed methodology helps answer whether passengers who continue to check bags in today's baggage‐fee era are more or less valuable than passengers who do not check bags. We explore this question empirically by examining, through a stated preference survey, if a history of checking or not checking bags can be used to segment passengers based on how their itinerary choices are influenced by common airline service attributes (on‐time performance, itinerary time, number of connections, airfare, and schedule delay). Contrary to the opinions of some top airline executives, we find that the passengers who continue to check bags at airlines that charge baggage fees are generally less sensitive to differences in three of these important service attributes and are less likely to switch airlines when a competing airline improves its offerings along these dimensions. Thus, airlines that charge for checked bags should consider improving the customer experience for their bag‐checking passengers, as they represent a potentially more valuable segment class to the airline.