Development and Validation of a Tool to Improve Physician Identification of Elder Abuse: The Elder Abuse Suspicion Index (EASI)©

ABSTRACT

This study aimed to develop and validate a brief tool for physician use to improve suspicion about the presence or absence of elder abuse. A literature review on elder abuse, obstacles to its identification, limitations of detection tools, and characteristics of screeners employed by physicians were used to generate elder abuse detection questions for critique by 31 doctors, nurses, and social workers in focus groups. Six resulting questions became the Elder Abuse Suspicion Index (EASI) administered by 104 family doctors to 953 cognitively intact seniors in ambulatory-care settings. Findings were compared to a recognized, detailed elder abuse Social Work Evaluation (SWE) later administered to participants by social workers blinded to the results of the EASI. The EASI had an estimated sensitivity and specificity of 0.47 and 0.75, usually took less than 2 minutes to ask, and 97.2% of doctors felt it would have some or big practice impact. This research is a first phase in the development and validation of a user-friendly tool that might sensitize physicians to elder abuse and promote referrals of possible victims for in-depth assessment by specialized professionals.     

Household Composition,Extended Kinship,and Reproduction in Taiwan: 1965–1985

Co-residence of a married couple with the husband's parents continues to be an important aspect of family life in Taiwan. This form of household extension continues despite Taiwan's industrialization and convergence with a Western model of consumption, and despite the increase in the prevalence of nuclear households over the past twenty years. Increases in nuclear units are associated primarily with declines in proportions living in households that are extended both laterally and across generations, while the percentage living with a parent in a stem household has declined only modestly since 1973. In all, declines in co-residence notwithstanding, in 1985 nearly half the respondents resided in extended units. In 1985, as in 1980, a history of residence in an extended household was related to more traditional reproductive behaviour.     

The Faculty Meeting: Practicing Social Justice-Oriented Group Work

Social group work scholars and practitioners have begun to locate and recognize important sites for thinking about and practicing social group work as increasing evidence demonstrates its diminishing importance. This article identifies faculty meetings as a significant site for integrating social group work more fully into departments and schools of social work and helping to achieve the profession's social justice mission. Challenging the meaning of the faculty meeting and thinking of it as a faculty group is a necessary prerequisite to realize this goal. A set of principles is presented and next steps explored to reclaim and reinsert the value of social group work for the profession today.     

Determinants of Mortality at Older Ages: The Role of Biological Markers of Chronic Disease

Researchers have had a longstanding interest in understanding the determinants of mortality. This article examines the impact of a broad array of biological markers, together with self‐reports of physical and mental health status, on the probability of dying for older adults. The estimates are derived from logistic regression models based on data from a national survey in Taiwan. The analysis confirms previous studies demonstrating the effects of clinical measures related to metabolic syndrome on mortality and identifies detrimental effects of neuroendocrine and immune‐system markers. The results reveal that biomarkers provide independent explanatory power in the presence of self‐reported health measures. The associations between biomarkers and mortality found here provide new avenues for projecting future mortality and elucidating differences in longevity across populations.     

Framing effect on the public's response to crisis: Human interest frame and crisis type influencing responsibility and blame

This study investigated the effects of a human interest frame and types of crisis in news coverage of a corporate crisis on people's responses to the crisis. To examine the effects, this study used 2 (human interest frame versus non-human interest frame) × 2 (an accident versus a transgression) mixed factorial design. The results indicate that the human interest frame influenced participants’ emotional response to the crisis and the emotional response influenced by the human interest frame was a significant predictor of blame and responsibility in a transgression crisis.     

Young Fathers: An Analysis of Risk Behaviors and Service Needs

One hundred and twenty eight young fathers participated in an assessment of risk behaviors and service needs prior to entering a program for young fathers. Of this group, 73% were unemployed, 69% were school drop-outs, almost 40% had substance abuse problems, close to 30% had committed a felony, and less than half had declared paternity for their children. The majority of these young fathers desired employment services and educational/vocational training. Despite their risk behaviors, young fathers did not want substance abuse counseling, child support services, or help in obtaining a GED. There appears to be a discrepancy between the problems and needs, and the services which these young fathers requested. Many young fathers believed employment would be a panacea to all their problems. These findings suggest that more attention should be given to examining these issues in programs targeting young fathers. Services such as preventive health and mental health should be considered prior to the final goals of employment and establishment of paternity.     

A novel equivalence probability weighted power prior for using historical control data in an adaptive clinical trial design: A comparison to standard methods

A standard two-arm randomised controlled trial usually compares an intervention to a control treatment with equal numbers of patients randomised to each treatment arm and only data from within the current trial are used to assess the treatment effect. Historical data are used when designing new trials and have recently been considered for use in the analysis when the required number of patients under a standard trial design cannot be achieved. Incorporating historical control data could lead to more efficient trials, reducing the number of controls required in the current study when the historical and current control data agree. However, when the data are inconsistent, there is potential for biased treatment effect estimates, inflated type I error and reduced power. We introduce two novel approaches for binary data which discount historical data based on the agreement with the current trial controls, an equivalence approach and an approach based on tail area probabilities. An adaptive design is used where the allocation ratio is adapted at the interim analysis, randomising fewer patients to control when there is agreement. The historical data are down-weighted in the analysis using the power prior approach with a fixed power. We compare operating characteristics of the proposed design to historical data methods in the literature: the modified power prior; commensurate prior; and robust mixture prior. The equivalence probability weight approach is intuitive and the operating characteristics can be calculated exactly. Furthermore, the equivalence bounds can be chosen to control the maximum possible inflation in type I error.     

Mother-Child Relations and Adolescent Sexual Attitudes and Behavior

We hypothesize that children who are close to their parents are more likely to have attitudes and behavior that are consistent with their parents' values than children who are not close to their parents. Using data from a probability sample of 888 mother-child pairs of white women in the Detroit metropolitan area, we tested this hypothesis, using both mother's and child's attitudes toward premarital sexual intercourse and the child's report of whether he or she had engaged in premarital sexual intercourse. Unlike most previous work in this area, which has posited a direct association between the closeness of the mother-child relation and the child's attitudes and behavior, we found that the quality of the relation interacted with the mother's attitudes in its effects on the child's attitudes and behavior. Children with close relations with their mothers were more likely to hold attitudes and behave in a manner consistent with their mothers' own attitudes than children with more distant relations.     

Exploring Politicized Trust in a Racially Diverse Computer Science Classroom

ABSTRACT

Over the past decade, abroad range of policymakers, corporations, educators, and scholars in the United States have catapulted computer science (CS) education from the sidelines to the center of K-12 public education discourse. While calls for CS education are often framed in terms of national and economic competitiveness, there is a growing interest amongst equity scholars in curricular interventions that directly engage the ethical and sociopolitical issues surrounding CS and its role in society. Yet, less attention has been given to how sociocultural dynamics of classrooms play a mediating role in these spaces. Drawing on video data from an equity-oriented CS classroom, we argue aconflict that arose during design activities was rooted in alack of trust and solidarity between students. Ultimately, we make the case that in addition to curricular innovations, equity efforts in CS education must prioritize the cultivation of positive student relationships.