Hospitalists: who they are and what they do

The hospitalist movement is spreading like wildfire. Find out the latest statistics on hospitalists.     

OUT OF UTOPIA:

An important segment of writings on postindustrialization is distinctly utopian in stressing the greater mastery and control made possible by recent innovations in information technology. The utopian theme underscores the technical outcomes of innovations and highlights their benefits for ameliorating social problems. By contrast, our work suggests that many of the social problems in contemporary society are a consequence of recent innovations in information technology. We argue that postindustrial theorists are correct in stressing mastery over certain technical problems but incorrect in slighting the destabilizing effect innovations have on organizations and the markets in which these organizations participate. These destabilizing effects complicate organizational strategies by increasing market risk and uncertainty. Since most organizations are risk aversive, social problems are created as organizations externalize their costs and pass along risk to other, more dependent actors. Illustrations from two institutions, politics and the economy, indicate that many postindustrial innovations are associated with heightened competition as well as greater risk and uncertainty across the institutional order. We conclude that postindustrial technology introduces no net gain in man aging the complexities of the social world. Risk and control are both integral to technological innovation and constitute the paradox of postindustrialization.     

Investigating Collaborative Interdisciplinary Practice to Develop a New Planning Undergraduate Course

Whilst there is widespread recognition of the importance of university education preparing planners for working in interdisciplinary environments, there is limited research available on interdisciplinary working in practice. As detailed knowledge of practice and continuing engagement with practitioners is important to ensuring the employability of graduates, a study of interdisciplinary collaborative practice was undertaken to help develop a new undergraduate planning course. This paper presents the findings of this research and discusses how they will inform the development of the course.     

Social Capital and Residential Decision Making Among Rural and Nonrural College Graduates

Due to the low demand for highly educated workers in rural areas, high‐achieving rural students have been portrayed as having to pick between staying close to home and facing limited economic opportunities or leaving to pursue higher education and socioeconomic advancement. But what of those who want both—college degree and return to rural living? Comparing the experiences of rural graduates who returned to rural locales with those who out‐migrated and nonrural graduates across one predominantly rural state, this study explores how social capital matters in the residential decision‐making process. Proximity to work and family were the primary factors determining adult residence. Sense of place—but not attachment to a specific community—also mattered, especially for rural graduates. Family, school, and community social capital were more likely to play a role in career development for rural students, as career aspirations during adolescence followed by career‐driven college choices created pathways for rural return. Findings underscore the importance of analyzing rural return from a regional lens, as respondents reframed lifestyle elements researchers tend to portray as mutually exclusive—rural lifestyle, proximity to family, and professional career—as compatible by employing broad and flexible definitions of proximity and place.     

Is There a Woodwork Effect? Addressing a 200-Year Debate on the Impacts of Expanding Community-Based Services

In U.S. social welfare history, many have suggested that if benefits were too attractive, consumers would come out of the woodwork to take advantage of the opportunity. Clinical trials have provided evidence of the woodwork effect’s existence, suggesting caution when expanding home- and community-based services (HCBS). However, it is unclear whether these studies are best suited to assess whether a system-level effect occurs. Using state and federal data tracking Ohio’s long-term services and support (LTSS) system from 1995 to 2015, this paper examines changes in the utilization rates and expenditures of Medicaid LTSS to explore whether a woodwork effect occurred as Ohio moved to improve its LTSS system balance (80% Nursing Home [NH], 20% HCBS) to (49% Nursing Home [NH], 51% HCBS). After accounting for population growth of individuals older than 60 and those with two or more impairments in activities of daily living, there was no change in utilization rates of older people with severe disability (1995: 491 per 1000 population, 2015: 495 per 1000 population) or overall LTSS expenditures (1997: $2.7 million [in 2013 dollars], 2013: $2.9 million). Our results suggest that states can make significant strides in HCBS expansion without increasing the overall long-term services utilization rate.     

Potential impacts of emerald ash borer invasion on biogeochemical and water cycling in residential landscapes across a metropolitan region

Trees provide important ecological services in cities, yet the vulnerability of the urban forest to massive tree losses from pest outbreaks could threaten those services, with unknown environmental consequences. The outbreak of emerald ash borer is an imminent threat to the ash population in North America. In the Minneapolis?CSaint Paul, Minnesota, metropolitan area, ash trees are present in 50?% of residential landscapes in Ramsey and Anoka Counties. We used a large survey of household activities, a tree inventory, a Household Flux Calculator accounting tool, and a set of annual evapotranspiration measurements, to quantify the current carbon, nitrogen, and phosphorus storage in ash trees, the cycling of these elements, and the total evapotranspiration from ash trees in residential areas in the metropolitan region. Ash represented 6?% of the trees in residential areas and the removal of the entire ash population would correspondingly reduce net primary production and carbon sequestration by only a few percent and would have negligible effects on losses of nitrogen and phosphorus from residential landscapes. Similarly, the effects of ash loss on the hydrologic cycle would be minimal and would depend largely on management choices for the ground currently underneath ash tree canopies. Overall, the percentage change in biogeochemical and hydrological fluxes corresponded closely with the percent of the total urban tree population that was represented by ash, suggesting that areas with higher densities of ash would experience correspondingly larger effects. A hypothetical tree replacement scenario with similar broadleaf species was determined to be likely to re-establish the original biogeochemical and hydrological conditions once the replacement trees reach maturity.     

Behavioral and Electrophysiological Indices of Memory in Typically Developing and Hypoxic‐Ischemic Injured Infants

Behavioral and electrophysiological indices of memory were examined in 12‐month‐old typically developing control infants (CON) and infants with history of perinatal hypoxic‐ischemic injury (HII) across 2 days. Using a visual paired comparison (VPC) procedure, novelty preference was tested immediately after a familiarization period and then after delays of 2 min and 24 h. Both groups showed a significant novelty preference only for the no‐delay condition. On day two, event‐related potentials (ERPs) were recorded while infants viewed the VPC familiar face, a more recently familiarized face, and a novel face, and mean amplitude for components thought to reflect memory (positive slow wave, PSW) and attention (negative central, Nc) were computed. In temporal regions, HII showed a diminished Nc and enhanced PSW to the recently familiarized face, while CON showed a similar trend for the PSW only. Overall, infants showed the largest PSW over left scalp regions. Finally, a positive correlation between VPC novelty preference after 24 h and PSW was found in CON, and preliminary results suggest that this association differs as a function of group. Therefore, in comparison with CON, HII showed both similarities and differences on individual tasks of memory as well as potentially disparate relations between the behavioral and neural mechanisms underlying memory performance.     

Hope,Coping, and Relationship Quality in Mothers of Children With Down Syndrome

Parenting a child with Down syndrome may pose unique challenges for parents’ relationship quality. This study used structural equation modeling with a sample of 351 mothers of children with Down syndrome to test if hope mediated the association between mothers’ various coping behaviors and mothers’ relationship quality. Hope was defined as a generalized positive state that comes from a personal sense of agency. Results indicated a greater degree of religious coping and internal coping were each significantly associated with more hope, whereas support seeking was not related with more hope. Higher hope was significantly associated with greater relationship quality. Bootstrapped indirect effects from both religious coping and internal coping to hope, and then hope to relationship quality, were identified. Implications for therapists and future research are described.