The nursing home crisis: a consumer study of Texas nursing home care

This article discusses the findings of a consumer-oriented survey to ascertain the perceptions of Texas nursing home residents, their families, and nursing home administrators about what factors they believe contribute to quality of care. The findings from previous studies and established practice standards are then used to further delineate the practice roles and functions of social workers in nursing facilities (NFs) and to inform social work curriculum.     

Comparative perspectives on changes to Canada's paid parental leave: Implications for class and gender

In 2001, Canada extended the length of time parents could claim benefits. When combined with maternity benefits, a total of 50 weeks of benefits is available for qualifying parents. This places Canada at the forefront of liberal welfare regimes in benefits for new mothers and parents. However, an examination of the nature and impact of these changes suggests that they further exacerbate gender and class divisions in access to, and take-up of, these benefits. A discussion of major trends in parental leave policies in Europe identifies the types of changes that are most likely to reduce the gender and class inequalities apparent in current policies.     

"Just like I'm saving money in the bank": client perspectives on care coordination services

Older adults face many challenges to community living. The literature has not sufficiently explored the roles of care coordination in the maintenance of housing and access to health care among older adults, particularly from their own perspectives. This qualitative study analyzes the findings from 25 interviews and 6 focus group discussions (48 participants) with a multiethnic sample of older adults in the New York City area. Care coordination services appear to assist older adults access health care, and to a lesser extent, maintain affordable housing. Disparities in access to care coordination appear to remain for immigrant, minority and suburban populations.     

The One-Box Challenge: Providing a Federated Search That Benefits the Research Process

The one-box federated search of databases brings as many challenges as promises to database searching, especially in terms of adapting these systems to user needs and the effects this new mode of searching will have on users' research behaviors. This issue of “The Balance Point” presents several librarians with strong interests in reference and instruction, who tell the story of adapting a federated search system for their libraries and reflect upon how federated searching can change the way students do research and on the implications federated searching has on information literacy skills and the quality of results found.     

One for Nine: The Shared Cataloging Program of the California Digital Library

Abstract

In 1999, the California Digital Library (CDL) began a new cooperative venture, the Shared Cataloging Program, to improve access to its growing collection of electronic resources. Now known within the University of California (UC) as the SCP, the Shared Cataloging Program, based at UC San Diego, distributes ready-to-use cataloging records for all electronic titles licensed by the CDL to each of the other eight (soon to be nine) physical UC campuses. The SCP is the result of an intensive systemwide planning process fostered by a desire for an innovative approach to providing traditional bibliographic access to large numbers of electronic resources. It was launched out of pragmatic necessity along with an institutional commitment to the cooperative ideals of labor-savings, experimentation, and the search for “best practices.” This article will describe its genesis, current operation, one library's use of the records, and issues for future development. Serials Review 2002; 28:4–12.     

Hypothesis Testing in Functional Comparative Calibration Models

The purpose of this article is to investigate hypothesis testing in functional comparative calibration models. Wald type statistics are considered which are asymptotically distributed according to the chi-square distribution. The statistics are based on maximum likelihood, corrected score approach, and method of moment estimators of the model parameters, which are shown to be consistent and asymptotically normally distributed. Results of analytical and simulation studies seem to indicate that the Wald statistics based on the method of moment estimators and the corrected score estimators are, as expected, less efficient than the Wald type statistic based on the maximum likelihood estimators for small n. Wald statistic based on moment estimators are simpler to compute than the other Wald statistics tests and their performance improves significantly as n increases. Comparisons with an alternative F statistics proposed in the literature are also reported.     

Simultaneous estimation of gamma means using a hierarchical generalized linear model

The problem of simultaneously estimating p Gamma means is investigated when the means are believed a priori to satisfy an r-dimensional generalized linear model. Using a Bayesian hierarchical model to reflect the uncertainty in the linear model, approximate methods are proposed to compute the posterior densities. The resulting estimator shrinks the usual estimator toward a prior estimator where the size of the shrinkage depends upon the agreement of the observed data with the proposed generalized linear model.     

Web-based triage in a college health setting

The authors describe the initiation and use of a Web-based triage system in a college health setting. During the first 4 months of implementation, the system recorded 1,290 encounters. More women accessed the system (70%); the average age was 21.8 years. The Web-based triage system advised the majority of students to seek care within 24 hours; however, it recommended self-care management in 22.7% of encounters. Sore throat was the most frequent chief complaint (14.2%). A subset of 59 students received treatment at student health services after requesting an appointment via e-mail. The authors used kappa statistics to compare congruence between chief complaint and 24/7 WebMed classification (kappa = .94), between chief complaint and student health center diagnosis (kappa = .91), and between 24/7 WebMed classification and student health center diagnosis (kappa = .89). Initial evaluation showed high use and good accuracy of Web-based triage. This service provides education and advice to students about their health care concerns.