Research note: imputing large group averages for missing data,using rural-urban continuum codes for density driven industry sectors

Understanding the effects and consequences of missing data imputation is vital to the ability to obtain meaningful and reliable statistics and coefficients in the examination of any quantitatively-based phenomena. Over time a series of sophisticated methods have been developed to handle the issue of missing data imputation however, these sophisticated methods may not always be appropriate or attainable. In these specific cases more traditional approaches to missing data imputation must be employed and driven by the research project, theoretical framework, and the data. In this research note we offer a brief account of one such instance, implementing a large-group mean imputation approach to handling missing data. The analysis is drawn from a much larger project and shows the effect of proper group selection in terms of mean imputation using a cross-validation approach based on the imputed data’s relation to known values. Ultimately, the results show that the use of Rural-Urban Continuum codes are superior to currently used group-means in the U.S., thus introducing a new, and more efficient, approach to the handling of missing data using group-mean imputation.     

USING STRUCTURAL EQUATION MODELING TO EXAMINE THE RELATIONSHIP BETWEEN POLITICAL CYNICISM AND RIGHT-WING AUTHORITARIANISM

The government's ability to gain and hold a high proportion of citizens' trust is essential to the functioning of an efficient and successful administration at all levels. This study aims to examine the relationship between an individual's demographic and psychosocial characteristics and their associated levels of trust in the local government. Results show that, while authoritarian attitudinal clusters are a significant predictor of government trust, they are not significant predictors of trust controlling for all related demographic controls. This finding can be explained using a Social Identity theoretical framework concerned with an individual's perceived place within their given community.     

Inequality,Health Infrastructure,and Spatial Context: Understanding Pathways to Variations in the Causal Determinants of Race-Specific Mortality Rates

Previous research examines the ecological relationship between income inequality and mortality, and results are inconclusive. This analysis builds upon these findings by implementing a spatially weighted path analysis to better understand the mediating relationships of economic and social inequality, health infrastructure, and mortality. In the analysis, overall and race-specific mortality rates are combined with local health infrastructure data, income inequality and racial segregation data, and a series of ecological controls to undertake this examination. Ultimately, findings show that income inequality is a stronger determinant of mortality than is segregation, for whites and blacks, regardless of the existing health infrastructure. We also find racial disparities in the direct effect of local health infrastructure on mortality. In contrast to previous literature suggesting no association between income inequality and mortality after accounting for race and model sophistication, we argue that the significance of the relationship persists using race-specific, spatially weighted path models.     

Transition from Home Care to Nursing Home: Unmet Needs in a Home- and Community-Based Program for Older Adults

A major effort is under way nationally to shift long-term care services from institutional to home- and community-based settings. This article employs quantitative and qualitative methods to identify unmet needs of consumers who transition from a statewide home- and community-based service program for older adults to long-term nursing home residence. Administrative data, care manager notes, and focus group discussions identified program service gaps that inadequately accommodated acute health problems, mental health issues, and stressed family caregivers; additional unmet needs highlighted an inadequate workforce, transportation barriers, and limited supportive housing options. National and state-level policy implications are considered.     

Simulation based learning in midwifery education: a systematic review

AimTo critically examine the evidence for simulation based learning in midwifery education.BackgroundSimulated Learning Programs (SLPs) using low to high fidelity techniques are common in obstetric professionals’ education and focus on the development of team work, labour and obstetric emergencies.Review methodsA systematic review incorporating critical appraisal approaches, setting clear objectives and a defined search and analysis strategy. Evidence from obstetrics, neonatology, technical and non-technical skills (teamwork) was included where it informed the development of midwifery curricula. Studies in English from 2000 to 2010 were included searching CINAHL Plus, OVID Medline, Cochrane, SCOPUS and ProQuest and Google Scholar.ResultsTwenty-four papers were identified that met the inclusion criteria. All were quantitative reports; outcomes and levels of evidence varied with two notable papers indicating that simulation had an impact on clinical practice. Benefits of SLP over didactic formats were apparent, as were the development of non-technical skills confidence and competence. The study outcomes were limited by the range of evidence and context of the reports which focussed on obstetric emergency training using a number of simulation techniques.ConclusionThere is evidence that simulated learning of midwifery skills is beneficial. Simulation learning has an educational and clinical impact and advantages over didactic approaches. Where clinical practice is infrequent i.e. obstetric emergencies, simulation is an essential component of curricula. Simulation enhances practice and therefore may reduce the time taken to achieve competence; however there is no evidence from the literature that simulation should replace clinical practice.     

The patient's view

Conclusion It is time to draw the threads together. I have been arguing that we should lower the historical gaze onto the sufferers. Banish money, wrote John Keats, - banish sofas - Banish wine - Banish Music - But right Jack Health- Honest Jack Health, true Jack Health - banish Health and banish all the world. Health is the backbone of social history, and affliction the fons et origo of all history of medicine. For whereas one could plausibly argue, a history of crime should start not with the criminals but with law and police-because these define criminality - the sick cannot possibly be regarded as a class apart, conjured up by the faculty. Moreover, it is especially important to get under the skin of the sufferers, because most maladies have not in fact been treated by the profession but by self- or community help, or in the paramedical marketplace where the sufferers' own initiatives, confidence, and pockets are critical. In addition, lay medical power has also been crucial in a sphere I haven't touched upon here, since I have been concentrating on the sufferer as an individual - in other words, lay-instigated social, civic, and institutional strategies for sickness, above all, in earlier times, for coping with epidemic pestilences such as plague. For what emerges, for example, from recent studies of civic health arrangements in the Italian Renaissance is that physicians regularly had to play second fiddle, in the teeth of various lay interests, to city fathers, philanthropic patrons, and, of course, the Church itself. Medicine has never enjoyed full monopoly or police powers, and most healing, like charity, begins at home. The upshot is that doctors traditionally had to remember that he who paid the piper called the tune. George Bernard Shaw was well aware of this:The doctor learns that if he gets ahead of the superstitions of his patients he is a ruined man; and the result is that he instinctively takes care not to get ahead of them. That is why all the changes come from the laity. I do not intend to conclude by offering a set of theoretical models for understanding sick person-doctor interaction in times past. That would certainly be premature, and probably also counterproductive, by creating the illusion of patterns of typicality and uniformity. But I should like to tabulate certain strategies and broad interpretive guidelines for future investigations.

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Understanding disabling barriers: a fruitful partnership between Disability Studies and social practices?

Disabled people are regularly denied their human rights, since policies and laws are hard to translate literally into practice. This article aims to make connections between social practice theories and Disability Studies, in order to understand the problems faced by disabled people, using different methods to look in detail at how practices are shaped and how disabled people get excluded. Disabled people are active agents in making change, both informally on an everyday basis and through formal actions. Thus we also suggest that the insights of disabled people could bring a fresh perspective to social practice theories, by troubling the taken-for-granted in our everyday lives.