Staff and family attitudes to fences as a means of detaining people with dementia in residential aged care settings: The tension between physical and emotional safety

This study investigates staff and family attitudes towards the use of the fences that surround many aged care facilities in Australia, in the context of indefinite detention of people with dementia. This indefinite detention has been described in a report from an Australian Senate Inquiry as “a significant problem within the aged care context”, which “is often informal, unregulated and unlawful”. Five focus groups comprising direct care workers, family members, nurse unit managers and facility managers discussed the reasons for and their attitudes towards fences. The results show a tension between the provision of physical and emotional safety. This is to say that even while it is illegal to detain people with dementia against their will, and even while participants understood the negative impact of fences on the well‐being and emotional safety of people with dementia, they accepted and supported the presence of perimeter fences because they provided the perception that fences kept people with dementia physically safe. This has implications for redressing the balance between physical and emotional safety in policy and practice.     

Learning from others: conditioning versus averaging

How should we revise our beliefs in response to the expressed probabilistic opinions of experts on some proposition when these experts are in disagreement? In this paper I examine the suggestion that in such circumstances we should adopt a linear average of the experts’ opinions and consider whether such a belief revision policy is compatible with Bayesian conditionalisation. By looking at situations in which full or partial deference to the expressed opinions of others is required by Bayesianism I show that only in trivial circumstances are the requirements imposed by linear averaging compatible with it.     

Web-Enhanced Preservice Training for Prospective Resource Parents: A Randomized Trial of Effectiveness and User Satisfaction

ABSTRACT

Traditionally, prospective resource parents must attend all preservice training in person. Although live sessions are necessary for screening applicants, instructional portions of training could be enhanced by Web-based sessions. This pilot study compares the effectiveness of online and classroom versions of one session from a widely used preservice training program. Ninety-two individuals enrolled in the program in two states were randomly assigned to a treatment group that viewed an online version of the class on child abuse and neglect or to a comparison group that took the same class in person. Written questionnaires were completed before and after the class. Significant group differences on knowledge of child maltreatment and empathy toward birth parents plus high user satisfaction were hypothesized. Analysis of covariance results showed the online training was more effective than the live training at increasing knowledge. Multivariate analysis of covariance findings on empathy were not significant but trended toward greater empathy for the online group. Feedback indicated high satisfaction with the online course. The finding that online instruction is more effective than live instruction has positive implications for practice, because Web-based training offers advantages like standardizing instruction, cutting agency and trainee costs, and providing greater flexibility.     

Emotional balance and probability weighting

We find suggestive evidence that emotional balance has an impact on probability weighting incremental to demographic controls. Specifically, low negative affectivity (implying high emotional balance) tends to be a characteristic of those whose probability weighting functions exhibit lower curvature and more neutral elevation. In other words, emotional balance seems to push people in the direction of normative expected utility theory.     

Making Sense of Anarchism: Errico Malatesta's Experiments with Revolution, 1889–1900

Noel W. Thompson, The People's Science (1984), viii+252 (Cambridge University Press, £22.50).

R. J. P.Kain and H. C. Prince, The Tithe Surveys of England and Wales (1985), xvi‐+327 (Cambridge University Press, £27.50).

John Breuilly and Wieland Sachse, Joachim Friedrich Martens (1860–1877) und die Deutsche Arbeiterbewegung (1984), 489 (Schwartz, Göttingen, DM 43.00). (Joachim Friedrich Martens and the German Labour Movement)

Anthony D. King, The Bungalow. The Production of a Global Culture (1984), xvii+310 (Routledge and Kegan Paul, £35.00).

A. J. A. Morris, The Scaremongers. The Advocacy oj War and Rearmament 1896–1914 (1984), xi+495 (Routledge &; Kegan Paul, £25.00).

L'Archéologie industrielle en France (C.I.L.A.C., 48 rue Saint Lambert, 75015 Paris, 440 FF per issue).     

THE PROCESS OF CHANGE IN COUPLES THERAPY: A QUALITATIVE INVESTIGATION

Open-ended interviews with 24 couples therapy clients regarding their experience of the process of change revealed shifts in clusters of affect, communication, and cognition. Six additional contextual preconditions for change were also identified. The change process within couples was uniformly reported to be gradual.     

THE PHYSICIAN LABOR MARKET IN A MANAGED CARE-DOMINATED ENVIRONMENT

The belief that doctors respond to declining demand by treating patients more aggressively has created skepticism about relying on market forces to restructure physician supply. We argue that even if the physician labor market is dysfunctional under fee-for-service incentives, it can perform better as managed care becomes dominant. Our model implies a nonlinear effect of managed care penetration on incomes. Physicians can offset most or all of initial declines in demand, but cannot insulate themselves indefinitely. This may explain the observation that, until recently, the growth of managed care has not been accompanied by large physician income changes. ( JEL III, J31)