Elder Abuse in Nursing Homes: An Ecological Perspective

Population trends suggest that the next 20 years will witness a dramatic increase in the adult population aged 65 and older. Projected increases in the elderly population are expected to significantly increase the stress on family and professional caretakers. Stress, in the context of caregiving relationships, is a risk factor associated with increased prevalence of elder abuse in familial and institutional settings. As increasing numbers of older adults are moved from family caregiving to nursing home care settings, it becomes important to identify the pattern of elder abuse risk factors in nursing home facilities. An ecological model is proposed for better understanding the risk factors associated with elder abuse in nursing homes and the complex interaction of individual/person characteristics and contextual factors in institutional elder abuse. An ecological perspective to institutional elder abuse provides a framework for guiding and informing future research on the risk factors of nursing home abuse and, in turn, for the development of effective interventions and relevant social policies.     

Social Work Student Interest in Nursing Home Employment: A North American Study

Nursing homes (NHs) are a primary setting for gerontological social work; yet, little is known about social workers' career interest relative to this setting. This article reports the findings of an online survey of social work students (177 US and 91 Canadian) that sought to identify personal characteristics and beliefs that influence NH employment intentions. Students who were enrolled in bachelors programs, lacked previous practice experience, and had already had a NH field placement or wanted this experience were more likely to express employment intent. The implications of these findings for social work education and research are discussed.     

Improving the Impact and Implementation of Disaster Education: Programs for Children Through Theory‐Based Evaluation

A main weakness in the evaluation of disaster education programs for children is evaluators’ propensity to judge program effectiveness based on changes in children's knowledge. Few studies have articulated an explicit program theory of how children's education would achieve desired outcomes and impacts related to disaster risk reduction in households and communities. This article describes the advantages of constructing program theory models for the purpose of evaluating disaster education programs for children. Following a review of some potential frameworks for program theory development, including the logic model, the program theory matrix, and the stage step model, the article provides working examples of these frameworks. The first example is the development of a program theory matrix used in an evaluation of ShakeOut, an earthquake drill practiced in two Washington State school districts. The model illustrates a theory of action; specifically, the effectiveness of school earthquake drills in preventing injuries and deaths during disasters. The second example is the development of a stage step model used for a process evaluation of What's the Plan Stan?, a voluntary teaching resource distributed to all New Zealand primary schools for curricular integration of disaster education. The model illustrates a theory of use; specifically, expanding the reach of disaster education for children through increased promotion of the resource. The process of developing the program theory models for the purpose of evaluation planning is discussed, as well as the advantages and shortcomings of the theory‐based approaches.     

Transformational–transactional leadership and upward influence: The role of Relative Leader–Member Exchanges (RLMX) and Perceived Organizational Support (POS)

By utilizing the resource theory of social exchange (Foa & Foa, 1974), we attempted to cast light on the dynamics of the relationship between transformational–transactional leadership and employees' upward influence tactics. Using data collected in two time points (N = 200, 1 year apart), we found perceptions of transformational leadership (Time 1) to be positively related to the use of soft and rational upward influence tactics (Time 2) whereas transactional leadership (Time 1) was positively related to the use of soft and hard upward influence tactics (Time 2). We also found support for a 3-way interaction between transformational–transactional leadership, relative Leader Member Exchanges (RLMX) and Perceived Organizational Support (POS) on employees' upward influence tactics. Specifically, in resource-constrained conditions (low RLMX and low POS), employees were likely to use soft tactics to influence a manager they perceived as transformational to a greater extent than in resource-munificent conditions. They were also likely to employ higher levels of soft and hard tactics to influence a transactional manager in resource-constrained rather than in resource-munificent conditions.     

Comparison of Subsidy Schemes for Reducing Waiting Times in Healthcare Systems

This study analyzes subsidy schemes that are widely used in reducing waiting times for public healthcare service. We assume that public healthcare service has no user fee but an observable delay, while private healthcare service has a fee but no delay. Patients in the public system are given a subsidy s to use private service if their waiting times exceed a pre‐determined threshold t. We call these subsidy schemes (s, t) policies. As two extreme cases, the (s, t) policy is called an unconditional subsidy scheme if t = 0, and a full subsidy scheme if s is equal to the private service fee. There is a fixed budget constraint so that a scheme with larger s has a larger t. We assess policies using two criteria: total patient cost and serviceability (i.e., the probability of meeting a waiting time target for public service). We prove analytically that, if patients are equally sensitive to delay, a scheme with a smaller subsidy outperforms one with a larger subsidy on both criteria. Thus, the unconditional scheme dominates all other policies. Using empirically derived parameter values from the Hong Kong Cataract Surgery Program, we then compare policies numerically when patients differ in delay sensitivity. Total patient cost is now unimodal in subsidy amount: the unconditional scheme still yields the lowest total patient cost, but the full subsidy scheme can outperform some intermediate policies. Serviceability is unimodal too, and the full subsidy scheme can outperform the unconditional scheme in serviceability when the waiting time target is long.     

At Home on the Range? Lay Interpretations of Numerical Uncertainty Ranges

Numerical uncertainty ranges are often used to convey the precision of a forecast. In three studies, we examined how users perceive the distribution underlying numerical ranges and test specific hypotheses about the display characteristics that affect these perceptions. We discuss five primary conclusions from these studies: (1) substantial variation exists in how people perceive the distribution underlying numerical ranges; (2) distributional perceptions appear similar whether the uncertain variable is a probability or an outcome; (3) the variation in distributional perceptions is due in part to individual differences in numeracy, with more numerate individuals more likely to perceive the distribution as roughly normal; (4) the variation is also due in part to the presence versus absence of common cues used to convey the correct interpretation (e.g., including a best estimate increases perceptions that the distribution is roughly normal); and (5) simple graphical representations can decrease the variance in distributional perceptions. These results point toward significant opportunities to improve uncertainty communication in climate change and other domains.     

Dynamic Decision-Making Under Uncertainty: An Experimental Investigation of Choices Between Accumulator Gambles

This paper presents an experiment that is designed to be more effective than previous studies at reproducing in the laboratory the affective experiences of risk-taking, such as hope, fear, thrill, pain of loss, regret, disappointment or elation. The use of dynamic choice problems involving accumulator gambles, and a particular randomisation device to resolve them, are central to the design. Our results both are inconsistent with orthodox dynamic choice theory and cast doubt on the generality of effects observed in previous designs. We discuss these findings, in terms of the relative impacts on behaviour of affective experience and judgement.     

The Effects of Financial Incentives in Experiments: A Review and Capital-Labor-Production Framework

We review 74 experiments with no, low, or high performance-based financial incentives. The modal result has no effect on mean performance (though variance is usually reduced by higher payment). Higher incentive does improve performance often, typically judgment tasks that are responsive to better effort. Incentives also reduce “presentation” effects (e.g., generosity and risk-seeking). Incentive effects are comparable to effects of other variables, particularly “cognitive capital” and task “production” demands, and interact with those variables, so a narrow-minded focus on incentives alone is misguided. We also note that no replicated study has made rationality violations disappear purely by raising incentives.