Managing in the Trenches of Consumer Care: The Challenges of Understanding and Initiating the Advance Care Planning Process

To better understand how community-based long-term care providers define advance care planning and their role in the process, we conducted 8 focus groups with 62 care managers (social workers and registered nurses) providing care for Ohio's Medicaid waiver program. Care managers shared that most consumers had little understanding of advance care planning. The care managers defined it broadly, including legal documentation, social aspects, medical considerations, ongoing communication, and consumer education. Care managers saw their roles as information providers, healthcare team members, and educators/coaches. Better education, resources, and coordination are needed to ensure that consumer preferences are realized.     

Roles of the institute of medicine in providing health science policy advice

Studies conducted by the Institute of Medicine (IOM) are one way that government agencies can get presumably neutral advice on health science policy issues. The traditional IOM study is undertaken using a committee of experts supported by professional staff on issues of particular importance related to health policy. The report is usually a consensus document from the group of experts who have various points of view on the topic. After a report is prepared, it undergoes an independent review process to assure that the conclusions are based on the best available science and vigorous analysis of the data. IOM reports make recommendations for further actions that could be undertaken by a diverse audience, and do not just provide a series of options as is done in reports from the Office of Technology Assessment.     

Pregnant women's attitudes toward the abortion of defective fetuses

A survey asked 190 pregnant women their opinions on whether a hypothetical other woman would be justified in having an abortion under ten different circumstances, four of which related to abnormalities of the fetus. They were then asked whether they would be justified in having an abortion under these same circumstances. Also assessed were these women's views concerning the justifiability of abortion for a specific group of fetal abnormalities, neural tube defects. Respondents were more likely to view abortion as justifiable for a hypothetical other than for themselves. However, there was no evidence that pregnant women's views about abortion are more conservative than those of the general public. The majority of respondents considered abortion of a defective fetus to be justified, both for themselves and for others. The best predictor of abortion attitudes was respondent's views about the ideal number of children in a completed family.This research was supported by a grant from Maternal and Child Health Research, Bureau of Community Health Services, DHHS. Reprint requests should be sent to Dr. Ruth Faden at the Johns Hopkins University School of Hygiene and Public Health, Division of Health Education, 615 N. Wolfe Street, Baltimore, MD 21205.     

Relational Strains and Delinquency: Assessing the Gendering of Emotions’ Claims among Chinese Adolescents*

This study assesses the gendering of emotions’ claims in an understudied population, that is, adolescents in mainland China. Specifically, it examines gender variations in the emotional reactions to relational strains and gendered responses to emotions with types of delinquency. Data drawn from over 500 middle‐school students from an urban city in China yield results in support of general strain theory in most respects, but culture‐specific patterns are noted. In general, Chinese boys and girls respond to different domains of relational strains, and relational strains are more strongly associated with depression than anger. Furthermore, boys respond to relational strains with anger more often than do girls, whereas girls and boys are about equal in responding to strains with depression. Gender differences are observed concerning responses to emotions with delinquency. Boys are more likely than girls to use aggression in response to anger and depression, whereas no gender differences are manifested in the reaction to emotions with non‐aggressive delinquency. Gender patterns are also noted in the assessment of negative emotions as mediators of the strain–delinquency relationship. We address these findings along with other observations in light of general strain theory and sociocultural factors pertinent to mainland China.     

Large sample bias of maximum likeihood estimates from a series of sparse ixj tables

For a large series of IxJ tables, each containing two observations, the bias of the maximum likelihood estimates of log linear partial association parameters is shown to be equal to the parameters, regardless of the size of I and J. The partial association considered is that between row and column variables; the three way interactions are assumed to be O. This is a generalization of Andersen's results (1973a, 1973b) for a series of 2x2 tables.     

Some multiple comparison procedures for comparing treatments within several groups

Multiple comparison procedures are extended to designs consisting of several groups, where the treatment means are to be compared within each group. This may arise in two-factor experiments, with a significant interaction term, when one is interested in comparing the levels of one factor at each level of the other factor. A general approach is presented for deriving the distributions and calculating critical points, following three papers which dealt with two specific procedures. These points are used for constructing simultaneous confidence intervals over some restricted set of contrasts among treatment means in each of the groups. Tables of critical values are provided for two procedures and an application is demonstrated. Some extensions are presented for the case of possible different sets of contrasts and also for unequal variances in the various groups.     

Online Teaching in Social Work Education: Understanding the Challenges

There is a rapidly growing industry of online learning and distance education programs at the Master of Social Work and Bachelor of Social Work levels both within Australia and globally. A number of best practices have emerged from the literature that warrant consideration when delivering social work programs in online learning and distance education modes. Given the significant advancements in technology that are likely to continue into the next decades, social work academic leaders and accrediting bodies must be prepared to address the changing landscape of higher education, including limited financial resources. Social work academics need to become aware and implement best practices in online learning and distance education e-teaching environments to ensure positive student outcomes, student retention, and student engagement to meet the flexibility needs of students in higher education settings. The purpose of this paper is to identify and discuss the challenges and benefits of distance education and online learning for consideration when providing a social work program in these delivery models.

IMPLICATIONS

• Given the significant advancements in technology that are likely to continue into the next decades, social work academic leaders and accrediting bodies must be prepared to address the changing landscape of higher education.

• Social work academics need to become aware and implement best practices in the distance education and online teaching environment to ensure positive student outcomes, student retention, and student engagement to meet the flexibility needs of students in higher education settings.

     

An Approach to Assessing the Impacts of Incident-Free Transportation of Radioactive Materials: I. Air Transportation

Annual radiation doses and risks to passengers and crew are calculated for shipments of radioactive materials in passenger aircraft under accident-free and incident-free conditions (i.e., under normal transportation conditions). The 1982 database developed by Sandia National Laboratories is used, and calculations are made using RADTRAN 4.0. This paper is one of two papers estimating radiological risk associated with incident-free transportation of radioactive materials.