The Attitudes of Social Work Students Toward End-of-Life Care Planning

This study examined the attitudes of social work students toward end-of-life care planning, as well as their degree of willingness to engage in this area of social work practice. Factors associated with their attitudes were measured through structured surveys completed by 102 social work students (N = 102) at a school of social work in the southeast. Results indicated that these social work students tended to have positive attitudes toward end-of-life care planning in general. Moreover, these attitudes were positively associated with preference for pain relief treatment, higher levels of comfort when discussing death, more emphasis on self-determination, and apprehension of conflicts of self-determination. The results of this study underscored the increased societal need for recognition of personal preferences in end-of-life care, higher levels of comfort when discussing death, and an increased commitment of social workers' to maintaining the ethical principle of the client's right to self-determination in end-of-life planning. While this is not surprising, it points to a continuing need to re-assess where the field stands in its preparation of social work professionals who will work closely with people who are dying and their families.     

Too old to test? Prevalence and correlates of HIV testing among sexually active older adults

ABSTRACT

Older adults account for 17% of new HIV diagnoses in the US and are more likely to be diagnosed with HIV later in the course of the disease compared to younger people. We calculated the prevalence and associated factors of having ever been tested for HIV among sexually active older adults. We analyzed data from the 2008–2016 General Social Survey Limited to respondents ≥65 years of age who reported more than one sex partner(s) in past 12 months (n = 757). HIV testing prevalence, prevalence ratios, and 95% confidence intervals were calculated by demographic variables and HIV-related risk behaviors. An estimated 16.3% of sexually active older adults have tested for HIV, and 15.9% were at increased risk for HIV infection (reported injection drug and/or crack–cocaine use, exchanging money for sex, more than three sex partners in the past year, or men who reported having sex with another man). In the adjusted model, adults aged 65–70, not married, self-identified as gay/bisexual, and at increased risk for HIV infection were more likely to have tested for HIV. An estimated 83.7% of sexually active older adults never tested for HIV. Strategies are needed to increase HIV awareness and testing among potentially high-risk older adults.     

Family Instability and the Transition to Adulthood

Children's experience of repeated family structure change has a robust association with compromised development across the early life course. Implicit in prior research is the expectation that disparities in cognition and behavior accumulate through childhood and adolescence to influence the transition to adulthood. The authors assessed the association of early and later family structure instability with events in the transition to adulthood up to age 24 using data from the National Longitudinal Study of Adolescent Health (N = 8,841).They found that early and later family instability are associated with low rates of college completion, early union formation and childbearing, and an early entry into the labor force. The associations are explained by family structure, delinquency, and academic performance in adolescence.     

Scientific Peer Review to Inform Regulatory Decision Making: Leadership Responsibilities and Cautions

The article offers insights on the peer-review process as it relates to scientific and technical reports used to inform regulatory decisions. Used effectively, peer review is a powerful tool for advising organizational leaders whether the scientific foundations of their decisions can be expected to withstand scrutiny as rule-making products move through interagency reviews, public comment and stakeholder processes, congressional oversight, and judicial review. The emphasis is "heads up" rather than "how to." That is, without delving into myriad technical and administrative details, the discussion highlights nine fundamental "leadership responsibilities" that determine the nature and course of peer review.     

The Role of Distrust in Offshore Safety Performance

Trust is recognized as a potentially important factor in safety within high-risk industries. However, little detailed empirical research has explored how trust operates in these contexts to influence worker safety performance. The present study addresses this by (i) identifying the target (occupational group) in which trust is most important for good safety, and (ii) establishing the "type" of trust (trust or distrust) with the greatest impact on safety performance. A questionnaire survey of 203 UK offshore gas workers' attitudes of trust and distrust toward four occupational groups (workmates, supervisors, offshore managers, and contractors) and an operating company was conducted. Logistic regression analysis identified attitudes toward offshore management as the strongest predictor of safety performance at an industry level. At an installation level, safety performance was best predicted by attitudes toward contractors and workmates. Further analysis revealed attitudes of distrust as better predictors of safety performance compared to attitudes of trust. These findings suggest that safety professionals should pay more attention to the role of distrust in safety performance. They also suggest that safety initiatives should target attitudes toward specific groups for optimal effectiveness.     

Challenges in assessing intent to die: can suicide attempters be trusted?

Assessing a person's intent to die in a suicide attempt is crucial for risk assessment and research, yet suicidal intent is notoriously difficult to measure. People who intended to die when they hurt themselves may deny it, and others may feign intent for secondary gain. Additionally, ambivalence, memory gaps, impulsivity, and fluidity of intent can hinder accurate assessment of intent. Circumstantial evidence, such as a suicide note, may illuminate true intentions but also has substantial limitations. This article summarizes disparate challenges to the measurement of suicidal intent; describes strengths and weaknesses of circumstantial indicators; reviews evidence from studies using the Suicide Intent Scale to show that subjective and circumstantial indicators do not strongly correlate with each other; and concludes with a call to place more trust in individuals whose disclosures of suicidal intent are questionable, even if the possibility for manipulation exists.