Professional Perspectives on Decision Making about the Long-term Care of Older People

With the increasing pressure on social and health care resources,professionals have to be more explicit in their decision makingregarding the long-term care of older people. This groundedtheory study used 19 focus groups and nine semi-structured interviews(99 staff in total) to explore professional perspectives onthis decision making. Focus group participants and intervieweescomprised care managers, social workers, consultant geriatricians,general medical practitioners, community nurses, home care managers,occupational therapists and hospital discharge support staff.The emerging themes spanned context, clients, families and services.Decisions were often prompted by a crisis, hindering professionalsseeking to make a measured assessment. Fear of burglary andassault, and the willingness and availability of family to helpwere major factors in decisions about living at home. Serviceavailability in terms of public funding for community care,the availability of home care workers and workload pressureson primary care services influenced decision ‘thresholds’regarding admission to institutional care. Assessment toolsdesigned to assist decision making about the long-term careof older people need to take into account the critical aspectsof individual fears and motivation, family support and the availabilityof publicly funded services as well as functional and medicalneeds.     

Temporary workers in Canada: a multifaceted program

"This article highlights important developments in the character of temporary worker flows to Canada between 1973 and 1985 through the use of unpublished data and new measures for analyzing this data. The number of employment authorizations are converted to person years to indicate the overall labor market impact of temporary worker flows and this measure is employed in an analysis of unpublished data from Employment and Immigration Canada. The analysis reveals that a significant and growing proportion of employment authorizations are exempted from governmental procedures which link the admission of temporary workers to the Canadian labor market." Reasons for these exemptions and policy implications are discussed     

Community,Family, and Race/Ethnic Differences in Health Status in Rural Areas1

Abstract Many race-specific differences in health outcomes that have been observed in previous research have been attributed to class and racebased group differences which either facilitate or constrain health opportunities and behaviors. These include such variables as different rates of poverty, health insurance coverage, and access to medical care. However, these relationships have been inadequately examined in rural communities where minority status may be even more detrimental to health than in urban areas, due to various constraints on access to health care. We present an analysis that assesses the effects of community, family structure, sociodemographic, and medical care variables on self-reported health status among Hispanics, Mrican Americans, and non-Hispanic whites in six rural communities in Florida. Community structural characteristics had a significant effect on self-reported health, as did some of the measures of how respondents “experience” community. These relationships held even when other sets of variables were added to the models. Family/household characteristics and sociodemographic and medical care variables were less important in explaining self-reported health status. These findings suggest that community continues to be important in explaining differences in health status in rural areas.     

Exploring Heideggerian hermeneutic phenomenology: A perfect fit for midwifery research

BackgroundHeideggerian hermeneutic phenomenology has been used widely to understand the meaning of lived experiences in health research. For midwifery scholars this approach enables deep understanding of women's and midwives’ lived experiences of specific phenomena. However, for beginning researchers this is not a methodology for the faint hearted. It requires a period of deep immersion to come to terms with at times impenetrable language and perplexing concepts.ObjectivesThis paper aims to assist midwives to untangle and examine some of the choices they face when they first come to terms with an understanding of this methodology and highlights the methodology's capacity to reveal midwifery authenticity and holistic practice.DiscussionThe illumination of a selection of various concepts underpinning hermeneutic phenomenology will inform midwives considering this methodology as suitable framework for exploring contemporary midwifery phenomena.     

Fitting Hierarchical Holographic Modeling into the Theory of Scenario Structuring and a Resulting Refinement to the Quantitative Definition of Risk

A point of view is suggested from which the Hierarchical Holographic Modeling (HHM) method can be seen as one more method within the Theory of Scenario Structuring (TSS), which is that part of Quantitative Risk Assessment having to do with the task of identifying the set of risk scenarios. Seen in this way, HHM brings strongly to our attention the fact that different methods within TSS can result in different sets of risk scenarios for the same underlying problem. Although this is not a problem practically, it is a bit awkward conceptually from the standpoint of the "set of triplets" definition of risk, in which the scenario set is part of the definition. Accordingly, the present article suggests a refinement to the set of triplets definition, which removes the specific set of scenarios, found by any of the TSS methods, from the definition of risk and casts it, instead, as an approximation to the "true" set of scenarios that is native to the problem at hand and not affected by the TSS method used.     

Strategies for planning

In recent years there has been a good deal of discussion amongst planning specialists and academics about the gap which exists between the theory of planning as set out in journals and textbooks, and the practice of planning in private and public organizations. Planners are continually complaining about the resistance to planning by top management and operating managers in divisions and departments.In this article the author aims to produce a reconciliation between theory and practice and to discuss what alternative strategies are open to planners in devising planning systems for their organizations.He suggests that the problem has its origin in the fact that corporate planning theory was first developed by management scientists as a total systems approach. Corporate planners have failed to sell an integrated planning system either as programme budgeting or as corporate planning. Research suggests that a management team can only adopt and implement a comprehensive planning system in very special circumstances, e.g. when the organization's survival is threatened, a new management team has been appointed and the staff of the organization are ready to accept radical change.In normal circumstances the planner is wrong to advocate a ‘root and branch’ solution. He must diagnose the planning needs of the organization and his objective must be not merely to establish a particular planning procedure but rather to discover how he can best improve the quality of management decisions.Recent studies on strategy formation indicate that the introduction of a formal planning procedure is only a partial answer to the problem of improving the quality of management decisions.The paper reviews various approaches to planning and considers how they relate to organizations with different strategic problems, with differing organization structures and various management styles.     

Estimation of nonseparable models with censored dependent variables and endogenous regressors

In this article we develop a nonparametric estimator for the local average response of a censored dependent variable to endogenous regressors in a nonseparable model where the unobservable error term is not restricted to be scalar and where the nonseparable function need not be monotone in the unobservables. We formalize the identification argument put forward in Altonji, Ichimura, and Otsu (2012 Altonji, J. G., Ichimura, H., Otsu, T. (2012). Estimating derivatives in nonseparable models with limited dependent variables. Econometrica 80:1701–1719.[Crossref], [Web of Science ®] , [Google Scholar]), construct a nonparametric estimator, characterize its asymptotic property, and conduct a Monte Carlo investigation to study its small sample properties. Identification is constructive and is achieved through a control function approach. We show that the estimator is consistent and asymptotically normally distributed. The Monte Carlo results are encouraging.     

Realistic Free-Spins Features Increase Preference for Slot Machines

Despite increasing research into how the structural characteristics of slot machines influence gambling behaviour there have been no experimental investigations into the effect of free-spins bonus features—a structural characteristic that is commonly central to the design of slot machines. This series of three experiments investigated the free-spins feature using slot machine simulations to determine whether participants allocate more wagers to a machine with free spins, and, which components of free-spins features drive this preference. In each experiment, participants were exposed to two computer-simulated slot machines—one with a free-spins feature or similar bonus feature and one without. Participants then completed a testing phase where they could freely switch between the two machines. In Experiment 1, participants did not prefer the machine with a simple free-spins feature. In Experiment 2 the free-spins feature incorporated additional elements such as sounds, animations, and an increased win frequency; participants preferred to gamble on this machine. The Experiment 3 “bonus feature” machine resembled the free spins machine in Experiment 2 except spins were not free; participants showed a clear preference for this machine also. These findings indicate that (1) free-spins features have a major influence over machine choice and (2) the “freeness” of the free-spins bonus features is not an important driver of preference, contrary to self-report and interview research with gamblers.     

Forecasting intraday time series with multiple seasonal cycles using parsimonious seasonal exponential smoothing

This paper concerns the forecasting of seasonal intraday time series that exhibit repeating intraweek and intraday cycles. A recently proposed exponential smoothing method involves smoothing a different intraday cycle for each distinct type of day of the week. Similar days are allocated identical intraday cycles. A limitation is that the method allows only whole days to be treated as identical. We introduce a new exponential smoothing formulation that allows parts of different days of the week to be treated as identical. The result is a method that involves the smoothing and initialisation of fewer terms. We evaluate forecasting up to a day ahead using two empirical studies. For electricity load data, the new method compares well with a range of alternatives. The second study involves a series of arrivals at a call centre that is open for a shorter duration at the weekends than on weekdays. Among the variety of methods considered, the new method is the only one that can model in a satisfactory way in this situation, where the number of periods on each day of the week is not the same.