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151.
Mapping the Elder Mistreatment Iceberg: U.S. Hospitalizations With Elder Abuse and Neglect Diagnoses
Sue Rovi PhD Ping-Hsin Chen PhD Marielos Vega BSN RN Mark S. Johnson MD MPH Charles P. Mouton MD MS FAAFP AGSF CMD 《Journal of elder abuse & neglect》2013,25(4):346-359
Purpose: This study describes U.S. hospitalizations with diagnostic codes indicating elder mistreatment (EM). Method: Using the 2003 Nationwide Inpatient Sample (NIS) of the Healthcare Costs and Utilization Project (HCUP), inpatient stays coded with diagnoses of adult abuse and/or neglect are compared with stays of other hospitalized adults age 60 and older. Results: Few hospitalizations (< 0.02%) were coded with EM diagnoses in 2003. Compared to other hospitalizations of older adults, patients with EM codes were twice as likely to be women (OR = 2.12, 95% CI = 1.63–2.75), significantly more likely to be emergency department admissions (78.0% vs. 56.8%, p < .0001), and, on average, more likely to have longer stays (7.0 vs. 5.6 days, p = 0.01). Patients with EM codes were also three to four times more likely to be discharged to a facility such as a nursing home rather than “routinely” discharged (i.e., to home or self-care) (OR = 3.66, 95% CI = 2.92–4.59). Elder mistreatment–coded hospitalizations compared to all other hospitalizations had on average lower total charges ($21,479 vs. $25,127, p < .001), with neglect cases having the highest charges in 2003 ($29,389). Implications: Knowledge about EM is often likened to the “tip of the iceberg.” Our study contributes to “mapping the EM iceberg”; however, findings based on diagnostic codes are limited and should not be used to minimize the problem of EM. With the so-called graying of America, training is needed in recognizing EM along with research to improve our nation's response to the mistreatment of our elderly population. 相似文献
152.
Ha Hoang Quynh Le Sue Kilpatrick Madeleine Jona Nidarshi Fernando 《Women and birth : journal of the Australian College of Midwives》2013,26(1):55-59
ObjectivesHome birth has attracted great controversy in the current context. There is a need for the public and health professionals to understand why maternity care providers have such different views on home birth, why they debate, what divides them into two opposite sides and if they have anything in common.MethodA qualitative study involving twenty maternity health providers in Tasmania was conducted. It used semi-structured interview which included closed and open-ended questions to provide opportunities for exploring emerging insights from the voices of the participants.FindingsHealth practitioners who support home birth do so for three reasons. Firstly, women have the right to choose the place of birth. Secondly, home birth may be more cost effective compared to hospital birth. Thirdly, if home birth is not supported, some women might choose to have a free birth. Those who opposed home birth argue that complications could occur at childbirth and the transfer time is critical for women's and babies’ safety. These differences in opinions can be due to the differences in the training and philosophy of the maternity care providers. Despite the differing views on home births, health professionals share a common goal to protect the women and the newborns from unexpected situations during childbirth.ConclusionThis article provides some significant insights derived from the study of home birth from the maternity health professionals’ perspectives and could contribute to the enhancement of mutual understanding and collaboration of health professionals in their services to expectant mothers. 相似文献
153.
Amanda Forti Helen Stapleton Sue Kildea 《Women and birth : journal of the Australian College of Midwives》2013,26(4):235-239
BackgroundAround-the-clock access to a known midwife is a distinct feature of Midwifery Group Practice (MGP) and caseload midwifery settings; although the literature suggests this aspect of working life may hinder recruitment and retention to this model of care. Mobile technologies, known as mHealth where they are used in health care, facilitate access and hence communication, however little is known about this area of midwifery practice.Research questionWhich communication modalities are used, and most frequently, by MGP midwives and clients?MethodsA prospective, cross sectional design included a purposive sample of MGP midwives from an Australian tertiary maternity hospital. Data on modes of midwife–client contact were collected 24 h/day, for two consecutive weeks, and included: visits, phone-calls, texts and emails. Demographic data were also collected.FindingsDetails about 1442 midwife–client contacts were obtained. The majority of contact was via text, between the hours of 07:00 and 14:59, with primiparous women, when the primary midwife was on-call. An average of 96 contacts per fortnight occurred.ConclusionThe majority of contact was between the midwife and their primary clients, reiterating a key tenet of caseload models and confirming mobile technologies as a significant and evolving aspect of practice. The pattern of contact within social (or daytime) hours is reassuring for midwives considering caseload midwifery, who are concerned about the on-call burden. The use of text as the preferred communication modality raises issues regarding data security and retrieval, accountability, confidentiality and text management during off-duty periods. The development of Australian-wide guidelines to inform local policies and best practice is recommended. 相似文献
154.
155.
Senior leaders are usually understood to be ideally positioned to drive the organizational changes needed to promote workplace gender equality. Yet seniority also influences leaders' values and attitudes, and how they interpret evidence of inequalities, determine organizational priorities, and design and implement remedies. This article examines leaders' perceptions of workplace gender equality using system justification theory to explain survey data from Australia's public sector (n = 2292). Multivariate analysis indicates that male and female leaders more positively rate the gender equality climate in their agencies, compared with lower-level staff, and that male leaders show most propensity to defend the status quo. Findings call into question the effectiveness of change strategies that rely on leadership and buy-in of those whose privilege is embedded in existing arrangements, and problematize dominant organizational approaches casting senior leaders as effective change agents for gender equality. The article helps to explain gendered power dynamics, which produce and sustain organizational inequalities and make workplace equality so hard to achieve, and points to ways to strengthen practical approaches to promote equality in organizations. 相似文献
156.
Christine Stirling Sue Kilpatrick Peter Orpin 《Human Resource Development International》2013,16(3):321-336
This study applies the concept of the psychological contract to the relationship between management practices and volunteers. Formalization of the voluntary sector is impacting on volunteers' experiences and may breach the psychological contract from the volunteers' perspective. This mixed method study interviewed 67 volunteers and volunteer coordinators/administrators, and collected mail survey information from 152 volunteer organizations. The transactional management practices of keeping formal records and not paying volunteers out of pocket expenses are negatively associated with volunteer recruitment and retention. Alternatively, publicly recognizing volunteers through a volunteer newsletter supports volunteers' relational expectations and is positively linked to adequate volunteer numbers. Our findings have important implications for the human resource development practices of non-profit organizations in dealing with theirvolunteers: they suggest that the relational expectations of volunteers are animportant aspect of the psychological contract, which could be used by organizations as a framework for developing management practices that fit the volunteer ethos of trust and networks. 相似文献
157.
The Analysis of Designed Experiments and Longitudinal Data by Using Smoothing Splines 总被引:10,自引:0,他引:10
Arnas P. Verbyla Brian R. Cullis Michael G. Kenward & Sue J. Welham 《Journal of the Royal Statistical Society. Series C, Applied statistics》1999,48(3):269-311
In designed experiments and in particular longitudinal studies, the aim may be to assess the effect of a quantitative variable such as time on treatment effects. Modelling treatment effects can be complex in the presence of other sources of variation. Three examples are presented to illustrate an approach to analysis in such cases. The first example is a longitudinal experiment on the growth of cows under a factorial treatment structure where serial correlation and variance heterogeneity complicate the analysis. The second example involves the calibration of optical density and the concentration of a protein DNase in the presence of sampling variation and variance heterogeneity. The final example is a multienvironment agricultural field experiment in which a yield–seeding rate relationship is required for several varieties of lupins. Spatial variation within environments, heterogeneity between environments and variation between varieties all need to be incorporated in the analysis. In this paper, the cubic smoothing spline is used in conjunction with fixed and random effects, random coefficients and variance modelling to provide simultaneous modelling of trends and covariance structure. The key result that allows coherent and flexible empirical model building in complex situations is the linear mixed model representation of the cubic smoothing spline. An extension is proposed in which trend is partitioned into smooth and non-smooth components. Estimation and inference, the analysis of the three examples and a discussion of extensions and unresolved issues are also presented. 相似文献
158.
This article gives attention to furthering understandings about what being successful at university means to social work students, focusing on the perspectives of students who speak English as an additional language (EAL). It departs from approaches in the literature that focus on problematic aspects of teaching and learning. The article is informed by data from a small-scale focus group study of nine students from an undergraduate and a postgraduate social work programme in a South Australian university. Drawing on a methodological approach known as ‘Appreciative Inquiry’, students were asked how they conceptualise, experience and imagine success at university. The study found that students’ understandings of success are inextricably intertwined with their individual, family and community aspirations. These findings are discussed in the light of current dominant assumptions about the notion of success and possible directions for future research and implications for social work education. 相似文献
159.
During the last 10 years, Northern Ireland has suffered the same economic fate as the rest of the United Kingdom—a severe decline in its manufacturing base, and with this a substantial growth in unemployment to unacceptable levels. In response, a strategy for regeneration has been constructed. The main thrust of this strategy has been three-fold:
1. (1) To seek Inward Investment.
2. (2) To stimulate New Firms.
3. (3) To encourage Existing Firms to grow.
The strategy has involved a wide range of schemes of advice and assistance, managed through the Department of Economic Development, the Industrial Development Board (IDB), the Local Enterprise Development Unit (LEDU), as well as local enterprise organizations.
However, whilst many of the problems encountered, for which various schemes have been devised, can be seen replicated elsewhere in the United Kingdom, the basic problems in Norther Ireland are different in character. 相似文献
160.
Sue Curry Jansen 《Qualitative sociology》1980,2(3):22-55
The belief that ‘the stranger’ (outsider, disinterested third party) sees things more clearly, i.e. is more “objective,” is
seen to be a corner-stone of folk wisdom; underlying Western judicial thought and concepts of objectivity in the social sciences.
The author raises the dilemma that both positivistic and humanistic sociologists accept this belief—suggesting 1) that it
is a residue of positivism and a quest for certain knowledge, or 2) the possibility that ‘the stranger’ does gain deeper insight
into group life than members. The paper examines the concept of the stranger, considering the aura of charisma that seems
to have been attached to it in ordinary discourse as well as within the sociological dialogue. Two types of strangers are
described: outsiders and enemies within. Finally, an attempt is made to examine the testimony of prominant strangers as they
describe their marginal status and speculate on the ways that status has made them unusually perceptive observers of social
phenomena. 相似文献