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Full-Text Articles in Social and Behavioral Sciences

Assessing Stakeholder Opinions Of Medical Review Of Impaired Drivers And Fitness To Drive: Recommendations For Massachusetts, Nina Silverstein, Kelli Barton Dec 2011

Assessing Stakeholder Opinions Of Medical Review Of Impaired Drivers And Fitness To Drive: Recommendations For Massachusetts, Nina Silverstein, Kelli Barton

Nina Silverstein

Driving is the main mode of travel for Americans age 65 and older, and although older adults are generally found to be safe drivers, aging often brings about functional limitations and an increase in medications that can impede safe driving and fitness to drive (Rosenbloom, 2003; Kissinger, 2008; Adler & Silverstein, 2008). Effective licensing policies and Medical Advisory Board practices are critical components in identifying medically at-risk drivers and may even have a role in the transition to alternative transportation options; yet, states vary greatly in their approach to licensing and renewal practices and in the utilization, composition, and function …


Talk, Trust And Time: A Longitudinal Study Evaluating Knowledge Translation And Exchange Processes For Research On Violence Against Women, C. Wathen, Shannon Sibbald, Susan Jack, Harriet Macmillan Sep 2011

Talk, Trust And Time: A Longitudinal Study Evaluating Knowledge Translation And Exchange Processes For Research On Violence Against Women, C. Wathen, Shannon Sibbald, Susan Jack, Harriet Macmillan

Shannon L. Sibbald

BACKGROUND: Violence against women (VAW) is a major public health problem. Translation of VAW research to policy and practice is an area that remains understudied, but provides the opportunity to examine knowledge translation and exchange (KTE) processes in a complex, multi-stakeholder context. In a series of studies including two randomized trials, the McMaster University VAW Research Program studied one key research gap: evidence about the effectiveness of screening women for exposure to intimate partner violence. This project developed and evaluated KTE strategies to share research findings with policymakers, health and community service providers, and women's advocates. METHODS: A longitudinal cross-sectional …


Medicare’S Bundled Payment Pilot For Acute And Postacute Care: Analysis And Recommendations On Where To Begin, Neeraj Sood, Peter Huckfeldt, Jose Escarce, David Grabowski, Joseph Newhouse Aug 2011

Medicare’S Bundled Payment Pilot For Acute And Postacute Care: Analysis And Recommendations On Where To Begin, Neeraj Sood, Peter Huckfeldt, Jose Escarce, David Grabowski, Joseph Newhouse

Peter J. Huckfeldt

In the National Pilot Program on Payment Bundling, a subset of Medicare providers will receive a single payment for an episode of acute care in a hospital, followed by postacute care in a skilled nursing or rehabilitation facility, the patient’s home, or other appropriate setting. This article examines the promises and pitfalls of bundled payments and addresses two important design decisions for the pilot: which conditions to include, and how long an episode should be. Our analysis of Medicare data found that hip fracture and joint replacement are good conditions to include in the pilot because they exhibit strong potential …


Symptom Persistence In Seriously Emotionally Disordered Children: Findings Of A Two-Year Follow-Up After Residential Treatment, Rebecca Cuthbert, Jeff St. Pierre, Shannon Stewart, Steven Cook, Andrew Johnson, Alan Leschied Jul 2011

Symptom Persistence In Seriously Emotionally Disordered Children: Findings Of A Two-Year Follow-Up After Residential Treatment, Rebecca Cuthbert, Jeff St. Pierre, Shannon Stewart, Steven Cook, Andrew Johnson, Alan Leschied

Andrew M. Johnson

Residential treatment is arguably the most costly and intensive part of the children’s mental health system. Yet, research suggests that a subset of the emotionally disordered children and youth admitted to intensive tertiary care treatment facilities fail to demonstrate symptom reductions upon discharge, with many continuing to deteriorate in their adjustment during the follow-up period. This study reports on the factors that characterize the children and youth that, while showing marginal benefit from residential treatment, continue to show community conduct problems at a two-year follow-up period. The results are discussed in the context of how knowledge of these factors can …


A Duty To Warn, An Uncertain Danger / Discussion, Frederic Reamer Jun 2011

A Duty To Warn, An Uncertain Danger / Discussion, Frederic Reamer

Frederic G Reamer

The commitment of confidentiality in the various health and mental health professions is deep-seated. Codes of ethics routinely cite the professional's obligation to hold in confidence information that a client shares. The Code of Ethics of the National Association of Social Workers--which is pertinent to Mrs. D's predicament--is representative: "The social worker should respect the privacy of clients and hold in confidence all information obtained in the course of professional service."


Aids, Social Work, And The "Duty To Protect", Frederic Reamer Jun 2011

Aids, Social Work, And The "Duty To Protect", Frederic Reamer

Frederic G Reamer

This article discusses social workers' obligation in cases where clients with aquired immune deficiency syndrome (AIDS) pose a threat to a third party. Emphasis is on cases where a client diagnosed with AIDS withholds that information from a sexual partner. Legal and ethical issues concerning the limits of confidentiality and the social worker's "duty to protect" third parties are reviewed. Relevant case law and emerging ethical standards in various professions are summarized. The author reviews legal precedents concerning disclosure of confidential information without a client's permission and discusses their relevance to AIDS cases. Implications and guidelines for social workers are …


Aids And Ethics, Frederic Reamer Jun 2011

Aids And Ethics, Frederic Reamer

Frederic G Reamer

The seriousness of the AIDS crisis is well known. Since the first case was documented in Los Angeles in 1981, the media have been filled with research updates, documentaries, and exposes on the dreaded disorder. Reports and case studies have ranged from informative to sensational. They have included serious academic studies, educational overviews targeted for the general public, and columns in weekly tabliods.


Aids And Social Work, Frederic Reamer Jun 2011

Aids And Social Work, Frederic Reamer

Frederic G Reamer

Social workers are becoming increasingly involved in casework and social policy debate related to the acquired immune deficiency syndrome (AIDS) crisis. To enhance their delivery of services and contribution to policy formulation, social workers need to be familiar with a wide range of ethical and civil liberties issues that have been generated by the AIDS epidemic. This article provides an overview of six major ethical and civil liberties issues pertaining to social work practice related to AIDS: (1) mandatory screening and testing of clients for the immunodeficiency virus (HIV), (2) client access to health insurance, (3) professionals' duty to treat …


A Qualitative Study Examining Tensions In Interdoctor Telephone Consultations, Anupma Wadhwa, Lorelei Lingard Jun 2011

A Qualitative Study Examining Tensions In Interdoctor Telephone Consultations, Anupma Wadhwa, Lorelei Lingard

Lorelei Lingard

OBJECTIVE: Communication skills have gained increasing attention in medical education. Much of the existing literature and medical curricula addresses issues of doctor-patient communication. The critical importance of communication between health professionals, however, is now coming under the spotlight. The interdoctor telephone consultation is a common health care setting in which health professional communication skills are exercised. Breakdowns in this communication commonly occur and, surprisingly, this skill is not formally addressed in medical training. This study sought to clarify the communication issues that can occur during interdoctor telephone consultations in order to inform future educational initiatives in this domain. METHODS: Data …


Towards Safer Interprofessional Communication: Constructing A Model Of "Utility" From Preoperative Team Briefings, Lorelei Lingard, Sarah Whyte, Sherry Espin, G. Baker, Beverley Orser, Diane Doran Jun 2011

Towards Safer Interprofessional Communication: Constructing A Model Of "Utility" From Preoperative Team Briefings, Lorelei Lingard, Sarah Whyte, Sherry Espin, G. Baker, Beverley Orser, Diane Doran

Lorelei Lingard

"Improved team communication" is broadly advocated in the discourse on safety but rarely supported by a precise understanding of the relationship between specific communication practices and concrete improvements in collaborative work processes. We sought to improve such understanding by analyzing the discourse arising from structured preoperative team briefings among surgeons, nurses, and anesthesiologists prior to general surgery procedures. Analysis of observers' fieldnotes from 302 briefings yielded a two-part model of communicative "utility", defined as the visible impact of communication on team awareness and behavior. "Informational utility" occurred when team awareness or knowledge was improved by provision of new information, explicit …


Surgeons Managing Conflict: A Framework For Understanding The Challenge, David Rogers, Lorelei Lingard Jun 2011

Surgeons Managing Conflict: A Framework For Understanding The Challenge, David Rogers, Lorelei Lingard

Lorelei Lingard

No abstract provided.


A Theory-Based Instrument To Evaluate Team Communication In The Operating Room: Balancing Measurement Authenticity And Reliability, Lorelei Lingard, Glenn Regehr, Sherry Espin, Sarah Whyte Jun 2011

A Theory-Based Instrument To Evaluate Team Communication In The Operating Room: Balancing Measurement Authenticity And Reliability, Lorelei Lingard, Glenn Regehr, Sherry Espin, Sarah Whyte

Lorelei Lingard

BACKGROUND: Breakdown in communication among members of the healthcare team threatens the effective delivery of health services, and raises the risk of errors and adverse events. AIM: To describe the process of developing an authentic, theory-based evaluation instrument that measures communication among members of the operating room team by documenting communication failures. METHODS: 25 procedures were viewed by 3 observers observing in pairs, and records of events on each communication failure observed were independently completed by each observer. Each record included the type and outcome of the failure (both selected from a checklist of options), as well as the time …


The Rhetorical 'Turn' In Medical Education: What Have We Learned And Where Are We Going?, Lorelei Lingard Jun 2011

The Rhetorical 'Turn' In Medical Education: What Have We Learned And Where Are We Going?, Lorelei Lingard

Lorelei Lingard

This paper presents a critical reflection on the contributions and challenges associated with one rhetorical approach to studying teaching and learning communication in health professions education. A rhetorical approach treats language as a social act, and attends to the role of language in establishing professional identities and relationships. The research has produced insights into the use of standard communication formats to teach novices, the nature of socialization on clinical teams, and the relationship between communication patterns and patient safety. Challenges and emerging questions include the problem of accounting for the material dimensions of communication in a rhetorical model, grappling with …


The Cost Of Treating Addiction From The Client's Perspective: Results From A Multi-Modality Application Of The Client Datcap, Kathryn Mccollister, Michael French, Jeffrey Pyne, Brenda Booth, Richard Rapp, Carey Carr Jun 2011

The Cost Of Treating Addiction From The Client's Perspective: Results From A Multi-Modality Application Of The Client Datcap, Kathryn Mccollister, Michael French, Jeffrey Pyne, Brenda Booth, Richard Rapp, Carey Carr

Michael T. French

There is a considerable disparity between the number of individuals who need substance abuse treatment and the number who actually receive it. This is partly due to the fact that many individuals with substance use disorders do not perceive a need for formal treatment. Another contributing factor, however, is a discrepancy between the real and perceived cost of services. Although many cost evaluations of substance abuse treatment have been conducted from the treatment provider perspective, less is known about the client-specific costs of attending treatment (e.g., lost work and leisure time, transportation, out-of-pocket and in-kind payments). Concerns about financial and …


Pharmaceutical Use Following Generic Entry: Paying Less And Buying Less, Peter Huckfeldt, Christopher Knittel Apr 2011

Pharmaceutical Use Following Generic Entry: Paying Less And Buying Less, Peter Huckfeldt, Christopher Knittel

Peter J. Huckfeldt

We study the effects of generic entry on prices and utilization using both event study models that exploit the differential timing of generic entry across drug molecules and cast studies. Our analysis examines drugs treating hypertension, high blood pressure, type 2 diabetes, and depression using price and utilization data from the Medical Expenditure Panel Survey. We find that utilization of drug molecules starts decreasing in the two years prior to generic entry and continues to decrease in the years following generic entry, despite decreases in prices offered by generic versions of a drug. This decrease coincides with the market entry …


Hiv/Aids And Food Insecurity In Sub-Saharan Africa: Challenges And Solutions, John Mazzeo Apr 2011

Hiv/Aids And Food Insecurity In Sub-Saharan Africa: Challenges And Solutions, John Mazzeo

John Mazzeo, Ph.D.

No abstract provided.


The Relation Of Self-Efficacy And Error-Related Self-Regulation, Jason Themanson, Matthew Pontifex, Charles Hillman, Edward Mcauley Mar 2011

The Relation Of Self-Efficacy And Error-Related Self-Regulation, Jason Themanson, Matthew Pontifex, Charles Hillman, Edward Mcauley

Jason R. Themanson, Ph.D

Relations between a modifiable psychosocial factor, self-efficacy (SE), and behavioral and neural indices of self-regulation, including post-error behavior, the error-related negativity (ERN), and error positivity (Pe) were examined in young adults during a flanker task emphasizing either accuracy or speed. SE was predicted to be associated with larger ERN and Pe amplitudes, as well as greater post-error behavioral performance during task conditions emphasizing accuracy, but not speed. Results showed that higher SE was associated with greater post-error response accuracy during the accuracy condition, but not the speed condition, and higher SE was related with greater ERN amplitudes across instruction conditions. …


Medical Expenditure Measures In The Health And Retirement Study, Dana Goldman, Julie Zissimopoulos, Yang Lu Mar 2011

Medical Expenditure Measures In The Health And Retirement Study, Dana Goldman, Julie Zissimopoulos, Yang Lu

Yang Lu

This paper reviews out-of-pocket (OOP) medical expenditure measures collected in the Health and Retirement Study (HRS). Medical expenditures are an important cost of poor health. Medical expenditure measures are important for understanding retirement decisions, financial preparation for retirement, and predicting the consequences of health care reform, particularly Medicare reform. Despite the comprehensiveness of the HRS, there are always limitations to what can be learned from population interviews. To assess the quality of current HRS measures of OOP spending, we compare various measures of OOP spending across survey waves to the Medical Expenditure Panel Survey (MEPS) and Medicare Current Beneficiary Survey …


Asymmetries In Motor Attention During A Cued Bimanual Reaching Task: Left And Right Handers Compared, Gavin Buckingham, Julie Main, David Carey Mar 2011

Asymmetries In Motor Attention During A Cued Bimanual Reaching Task: Left And Right Handers Compared, Gavin Buckingham, Julie Main, David Carey

Gavin Buckingham

Several studies have indicated that right handers have attention biased toward their right hand during bimanual coordination (Buckingham and Carey, 2009; Peters, 1981). To determine if this behavioral asymmetry was linked to cerebral lateralization, we examined this bias in left and right handers by combining a discontinuous double-step reaching task with a Posner-style hand cueing paradigm. Left and right handed participants received a tactile cue (valid on 80% of trials) prior to a bimanual reach to target pairs. Right handers took longer to inhibit their right hand and made more right hand errors, suggesting that their dominant hand was more …


Assessing The Needs And Guiding The Future: Findings From The Health Needs Assessment In 13 Asian American Communities Of Maryland In The United States, Sunmin Lee, Chiehwen Ed Hsu Mar 2011

Assessing The Needs And Guiding The Future: Findings From The Health Needs Assessment In 13 Asian American Communities Of Maryland In The United States, Sunmin Lee, Chiehwen Ed Hsu

Chiehwen Ed Hsu

There is lack of in depth data on health needs of diverse Asian American communities. We conducted 19 focus groups in 13 Asian American communities in Maryland in 2007. We developed a moderator’s guide to collect qualitative data on health needs from 174 participants, and used MAX QDA to analyze data and code emergent themes. Cardiovascular disease related conditions, diabetes, and mental health were the top three health concerns. Weight concerns, cancer, arthritis, smoking, osteoporosis, and hepatitis B followed next. Many participants were not receiving preventive health service such as cancer screening due to a lack of access to health …


The Role Of Vision In Detecting And Correcting Fingertip Force Errors During Object Lifting, Gavin Buckingham Mar 2011

The Role Of Vision In Detecting And Correcting Fingertip Force Errors During Object Lifting, Gavin Buckingham

Gavin Buckingham

No abstract provided.


Effects Of Bite Blocks And Hearing Status On Vowel Production, Harlan Lane, Margaret Denny, Frank Guenther, Melanie Matthies, Lucie Ménard, Joseph Perkell, Ellen Stockmann, Mark Tiede, Jennell Vick, Majid Zandipour Feb 2011

Effects Of Bite Blocks And Hearing Status On Vowel Production, Harlan Lane, Margaret Denny, Frank Guenther, Melanie Matthies, Lucie Ménard, Joseph Perkell, Ellen Stockmann, Mark Tiede, Jennell Vick, Majid Zandipour

Harlan Lane

This study explores the effects of hearing status and bite blocks on vowel production. Normal-hearing controls and postlingually deaf adults read elicitation lists of /hVd/ syllables with and without bite blocks and auditory feedback. Deaf participants' auditory feedback was provided by a cochlear prosthesis and interrupted by switching off their implant microphones. Recording sessions were held before prosthesis was provided and one month and one year after. Long-term absence of auditory feedback was associated with heightened dispersion of vowel tokens, which was inflated further by inserting bite blocks. The restoration of some hearing with prosthesis reduced dispersion. Deaf speakers' vowel …


An Investigation Of The Relation Between Sibilant Production And Somatosensory And Auditory Acuity, Satrajit Ghosh, Melanie Matthies, Edwin Maas, Mark Tiede, Lucie Ménard, Frank Guenther, Harlan Lane, Joseph Perkell Feb 2011

An Investigation Of The Relation Between Sibilant Production And Somatosensory And Auditory Acuity, Satrajit Ghosh, Melanie Matthies, Edwin Maas, Mark Tiede, Lucie Ménard, Frank Guenther, Harlan Lane, Joseph Perkell

Harlan Lane

The relation between auditory acuity, somatosensory acuity and the magnitude of produced sibilant contrast was investigated with data from 18 participants. To measure auditory acuity, stimuli from a synthetic sibilant continuum ([s]-[ʃ]) were used in a four-interval, two-alternative forced choice adaptive-staircase discrimination task. To measure somatosensory acuity, small plastic domes with grooves of different spacing were pressed against each participant's tongue tip and the participant was asked to identify one of four possible orientations of the grooves. Sibilant contrast magnitudes were estimated from productions of the words "said," "shed," "sid," and "shid." Multiple linear regression revealed a significant relation indicating …


Effects Of Masking Noise On Vowel And Sibilant Contrasts In Normal-Hearing Speakers And Postlingually Deafened Cochlear Implant Users, Joseph Perkell, Margaret Denny, Harlan Lane, Frank Guenther, Melanie Matthies, Mark Tiede, Jennell Vick, Majid Zandipour, Ellen Burton Feb 2011

Effects Of Masking Noise On Vowel And Sibilant Contrasts In Normal-Hearing Speakers And Postlingually Deafened Cochlear Implant Users, Joseph Perkell, Margaret Denny, Harlan Lane, Frank Guenther, Melanie Matthies, Mark Tiede, Jennell Vick, Majid Zandipour, Ellen Burton

Harlan Lane

The role of auditory feedback in speech production was investigated by examining speakers' phonemic contrasts produced under increases in the noise to signal ratio (N/S). Seven cochlear implant users and seven normal-hearing controls pronounced utterances containing the vowels /i/, /u/, /ε/ and /æ/ and the sibilants /s/ and /ʃ/ while hearing their speech mixed with noise at seven equally spaced levels between their thresholds of detection and discomfort. Speakers' average vowel duration and SPL generally rose with increasing N/S. Average vowel contrast was initially flat or rising; at higher N/S levels, it fell. A contrast increase is interpreted as reflecting …


Note On The Variability Hypothesis In Category Scaling, B. Schneider, H. Lane Feb 2011

Note On The Variability Hypothesis In Category Scaling, B. Schneider, H. Lane

Harlan Lane

The "variability hypothesis" attributes the nonlinear relation between category and magnitude scales to the growth of variability along the psychological continuum. The findings of some earlier research seemed to contradict the hypothesis. Now, an alternative interpretation of these findings is presented.


Speech Deterioration In Postlingually Deafened Adults, Harlan Lane, Jane Webster Feb 2011

Speech Deterioration In Postlingually Deafened Adults, Harlan Lane, Jane Webster

Harlan Lane

Postlingually deafened adults reading the Rainbow Passage differed from hearing-control subjects in producing greater pitch variability and mean pitch on stressed and unstressed vowels, greater fluctuations in pitch within sentences, less correlation of intrinsic pitch with vowel height and slower temporal parameters. When reading the Phonetic Inventory Sentences, they revealed less differentiation of place of articulation in fricative and plosive consonants. The present findings, taken together with those of longitudinal and implant studies, are applied to constraining models of the role of self hearing in the elaboration of speech.


Changes In Voice-Onset Time In Speakers With Cochlear Implants, Harlan Lane, Jane Wozniak, Joseph Perkell Feb 2011

Changes In Voice-Onset Time In Speakers With Cochlear Implants, Harlan Lane, Jane Wozniak, Joseph Perkell

Harlan Lane

Voice-onset time (VOT) and syllable duration were measured for the English plosives in /Cɑd/ (C=consonant) context spoken by four postlingually deafened recipients of multichannel (Ineraid) cochlear implants. Recordings were made of their speech before, and at intervals following, activation of the speech processors of their implants. Three patients reduced mean syllable duration following activation. Using measures of VOT and syllable duration from speakers with normal hearing [Volaitis and Miller, J. Acoust. Soc. Am. 92, 723–735 (1992)] and from the subjects of this study, VOT is shown to vary approximately linearly with syllable duration over the ranges produced here. Therefore, the …


Interactions Of Speaking Condition And Auditory Feedback On Vowel Production In Postlingually Deaf Adults With Cochlear Implants, Lucie Ménard, Marek Polak, Margaret Denny, Ellen Burton, Harlan Lane, Melanie Matthies, Nicole Marrone, Joseph Perkell, Mark Tiede, Jennell Vick Feb 2011

Interactions Of Speaking Condition And Auditory Feedback On Vowel Production In Postlingually Deaf Adults With Cochlear Implants, Lucie Ménard, Marek Polak, Margaret Denny, Ellen Burton, Harlan Lane, Melanie Matthies, Nicole Marrone, Joseph Perkell, Mark Tiede, Jennell Vick

Harlan Lane

This study investigates the effects of speaking condition and auditory feedback on vowel production by postlingually deafened adults. Thirteen cochlear implant users produced repetitions of nine American English vowels prior to implantation, and at one month and one year after implantation. There were three speaking conditions (clear, normal, and fast), and two feedback conditions after implantation (implant processor turned on and off). Ten normal-hearing controls were also recorded once. Vowel contrasts in the formant space (expressed in mels) were larger in the clear than in the fast condition, both for controls and for implant users at all three time samples. …


The Trajectory Of Change For Children And Youth In Residential Treatment, J. Noftle, Steven Cook, Alan Leschied, Jeff St. Pierre, Shannon Stewart, Andrew Johnson Jan 2011

The Trajectory Of Change For Children And Youth In Residential Treatment, J. Noftle, Steven Cook, Alan Leschied, Jeff St. Pierre, Shannon Stewart, Andrew Johnson

Andrew M. Johnson

This study examined the symptom response trajectories for 225 children and youth throughout a period of residential treatment. With the 10-item Conners' Global Index (CGI) as the primary outcome measure, assessments were completed on a bi-weekly basis during the average 4 month stay within the youth's residential treatment. Clients demonstrated an ongoing reduction of symptoms, and the severity of baseline symptoms influenced the trajectory of the symptom reduction. In addition, symptom reduction was characterized as logarithmic, particularly when controlling for the baseline severity of symptoms. Implications of these findings for administrators, practitioners, and researchers of residential treatment are discussed.


The Role Of Vision In Detecting And Correcting Fingertip Force Errors During Object Lifting, Gavin Buckingham, Nathalie Ranger, Melvyn Goodale Jan 2011

The Role Of Vision In Detecting And Correcting Fingertip Force Errors During Object Lifting, Gavin Buckingham, Nathalie Ranger, Melvyn Goodale

Gavin Buckingham

Vision provides many reliable cues about the likely weight of an object, allowing individuals to predict how heavy it will be. The forces used to lift an object for the first time reflect these predictions. This, however, leads to inevitable errors during lifts of objects that weigh unexpected amounts. Fortunately, these errors are rarely made twice in a row-lifters have the impressive ability to detect and correct large or small misapplications of fingertip forces, even while experiencing weight illusions. Although it has been assumed that we detect and correct these errors exclusively with our sense of touch, recent evidence has …