Factors affecting hospice social work utilization among hospice patients: Focusing on place of care and economic status

Objective. Hospice social workers empower their patients and families as they journey through end of life. However, even when social work services are available, some hospice families choose not to use or fully utilize this service. Guided by the Anderson behavioral model, this study examined factors affecting utilization of hospice social work services with particular focus on two enabling factors - place of care and economic status. Method. Data came from the 2007 National Home and Hospice Care Survey. The sample was restricted to Medicare Hospice Benefit enrollees 65 years of age and older. Hospice social work utilization was categorized into six visit intervals (0= none, 5= more than two visits in a week). Bivariate and ordinal logistic regressions were used to examine associations between hospice social work utilization and 1) place of care (home vs. institution) and 2) economic status (low vs. not low). Results. The frequencies of hospice social work utilization were found to be significantly different between place of care (χ2(1)=92.86, p\u3c.001) and economic status (χ2(5)=11.28, p\u3c.05). Even after controlling for predisposing and need factors in ordinal logistic regressions, hospice patients receiving care at home (Coef.=-.58, p\u3c.001) and of low economic status (Coef.=-0.35, p\u3c.001) were found to use social work services less frequently than their counterparts. Discussion. This study adds to the limited body of literature on enabling factors associated with hospice social work utilization. Possible implications and suggestions aimed at addressing these disparities are discussed

A Theory of Rural Telehealth Innovation - A Paradoxical Approach

Telehealth promises to provide underserved communities with better medical services and to help rural healthcare institutions become financially sustainable. However, these institutions find it challenging to implement telehealth because their resources are severely constrained even to maintain current operations. This paper investigates how a rural health institution successfully addressed this paradoxical situation by integrating telehealth into its operations over a 20-year period. We identify three sets of tensions that manifest during the telehealth implementation process: autonomy vs. dependence (relating to resource acquisition), controlling vs. drifting (relating to enabling the innovation), and exploration vs. exploitation (relating to creating a sustainable solution). Drawing on Poole and Van de Ven’s (1989) paradoxical approach, we develop four propositions comprising a theory of rural telehealth innovation. We suggest that three paradoxes shape rural telehealth innovation: Paradox of Alliance, Paradox of Governance, and Paradox of Learning, and explain how innovation unfolds in response to these paradoxes

Physical Activity Health Communication for Adults with Mood Disorders in the United States

Using national representative data, this study sought to examine receipt of physical activity communication and counseling among adults with mood disorders in comparison to the general population in the United States. The sample consisted of adult primary-care visits in the National Hospital Ambulatory Medical Care and National Ambulatory Medical Care Surveys. Multivariable logistic regression was used to examine the relationship between mental health status and receipt of physical activity communication and counseling. Overall, less than 20% of visits included physical activity communication and counseling. Controlling for covariates, visits for adults with a mood disorder diagnosis were associated with an increased odds of including physical activity communication and counseling, odds ratio = 1.25, 95% confidence interval = [1.08, 1.45]. Although adults with mood disorders were more likely to receive physical activity communication and counseling, most primary-care visits for adults in the United States did not include physical activity communication and counseling

Shape-controlled single-crystal growth of InP at low temperatures down to 220 °C.

III-V compound semiconductors are widely used for electronic and optoelectronic applications. However, interfacing III-Vs with other materials has been fundamentally limited by the high growth temperatures and lattice-match requirements of traditional deposition processes. Recently, we developed the templated liquid-phase (TLP) crystal growth method for enabling direct growth of shape-controlled single-crystal III-Vs on amorphous substrates. Although in theory, the lowest temperature for TLP growth is that of the melting point of the group III metal (e.g., 156.6 °C for indium), previous experiments required a minimum growth temperature of 500 °C, thus being incompatible with many application-specific substrates. Here, we demonstrate low-temperature TLP (LT-TLP) growth of single-crystalline InP patterns at substrate temperatures down to 220 °C by first activating the precursor, thus enabling the direct growth of InP even on low thermal budget substrates such as plastics and indium-tin-oxide (ITO)-coated glass. Importantly, the material exhibits high electron mobilities and good optoelectronic properties as demonstrated by the fabrication of high-performance transistors and light-emitting devices. Furthermore, this work may enable integration of III-Vs with silicon complementary metal-oxide-semiconductor (CMOS) processing for monolithic 3D integrated circuits and/or back-end electronics

Implanting Life-Cycle Privacy Policies in a Context Database

Ambient intelligence (AmI) environments continuously monitor surrounding individuals' context (e.g., location, activity, etc.) to make existing applications smarter, i.e., make decision without requiring user interaction. Such AmI smartness ability is tightly coupled to quantity and quality of the available (past and present) context. However, context is often linked to an individual (e.g., location of a given person) and as such falls under privacy directives. The goal of this paper is to enable the difficult wedding of privacy (automatically fulfilling users' privacy whishes) and smartness in the AmI. interestingly, privacy requirements in the AmI are different from traditional environments, where systems usually manage durable data (e.g., medical or banking information), collected and updated trustfully either by the donor herself, her doctor, or an employee of her bank. Therefore, proper information disclosure to third parties constitutes a major privacy concern in the traditional studies

The Law and Economics of Self-Dealing

We present a new measure of legal protection of minority shareholders against expropriation by corporate insiders: the anti-self-dealing index. Assembled with the help of Lex Mundi law firms, the index is calculated for 72 countries based on legal rules prevailing in 2003, and focuses on private enforcement mechanisms, such as disclosure, approval, and litigation, governing a specific self-dealing transaction. This theoretically-grounded index predicts a variety of stock market outcomes, and generally works better than the commonly used index of anti-director rights.