P20. The Intersection of Medical Assistance in Dying and Social Work Practice

In June 2016, Parliament amended the Criminal Code to create exemptions from the offences of culpable homicide, aiding suicide, and administering a noxious thing, in order to permit medical practitioners and nurse practitioners to provide medical assistance in dying (“MAiD”). The amendment permits social workers to assist in the process. However, the role of the social worker in this context remains unclear and has left many professional social workers uncertain as to how their practice may be affected by the new MAiD law. The objectives of this research are to identify the role of social workers within the context of MAiD services and to clarify professional boundaries and responsibilities when practicing within MAiD. A liability assessment will be conducted once the professional responsibilities of social workers are identified. A doctrinal research methodology will be used to understand the eligibility requirements and safeguards of the MAiD legislation and assess how this interacts with the professional responsibilities of registered social workers. Front line social workers will need guidance and support on developing and following best practices while working within the MAiD context. They will also require advice on the possible liability arising from practicing within the context of MAiD. The intersection between law and social work practice cannot be minimized. Healthcare institutions and community healthcare programs are currently developing ways to facilitate MAiD. This research will assist administrators and direct service providers in understanding the role of the social worker as well as the potential liability arising from practicing within this context

Differences in the association of subjective wellbeing measures with health, socioeconomic status, and social conditions among residents of an eastern cape township

Objective: The use of variably self-reported measures of wellbeing may produce differing outcomes. This study examined the differences in association with health, socioeconomic status, and social conditions (marital status, social capital) of two widely used cognitive subjective wellbeing measurements: Cantril’s ladder and Diener’s five-item Satisfaction with Life Scale.Methods: A stratified sampling design was used to collect data from representative households in the 20 neighborhoods of Rhini, a deprived suburb of Grahamstown in the Eastern Cape province of South Africa. Correlation and stepwise multiple regression analyses investigated differences in the associations between wellbeing and health, demographics, socioeconomic status, and social conditions determined by the three measurements. Results: We found that the multiple-item satisfaction with life scale elicited more discriminating responses that took into account a broader range of life domains. This scale reported more significant relationships between subjective wellbeing and health, socioeconomic status, and social conditions. Cantril’s ladder produced a narrower range of career-like comparisons. The direction of association between measures of wellbeing and socioeconomic characteristics never changes according to the measures used.Conclusions: Policy-makers, researchers, and practitioners using these instruments should be aware of the differences between single- and multiple-item wellbeing measures, and recognize that the choice of instrument will affect the life domains found to be associated with wellbeing

Structural and magneto-transport characterization of Co_2Cr_xFe_(1-x)Al Heusler alloy films

We investigate the structure and magneto-transport properties of thin films of the Co_2Cr_xFe_(1-x)Al full-Heusler compound, which is predicted to be a half-metal by first-principles theoretical calculations. Thin films are deposited by magnetron sputtering at room temperature on various substrates in order to tune the growth from polycrystalline on thermally oxidized Si substrates to highly textured and even epitaxial on MgO(001) substrates, respectively. Our Heusler films are magnetically very soft and ferromagnetic with Curie temperatures up to 630 K. The total magnetic moment is reduced compared to the theoretical bulk value, but still comparable to values reported for films grown at elevated temperature. Polycrystalline Heusler films combined with MgO barriers are incorporated into magnetic tunnel junctions and yield 37% magnetoresistance at room temperature

High-quality chronic care delivery improves experiences of chronically ill patients receiving care

__Abstract__ Objective. Investigate whether high-quality chronic care delivery improved the experiences of patients. Design. This study had a longitudinal design. Setting and Participants. We surveyed professionals and patients in 17 disease management programs targeting patients with cardiovascular diseases, chronic obstructive pulmonary disease, heart failure, stroke, comorbidity and eatin

The Importance of Neighborhood Social Cohesion and Social Capital for the Well Being of Older Adults in the Community

We aimed to investigate whether social capital (obtaining support through indirect ties such as from neighbors) and social cohesion (interdependencies among neighbors) within neighborhoods positively affect the well being of older adults. Design and Methods: This crosssectional study included 945 of 1,440 (66% response rate) independently living older adults (aged !70 years) in Rotterdam. We fitted a hierarchical random effects model to account for the hierarchical structure of the study design: 945 older adults (Level 1) nested in 72 neighborhoods (Level 2). Results: Univariate analyses showed that being born in the Netherlands, house ownership, education, income, social capital of individuals, neighborhood security, neighborhood services, neighborhood social capital, and neighborhood social cohesion were significantly related to the well being of older adults. Multilevel analyses showed that social capital of individuals, neighborhood services, neighborhood social capital, and neighborhood social cohesion predicted the well being of older adults. Single and poor older adults reported lower well being than did better off and married older adults. However, the effects of marital status and income were mediated by neighborhood services, social capital, and social cohesion. Neighborhood services, social capital, and social cohesion may act as buffer against the adverse effects of being single and poor on the well being of older adults. Implications: The results of this study support the importance of social capital of individuals, as well as social capital within the neighborhood and social cohesion within the neighborhood for well being of older adults. The well being of older adults may also be enhanced through the improvement of quality of neighborhood services

Spatially resolved observation of uniform precession modes in spin-valve systems

Using time-resolved photoemission electron microscopy the excitation of uniform precession modes in individual domains of a weakly coupled spin-valve system has been studied. A coupling dependence of the precession frequencies has been found that can be reasonably well understood on the basis of a macrospin model. By tuning the frequency of the excitation source the uniform precession modes are excited in a resonant way.Comment: This article has been accepted by Journal of Applied Physics. After it is published, it will be found at http://jap.aip.or

Individual- and Neighbourhood-Level Indicators of Subjective Well-Being in a Small and Poor Eastern Cape Township: The Effect of Health, Social Capital, Marital Status, and Income

Our study used multilevel regression analysis to identify individual- and neighbourhood-level factors that determine individual-level subjective well-being in Rhini, a deprived suburb of Grahamstown in the Eastern Cape province of South Africa. The Townsend index and Gini coefficient were used to investigate whether contextual neighbourhood-level differences in socioeconomic status determined individual-level subjective well-being. Crime experience, health status, social capital, and demographic variables were assessed at the individual level. The indicators of subjective well-being were estimated with a two-level random-intercepts and fixed slopes model. Social capital, health and marital status (all p < .001), followed by income level (p < .01) and the Townsend score (p < .05) were significantly related to individual-level subjective well-being outcomes. Our findings showed that individual-level subjective well-being is influenced by neighbourhood-level socioeconomic status as measured by the Townsend deprivation score. Individuals reported higher levels of subjective well-being in less deprived neighbourhoods. Here we wish to highlight the role of context for subjective well-being, and to suggest that subjective well-being outcomes may also be defined in ecological terms. We hope the findings are useful for implementing programs and interventions designed to achieve greater subjective well-being for people living in deprived areas

Validation of the Caregivers’ Satisfaction with Stroke Care Questionnaire: C-SASC hospital scale

To date, researchers have lacked a validated instrument to measure stroke caregivers’ satisfaction with hospital care. We adjusted a validated patient version of satisfaction with hospital care for stroke caregivers and tested the 11-item caregivers’ satisfaction with hospital care (C-SASC hospital scale) on caregivers of stroke patients admitted to nine stroke service facilities in the Netherlands. Stroke patients were identified through the stroke service facilities; caregivers were identified through the patients. We collected admission demographic data from the caregivers and gave them the C-SASC hospital scale. We tested the instrument by means of structural equation modeling and examined its validity and reliability. After the elimination of three items, the confirmatory factor analyses revealed good indices of fit with the resulting eight-item C-SASC hospital scale. Cronbach’s α was high (0.85) and correlations with general satisfaction items with hospital care ranged from 0.594 to 0.594 (convergent validity). No significant relations were found with health and quality of life (divergent validity). Such results indicate strong construct validity. We conclude that the C-SASC hospital scale is a promising instrument for measuring stroke caregivers’ satisfaction with hospital stroke care

A large-scale longitudinal study indicating the importance of perceived effectiveness, organizational and management support for innovative culture

AbstractTeams participating in QI collaboratives reportedly enhance innovative culture in long-term care, but we currently lack empirical evidence of the ability of such teams to enhance (determinants of) innovative culture over time. The objectives of our study are therefore to explore innovative cultures in QI teams over time and identify its determinants. The study included QI teams participating between 2006 and 2011 in a national Dutch quality program (Care for Better), using an adapted version of the Breakthrough Method. Each QI team member received a questionnaire by mail within one week after the second (2–3 months post-implementation of the collaborative = T0) and final conference (12 months post-implementation = T1). A total of 859 (out of 1161) respondents filled in the questionnaire at T0 and 541 at T1 (47% response). A total of 307 team members filled in the questionnaire at both T0 and T1. We measured innovative culture, respondent characteristics (age, gender, education), perceived team effectiveness, organizational support, and management support. Two-tailed paired t-tests showed that innovative culture was slightly but significantly lower at T1 compared to T0 (12 months and 2–3 months after the start of the collaborative, respectively). Univariate analyses revealed that perceived effectiveness, organizational and management support were significantly related to innovative culture at T1 (all at p ≤ 0.001). Multilevel analyses showed that perceived effectiveness, organizational support, and management support predicted innovative culture. Our QI teams were not able to improve innovative culture over time, but their innovative culture scores were higher than non-participant professionals. QI interventions require organizational and management support to enhance innovative culture in long-term care settings

TB treatment initiation and adherence in a South African community influenced more by perceptions than by knowledge of tuberculosis

Background. Tuberculosis (TB) is a global health concern. Inadequate case finding and case holding has been cited as major barrier to the control of TB. The TB literature is written almost entirely from a biomedical perspective, while recent studies show that it is imperative to understand lay perception to determine why people seek treatment and may stop taking treatment. The Eastern Cape is known as a province with high TB incidence, prevalence and with one of the worst cure rates of South Africa. Its inhabitants can be considered lay experts when it comes to TB. Therefore, we investigated knowledge, perceptions of (access to) TB treatment and adherence to treatment among an Eastern Cape population. Methods. An area-stratified sampling design was applied. A total of 1020 households were selected randomly in proportion to the total number of households in each neighbourhood. Results. TB knowledge can be considered fairly good among this community. Respondents' perceptions suggest that stigma may influence TB patients' decision in health seeking behavior and adherence to TB treatment. A full 95% of those interviewed believe people with TB tend to hide their TB status out of fear of what others may say. Regression analyses revealed that in this population young and old, men and women and the lower and higher educated share the same attitudes and perceptions. Our findings are therefore likely to reflect the actual situation of TB patients in this population. Conclusions. The lay experts' perceptions suggests that stigma appears to effect case holding and case finding. Future interventions should be directed at improving attitudes and perceptions to potentially reduce stigma. This requires a patient-centered approach to empower TB patients and active involvement in the development and implementation of stigma reduction programs