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

A Legal Framework for the Assessment of a Voluntary Request for Medical Assistance in Dying

In response to the Supreme Court of Canada’s (“SCC”) 2016 ruling Carter v. Canada, Parliament passed Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying). Bill C-14 primarily amended section 241 of the Criminal Code to create an exemption to the crime of counselling or aiding suicide, thereby allowing physicians and nurse practitioners to provide eligible patients with medical assistance in dying (MAID). Since Bill C-14, there has been further evolution in the law to allow patients to access MAID if their natural death is reasonably foreseeable or even if natural death is not reasonably foreseeable provided the associated safeguards are met. The evolution of the law to include those whose natural death is not reasonably foreseeable has raised concerns in the medical and legal community about the interpretation of the legal requirement that a request for MAID be voluntary and not the result of external pressure. These concerns include who should be involved in assessing voluntariness and how this is best achieved. Recently this has expanded to include the extent to which psycho-social-economic concerns, factors that may be beyond the control of the individual requesting MAID and the health care team, influence the assessment of voluntariness. This project examines the idea of voluntariness and argues that social workers are uniquely situated to assist with assessing whether a patient’s request is voluntary. Chapter two explores the historical decriminalization of assisted suicide and how voluntariness has been considered in the relevant jurisprudence, including Rodriguez v British Columbia (Attorney General) and Carter v Canada (Attorney General). Chapter three expands my scope of review to other areas of law that consider voluntariness such as the confessions rule arising in the criminal law context, unconscionability as it relates to contract law, and informed consent in health law. A comprehensive review of the various special senate committee reports, which address the development of Bill C-14 and the subsequent expansion of Canada’s MAID regime, is used to inform the intention of the voluntary request provision. Chapter four explores the role of social workers in assisting with voluntariness assessments and considers how they are uniquely situated to assist with this work arising from their professional Code of Ethics and scope of practice. The social work profession has a particular interest in the needs of the vulnerable and identifying barriers to services and unmet psycho-social-economic needs. The consideration of unmet needs play an important role in the assessment of voluntariness. Chapter five pulls together the learnings from the previous chapters and identifies the key legal considerations when assessing voluntariness and the important role of social workers in this work. This project ultimately identifies a role for social workers in assisting physicians and nurse practitioners with voluntariness assessments and suggests they serve as an additional safeguard for ensuring comprehensive voluntariness assessments that consider the individuals’ biopsychosocial context in which the request for MAID arises. It concludes by identifying key legal considerations to assess voluntariness and how the law supports the role of social workers in this work

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

Measuring the Realisation of Well-Being Needs of Adolescents:Validation of the Social Production Function Instrument for the Level of Well-Being–Short (SPF-ILs)

Adolescent well-being is increasingly scrutinized due to its decline. This study was conducted to validate a theory-driven instrument for the measurement of well-being needs with a sample of Dutch adolescents. The short (15-item) Social Production Function Instrument for the Level of well-being (SPF-ILs) measures whether a person’s needs for stimulation, comfort, behavioural confirmation, affection and status are met. In this study, its psychometric properties for adolescents were examined. Data collected in spring 2018 (T1) and spring 2019 (T2) from 1,304 Dutch adolescents (53.0% girls) aged 11–17 (mean, 13.7 ± 1.1) years were used. The instrument’s factor structure, internal consistency, construct validity, and gender and age factorial invariance were evaluated. The results showed that the SPF-ILs is valid and reliable for the assessment of adolescents’ well-being needs realisation. Confirmatory factor analyses supported the five-factor (stimulation, comfort, behavioural confirmation, affection and status) model, showing good internal consistency (α = 0.86 at T1, 0.88 at T2), convergent/divergent validity, as well as gender and age factorial invariance. Comparison across groups revealed the expected differences in the realisation of physical (comfort and stimulation) and social (behavioural confirmation, status and affection) well-being needs between girls and boys and over time. SPF-ILs use increases our understanding of how adolescents achieve well-being via the fulfilment of well-being needs. The maintenance of adolescents’ well-being is a global challenge, and this study revealed clear differences in adolescents’ realisation of well-being needs, increasing our understanding of what interventions are needed to support such realisation.</p