Delivering on the Promise: A State Guide to the Next Steps for Health Care Reform

Outlines recommendations and considerations for creating health insurance exchanges, lowering costs and improving quality, providing consumer protections, addressing reforms beyond the federal law, and offering state-level public options

Making the Grade: A Scorecard for State Health Insurance Exchanges

Assesses states' progress in creating exchanges and grades established exchanges on policies regarding governance and structure, negotiating power and ability to drive value, consumer experience, and stability, including protection from adverse selection

Building a Better Health Care Marketplace

Details issues for creating insurance exchanges, including accountability and transparency, power to negotiate, innovations in cost and quality, stability, consumer-friendly design, and coordination with public programs, with a focus on small businesses

Trends in Adult Attachment Styles and Personality Traits Disorders in Adult Male Sex Offenders

The purpose of this study was to identify trends in attachment styles and personality traits/disorders in adult male sex offenders. Bartholomew’s (1990) four prototypical attachment style model was used in identifying adult attachment relationship styles. Forty-five men from an inpatient sex offender treatment program were given the Relationship Questionnaire (RQ) and the Relationship Scales Questionnaire (RSQ) to measure their style of adult attachment based on Bartholomew ‘s (1990) four theoretical attachment styles. Personality disorders and traits diagnosed through psychological testing upon admission to the hospital were taken from each patients personal record. One hypothesis is used to predict trends in characteristics of adult attachment styles that support characteristics of personality disorders/traits in sex offenders. A frequency distribution was implemented to identify trends and patterns. No consistent trends were identified. Two out of the four attachment prototypes proposed by Bartholomew (1990) include personality disorders/traits consistent with the positive/negative self/other internal working model. The most prominent attachment pattern in this population of sex offenders was the fearful attachment which is representative of a negative view of self and negative view of others. Many who endorsed a fearful attachment were diagnosed with antisocial personality disorder/traits. Preoccupied attached individuals most frequently were diagnosed with a dependent personality disorder/trait. These personality characteristics are in keeping with the four prototype attachment model of negative view of self and positive view of others. Those who endorsed a dismissing attachment style were also diagnosed with avoidant personality as often as dependent personality. This too is in keeping with Bartholomew’s model. Four individuals identified as securely attached. All securely attached individuals received at least one personality disorder/trait diagnosis whose characteristics are not in keeping with the Bartholomew model

Can a web-based community of practice be established and operated to lead falls prevention activity in residential care?

The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted using the web, but frequency of engagement by any participant was low. Participatory barriers, including competing demands from other tasks and low levels of knowledge about information communication technology (ICT) applications, were identified by CoP members. A web-based CoP can be established and operated across multiple RAC sites if RAC management support dedicated time for web-based participation and staff are given web-based training

The effect of complex falls prevention interventions on falls in residential aged care settings: A systematic review protocol

The objective of this review is to synthesize the best available evidence on the effectiveness of complex falls prevention interventions on fall reductions in the residential aged care population, implemented at two or more of the following levels: organization, facility or resident. Specifically the review question is: What is the effect of complex falls prevention interventions on falls in residential aged care settings

Models for community based day care for older people: A narrative review

Objectives: Older Australians are choosing to live within the community and there are a number of initiatives to enable this sector of the population to do so for longer. In an effort to ensure that they remain both physically and psychologically engaged, one initiative has been to provide community based day care (CBDC). Method: A narrative review was undertaken through searching MEDLINE, CINAHL Plus, Scopus and AgeInfo using keywords related to facility related, target group related and purpose/program of CBDC services. Results: Results indicated that there is a much research investigating different approaches but little consensus regarding the optimal delivery model thereby rendering it difficult to make a direct correlation as to the most effective CBDC. Discussion: The review presents an overview of the array of models providing centre based day care for older people. The challenge for future service delivery is to determine which of CBDC services are most successful in catering for the needs of older community dwelling adult or are new innovative models of CBDC require