Disability carries negative social meaning, and little is known about when (or if), in the process of health decline, persons identify themselves as "disabled." We examine the social and health criteria that older adults use to subjectively rate their own disability status. Using a panel study of older adults (ages 72+), we estimate ordered probit and growth curve models of perceived disability over time. Total prevalent morbidity, functional limitations, and cognitive impairment are predictors of perceived disability. Cessation of driving and receipt of home health care also influence older adults 'perceptions of their own disability. A dense social network slowed the rate of labeling oneself disabled, while health anxiety accelerated the process over time, independent of health status. When considering perceived disability, the oldest old use multidimensional criteria capturing function, recent changes in health status and social networks, and anxiety about their health.
Tree core concentrations of tetrachloroethylene (perchloroethene, PCE) at the Riverfront Superfund Site in New Haven, MO, were found to mimic the profile of soil phase concentrations. The observed soil-tree core relationship was stronger than that of groundwater PCE to tree core concentrations atthe same site. Earlier research has shown a direct, linear relationship between tree core and groundwater concentrations of chlorinated solvents and other organics. Laboratory-scale experiments were performed to elucidate this phenomenon, including determining partitioning coefficients of PCE between plant tissues and air and between plant tissues and water, measured to be 8.1 and 49 L/kg, respectively. The direct relationship of soil to tree core PCE concentrations was hypothesized to be caused by diffusion between tree roots and the soil vapor phase in the subsurface. The central findings of this research are discovering the importance of subsurface vapor-phase transfer for VOCs and uncovering a direct relationship between soil vapor-phase chlorinated solvents and uptake rates that impact contaminant translocation from the subsurface and transfer into the atmosphere.
Structured Abstract
Objectives
To create data driven typologies of licensed nurse staffing and health services in residential care/assisted living (RC/AL).
Design
Cluster analysis was used to describe the patterns of licensed nurse staffing and 47 services, and the extent to which these clusters were related.
Setting
RC/AL communities in the United States.
Participants
A convenience sample of administrators and health care supervisors from 89 RC/AL communities in 22 states.
Measurement
RC/AL characteristics, licensed nurse staffing (total number of hours worked by registered nurses [RNs] and licensed practical nurses [LPNs]), number of hours worked by contract nurses, and availability of 47 services.
Results
Analysis revealed four licensed nurse staffing clusters defined by total number of hours and the type of nurse providing the hours (RN, LPN, or a mix of both). They ranged from no/minimal RN and LPN hours to high nursing hours with a mix of RNs and LPNs. The 47 services clustered into five clusters including Basic Services, Technically Complex Services, Assessments, Wound Care and Therapies, Testing and Specialty Services, and Gastrostomy and IV Medications. The availability of services was related to the presence of nurses (both RNs and LPNs) except for the Gastrostomy and IV Medications services, which were not readily available.
Conclusion
The amount and skill mix of licensed nurse staffing varies in RC/AL and is related to the types of services available. These findings may have implications for resident care and outcomes. Future work in this area, including extension to include non-nurse direct care workers, is needed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.