This study suggests that there are sex differences in vocational attitude maturity. In the four-school stratified sample of eleventh grade boys and girls studied, the girls scored significantly higher than the boys in vocational attitude. No sex differences in overall level of self-esteem, as measured by the Tennessee Self-Concept Scale, were found. For both sexes a significant relationship between the over all level of self-esteem and vocational attitude maturity was indicated, with the relationship being higher for males than for females. The self-concept variables of self-satisfaction, family, and moral-ethical self were found to contribute to the vocational attitude maturity of males. For females, the self-concept variables of identity and moral-ethical self contributed to their vocational attitude maturity.

Sex Differences in

Background: Advance care planning is the process of discussing and recording patient preferences concerning goals of care for patients who may lose capacity or communication ability in the future. Advance care planning could potentially improve end-of-life care, but the methods/tools used are varied and of uncertain benefit. Outcome measures used in existing studies are highly variable. Aim: To present an overview of studies on the effects of advance care planning and gain insight in the effectiveness of different types of advance care planning. Design: Systematic review. Data sources: We systematically searched PubMed, EMBASE and PsycINFO databases for experimental and observational studies on the effects of advance care planning published in 2000-2012. Results: The search yielded 3571 papers, of which 113 were relevant for this review. For each study, the level of evidence was graded. Most studies were observational (95%), originated from the United States (81%) and were performed in hospitals (49%) or nursing homes (32%). Do-not-resuscitate orders (39%) and written advance directives (34%) were most often studied. Advance care planning was often found to decrease life-sustaining treatment, increase use of hospice and palliative care and prevent hospitalisation. Complex advance care planning interventions seem to increase compliance with patients' end-of-life wishes. Conclusion: The effects of different types of advance care planning have been studied in various settings and populations using different outcome measures. There is evidence that advance care planning positively impacts the quality of end-of-life care. Complex advance care planning interventions may be more effective in meeting patients' preferences than written documents alone. More studies are needed with an experimental design, in different settings, including the community.

The effects of advance care planning on end-of-life care: a systematic review.

Different continuous-time models for interest rates coexist in the literature. We test parametric models by comparing their implied parametric density to the same density estimated nonparametrically. We do not replace the continuous-time model by discrete approximations, even though the data are recorded at discrete intervals. The principal source of rejection of existing models is the strong nonlinearity of the drift. Around its mean, where the drift is essentially zero, the spot rate behaves like a random walk. The drift then mean-reverts strongly when far away from the mean. The volatility is higher when away from the mean.

Testing Continuous-Time Models of the Spot Interest Rate

Exposing some important barriers to health care access in the rural USA

Diabetes and depression: global perspectives.

Background: Depression affects more Hispanics with type 2 diabetes than other ethnic groups. This exploratory, binational study examined the prevalence and correlates of clinical depressive symptoms in Hispanics of Mexican origin with type 2 diabetes living on both sides of the Texas Mexico border. Methods: Two binational samples, consisting of 172 adult patients of Mexican origin with type 2 diabetes in South Texas and 200 from the Northeastern region of Mexico, were compared. Logistic regression analyses were used to test personal and social correlates to clinical depressive symptoms. Results: The rate of clinical depressive symptoms was similar in both South Texas and Northeastern Mexico patients (39% and 40.5%, respectively). Gender, education, emergency department visits, and burden of diabetes symptoms were predictors of clinical depressive symptoms in the South Texas sample. Among respondents in the Northeastern Mexico sample, the only statistically significant correlate to clinical depressive symptoms was the burden of diabetes symptoms. Conclusions: Diabetes and depression must be addressed as priorities in diabetes initiatives at the US Mexico border region. Further research is warranted to examine the extent and impact of involving family practice physicians from both sides of the border in depression screenings among patients with type 2 diabetes.

Clinical Depressive Symptoms and Diabetes in a Binational Border Population

Objective: To present comprehensive profiles of residents in hospice care at admission to the nursing home using the Minimum Data Set (MDS).Design and Setting: We analysed 40,622 MDS admission assessments for nursing home residents in hospice care. The MDS contains resident-focused data on pain, cognitive patterns, physical function, disease diagnoses, medications, nutrition, and specific treatments received.Results: About four in five recently admitted hospice residents had ‘do not resuscitate’ orders and only 27% had a living will. Over 70% of recently admitted hospice residents experienced pain, with almost one half experiencing daily pain. Over one half of those hospice residents in pain experienced moderate pain and almost one third experienced horrible or excruciating pain. About 57% of recently admitted hospice patients had cancer, 21% had congestive heart failure, 20% had emphysema/chronic obstructive pulmonary disease, and 18% had depression. About one in two recently admitted hospice residents e...

Analyses of nursing home residents in hospice care using the Minimum Data Set

Analyses of nursing home residents with Parkinson's disease using the minimum data set.

Analyses of gender differences in profiles of nursing home residents with Alzheimer's disease.

This paper profiles nursing home residents with multiple sclerosis (MS) at the time of admission, including sociodemographic characteristics, health status measures, and treatments received. Admission assessments from the Minimum Data Set are used to create these profiles of residents with MS. There are 9,013 admission assessments in the MDS for residents with MS between June 22, 1998 and January 17, 2000 analyzed for this study. Residents with MS are distinctly younger at admission than most nursing home residents, averaging 57.98 years of age. Recently admitted residents with MS are more physically dependent than other nursing home residents and tend to have limited range of motion and loss of voluntary movement About one in three newly admitted residents with MS had some degree of impaired cognitive function. Over one third of residents with MS were depressed at admission, yet only 11.7% of recently admitted residents with MS were evaluated by a licensed mental health specialist This prompts concem about the psychosocial well-being of MS residents in nursing homes.

Suojin Wang

Papers

Clinical Depressive Symptoms and Diabetes in a Binational Border Population

Analyses of nursing home residents in hospice care using the Minimum Data Set

Analyses of nursing home residents with Parkinson's disease using the minimum data set.

Analyses of gender differences in profiles of nursing home residents with Alzheimer's disease.

Profiles of nursing home residents with multiple sclerosis using the minimum data set.