This study examined framing effects in decisions concerning public health. Tversky and Kahneman’s famous Asian Disease Problem served as experimental paradigm. Subjects chose between a sure and a risky option either presented as gains (saving lives) or as losses (dying). The amount of risk varied in terms of different probabilities. The number of affected people was either small (low need) or large (high need). Additionally, the decisions were linked to three different types of diseases (unusual infection, AIDS, leukemia). We also implemented two different time constraints during which the subjects had to give a response. Finally, we tested a within-subject design. The data analysis assuming a linear mixed effects model revealed significant effects of framing, probabilities, and need. Furthermore, the type of disease and time constraints were moderating the framing effect. Across the different diseases, framing effects were amplified when decision time was short.

Les difficultés cognitives consécutives aux troubles neurocognitifs majeurs (TNCM) engendrent des enjeux dans la réalisation d’activités de la vie quotidienne. Ce projet visait à identifier auprès des proches aidants et des intervenants des situations nécessitant des méthodes optimisant l’apprentissage pour faciliter l’engagement de personnes vivant avec un TNCM dans leurs activités de la vie quotidienne. Des entrevues individuelles semi-dirigées, d’une durée de 60 à 90 minutes, ont été menées auprès de proches aidants et d’intervenants. Les résultats montrent que les activités quotidiennes et domestiques sont notamment affectées par les difficultés à repérer ou à utiliser les objets, à garder en tête la tâche en cours, à mettre en séquences des étapes, à ne pas se laisser distraire par autre chose et à constater ses difficultés pour s’y adapter. Les proches aidants souhaitent du soutien dans l’application des méthodes optimisant l’apprentissage pour contribuer au maintien de l’autonomie des personnes vivant avec un TNCM.

The EU and OECD’s use of poverty lines set at a percentage of national average income is testimony to the widespread acceptance of Peter Townsend’s purely relative poverty definition. It has often been defended, including by Townsend, as a development of Adam Smith’s reference to ‘necessaries’ differing across social contexts. This article contends that Townsend’s definition is clearly inconsistent with Smith’s work but entirely consistent with a passage by Wilhelm Schulz which established the term ‘relative poverty’ and asserted that people’s material needs are proportionate to their nation’s economic output per head; Karl Marx quoted that passage in a short piece that criticised Smith. A recent defence of Townsend’s definition is its supposed international public endorsement in empirical studies of socially perceived necessities. A review of this evidence finds that publics, like Smith and British poverty researchers before Townsend – most notably Seebohm Rowntree – see the extent of material need as affected by social context but not proportionate to national average income. Publishing purely relative and absolute purchasing power poverty statistics together offers a way of portraying hardship levels that is balanced to reflect publics’ more narrowly relative understanding of material needs.

The justice literature has coalesced around the notion that actors (e.g., supervisors) tend to utilize the norm of equity for resource allocation decisions because it is generally considered most fair when employees who contribute more to the organization receive more resources. Yet, actors might sometimes utilize a need norm to allocate resources to those most in need. Studies that have addressed need-based resource allocations have assumed a relatively straightforward conceptualization of need. However, research from related areas suggests that multiple characteristics of the need itself could trigger actors’ use of a need norm to allocate resources. We advance a theoretical framework that outlines various need characteristics that drive actors’ use of a need norm. The framework draws on the processes outlined in attribution theory and integrates those with the content domains addressed in fairness theory. A discussion of the implications for justice, attribution, and fairness theory research follows.

Phosphorus (P) is an essential nutrient in livestock feed but can pollute waterways. In order for pig production to become less of a threat to the environment, excreta must contain as little P as possible or be efficiently used by plants. This must be achieved without decreasing the livestock performance. Phosphorus and calcium (Ca) deposition in the bones of growing pigs must be optimised without affecting the muscle gain. This requires precision feeding based on cutting-edge techniques of diet formulation throughout the animal growth phase. Modelling and data mining have become important tools in this quest. In this study, a mechanistic model taking into account the distribution of P between bone and soft tissues was compared to the established factorial models (INRA (Jondreville and Dourmad, 2005) and NRC (National Research Council, 2012)) that predict P (apparent total tract digestible, ATTD-P; or standardised total tract digestible, STTD-P) and Ca (total and STTD) requirements as a function of BW and protein deposition. The requirements for different bone mineralisation scenarios, namely, 100% and 85% of the genetic potential, were compared with these two models. Sobol indices were used to estimate the relative impact of growth-related parameters on mineral requirements at 30, 60 and 120 kg of BW. The INRA showed the highest value of ATTD-P requirement between 29 and 103 kg of BW (6%) and lower for lighter and higher BW. Similarly, the model for 85% bone mineralisation showed lower STTD-P requirement than NRC between 29 and 93 kg of BW (7%) and higher for lighter and higher BW. Contrary to other models, the Ca requirement of the proposed model is not fixed in relation to P. It increases from 95 kg of BW while the others decrease. The INRA showed the highest Ca requirements. The model Ca requirements for 100% bone mineralisation are higher than NRC from 20 to 38 kg of BW similar until 70 kg of BW and then higher again. For 85% objective, the model showed lower Ca requirements from 25 to 82 kg of BW and higher for lighter and higher BW. The potential Ca deposition in bones is the most sensitive parameter (84% to 100% of the variance) of both ATTD-P and Ca at 30, 60 and 120 kg. The second most sensitive parameter is the protein deposition, explaining 1% to 15% of the ATTD-P variance. Studies such as this one will help to usher in a new era of sustainable and eco-friendly livestock production.

The social care system of China has come under close scrutiny from policy makers due to the rapid ageing of China's population. Unfortunately, there is very little Chinese research evidence that might be used to plan future service developments. This article is a contribution to filling that gap and it provides essential new information on the expressed demand among older people in China for various community care services. The data are from the 2008 wave of the Chinese Longitudinal Healthy Longevity Survey. According to the characteristics of the dependent variables, we used Binary Logistic Regression Analysis to analyse the need for community care among older people in China. The results show considerable need for such care, but China is still a developing country and there are insufficient resources to fund a Western-style social care system (even if that was desirable). Thus, it is argued that the development of social care in China should emphasise community-based care, in partnership with families, with institutional care as a last resort. In addition, it is argued that China (and other countries) should introduce measures to prevent the demand for social care.

This article provides practical ethical guidance for clinicians making decisions after a nuclear detonation, in advance of the full establishment of a coordinated response. We argue that the utilitarian maxim of the greatest good for the greatest number, interpreted only as “the most lives saved,” needs refinement. We take the philosophical position that utilitarian efficiency should be tempered by the principle of fairness in making decisions about providing lifesaving interventions and palliation. The most practical way to achieve these goals is to mirror the ethical precepts of routine clinical practice, in which 3 factors govern resource allocation: order of presentation, patient's medical need, and effectiveness of an intervention. Although these basic ethical standards do not change, priority is given in a crisis to those at highest need in whom interventions are expected to be effective. If available resources will not be effective in meeting the need, then it is unfair to expend them and they should be allocated to another patient with high need and greater expectation for survival if treated. As shortage becomes critical, thresholds for intervention become more stringent. Although the focus of providers will be on the victims of the event, the needs of patients already receiving care before the detonation also must be considered. Those not allocated intervention must still be provided as much appropriate comfort, assistance, relief of symptoms, and explanations as possible, given the available resources. Reassessment of patients' clinical status and priority for intervention also should be conducted with regularity.

(Disaster Med Public Health Preparedness. 2011;5:S46-S53)

This research compared older adults' use of medical assistive devices (ADs) with their use of everyday ADs as a means of managing chronic physical disability. The study also examined whether predisposing, need, and enabling factors were associated with device use in three domains of activity: personal care / in-home mobility, household activities, and community mobility. Participants were 248 adults, aged 55 years and older, with a wide range of disability levels as a result of osteoarthritis. All participants were administered an in-depth, structured questionnaire, as part of a larger study examining older adults' independence and adaptation to chronic physical illness. The results revealed that respondents actively adapted to their disabilities and used a wide range of medical and everyday devices, with everyday devices being reported more than twice as often as medical ADs and the fewest devices overall being reported for community mobility. In general, medical devices were used when subjective and objective need for ADs was considerable. Everyday devices were reported earlier in the trajectory of the disease, at mild and moderate disability levels, and were associated with a broader pattern of adaptation that included planning to avoid problems, exercise, and pacing activities.

Background: Mental illness and cognitive impairment are risk factors for poor dental health.

Methods: We conducted a cross-sectional study to compare the dental health of older patients attending out-patient clinics and day hospitals of old age psychiatry services (the psychiatry group, n = 103) with those attending general/geriatric medical services (the medical group; n = 99). Those living in care homes, and those with diagnosed mental illness (in the medical group) were excluded. A registered mental health nurse assessed mental and general health using validated and previously published instruments. A registered dentist made an independent assessment of dental health (examination to assess oral pathology, status of remaining teeth, and dentures) and made an overall judgment about whether the patient needed any dental treatment (a “normative” need).

Results: The normative need for dental treatment was significantly higher among the psychiatry group compared to the medical group (85% vs 52%; p<0.001); even after taking account of the effect of age, gender, teeth status, physical comorbidity, cognition, depressive symptoms, and overall mental and social health [adjusted odds ratio, OR (95% confidence interval): 4.32 (2.09, 8.91)]. The presence of any natural remaining teeth [OR: 4.44 (2.10, 9.42)] and Barthel Index [OR: 0.96 (0.93, 0.99)] were the two other independent predictors of the need for treatment.

Conclusion: Dental problems are common in community-living older people, especially those with some natural remaining teeth and those with mental illness. There is a need to develop integrated mental health and dental care services for older people with emphasis on prevention of dental problems.

The Framework for the Assessment of Children in Need and their Families signifies a major achievement in the development of a coherent approach to promoting the welfare of children while safeguarding them from harm. In this article, the aspirations of the Framework are considered, with particular focus on the challenges posed by the Framework, not only to the practice of social workers but also to the status of the social work profession. The area of professional judgement making is discussed, along with the threats to the effective implementation of the Framework. The author concludes that the Framework could bring about not only a better deal for children and families service users, but a new era of professional respect for social workers.