Public reporting of nursing home quality of care : Lessons from the United States experience for Canadian policy discussion

While the demand for continuing care services in Canada grows, the quality of such services has come under increasing scrutiny. Consideration has been given to the use of public reporting of quality data as a mechanism to stimulate quality improvement and promote public accountability for and transparency in service quality. The recent adoption of the Resident Assessment Instrument (RAI) throughout a number of Canadian jurisdictions means that standardized quality data are available for comparisons among facilities across regions, provinces and nationally. In this paper, we explore current knowledge on public reporting in nursing homes in the United States to identify what lessons may inform policy discussion regarding potential use of public reporting in Canada. Based on these findings, we make recommendations regarding how public reporting should be progressed and managed if Canadian jurisdictions were to implement this strategy.

The impact of school tobacco policies on student smoking in Washington State, United States and Victoria, Australia

This paper measures tobacco polices in statewide representative samples of secondary and mixed schools in Victoria, Australia and Washington, US (N = 3,466 students from 285 schools) and tests their association with student smoking. Results from confounder-adjusted random effects (multi-level) regression models revealed that the odds of student perception of peer smoking on school grounds are decreased in schools that have strict enforcement of policy (odds ratio (OR) = 0.45; 95% CI: 0.25 to 0.82; p = 0.009). There was no clear evidence in this study that a comprehensive smoking ban, harsh penalties, remedial penalties, harm minimization policy or abstinence policy impact on any of the smoking outcomes.

Rural adolescent alcohol, tobacco, and illicit drug use: a comparison of students in Victoria, Australia, and Washington State, United States

Purpose: There are inconsistent research findings regarding the impact of rurality on adolescent alcohol, tobacco, and illicit substance use. Therefore, the current study reports on the effect of rurality on alcohol, tobacco, and illicit
drug use among adolescents in 2 state representative samples in 2 countries, Washington State (WA) in the United States and Victoria (VIC) in Australia.
Participants: The International Youth Development Study (IYDS) recruited representative samples of students from Grade 7 (aged 12 to 13 years) and Grade 9 (aged 14 to 15) in both states. A total of 3,729 students responded to questions about alcohol, tobacco, cannabis, and other illicit substance use (n_VIC = 1,852; n_WA = 1,877). In each state, males and females were equally represented and ages ranged from 12 to 15 years.
Methods: Data were analyzed to compare lifetime and current (past 30 days) substance use for students located in census areas classified as urban, large or small town, and rural. Findings were adjusted for school clustering and
weighted to compare prevalence at median age 14 years.
Findings: Rates of lifetime and current alcohol, tobacco, and cannabis use were significantly higher in rural compared to urban students in both states (odds ratio for current substance use = 1.31).
Conclusions: In both Washington State and Victoria, early adolescent rural students use substances more frequently than their urban counterparts. Future studies should examine factors that place rural adolescents at risk for alcohol, tobacco, and illicit drug use.

The impact of school suspension on student tobacco use : a longitudinal study in Victoria, Australia, and Washington State, United States

Context: School suspension may have unintended consequences in contributing to problem behaviors, including dropping out from school, substance use, and antisocial behavior. Tobacco use is an early-onset problem behavior, but prospective studies of the effects of suspension on tobacco use are lacking.

Method: Longitudinal school-based survey of students drawn as a two-stage cluster sample, administered in 2002 and 2003, in Washington State, United States, and Victoria, Australia. The study uses statewide representative samples of students in Grades 7 and 9 (N = 3,599). Results: Rates of tobacco use were higher for Victorian than Washington State students. School suspension remained a predictor of current tobacco use at 12-month follow-up, after controlling for established risk factors including prior tobacco and other drug use for Grade 7 but not Grade 9 students.

Conclusions: School suspension is associated with early adolescent tobacco use, itself an established predictor of adverse outcomes in young people. Findings suggest the need to explore process mechanisms and alternatives to school suspensions as a response to challenging student behavior in early adolescence.

Code of ethics quality : an international comparison of corporate staff support and regulation in Australia, Canada and the United States

The objective of this paper is to examine the ‘Code of Ethics Quality’ (CEQ) in the largest companies of Australia, Canada and the United States. For this purpose, a proposed CEQ construct has been applied. It appears from the empirical findings that while Australia, Canada and the United States are extremely similar in their economic and social development, there may well be distinct cultural mores and issues that are forming their business ethics practices. A research implication derived from the performed research is that the construct provides a selection of observable and measurable elements in the context of CEQ. The construct of CEQ consists of nine measures divided into two dimensions (i.e. staff support and regulation). They should not be seen as a complete list. On the contrary, it is encouraged that others propose and elaborate revisions and extensions. A practical implication of this paper is a structure of what and how to examine the CEQ in a managerial setting. It may assist companies in their efforts to establish, maintain and improve their ethical culture, norms and beliefs within the organization and supporting them in their ethical business practices with different stakeholders in the marketplace and society. The dimensions and measures of the construct may be used as a frame of reference for further research. They may be useful and applicable across contexts and over time using similar samples when it comes to large companies, as small- or medium-sized ones may not have considered all areas nor have the elements in place. This is a research limitation, but it provides an opportunity for further research.

Does school suspension affect subsequent youth non-violent antisocial behaviour? A longitudinal study of studnets in Victoria, Australia and Washington State, United States

School suspension has been not only associated with negative behaviours but also is predictive of future poor outcomes. The current study investigates (1) whether school suspension is a unique predictor of youth non-violent antisocial behaviour (NVAB) relative to other established predictors, and (2) whether the predictors of NVAB are similar in Australia and the United States (USA). The data analysed here draw on two statewide representative samples of Grade 7 and 9 students in Victoria, Australia and Washington State, USA, resurveyed at 12-month follow-up (N = 3,677, 99% retention). School suspension did not uniquely predict NVAB in the final model. The predictors of NVAB, similar across states, included previous student NVAB, current alcohol and tobacco use, poor family management, association with antisocial friends, and low commitment to school. An implication of the findings is that US evidence-based prevention programmes targeting the influences investigated here could be trialled in Australia.

Student and school factors associated with school suspension : A multilevel analysis of students in Victoria, Australia and Washington State, United States.

One of the common issues schools face is how best to handle challenging student behaviors such as violent behavior, antisocial behavior, bullying, school rule violations, and interrupting other students' learning. School suspension may be used to remove students engaging in challenging behaviors from the school for a period of time. However, the act of suspending students from school may worsen rather than improve their behavior. Research shows that suspensions predict a range of student outcomes, including crime, delinquency, and drug use. It is therefore crucial to understand the factors associated with the use of school suspension, particularly in sites with different policy approaches to problem behaviors. This paper draws on data from state-representative samples of 3,129 Grade 7 and 9 students in Washington State, United States and Victoria, Australia sampled in 2002. Multilevel modeling examined student and school level factors associated with student-reported school suspension. Results showed that both student (being male, previous student antisocial and violent behavior, rebelliousness, academic failure) and school (socioeconomic status of the school, aggregate measures of low school commitment) level factors were associated with school suspension and that the factors related to suspension were similar in the two states. The implications of the findings for effective school behavior management policy are that, rather than focusing only on the student, both student and school level factors need to be addressed to reduce the rates of school suspension.