Understanding the Financial Knowledge Gap: A New Dimension of Inequality in Later Life.

To understand individuals' financial behaviors, it is important to understand the financial knowledge gap - the distance between one's objective and subjective financial knowledge. Overestimating one's financial knowledge can lead to risky financial behaviors. To date, limited empirical work has examined how financial knowledge gap varies across age groups. We analyze the size and nature of the financial knowledge gap and its variation across age groups. Using nationally representative data, we find robust evidence that older adults overestimate their financial knowledge. Social workers can assess the financial knowledge gap and educate their clients to protect from financial fraud, exploitation, and abuse.

'Growing Old' in Shelters and 'On the Street': Experiences of Older Homeless People.

Homelessness among older people in Canada is both a growing concern, and an emerging field of study. This article reports thematic results of qualitative interviews with 40 people aged 46 to 75, carried out as part of a mixed-methods study of older people who are homeless in Montreal, Quebec, Canada. Our participants included people with histories of homelessness (n = 14) and persons new to homelessness in later life (n = 26). Interviews focused on experiences at the intersections of aging and homelessness including social relationships, the challenges of living on the streets and in shelters in later life, and the future. This article outlines the 5 main themes that capture the experience of homelessness for our participants: age exacerbates worries; exclusion and isolation; managing significant challenges; shifting needs and realities; and resilience, strength, and hope. Together, these findings underscore the need for specific programs geared to the unique needs of older people who are homeless.

Socioeconomic differences and global trends in youth wellbeing and emotional distress in 165 countries and territories.

Social stratifications in youth wellbeing are a concern for social policy. Using data from the Gallup World Poll (2009-2022), we examined time trends and income differences in youth wellbeing and their associations with area-level income and income inequality. Results showed that a growing proportion of youth have experienced emotional distress in recent years, and this trend disproportionately affected youth at lower incomes. Higher income inequality relates to lower life satisfaction and larger income differences in life satisfaction. Socioeconomic inequality in youth wellbeing underscores the need for coordinated policy actions that reduce economic inequality and its impacts on youth wellbeing.

How is Consumer Financial Capability Measured?

The research literature on the growing field of consumer financial capability displays a wide diversity of understanding about the meaning and measurement of the concept. While sufficient research literature has been produced for a review of measurement domains and indicators, this work remains undone. The aim of the study is to assess the quantitative peer-reviewed research literature to advance the field toward building an evidence base for financial capability interventions and policies to improve family financial well-being and reduce economic inequality. This scoping review study analyzed the financial capability scholarly literature between 2015 and 2018. Overall, 34 studies used quantitative data and met all inclusion criteria for this study. Findings suggest that financial capability measurement constructs were operationalized in 12 different ways (n = 22). Most commonly, financial capability was operationalized as the combination of objective financial knowledge and financial access. Few studies included measurement of financial socialization or financial well-being. Most studies measured financial access using only formal financial access measures, such as bank account ownership and/or whether the consumer has investments. A smaller number of studies measured both formal and informal access (including use of non-bank financial institutions/products). Half of the articles that included financial access used bank account either solely or in combination with other measures as the indicator(s). Many studies lacked any measure of financial access. Recommendations are made about standardizing measurement for the constructs within financial capability and measurement of financial capability.

Introduction to the Special Issue on "Financial Capability and Asset Building for Family Financial Wellbeing".

The papers in this issue emerged from a 2020 social work academic conference focused on financial capability and asset building (FCAB) research. This introduction provides an overview of the challenging financial and economic realities for U.S. families that provide the context for these papers. An outline of social work?s unique role with these families precedes a brief introduction to each included paper. ?Building on these papers, the authors provide an overview of future directions for FCAB research in the areas of theory and methods. Regarding theory, the FCAB field will benefit from the further exploration of the role of access and context for financial capability, as well as the use of institutional theory in FCAB practice and research. The role of relationships on financial behavior is also under-researched along with the intersection of FCAB with clinical issues and other human needs. Regarding methods, future research that uses qualitative and longitudinal data is also needed to advance FCAB knowledge. Overall, interdisciplinary work across social work and consumer finance to build models that span professional boundaries and incorporate FCAB into consumer financial wellbeing models will advance theory and evidence.

Income trajectories of families raising a child with a neurodisability.

PURPOSE: To examine household income trajectories of children with and without neurodisability over a period of 6 years. METHOD: We used four cycles of the Canadian National Longitudinal Survey of Children and Youth, a longitudinal study of the development and well-being of Canadian children from birth into adulthood. RESULTS: While household income increased over time for both groups, families of children with neurodisability had consistently lower household income compared to families of children without neurodisability even after controlling for child and family socio-demographic characteristics. The presence of an interaction effect between parent work status and child with neurodisability at baseline indicated that among children whose parent(s) were not working at baseline, household incomes did not differ between children with and without neurodisability. CONCLUSIONS: The association between child with neurodisability and lower household income may not hold for all types of parents', working status is an important consideration.Implications for RehabilitationFindings support the health selection hypothesis that health status shapes diverging economic conditions over time: children with a ND have lower household incomes than children without a ND child across all waves of the Canadian National Longitudinal Survey of Youth.Income gaps did not increase or decrease over time; rehabilitation services and policies must consider the lower average incomes associated with raising a child with a ND.Social assistance support likely plays a key role in closing the gap, especially for non-working families.

Hemangiopericytoma/Solitary Fibrous Tumor of the Parietal Bone: A Case Report.

Hemangiopericytoma/solitary fibrous tumor (HPC/STF) is a rare tumor arising from Zimmerman's pericytes and it is characterized by an aggressive malignancy, with a high tendency for local and distant recurrence. The authors report the case of a middle-aged woman with HPC/SFT of the right parietal bone, which is an extremely rare primary location of involvement. The patient presented with a painful deformity of insidious growth at the right parietal region. Assessment with cranial computed tomography scan and magnetic resonance imaging revealed an expansive lesion at the right parietal bone, with exocranial extension and 27 mm of maximal diameter. Craniotomy with gross tumor removal, duraplasty, and cranioplasty was performed, and the diagnosis of HPC/SFT, WHO grade III, was established by pathological and immunohistochemical analysis. The patient was then evaluated for adjuvant radiation therapy and received a dose of 60 Gy (2 Gy/fraction) with 3D conformal radiotherapy to the surgical bed. The adjuvant treatment was uneventful and, after 8 months of follow-up, there was no suspected local or distant recurrence. The rarity of this diagnosis, its aggressive behavior, and the lack of published data posed several challenges for the treatment management.

Savings ownership and the use of maternal health services in Indonesia.

In low- and middle-income countries (LMICs), many women of reproductive age experience morbidity and mortality attributable to inadequate access to and use of health services. Access to personal savings has been identified as a potential instrument for empowering women and improving access to and use of health services. Few studies, however, have examined the relation between savings ownership and use of maternal health services. In this study, we used data from the Indonesian Family Life Survey to examine the relation between women's savings ownership and use of maternal health services. To estimate the effect of obtaining savings ownership on our primary outcomes, specifically receipt of antenatal care, delivery in a health facility and delivery assisted by a skilled attendant, we used a propensity score weighted difference-in-differences approach. Our findings showed that acquiring savings ownership increased the proportion of women who reported delivering in a health facility by 22 percentage points [risk difference (RD) = 0.22, 95%CI = 0.08-0.37)] and skilled birth attendance by 14 percentage points (RD = 0.14, 95%CI = 0.03-0.25). Conclusions were qualitatively similar across a range of model specifications used to assess the robustness of our main findings. Results, however, did not suggest that savings ownership increased the receipt of antenatal care, which was nearly universal in the sample. Our findings suggest that under certain conditions, savings ownership may facilitate the use of maternal health services, although further quasi-experimental and experimental research is needed to address threats to internal validity and strengthen causal inference, and to examine the impact of savings ownership across different contexts.

Comparison of sensorimotor disturbance between subjects with persistent whiplash-associated disorder and subjects with vestibular pathology associated with acoustic neuroma.

OBJECTIVE: To determine if differences exist in reported symptoms and in outcomes of sensorimotor tests (cervical joint position error [JPE], neck-influenced eye movement control, postural stability) between subjects with persistent whiplash and subjects with unilateral vestibular pathology associated with acoustic neuroma. DESIGN: Repeated measures, case controlled. SETTING: Tertiary institution and metropolitan hospital. PARTICIPANTS: Twenty subjects with persistent whiplash, 20 subjects with acoustic neuroma, and 20 control subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Symptom descriptors, Dizziness Handicap Inventory (short form), measures of cervical JPE, the smooth pursuit neck torsion (SPNT) test, and forceplate measures of postural stability in comfortable and narrow stances. RESULTS: The results showed differences in SPNT (P=.00), selected measures of postural stability (P<.04), and reported symptoms between the whiplash and vestibular groups. There was no between-group difference in cervical JPE (P>.27) or dizziness handicap (P>.69). CONCLUSIONS: This study showed differences in sensorimotor disturbances between subjects with discreet whiplash and those with vestibular pathology associated with acoustic neuroma. The results support the SPNT test as a test of cervical afferent dysfunction. Further research into cervical JPE as a discreet test of cervical afferentation is warranted.

Patterns of Shelter Use Among Men New to Homelessness in Later Life: Duration of Stay and Psychosocial Factors Related to Departure.

People who become homeless for the first time in late life are a growing but understudied population. This study draws on administrative data from one shelter (N = 1,214 first-time homeless) to assess the extent to which age is related to shelter stay and, to examine psychosocial factors that may be associated with shelter departure. Our bivariate and survival analysis results suggest that older homeless men stay in the shelter 2 weeks longer than younger clients. Older men with pending legal issues and mobility concerns were more likely to leave the shelter than those without such concerns. Findings highlight the impact of age and other psychosocial variables on shelter stay, and provide direction from which to address homelessness among men who are new to homelessness in later life.

The Effects of Socioeconomic Vulnerability, Psychosocial Services, and Social Service Spending on Family Reunification: A Multilevel Longitudinal Analysis.

Socio-environmental factors such as poverty, psychosocial services, and social services spending all could influence the challenges faced by vulnerable families. This paper examines the extent to which socioeconomic vulnerability, psychosocial service consultations, and preventative social services spending impacts the reunification for children placed in out-of-home care. This study uses a multilevel longitudinal research design that draws data from three sources: (1) longitudinal administrative data from Quebec's child protection agencies; (2) 2006 and 2011 Canadian Census data; and, (3) intra-province health and social services data. The final data set included all children (N = 39,882) placed in out-of-home care for the first time between 1 April 2002 and 31 March 2013, and followed from their initial out-of-home placement. Multilevel hazard results indicate that socioeconomic vulnerability, controlling for psychosocial services and social services spending, contributes to the decreased likelihood of reunification. Specifically, socioeconomic vulnerability, psychosocial services, and social services spending account for 24.0% of the variation in jurisdictional reunification for younger children less than 5 years of age, 12.5% for children age 5 to 11 years and 21.4% for older children age 12 to 17 years. These findings have implications for decision makers, funding agencies, and child protection agencies to improve jurisdictional resources to reduce the socioeconomic vulnerabilities of reunifying families.

Balance, mobility and gaze stability deficits remain following surgical removal of vestibular schwannoma (acoustic neuroma): an observational study.

QUESTION: Are there residual deficits in balance, mobility, and gaze stability after surgical removal of vestibular schwannoma? DESIGN: Observational study. PARTICIPANTS: Twelve people with a mean age of 52 years who had undergone surgical removal of vestibular schwannoma at least three months previously and had not undergone vestibular rehabilitation. Twelve age- and gender-matched healthy people who acted as controls. OUTCOME MEASURES: Handicap due to dizziness, balance, mobility, and gaze stability was measured. RESULTS: Handicap due to dizziness was moderate for the clinical group. They swayed significantly more than the controls in comfortable stance: firm surface eyes open and visual conflict (p < 0.05); foam surface eyes closed (p < 0.05) and visual conflict (p < 0.05); and feet together: firm surface, eyes closed (p < 0.05), foam surface, eyes open (p < 0.05) and eyes closed (p < 0.01). They displayed a higher rate of failure for timed stance and gaze stability (p < 0.05) than the controls. Step Test (p < 0.01), Tandem Walk Test (p < 0.05) and Dynamic Gait Index (p < 0.01) scores were also significantly reduced compared with controls. There was a significant correlation between handicap due to dizziness and the inability to maintain balance in single limb and tandem stance (r = 0.68, p = 0.02) and the ability to maintain gaze stability during passive head movement (r = 0.78; p = 0.02). CONCLUSION: A prospective study is required to evaluate vestibular rehabilitation to ameliorate dizziness and to improve balance, mobility, and gaze stability for this clinical group.

What leads to homeless shelter re-entry? An exploration of the psychosocial, health, contextual and demographic factors.

OBJECTIVES: A longer duration of homelessness is associated with poorer health outcomes. Following this logic, policies that aim to reduce repeated episodes of homelessness by addressing its root causes can result in better long-term health. This paper explores how many people return to the shelter in a Canadian context and examines factors related to returns to homelessness. METHODS: The sample included 634 adult men who participated in transitional programming at a large homeless shelter in Montreal, Quebec between 2011 and 2014. Descriptive statistics, survival analysis and multinomial logistic regression techniques were used to examine how psychosocial elements, demographic characteristics and contextual factors were related to returns to the shelter over a one-year follow-up period. RESULTS: Approximately 38% of the sample returned to the shelter within a year of program departure. A return was positively associated with a lack of support from friends and family (p < 0.05) and an imposed departure from the shelter (p < 0.05). Poor support was also associated with a faster time to return (p < 0.05) to the shelter, as was an imposed departure (p < 0.01). CONCLUSIONS: Building social networks and altering programs to accommodate those at high risk of an imposed departure may lead to fewer returns to homelessness and subsequently better health outcomes.

A Literature Review of Homelessness and Aging: Suggestions for a Policy and Practice-Relevant Research Agenda.

Homelessness among older people is a growing concern across Canada and is expected to rise with demographic change (Crane & Warnes, 2010; Culhane, Metraux, Byrne, Stino, & Bainbridge, 2013). Yet current knowledge, policies, and practices on homelessness largely focus on younger populations. Likewise, research and policies on aging typically overlook homelessness. Responses to homelessness among older people must address complex needs related to health, income security, and housing. Based on a comprehensive literature review, this article outlines the existing and needed research with regards to homelessness among older people. We clarify the intersections of aging and homelessness; review the relevant statistics, including estimated prevalence; discuss pathways and variations in experience; and identify gaps in knowledge. We conclude with a call for an inclusive research agenda that will help build policies and practices to reduce and ultimately to eliminate homelessness among older people in Canada.

Adverse events in patients with return emergency department visits.

OBJECTIVES: This study describes the proportion of emergency department (ED) returns within 7 days due to adverse events, defined as adverse outcomes related to healthcare received. DESIGN: Prospective cohort study. SETTING: We used an electronically triggered adverse event surveillance system at a tertiary care ED from May to June 2010 to examine ED returns within 7 days of index visit. PARTICIPANTS: One of three trained nurses determined whether the visit was related to index emergency care. For such records, one of three trained emergency physicians conducted adverse event determinations. MAIN OUTCOME MEASURE: We determined adverse event type and severity and analysed the data with descriptive statistics, χ(2) tests and logistic regression. RESULTS: Of 13,495 index ED visits, 923 (6.8%) were followed by ED returns within 7 days. The median age of all patients was 47 years and 52.8% were women. After nursing review, 211 cases required physician review. Of these, 53 visits were adverse events (positive predictive value (PPV)=5.7%, 95% CI 4.4% to 7.4%) and 30 (56.6%) were preventable. Common adverse event types involved management, diagnostic or medication issues. We observed one potentially preventable death and 58.5% of adverse events resulting in transient disability. The PPV of a modified trigger with a cut-off of return within 72 h, resulting in admission was 11.9% (95% CI 6.8% to 18.9%). CONCLUSIONS: Our electronic trigger efficiently identified adverse events among 12% of patients with ED returns within 72 h, requiring hospital admission. Given the high degree of preventability of the identified adverse events, this trigger also holds promise as a performance measurement tool.