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ABSTRACT 'Identity loan' is common among U.S. farmworkers. In contrast to 'identity theft,' it is a voluntary exchange in which citizens and legal permanent residents lend unauthorized migrants their identity documents so that the latter may obtain a job. Drawing on nine months of ethnographic fieldwork and interviews with 45 migrant farmworkers in California's Central Valley, I show that federal and state policies have encouraged identity loan as a mode of reciprocal gift-giving in resource- and document-poor migrant communities. Document exchange benefits 'identity donors' by increasing their unemployment payments and directly depositing deductions from unauthorized migrants' wages into their Social Security accounts. While many scholars theorize that unauthorized status serves as a hidden subsidy for the state, this study illuminates the microprocesses through which ordinary citizens and residents agentively vie to divert this 'profit reserve' into their own pockets. [ABSTRACT FROM AUTHOR]

Background: Older adults experiencing chronic homelessness (i.e., prolonged homelessness and a disabling condition) have low rates of advance care planning (ACP) despite high rates of morbidity and mortality. Rehousing of homeless‐experienced individuals into permanent supportive housing (PSH) may present an opportunity to introduce ACP; but this is unknown. Therefore, we explored staff and resident perceptions of conducting ACP in PSH. Methods: We conducted semi‐structured interviews with PSH staff (n = 13) and tenants (PSH residents) (n = 26) in San Francisco. We used the capability (C), opportunity (O), motivation (M), behavior (COM‐B) framework within the Behavior Change Wheel model and the Theoretical Domains Framework (TDF) to inform interviews, categorize themes, and guide qualitative thematic analysis. Results: The mean age of PSH residents was 67 (SD = 6.1) years and 52% were women. Of staff, 69% were women. Important COM‐B barriers included ACP complexity (C), complicated relationship dynamics (O), resource limitations (O), pessimism (M), variable staff confidence (M), and competing priorities (M). Facilitators included easy‐to‐use documents/videos, including the PREPARE for Your Care program (C), stability with housing (O), exposure to health crises (O), potential for strong relationships (O), and belief that ACP is impactful (M). Recommendations included adapting materials to the PSH setting, providing staff trainings/scripts, and using optional one‐on‐one or group sessions. Conclusions: We identified behavioral determinants related to ACP for formerly chronically homeless older adults in PSH. Future interventions should include using easy‐to‐use ACP materials and developing resources to educate PSH residents, train staff, and model ACP in groups or one‐on‐one sessions. [ABSTRACT FROM AUTHOR]

This editorial comments on the articles by Zingmond et al. and Jennings et al. in this issue. [ABSTRACT FROM AUTHOR]

Background: Physician Orders for Life‐Sustaining Treatment (POLST) facilitates documentation and transition of patients' life‐sustaining treatment orders across care settings. Little is known about patient and facility factors related to care preferences within POLST across a large, diverse nursing home population. We describe the orders within POLST among all nursing home (NH) residents in California from 2011 to 2016. Methods: California requires NHs to document in the Minimum Data Set whether residents complete a POLST and orders within POLST. Using a serial cross‐sectional design for each year, we describe POLST completion and orders for all California NH residents from 2011 to 2016 (N = 1,112,668). We used logistic mixed‐effects regression models to estimate POLST completion and resuscitation orders to understand the relationship with resident and facility characteristics, including Centers for Medicare and Medicaid Services (CMS) Nursing Home Compare overall five‐star quality rating. Results: POLST completion significantly increased from 2011 to 2016 with most residents having a POLST in 2016 (short‐stay:68%; long‐stay:81%). Among those with a POLST in 2016, 54% of long‐stay and 41% of short‐stay residents had a DNR order. Among residents with DNR, >90% had orders for limited medical interventions or comfort measures. Few residents (<6%) had a POLST with contradictory orders. In regression analyses, POLST completion was greater among residents with more functional dependence, but was lower among those with more cognitive impairment. Greater functional and cognitive impairment were associated with DNR orders. Racial and ethnic minorities indicated more aggressive care preferences. Higher CMS five‐star facility quality rating was associated with greater POLST completion. Conclusions: Six years after a state mandate to document POLST completion in NHs, most California NH residents have a POLST, and about half of long‐stay residents have orders to limit life‐sustaining treatment. Future work should focus on determining the quality of care preference decisions documented in POLST. This article comments on the editorial by Lam et al. and the letter by Zingmond et al. in this issue. [ABSTRACT FROM AUTHOR]

Policy PointsClarifications to Senate Bill (SB) 1152 are necessary to address the differences between inpatient and emergency department (ED) discharge processes, determine how frequently an ED must deliver the SB 1152 bundle of services to a single patient, and establish expectations for compliance during off‐hours when social services are unavailable.Because homelessness cannot be resolved in a single ED visit, the state should provide funding to support housing‐focused case workers that will follow patients experiencing homelessness (PEH) through the transition from temporary shelters to permanent supportive housing. Medi‐Cal could fund the delivery of the SB 1152 bundle of services to defray the costs to public hospitals that provide care for high numbers of PEH.California legislators should consider complementary legislation to increase funding for shelters so that sufficient capacity is available to accept PEH from EDs and hospitals, and to fund alternative strategies to prevent poverty and the upstream root causes of homelessness itself. Context: Prompted by stories of "patient dumping," California enacted Senate Bill (SB) 1152, which mandates that hospitals offer patients experiencing homelessness (PEH) a set of resources at discharge to ensure safety and prevent dumping. Methods: To evaluate interventions to meet the requirements of SB 1152 across three emergency departments (EDs) of a Los Angeles County public hospital system with a combined annual census of 260,000 visits, we used an explanatory sequential mixed methods approach, focusing first on quantitative evaluation and then using information from qualitative interviews to explain the quantitative findings. Findings: In total, 2.9% (1,515/52,607) of encounters involved PEH. Documentation of compliance with the eight required components of SB 1152 was low, ranging from 9.0% to 33.9%. Twenty‐five provider interviews confirmed support for providing assistance to PEH in the ED, but the participants described barriers to compliance, including challenges in implementing universal screening for homelessness, incongruity of the requirements with the ED setting, the complexity of the patients, and the limitations of SB 1152 as a health policy. Conclusions: Despite operationalizing universal screening for homelessness, we found poor compliance with SB 1152 and identified multiple barriers to implementation. [ABSTRACT FROM AUTHOR]

The Sixteenth Annual Meeting of the Society for Psychophysiological Research will be held at the Vacation Village Hotel in San Diego, California, in October 1976. Registration information may be obtained from Dr. Laverne C. Johnson or Richard Townsend. Information regarding submission of papers and deadline for abstracts may be obtained from Dr. Gary E. Schwartz. Department of Psychology of Yale University in New Haven, Connecticut.

Older homeless‐experienced adults have low engagement in advance care planning (ACP) despite high morbidity and mortality. We conducted a cross‐sectional analysis of a cohort of 350 homeless‐experienced adults aged 50 and older in Oakland, California. We assessed the prevalence of potential surrogate decision‐makers, ACP contemplation, discussions, and ACP documentation (surrogate designation, advance directives). We used multivariable logistic regression to examine factors associated with ACP discussions and documentation. The median age of the cohort was 59 (range 52–82), 75.2% were male, and 82.1% were black. Sixty‐one percent reported a potential surrogate, 21.5% had discussed ACP, and 19.0% reported ACP documentation. In multivariable models, having 1 to 5 confidants versus none (adjusted odds ratio (aOR)=5.8, 95% confidence interval (CI)=1.7–20.0), 3 or more chronic conditions versus none (aOR=2.3, 95% CI=0.9–5.6), and a recent primary care visit (aOR=2.1, 95% CI=1.0–4.4) were associated with higher odds of ACP discussions and each additional 5 years of homelessness (aOR=0.7, 95% CI=0.5—0.9) with lower odds. Having 1 to 5 confidants (aOR=5.0, 95% CI=1.4–17.5), being black (aOR=5.5, 95% CI=1.5–19.5), and having adequate versus limited literacy (aOR=7.0, 95% CI=1.5–32.4) were associated with higher odds of ACP documentation and illicit drug use (aOR=0.3, 95% CI=0.1–0.9) with lower odds. Although the majority of older homeless‐experienced adults have a potential surrogate, few have discussed or documented their ACP wishes; the odds of both were greater with larger social networks. Future interventions must be customized for individuals with limited social networks and address the instability of homelessness, health literacy, and the constraints of safety‐net healthcare settings. [ABSTRACT FROM AUTHOR]

National changes in the context for public health services are influencing the nature of public health nursing practice. Despite this, the document that defines public health nursing as a specialty- The Definition and Role of Public Health Nursing-has remained in wide use since its publication in 1996 without a review or update. With support from the American Public Health Association ( APHA) Public Health Nursing Section, a national Task Force, was formed in November 2012 to update the definition of public health nursing, using processes that reflected deliberative democratic principles. A yearlong process was employed that included a modified Delphi technique and various modes of engagement such as online discussion boards, questionnaires, and public comment to review. The resulting 2013 document consisted of a reaffirmation of the one-sentence 1996 definition, while updating supporting documentation to align with the current social, economic, political, and health care context. The 2013 document was strongly endorsed by vote of the APHA Public Health Nursing Section elected leadership. The 2013 definition and document affirm the relevance of a population-focused definition of public health nursing to complex systems addressed in current practice and articulate critical roles of public health nurses ( PHN) in these settings. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate older people's use of supplements, including multivitamins, and their disclosure of supplementation to their physicians. Researchers evaluated 14 physicians from California and 256 of their patients between 2009 and 2010. They found that while 56% of patients reported taking at least one supplement there was incomplete discussion and documentation about supplement use during office visits with physicians.

The article states that Coordinate Indexing (Uniterm System) was initiated at the Naval Ordnance Test Station (NOTS), China Lake, California, and the NOTS Pasadena Annex Technical Libraries in the spring of 1953. At that time, the library needed an effective system of subject analysis. The answer to the cumulating problem of subject analysis for the report literature seemed to come in a series of lectures given early in 1953 by Mortimer Taube in which the theme was Coordinate Indexing. Several people of the NOTS library staff who attended these lectures felt that Coordinate Indexing was the solution to their subject heading problem.