Minimal treatments and problem gamblers: A preliminary investigation

In view of the increasing popularity of minimal intervention treatments for problem drinking, a self-help manual for people who wish to reduce or stop gambling was prepared. Twenty-nine (ACT residents) who responded to advertisements for help with problem gambling were allocated to either of two minimal treatments, Manual (only) and Manual & Interview. On average, clients from both groups reduced the frequency of their gambling sessions, frequency of overspending, and amount spent per week in the first three months and next three months after first contact, but expenditure per session increased from three to six months, after an initial improvement. There was no evidence that a single in-depth interview added to the effectiveness of the manual.This project was funded by a grant from the Australian National University Faculties Research Fund.     

Bringing baby home: a comprehensive case management program for obstetrical services

Originally presented to the Society of Home Health Care Management of the American College of Physician Executives at its November 16, 1993, meeting in Tucson, Ariz., the program described in this article was the winner of the College's 1994 Innovations Award in Medical Quality Management, sponsored by Merck Sharp & Dohme. The program shows the potential of case management for both improvement in the quality of care and containment of costs for a managed care population with a substantial Medicaid segment. This article is part of a continuing series on innovative programs in home health care.     

An evaluation of population projection errors for census tracts

"In this article we evaluate the accuracy and bias of projections of total population and population by age group for census tracts in three counties in Florida. We use [U.S. census] data from 1970 and 1980 and several simple extrapolation techniques to produce projections for 1990; we then compare these projections with 1990 census counts and evaluate the differences. For the total sample, we find mean absolute errors of 17%-20% for the three most accurate techniques for projecting total population and find no indication of overall bias. For individual age groups, mean absolute errors range from 20%-29%." This is a revised version of a paper presented at the 1993 Annual Meeting of the Population Association of America.     

Finite mixture models with concomitant information: assessing diagnostic criteria for diabetes

The World Health Organization (WHO) diagnostic criteria for diabetes mellitus were determined in part by evidence that in some populations the plasma glucose level 2 h after an oral glucose load is a mixture of two distinct distributions. We present a finite mixture model that allows the two component densities to be generalized linear models and the mixture probability to be a logistic regression model. The model allows us to estimate the prevalence of diabetes and sensitivity and specificity of the diagnostic criteria as a function of covariates and to estimate them in the absence of an external standard. Sensitivity is the probability that a test indicates disease conditionally on disease being present. Specificity is the probability that a test indicates no disease conditionally on no disease being present. We obtained maximum likelihood estimates via the EM algorithm and derived the standard errors from the information matrix and by the bootstrap. In the application to data from the diabetes in Egypt project a two-component mixture model fits well and the two components are interpreted as normal and diabetes. The means and variances are similar to results found in other populations. The minimum misclassification cutpoints decrease with age, are lower in urban areas and are higher in rural areas than the 200 mg dl^-1 cutpoint recommended by the WHO. These differences are modest and our results generally support the WHO criterion. Our methods allow the direct inclusion of concomitant data whereas past analyses were based on partitioning the data.     

Ability, disability, and the oldest old

A measure of range of ability is used to profile the 85-years-old-and-older (oldest old) population, including the highly disabled institutional population. This new measure uses two new questions available in the 1990 Decennial Census concerning a self-care limitation and a mobility limitation as well as the usual question concerning a work limitation. In addition to examining the extent of disability among the oldest old, the article examines the extent of care potentially available in the household as well as the economic characteristics of this age group. It is also profiled in terms of relevant personal characteristics, including age, gender, marital status, race, ethnicity, rural residence, education, and employment. A key question addressed is the need for help or care among the oldest old and how various long-term care proposals would meet such needs. A careful analysis of this unique and growing population is necessary to both allay fears of the cost of care or help as well as to dispel stereotypes of this age group as frail and dependent, and in need of institutional care.     

Disciplines of Organizational Learning: Contributions and Critiques

The paper argues against attempts to create asingle framework for understanding organizationallearning. Relevant literature is reviewed from sixdisciplinary perspectives: psychology and OD; management science; sociology and organizational theory;strategy; production management; and culturalanthropology. It is argued that each discipline providesdistinct contributions and conceptions of problems.Furthermore, a basic distinction between organizationallearning and the new idea of the learning organizationis noted. Whereas the former is discipline based andanalytic,the latter is multidisciplinary and emphasizes action and the creation of anideal-type of organization. Due to thediversity of purpose and perspective, it is suggestedthat it is better to consider organizational learning asa multidisciplinary field containing complementary contributions andresearch agendas.     

Why China failed to create an endogenous industrial capitalism

Conclusion Weber almost anticipated the idea of the high-level equilibrium trap. Speaking about bureaucracy, he observed that as always in the area of'techniques' ... advance proceeded most slowly wherever older structural forms were in their own way technically highly developed and functionally particularly well-developed to the requirements at hand. It is a pity that he did not utilize this insight to analyze what he called the increasing stability of the economic situation under conditions of the economically self-sufficient and socially homogenously composed world-empire of China. Instead he pursued the idea that the absence of self-generated capitalism in China was due basically to the lack of a particular mentality. This inappropriate mentality had several aspects. One was the personalist principle. Others are listed in a catalog of alleged traits of personality taken largely from Arthur Smith's Chinese Characteristics. They include stolidity, patience, dislike of novelty, absence of curiosity, credulity, and a general distrust of and dishonesty towards all. Having acknowledged China's considerable technical endowments and inventions (Weber's own quotation marks), he argued that the magic stereotyping of technology and economics... completely precluded the advent of indigenous modern enterprises in communication and industry. The Chinese world, in a famous phrase, was a magic garden in which the ethical rationality of the miracle [was] out of the question. Certain points of detail may be disputed. Thus the miracles attributed to the piety of sons and the fidelity of widows were entirely ethically rational. But the crucial fact is that this conception of the problem led Weber in practice to place an excessive faith in the explanatory power of an analysis of ideas considered in relative isolation from their socioeconomic context. It probably also weakened his sense of the need to sort out more systematically the somewhat internally contradictory opinions that he held on the more specifically economic aspects of Chinese society.

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