Tibetans in South Asia: a research note

The research note provides an overview of Tibetan refugee settlements in South Asia, viz. in India, Nepal and Bhutan. The note focuses on the residential status of Tibetans and their life and livelihood. Tibetan refugees are viewed as representatives of Tibetan culture and religion in these countries.     

Child sexual abuse: from prevention to self‐protection

There are a growing number of child abuse prevention and education programmes, including primarily group‐based parent and child education, which are taught by teachers within the school system. This article reviews some of the existing sexual abuse education and/or body safety programmes, as well as the research surrounding them. Advantages as well as criticisms of such programmes are reviewed. Issues such as target populations (i.e. children, teachers, parents), programme components and methodological limitations are addressed. Major findings include: children as young as three can be effectively taught self‐protection skills, parental and family involvement in training is important, and repeated exposure helps children maintain knowledge gains. The components of successful programmes include teaching children to identify and resist inappropriate touching, reassuring children that it is not their fault and learning the proper names of their genitals. Finally, future directions for programme development, research and policy are explored. Copyright © 2008 John Wiley & Sons, Ltd.     

Improving Performance in Outpatient Appointment Services with a Simulation Optimization Approach

Outpatient health care service providers face increasing pressure to improve the quality of their service through effective scheduling of appointments. In this paper, a simulation optimization approach is used to determine optimal rules for a stochastic appointment scheduling problem. This approach allows for the consideration of more variables and factors in modeling this system than in prior studies, providing more flexibility in setting policy under various problem settings and environmental factors. Results show that the dome scheduling rule proposed in prior literature is robust, but practitioners could benefit from considering a flatter, “plateau‐dome.” The plateau–dome scheduling pattern is shown to be robust over many different performance measures and scenarios. Furthermore, because this is the first application of simulation optimization to appointment scheduling, other insights are gleaned that were not possible with prior methodologies.     

Comparison of Advance Medical Directive Inquiry and Documentation for Hospital Inpatients in Three Medical Services: Implications for Policy Changes

Following the introduction of the Patient Self-Determination Act of 1990, the Veterans Health Administration developed its own advance medical directive (AMD) policy, which most recently states that documentation is mandatory for all hospital patients in all settings. The object of this study was to assess the effectiveness of AMD documentation at a local Veterans Affairs Medical Center. AMD documentation was compared among three inpatient services: surgery, medicine, and psychiatry. Retrospective in nature, 594 inpatient cases were compared. Results revealed that, overall, the rate of AMD documentation was 37.7%. AMD documentation on surgery was statistically more frequent (45.6%) than for either medicine (33.2%) or psychiatry (34.5%). The difference between the numbers of days to AMD documentation for all three services was not statistically significant. While there was no statistically significant difference across gender, Caucasians had AMDs documented more frequently than African Americans (p < .001). Logistic regression reveals that social worker and physician intervention, not patient-specific variables, are the primary predictors of AMD incidence. Policy makers may need to consider the realities of hospital care, especially in emergency settings, and be more specific in the steps of implementation of the policy in the evenings, weekends, and holidays. True adherence to policy implementation may require hospital administrators to increase staff and educational efforts so that the concept of AMD communication and documentation is completely explained to all staff and patients. Policy should include an electronic record reminder that is renewed every 3 years and provisions for accommodating patients who arrive on weekends and holidays, with special awareness of the particular communication needs of minority groups. The study conclusions are that further inquiry is needed to understand these policy nuances to enable the Veterans Affairs Administration to improve its policies and performance in this important aspect of healthcare.     

Collective intelligence: Scale development and validation

In today’s growing competition, organizations face shrinking innovation cycles, swelling customer expectations, and distributed talent which impels organizations to apply knowledge, skills, and experience of employees most effectively. Applying collective intelligence, i.e., the combined knowledge and expertise of a diverse group, has become the order of the day. Therefore, collective intelligence level of an individual is of immense importance for high performance and achievement of the goals. In the present research, an attempt is made to operationalize the components of organizational collective intelligence from working professionals. Specifically, an attempt is made to develop a scale to measure collective intelligence among 600 working professionals. The results were subjected to the robust measurement tools such as Exploratory Factor Analysis and Structures Equation Modeling to confirm the factor structure. The instrument resulted in four factors and a 17-item scale. The instrument can be used by the policymakers and human resource managers for selecting, harnessing, and retaining appropriate talent in the organization.     

The Effects of Children, Dual Earner Status, Sex Role Traditionalism, and Marital Structure on Marital Happiness Over Time

In this study, the link between marital happiness and the advent of children is demonstrated, accounting for dual earner status, sex role traditionalism, and marital structure. A subset of 1,275 respondents from a longitudinal data set (Marital Instability Over the Life Course: A Three Wave Panel Study, 1980–1988) whom remained married through the 3 waves was used to compare the level of marital happiness of respondents who added children between waves to those who did not. Although the addition of children negatively affected marital structure and thus indirectly lowered marital happiness, results showed children also had positive counterbalancing direct effects. Dual-earner status, income, and sex role nontraditionalism were shown to mitigate the negative effects of children on marital happiness.     

Strategies for Appointment Policy Design with Patient Unpunctuality

Appointment policy design is complicated by patients who arrive earlier or later than their scheduled appointment time. This article considers the design of scheduling rules in the presence of patient unpunctuality and how they are impacted by various environmental factors. A simulation optimization framework is used to determine how to improve performance by adjusting the schedule of appointments. Prior studies (that did not include patient unpunctuality) have found that a scheduling policy with relatively consistent appointment interval lengths in the form of a dome or plateau dome rule to perform well in a variety of clinic environments. These rules still perform reasonably well here, but it is shown that a combination of variable‐length intervals and block scheduling are better at mitigating the effects of patient unpunctuality. In addition, performance improves if the use of this policy increases toward the end of the scheduling session. Survey and observational data collected at multiple outpatient clinics are used to add realism to the input parameters and develop practical guidelines for appointment policy decision making.