Delivering decision making support to people with cognitive disability — What has been learned from pilot programs in Australia from 2010 to 2015

The UNCRPD has generated debate about supported decision making as a way to better enable people with cognitive disability to participate in decision making. In Australia, between 2010–2015, a series of projects have piloted various models of delivering decision making support. A critical review was conducted on the program documents and evaluations of these pilot projects. The pilots were small scale, conducted by both statutory and non‐statutory bodies, and adopted similar designs centred on supporting a decision maker/supporter dyad. Primarily, participants were people with mild intellectual disability. Themes included: positive outcomes; uncertain boundaries of decision support; difficulty securing supporters; positive value of program staff and support to supporters; limited experience and low expectations; and varying value of written resources. The lack of depth and rigour of evaluations mean firm conclusions cannot be reached about program logics, costs or outcomes of the pilots. The pilots demonstrate feasibility of providing support for decision making rather than resolving issues involved in delivering support. They suggest that some form of authority may facilitate the role of decision supporters, help to engage others in a person's life, and integrate decision making support across all life domains.     

An experimental investigation of violations of transitivity in choice under uncertainty

Several models of decision-making imply systematic violations of transitivity of preference. Our experiments explored whether people show patterns of intransitivity predicted by regret theory and majority rule. To distinguish “true” violations from those produced by “error,” a model was fit in which each choice can have a different error rate and each person can have a different pattern of true preferences that need not be transitive. Error rate for a choice is estimated from preference reversals between repeated presentations of that same choice. Our results showed that very few people repeated intransitive patterns. We can retain the hypothesis that transitivity best describes the data of the vast majority of participants.

Cumulative harm in the child protection system: The Australian context

Cumulative harm is a major child protection concern, with significant consequences for child well‐being and development often into adult life. This systematic literature review examines how the construct of cumulative harm is understood and operationalized within current Australian child protection legislation, policy, and practice and situates this within an international context. Scholarly articles and grey literature were qualitatively analysed to explore two main research questions: How is cumulative harm to children identified, assessed, and ultimately incorporated into child protection and legal structures? And what are the most effective responses to cumulative harm identified for child protection practice? What was found was that although the construct of cumulative harm is increasingly incorporated into child protection practice and legislation, in practice, this remains crisis‐driven. Although the literature emphasized prevention and early intervention as responses to reducing the cumulative impact of adverse childhood experiences, there is negligible research on what constitutes an effective response to cases involving cumulative harm. They are cases which are less visible within the child protection paradigm; attention to the impact of risk of maltreatment and its influence on long‐term developmental outcomes is less well addressed creating uncertainty and ambiguity about effective responses for child protection.     

The price of risk with incomplete knowledge on the utility function*

When a risk is exchanged, the exact value for the minimum price (positive or negative) that the purchaser (investor, or insurer) is willing to pay is given by the certainty equivalent wealth level, which in turn depends on his specific utility function. When this utility function is unknown, then only a sufficient condition on the price can ever be found. This paper provides methods for calculating such a sufficient condition, when only limited information on the utility function is known.     

The Role of Physical Context,Verbal Skills,Non‐parental Care,Social Support,and Type of Parental Discipline in the Development of ToM Capacity in Five‐Year‐Old Children

The aim of this study was to analyze the influence of family context on the performance of 5‐year‐old children (N = 70) in theory of mind (ToM) tasks. The children's performances were assessed during individual sessions held at school. Children's verbal skills were assessed using the Peabody picture vocabulary test (PPVT). Interviews were also conducted with parents in the family home in order to gather sociodemographic data and to assess diverse variables of the family context. In addition to confirming the important role played by children's verbal skills in ToM, the results also supported a potential influence of family context in ToM development through variables, such as quality of non‐parental care or level of social contact and support. The educational implications of these results are discussed in relation to family intervention.     

Substance use and decision‐making in adolescent best friendship dyads: The role of popularity

In adolescent best friendship dyads, we examined: (a) similarity in substance use and decision‐making; (b) associations between participants' decision‐making and their own and best friend's substance use, (c) the influence of relative popularity within the dyad on these associations. Participants (n = 172; 12–18 years) named their best friend, completed popularity ratings, and a substance use questionnaire. Computer tasks were administered to assess risk‐taking and immediate reward preferences. Reciprocated same‐sex best friendship dyads (n = 49) were distinguished on their popularity, and we controlled for age differences between dyads in the analyses. Best friends were similar in substance use and risk‐taking preferences. More popular friends' risk‐taking preferences were positively associated with alcohol use of less popular friends. These findings underscore best friendship similarity in risky behaviors, and the influence of popular friends.     

The impact of parental incarceration on children's care: identifying good practice principles from the perspective of imprisoned primary carer parents

Parental incarceration has wide‐ranging impacts on families. One key effect may be disruption to the care and legal custody of children, yet few studies have examined processes and outcomes relating to care planning for children of prisoners. This paper presents findings of interviews with 151 primary carer prisoners in two Australian states which aimed to address this research gap. The study examined care planning for children upon parental arrest, sentencing and imprisonment, stability of care arrangements and primary carer prisoners' involvement and satisfaction with care planning. Around one third of prisoners had discussions regarding children's care arrangements at arrest and imprisonment, although the issue was more commonly raised at sentencing. While there was much variation in the stability of care arrangements, children placed in out‐of‐home care experienced the most instability. A minority of prisoners reported being involved in care planning and decision‐making for children upon imprisonment, and around one third rated care planning process poorly. Prisoners were more satisfied with care planning when there were fewer movements of children, where prisoners felt involved with decision‐making, and when police officers, lawyers and corrections staff inquired about the welfare of their children. Implications for policy and future research are discussed.     

The documented layer of children's rights in care order decision‐making

The recognition of children as rights holders is a true challenge for any policy and practice that involves children, but it is even more so for making decisions about taking children into care. This article departs from the view that when children are perceived as bearers of rights, this should also be reflected in the institutional documents of decision‐making. That is why the documented layer of decisions about taking a child into care is examined here. The empirical data consist of documents of hearings (prehearing and hearing reports) in which children (33) are asked to give their view about a proposed care order and placement in Finland. The documented layers of involving children as rights holders are divided into two types: a minimalist type and a more individualised, thorough and detailed type. The former type represents children as rights holders in a routinised manner, whereas the latter one treats them in a particularised manner: how this particular child in this particular hearing received and gave information and on what grounds her/his view rested. As the documents may have some controversial implications, the recording of children as rights holders should not be treated as an isolated and technical issue.     

The effect of teaching strategies on student achievement: An analysis using TALIS-PISA-link

The present study investigates the effects of different teaching strategies on student achievement using data from the so-called TALIS-PISA link created by the OECD. This is a recently developed instrument that allows for connecting data about teacher characteristics and practices collected in the TALIS (Teaching and Learning International Survey) survey with students’ academic performance measured in PISA (Programme for International Student Assessment). Our empirical strategy is based on an instrumental variable (IV) approach. Our results suggest that traditional teaching methods have a positive influence on students’ proficiency in mathematics, while the implementation of more innovative active learning strategies seem to have a negative impact on student achievement.     

Risk Management Paradigms in Health and Social Services for Professional Decision Making on the Long-Term Care of Older People

Risk management systems and structures are developing rapidlywithin UK health and personal social services. However, therisk management strategies of organizations need to take intoaccount the conceptual frameworks used by professionals. Thisgrounded theory study used data from nineteen focus groups andnine semi-structured interviews (ninety-nine staff in total)to explore perspectives on risk and decision-making regardingthe long-term care of older people. Focus group participantsand interviewees comprised social workers, care managers, consultantgeriatricians, general medical practitioners, community nurses,occupational therapists, home care managers and hospital dischargesupport staff. Social work and health care professionals conceptualizedrisk and its management according to six paradigms that appearedto be in a state of reciprocal tension: (i) Identifying andMeeting Needs; (ii) Minimizing Situational Hazards; (iii) Protectingthis Individual and Others; (iv) Balancing Benefits and Harms;(v) Accounting for Resources and Priorities; and (vi) Warinessof Lurking Conflicts. The effective translation into practiceof risk management strategies needs to address the complex andoften contradictory issues facing health and social servicesprofessionals.     

Adoption and permanence planning in Scotland: Impact of the Adoption and Children (Scotland) Act 2007 on key processes and timescales

Adoption and permanence planning has been a key feature of Scotland's policy in relation to children and young people who are “looked after.” Although policy and law has significantly developed in recent years, there has been comparatively little research on permanence processes in Scotland. This paper outlines key findings from the first comprehensive study of permanence planning in Scotland. It examines the process for two cohorts of children where adoption or other types of permanence orders were made. The children were selected under the long standing Adoption (Scotland) Act 1978 and the more recent Adoption and Children (Scotland) Act 2007. In total, 300 cases were examined, analysing data from the children's first contact with services through to the order made by the Scottish Courts. This paper pays particular attention to the timescales found at key stages under the two sets of legislation and asks what difference the change in legislation has made.     

The Cycle of Bias in Health Research: A Framework and Toolbox for Critical Appraisal Training

Recognizing bias in health research is crucial for evidence-based decision making. We worked with eight community groups to develop materials for nine modular, individualized critical appraisal workshops we conducted with 102 consumers (four workshops), 43 healthcare providers (three workshops), and 33 journalists (two workshops) in California. We presented workshops using a “cycle of bias” framework, and developed a toolbox of presentations, problem-based small group sessions, and skill-building materials to improve participants' ability to evaluate research for financial and other conflicts of interest, bias, validity, and applicability. Participant feedback indicated that the adaptability of the toolbox and our focus on bias were critical elements in the success of our workshops.     

The Influence of Classroom Ethnic Composition on Same- and Other-ethnicity Peer Nominations in Middle School

The study of peer group status typically involves examination of peer nominations received. In this study, the focus was on nominations given and received. We examined the degree to which middle school students from different ethnic groups demonstrate same‐ethnicity preferences in their peer nominations, the effects of the classroom ethnic composition on these preferences, and the association between same‐ethnicity preferences and social standing. Latina/o, Asian, and White students demonstrated a positive same‐ethnicity bias (i.e., greater acceptance and less rejection of same‐ethnicity peers) whereas African‐American students demonstrated a global same‐ethnicity bias (i.e., they were more likely to nominate African‐American students in general). All students made more nominations to same‐ethnicity peers when there were larger numbers of same‐ethnicity peers in the classroom. Students who made more acceptance nominations to same‐ethnicity peers were more accepted among same‐ethnicity peers and less accepted among other‐ethnicity peers. The significance of the ethnic context to understanding students' peer status and the benefits and costs of same‐ethnicity biases are discussed.     

The effects of social and political openness on the welfare state in 18 OECD countries

Studies examining the relationship between globalisation and the welfare state tend to focus on the effects of economic dimensions of globalisation, the extent to which a country is part of the world market. Globalisation also has social and political dimensions and the effects of these on welfare states – in terms of social security transfers and generosity – are studied in this article. Data from the KOF Index of Globalisation , the OECD Historical Statistics and the Comparative Welfare Entitlements Dataset are used to analyse the effects of social and political openness on the welfare states of 18 countries of the Organisation for Economic Cooperation and Development between 1970 and 2000. The analyses show that social security transfers and generosity have increased less in countries with the highest increase in social openness and that the welfare state is not affected by political openness.     

The Effects of Neighborhood Variables on Needs of Social Care: A Hierarchical Multiple Regression of Senior Residents in China

Community-based elder care has become a dominant model in the world. However, the role of community-level factors in helping or hindering the individuals concerned in obtaining the needed care has not received much attention. This research aims to investigate how community-level factors, including neighborhood disadvantage, residential instability, and social service environment affect the need for instrumental, medical, and emotional services of Chinese senior residents. Employing the hierarchical multiple regression analysis, the results show that instrumental activities of daily living impairment contributed significantly to the need for instrumental, medical and emotional services. Living alone was found to be associated with the need for medical and emotional services. Objective socioeconomic status was only significantly related to the need for medical care. The type of urban community was positively associated with the need for instrumental services and was negatively related to the need for medical care. Residential instability was positively associated with of the need for instrumental services and medical care. Social service environments had heterogeneous effects on the need for social services. However, neighborhood disadvantage had no significant impact on the need for social services. Implications for future research and policy reform were also discussed.     

The Effect of Socioeconomic Status and Family Structure on Parental Warmth and Parental Control in a Chinese Context: Implications for Social Work Practice

We report the results of a telephone survey conducted in 2008 in Hong Kong, which aimed to identify Chinese parents' parental warmth and parental control (guan) and to explore their relationship with the sociodemographic characteristics of the parents. The respondents perceived themselves to be warm (mean = 3.44) and educating their child (mean = 3.46). The results of multiple regression analysis showed that the five sociodemographic characteristics explained 15.8% and 8.2% of the variance in parental warmth and guan respectively. The mothers were warmer than the fathers; parents with higher monthly household income, higher educational attainment and with their smallest child young in age were warmer than parents of lower household income, lower educational attainment and with their smallest child older in age. However, parental guan did not vary among the five sociodemographic characteristics except educational attainment. Implications of the study for social work practice are discussed.     

The effect of incentive regulation on productive efficiency in telecommunications

Incentive regulation is now an important regulatory tool in the telecommunications industry in the United States. The issue explored here is whether incentive regulation has resulted in an increase in productive efficiency. After providing an overview of the nature of incentive regulation, one methodology for measuring the effects of incentive regulation on productive efficiency is reviewed. This methodology is data envelopment analysis (DEA) and allows for the measurement of both scale efficiency and technical efficiency of individual local exchange carriers (LECs). The results indicate that most LECs were technically efficient over the 1988–1998 period. Four LECs, however, consistently demonstrate scale inefficiency. In the aggregate, however, based on the DEA results there was no identifiable improvement in aggregate LECs' technical efficiency between 1988 and 1998. Subsequently, an alternative methodology, a stochastic frontier production function approach, is considered. The results from this methodology confirm that there was no change in technical efficiency over the period of study, something that incentive regulation was specifically designed to enhance.