Child welfare privatization: quantitative indicators and policy issues

The purpose of this study was to demonstrate the development of safety, permanency, and child well-being indicators by using administrative data sets as well as by using these indicators as tools for evaluating Florida's Community-Based Care (CBC) initiative. Longitudinal data from 37 counties including 4 counties that implemented community-based care were examined in this study. The results of the study indicated that the overall performance of CBC counties is at least as good as the performance of their comparison run by the state counties. The findings that emerged from this study may provide important lessons for developing a performance measurement system in the child welfare field.     

Staff & client perceptions of unit quality: a pilot study

This pilot study compared psychiatric health care team members' perceptions of unit quality with discharged clients' perceptions of quality of care received on the unit. The staff members were from four different service units in one acute care psychiatric facility. The study used the Perceptions of Unit Quality (PUQ) scale, a valid and reliable outcome measurement instrument, developed by Cronenwett. Most quality assurance instruments that exist have focused on individual caregivers' or service-specific views of quality, but the PUQ scale allows quality assurance data that represent team performance to be described through team perceptions of quality. Results of this pilot study suggest that use of the PUQ scale, in conjunction with clients' perceptions of unit quality, may be a legitimate approach in continuous quality improvement efforts in psychiatric-mental health care centers.     

Couple age discrepancy and risk of intimate partner homicide

Although national level studies in the United States and Canada find that extreme partner age discrepancy is a risk factor for intimate partner homicide in opposite-sex couples, these studies carry two caveats: They are limited to cohabiting marital or common-law couples and they are not detailed enough to explore alternative explanations for the age discrepancy-homicide risk association. Using the Chicago Homicide Dataset, which includes all homicides that occurred in Chicago from 1965 to 1996, we analyze the 2,577 homicides in which the victim was killed by a current or former legal spouse, common-law spouse, or heterosexual boyfriend or girlfriend, and in which the woman was at least 18 years of age. Within each of 14 categories of couple age discrepancy, we estimate the population of intimate heterosexual couples and calculate the population-based risk of homicide. The results replicate national level findings showing that the risk of intimate partner homicide is considerably elevated for couples with a large discrepancy between their ages-where the man is at least 16 years older than the woman or the woman is at least 10 years older than the man. This risk pattern occurs regardless of whether the man or the woman was the homicide offender. We then investigate whether the link between partner age discrepancy and homicide risk is explained by the offender's arrest record. Results show that the higher risk of intimate partner homicide for age discrepant couples is robust, and does not depend on the previous arrest record of the offender. Discussion addresses other possible explanations for the increased risk of partner homicide for age discrepant couples, and the practical implications of these findings.     

The importance of employer sponsorship in the long-term care insurance market

Medicare and Medicaid are major sources of long-term care payments and thus will bear much of the burden from the growth in long-term care service use. The large future demand for long-term care services is of great concern among policymakers due to its expense and the use of public program dollars. It is argued that the individual purchase of long-term care insurance can help alleviate the increasing financial pressure on public programs responsible for the majority of longterm care financing. However, consumers have shown little interest in insuring against the high costs of long-term care. This analysis examines the effect of several factors on the decision to purchase a long-term care insurance policy: knowledge and attitudes of long-term care insurance and the long-term care financing system, the perceived risk for longterm care, financial planning behavior, and the availability of long-term care insurance. The interim results indicate the factor most likely to affect the decision to purchase long-term care insurance is access to employer-sponsored long-term care insurance. This suggests tht the availability of affordable and high quality coverage is more important than demand-side factors such as awareness of long-term care insurance and a perceived greater risk for long-term care.     

An online learning course in Ergonomics

For the past two years, the Department of Occupational Therapy at the University of Haifa has offered an online course to third year occupational therapists on the topic of Ergonomics for Health Care Professionals. The development and implementation of this course was funded by the Israeli Ministry of Education. Unique teaching materials, developed and uploaded to the University's server via "High Learn", included interactive and self-directed documents containing graphics, animations, and video clips. Extensive use was made of the discussion forum and survey tools, and students submitted all assignments online. For the final topic, an expert in ergonomics from Boston University delivered a lecture via two-way videoconferencing. The course site included comprehensive library listings in which all bibliographic materials were made available online. Students accessed course materials at the University in a computer classroom and at home via modem. In an accompanying research study, the frequency of student usage of the various online tools was tracked and extensive data were collected via questionnaires documenting students' demographic background, preferred learning style, prior usage of technology, satisfaction with the course and academic achievement. This paper focuses on the results of the research study that examined how the students responded to and coped with teaching material presented and accessed in this format.     

A comparison of disability management practices in Australian and Canadian workplaces

The health, well-being and productivity of workers and employers in today's society is becoming increasingly important. The social, emotional and economic costs of injury and illness are such that governments throughout the world are attempting to implement policies and practices to contain these costs. One response in this area is Disability Management (DM). DM focuses on the management of employees with work injuries or illnesses in the workplace rather than offsite in rehabilitation centres. Regional interest in the DM approach has now gained momentum in North America, Europe and the Asia-Pacific. This article briefly reviews two studies that were conducted in Australia and Canada (results have or are being published elsewhere). Although the two studies were not designed for comparison purposes they provide interesting and useful information about the similarities and differences in the practice of DM in Australia and Canada. Findings are compared in terms of five primary principles of DM and it is argued that it is important to understand the ecological contexts in which DM occurs as well as share trans-national research in this area to help inform policy and practice.     

Blurring the lines for learning: the role of out-of-school programs as complements to formal learning

As debates continue over the effectiveness of after-school programs, we need to create stronger links between schools and out-of-school activities. Where do such connections begin? How can we integrate skill-building and academic competence into the out-of-school-time context?     

Sexual health education group for adolescents with mental problems

1. Providing sexual health education for adolescents with mental health problems presents a difficult but important clinical task. 2. Using a group format for this task is an effective way to provide information about sexual health and promote positive coping strategies related to relationships and sexual issues. 3. Group leaders need to be aware of their own values related to sexual issues and have the ability to be frank and nonjudgmental.     

Social security reform ideas in Japan

Japan has a complex social security system. This article discusses the demographic and economic situation in Japan as background for understanding the setting in which the social security system functions. Japan has a three-pillar system for retirement income. The first pillar is the social security pension plan; the second pillar is the voluntary occupational pension plan; and the third pillar is personal savings, including the personal pension plan. The most important part of the retirement income system is the social security pension plan, which paid benefits accounting for 64% of the total income of elderly households in 1998. The five Employees' Pension Plans are established on a compulsory social insurance basis. Most large Japanese employers have a mandatory retirement age. Over 90% of all employees, including public sector ones, must retire from their career jobs at age 60.     

Evaluating consumer satisfaction in residential continuing care settings

The outcome of the project reported on here is a client-centered consumer satisfaction questionnaire designed to evaluate new models of residential continuing care in Alberta, Canada. Satisfaction is defined as a multi-dimensional construct that is grounded in the consumer's experience. Consultation with the clients of the services during development of the instrument ensured that characteristics important to the clients were assessed. The result is an instrument with which to measure satisfaction that is fully client-centered and that, with appropriate modifications, can be used to monitor any client-centered program for cognitively-able continuing care clients.