Emerging Patterns of Care Management: Arrangements for Older People in England

One of the key objectives of the community care legislation, implemented in the UK in 1993, was the development of care management systems. Subsequent studies based on limited samples of local authorities have indicated that there is much variation in the forms and types of arrangements being developed. This paper explores whether typologies of care management arrangements for older people can be discerned through the analysis of a series of key indicators. Data were drawn from a survey of all English local authorities, undertaken as part of the PSSRU study: Mapping and Evaluation of Care Management Arrangements for Older People and Those with Mental Health Problems. Care management arrangements were categorized using a limited number of key indicators chosen on an empirical and an a priori basis. This resulted in the formulation of six categories of care management arrangements for older people, within which approximately 80 per cent of local authorities could be included.     

The Effects of Information Overload on Software Project Risk Assessment*

Managers are responsible for providing effective information technology governance of the software development process. Ineffective governance leads to serious resource misallocations and negative consequences concerning Sarbanes‐Oxley compliance. In order for managers to make informed decisions about software development projects, they often need more information than is available through normal information channels, that is, they need an in‐depth review of the at‐risk project. Such in‐depth reviews, however, are costly. Hence, accurate identification of at‐risk projects for in‐depth review is critical to management's ability to govern. This research considers how two factors, information load and time pressure, affect the quality of the project‐selection process. We examine quality by observing the decision strategies involved and then relating these strategies to subsequent decision making. An experiment was conducted with experienced information systems auditors using a combination of policy‐capturing and computerized process‐tracing techniques. The participants in our study cope with information overload by accelerating their decision‐making process and adopting noncompensatory decision processes. Contrary to prior research, our process‐tracing analysis suggests that participants rarely filter information, thus implying that decision makers are unable to process all the information. Coping by resorting to noncompensatory strategies did not decrease decision quality unless combined with accelerated information processing. Participants also increase their weight on the software project risk factors that they repeatedly access and that they view for longer periods of time. The theoretical contributions and practical implications regarding what actions managers can take to reduce the negative impact of information overload are discussed.     

Productive Activities And Subjective Well-Being Among Older Adults: The Influence Of Number Of Activities And Time Commitment

This study examines relationships among three measures of subjective well-being (life satisfaction, happiness and depressive symptoms), and two global measures of productive activity (number of activities and time commitment). We argue that participation in multiple productive activities should increase subjective well-being because these behaviors increase social integration and provide meaningful social roles. Using the first two waves of the Americans’ Changing Lives survey, we estimate a series of OLS and ordered logistic regression models to examine this issue among a sample of respondents 60 years old and older. Our multivariate regression results show that as time committed to productive activities increases, life satisfaction increases. Both increasing numbers of productive activities and increasing time commitment predict higher levels of happiness. Also, we find only modest support for a relationship between productive activities and the number of and changes in depressive symptoms. Our results provide support for the idea that engaging in productive activities is beneficial to older persons’ well-being, implying confirmation of the role enhancement hypothesis and demonstrating the importance of social integration.This research was partially supported by a grant from the National Institute on Aging (R03 AG018910). We thank Jan Mutchler for helpful comments on an earlier version of this paper.     

The slowing metabolism of marriage: Figures from 1988 U.S. marital status life tables

Marital status life tables for the United States, 1988, show a continuing retreat from marriage. For both sexes, the proportion ever marrying declined and the average age at first marriage rose. The 1988 rates imply that 43% of marriages end in divorce. That represents a slight decline from the 1983 figure, and suggests that divorce has peaked at a level below that estimated in earlier analyses.     

Perceived Stigma and Depression among Black Adolescents in Outpatient Treatment

Despite the high prevalence of depression among children and adolescents, most that need mental health treatment do not seek care. This is especially true for ethnic minority adolescents. Prior research has shown that perceived stigma may act as a barrier to the initiation of and adherence to depression treatment, yet few studies have examined the relationship between stigma and depression among Black adolescents. This exploratory study examined the relationship between Black adolescents' depression severity and their current level of perceived stigma in an outpatient sample. Face-to-face interviews were conducted with a clinical sample of adolescents referred for mental health services at a community-based outpatient clinic (n =108), participating in a prospective pilot study on adolescents' patterns of mental health service use. The analyses revealed that greater depression severity was significantly associated with higher perceived stigma (p < .05), particularly among females. The results also suggest that Black adolescents appear to exhibit an appropriate level of self-assessment regarding their need for mental health services. These results are interpreted in relation to previous literature, and limitations and directions for future research are discussed.     

Victimization, Psychological Distress and Subsequent Offending Among Youth

The current study examined the relationship between the victimization of youth, psychological distress and subsequent offending. It examined whether direct and vicarious victimization by exposure to violence in the family, among peers, and in the neighborhood, significantly predicted psychological distress among study participants and whether psychological distress significantly predicted subsequent offending over time. In addition, it examined the extent (if any) to which psychological distress mediated the relationship between victimization and subsequent offending. Method: study data are from wave 1 and wave 2 of the Buffalo Longitudinal Study of Young Men (BLSYM), a population based sample (n = 625) of young men, ages 16-19 years old in a metropolitan area of Buffalo, New York. A path analytic approach was used for the main analyses. Findings: personal, vicarious victimization by exposure to violence among peers, and perception of neighborhood safety were significant predictors of offending at wave 1. Personal and property victimization was significant predictors of psychological distress. Psychological distress did not have a significant relationship with offending at wave 1 yet, it did at wave 2. Vicarious victimization by exposure to violence among peers and offending at wave 1 were all significant predictors of offending at wave 2. The results highlight the need to respond to both direct and vicarious victimization among young males to reduce psychological distress and subsequent offending.     

Neglect of older adults in Michigan nursing homes

Although research on domestic elder abuse and neglect has grown over the past 20 years, there is limited research on elder neglect in nursing homes. The purpose of this study is to estimate the incidence of elder neglect in nursing homes and identify the individual and contextual risks associated with elder neglect. Data came from a 2005 random digit dial survey of individuals in Michigan who had relatives in long term care. Our analytic sample included 414 family members who had a relative aged 65 or older in nursing homes. Results showed that about 21% of nursing home residents were neglected on one or more occasion in the last 12 months. Two nursing home residents' characteristics reported by family members appear to significantly increase the odds of neglect: functional impairments in activities of daily living and previous resident-to-resident victimization. Behavior problems also are associated with higher odds of neglect (p = 0.078). Policy implications of these results are discussed.     

Perceptions of intimate partner violence, age, and self-enhancement bias

Educational programs in human service professions such as social work, criminal justice, psychology, and public administration stress the importance of recognizing domestic/intimate partner violence as well as elder abuse. Students' abilities to recognize domestic violence in older couples have not been well-investigated. In this study, three vignettes were developed (Pat and Lee at age 75, Pat and Lee at age 30, Imagine yourself with Lee at age 75) in which intimate partner violence was perpetrated by the character Lee. Twenty-five items followed each vignette. When the variables of educational standing (graduate/undergraduate), ethnicity, and academic major were controlled, there were significant differences between the vignettes in 14 of 25 items (General Linear Model, F = 1.552, df = 50, p = .012). More than three out of four respondents for each vignette identified this as domestic violence and believed there was potential for serious harm. However, respondents were less likely to believe that a 75-year-old partner would know when to terminate a relationship in which there was intimate partner violence. Respondents who were asked to imagine themselves with Lee at 75 were likely to perceive Lee as more dangerous than respondents for the other vignettes. Implications are considered for educators.     

Envisioning emerging nanotechnologies: a three-year panel study of South Carolina citizens

This article reports results from a three-year panel study of a nonrandom sample of 76 South Carolina citizens, recruited from a variety of walks of life, and their impressions of emerging nanotechnology. This discussion focuses on material from depth interviews conducted alongside a baseline opinion and awareness inventory at the beginning of the study, the most intensive data-gathering phase. These results are placed in the context of data from three additional surveys conducted at about equal intervals over the three years, plus exit interviews from 21 of the 34 individuals who completed the entire study. The results give insight into popular thinking about technology but little indication of strong emerging concerns, a trajectory of amplification of those concerns, or opinion polarization over time, despite some awareness of risks and potential ethical dimensions. Nanotechnology may stand out more as an example of risk attenuation than of risk amplification, consistent with most results from national surveys.