The role of self-advocacy in work for people with learning difficulties

This paper explores the relationship between self-advocacy and work for people with learning difficulties [1]. Explorations are based mainly on a participant observation study in which members of a self-advocacy group for people with learning difficulties included the researcher in their regular meetings. Discussions about work, most broadly defined as meaningful activity which makes a contribution to society, emerged as a critical preoccupation. We examine the importance of self-advocacy as a vehicle for people with learning difficulties who want to remove or circumvent barriers which surround their employment. Our research shows that understanding the role of self-advocacy in relation to work creates many development opportunities for both disabled employees and their prospective, or actual, employers. It is suggested that self-advocates can themselves achieve change in employers' attitudes by challenging oppressive images of people with learning difficulties in the workplace. It is hoped the paper will advance recognition of the importance of self-advocacy for maximising the participation of people with learning difficulties in work, and for acceptance of their status as workers.     

Population health performance as primary healthcare governance in Australia: professionals and the politics of performance

ABSTRACT

A range of institutional and financial instruments has been used to drive population health outcomes in primary health care in Australia. However, GP sovereignty and the corporatized nature of general practice have generated major challenges. The core of government reform strategy since 1992 has been the creation and financing of Primary HealthCare Organizations (PHCOs), in various forms, to provide an organizational basis to connect GPs to population health performance, and a closer link between the state and GPs. The shift from Divisions of General Practice, the first PHCO, to Medicare Locals (MLs) in 2011 was notable. The latter constructed the object of performance as a raft of broader population health goals, which were framed in terms of accountability to communities through public reporting. Drawing on interviews with Federal government, health professional associations, ML executives and GPs, this paper examines the ways in which such performance instruments were imagined and understood, and areas of contestation. The findings show the different rationalities at play and how different actors seek control of the policy space. They also demonstrate the political precariousness of PHCOs, and the wider difficulty of steering market-based professionals in the achievement of population health objectives.     

Practitioners' Documentation of Assessment and Care Planning in Social Care: The Opportunities for Organizational Learning

This paper analyses practitioners’ documentation of socialcare assessments and care plans for disabled adults of workingage. The data were collected in the course of an innovativeproject that introduced new outcome-focused documentation intoroutine social care assessment, care management and review processes.The project aimed to encourage practitioners to focus duringthese processes on the full range of outcomes that individualdisabled adults might seek to achieve; and identify the appropriateservices for realizing those outcomes. Analysis of the new documentationprovides insights into the diverse range of priorities and outcomesthat service users aspire to achieve as a result of receivingservices, and the service inputs that were agreed between practitionersand service users. However, despite the new documentation, themajority of both outcomes and services that were recorded tendedto cluster around a fairly narrow range of conventional socialcare service functions. Moreover, the emphasis of both outcomesand service inputs differed between different groups of socialcare professionals. In the context of current policies to makesocial care services more individualized and outcome-focused,each of these findings has major organizational implications.The opportunities for using routine practitioner documentationto identify areas of organizational and professional changeand learning are discussed.     

The Joint Action of Parents and Adolescents in Conversation About Career

Analyses of 14 videotaped parent—adolescent career conversations reveal the socially constructed nature of career. These analyses are used to identify joint actions in career conversations, determine their patterns, and address their meaning for the participants. Joint action refers to the action that people take together or that occurs between them. The participants used 3 superordinate joint actions (struggle, exploration, and negotiation) and several subordinate joint actions. Three patterns of joint actions were also identified. The joint actions had particular meaning for both career and the relationship between the participants.     

Failures of the reduction principle in an Ellsberg-type problem

Segal (1987) suggested that the Ellsberg paradox might be explained in terms of individuals mentally representing the decision problem as a two-stage lottery which they evaluated according to a non-expected utility model. This paper describes an experiment involving an explicitly two-stage analogue to an Ellsberg-type problem. This design substantially reduces the frequency of classic Ellsberg behaviour, but reveals other systematic violations of conventional theory. The paper discusses the particular patterns of choice and raises the more general problem of modelling individual decisions when the reduction principle does not hold.     

Paying nonprofits: Streamlining the new york state system

Many state and local governments now rely on contracts with nonprofit organizations to deliver a broad range of public services. Nonprofits benefit from these contracts but can also experience costly delays in obtaining payment for services delivered. The article describes two laws adopted by New York State to curb these delays. One law deals with slow payment of vouchers. The other addresses the costly problem of delayed delivery of contracts for activities such as child care or services to the disabled where nonprofits cannot stop delivering services without harm to the recipients.     

Do Trade Union Leaders Violate Subjective Expected Utility? Some Insights From Experimental Data

This paper presents the results of two experiments designed to test violations of Subjective Expected Utility Theory (SEUT) within a sample of Italian trade union delegates and leaders. Subjects priced risky and ambiguous prospects in the domain of gains. Risky prospects were based on games of chance, while ambiguous prospects were built on the standard Ellsberg paradox and on event lotteries whose outcomes were based either on the results of a fictional election or on the future results of the 1999 European Parliamentary election in Italy and the U.K. The experiments show that, although risky prospects were priced at their expected values on average, trade union delegates and leaders did violate SEUT when assessing ambiguous prospects. Moreover, their behaviour depended on the source of uncertainty (Ellsberg paradox vs. electoral results; fictional vs. real election; Italy vs. U.K. election outcomes). We discuss the implications of these results for the economic theory of the trade union.