Met needs and unmet needs, and satisfaction among Social HMO members

This article reports on a survey of 800 members of four Social HMO demonstration sites, who were receiving home-based, community-based, and short-term institutional services under the demonstration's expanded community care benefits. The survey asked whether members needed help in 11 areas, whether they received help in each area from an informal caregiver, whether they wanted more help from the Social HMO, and whether help provided by both was adequate. Satisfaction with the program and with service coordination was also assessed. The adequacy of informal care differed by problem area, as did the help desired from the Social HMO and its responsiveness. Members were less satisfied when they had weaker informal care, were African American, and when they received inadequate help from the plan with ADLs, transportation, medical access, and managing money. Members were more satisfied when they were professionals, home owners, knew their service coordinator's name (or how to contact her), and received help with their problems. The findings point to the importance of clarifying divisions of labor with informal caregivers, as well as possible expansions in responsibilities for service coordinators and benefits beyond traditional boundaries.     

The critique of intelligent design: Epicurus,Marx, Darwin,and Freud and the materialist defense of science

A new version of the age-old controversy between religion and science has been launched by today’s intelligent design movement. Although ostensibly concerned simply with combating Darwinism, this new creationism seeks to drive a “wedge” into the materialist view of the world, originating with the ancient Greek philosopher Epicurus and manifested in modern times by Darwin, Marx, and Freud. Intelligent design proponents thus can be seen as challenging not only natural and physical science but social science as well. In this article, we attempt to explain the long history of this controversy, stretching over millennia, and to defend science (especially social science) against the criticisms of intelligent design proponents – by defending science’s materialist roots.

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Public Management at the Ballot Box: Performance Information and Electoral Support for Incumbent English Local Governments

Publishing performance information about local public services,an increasing trend in many Organisation for Economic Co-operationand Development countries, matters politically because it hasan effect on incumbent local governments' electoral support.Voters are able to use performance information to punish orreward incumbents in the elections that follow their publication,which may fill a gap in the chain of accountability betweenvoters and governments. We model the introduction of publishedComprehensive Performance Assessments of local authorities inEngland, which make summary information about performance availableto voters, as a "shock" to the relationship between voters andincumbents. Controlling for an unpublicized measure of performancechange over time, change in the local tax level, change in localeconomic conditions, and whether the local incumbent is theparty of the incumbent government at the national level, wefind negativity bias. Incumbents in local authorities in the"poor" performance category experience a substantial reductionin aggregate vote share at the election following publication,but there is no similarly sized reward for those in the highestperformance category.     

Camera-Related Behaviors during Video Recorded Medical Interactions

Video recording provides an objective record of the content of medical interactions. However, there is concern that cameras may be reactive measurement devices that alter what normally transpires during interactions. This study addressed potential reactivity of cameras in medical interactions. Interactions between 45 patients and 14 medical oncologists were video recorded and coded for camera-related behaviors. Eleven of 45 patients performed none of the behaviors. Among the other patients, camera-related behaviors were infrequent and, on average, constituted about 0.1% (one-tenth of one percent) of total interaction time. Behaviors occurred most often in very early stages of interactions, and when physicians were absent from the room. Seven physicians showed camera-related behaviors, comprising less than 0.1% of the time they were in the interaction. Results suggest video recording can provide nonreactive means of studying medical interactions.

Resolutions: Working with Families Where Responsibility for Abuse is Denied

Current thinking suggests that little productive work can be undertaken with families where serious physical or sexual abuse of children has occurred in the absence of a clear acceptance of responsibility for that abuse. This means that children are often removed from their families because of the perceived risks, with the disadvantages that being looked after in local authority care often brings. Alternatively, children may be left in the same environment where serious abuse has taken place with little or no work being undertaken with the family. Either approach fails children, especially those who have made clear and believable allegations in the hope of bringing about a process of change and protection. This article describes the work of a pilot project at the Avon NSPCC in Bristol working with families where the alleged abuser disputes responsibility for maltreating the child. Key to this approach is the support of the non-abusing carer and the child/ren while the concerns of the professional agencies are addressed. The work has two main phases. The first looks for structural change in the organization of family life. The second part asks carers to role-play a ‘similar’ hypothetical family where child abuse has been established. This enables difficult issues raised by the abuse to be addressed and provides an opportunity for carers to express thoughts and feelings to their partner regarding abuse without the seriousness of the concerns being lost.     

Unemployment Stigma and Multiple Labour Market Equilibria: A Social-Psychological Interpretation of Hysteresis

ABSTRACT: This paper supplements a simple one period non-shirking efficiency wage model with behavioural assumptions drawn from the social-psychological literature. A model of social interaction is developed in which the status associated with various labour market options yields implications for the shape of the non-shirking constraint and, thereby, for the number and type of labour market equilibria. The significance of such a finding for the existence of unemployment hysteresis is explored.     

Stochastic and Intransitive Behavior in a State-Preference Model of Asset Choice*

Most models of investor behavior assume a time-state independent utility function and result in a deterministic solution where a given set of inputs uniquely specifies the decision. In contrast, a state preference model using a time-state dependent utility function is derived in this paper. The model allows the investment choice decision to be analyzed in a game theoretic context. The general solution is a mixed strategy which allows for a probabilistic interpretation of the decision. The approach presented in this paper can accommodate anomalies such as intransitivity of preference and satisficing as rational behavior. An example of a possible implementation is given along with interpretations of the outcomes.     

An Evaluation of Capacity Sensitive Order Review and Release Procedures in Job Shops

We investigate the performance of capacity-sensitive order review and release (ORR) procedures in job shop environments that have not been previously explored. Previous research has ignored the case of job shops which must perform to very tight due-dates because of time-sensitive customers. We propose and test a new capacity sensitive ORR procedure called path based bottleneck (PBB) in such environments, along with the modified infinite loading (MIL) procedure which has been shown to work well in several studies. We compare the performance of these two controlled release rules with that of immediate release rule under different conditions of capacity utilization and customer specified exogenous duedates. Our results indicate that PBB performs well in lowering total costs when due-dates are tight, while MIL is a better procedure with relatively loose to medium due-dates. We also show that in many cases, the shortest processing time (SPT) dispatching rule is a superior performer than a due-date based rule like critical ratio (CR); a conclusion which is contrary to the existing research in this area. In addition, the shop floor control policies recommended are shown to be sensitive to the cost structure of the firm. The managerial implications of this research in providing effective shop floor control in job shops operating under tight due-date conditions are also discussed.     

Addiction science and the perception of freewill

Do people think individuals with Substance Use Disorder (SUD) have freewill? How does addiction science inform views on the issue? We distinguish between two senses of freewill: 1) libertarian freewill , in which freedom turns on a particular metaphysical conception of action (sometimes operationalized as “could have done otherwise”), and 2) compatibilist freewill , in which freedom depends on the relation between the actor's psychology and her actions (e.g., “was the act what she wanted to do?”). We argue that, in different ways, scientific accounts can impact conceived freewill by linking addictive behavior to mechanisms that observers view as peripheral to the actor ( motivation modularity) . While a variety of impacts on conceived compatibilist freewill are plausible, we argue that contemporary addiction science has no direct bearing on conceived libertarian freewill. Addiction science may, however, indirectly impact conceived libertarian freewill by priming an explanatory framework in which intention is superfluous (especially materialism).