Evaluating risk: global fees and episodic care

In 1999, two articles in The Physician Executive -- "Part I: Global Theory and the Nature of Risk (July-August)." and "Part II: Towards a Choice-Based Model of Managed Care (October-November)" -- outlined the flaws of orthodox managed care theory and highlighted the unique advantages of moving to a genuinely market-based model, which included the concept of direct contracting for integrated episodes of care. This follow-up focuses on comparing an episode contracting system to a traditional capitated program and outlines the features that make this approach much more attractive to physicians, payers, and most importantly patients.     

Stalking and other forms of intrusive contact after the dissolution of adolescent dating or romantic relationships

Social science research has recently begun to focus on stalking and other forms of intrusive contact occurring among adolescents and young adults. This article presents results from a survey of 681 undergraduates about their experiences with stalking or other forms of intrusive contact occurring after the end of a dating or romantic relationship. Twenty percent of the respondents had been the target of intrusive contact, 8% had initiated intrusive contact, and 1% had been the target of intrusive contact after one relationship and had initiated intrusive contact after another. More females than males were the target of intrusive contact; however, there were no sex differences associated with initiating intrusive contact. About 20% of the respondents had feared for their safety during the intrusive contact. Thirty-one percent of the respondents described the intrusive contact as having a decidedly negative influence on either their subsequent dating relationships or their lives in general.     

Drinking Game Participation Among Undergraduate Students Attending National Alcohol Screening Day

Abstract

Objectives, Participants, Methods: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007. Results: A large percentage of the sample reported lifetime (77%) and recent (52%) drinking game participation. Males were more likely to report recent participation and reported higher levels of consumption while playing drinking games. Drinking game participants were more likely to experience a range of alcohol-related problems, and the relationship between drinking game participation and alcohol-related problems was mediated by weekly alcohol consumption. Conclusions: These results suggest that drinking game participation is a risk factor for elevated levels of alcohol consumption and alcohol-related problems. Programs should be developed to educate students about the risks of drinking game participation, and prevention programs like NASD should address drinking games.     

Association of educational level and child sex ratio in rural and urban India

Utilizing data from the Census of India, this study compared child sex ratio in rural and urban regions of India and analyzed whether the child sex ratio was associated with mother’s education level. The child sex ratios in the rural and urban regions throughout India were analyzed using the two-sample and paired Student’s t-test. Further, the Chi-square test for trend in binomial proportions was used to assess the association between child sex ratios and mother’s education levels in rural and urban areas. Analysis of the data showed that there was a significant difference between the child sex ratios in rural areas versus urban areas. In addition, the Chi-square test for trend showed that there was a significant association of the child sex ratio and the educational levels of their mothers. This trend occurred in both rural and urban areas.     

Information sharing and reporting systems in the UK and Ireland: Professional barriers to reporting child maltreatment concerns

Across the UK recent policy developments have focused on improved information sharing and inter‐agency cooperation. Professional non‐reporting of child maltreatment concerns has been consistently highlighted as a problem in a range of countries and the research literature indicates that this can happen for a variety of reasons. Characteristics such as the type of abuse and the threshold of evidence available are key factors, as are concerns that reporting will damage the professional‐client relationship. Professional discipline can also impact on willingness to report, as can personal beliefs about abuse, attitudes towards child protection services and experiences of court processes. Research examining the role of organisational factors in information sharing and reporting emphasises the importance of training and there are some positive indications that training can increase professional awareness of reporting processes and requirements and help to increase knowledge of child abuse and its symptoms. Nonetheless, this is a complex issue and the need for training to go beyond simple awareness raising is recognised. In order to tackle non‐reporting in a meaningful way, childcare professionals need access to on‐going multidisciplinary training which is specifically tailored to address the range of different factors which impact on reporting attitudes and behaviours. Copyright © 2009 John Wiley & Sons, Ltd.     

THE PROCESS OF CHANGE IN COUPLES THERAPY: A QUALITATIVE INVESTIGATION

Open-ended interviews with 24 couples therapy clients regarding their experience of the process of change revealed shifts in clusters of affect, communication, and cognition. Six additional contextual preconditions for change were also identified. The change process within couples was uniformly reported to be gradual.     

License Mapping for ERM Systems: Existing Practices and Initiatives for Support

In the process of analyzing and/or mapping license agreements into their electronic resource management (ERM) systems or in developing services to support the license mapping process, library professionals were interviewed to provide a status report of license mapping in academic libraries. Areas discussed include existing practices, challenges, and support for and benefits of the mapping process. These conversations from the trenches should help professionals in the early stages of ERM implementation better conceptualize resource needs and effective practices for license mapping.