Sequencing and Scheduling Appointments with Potential Call‐In Patients

This paper studies appointment scheduling for a combination of routine patients who book well in advance and last‐minute patients who call for an appointment later that same day. We determine when these same‐day patients should be scheduled throughout the day, and how the prospect of their arrivals affects the appointment times of the routine patients. By formulating the problem as a stochastic linear program, we are able to incorporate random and heterogeneous service times and no‐show rates, ancillary physician tasks, and appointment delay costs for same‐day patients who prefer to see the doctor as early as possible. We find that the optimal patient sequence is quite sensitive to the no‐show probabilities and the expected number of same‐day patients. We also develop two simple heuristic solutions to this combinatorial sequencing problem.     

Engaging with Comparative Risk Appraisals: Public Views on Policy Priorities for Environmental Risk Governance

Communicating the rationale for allocating resources to manage policy priorities and their risks is challenging. Here, we demonstrate that environmental risks have diverse attributes and locales in their effects that may drive disproportionate responses among citizens. When 2,065 survey participants deployed summary information and their own understanding to assess 12 policy‐level environmental risks singularly, their assessment differed from a prior expert assessment. However, participants provided rankings similar to those of experts when these same 12 risks were considered as a group, allowing comparison between the different risks. Following this, when individuals were shown the prior expert assessment of this portfolio, they expressed a moderate level of confidence with the combined expert analysis. These are important findings for the comprehension of policy risks that may be subject to augmentation by climate change, their representation alongside other threats within national risk assessments, and interpretations of agency for public risk management by citizens and others.     

A Reply to Gambino's "An Epidemiologic Note on Verification Bias: Implications for Estimation of Rates"

While two-stage designs in problem gambling research are expensive and relatively difficult to execute, they have the potential to yield more accurate prevalence estimates as well as valuable additional information about gambling and problem gambling in the community. However, gains in precision are heavily dependent on the accuracy of the screening methods used and the sample sizes involved. Sound practice requires reliable information about the variances and confidence levels associated with different screens. In the spirit of contributing to the ongoing dialog about ways to improve the measurement of problem gambling, we examine several reasons to question whether the revised estimates offered by Gambino are in fact an improvement.     

Editorial—On the role of the humanities in urban ecology: The case of St. Petersburg

Urban ecology is increasingly interdisciplinary, with biophysical and social scientists joining forces to study how human and built environments and processes interact with non-human nature. Humanistic disciplines that study high culture and intellectual currents also bear upon urban ecology, since cities are not simply aggregates of human and non-human factors but seats of civilization and loci of concentrated creative energy. The Russian city of St. Petersburg, which Dostoevsky called the most abstract and intentional city in the world, offers an example of the way individual acts of intellectual and artistic creation affect the energy balance of a city and its interaction with ecological forces. Such concentrated creative energy may be a key to making cities sustainable, and it should not remain outside the calculus of urban ecology.     

Problem-solving communication in foster families and birthfamilies

This study assessed child behavior problems and parent-child communication behaviors during problem solving in three groups of families with adolescent children: foster families, birthfamilies with a child at risk for behavior problems, and birthfamilies with a child not at risk. Levels of positive and negative communication behaviors in the foster families were similar to those in the lower-risk families and were significantly related to foster child behavior problems.     

Events and experiences impacting the development of clinical self confidence: a study of the first year of client contact

Research was conducted to identify the events and experiences influencing the development of clinical self-confidence during the first year of client contact for beginning marriage and family therapists. Thirty-nine recent graduates of a master's degree training program participated in a semistructured interview in which they were asked to describe the influences on their clinical self-confidence. Through qualitative analysis, four event and experience categories emerged as exerting the most influence on confidence at this stage of professional development: supervision, contact with clients, contact with peers, and personal life stress. The authors recommend providing strength-focused supervision, acknowledging the effects of client contact, encouraging peer contact, and attending to personal life stress.     

The Right to Take Risks: Alcohol and Older People

This paper examines policy and practice regarding the purchase of alcohol for older clients of home carers in three local authorities in the Greater London area. Data were gathered from interviews with home carers and their managers, focus group discussions, and a postal survey. None of the local authorities had a written policy or written guidance on alcohol purchase or on appropriate responses to the identification of problematic drinking in older clients. The findings illustrate the problem of balancing "rights" and "risks" within a philosophy of community care which emphasizes client choice and autonomy, and show how policy and practice are "tailored" by local contexts. It is suggested that both home carers and other domiciliary workers, as well as their older clients, could benefit from a clear code of practice regarding responses to alcohol consumption and problematic drinking by older people.     

Parenting as a Dynamic Process: A Test of the Resource Dilution Hypothesis

In this paper, we tested the resource dilution hypothesis, which posits that, because parenting resources are finite, the addition of a new sibling depletes parenting resources for other children in the household. We estimated growth curve models on the self‐reported parenting practices of mothers using four waves of data collected biennially between 1994 and 2000 on a nationally representative sample of 2,082 Canadian children aged 2 to 5 at initial interview and in continuously intact, two‐biological‐parent households. Results showed that when new children were added to the household, mothers exhibited declines in positive interaction, but increased their levels of consistent parenting. Taken together, these findings suggested that parenting resources were reallocated, rather than diluted, when family size increased.