Gambling among lottery winners: Before and after the big score

The proliferation of state lotteries raises the possibility of increasing pathological gambling because large segments of the population are purchasing tickets. This study, based on a 50% response rate of million dollar winners in Ohio in 1986, indicates lottery winners spend relatively small amounts of money on tickets, did not appreciably increase the amount of money they spent on tickets after winning, and rarely engaged in other forms of gambling before or after they won. These data do not support the assumption that lotteries significantly increase the amount of compulsive gambling in our society, but the subject deserves further exploration.     

Effectiveness, accountability, and efficiency

Management of health care is compromised by its singular reliance on billing information--i.e., a claims trail tells little of what providers think. It relates to neither prevention of disease nor reduction of unnecessary health care costs. Billing information is not the substrate to be used in the pursuit of appropriateness, effectiveness, and value. To improve medical management of health care, a protected, but accessible clinical database is needed.     

Improving social psychiatric treatment in residential programmes for emerging dependence groups in Europe: cross-border networking, methodological innovations and substantive discoveries

A mini-symposium series of papers presenting the results of the European Commission-supported Biomed II project is introduced. The project accomplished a cross-border scientific networking engaging 31 European residential treatment programmes. The results showed that scientific development is best served by a flexible bureaucratic approach. 'Old' science and the 'new' science ways of working were balanced. 'History' and 'social networks' are the key concepts signalling the project knowledge gains. A treatment sample (N=723) was extracted from a database of 1028 current European cases. Non-drug-specific characteristics are as important as drug-specific characteristics in distinguishing emerging dependence groups. The project networking created a process that increased the level of involvement of science and the service communities. To sustain the gains of the project, a reaching out of existing European treatment services to extended family and friendship networks with a history of dependence-related problems will be required.     

Strategic Performance Measurement and Management in Nonprofit Organizations

The managers and constituents of nonprofits are increasingly concerned about measuring and managing organizational performance. Financial measures alone, or even supplemented with a collection of ad hoc nonfinancial measures, are not sufficient to motivate and evaluate mission accomplishments. This article describes the adaptation of a new performance measurement and management approach, the Balanced Scorecard, to the nonprofit sector. Several examples of actual implementation are provided.     

Perceptions of teen motherhood in Australian adolescent females: Life-line or lifederailment

PurposeThe findings presented in this paper describe the beliefs and attitudes of three different groups of adolescent females about teen motherhood. These were elicited from a larger analysis that explored and theorized contraceptive pathways in a sample of young Australian women.MethodsA purposive sample of females aged 14 to 19 years was recruited from three distinct populations in the city of Perth, Western Australia: (1) never-pregnant; (2) pregnant-terminated; and (3) pregnant-continued. Grounded theory principles were used to analyze data generated from 69 semi-structured interviews conducted over a 21 month period (2006–2008).ResultsTwo categories that described teenagers’ attitudes to pregnancy and motherhood were elicited from the analysis. These explained the level of priority that teenagers placed on using contraception and postponing the transition to parenthood. The category labeled ‘life derailment’ represented how those who had never had a pregnancy or had terminated a pregnancy constructed teen motherhood as potentially restricting their personal, career and social transition to adulthood. The alternative category, ‘life-line’, reflected how those who continued with their pregnancy perceived teen motherhood as a positive and transformative experience that fostered personal growth.ConclusionsThe findings from this study contribute further insight into the complex nature of adolescent contraceptive use and pregnancy risk. The analysis has strengthened evidence of the critical role of self-perceptions of pregnancy and childbearing on teenagers’ fertility outcomes. It has also emphasized the broader life circumstances that shape these attitudes, intentions and related behavior. Strategies directed toward academic support and vocational skill development may broaden teenage girls’ perceived future options and achievement capacity, thus influencing key reproductive health outcomes.