Managed care information needs: a summary perspective

The key to survival in managed care is management of financial risk. You need to know what is in your contract and what you are obligated to do for which population during which period. Information systems can be an enormous help in managing managed care contracts and the financial risks they entail, but poorly selected and configured information systems will do little good for the organization that licenses them. The most important activity of a physician executive who is moving his or her organization into managed care contracting is to lead the process to define the functional requirements for information the organization will need to manage managed care contracts successfully.     

Japanese male gay and bisexual identity

Few studies have ever dealt with Japanese male gay and bisexual identity. This exploratory study investigated gay and bisexual identity through interviews of 34 Japanese gay and bisexual men. Though Japan has unique cultural aspects that are different from Western countries, it can be shown that Western concepts or models of homosexual identity are applicable to a considerable extent to Japanese gay and bisexual men. The results of this study suggest that there are two distinct types of Japanese men sexually interested in men, which the author will call "bisexual" and "gay." These two types are compared in terms of three aspects: self-identity, sexual preference, and social identity and role. A significant number of respondents have careers or vocations in the arts. This study touches on the correlation between art and male-male sexual orientation in Japan.     

Uncertain identities and health-risking behaviour: the case of young people and smoking in late modernity

This paper argues that 'uncertain identities' are a distinct contributing factor to the residual and intractable level of smoking among young people. Further, it argues that the significance of this factor is increased by the specific social/historical context of late modernity. Findings from research with 15 to 16 year olds in the East Midlands of England are used to explore the role that smoking is perceived to play in constructing a self identity. A voluntaristic perspective is adopted on the use of tobacco, reflecting both the focus on young people's motivation to smoke and the tendency for many young people to perceive smoking as a matter of personal choice. Smoking was found to have a symbolic significance not only in terms of the presentation of self to others but also in terms of the reflexive construction of the self by those involved. The paper analyses the role of smoking in relation to self-image, self-empowerment and self-affirmation and it is concluded that for many young people smoking has certain benefits in terms of coping with uncertain identities.     

Framing nursing practice within a forensic outpatient service

The role of the outpatient forensic nurse is evolving as a specialized area of nursing practice in the community. Nurses must have comprehensive knowledge of the patients, keen intuition, and sound judgment in the continuous clinical assessment of the criminogenic factors that help determine the patients' level of risk. In addition, it is crucial to know and understand the court system, the process of the ORB, and the implications of the disposition order. The comprehensive, client-centered care provided by the Forensic Outpatient Service encompasses multifunctional and complex roles and responsibilities and clearly demonstrates the importance of the forensic outpatient nurse in working with this group of patients.     

Tools for evaluating research output. Are citation-based rankings of economics journals stable?

Journal rankings are important for evaluating research output, for academic promotions, and for allocating funds. Examining the assignment of economics journals to different quartiles of citation-based rankings, the authors found that about 60% of journals remain in the same quartile and about 95% of journals remain in the same or move in a neighborhood quartile within 5- to 10-year intervals. Top journal rankings exhibit even more inertia, which is a desirable property for decisions on promotion, tenure, or institutional evaluation. A reexamination of journal assignment to different quality categories every 5 or 10 years, therefore, suffices for practical evaluation purposes.     

Internal family systems therapy for children in family therapy

This article presents a developmentally supported implementation of Internal Family Systems Therapy for school-age children and their families. Relevant developmental characteristics of children are described. Suggestions for working with parents, child-oriented interventions, and a case example are presented.     

Attitudinal acceptance of intimate partner violence among U.S. adults

Attitudinal acceptance of intimate partner violence (IPV) is an important correlate of violent behavior. This study examined acceptance of IPV using data collected from a nationally representative telephone survey of 5,238 adults. Multivariable logistic regression analyses were used to test for associations between sociodemographic characteristics, exposure to violence, question order, and acceptance of hitting a spouse or boyfriend/girlfriend under specific circumstances. Depending on the circumstance examined, acceptance of IPV was significantly higher among participants who were male and younger than 35; were non-White; were divorced, separated, or had never married; had not completed high school; had a low household income; or were victims of violence within the past 12 months. Participants were more accepting of women hitting men; they also were consistently more likely to report tolerance of IPV if they were asked first about women hitting men rather than men hitting women. Reports of IPV tolerance need to be interpreted within the context of the survey. Efforts to change IPV attitudes can be tailored to specific IPV circumstances and subgroups, and these efforts should emphasize that the use of physical violence is unacceptable to both genders.     

Borderline personality disorder: Psychosocial considerations and rehabilitation implications

The article describes the medical and psychosocial aspects of borderline personality disorder, a common and sometimes severe psychiatric condition marked by emotional instability and problems with interpersonal relationships. Medication, psychosocial and other treatment issues are discussed within the context of the rehabilitation counselor's role in providing vocational services for people with borderline personality disorder.