The certainty of judgments in health evaluations

Most evaluators seem to presume that all evaluative studies should result in conclusive evidence. Often, however, less than conclusive evidence may not only suffice, but be the only real alternative under conditions of limited evaluation resources. Three levels of evidence common to evaluation studies are discussed: suggestive evidence, preponderant evidence, and conclusive evidence. Ten factors are also presented which can be used to determine the level of certainty appropriate for a given evaluation study. Consideration of these factors enables the evaluator to specify when less than conclusive evidence is acceptable.     

Public opinion and the privatization of welfare: some theoretical implications

The social policy of the Thatcher government is characterized by an abrupt shift in the direction of the private sector. To what extent does this reflect what people want? The Institute of Economic Affairs conclude from the only suitable national opinion survey that such a move is strongly supported. Our reanalysis of their data shows that this strand in public opinion can coexist with, and need not contradict, an equal public enthusiasm for state welfare. Such results have important implications for our understanding of social policy. We conclude, therefore, with a discussion of contrasting marxist and liberal accounts which seeks to show that the evidence of ambivalence in popular attitudes about the welfare state supports particular developments in theory.     

Internalized Other Interviewing in Relational Therapy: Three Discursive Approaches to Understanding its Use and Outcomes

For over 20 years, family therapist Karl Tomm has been engaging families and couples with a therapeutic intervention he calls Internalized Other Interviewing (IOI). The IOI (cf. Emmerson‐Whyte, 2010; Hurley, 2006) entails interviewing clients, from the personal experiences of partners and family members as an internalized other. The IOI is based on the idea that through dialogues over time, one can internalize a sense of one's conversational partner responsiveness in reliably anticipated ways. Anyone who has thought in a conversation with a family member or partner, “Oh there s/he goes again,” or anticipates next words before they leave the other's mouth, has a sense of what we are calling an internalized other. For Tomm, the internalized anticipations partners and family members may have offers entry points into new dialogues with therapeutic potential—particularly, when their actual dialogues get stuck in dispreferred patterns.     

Using Technology to Facilitate Collaboration in Community-Based Participatory Research (CBPR)

This study explores the use of Computer-Supported Collaborative Work (CSCW) technologies, by way of a computer-based system called iCohere. This system was used to facilitate collaboration conducting Community-Based Participatory Research (CBPR). Data was gathered from 13 members of a Community Collaborative Board (CCB). Analysis revealed that iCohere served the following functions: facilitating communication, providing a depository for information and resource sharing, and allowing for remote meeting attendance. Results indicated that while iCohere was useful in performing these functions, less expensive technologies had the potential to achieve similar goals if properly implemented. Implications for future research on CSCW systems and CBPR are discussed.     

Ambulance allocation for maximal survival with heterogeneous outcome measures

This paper proposes new models for locating emergency medical services (EMS) by incorporating survival functions for capturing multiple-classes of heterogeneous patients. The Maximal Expected Survival Location Model for Heterogeneous Patients (MESLMHP) aims to maximize the overall expected survival probability of multiple-classes of patients, whereby different classes could be defined according to agreed patient categories based on response time targets, or by capturing differing medical conditions each with a corresponding survival function. Furthermore, we propose and demonstrate an approximation approach to solving the extended stochastic version of MESLMHP, which utilizes queuing theory to permit the modeling of congestion and utilization at each ambulance station, and does not require assumptions to be made on the utilization of ambulances. Both models are demonstrated using data from the ambulance service in Wales. We show that our multiple outcome measures and survival-maximizing approach, rather than one based on average response time targets alone or a single patient class provides more effective EMS ambulance allocations.     

Bittersweet and Paradoxical

The American Red Cross is the most active nonprofit organization involved in disaster planning and response in the United States. The organization deployed nearly 50,000 volunteers to provide essential support to victims of some 125,000 domestic disasters, including home fires, hurricanes, wildfires, and floods, in a recent two‐year period. This study asks how American Red Cross disaster response volunteer experiences function to cultivate satisfaction and, at the other end of the spectrum, the kind of dissatisfaction that leads people to quit; it pays particular attention to ways in which volunteer management shapes dissatisfaction and fatigue because of implications for volunteer retention. Paradoxically, the Red Cross facilitates the highly satisfying act of helping victims, but volunteers feel dissatisfied when management practices get in the way of helping. The study suggests voluntary organizations that rely on skilled, long‐term volunteers to deliver services should evaluate and strengthen their communication strategies, recognition practices, and support systems for volunteers in distress.     

Incomes after Job‐loss in the United States: From Programme Rules to Panel Data

Welfare state studies are usually motivated by one or both of two concerns: programme effects on the incidence of poverty, and the possibility of perverse incentive effects. Most research has been comparative, using cross‐national indicators from the Organisation for Economic Co‐operation and Development and other international organizations. That research often contrasts the generosity of programmes in a number of European countries and the lack of it in the USA. Focusing on income transfers after job‐loss, in this article we critically examine the comparative evidence on US welfare state generosity and then use the Panel Study of Income Dynamics (PSID) to estimate what happens to job‐losers' incomes. The comparative analysis suggests conclusions more nuanced than found in much of the literature. The PSID analysis shows how the income effects of job‐loss vary across job‐losers and suggests that the role of unemployment compensation programmes in supporting incomes may be overstated.     

Coming Full Circle: Reoccurring Career Development Trends in Schools

Current state and national mandates focusing on academic achievement have drawn critical counseling resources away from career development. As the world of work radically changes and economic situations remain uncertain, the call for a return to school counseling roots based in career guidance has never been louder. The authors explore reoccurring career guidance trends throughout the history of school counseling to expand awareness of the basis of today's career and technical education discussions and increase understanding of the interconnectedness of career guidance and counseling and educational reform.