Utilization management in Alberta's new funding environment

Although physicians have the greatest influence on the resource utilization of hospital patients, Canadian hospitals have not been too successful in bringing physicians into the resource planning and decision-making processes. This is because most hospitals have been unable to provide the information needed by physicians to participate in resource management in a meaningful way. With the introduction of a new system in the Canadian Province of Alberta that fundamentally changes the way hospitals are funded, it has become even more important to involve medical staffs in the utilization management process. This article describes the new funding system and highlights some of the ways in which Wetaskiwin Health Care Centre has leveraged information technology to support the utilization management process in this new environment.     

Mental Health Among Mexican-Origin Immigrant Families: The Roles of Cumulative Sociodemographic Risk and Immigrant-Related Stress

The current study examined the unique effects of cumulative sociodemographic risk and immigrant-related stress on mental health symptoms among Mexican-origin immigrant parents and their school-age children. Further, this study tested whether the effects of cumulative sociodemographic risk and immigrant-related stress on child mental health were mediated by parent mental health. Participants included 104 Mexican-origin immigrant families. Families in the study had a child between the ages of 6 and 10 (M_age = 8.39; 61% female). Data were collected across three time points spaced 6 months apart. Immigrant-related stress was found to predict parent mental health, which in turn predicted child mental health. Cumulative sociodemographic risk did not predict parent or child mental health. Mental health symptoms generally decreased over time, but for children, change in mental health symptoms depended on parent mental health symptoms. Given the high levels of mental health symptoms among Mexican-origin parents and children, reducing a context of stress and promoting mental health interventions for Mexican-origin immigrants is critical.     

Rank Xerox--management revolution

For 20 years Rank Xerox dominated the photocopier market until the Japanese entered the market in the late 1970s. Rank Xerox responded to the competitive challenge by instituting competitive benchmarking, and subsequently the Leadership Through Quality Strategy. The author describes the changes in the management philosophy and the organizational structure which enabled Rank Xerox to win back market share from the Japanese. Rank Xerox is now market led with sharp customer focus. It is strongly business led and has a team working culture to support it.     

Anniversary reactions: Trauma revisited

This article is intended to acquaint the reader with a phenomena known in the psychoanalytic literature as anniversary reactions. Conceptualized as ensuing from incomplete forms of mourning, these reactions may be evident in various forms including somatic symptoms and diseases, depression, psychosis, suicide, and homicide on the anniversary date of a significant past traumatic event. This article identifies various manifestations of anniversary reactions and familiarizes the reader with some of the elements thought to constitute them: trauma, incomplete mourning, identification and an unconscious sense of time. A clinical vignette is presented and discussed.     

Home-based workers: Worker and work characteristics

The purpose of the study reported here is to describe the worker and work characteristics of 899 home-based business owners and wage earners, using a definition that excludes farmers, hobbyists, and persons taking work home from a job located elsewhere. Contrary to predictions by futurists of an influx of white-collar workers from the office to home, the home-based workers in this research are more likely to be marketing and sales persons, contractors, or mechanical and transportation workers. Full- or part-time employment status, home tenure, seasonality of work, and occupation are significantly associated with ownership status. Findings show significant group differences on age, education, years in the community, household size, and net annual home-based income. Business owners, on average, are older, have less education, come from larger households, have lived in their communities more years, and have lower net annual home-based incomes than their wage earner counterparts.This article reports results from the Cooperative Regional Research Project, NE-167, entitled, At-Home Income Generation: Impact on Management, Productivity and Stability in Rural and Urban Families, partially supported by Cooperative States Research Service, U.S. Department of Agriculture and the Experiment Stations at the University of Hawaii, Iowa State University, Lincoln University (Missouri), Michigan State University, Cornell University (New York), The Ohio State University, The Pennsylvania State University, Utah State University, and University of Vermont. Appreciation is expressed to Ana Marie Vargas and Johnny M. H. On for their assistance with the computer analyses, and to Florence Abe, Laraine Hoffman, and Meesok Lee for their help in the final preparation of this article. The authors acknowledge the patience and helpful suggestions of two anonymous reviewers.Her current research interests include home-based employment, multiple farm income families, and computer-based education. She received her Ph.D. from Oregon State University.Her current research interests include home-based employment, economic adjustments of farm families, and the interrelationship of management to an individual's quality of life. She received her Ph.D. from Purdue University.Her primary areas of research are rural households, the impact of employment on a family, learning theories as applied to financial education, retirement, and home-based employment. She received her Ph.D. from The Pennsylvania State University.     

The United States should recognize and support caregiving youth

In the United States, more than 5.4 million children and adolescents under age 18 provide care for family members who are aging or have chronic illness, disability, or other health conditions that require assistance. In this policy report, we describe youth’s care for the family, and highlight the increasing prevalence, global challenges, and uneven successes of measurement and categorization. We briefly summarize research on how caregiving affects youth’s academic, social, and emotional well-being. Next, we present novel, emerging evidence from the public school-based 2019 Youth Risk Behavior Survey for the State of Florida, which suggests that as many as 24% of middle school students and 16% of high school students provide at least some care to the family on a regular basis. Drawing on this evidence, we discuss targeted social programs which have been shown to promote the well-being of caregiving youth outside of the United States, as well as a 13-year-old school-based intervention in The School District of Palm Beach County, Florida. We conclude with specific recommendations for a path toward recognizing and supporting caregiving youth via policy and practice in the United States. Our aim is to increase the awareness and feasibility of identifying and supporting caregiving youth and their families via government-organized data collection and targeted social policies.     

The Interactive Impacts of High School Gay-Straight Alliances (GSAs) on College Student Attitudes Toward LGBT Individuals: An Investigation of High School Characteristics

Although gay-straight alliances (GSAs) are becoming more popular in high schools across the U.S., empirical studies investigating GSAs and their impact are sparse. Utilizing a sample of college students drawn from a large Southern university (N = 805; 78% White; 61% female; average age 22), the current study investigates the ways that the presence of high school GSAs affect college student attitudes toward LGBT individuals and how these relationships may vary by high school GSA location (South vs. non-South), town type (rural/small town, suburban, large city), and high school student population size. Overall, results from the current study show that the presence of a GSA in high school is a robust positive predictor of supportive attitudes toward LGBT individuals, even when considering many control variables. Such results suggest that the presence of GSAs in high schools may have significant positive and potentially long-lasting effects on college students’ attitudes toward LGBT individuals.