Validating quality indicators. Quality as relationship between structure, process, and outcome

Theory and research have not kept pace with the growing interest in evaluating quality of mental health care, resulting in the use of unvalidated quality indicators. A framework for validating quality indicators is offered by which quality is viewed as the relationship between service structures, processes, and outcomes. Adoption of this framework will facilitate the measurement of quality using valid indicators and should be useful to agencies in their continuous quality improvement efforts. Valid information about the quality of mental health care services will help purchasers and consumers make more informed health care decisions.     

Long-term impact of Drug Abuse Resistance Education (D.A.R.E.). Results of a 6-year follow-up

The long-term effectiveness of Drug Abuse Resistance Education (D.A.R.E.) was assessed by contrasting drug use and other D.A.R.E.-related attitudinal latent variables among 356 twelfth-grade students who had received the program in the 6th grade with 264 others who did not receive it. A prior study of these subjects when they were in 9th grade had shown no significant differences. A follow-up survey in 12th grade assessed central D.A.R.E. concepts such as self-esteem, police bonds, delay of experimentation with drugs, and various forms of drug use. Although the authors found no relationship between prior D.A.R.E. participation and later alcohol use, cigarette smoking, or marijuana use in 12th grade, there was a significant relationship between earlier D.A.R.E. participation and less use of illegal, more deviant drugs (e.g., inhalants, cocaine, LSD) in a development sample but not in a validation sample. Findings from the two studies suggest a possible sleeper effect for D.A.R.E. in reference to the use of harder drugs, especially among teenage males.     

Scenarios,uncertainty and conditional forecasts of the world population

This study is concerned with the methods available for the forecasting of future trends in the world's population. Particular attention is given to the problem of the uncertainties that these forecasts include. "The purpose of this paper is to show how subjective and data-based probabilistic assessments of error can be combined, to give a user a realistic assessment of the uncertainty of demographic forecasts, and to apply these concepts to forecasts of the world population. Moreover, we shall show how conditional forecasts can provide a simple conceptual framework in which to view scenarios. They can be particularly useful in the evaluation of proposed policies. Indeed, the so-called environmental impact assessments...that are now mandatory in many countries for major construction projects typically contain elements of conditional forecasting." The concepts discussed are illustrated by comparing a scenario of future global population growth prepared at the Institute of Applied Systems Analysis with a UN population projection.     

The role of demographic and economic characteristics of twelve member states of the European Union in the diversity of state support for families

"This study is based upon an international dataset comparing state support for families in fifteen countries (of which twelve are member states of the European Union).... Using multiple regression analysis, the levels of state support are explained by the principal parameters used for setting the levels of benefit, and by the demographic and economic characteristics of the countries concerned....[Results suggest] that the economic convergence of the member states is likely to promote greater similarity in their systems of state welfare support for families." (EXCERPT)     

Will a large-scale migration of Russians to the Russian Republic take place over the current decade?

The author discusses "the likely scale of in-migration from the other former union republics into the Russian Republic over the remainder of this decade....I believe that during the 1990s there will be continued mass in-migration into Russia from the seven former union republics of Central Asia and the Transcaucasus....I also foresee that Russians will continue to leave such inhospitable milieux as southern Kazakhstan and western Ukraine."     

Ireland: an "emigrant nursery" in the world economy

"This paper focuses on historical and contemporary aspects of Irish emigration and argues that a world-systems, comparative approach avoids the pitfalls of behaviouralism and national exceptionalism in conventional accounts of Irish emigration. It suggests that causes and consequences vary with social class, ethnic group and regional context, compares 'traditional' with 'new wave' emigration and argues that it is premature to talk of the 'Europeanisation' of Irish emigration." (SUMMARY IN FRE AND SPA)     

Subsidized elderly housing: public-private partnerships on the brink

Starting in the early 1960s, the federal government joined with the private-sector housing developers in a partnership: in return for subsidized mortgages and tax benefits, developers would rent to low- and moderate-income tenants. Today, many elderly people live in these "publicly subsidized" units. The initial agreement, however, held out an escape clause: after 15 to 20 years, for-profit developers that wanted to end the partnership could prepay their mortgages, leaving tenants in those buildings "at risk" of rent increases and/or evictions. This article discusses that partnership, its options for dissolution, and the current solutions to the problem of the expiring agreements, including a moratorium, vouchers, and incentives. The compromise legislation responds to all interested parties--owners, current and would-be tenants, local governments, tax-payers--through a multi-stage sequence of dissolution, yet such a finely tuned, acutely sensitive legislative solution may not work easily or efficiently.     

The double-edged sword of social service contracting: public accountability versus nonprofit autonomy

The increased role of government contracts in the funding of nonprofits has heightened tensions as governments seek accountability and nonprofits seek to preserve autonomy. Considering both sides of the contract market this article suggests that the threat of government funding is exaggerated. Nonprofits are attractive contractor options because of their experience and trustworthiness. Governments should recognize that excessive intrusions limit the advantages of the nonprofit sector. At the same time, nonprofits should be conscious of the implications of public funding, just as they must be of other sources of funding.     

Pastoral care in Candyland. Maintaining power and life in a world of illness

Wrestling with ghosts and staging fatal accidents with Matchbox cars allow a critically ill six-year-old to come to terms with the fears prompted by his illness.