Enhancing participatory research with the community oriented primary care model: A case study in community mobilization

Refining Participatory Research with the methodology of Community Oriented Primary Care (COPC), sociologists, medical providers and other “professionals” were able to assist the people of a small, rural county in western Appalachian North Carolina create a “community health consortium.” The consortium grew out of a research process funded by the W.K. Kellogg Foundation, which included some 40 interviews with community groups that articulated health problems and barriers to health care. The consortium then undertook action projects, which in turn enhanced networking between community groups and agencies while reducing mistrust between them. The consortium empowered people to articulate their realities, needs and became a force for change able to make demands on political office holders and decision makers. Despite its democratic origins and ideology, the consortium needs to do more to extend its outreach to include the marginal and disenfranchised.     

The closed-loop supply chain network with competition,distribution channel investment,and uncertainties

In this paper, a closed-loop supply chain network is investigated with decentralized decision-makers consisting of raw material suppliers, retail outlets, and the manufacturers that collect the recycled product directly from the demand market. We derive the optimality conditions of the various decision-makers, and establish that the governing equilibrium conditions can be formulated as a finite-dimensional variational inequality problem. We establish convergence of the proposed algorithm that can allow for the discussion of the effects of competition, distribution channel investment, yield and conversion rates, combined with uncertainties in demand, on equilibrium quantity transactions and prices. Numerical examples are provided for illustration.     

Returning children home from care: What can be learned from local authority data?

International Human Rights and child rights conventions as well as U.K. wide legislation and guidance require that children in care should be returned home to one or both parents wherever possible. Reunification with parents is the most common route out of care, but rates of re‐entry are often higher than for other exit routes. This study used 8 years of administrative data (on 2,208 care entrants), collected by one large English local authority, to examine how many children were returned home and to explore factors associated with stable reunification (not re‐entering care for at least 2 years). One‐third of children (36%) had been reunified, with adolescent entrants being the most likely age group to return home. Three quarters (75%) of reunified children had a stable reunification. In a fully adjusted regression model, age at entry, being on a care order prior to return home, staying longer in care, being of minority ethnicity, and having fewer placements in care were all significant in predicting chances of stable reunification. The results underline the importance of properly resourcing reunification services. The methods demonstrate the value to local authorities of analysing their own data longitudinally to understand the care pathways for children they look after.     

A comparison of the NZDep and New Zealand IMD indexes of socioeconomic deprivation

ABSTRACT

The aims of this study were to compare the NZ Indices of Multiple Deprivation (IMD) with the NZDep index of socioeconomic deprivation in terms of their: (1) theoretical and methodological approaches; (2) use of small areas; (3) rankings of small areas; and (4) relationships with various health and social outcomes. Literature sources were reviewed for aim 1. The data sources for aims 2–4, all contained within Statistics New Zealand’s Integrated Data Infrastructure, were: (1) 2013 Census, (2) health data sets, (3) Police database, and (4) 2014 General Social Survey. Outcomes were smoking, mortality, respiratory disease, crime, self-assessed health status. Spearman’s rho was used as a measure of correlation. Deciles were treated as categorical in the stepwise logistic regressions. The key finding is that there is a range of theoretical and methodological differences between the indexes. Despite these differences, the indexes behave in a similar, but not identical, manner in their ranking of small areas and in their associations with health and social outcomes. In conclusion, for practical purposes for many applications the two indexes give similar results when analysing very large data sets, although there are some important caveats related to this conclusion for both large and small data sets.     

The Sandwich Generation

This article reviews the literature on the sandwich generation and includes related theories and research. Psychological perspectives on the developmental issues associated with middle adulthood in general, and the sandwich generation in particular, are examined. Clinical vignettes highlight the magnitude of elder care in the United States and the impact on caregivers.     

Placed and paid for: a national overview of the use of private and voluntary day care facilities for children in need

This paper examines day care provision for children in need, who are placed and paid for by local authorities in non local authority services. The England and Wales Children Act 1989 placed a new duty on local authorities to provide day care services for children who are defined as being 'in need', and the guidance accompanying the Act encourages the use of independent sector services for this purpose. This paper brings together the main findings from a survey of all English local authorities, an analysis of local authority documentation and secondary analysis of government statistics to provide a national overview of the use of sponsored day care places for children 'in need'. It concludes that the majority of English local authorities value the contribution of independent day care providers, but that there are potential problems with adopting a market approach to welfare services, such as low levels of training and support for such providers, and a shortage of suitable service provision in the areas where they are most needed. These require further consideration by policy makers and local authorities.