Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.     

What is good taste good for?

Bourdieu afflrme que le capital cultural est utile lorsque Ton veut obtenir une situation de classe supérieure, particuliérement dans certains secteurs, et n'est en fait qu'une seule chose: une culture de condition supérieure. Mais son argument, établit pour une France centralisée, est moins valable pour le Canada plus subdivisé. Cet article étudie les idées de Bourdieu sous tous leurs aspects pour un échantillon quota de Torontoniens. Les résultats suggèrent qu'un capital culturel de condition supérieure existe à Toronto, mais qu'il a peu d'effet sur les relations de classe au travail, ou le véritable capital culturel dirige la culture d'entreprise qui domine les entreprises privées. La culture d'entreprise est aussi repartie en classes et pourrait jouer un role dans la reproduction de classes qui est tres similaire a ce que Bourdieu revendique comme culture de condition supérieure.
Bourdieu argues that cultural capital is useful in gaining higher class location, especially in some sectors, and is essentially a single thing: high status culture. But his argument, developed for centralized France, is less suitable for more subdivided Canada. This paper explores Bourdieu's ideas through a quota sample of 40 Torontonians. Results suggest that high status cultural capital does exist in Toronto, but has little part in class relationships at work, where the true cultural capital is command of the business culture which dominates private enterprises. Business culture is also class stratified, and may play a role in class reproduction which is quite similar to that which Bourdieu asserts for high status culture.     

Contributors to disruption and dissolution of older-child adoptions

According to recent evidence, adoptive placements that do not work out are increasingly common. This article reviews research on rates of, and contributors to, adoption and "foster-adoption" disruptions and dissolutions. Implications for practice are included.     

DETERMINING OPTIMAL SHIFT SCHEDULES FOR TELEPHONE TRAFFIC EXCHANGE OPERATORS

A branch and bound algorithm is presented for determining the minimum number of telephone operators, and their shift schedules, required to meet demand that varies over a 24 hour operating period. An integer linear programming formulation is used, and the algorithm is described in terms of its separation, relaxation, fathoming, and branching procedures. Computational results are provided, using actual operating data. The results indicate that practical sized problems can be solved by the algorithm, involving as many as 100 different shift type variables and demand profiles typical of those encountered in many telephone traffic exchanges.     

Rhetoric and Reality of Economic Self-sufficiency Among Rural,Low-Income Mothers: A Longitudinal Study

This study examined the contributions of maternal labor force participation and marital status on economic self-sufficiency over time for rural mothers. Data were from 174 rural families participating in three waves of data collection in Rural Families Speak. χ ² and multiple logistic regression were utilized. Results revealed only one-third of mothers moved toward economic self-sufficiency over three years. Maternal education, employment status, and weekly work hours were associated with improved economic well-being. Compared to single-parent families, unmarried-couple and married-couple families had increased odds of improving economically. In an analysis of all mothers with partners, married or unmarried, martial status was not significant in economic improvement. Findings suggest the role of marriage in welfare reform for rural families should be reconsidered.

Key Determinants to using Telehealth Technology to Serve Medically Ill and Depressed Homebound Older Adults

Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating chronic diseases, and comorbid depression among older adults, they have been slowly adopted by home health care (HHC) agencies. Therefore, this study aimed to identify factors that determine telehealth technology adoption. Twenty directors from the National Association for Homecare & Hospice member agencies completed a 45-min telephone interview. Questions were asked regarding their perceptions of telehealth, the key determinants of telehealth adoption and use, and recommendations they would give on telehealth adoption. The majority of the participants perceived telehealth as effective for managing symptoms and reducing cost. Meanwhile, some participants had a mixed feeling toward telehealth for depression care as they did not recognize their agency as equipped with the necessary resources and trained staff. Moreover, significant determinants of telehealth adoption included the agency-related characteristics, the patient-home environment, reimbursement and cost-related factors, and staff telehealth perception. Findings imply that there is a need for financial support both at the state and the federal levels to encourage telehealth adoption among HHC agencies. Future studies should consider exploring strategies used by successful programs to overcome barriers.     

AN ANALYSIS OF CAPACITY PLANNING PROCEDURES FOR A MATERIAL REQUIREMENTS PLANNING SYSTEM*

This paper is concerned with planning work-center capacity levels in manufacturing firms that employ a material requirements planning (MRP) system. It presents four procedures for developing work-center capacity plans designed to insure the production of components and assemblies as specified by the MRP plan and the master production schedule (MPS). These procedures (capacity planning using overall factors, capacity bills, resource profiles, and capacity requirements planning) are compared using simulation analysis. The results indicate that the performance of a procedure when measured against the MPS depends on the operating conditions of the manufacturing system. The results also indicate that the choice of a particular procedure often represents a compromise among the benefits of improved MPS performance, the costs of preparing and processing data, and the premium expenses required for more frequent adjustments in work-center capacity levels.     

Power play: the use of space to control and signify power in the workplace

ABSTRACT

The findings of this article emerge from an eight-month study examining career identity practices amongst a select group of fitness professionals in the U.K. We examine how the inter-relationship between physical and social space can denote how power is acquired, displayed, and used by individuals interacting in a shared space. The findings show that power is signified through spatial practices as individuals negotiate through triadic space, creating an identity of space and place for both trainer and client that identifies power, and signifies who has power. Fitness professionals with high levels of symbolic power are able to subvert organizational spatial norms to better serve themselves and their clients, while those with lower levels of symbolic power are forced to, or choose to, negotiate or abdicate space to others. These findings are relevant to a wide range of occupations where self-employment and contract workers interact in shared space.