Implementation of Intensive Permanence Services: A Trauma-Informed Approach to Preparing Foster Youth for Supportive Relationships

Youth in foster care who have histories of grief, loss, and placement disruptions need trauma-informed programs that can help them maintain stable and consistent connections with supportive adults. The purpose of this study was to explore the experiences of staff who implemented a trauma-informed model called Intensive Permanence Services (IPS). We conducted qualitative interviews with staff (N?=?7) who developed and implemented the IPS model and reviewed agency documents to identify the key characteristics of the model, the strategies staff used in their work with youth, and the challenges they faced to implementing IPS. Findings highlight these critical components: (1) using a youth-driven approach that prioritizes accountability to the youth and youth empowerment; (2) adopting an organizational culture of well-being using strategies such as secondary traumatic stress education, peer support, and structured supervision; and (3) promoting systems change for improved collaboration with all stakeholders, including the youth, families, caregivers, and other service providers. Overall, our findings stressed the importance of adopting a more holistic, trauma-informed, and youth-driven approach to improve permanence and well-being for youth in care.     

Tackling and Mitigating Health Inequalities – Policymakers and Practitioners ‘Talk and Draw’ their Theories

In the context of a long‐standing academic acceptance of the socially structured nature of health inequalities, there has been a growing literature that critically examines policies that aim to reduce them. This has demonstrated inadequate policy assessment of the nature of the problem of health inequalities and correspondingly partial solutions that privilege interventions that focus on individual lifestyle solutions over more structural approaches. Much of the research that has been undertaken in this field to explore competing theories of inequalities has analyzed national policy documents or the views of senior policy advisers rather than practitioners. This study uses Raphael’s ‘seven discourses of the social determinants of health’ to understand the implicit theories of health inequalities of both practitioners and policymakers working within a single health care system as they talk about different policy typologies. To help penetrate potentially well‐rehearsed discourses about health inequalities, it tests a visual method of stimulating discussion about how different types of policy might operate to narrow/widen existing gaps in outcomes. Building on Raphael, it finds that individuals’ theories of health inequalities contain co‐existing although not synthesized material and behavioural explanations and that, although the social patterning of material disadvantage was recognized, the role of power and politics is underplayed. Variations between participants did not align with role (policy/practice) and using visual methods to represent the impact of different policy types on health inequalities, though challenging for participants, stimulated reflection about a subject matter that has otherwise become rather stagnant.     

Complicating categories: Personae mediate racialized expectations of non‐native speech

This paper examines how American listeners’ expectations of non‐native English speech from speakers of East Asian descent can be modulated by the persona invoked by a speaker's visual display. While prior work has typically linked expectations of non‐native speaker status with East Asian‐ness broadly construed, this study indicates that US listeners’ expectations can be tied to more particular manifestations of this racialized identity, themselves informed by raciolinguistic ideologies. In a lexical recall task with persona‐based photographic primes, different visual styles embodied by the same Korean individual induced contrasting expectations of “foreign accented” speech, which corresponded to significant differences in how well the speech was remembered. Ultimately, I argue that models of sociolinguistic perception should include cognitive representations of social constructs like personae, not only to better capture the detailed nature of listeners’ sociolinguistic expectations, but also to avoid perpetuating homogenizing treatments of racialized groups’ language practices.     

Risky health decisions under regulatory constraints: Abortion tourism in Switzerland

Journal of Risk and Uncertainty - This study provides both a behavioral model and empirical evidence on the risky search for a health service across jurisdictions that differ in their regulatory...     

Unmet needs in self-directed HCBS programs

ABSTRACT

Unmet need for long-term services and supports has been linked to a variety of harmful health outcomes. One suggested strategy for ameliorating unmet need is to give participants control of a budget and let them construct individualized plans. The evaluation of the Cash and Counseling controlled experiment (CCDE) documented a marked reduction in unmet need when compared to traditional agency-based solutions, but it also showed significant unmet needs remained. This paper reanalyzes 76 case studies from the CCDE to, for the first time gain an understanding of what those unmet needs are, who sees them, and what participants, caregivers and support brokers think might reduce this problem. Using a collective or multiple case study approach to understand this phenomenon, unmet needs were sorted into five categories using real life experiences of respondents. Unmet needs for assistance in managing the employer and budget tasks of self-direction were also captured.This paper discusses situations where the clinician researchers documented needs that were not expressed by the care recipients and provides a picture of where and why unmet needs remain.The paper concludes with strategies for reducing unmet needs and training future social workers.     

Why is diversification an attractive farm adjustment strategy? Insights from Texas farmers and ranchers

State agencies have been encouraging the development of different enterprises to diversify farm incomes in an effort to retain farmers in business, attract new entrants to agriculture and promote regional development. Entrepreneurship and farming are known to be driven by a complex set of goals including those which are economic and intrinsic in nature. However, little information is available regarding the set of goals that drive agriculture entrepreneurship, preventing state agencies to adequately target potential diversifiers. This paper provides a better understanding of the range of goals, both financial and nonfinancial, that are important in farmers' decisions to diversify their operations. The generation of additional income, the continuance of farming and ranching, and the enhancement of quality of life are among the most important diversification goals in Texas. A principal component factor analysis performed on the importance ratings of diversification goals resulted in six dimensions: (F1) Reduce Uncertainty and Risk; (F2) Grow and Service Markets; (F3) Enhanced Financial Condition; (F4) Individual Aspirations and Pursuits; (F5) Revenues Enhancement; and (F6) Family Connections. The study also examined the relationship between various entrepreneur and farm characteristics and the goal pursuit dimensions. Operator's age, number of generations the farm had been in the family, household income, number of farm employees, and distance to an urbanized area influence types of goals pursued through diversification.     

Performance of phase-I dose finding designs with and without a run-in intra-patient dose escalation stage

Dose-finding designs for phase-I trials aim to determine the recommended phase-II dose (RP2D) for further phase-II drug development. If the trial includes patients for whom several lines of standard therapy failed or if the toxicity of the investigated agent does not necessarily increase with dose, optimal dose-finding designs should limit the frequency of treatment with suboptimal doses. We propose a two-stage design strategy with a run-in intra-patient dose escalation part followed by a more traditional dose-finding design. We conduct simulation studies to compare the 3 + 3 design, the Bayesian Optimal Interval Design (BOIN) and the Continual Reassessment Method (CRM) with and without intra-patient dose escalation. The endpoints are accuracy, sample size, safety, and therapeutic efficiency. For scenarios where the correct RP2D is the highest dose, inclusion of an intra-patient dose escalation stage generally increases accuracy and therapeutic efficiency. However, for scenarios where the correct RP2D is below the highest dose, intra-patient dose escalation designs lead to increased risk of overdosing and an overestimation of RP2D. The magnitude of the change in operating characteristics after including an intra-patient stage is largest for the 3 + 3 design, decreases for the BOIN and is smallest for the CRM.     

The importance of employee participation in determining pay system effectiveness

Managing pay systems is one of the most controversial and hotly debated areas of human resource management in which contingency theory approaches have dominated over the past few decades. The paper exposes the inadequacies of contingency approaches to pay system design and implementation and assesses the implications of more recent 'best practice' approaches, debating the role of pay within the HR bundle. It then reviews research evidence on the objectives and outcomes of different forms of variable pay, with close attention devoted to the role of employee participation in achieving pay system effectiveness. The significance of employee perceptions of distributive, procedural and interactional justice is explored as a means of explaining why employee participation in pay system management appears to be such a critical success factor. The paper concludes by arguing that we need to move away from a fixation with 'best practice' to a focus on 'best process' as a lens through which to investigate the design, implementation and management of pay systems.     

Corporatism Revisited—The Legacy of History and the German Nonprofit Sector

Salamon argues strongly in favor of a public–nonprofit partnership model expressing the European flavor of corporatism. Germany provides a textbook example of corporatist arrangements, particularly in the fields of health care and social services. Whereas American nonprofit organizations are suffering from a crisis of legitimacy caused by marketization, German nonprofit organizations have been confronted with a crisis of legitimacy and identity caused by corporatism since the early 1980s. This particular scenario, however, is not covered by Salmon's analysis.