Planning and health care—The approach in a reorganized NHS

From April 1974, National Health Service authorities have been merged to provide integrated and comprehensive services. The reorganization policies place considerable emphasis on the need for management and planning but planning for health services is not well developed. Ambiguous operational objectives and obscured criteria for effectiveness are not the most promising basis for planning. Nevertheless, a commendable beginning is to be made on planning comprehensively through a systematic annual review of Government health service policies and planning and programming procedures for health authorities. The outlines of the system are described and the prospects for success and further development are considered.     

TOR pathway: linking nutrient sensing to life span

Recent studies point to an emerging role for the TOR (target of rapamycin) pathway in the regulation of life span. In this Perspective, we discuss the possibility that this pathway is an important modulator of nutrient-dependent changes in life span. Additionally, we discuss the interactions between the TOR and insulin-like signaling pathways as well as the key downstream processes that TOR regulates.     

Characteristics of effective providers of marital and family therapy in rural mental health settings

Characteristics of effective providers of marital and family therapy (MFT) in rural mental health settings were investigated. The survey sample included 74 members of the National Association for Rural Mental Health who, through a modified Delphi process, created a composite picture of effective MFT providers. The findings yielded six major rank-ordered characteristics of effective MFT providers in rural mental health settings, with effective skills in MFT ranked first. Rural community understanding, appreciation and participation ranked second. Specific competencies contributing to each major characteristic were also identified and are discussed. Recommendations for use of this information are provided.     

Everything I needed to know about medical management I learned in acting school

Some people are doctors. Some people play them on TV. Brian Meltzer could probably do both. A physician executive at Memorial Sloan-Kettering Cancer Center, Meltzer relies on skills he learned in acting school to help manage business decisions. In the first of several essays for The Physician Executive, Meltzer explains how acting can help you become a better leader.     

Dimensions of Community Attachment and Their Relationship to Well‐Being in the Amenity‐Rich Rural West*

Abstract This research had two primary objectives: 1) to broaden the sociological construct of community attachment to incorporate both social and natural environment dimensions of attachment, and 2) to examine how variations in attachment relate to two dimensions of well‐being in natural amenity‐rich rural communities. The specific dimensions of well‐being measured are two important factors identified in previous research—collective action and perceptions of open communication. Factor analysis of fourteen measures of attachment indicated social attachment and attachment to the natural environment are distinct dimensions of the broader concept of community attachment. Participation in collective action and perceptions of open communication within a respondent's community explained only a small portion of the variance in levels of both social and natural environment attachment. Religious affiliation and length of residence were strongly associated with social attachment, supporting findings from previous empirical work. However, length of residence and religious affiliation were not statistically associated with levels of attachment to the natural environment, further reinforcing the distinction between the two dimensions of attachment.     

A Two-Phase Exact Algorithm for MAX-SAT and Weighted MAX-SAT Problems

We describe a two-phase algorithm for MAX-SAT and weighted MAX-SAT problems. In the first phase, we use the GSAT heuristic to find a good solution to the problem. In the second phase, we use an enumeration procedure based on the Davis-Putnam-Loveland algorithm, to find a provably optimal solution. The first heuristic stage improves the performance of the algorithm by obtaining an upper bound on the minimum number of unsatisfied clauses that can be used in pruning branches of the search tree.We compare our algorithm with an integer programming branch-and-cut algorithm. Our implementation of the two-phase algorithm is faster than the integer programming approach on many problems. However, the integer programming approach is more effective than the two-phase algorithm on some classes of problems, including MAX-2-SAT problems.     

Supply Chain Consequences of Subsidies for Corporate Social Responsibility

The use of government incentives tied to market prices as means of boosting corporate social responsibility (CSR) has expanded notably in recent decades. Enhanced business tax deductions for charitable donations and credits for conservation easements are notable cases. While providing incentives for socially desirable behavior to achieve legislative goals has intuitive appeal, the broader economic consequences are not always fully understood. In this study, we examine such wider consequences for supply chains when subsidies for CSR are offered. One effect we identify is that since incentives are typically tied to market value, firms have not only an added incentive to achieve societal objectives (say by donating inventory) but also an incentive to raise output (retail) market prices. A second consequence is that since firms forgo potential revenues by engaging in socially desired behavior, they become increasingly sensitive to supplier pricing; in an uncoordinated supply chain this leads to input (wholesale) price concessions. Among other things, the results underscore that incentives put in place to meet broader societal objectives also have notable ramifications for suppliers, retailers, and consumers in primary markets.     

Layered supervisory control architecture for reconfigurable automation

The development of control systems and supporting software remains one of the greatest obstacles to the widespread implementation of highly adaptive reconfigurable automation technology. This paper will present the structure of a modular automation control system designed to support rapid reconfiguration and redeployment of automation components. The paper will first present the concept of a layered system architecture and the use of modular automation components to support the construction of a wide variety of automated systems. This layered system architecture is then applied to the proposed modular supervisory control system responsible for configuring and driving automated production resources. Each of the control components comprising this modular control system will be presented.     

Conceptualising the psycho‐emotional aspects of disability and impairment: the distortion of personal and psychic boundaries

Recent feminist critics of the social model of disability have pointed towards a danger that disability studies may give relatively little attention to personal and emotional aspects of disablist oppression and impairment. We argue for consideration of the centrality of the distortion of personal and psychic boundaries as a key aspect of oppressive relational dynamics surrounding disability. Within the observer the disturbing psychic evocations of disability, and related defences, are connected to the maintenance of dynamics of unreal, collusory and alienating modes of relating, which may deprive disabled people of the recognition of subjective experience and personhood. Skewed socialisation of disabled people, involving inter alia the protection of the emotional lives of others, as well as the reality of inaccessible material resources, contributes to the internalisation of disablism and the ideological recruitment of disabled people as complicit in their marginalisation.