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.     

Illinois's child welfare research agenda: an approach to building consensus for practice-based research

This article presents a consensus-building initiative to develop a statewide research agenda that responds to the needs of Illinois's child welfare community. Researchers conducted this process through a university-community partnership to engage those interested in child welfare services. The process and findings resulted in a living document that will guide child welfare research throughout the state. Findings of the inquiry suggest that the development of best practice models may be one of the most important contributions research can make to practice.     

Experience of cumulative trauma disorders on life roles of worker and family member: a case study of a married couple

The prevalence of diagnosed cumulative trauma disorders (CTD) within the workforce comes at a high price for employers burdened with financial losses from missed work and worker's compensation costs. Research has focused primarily on the impact of CTD on the worker role within the workplace, overlooking the impact on roles across multiple environments [24,35,54]. Furthermore, the influence of CTD on life roles of a spouse has not been examined. This single case study illustrated the experience of CTD within a marital relationship through the use of grounded theory. Results indicated that adaptations to CTD symptoms were least altering to the established routines and roles of the couple. With progression of symptoms, the spouse without symptoms was relied on more heavily for adaptations to manage pain. The results of this study indicate that occupational therapists must examine the client's valued roles and incorporate the family into intervention strategies.     

Conditional Generalized Liouville Distributions on the Simplex

Liouville and generalized Liouville distributions on the simplex have been proposed for modeling compositional data and have been shown to be free from the extreme independence structure that characterizes the Dirichlet class. In this article, generalized Liouville distributions are shown to be rich enough to distinguish some lesser modes of independence as well. Unfortunately, it is noted that the applicability of the Liouville family will be limited, owing to the lack of invariance with respect to the chosen fill-up value. As an alternative, a new family of simplex distributions is proposed, one that admits invariance with respect to choice of fill-up value, as well as the ability to differentiate among many forms of independence.     

Assessing program impact using latent growth modeling: a primer for the evaluator

Latent growth modeling (LGM) has emerged as a flexible analytic technique for modeling change over time because it can describe developmental processes at both the inter- and intra-individual levels. The LGM method can also provide a means for testing the contribution of other variables in order to explain variability in growth trajectories. This paper didactically illustrates the use of LGM as an analytical tool in program evaluation. Specifically, a hypothetical evaluation of a high school drug prevention program was used to demonstrate: (a) how LGM can be used to assess the longitudinal impact of a prevention program by comparing treatment and control populations with respect to individual differences in initial status and in rate of change; and (b) how predictors of initial status (post-intervention) and growth selected on the basis of a particular program theory can be incorporated in the model to explain program impact. Some advantages and limitations of using LGM in program evaluation are highlighted.