Rates of missing responses in personal digital assistant (PDA) versus paper assessments

This article describes rates of missing item responses in personal digital assistant (PDA) assessments as compared to paper assessments. Data come from the evaluation of a classroom-based leisure, life skills, and sexuality education program delivered to high school students in Cape Town, South Africa. Analyses show that the paper assessments had much higher rates of missing-ness than PDA assessments. This association is moderated by item order. Certain analyses also suggest that paper assessments have higher rates of missingness for items pertaining to participants' sexual behavior. Implications of these results for evaluation research will be discussed.     

Genetics After the Act: A Specialist Health Service Amid NHS Reform

This article considers the impact of the recent reform of the National Health Service (NHS) on specialist regional health services. A case study of medical genetic services is presented to highlight some problems arising from the implementation of the 1990 NHS and Community Care Act. New financial arrangements introduced by the Act have led many regional health authorities to devolve the finance and organization of specialist health services to districts. The introduction of competition and devolved budgets may pose especial problems for some specialist health services. In the case of genetic services these difficulties are exacerbated by new pricing rules. The paper explores these issues and suggests that the imposition of the market model on health care overlooks some vital, human elements which do not fit neatly into such a model.     

Into the Community: A Comparison of Care Management and Traditional Approaches to Resettlement1

The resettlement of people with learning disabilities (mental handicap) from long-stay hospitals has been under way for a number of years in England. This process has generally been dominated by the exigencies of the available services. A needs-led approach, emphasized in recent community care legislation, in which new services are sought on the basis of the specific requirements of service users, has been used infrequently for this purpose. This paper compares the process of implementing a needs-led care management approach to resettlement with the implementation of a more traditional service-led approach. It also suggests some important lessons for the application of a needs-led approach to hospital resettlement.     

Defining Community Care: realities and myths

This article looks critically at the concept of community care and argues that it is unhelpful and redundant. It makes three main points: first, that many care settings have elements of institutional and so-called community care and that there is no clear dichotomy between the two. Second, it is argued that the real distinction is not between the institution and the community but is between the institution and home. Community care is not provided by anonymous, altruistic others but comes from specific individuals (usually women) in domiciliary settings. The concept and definition of “home” are briefly discussed and it is suggested that most care is delivered either in a home , from home or at home. The third argument is that careful individual assessment is required to ensure that dependent people are not offered housing or residential solutions when what they need (and want) is care and services.     

Patterns of Governance: The Curious Case of Non-profit Community Services in Australia

"Community" has taken on a new significance in Australian social policy discourse. Seemingly sound and morally justifiable, in the context of neo-liberalism the language of community positions non-profit delivery of services as superior to state-provided services. As a consequence, non-profit community services are being centrally positioned to mediate the relationship between the state and citizen subjects. In the first part of this paper we trace some of the key historical developments in Australia's welfare state and patterns of governance that are propelling the non-profit sector from the margins to the centre. The second section examines the relationship between Australia's shifting political landscape and the emerging welfare regime. One key feature of this new regime is the attempt to relocate citizenship away from the domain of the state and into that of civil society. The article concludes by sketching out some research themes, focusing, for example, on the impact of devolution of governance in terms of client rights and public accountability.     

Neighbourhood Life,Social Capital and Perceptions of Safety in the Western Suburbs of Adelaide

In this paper we report on a South Australian study of perceptions of safety and aspects of neighbourhood life including social capital which involved the analysis of 2400 self‐completed questionnaires. A path analysis found that perceptions of safety were directly associated with gender, age, perceptions of neighbourhood pollution and neighbourhood trust, and indirectly associated with age, neighbourhood pollution and neighbourhood connections. We conclude with a discussion of the implications of the findings for public policy.     

Analysis of repeated categorical responses from fully and partially cross-classified data

Many follow-up studies involve categorical data measured on the same individual at different times. Frequently, some of the individuals are missing one or more of the measurements. This results in a contingency table with both fully and partially cross-classified data. Two models can be used to analyze data of this type: (i) The multiple-sample model, in which all the study subjects with the same configuration of missing observations are considered a separate sample. (ii) The single-sample model, which assumes that the missing observations are the result of a mechanism causing subjects to lose the informtion from one or some of the measurements. In this work we compare the two approaches and show that under certain conditions, the two models yield the same maximum likelihood estimates of the cell probabilities in the underlying contingency table.     

Likelihood-Based Inference for Semi-Competing Risks

Consider semi-competing risks data (two times to concurrent events are studied but only one of them is right-censored by the other one) where the link between the times Y and C to non-terminal and terminal events, respectively, is modeled by a family of Archimedean copulas. Moreover, both Y and C are submitted to an independent right censoring variable D. We propose to estimate the parameter of the copula and some resulting survival functions using a pseudo maximum likelihood approach. The main advantage of this procedure is that it extends to multidimensional parameters copulas. We perform simulations to study the behavior of our estimation procedure and its impact on other related estimators and we apply our method to real data coming from a study on the Hodgkin disease.