Alone and content: frail seniors living in their own homes compared to those who live with others

This study compared the psychosocial well-being and functioning of frail elderly people who live alone to those who live with others. An exploratory study was conducted with a sample of 5,265 members of a social HMO in Southern California. Those living alone were more likely to be widowed, female, and European American. Elderly people living with others reported higher levels of depression and poorer functioning. Both groups reported having a social support network, but the sources of support varied. This study contradicts older research with its finding that living alone is not synonymous with depression. Further research is recommended.     

Tending and befriending: the intertwined relationships of quilters

Using the convoy model of social relations, we explored the contributions of quilting activities to the relationships of middle- and older-aged women in three distinct groups: Amish, Appalachian, and Latter Day Saints. Semi-structured interviews were conducted with ten women from each group and analyzed qualitatively using McCracken's five-step method for analysis of long interviews. We found that these women had considerable horizontal and vertical connections to others. Specifically, they exhibited generativity by teaching their skills to others, building bonds with grandchildren through quilting, and leaving legacies through their quilts. Many developed friendships with other quilters that provided social support to deal with life challenges. Additional study of the contributions of mid-late life women's leisure activities to their social milieu, personal development, and well-being is needed.     

The Management of Technology: A Production and Operations Management Perspective

We highlight many of the traditional research themes in the management of technology as well as research themes on emerging topics such as those that appear in this focused issue. The discussion demonstrates the breadth and multidisciplinary nature of management of technology as well as the variety of methods employed in management of technology research. We conclude by offering a list of research themes that are of particular interest to the Management of Technology Department of Production and Operations Management.     

Score Tests for Zero-Inflation in Overdispersed Count Data

The negative binomial (NB) model and the generalized Poisson (GP) model are common alternatives to Poisson models when overdispersion is present in the data. Having accounted for initial overdispersion, we may require further investigation as to whether there is evidence for zero-inflation in the data. Two score statistics are derived from the GP model for testing zero-inflation. These statistics, unlike Wald-type test statistics, do not require that we fit the more complex zero-inflated overdispersed models to evaluate zero-inflation. A simulation study illustrates that the developed score statistics reasonably follow a χ² distribution and maintain the nominal level. Extensive simulation results also indicate the power behavior is different for including a continuous variable than a binary variable in the zero-inflation (ZI) part of the model. These differences are the basis from which suggestions are provided for real data analysis. Two practical examples are presented in this article. Results from these examples along with practical experience lead us to suggest performing the developed score test before fitting a zero-inflated NB model to the data.     

‘Reasonable and necessary’ care: the challenge of operationalising the NDIS policy principle in allocating disability care in Australia

Disability reform in Australia centres on a National Disability Insurance Scheme (NDIS), which aims to provide lifelong, individualised support based on the principle of ‘reasonable and necessary’ care. As a universal rights‐based scheme it represents a historical shift in allocation principles in Australia's disability policy. Nonetheless, attention will be on determining who receives what care given the diversity of personal and family contexts. The aim of this paper is to discuss the operational complexities of a principle of reasonable and necessary care with reference to the findings of a three‐year study on the experiences and perspectives of disability care of 25 adults with acquired disability, their 22 nominated family members and 18 service providers. Evidence from this study suggests enacting the principle of reasonable and necessary care and support will be problematic, in particular as it relates to personalising the level and scope of services, balancing formal and informal care, and principles of equity. The paper contributes to the literature about allocation principles in social policy and the challenges of implementation. Further, it provides an empirically informed discussion of some of the specific policy implementation challenges concerning the NDIS.     

Education and employment opportunities among staff in Aboriginal family service agencies

The purpose of the study was to describe ways that successful culture‐based Aboriginal preventive family service agencies offer employment and education opportunities for staff. Staff in three inner‐city, culture‐based Aboriginal family agencies were asked about their employment and educational opportunities. Forty‐four individuals were asked the question: ‘what employment and education opportunities have you had while in this job?’ A total of 81 unique responses were received. Participants grouped the responses into eight themes including: planning for services, promotion within the agency, specific skill development, enhanced self‐confidence, cultural awareness, teaching others, workshops as well as certified training. Differences between the experiences of study participants and the existing literature indicate that practices within culture‐based Aboriginal family agencies are distinct in relation to funding, staff mobility, strengths‐base, practical training and cultural knowledge, and that these should be understood and recognized formally in funding decisions and in future research.     

Geographic morbidity differentials in the late nineteenth-century united states

We use a national cross-sectional database, the 1880 Integrated Public Use Microdata Sample, to examine aggregate patterns and individual-level estimates of chronic-disease morbidity and long-term disability in the United States in the late nineteenth century. Despite higher levels of urban mortality in 1880, morbidity prevalence rates were highest in the rural areas of the country, especially in the western and the southern regions. Equations using microdata show that the estimated risk of chronic disease and impairment was highest for males and females who were older, of lower socioeconomic status, or from rural areas. This era was marked by geographically uneven but significant levels of endemic chronic disease, likely the outcomes of prior episodes of infectious disease and exposure to conditions generated by human action, such as the Civil War and migration.     

Treating drug-abusing offenders. Initial findings from a five-county study on the impact of California's Proposition 36 on the treatment system and patient outcomes

Five counties (Kern, Riverside, Sacramento, San Diego, San Francisco) that demonstrate both variations and similarities in their implementation of Proposition 36 (e.g., treatment approaches, urine testing) and patient mix have been selected to participate in a study assessing how California's Proposition 36 is affecting the drug treatment system and patient outcomes. Except for San Francisco, treatment admissions increased during the first year of Proposition 36 implementation over the prior year (27% in Kern, 21% in Riverside, 17% in Sacramento, and 16% in San Diego), mostly in outpatient drug-free programs. Compared to non-Proposition 36 patients, Proposition 36 patients were more likely to be men, first-time admissions, treated in outpatient drug-free programs, employed full-time, and users of methamphetamine or marijuana. They were less likely to be treated in residential programs or methadone maintenance programs and fewer reported heroin use or injection drug use. Guided by the multilevel open systems framework, the study examines key issues of Proposition 36 that influence treatment systems and outcomes and empirically identifies "best practice" approaches in treating drug-abusing offenders.     

Medical Decision Making and Elective Surgery: The Case of Hysterectomy

Review and analyses of three sources of data are presented indicating that 25% of hysterectomies are elective. Annual mortality associated with elective hysterectomy is estimated to be 319, or about 12,122 woman years. Cost-benefit analyses of mortality, life expectancy, morbidity, psychological sequelae, as well as dollar expenditures, reveal high costs and relatively limited benefits. Explanations for this apparent anomaly in decision making are explored and include economic incentives, system structure, sexism, and cancer prophylaxis. Principles of risk perception are discussed in terms of potential biases associated with the cancer prophylaxis motive. It is suggested that physicians' judgements of risk may be more salient to the decision process than those of prospective patients.     

Parenting as a moderator of minority, adolescent victimization and violent behavior in high-risk neighborhoods

Adolescent male youth in high-crime neighborhoods are at the greatest risk for personal victimization and violent behavior. The temporal relationship between victimization and violent behavior for minority youth in high-crime neighborhoods was examined to determine whether victimization is a risk factor for or by-product of violent behavior. Whether parenting and other control factors moderated the relationship between victimization and violent behavior was also examined. Interviews with 349 urban Hispanic and African American youth revealed that victimization was strongly associated with violent behavior and violent behavior was found to precede direct victimization. Race was found to moderate the relationship between parental attachment and violent behavior. African American youth with the highest levels of parental attachment also had the highest levels of violent behavior, while higher parental attachment for Latino youth was associated with lower violent behavior.