Health Authorities, Priority-setting and Resource Allocation: A Study in Decision-making in New Labour's NHS

This paper analyses the decision‐making process of health authorities under New Labour in the NHS through a study of their qualitative responses to questionnaires. We find a considerable frustration and cynicism with the government's plans for reform, with its interference at the local level with services, and an acknowledgement of the differences between health authorities’ practice and what they believe the government requires, with, often, only minimal effort being made attempting to achieve new governmental performance targets. We conclude by making suggestions for an alternative strategy less likely to antagonize local health service providers.     

Preschool and School Readiness of Children of Immigrants*

Objective. In this article, we use data from the Early Childhood Longitudinal Survey—Kindergarten Cohort to analyze the links between preschool attendance and the school readiness of children of immigrants. Methods. Using data from the Early Childhood Longitudinal Survey—Kindergarten Cohort, we estimate multivariate regression models for the effects of preschool on school readiness for children of immigrants and children of natives. Results. We find that children whose mothers were born outside the United States are less likely to be enrolled in school or center‐based preschool programs than other children. We find that preschool attendance raises reading and math scores as much for children of immigrants as it does for other children. Attending preschool also raises the English‐language proficiency of children of immigrants. Although not the main focus of our study, we examined the effects of Head Start, and found that this program improves children's English proficiency, with especially large effects for children of immigrants whose mothers have less than a high school education; in this latter group, Head Start also improved math scores. Conclusions. Given that preschool benefits children of immigrants as much as it does children of natives and given that children of immigrants are less likely to be enrolled, our findings strongly suggest that enrolling more children of immigrants in preschool would help reduce inequality in skills at school entry.     

Old Lesbians in the UK: Community and Friendship

Drawing on data from the first large-scale comprehensive study of older lesbian life in the United Kingdom, this article explores the nature of friendship and community among old lesbians. Strong friendship bonds and social networking emerge as key features of old lesbian culture. In particular the article focuses on “chosen families,” including relationships with ex-lovers, and on the extensive network of both organized and informal social groups that continue to structure and support a sense of community among old lesbians. It shows the lasting importance of friendships and social structures formed earlier in life against a background of stigmatization, homophobia, and heterosexism, and argues for the recognition of these communities of identity by those who care for older people.     

Catholic Civics Education in the Early Cold War: Zeal for Democracy,Zeal for Christ

In the late 1940s and 1950s American Catholic educators faced the dilemma of how to transmit Catholic faith and culture to the next generation while also reassuring their non-Catholic neighbors that they were fully American in lifestyle and loyalties. This article examines one response to that dilemma: the convergence of public and Catholic school civics curricula through the widespread use of experiential pedagogy in Catholic civics education. Using a content analysis of civics textbooks and teacher's guides from both school systems, this article demonstrates how both kinds of schools converged on an experiential style of civics education, despite vocal opposition to “progressive” pedagogy at elite levels of Catholic educational discourse. The article then presents a partial explanation for this dissonance, demonstrating the moral certainty exhibited in the same Catholic-school textbooks, and suggesting that Catholic educationists understood American Catholics to be morally privileged in a way that gave them special insight into American democracy and protected them from the negative influences of secular educational philosophy. This case study speaks to larger questions of how organizations manage conflicts between abstract principles and practical action, and suggests the value of including religious schools in the sociological study of “loose coupling” in educational organizations.     

The Role of Industry Studies and Public Policies in Production and Operations Management

The research domain Industry Studies and Public Policy (IS&PP) seeks to further our understanding of industrial practices and managerial challenges by explicitly considering contextual details in the design and interpretation of research studies. These details can be vital considerations when shaping public policies. This article reviews a sample of IS&PP publications and analyzes the content of 180 selected papers—85 papers published in the Production and Operations Management (POM) journal and 95 papers published in related journals between 1992 and 2014. Our analysis of the sample dataset and examination of exemplar papers provide four findings. First, studies in different industries emphasize different themes of operational decisions. This difference in emphasis reveals potential research opportunities, especially for conducting inter‐industry studies. Second, our analysis reveals a shift in focus over time. Earlier studies contain a mix of benchmarks and inter‐industry comparisons, while later studies tend to be context‐specific, intra‐industry studies. Third, we report on empirics → analytics → empirics cycles that reveal gaps for building novel theories. Finally, we observe that the relationship between POM decisions and public policy is bi‐directional. This highlights the need to jointly examine operational decisions with policy considerations, especially in information goods, healthcare, sustainable operations and high‐tech manufacturing industries.     

Disabled people in Britain and the impact of the COVID-19 pandemic

This paper reports on in-depth qualitative interviews conducted with 69 disabled people in England and Scotland, and with 28 key informants from infrastructure organisations in the voluntary and statutory sectors, about the impact of COVID-19, and measures taken to control it. Participants were recruited through voluntary organisations. As with everyone, the Pandemic has had a huge impact: we discuss the dislocations it has caused in everyday life; the failures of social care; the use of new technologies; and participants' view on leadership and communication. We conclude with suggestions for urgent short term and medium term responses, so that the United Kingdom and other countries can respond better to this and other pandemics, and build a more inclusive world.     

Improving OpenURL Menus: User Testing of Revisions to SFX® Menus

Abstract

Twenty-one volunteers tested the usability of revisions to the Texas A&M University Libraries' SFX® OpenURL link resolver menus, including the addition of Ex Libris' new bXâ?¢ recommendation service and a plug-in which pulls additional information about the journal into the menu. The volunteers also evaluated the quality and desirability of the bX recommendations and discussed their preferences for help options and full-text format. Results of the usability testing are reported along with the resultant menu changes. This study will be of interest to librarians implementing or redesigning OpenURL menus as well as those interested in the user experience.     

A novel in statistics

Jane Yardley spends her days organising clinical trials. By night she writes successful novels. Her latest involves mystery, wartime crime and Sibelius; and its heroine is a biostatistician. Why? Chocolate teddybears, a father who worked with toxic chemicals and a bookmaker's clerk made her do it …     

Analysing data from a cluster randomized trial (cRCT) in primary care: a case study

Health technology assessment often requires the evaluation of interventions which are implemented at the level of the health service organization unit (e.g. GP practice) for clusters of individuals. In a cluster randomized controlled trial (cRCT), clusters of patients are randomized; not each patient individually.

The majority of statistical analyses, in individually RCT, assume that the outcomes on different patients are independent. In cRCTs there is doubt about the validity of this assumption as the outcomes of patients, in the same cluster, may be correlated. Hence, the analysis of data from cRCTs presents a number of difficulties. The aim of this paper is to describe the statistical methods of adjusting for clustering, in the context of cRCTs.

There are essentially four approaches to analysing cRCTs: 1. Cluster-level analysis using aggregate summary data.

2. Regression analysis with robust standard errors.

3. Random-effects/cluster-specific approach.

4. Marginal/population-averaged approach.

This paper will compare and contrast the four approaches, using example data, with binary and continuous outcomes, from a cRCT designed to evaluate the effectiveness of training Health Visitors in psychological approaches to identify post-natal depressive symptoms and support post-natal women compared with usual care. The PoNDER Trial randomized 101 clusters (GP practices) and collected data on 2659 new mothers with an 18-month follow-up.     

An Empirical Investigation of the Effects of Decision Aids on Problem-Solving Processes*

Despite the growing number of investigations examining decision support systems (DSS), relatively few empirical studies have evaluated the effects of DSS on problem-solving processes. This study uses protocol analysis to investigate the impact of a specific decision aid on problem-solving processes in a semi-structured problem. Results indicate that decision aids influence the problem-solving processes of decision makers. The effect of a decision aid is found to be contingent on familiarity with the decision aid, task familiarity, and the interaction of these two factors. Suggestions for incorporating interaction effects and problem-solving processes into future examinations are proposed.