A collaborative model: ambulatory pharmacotherapy for chronic psychiatric patients.

1. Increases in patient acuity and diagnosis related groups limiting hospital lengths of stay have contributed to the heightened demand for structured outpatient programs. 2. The Medication Clinic and Medication Group, a daily functioning outpatient program, is designed to shift the responsibility for medication management from the health-care provider to the patient and family through education and participation. 3. Within the framework of a collaborative practice model, the patient, clinical nurse specialist, and psychiatrist share equal power and responsibility. A phenomenologically oriented approach whereby the health-care provider attempts to understand the patient's illness from the patient's perspective is a crucial component. 4. The Medication Program combines the expertise of nursing and medicine in a complementary fashion, conducive to both revenue-generating activity and cost-effective role use.     

Decision-making processes in community transport organisations: a comparative case study of service providers

Transport services provided by voluntary organisations have grown dramatically in recent years. However, little systematic research has been undertaken on the functioning of these organisations. The aim of the research on which this paper is based was to rectify the lack of information on how decisions relating to service provision are made by such organisations — often called community transport (CT) operators. Three organisations were selected for a comparative case study approach. The results show that the leadership approach of their key staff was of particular significance. Each organisation is moving in the direction of greater professionalism and away from its community roots. This cultural change can be attributed to responses to external forces, especially those affecting resources. Evidence suggests they are being forced towards adopting practices of the private sector, but that this need not be the case. Community transport provision is in a period of transition, the outcome of which may radically alter both its structure and its survival capacities.The research on which this paper is based was funded by the Economic and Social Research Council. The authors would also like to place on record their thanks to the three organisations who participated in this study.     

Marital Status and Perceived Discrimination Among Transgender People

Despite calls for increased attention to the experiences of transgender people, scientific understanding of the stigma and discrimination this population experiences is limited. The authors integrate minority stress and marital advantage perspectives to assess marital status differences in transgender‐related perceived discrimination among transgender people in multiple life domains: the workplace, family, health care, and public accommodations. They analyze one of the first and most comprehensive large‐scale samples of transgender people in the United States (N = 4,286), the National Transgender Discrimination Survey. They find that married transgender respondents tend to report lower levels of perceived discrimination than their cohabiting and previously married transgender counterparts. Married transgender respondents do not, however, report lower levels of perceived discrimination than their never married counterparts, once all covariates are accounted for. These marital status differences appear primarily among transwomen but not transmen. Economic resources account for some, but not all, of these differences.     

How many men work in the English early years sector? Why is the low figure so ‘stubbornly resistant to change’?

This study draws on data from the GenderEYE project, research conducted in England between 2018 and 2020, which aimed to examine the recruitment, support and retention of male teachers within early years education (EYE) with a view of developing a more gender diverse workforce in this sector. Data collection was by means of a survey, 9 case studies with early years settings and interviews with key stakeholders. In this study, we examine a key finding about the persistently low numbers of male EYE professionals, linking this to another finding concerning a lack of specific strategy to recruit and support men.     

Friendly foes under friendly fire: a risk-based approach to benefit society failures in West Kent, 1860–1885

ABSTRACT

Much of the extensive historiography of nineteenth-century English friendly societies has focused on their capacity to create social capital and their predisposition towards insolvency, although more recently historians have argued that the ability of affiliated orders to raise levies made them financially stronger than previously supposed. However, given that societies still failed regularly, in what circumstances was it impossible to mount such rescues, and why? This article answers this question through a case study of three small ‘local’ societies in West Kent. Using the perspective of risk and risk transfer, it suggests they all suffered from a serious combination of membership and competitor risk which, when mishandled, also caused significant reputational damage to both societies and their managers. A further major tension was that many local opinion formers were starting to demand higher standards of accountability, including from friendly society trustees. The article also looks at the survival strategies of individual managers and members, arguing that – during financial crises – self-interest exerted powerful forces on those societies. In each case, the evidence reveals that often longstanding local relationships, based on mutual trust and shared values, were fractured so completely that raising levies or other bailouts to keep them afloat proved impossible.     

Industry culture and strategic response: the case of the british bus industry

This article is concerned to demonstrate the utility of the notion of culture at the industry level. A multiple-case study of nine British bus companies highlights the way in which entrenched views and practices which were common among the nine companies restricted the range of strategic thinking among them. Many of these views and practices are emblematic of traditional bus company perspectives and are common throughout the industry. The reasons for the “hold” that the industry culture has on managers are examined. These include such factors as the impact of leadership and the inheritance of pre-deregulation features.     

Thinking with suffering

Abstract

This article provides a critical review of literature on ‘social suffering’. Analytical attention is focused upon the ways in which writers struggle to bring ‘meaning’ to this topic. All sense that there is always something in events of extreme suffering that resists conceptualisation and defies analysis. This problem of establishing a language for ‘thinking with suffering’ is explored with reference to the works of Hannah Arendt, Paul Ricoeur and Max Weber. An agenda for sociological research is proposed which focuses on the struggle to make sense out of the phenomenon of suffering as a force of cultural innovation. In this context, it is suggested that what is most interesting here is the evidence to suggest that, when faced with the ‘brute fact’ of a world where there appears to be too much suffering, people are always moved to make this phenomenon productive for thought and action.     

Origins and Destinations,but How Much and When? Educational Disparities in Smoking and Drinking Across Adolescence and Young Adulthood

Educational inequalities in health behaviors change dynamically across the life course. Yet, how parental and personal education interactively shape age-specific behavioral inequalities across the transition to adulthood has yet to be understood. Drawing on national Add Health data (N?=?12,605; 6,675 women and 5,930 men), we analyze age- and gender-specific trajectories of current smoking and binge drinking from adolescence to young adulthood. In line with previous work, we find that parental education associates with smoking and drinking disparities even after respondents’ own education is completed. Reciprocally, we also find that disparities by eventual educational attainment appear early. During the college years, higher parental education predicts higher—not lower—rates of binge drinking. We find that attaining higher education “against the odds” of an educationally disadvantaged family background circumscribes the lowest rates of smoking and drinking for men and women alike, and especially during the college years, while “falling from grace” by not attaining higher education at levels matching one’s parents predicts the highest levels of smoking and drinking for both genders during or after college. These results shed new light on the interactive socioeconomic processes that help to explain behavioral health gradients across adolescence and adulthood.