Practitioners preferences of care coordination for older people: A discrete choice experiment

These findings demonstrate the importance of organisations providing care coordination for older people receiving long-term funding. Further research is required to investigate the influence of service setting on practitioner preferences.

This study explored practitioner preferences about the relative value of attributes of care coordination services for older people. A Discrete Choice Experiment (DCE) survey was used to identify the views of 120 practitioners from 17 services in England in 2015. The survey design was informed by an analysis of standards of care coordination, a postal survey and a consultation with carers of older people. Results of the DCE survey were supplemented by a content analysis of qualitative comments and fieldwork notes. Most respondents were over 30 years of age, female and almost half worked part-time. Continuity of care (care provided by the same care coordinator) and the ability to access the range of services outlined in the care plan were the most important service attributes. Service setting influenced practitioner preferences. Those in specialist services for people with dementia identified the length of time a service was provided as another important attribute. The DCE methodology has provided the opportunity to systematically canvas practitioner preferences.     

Personality analysis of a swingers' club

Thirty swingers (16 females, 14 males) from a private metropolitan swinging club volunteered to take the MMPI. One half of the 30 had significant elevations on the clinical and/or validity scales, most frequently on the 9 scale (Hypomania). One third of the sample with normal MMPI scale elevations had significant elevations on validity scales that indicate defensiveness in responding. Analysis of a selected group of special scales of the MMPI indicated that a significant minority of the subjects 1) may be seriously emotionally disturbed, 2) may be substance abusers, or 3) may have serious sexual problems. The MMPI records suggest further that the absence of significantly elevated clinical scales among the normal subgroup may have been a function of defensiveness. On the other hand, most of the subgroup evidencing psychopathology possess ego resources sufficient to enable them to cope with emotional problems.A paper based primarily on the clinical scale analysis was read by the senior author at the meeting of the Society for Sex Therapy and Research, Charleston, SC, 1982. A paper based primarily on the special scale and critical item analyses was read by the junior author at the Eastern Regional meeting of the Society for the Scientific Study of Sex, Philadelphia, PA, 1982. The authors are grateful for the cooperation of Dr. Robert L. McGinley in the collection of the data of this report. Address requests for reprints to: Eugene E. Levitt, Ph.D., Department of Psychiatry, Indiana University School of Medicine, 791 Union Drive, Indianapolis IN 46223.     

Seasonal migration and seasonal variation in fecundabillty: Effects on birth rates and birth intervals

Seasonal patterns in conception rates have been documented in several recent studies. In this paper, a mathematical model of the reproductive process is developed through which the impact of such variation in conception rates is assessed. It is found that the effect on fertility can be quite substantial, but that the birth rate when seasonal variation is occurring is approximated well by the birth rate calculated when conception rates are constant at their mean. These results indicate that further documentation of seasonality in conception rates and exploration of the causes of these patterns and their change is an important area for demographic research.     

Polynesian child rearing: An alternative model

Literature on child-rearing practices and family style in Polynesia is reviewed. The five following themes common to Polynesian cultures are identified: community responsibility for the care of children, multiple parenting, early indulgence, early independence, and caretaking by siblings and peers. The persistence of, and changes in, the behavior patterns which flow from these themes are then described. Finally, the implications for Western child-rearing practices of Polynesian child-rearing patterns are discussed.     

Individual outpatient treatment of pathological gambling

Recovery from pathological gambling is viewed as a process whereby the pathological gambler chooses to lose an addiction to gambling and maintains that choice while mourning the loss of the gambling. The self-induced and self-escalating addictive crisis leading up to that choice is explored, as is the crisis caused by the loss of the gambling itself. It is proposed that gambling provides the gambler with action, a method of dealing with stress aand avoiding unpleasant affect, and a variety of social, psychological, and existential benefits. The loss of gambling is seen as a complicated and significant one which elicits grief responses similar to those seen in response to other types of major loss. It is proposed that in the individual outpatient treatment of pathological gamblers, the therapist helps the recovering gambler to accept the loss of the gambling and learn to live a rewarding life without it. Four phases of treatment are suggested which correspond to stages of grieving and accepting the loss of the gambling.     

Hypernetwork sampling: Duality and differentiation among voluntary organizations

One of the recurrent problems in the study of social organization is that survey researchers are forced to study individuals, while they are often interested in hypotheses about organizations or systems of organizations. This paper offers some methods which allow survey researchers to address hypotheses about the relations generated among individuals by organizations, the organizations themselves, and the relations among organizations. Estimators are developed for the number and size distribution of organizations in communities, the density of relations among individuals generated by organizations, the number and density of interorganizational linkages, and the amount of membership overlap among organizations. This approach combines Granovetter's idea of network sampling with Breiger's notion of the duality of persons and groups to produce a quantitative approach to the study of voluntary organization. We provide an illustration of the methods we develop by testing two of Blau's structural hypotheses on data concerning voluntary organizations. The hypotheses that structural differentiation increases with system size and that this increase is at a decreasing rate are strongly supported. The paper closes with some suggestions for further elaborations of the hypernetwork approach.