Met needs and unmet needs, and satisfaction among Social HMO members

This article reports on a survey of 800 members of four Social HMO demonstration sites, who were receiving home-based, community-based, and short-term institutional services under the demonstration's expanded community care benefits. The survey asked whether members needed help in 11 areas, whether they received help in each area from an informal caregiver, whether they wanted more help from the Social HMO, and whether help provided by both was adequate. Satisfaction with the program and with service coordination was also assessed. The adequacy of informal care differed by problem area, as did the help desired from the Social HMO and its responsiveness. Members were less satisfied when they had weaker informal care, were African American, and when they received inadequate help from the plan with ADLs, transportation, medical access, and managing money. Members were more satisfied when they were professionals, home owners, knew their service coordinator's name (or how to contact her), and received help with their problems. The findings point to the importance of clarifying divisions of labor with informal caregivers, as well as possible expansions in responsibilities for service coordinators and benefits beyond traditional boundaries.     

The critique of intelligent design: Epicurus,Marx, Darwin,and Freud and the materialist defense of science

A new version of the age-old controversy between religion and science has been launched by today’s intelligent design movement. Although ostensibly concerned simply with combating Darwinism, this new creationism seeks to drive a “wedge” into the materialist view of the world, originating with the ancient Greek philosopher Epicurus and manifested in modern times by Darwin, Marx, and Freud. Intelligent design proponents thus can be seen as challenging not only natural and physical science but social science as well. In this article, we attempt to explain the long history of this controversy, stretching over millennia, and to defend science (especially social science) against the criticisms of intelligent design proponents – by defending science’s materialist roots.

---

Public Management at the Ballot Box: Performance Information and Electoral Support for Incumbent English Local Governments

Publishing performance information about local public services,an increasing trend in many Organisation for Economic Co-operationand Development countries, matters politically because it hasan effect on incumbent local governments' electoral support.Voters are able to use performance information to punish orreward incumbents in the elections that follow their publication,which may fill a gap in the chain of accountability betweenvoters and governments. We model the introduction of publishedComprehensive Performance Assessments of local authorities inEngland, which make summary information about performance availableto voters, as a "shock" to the relationship between voters andincumbents. Controlling for an unpublicized measure of performancechange over time, change in the local tax level, change in localeconomic conditions, and whether the local incumbent is theparty of the incumbent government at the national level, wefind negativity bias. Incumbents in local authorities in the"poor" performance category experience a substantial reductionin aggregate vote share at the election following publication,but there is no similarly sized reward for those in the highestperformance category.     

Camera-Related Behaviors during Video Recorded Medical Interactions

Video recording provides an objective record of the content of medical interactions. However, there is concern that cameras may be reactive measurement devices that alter what normally transpires during interactions. This study addressed potential reactivity of cameras in medical interactions. Interactions between 45 patients and 14 medical oncologists were video recorded and coded for camera-related behaviors. Eleven of 45 patients performed none of the behaviors. Among the other patients, camera-related behaviors were infrequent and, on average, constituted about 0.1% (one-tenth of one percent) of total interaction time. Behaviors occurred most often in very early stages of interactions, and when physicians were absent from the room. Seven physicians showed camera-related behaviors, comprising less than 0.1% of the time they were in the interaction. Results suggest video recording can provide nonreactive means of studying medical interactions.

A UNIVERSITY EXAMINATION-SCHEDULING MODEL TO MINIMIZE MULTIPLE-EXAMINATION DAYS FOR STUDENTS

Scheduling university examinations is often done with the objective of spreading a student's required examinations over an examination week. That is the equivalent of the problem of minimizing the number of examinations a student must take on any one day. An approach to scheduling exams which relates the problem to the classical assignment problem is discussed. The model developed is a symmetry-constrained assignment model, and the solution method requires use of a branch-and-bound algorithm. Results from application of the algorithm to six semesters of actual data are presented.     

USING AN UNCERTAINTY MODEL TO ASSESS SALES RESPONSE TO ADVERTISING*

Implications of a probabilistic “random walk” model of incremental sales response to advertising are developed for various timing patterns of advertising expenditures. Maximum likelihood procedures for assessing advertising effectiveness and for estimating a decay (forgetting) rate are developed and applied to artificial data of known configuration and are used to assess the impact over time of a brochure program on mail-order sales. Results are also compared to those from alternative models involving various lag patterns in advertising effects.     

Unmet Need for Family Planning in Developing Countries and Implications for Population Policy

Unmet need for family planning has been a core concept in international population discourse for several decades. This article reviews the history of unmet need and the development of increasingly refined methods of its empirical measurement and delineates the main questions that have been raised about unmet need during the past decade, some of which concern the validity of the concept and others its role in policy debates. The discussion draws heavily on empirical research conducted during the 1990s, much of it localized, in‐depth studies combining quantitative and qualitative methodologies. Of the causes of unmet need other than those related to access to services, three emerge as especially salient: lack of necessary knowledge about contraceptive methods, social opposition to their use, and health concerns about possible side effects. The article argues that the concept of unmet need for family planning, by joining together contraceptive behavior and fertility preferences, encourages an integration of family planning programs and broader development approaches to population policy. By focusing on the fulfillment of individual aspirations, unmet need remains a defensible rationale for the formulation of population policy and a sensible guide to the design of family planning programs.     

Pricing in Electricity Markets

The technical characteristics of electricity generation and transmission have implications for the way in which economic principles are adapted to evaluate pricing and regulation issues in electricity markets. In particular, there is an externality associated with the way in which electricity flows in networks because of Kirchoff's laws. In this paper, a mathematical programming model is presented that simulates a competitive electricity market, based on the spatial-intertemporal equilibrium models pioneered by Takayama and Judge (1971). The model is used to simulate the operation of a hypothetical electricity market, illustrating some of the issues arising from the network externality.     

Cohabitation in Great Britain: not for long, but here to stay

This paper uses a new source of data to study the dramatic increase in cohabiting unions in Great Britain. It analyses, in turn, entry into first partnership, the stability of cohabiting unions and repartnering after dissolution of cohabitation. In excess of 70% of first partnerships are now cohabitations, and these last a relatively short time before being either turned into marriage or dissolved. The shift to cohabitation as the dominant mode of first partnership plays an important role in the delay of first marriage and motherhood. The paper also investigates the factors that are associated with the outcome of cohabitations.