The State of Care Management in Learning Disability and Mental Health Services 12 Years into Community Care

This paper reports on the organization of care management froma longitudinal study of community care for people resettledfrom long-stay learning disability and psychiatric hospitals.The findings from a 12-year follow-up of care management arrangementsin 12 learning disability and eight mental health study siteservices are described. The diversity of care management arrangementsfound at earlier points in the evaluation remained evident.Also, many of the former ‘care in the community’service users were excluded from mainstream care managementarrangements in their localities. The difficulty of developingperson-centred arrangements in learning disability and the lackof integration of the Care Programme Approach and care managementwere evident. The findings and observations are placed in thewider policy and practice context, with suggestions for takingcare management forward nationally and locally.     

Benchmark Analysis: Shopping with Proper Confidence

We discuss the issue of using benchmark doses for quantifying (excess) risk associated with exposure to environmental hazards. The paradigm of low-dose risk estimation in dose-response modeling is used as the primary application scenario. Emphasis is placed on making simultaneous inferences on benchmark doses when data are in the form of proportions, although the concepts translate easily to other forms of outcome data.     

Comparing Networks Across Space and Time, Size and Species

We describe and illustrate methodology for comparing networks from diverse settings. Our empirical base consists of 42 networks from four kinds of species (humans, nonhuman primates, nonprimate mammals, and birds) and covering distinct types of relations such as influence, grooming, and agonistic encounters. The general problem is to determine whether networks are similarly structured despite their surface differences. The methodology we propose is generally applicable to the characterization and comparison of network–level social structures across multiple settings, such as different organizations, communities, or social groups, and to the examination of sources of variability in network structure. We first fit a p^* model (Wasserman and Pattison 1996) to each network to obtain estimates for effects of six structural properties on the probability of the graph. We then calculate predicted tie probabilities for each network, using both its own parameter estimates and the estimates from every other network in the collection. Comparison is based on the similarity between sets of predicted tie probabilities. We then use correspondence analysis to represent the similarities among all 42 networks and interpret the resulting configuration using information about the species and relations involved. Results show that similarities among the networks are due more to the kind of relation than to the kind of animal.     

Social choice with analytic preferences

Arrow's axioms for social welfare functions are shown to be inconsistent when the set of alternatives is the nonnegative orthant in a multidimensional Euclidean space and preferences are assumed to be either the set of analytic classical economic preferences or the set of Euclidean spatial preferences. When either of these preference domains is combined with an agenda domain consisting of compact sets with nonempty interiors, strengthened versions of the Arrovian social choice correspondence axioms are shown to be consistent. To help establish the economic possibility theorem, an ordinal version of the Analytic Continuation Principle is developed. Received: 4 July 2000/Accepted: 2 April 2001     

Betrayal and repetition: Understanding aggression in sexually abused girls

Betrayal by a significant object is seen as primary in causing behavioral and emotional disturbances in incest victims, leading to a pervasive identification with the aggressor and disturbances in object relations development. Identification with the aggressor is understood not as a uniform defense mobilized against a specific affect but as a complex compromise formation which defends against anxiety, while also providing libidinal, aggressive and superego gratifications. Far from simply attempting to overcome the past, identifications thus preserve affects that have become pleasurable and self-defining. Two case studies of adolescent girls illustrate how treatment can help victims recognize and begin to forego the sadomasochistic pleasure derived from these identifications, a relinquishment necessary for true mastery.