The Search For Stability and Permanence: Modelling the Pathways of Long-stay Looked After Children

This paper presents findings from a study of children lookedafter by 24 local authorities. It combines analysis of statisticaldata with analysis of qualitative and quantitative data froma questionnaire survey of a targeted sub-sample of childrenwho had been looked after for 4 years or more. The paper highlightsa complex picture of continuity and discontinuity in attemptsto achieve stability and permanence in a range of birth family,foster care, adoption, residential and leaving care placementsfor long-stay children. Some long-stay children are moving smoothlyand in a planned way towards a family for life, while some experiencelong periods in stable but temporary placements or have a numberof moves prior to finding stability and a sense of belonging.A further group of children experience stability or moves whilelooked after, without having a family to belong to when theymove into adult life. The paper discusses the difficulty withthe Government’s current long-stay performance measurein capturing the difference between stability in placement andplanned permanence for children and families.     

Collective Decision-Making: the Analytic Hierarchy Process

Analytic Hierarchy Process (AHP) is a method to improve decision making whose application here is to complex environments. “A.H.P.” involves structuring a decision into a hierarchy, determining relative priorities for the elements in the hierarchy, and combining the numbers into overall weights estimating each decision outcome. The need for decision aids such as AHP, is supported by the literature, which suggests that even experts can contend with only limited amounts of information and tend to arrive at decisions in a simple fashion. AHP allows for using more information to make decisions in more complex ways. This leads to more coherent decisions. In the case presented AHP helped a committee make resource allocation decisions in an urban renewal project in Israel. The example highlights the usefulness of AHP in group settings. Areas of disagreement were easily identified and discussed. This diffused much of the tension typical of these proceedings.     

Embedding effects: Stimulus representation and response mode

Thecontingent valuation (CV) methodology assigns prices to environmental amenities by asking people how much they would be willing to pay in order to preserve or acquire those amenities. If this measurement procedure is valid, then responses should be sensitive to relevant changes in the amenities being judged and insensitive to irrelevant changes. One apparent demonstration of inappropriate insensitivity is theembedding effect: the observation that people are apparently willing to pay the same amount of money for a good as for a minor subset of that good. This study examined the possibility that the source of this effect lies with each of two (potentially treatable) methodological problems: 1) subjects have difficulty using quantitative (dollar) response modes to express their values; and 2) subjects have difficulty absorbing the essential details of the CV scenarios describing those goods. The study found that 1) subjects showed considerable embedding both with a simple paired-comparison response mode and with a more demanding one requiring direct dollar estimates; 2) embedding was much reduced with the simpler response mode; 3) subjects' preferences with the two response modes were usually inconsistent; 4) when asked to describe the CV scenario that they had just heard, subjects often reported key task details inaccurately; and 5) there was less embedding when tasks were reinterpreted in terms of the questions subjects reported having answered (as opposed to what had actually been asked). These results are discussed in terms of the match between the questions that investigators would like to ask and the ones that subjects are capable of answering.     

Benefits and incentives for lone parents: A comparative analysis

One of the most striking trends over the past 20 years is the growth in the number of lone parent families in developed countries. This article provides an analysis of the structure of incentives in benefit systems for lone parents in a cross-national perspective, using data from a recent comparative study of the systems of support for families with children in 17 countries (the members of the European Union, Australia, Japan, Norway, Sweden and the United States). The article compares the level of benefits for lone parents and takes into account the impact of housing costs, health costs, and education and preschool provision. It assesses the possible incentive effects of different systems through a comparison of the financial positions of lone parents not in paid employment, lone parents in the labour market and other family types.     

Conundrum of Sexual Decision Making in Marital Relationships: Safer-Sex Knowledge,Behavior, and Attitudes of Married Women in Zambia

Recent research suggests that Zambian women face an increasing risk of contracting human immunodeficiency virus (HIV) within marital relationships. Married women's perceived ability to negotiate safer sex or adopt self-efficacy practices is recognized as critical in preventing new infections within marriage. Yet women's self-efficacy practices, such as requesting condom use or refusing sex within marriage, are influenced by individual and context-specific factors. Using the 2007 Zambia Demographic and Health Survey data from 4,306 married women, this article examines the association between married women's perceived ability to negotiate safer sex and a range of attitudinal, knowledge, and sociodemographic variables. Results from complementary log-log regression models reveal that married women who have factual knowledge about HIV transmission and prevention, as well as those who have been tested for their HIV serostatus, were more likely to report they can request that their husbands use a condom. Rural married women were more likely to report they can refuse their husbands sex compared to woman in urban areas. Likewise, married women who agree that a wife is justified in refusing her husband sex if he sleeps with other women were more likely to report they can negotiate safer sex compared to women who disagree. These findings suggest that married women are able to negotiate safer sex if they have correct factual knowledge about HIV transmission and are aware of their rights within marital relations.     

FIELD EXPERIMENTS ON THE ANCHORING OF ECONOMIC VALUATIONS

A pillar of behavioral research is that preferences are constructed during the process of choice. A prominent finding is that uninformative numerical “anchors” influence judgment and valuation. It remains unclear whether such processes influence market equilibria. We conduct two experiments that extend the study of anchoring to field settings. The first experiment produces evidence that some consumers' valuations can be anchored in novel situations; there is no evidence that experienced agents are influenced by anchors. The second experiment finds that anchors have only transient effects on market outcomes that converge to equilibrium predictions after a few market periods. (JEL C93, D11)     

Does Japan Still Matter? Past Tendencies and Future Opportunities in the Study of Japanese Firms

This paper engages with the question ‘does Japan still matter’ by systematically reviewing publication patterns in peer‐reviewed academic journal articles addressing Japanese firms and their management practices, illustrating the academic discourse surrounding Japanese firms over four decades, and by identifying future research opportunities. Initially, particularly from the 1980s when Japanese firms came to prominence, these practices tended to be identified as ‘best practice’. However, at least in part due to socio‐economic changes, this tendency has become less prominent since the ‘bubble economy’ burst. Instead, three broader developments are observed: the examination of the continuity and change in the traditional Japanese model, a more complex approach that involves multiple themes of research, and leveraging new contexts to examine Japanese firms, including the long‐term recession, the rise of the East Asian economy, and the increasing importance of corporate social responsibility.     

Reducing Hospital Readmissions by Integrating Empirical Prediction with Resource Optimization

Hospital readmissions present an increasingly important challenge for health‐care organizations. Readmissions are expensive and often unnecessary, putting patients at risk and costing $15 billion annually in the United States alone. Currently, 17% of Medicare patients are readmitted to a hospital within 30 days of initial discharge with readmissions typically being more expensive than the original visit to the hospital. Recent legislation penalizes organizations with a high readmission rate. The medical literature conjectures that many readmissions can be avoided or mitigated by post‐discharge monitoring. To develop a good monitoring plan it is critical to anticipate the timing of a potential readmission and to effectively monitor the patient for readmission causing conditions based on that knowledge. This research develops new methods to empirically generate an individualized estimate of the time to readmission density function and then uses this density to optimize a post‐discharge monitoring schedule and staffing plan to support monitoring needs. Our approach integrates classical prediction models with machine learning and transfer learning to develop an empirical density that is personalized to each patient. We then transform an intractable monitoring plan optimization with stochastic discharges and health state evolution based on delay‐time models into a weakly coupled network flow model with tractable subproblems after applying a new pruning method that leverages the problem structure. Using this multi‐methodologic approach on two large inpatient datasets, we show that optimal readmission prediction and monitoring plans can identify and mitigate 40–70% of readmissions before they generate an emergency readmission.