Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.     

Generalized additive models for location, scale and shape

Summary.  A general class of statistical models for a univariate response variable is presented which we call the generalized additive model for location, scale and shape (GAMLSS). The model assumes independent observations of the response variable y given the parameters, the explanatory variables and the values of the random effects. The distribution for the response variable in the GAMLSS can be selected from a very general family of distributions including highly skew or kurtotic continuous and discrete distributions. The systematic part of the model is expanded to allow modelling not only of the mean (or location) but also of the other parameters of the distribution of y , as parametric and/or additive nonparametric (smooth) functions of explanatory variables and/or random-effects terms. Maximum (penalized) likelihood estimation is used to fit the (non)parametric models. A Newton–Raphson or Fisher scoring algorithm is used to maximize the (penalized) likelihood. The additive terms in the model are fitted by using a backfitting algorithm. Censored data are easily incorporated into the framework. Five data sets from different fields of application are analysed to emphasize the generality of the GAMLSS class of models.     

Gender,lineage, and fertility‐related outcomes in Ghana

A growing literature examines the empirical relationship between the joint reproductive preferences of marital partners and reproductive outcomes in Africa. Less explored is how spousal power in decision making may be influenced by lineage type. Using pooled data from Ghana, we investigate how lineage affects gendered reproductive decision outcomes and find some evidence that matrilineal women are more able than nonmatrilineal women to translate their reproductive preferences into action consistent with their goals.     

How Welfare Policies Affect Adolescents' School Outcomes: A Synthesis of Evidence From Experimental Studies

Using data from 8 random assignment studies and employing meta‐analytic techniques, this article provides systematic evidence that welfare and work policies targeted at low‐income parents have small adverse effects on some school outcomes among adolescents ages 12 to 18 years at follow‐up. These adverse effects were observed mostly for school performance outcomes and occurred in programs that required mothers to work or participate in employment‐related activities and those that encouraged mothers to work voluntarily. The most pronounced negative effects on school outcomes occurred for the group of adolescents who had a younger sibling, possibly because of the increased home and sibling care responsibilities they assumed as their mothers increased their employment.     

A general inverse sampling scheme and its application to adaptive cluster sampling

Not having a variance estimator is a seriously weak point of a sampling design from a practical perspective. This paper provides unbiased variance estimators for several sampling designs based on inverse sampling, both with and without an adaptive component. It proposes a new design, which is called the general inverse sampling design, that avoids sampling an infeasibly large number of units. The paper provide estimators for this design as well as its adaptive modification. A simple artificial example is used to demonstrate the computations. The adaptive and non‐adaptive designs are compared using simulations based on real data sets. The results indicate that, for appropriate populations, the adaptive version can have a substantial variance reduction compared with the non‐adaptive version. Also, adaptive general inverse sampling with a limitation on the initial sample size has a greater variance reduction than without the limitation.     

Testing symmetry under a skew Laplace model

We develop tests of hypothesis about symmetry based on samples from possibly asymmetric Laplace distributions and present exact and limiting distribution of the test statistics. We postulate that the test statistic derived under the Laplace model is a rational choice as a measure of skewness and can be used in testing symmetry for other, quite general classes of skew distributions. Our results are applied to foreign exchange rates for 15 currencies.     

Vulnerability and Agenda: Context and Process in Project Management

This paper explores how the project management role is conditioned by the context in which change is progressed. The argument draws on Pettigrew's (1985, 1987) contextual and processual view of change, a view which does not clarify the management implications of contextual variation. Using data from a two-stage research design combining diary and survey methods, four context dimensions are identified, concerning ‘interlocking’, ‘shifting sands’, ‘ownership’ and ‘senior management view’. For analytical purposes, two extreme contexts are characterized as exposing the project manager to high and low levels of ‘vulnerability’ respectively. Project management literature typically offers a rational-linear account of change, and concentrates on ‘content’ and ‘control’ agendas, concerning technical expertise on the one hand, and planning, budgeting and monitoring techniques on the other. Sociological analyses reveal the limitations of the rational-linear account, and focus on the political and cultural dimensions of the ‘process’ agenda. The data suggest how contextual variation affects the relative priority of these agendas. The management implications of these findings are explored, for project management selection, career progression, and the development of diagnostic skills and ‘agenda management’ strategies.     

Ethnic preferences and perceptions among Asian and White British middle school children

Asian and White middle school children were shown photographs of unknown Afro-Caribbean, Asian, and White individuals of approximately the same age as themselves, and asked which one wax most like them, which one they would prefer to be, which ones they would prefer to engage in various activities with, and finally, to allocate positive and negative traits to the three groups or to nobody. A similar majority of both Asian and While children selected an own-race photograph as being most like them, but only about a half selected the own-race photograph as the one they would most like to he. For sharing activities, children showed a strong own-tender preference, followed by an own-race preference. White children stated a greater preference for sharing activities with White children, then with Afro-Caribbean children, and least with Asian children. Asian children preferred Asian and White children the most, Afro-Caribbean the least. On a stereotypes test, similar trends were obtained; White children evaluated While children highest and Asian lowest; Asian children tended to evaluate Asian children highest but to a nonsignificant extent. The relative proportion of Asian/White children in school appeared to have little systematic influence on the results, thus arguing against the contact hypothesis of prejudice reduction in its simple form.