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791.
The provision of parenting support is a key feature of wealthier nations’ health and social care services. However, attendance and engagement by the neediest parents remains poor. Barriers experienced by parents include personal life factors (beliefs, lifestyles and limited resources) and programme‐specific factors (delivery, content and support arrangements). Here we give consideration to these issues, drawing on published reviews of parenting programme effectiveness identified through a comprehensive search of electronic databases. We suggest ways of improving attendance and engagement, by providing programmes as part of a comprehensive framework of family support.  相似文献   
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Abstract

Decreasing demand and reduced budgets are driving changes to traditional crewing methods in the UK Fire and Rescue Service. Using an integration of two years' operational data within a novel framework, this paper assesses the impact of alternative crewing on operational effectiveness in one UK FRS. Changes in crewing patterns were implemented without substantial impact on overall operational effectiveness, but there may be a risk to wider operational resilience. The Overall Effectiveness of Fire Operations (OEFO) assessment tool can inform FRS decision making in an authentic way allowing stakeholder confidence in the outcomes, whilst being timely and not too complex or costly to evaluate. The OEFO approach is an important contribution to practice through its ability to assess public services at a time of challenging reform and demonstrates alterations can be made to crewing patterns to better match demand provided there is consideration of the potential wider impact.  相似文献   
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In this paper, we analyse how a migrant population that is both expanding and changing in composition has affected the composition of Swedish neighbourhoods at different scales. The analysis is based on Swedish geocoded individual-level register data for the years 1990, 1997, 2005, and 2012. This allows us to compute and analyse the demographic composition of neighbourhoods that range in size from encompassing the nearest 100 individuals to the nearest 409,600 individuals. First, the results confirm earlier findings that migrants, especially those from non-European countries, face high levels of segregation in Sweden. Second, large increases in the non-European populations in combination with high levels of segregation have increased the proportion of non-European migrants living in neighbourhoods that already have high proportions of non-European migrants. Third, in contrast to what has been the established image of segregation trends in Sweden, and in an apparent contrast to the finding that non-European migrants increasingly live in migrant-dense neighbourhoods, our results show that segregation, when defined as an uneven distribution of different populations across residential contexts, is not increasing. On the contrary, for both European migrants from 1990 and non-European migrants from 1997, there is a downward trend in unevenness as measured by the dissimilarity index at all scale levels. However, if segregation is measured as differences in the neighbourhood concentration of migrants, segregation has increased.  相似文献   
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Although the rate of alcohol use among adolescents has declined, it remains their drug of choice. Parent and peer alcohol use are powerful risk factors for youth alcohol use. However, questions remain about how these factors influence underage drinking. The present study investigates the relationship between exposure to parent or peer alcohol use and two stages of adolescent drinking—onset and escalation—overall and at five age points during adolescence. Participants were 9348 adolescents in Waves I (WI) and II (WII) of the National Longitudinal Study of Adolescent Health, whose parents completed interviews at WI, and who identified themselves as either non-drinkers or experimental drinkers at WI. Reports of WII alcohol use were used to measure onset among WI non-drinkers and escalation among WI experimenters. Risk ratios were calculated to assess the overall impact of exposure to parent or peer alcohol use on onset and escalation, and at five age points (i.e., ≤?13, 14, 15, 16, and ≥?17). Findings show that exposure to either parent or friend alcohol use increased the risk of onset and escalation. Age-based analyses reveal a more nuanced relationship, showing variability in the nature and strength of influence by stage of drinking and by age. This study highlights the relevance of both parent and peer modeling on youth drinking throughout adolescence. Implications in advancing prevention and treatment include parental education about the impact of their own behaviors and the importance of monitoring teens’ friendships.  相似文献   
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In common with many advanced welfare states, England has increasingly relied on consumerist principles to deliver both greater quality and improved efficiency in the long‐term care system. The Individual Budget (IB) pilots marked the next step in this process, through a new system of funding whereby greater control of resources is given to service users, in lieu of direct in‐kind care provision. IBs have the potential to transform the market for care services as well as the relationships between key stakeholders within it. Purchasing will increasingly be shaped by the demands of IB holders, with providers expected to deliver a wider range of personalized services. What will this mean for providers, and what can they do to prepare for these changes? These questions are relevant not just in England but in many other countries adopting similar mechanisms for devolving control over the design, delivery and funding of care to the end‐user. The article explores the early impact of IBs on providers' services, on their workforces, and on the administrative implications for providers of managing IBs. The study finds that providers were positive about the opportunities for better‐quality services that IBs can bring about. However, participants highlighted a number of obstacles to their effectiveness, and reported a range of potentially adverse administrative and workforce consequences which have the potential to jeopardize the consumerist policy objectives of increased choice and efficiency.  相似文献   
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