The impact of quasi-markets on processes and factors affecting the costs of contracting

The aim of this paper is to ascertain the impact of quasi-markets on contracting processes and factors affecting the costs of contracting in Finnish health care in the specific case of laboratory services. By means of a comparative case analysis, we ascertained the changes in organizational contracting practices and identified the actions affecting the transaction costs of contracting in the case of an autonomous municipal enterprise laboratory compared with the same laboratory as a hierarchically run municipal unit. The research was conducted during the years 2007–2011. The results suggest that introducing quasi-markets into laboratory services increased the cost factors of contracting; and had a negative impact on the laboratories’ willingness to create new market relationships.     

Access Barriers to Mental Health Services for Older Adults from Diverse Populations: Perspectives of Leaders in Mental Health and Aging

This project is based on the results of telephone surveys with 52 local, state, and national informed respondents including policymakers, county leaders, planners, and advocates in mental health and aging with a particular focus on the states of California and Florida. This article addresses challenges to access to mental health services for diverse older adults including barriers related to race and ethnicity, socioeconomic status, location, age, gender, immigrant status, language, sexual orientation, and diagnosis. The article also highlights broad themes that emerged including (1) the importance of outreach and transportation tailored to diverse elders, and (2) recruitment of diverse staff and training related to diversity. The article concludes with policy and practice recommendations to reduce these disparities in access to mental health services for diverse populations of older adults.     

Perceived Family Functioning and Family Resources of Hong Kong Families: Implications for Social Work Practice

This article reports the results of a telephone survey (n = 1,015 respondents) that aims to identify the perceived general family functioning and family resources of Hong Kong Chinese families and their linkage to each other in a rapidly transforming society. The perceived general family functioning of the respondents was average, and the five types of family resources—time, income, human capital, psychological capital, and social capital—of the respondents ranged from average to good. The following family resource domains, in descending order, have accounted for significant variance in perceived general family functioning: income, time spent with family, stress coping efficacy, religion, and satisfaction with the living environment. Our findings provide empirical support for policy formulation and social work practice.     

The effect of expansions in medicaid income eligibility on abortion

In this paper we examine the effect of expansions in Medicaid income eligibility on abortion, using individual-level data from South Carolina, Tennessee, and Virginia. The results suggest that for unmarried nonblack women with less than a high school degree, expansions of income eligibility lowered the probability of abortion by two to five percentage points. Most of the impact of the Medicaid expansions on abortion occurred in the first round of expansions from approximately 45% of the federal poverty level to 100%. For black unmarried women with less than a high school degree, we generally find no effect of expansions in Medicaid income eligibility on abortion.     

The effect of pregnancy intention on child development

In this paper, we use data from the National Longitudinal Survey of Youth to investigate the empirical link between unintended pregnancy and child health and development. An important contribution of our study is the use of information on siblings to control for unmeasured factors that may confound estimates of the effect of pregnancy intentions on infant and child outcomes. Results from our study indicate that unwanted pregnancy is associated with prenatal and postpartum maternal behaviors that adversely affect infant and child health, but that unwanted pregnancy has little association with birth weight and child cognitive outcomes. Estimates of the association between unwanted pregnancy and maternal behaviors were greatly reduced after controls for unmeasured family background were included in the model. Our results also indicate that there are no significant differences in maternal behaviors or child outcomes between mistimed and wanted pregnancies.     

COST-VOLUME-PROFIT ANALYSIS IN STOCHASTIC PROGRAMMING MODELS

This paper applies mathematical programming to cost-volume-profit (CVP) analysis under contribution margin uncertainty. Three CVP probabilistic chance-constraint models based on various safety-first criteria for decisions under uncertainty are presented and compared. It is shown that a break-even segment of the mean-standard deviation frontier is a set of optimal solutions for the proposed models. An operational parametric quadratic programming (QP) model is constructed, and the efficiency frontier is generated. The procedures for locating an optimal solution on the efficiency frontier are then presented. The recommended QP procedure offers both technical relief from the computational difficulties posed by the probabilistic constraints and a desired flexibility in generating and presenting the relevant information for decisions under uncertainty.     

THE CAREER ATTAINMENT OF CAUCASIAN AND ASIAN ENGINEERS

This article explores the influence of race and nativity on the one hand and assimilation, human capital, and market structure on the other to explain patterns of income and career transitions of Caucasians and Asians in the engineering profession. Multiple and logistic regression techniques are employed to analyze the career histories of 12,200 Caucasian and Asian engineers followed from 1982 through 1986. The objective is to determine how well Asians have performed in the American engineering labor market in terms of wages, occupational status, and promotion in comparison to Caucasians. The results indicate more racial disparity in managerial representation and upward mobility than in earnings, and more disparity in career attainment between foreign-born Asians and Caucasians than between native-born Asians and Caucasians. The data suggest that Asian engineers, except recent immigrants, have achieved earnings parity but have not yet attained occupational equality with Caucasians.     

Childhood and adult sexual abuse: relationships with alcohol and other psychoactive drug use

Questions concerning sexual abuse before and after the age of 16 years were included in a general population survey of a representative sample of 1052 UK women and 975 UK men. A total of 12.5% of women reported experiencing some form of sexual abuse before the age of 16 years. The corresponding ?gures for men in this category were 11.7%. After the age of 16, the ?gure for women remained at this level. However, the proportion of men reporting these traumatic experiences dropped to 3.2%. Sexual abuse both pre and post age 16 was associated with being single or cohabiting, with higher levels of cigarette‐smoking, alcohol consumption, experience of alcohol‐related problems and use of illicit drugs. The relationship between drinking and other forms of psychoactive drug use and sexual abuse is complex. Some possible explanations for this connection and its therapeutic and practical implications are discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

The renovative aspect of psychoanalytic reconstruction in psychotherapy

Reconstruction of the origins of present day psychic phenomena constitutes an essential component of psychoanalytically oriented treatment. The clinician seeks to help restore to the patient a picture of the past and to correct or revise those early impressions that have been distorted as a result of cognitive immaturity or altered by the employment of defense, fantasy, or compensatory adaptations. It is this renovative aspects of reconstruction which will be elaborated upon, drawing from the treatment of a borderline woman who, since childhood, had overly employed the autoerotic resources of her body to compensate for missed object experiences. Ultimately this effort came to block her development, distort organization, and compromise self valuation. By tracing her polymorphous perversity in adulthood back to its origins, it was possible to enable her to regard her responses to chronic childhood trauma in a new light. This in turn aided in the revision of the predominantly negatively coloured self representations, leading to more positive development in the narcissistic sphere of her personality.