Health Care innovation and children in poverty: lived experiences of caregivers of children with disabilities in a medicaid-serving ACO

This paper reports the results of a qualitative study of caregivers of children with disabilities enrolled in a Medicaid-serving accountable care organization (ACO). The state of Ohio mandated ACO enrollment for Medicaid-eligible children with disabilities in 34 of 88 counties effective July 2013. Research participants were queried in focus groups and individual interviews about their children’s care experiences and care coordination after enrollment. Most told researchers that they themselves are their children’s care coordinators, and many indicated that resource scarcity is a more pressing problem than fragmented care. Data analysis identified a theme of scarcity and four categories of insufficiency that made caregiver efforts on behalf of their children more difficult: a lack of health services under managed care, resource constraints on other agencies and programs for which families were eligible, a lack of financial support, and a lack of family support. A conceptual framework places ACO care coordination among more upstream factors and identifies ways in which ACOs serving Medicaid populations may wish to address the social determinants of the well-being of children with disabilities. Implications for future research are discussed.     

Social Media(tion) and the Reshaping of Public/Private Boundaries in Employment Relations

Tensions surrounding social media in the employment relationship are increasingly evident in the media, public rhetoric, and courts and employment tribunals. Yet the underlying causes and dimensions of these tensions have remained largely unexplored. This article firstly reviews the available literature addressing social media and employment, outlining three primary sources of contestation: profiling, disparaging posts and blogs, and private use of social media during work time. In each area, the key dynamics and underlying concerns of the central actors involved are identified. The article then seeks to canvas explanations for these forms of contestation associated with social media at work. It is argued that the architecture of social media disrupts traditional relations in organisational life by driving employer and employee actions that (re)shape and (re)constitute the boundaries between public and private spheres. Although employers and employees are using the same social technologies, their respective concerns about and points of entry to these technologies, in contrast to traditional manifestations of conflict and resistance, are asymmetric. The article concludes with a representational summary of the relative legitimacy of concerns for organisational actors and outlines areas for future research.     

The use of client surrogates in determining the reliability of a standardized assessment instrument in multiple, diverse settings

Since its introduction in 1980, the widely-used Addiction Severity Index has been subjected to extensive validity and reliability studies. Reliability procedures have commonly entailed test–retest and multiple judge video reviews, all within controlled environments. The following study uses a method that differs substantially from conventional reliability assessment by employing trained, professional actors as client surrogates to examine the reliability of the instrument when administered in the field, in naturalistic, diverse agency settings. This article details this method, addressing the question, to what extent did this method produce consistent stimuli to enable the measurement of reliability?     

Psychosocial predictors of self-esteem in a multiethnic sample of women over 50 at risk for HIV

Self-esteem is linked to high-risk behaviors in other populations but has not been examined in women aged 50 and older. This study explored how self-esteem is related to variables that can influence high-risk sexual behaviors in women over 50. A multiethnic community-based sample of 572 women aged 50 and older completed an anonymous questionnaire on sexual behaviors, sociodemographic characteristics, and psychosocial measures relevant to midlife and older women. Regression analysis showed sensation-seeking, HIV stigma, sexual assertiveness, and self-silencing predicted self-esteem in women over 50 (F = 43.632, p < .001). Factors such as relational context, interpersonal power, and silencing can affect self-esteem and may be contributing to HIV risk in this group.     

Replanning the Master Production Schedule for a Capacity-Constrained Job Shop

This research examines the use of both frozen and replanning intervals for planning the master production schedule (MPS) for a capacity-constrained job shop. The results show that forecast error, demand lumpiness, setup time, planned lead time, and order size have a greater impact on the mean total backlog, total inventory, and number of setups than the frozen and replanning intervals. The study also shows that a repetitive lot dispatching rule reduces the importance of lot sizing, and a combination of repetitive lot dispatching rule and single-period order size consistently produces the lowest mean total backlog and total inventory. The results also indicate that rescheduling the open orders every period produces a lower mean total backlog and total inventory when the forecast errors are large relative to the order sizes. This result suggests that the due date of an open order should be updated only when a significant portion of the order is actually needed on the new due date.     

The Determinants of Blue CollarWage Rates: An Analysis of a DataSet Incorporating Observed Job Characteristics

There is wide agreement that one of the major problems in the estimation of wage equations, and in testing theories of wages, is the quality of the data available. In particular, the data used in almost all studies involve indirect or unsatisfactory measures of a variety of relevant factors, including working conditions. In this paper we exploit an unusual data set that includes measures of characteristics of jobs generated by observation (rather than self report, or through inference from the Dictionary of Occupational Titles). With these data we estimate a wage equation in which compensating differentials play a significant role in wage determination and, once working conditions and other characteristics are effectively controlled, all but one measure of previous labour market experience had no effect on the wage rate.     

An agenda for future research regarding the mental health of young people with care experience

Young people who are currently or were previously in state care have consistently been found to have much higher rates of mental health and neurodevelopmental difficulties than the general youth population. While a number of high-quality reviews highlight what research has been undertaken in relation to the mental health of young people with care experience and the gaps in our knowledge and understanding, there is, until now, no consensus, so far as we aware, as to where our collective research efforts should be directed with this important group. Through a series of UK wide workshops, we undertook a consultative process to identify an agreed research agenda between those with lived experience of being in care (n = 15), practitioners, policy makers and researchers (n = 59), for future research regarding the mental health of young people with care experience, including those who are neurodiverse/have a neurodevelopmental difficulty. This consensus statement identified 21 foci within four broad categories: how we conceptualize mental health; under-studied populations; under-studied topics; and underused methodologies. We hope that those who commission, fund and undertake research will engage in this discussion about the future agenda for research regarding the mental health of young people with care experience.     

Separate Spheres or Increasing Equality? Changing Gender Beliefs in Postwar Japan

This research investigates change in gender beliefs in Japan during a period of economic hard times in the late 1990s. Using data from the International Social Survey Programme on the Japanese population from 1994 (n = 1,054) and 2002 (n = 872), we examined how cohort replacement and intracohort change contributed to changes in gender beliefs. We found important differences from the patterns of change reported for many Western countries, namely, a decoupling between societal trends in the female labor force participation rate and beliefs about gender. Such differences may be attributable to factors such as the high societal valuation of the housewife role compared to that in other postindustrial countries and sanctions against full‐time employment for women in Japan.     

A reverse form of welfarism: some reflections on Australian housing policy

In this paper I argue that we have been amiss in diagnosing the role played by government, which has exacerbated the housing problems afflicting low‐income households in Australia. However, I argue further we have placed too much faith in the capacity of managerial interventions to ameliorate what are far more deep‐rooted and systemic challenges. It is suggested that researchers need to adopt a more critical account of the conduct of contemporary government policy making, one that casts aside a view of the State as a benevolent agency whose primary objective is to ameliorate the conditions of the disadvantaged. Instead, the State should be understood as an agency that sustains the conditions necessary for the finance industry, developers and real estate agents, along with well‐off householders and landlords, to reap profits. The political economy of Australian housing, in its current incarnation, performs a form of reverse welfarism that exacerbates social inequality.