Emerging Patterns of Care Management: Arrangements for Older People in England

One of the key objectives of the community care legislation, implemented in the UK in 1993, was the development of care management systems. Subsequent studies based on limited samples of local authorities have indicated that there is much variation in the forms and types of arrangements being developed. This paper explores whether typologies of care management arrangements for older people can be discerned through the analysis of a series of key indicators. Data were drawn from a survey of all English local authorities, undertaken as part of the PSSRU study: Mapping and Evaluation of Care Management Arrangements for Older People and Those with Mental Health Problems. Care management arrangements were categorized using a limited number of key indicators chosen on an empirical and an a priori basis. This resulted in the formulation of six categories of care management arrangements for older people, within which approximately 80 per cent of local authorities could be included.     

The Effects of Information Overload on Software Project Risk Assessment*

Managers are responsible for providing effective information technology governance of the software development process. Ineffective governance leads to serious resource misallocations and negative consequences concerning Sarbanes‐Oxley compliance. In order for managers to make informed decisions about software development projects, they often need more information than is available through normal information channels, that is, they need an in‐depth review of the at‐risk project. Such in‐depth reviews, however, are costly. Hence, accurate identification of at‐risk projects for in‐depth review is critical to management's ability to govern. This research considers how two factors, information load and time pressure, affect the quality of the project‐selection process. We examine quality by observing the decision strategies involved and then relating these strategies to subsequent decision making. An experiment was conducted with experienced information systems auditors using a combination of policy‐capturing and computerized process‐tracing techniques. The participants in our study cope with information overload by accelerating their decision‐making process and adopting noncompensatory decision processes. Contrary to prior research, our process‐tracing analysis suggests that participants rarely filter information, thus implying that decision makers are unable to process all the information. Coping by resorting to noncompensatory strategies did not decrease decision quality unless combined with accelerated information processing. Participants also increase their weight on the software project risk factors that they repeatedly access and that they view for longer periods of time. The theoretical contributions and practical implications regarding what actions managers can take to reduce the negative impact of information overload are discussed.     

Everyday territories: homelessness,outreach work and city space

This article develops a situational approach to understanding urban public life and, in particular, the production of urban territories. Our aim is to examine the ways in which city space might be understood as comprising multiple, shifting, mobile and rhythmed territories. We argue that such territories are best understood through attending to their everyday production and negotiation, rather than handling territory as an a priori construct. We develop this argument from the particular case of the street‐level politics of homelessness and street care. The experience of street homelessness and the provision of care in the public spaces of the city is characterised by precarious territorial claims made and lost. We describe some of the ways in which care work with rough sleepers is itself precarious; ‘homeless’, in lacking a distinct setting in which it might get done. Indeed, outreach work takes place within and affirms homeless territories. The affirmation of territory is shown to be central to the relationship developed between the workers and their rough sleeping clients. We also show, however, the ways in which outreach workers operate on territory not their own, twice over. Outreach work is precarious in that it is practised within, and can run counter to, other territorial productions in which the experience of urban need and the work and politics of care are entangled. In sum, this article aims to move beyond static and binary understandings by developing a mobile and situational approach to city space which recognises the intensive yet overlooked work of territorial production.     

The Dynamics of Social Indicator Research for California’s Central Valley in Transition

How can social indicator research improve understanding of community health as well as inform stakeholders about the assets disadvantaged communities have for coping with disparities? This paper describes the development and evolution of the Partnership for Assessment of Communities (PAC) and its best practices for social indicator research. The PAC will be of interest to researchers across multiple disciplines for a number of reasons. First, PAC is a working model of best practices for multidisciplinary scholarly inquiry. Second, it has developed an integrated model of quantitative and qualitative methodology to define and measure community health as compared to traditional quality-of-life indicators. Third, it serves as an example of “action research,” in that the findings have the potential to make an impact on community stakeholders and policy outcomes in the greater Central San Joaquin Valley of California, a region characterized by deep social and economic disparities.     

Examination of the Role of Therapeutic Alliance,Treatment Dose,and Treatment Completion in the Effectiveness of The Seven Challenges

Adolescent alcohol and illicit drug (AOD) use is a major public health concern. This longitudinal study examines the effectiveness of The Seven Challenges in reducing adolescent substance use and mental health problems, as well as the process by which it is effective. Participants were 89 adolescents (72 male, 17 female) enrolled in a 3 month intensive outpatient adolescent substance abuse treatment program using The Seven Challenges and who provided self-report data at pre- and post-treatment. Results indicated that The Seven Challenges was effective at increasing the number of days refrained from using AOD, reducing use of tetrahydrocannabinol (THC) and other drugs, and reducing substance use problems and internal mental distress. Results also indicated that The Seven Challenges drug counselors effectively established and maintained therapeutic alliance but this seems to not play a role in the effectiveness of The Seven Challenges. Both treatment dose and completion played a role in the effectiveness of The Seven Challenges; they were both positively related to post-treatment days refrained from AOD use, and negatively related to days of THC use, substance use problems, and internal mental distress. However, the strength of the influence of treatment completion was stronger when treatment dose was low than when it was high. Despite a small sample and other limitations, findings add to existing literature that suggests that The Seven Challenges is an effective substance abuse treatment for adolescents. Furthermore, findings suggest that adolescent substance abuse treatment should focus on clients meeting pre-determined program goals as well as on dose.     

Resident Perspectives on Life in a Transitional Living Program for Homeless Young Adults

Safe and affordable housing is critical for any young person’s well-being, and yet many youth are without a reliable place to live. Knowledge of the perceptions of housing programs and shelter among homeless young adults ages 18–24 is very limited. Using qualitative methodology, the present study explores the perceptions of homeless young adults on their experiences as residents of a transitional living program (TLP) by asking the following research questions: (1) What are TLP residents’ expectations of themselves and others in the program? and (2) How do residents perceive the rules and structure of the TLP? Sixteen interviews were conducted with residents at a TLP for homeless young adults, with participants ranging in age from 18 to 22. Findings illuminated residents’ strong emphasis on the values of hard work, self-discipline and a good attitude. Results revealed that residents felt that they are overly monitored within the program, particularly around daily living in the residence and felt a lack of flexibility in the rules and regulations. It is important that the structure of a TLP housing program so that rules are not disruptive to healthy development and successful transition from adolescence to adulthood. Further implications for practice are discussed.     

Preference Functions for Spatial Risk Analysis

When outcomes are defined over a geographic region, measures of spatial risk regarding these outcomes can be more complex than traditional measures of risk. One of the main challenges is the need for a cardinal preference function that incorporates the spatial nature of the outcomes. We explore preference conditions that will yield the existence of spatial measurable value and utility functions, and discuss their application to spatial risk analysis. We also present a simple example on household freshwater usage across regions to demonstrate how such functions can be assessed and applied.     

Rural Environmental Concern: Effects of Position,Partisanship, and Place

The social bases of environmental concern in rural America resemble those for the nation as a whole, but also reflect the influence of place. Some general place characteristics, such as rates of population growth or resource‐industry employment, predict responses across a number of environmental issues. Other unique or distinctive aspects of local society and environment matter as well. We extend earlier work on both kinds of place effects, first by analyzing survey data from northeast Oregon. Results emphasize that “environmental concern” has several dimensions. Second, we contextualize the Oregon results using surveys from other regions. Analysis of an integrated dataset (up to 12,000 interviews in 38 U.S. counties) shows effects from respondent characteristics and political views, and from county rates of population growth and resource‐based employment. There also are significant place‐to‐place variations that are not explained by variables in the models. To understand some of these we return to the local scale. In northeast Oregon, residents describe how perceptions of fire danger from unmanaged forest lands shape their response to the word conservation. Their local interpretation contrasts with more general and urban connotations of this term, underlining the importance of place for understanding rural environmental concern.     

The slowing metabolism of marriage: Figures from 1988 U.S. marital status life tables

Marital status life tables for the United States, 1988, show a continuing retreat from marriage. For both sexes, the proportion ever marrying declined and the average age at first marriage rose. The 1988 rates imply that 43% of marriages end in divorce. That represents a slight decline from the 1983 figure, and suggests that divorce has peaked at a level below that estimated in earlier analyses.