College students with congenital heart disease: A critical time for transition

As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition. Participants: A case of a male with CHD presenting to the college health clinic with a new onset headache. Methods: The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD. In addition, they make recommendations on how best to care for these patients and how best to coordinate care with CHD students other care providers. Results: This student with a history of coarctation of the aorta presented with new onset headaches and was found to have high blood pressure. He was diagnosed with recurrent coarctation, underwent percutaneous treatment with stenting and quickly resumed classes. Conclusions: As more students with CHD enter college, college health providers will need to understand some of the health risks that CHD students face. In addition, understanding some of the optimal ways to coordinate care with CHD providers can ease the transition that CHD students face as they enter college.     

A comparative analysis of public sector restructuring in the U.S., Canada, Mexico, and the Caribbean

We examine public sector restructuring in North America and selected Commonwealth Caribbean nations. Although all the countries studied experienced significant restruc-turing in response to public debt pressures, there were major differences across coun-tries in the magnitude, pace, form, and the manner in which restructuring decisions were made. These differences reflect the state of economic development and institu-tional characteristics, e.g., the role of the state and the industrial relations system. In developing countries, international lending institutions played a major role in trans-forming the role of the state. In developed countries, the inherent stability of the eco-nomic systems and institutional pressures led to a gradualist approach to restructuring.     

Exploring Rotation Placements for Social Work: A Focus on Student and Supervisor Experiences

Increasing demand for social work placements in a climate of decreasing availability has intensified the search for capacity-building models of field education. Rotation placements may be part of the solution, yet little is currently known about how rotations affect the experience of field education in the context of block placements. A study of 128 Master of Social Work (MSW) students and 92 supervisors provided insights into the experience of rotation placements in five Australian hospitals. The study adopted a mixed-methods design using online surveys followed by postplacement interviews over 3 years. The findings show that experiences were mixed. However, there were also some common themes that help inform what might work, for whom, and under what circumstances.     

An empirical Bayes' procedure for ranking players in Ryder Cup golf

We describe a model to obtain strengths and rankings of players appearing in golf's Ryder Cup. Obtaining rankings is complicated because of two reasons. First, competitors do not compete on an equal number of occasions, with some competitors appearing too infrequently for their ranking to be estimated with any degree of certainty, and second, different competitors experience different levels of volatility in results. Our approach is to assume the competitor strengths are drawn from some common distribution. For small numbers of competitors, as is the case here, we fit the model using Monte-Carlo integration. Results suggest there is very little difference between the top performing players, though Scotland's Colin Montgomerie is estimated as the strongest Ryder Cup player.     

Collaborations with faith‐based social service coalitions

Based on the first national survey of faith‐based social service coalitions in the United States, this article presents data on the degree to which these nonprofit organizations collaborate with other specific organizational types, as well as the range and intensity of these collaborations. In general, faith‐based coalitions tend to collaborate most frequently with other faith‐based agencies, a pattern especially characteristic of the more religiously expressive ones. However, collaboration with non‐faith‐based organizations is also quite common. Based on seven organizational characteristics, we are able to predict which faith‐based coalitions are most likely to collaborate with different types of organizations: coalitions that have more explicitly religious policies and practices with reference to clients and staffs are less likely to participate in intense collaborations with some types of secular organizations, and consistently less likely to do so with all types of governmental agencies.     

Managing the introduction of new technology

Most of the existing literature on the implications of new technology focuses on either its ‘impact’ or the social choices that lie behind strategies for its introduction into work organisations. The problems of managing the implementation of new technology have yet to be extensively examined despite this being one of the most critical aspects in the process of technological change. The findings from two case studies are presented which show how managers in the organisations concerned developed contrasting approaches to the problem of implementation in the context of opportunities and constraints presented by product markets and technological advance. Similarities between the two approaches are identified, in particular the role played by top management support in facilitating the acceptance of the new technology. The argument that management is able to develop a single unitary strategy towards the introduction of new technology is rejected in favour of a view of managerial actions as a series of flexible and changing sub-strategies associated with different stages in the process of change.     

Testing for space-time clusters of unknown size

The Knox test is widely used in epidemiology to test for infection or contagion, which is indicated by an excess of cases that are close both in space and time. Often, however, the values of the space and time critical parameters that define 'closeness' are unknown. An exact test is proposed for this situation, its computer implementation is described and examples of its use on published data sets are given. Other possible applications of the method adopted here are discussed. This is an example of a test where nuisance parameters are absent under H0, and where the distribution of the test statistic can be found numerically.     

Cognitive therapy and behavioural coping in the management of work-related stress: An intervention study

Transactional models of stress emphasize the importance of cognitive appraisal of potential stressors in the determination of the stress response. This appraisal can be modified by the use of techniques normally associated with cognitive therapy. The contribution of a specifically cognitive component when intervening in work-related stress has not been well evaluated to date. This research seeks to determine the effectiveness of stress management training in the treatment of the work-related effects of stress by comparing the role of modifying dysfunctional cognitions with the teaching of appropriate behavioural coping strategies. Participants were allocated to one of two intervention conditions or to a waiting list control group. Those in the intervention conditions received group stress management either with the focus on delivering cognitive therapy techniques or with the focus on behavioural coping skills. Measures of general health were taken at the beginning and end of intervention and at 3-month follow-up. Participants in the cognitive therapy groups who were reporting symptoms of general ill-health at the start of the intervention showed a significant improvement at follow-up. Cognitive therapy appears to have been an effective intervention in work-related stress. Those in the behavioural group showed a smaller but still clinically effective improvement. Results are discussed in terms of methodological issues and implications for future research. It is suggested that changes in cognitive appraisal may need to be developed.