District Health Organization

Government policy in the UK has been to provide comprehensive personalized health care to the whole population free at the point of delivery. However, the first major attempt to unify and regionalize the service in 1974 left a number of problems, and a further restructuring of the NHS was required. This article reports on the results of research into the 1982 restructuring. The main feature of this second reorganization was the formation of territorial entities called "Districts", and their organizational subdivision into "Units". The kind and level of work and authority assigned to Districts and Units is discussed. An important fading, seemingly counter to official policy, is the existence of small Districts which operate at the same level as Units of the larger Districts.     

Reading “Monosexual”

This essay interrogates the meanings, uses, and implications of the emergent U.S./U.K. bisexual community’s adoption of the term “monosexual” to define non-bisexuals. The authors provide a historical and theoretical context for the term, explicitly linking its oppositional rhetoric to that coined by other recent identity movements, and to that inherent in psychological and psychoanalytical models of identity development. The authors further emphasize their own personal and political responses to and dislike of the term. The essay examines the inconsistencies implicit in the meanings and uses of the term, highlighting the differences between sexual behavior and sexual identity. The unsuitability of the monosexual/bisexual paradigm for a bisexual movement that always overlaps—theoretically, politically, and personally—with other movements is also discussed. The authors conclude by stressing the importance of developing language that expresses the complexity of sexual identity and divergent political affiliation.     

The Appropriateness of Some Common Procedures for Testing the Equality of Two Independent Binomial Populations

For testing the equality of two independent binomial populations the Fisher exact test and the chi-squared test with Yates's continuity correction are often suggested for small and intermediate size samples. The use of these tests is inappropriate in that they are extremely conservative. In this article we demonstrate that, even for small samples, the uncorrected chi-squared test (i.e., the Pearson chi-squared test) and the two-independent-sample t test are robust in that their actual significance levels are usually close to or smaller than the nominal levels. We encourage the use of these latter two tests.     

Did Australia’s Baby Bonus Increase Fertility Intentions and Births?

In May 2004, the Australian government announced a “Baby Bonus” policy, paying women an initial A$3,000 per new child. We use household panel data from the Household, Income and Labour Dynamics in Australia Survey (N = 14,932) and a simultaneous equations approach to analyze the effects of this bonus on fertility intentions and ultimately births. The results indicate that opportunity costs influence intentions and births in predictable ways. Fertility intentions rose after the announcement of the Baby Bonus, and the birth rate is estimated to have risen modestly as a result. The marginal cost to the government for an additional birth is estimated to be at least A$3,000 per new child. We use household panel data from the Household, Income and Labour Dynamics in Australia Survey (N = 14,932) and a simultaneous equations approach to analyze the effects of this bonus on fertility intentions and ultimately births. The results indicate that opportunity costs influence intentions and births in predictable ways. Fertility intentions rose after the announcement of the Baby Bonus, and the birth rate is estimated to have risen modestly as a result. The marginal cost to the government for an additional birth is estimated to be at least A126,000.     

Order Progress Information: Improved Dynamic Emergency Ordering Policies

Technologies such as radio‐frequency identification and global positioning systems can provide improved real‐time tracking information for products and replenishment orders along the supply chain. We call this type of visibility order progress information. In this paper, we investigate how order progress information can be used to improve inventory replenishment decisions. To this end, we examine a retailer facing a stochastic lead time for order fulfillment. We characterize a replenishment policy that is based on the classical (Q, R) policy and that allows for releasing emergency orders in response to the order progress information. We show that the optimal structure of this policy is given by a sequence of threshold values dependent on order progress information. In a numerical study we evaluate the cost savings due to this improved replenishment policy.     

Fitness Profiles and Activity Patterns of Entering College Students

Abstract

Fitness levels of American youth have shown a marked decline in the last decade, according to recent studies. To determine whether such a tendency persists for entering college students, the authors evaluated 115 male and 143 female students for performance on the following fitness-related variables: (1) maximal oxygen consumption (estimated from Astrand cycling protocol), (2) body composition (skin-fold techniques), (3) muscle endurance (sit-up protocol), (4) muscle strength (bench-press protocol), and (5) joint flexibility (upper and lower body protocols).

Although neither men nor women exhibited high levels of cardiorespiratory fitness, the women in the study showed higher relative levels than their male counterparts. Both groups showed excellent levels of muscle strength (compared with normative standards), but they achieved only an average standard for muscle endurance. Findings of relatively low levels of cardiovascular fitness compared with levels of muscle strength, particularly in men, seem to be a reflection of an inappropriate concentration of physical activity.     

Trial and Lifetime Smoking Risks Among African American College Students

Abstract

The authors surveyed 614 African American university students to determine the magnitude of cigarette use, identify risk factors, and develop models to predict smoking. More than half (58.3%) of the participants had smoked at least once, and 9.3% of that group were lifetime smokers. Among the lifetime smokers, 71.3% had smoked during the 30 days preceding the survey. More women (66.8%) than men (56.1%) had tried smoking and were classed as lifetime smokers. Residence, parental, and peer smoking (current and childhood) were associated with trying smoking; age, race/ethnicity, and marital status were additional factors for becoming a lifetime smoker. The risk of being a lifetime smoker was reduced when neither friends nor parents of the student smoked and the student viewed spirituality as important. The results of this study add to the growing understanding of health risk behaviors among African Americans and can be useful in reducing smoking.     

Game-Based Cognitive-Behavioral Therapy (GB-CBT) Group Program for Children Who Have Experienced Sexual Abuse: A Preliminary Investigation

This preliminary investigation examined the efficacy of a game-based cognitive-behavioral therapy group program for elementary school-aged children who have experienced sexual abuse. Treatment aimed to improve: (a) internalizing symptoms, (b) externalizing behaviors, (c) sexually inappropriate behaviors, (d) social skills deficits, (e) self-esteem problems, and (f) knowledge of healthy sexuality and self-protection skills. Results indicate that game-based cognitive-behavioral therapy was effective for improving internalizing and externalizing symptoms, reducing sexually inappropriate behaviors, and improving children's knowledge of abuse and self-protection skills. Although results pointed in a positive direction for social skills and self-perception, these findings were not statistically significant. Clinical significance was also evaluated to assess the clinical utility of treatment effects. Treatment implications of the findings and future research directions are discussed.