Integrating Health and Social Care at the Micro Level: Health Care Professionals as Care Managers for Older People

A common problem in the provision of coordinated long‐term care is the separation of health and social care. The present government has been increasingly concerned with promoting convenient, user‐centred services and improving integration of health and social care. One arrangement that could contribute to this for some older service users is for health care staff to act as care managers, coordinating the provision of both health and social care. This paper presents the findings of a survey of arrangements in place in local authorities for health staff to work as care managers for older people. This was designed to provide details about the range and scope of care management activities undertaken by health care professionals. Key areas of enquiry included: which kinds of health care staff undertook care management and in what settings; how long the arrangements had been in place and how widely available they were; whether there was a distinction between the types of cases and care management processes undertaken by health care staff compared with their social service department counterparts; and what management and training arrangements were in place for the health care staff.     

The aborted sibling factor: A case study

The number of abortions in the world is steadily increasing, and there are now millions of children who have survived the abortion of a sibling. There is increasing evidence that even very young children may be aware of maternal abortions despite family attempts to maintain secrecy. For those children experiencing other powerfully unresolved conflicts, the abortion of a sibling may trigger a severe reaction. A case is presented in which it gradually became clear that a 5-year-old girl's withdrawn regression was related to her mother's multiple abortions and her own fear of being destroyed through maternal aggression.     

Part-time medical director: way station or end of the line?

This article is mostly directed to physicians who are contemplating a career change into management. You may be one of those persons who is contemplating taking a part-time position and continuing part-time clinical practice to see if you might enjoy management. It is important to understand that a part time medical director is there primarily because management perceives a need for a physician's skills and license. When a physician is hired on a part-time basis, it is unlikely that management realizes the larger benefits that can accrue to the organization from the physician manager's knowledge of health care and unique approach to the problems and opportunities in the delivery of that health care. Part-time medical directors seldom have an opportunity to be exposed to real management issues and activities and are usually sequestered and limited to functions that a naive management team thinks are most appropriate to a physician's skills and temperament. Be cautious in extrapolating a part-time experience to a full-time role. Consider taking the plunge to full-time management without a part-time transition phase.     

Objectification as negotiation: reexamining the agency of targets

Why and under what conditions do individuals participate in their own physical objectification? Literature across disciplines acknowledges such conditions exist but has limited capacity to specify when and how a person might participate in her own objectification. This article argues that a target of objectification, under certain conditions, can accept objectification in pursuit of another goal. This conception is counterintuitive given that existing approaches sometimes treat the targets of objectification as lacking agency. However, by obscuring this agency such accounts further the same objectification they highlight as problematic. This article offers a positive model of objectified targets’ agency. This model, called “Negotiated Objectification,” serves as an analytical tool that scholars can leverage in feminist academic debates over objectification. The utility of the model is illustrated using three examples: FEMEN’s topless protests; the politics of the Muslim headscarf; and women’s body writing in support of the Israel Defense Forces. The article concludes by considering the implications of women’s agency in each case for debates over the role of agents under objectification.     

Daily Grind: A Comparison of Causality Orientations,Emotions, and Fantasy Sport Participation

In 2015, daily fantasy football entered the fantasy sports market as an offshoot of the traditional, season-long form of the game. With quicker payouts and less commitment, the new activity has drawn comparisons to other forms of illegal gambling, and the determination of whether it is a primarily a game of skill or chance has become the center of the comparison. For the most part, legal commentators and society, in general, views traditional, season-long fantasy football as an innocuous, social activity governed equally by both skill and chance. Little evidence exists, however, about participant perception of skill and chance components in daily fantasy football. The current study surveyed 535 daily and traditional-only fantasy football participants in order to understand differences and similarities in the causality orientations of participation (skill or chance). In addition, enjoyment and anxiety were tested for mediating effects on causality orientations and consumption behavior. The results suggest the differences between the activities are not extreme. However, differences were found in which causality orientations influenced enjoyment and which emotion mediated the relationship between perceived skill and consumption.