Search results

This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.

We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design.

Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models.

Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized.

There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.

This paper attempts to critically question present IPE approaches and analyses that aim at assessing China’s role within the international political economy. Thus, unlike common theorizations that see the country as being integrated within US hegemony (Panitch and Gindin) or those accounts that claim that we are already witnessing the “terminal crisis” of US hegemony accompanied by a hegemonic transition toward China (Arrighi), the paper will argue that China was able to gain “relative geopolitical autonomy” as a result of the revolutionary processes it went through and eventually assert itself as a contender state, now just in the process of challenging US hegemony. Dissatisfied with existent theorizations of hegemony, I will be drawing on the critical edition of Gramsci’s Quaderni and attempt to offer a new perspective regarding the conceptualization thereof. Thus applying the elaborated framework of analysis to the current situation, I argue that unlike the US’s ability to counter the challenge of its traditional imperial rivals Germany and Japan as they developed under the grip of US hegemony, the country is facing difficulties in countering China’s ascent. However, while maintaining that China does indeed represent a challenge to US hegemony, particularly in East Asia, I will argue that the idea of a “crisis of US hegemony” is premature as China remains distant from fully realizing hegemonic relations, even at the regional level.

Examines the role of medical audit in the internal market‐driven quality process in health care provision. Explores the requirements to establish an efficient and effective medical audit function in practice and examines the inter‐relationship between medical audit, information technology and training. Explores the practical implementation of medical audit in South Warwickshire District Health Authority, including the outcomes of a specific project on information management technology training for medical staff. Considers the information technology issues in the context of the District Authority also being a pilot site for the implementation of Hospital Information Support System (HISS) running on an IBM AS/400. Demonstrates a cost‐effective PC networked solution to the information requirements of medical audit and quality processes. Training and attitudinal obstacles to medical audit and information technology are tackled by a flexible, action learning approach.

Attempts to establish the extent to which the use of computers in Australia’s Department of Social Security (DSS) has facilitated changes in social security policy and its administration. Bases findings on case studies relating to two new DSS policies, supplemented with documentary evidence. Identifies that computers are used in the DSS for six main purposes ‐ administering, automating, protecting, monitoring and evaluating policy, as well as for modelling future policy options. Identifies that, instead of increasing efficiency in administration, computers have simply increased productivity by enabling administrative practices to be extended into new areas; observes an emerging computer‐dependent culture dominated by quantitative (rather than qualitative) practices. Establishes that the flexibility offered by computer technology has also contributed to the introduction of more complex social security policies. Concludes that computer technology has contributed to the formulation and administration of social security policies.

While national policies generally support the development of inclusive learning environments, schools can struggle to implement these policies in practice. This longitudinal study offers a unique opportunity to examine at ground level the strengths and limitations of school attempts to implement inclusive practices in relation to children and young people who have special educational needs. This chapter will address the following: government and school policies addressing provision for children and young people with special educational needs; school leaders and implementing policies in practice; types of support provision developed to support those who have literacy difficulties.

Little is known about the characteristics of residential educational settings for young people with intellectual or developmental disabilities (IDD) in England. Previous research has focussed on the characteristics and experiences of the young people attending such settings rather than the setting itself; therefore, an overview of national provision is needed. The paper aims to discuss these issues.

As part of a larger project, data were collected for all residential schools and colleges in England. Data relate to settings offering residential provision for at least 4 nights per week for 30 weeks per year, either at the school/college itself, or in an associated residential home. Due to the remit of the main project, settings offering placements only to young people aged under 16 were excluded. Data were collected from a range of sources, including school/college websites, Ofsted and Department for Education resources, and liaison directly with the setting.

In total, 342 residential educational settings were identified with 57 of these offering post-16 provisions only. A range of data is presented about these settings, including location, placement numbers and types available, age range catered for, special educational needs categories registered for, governance arrangements (e.g. LA maintained, privately owned, and charitable organisation), and Ofsted educational ratings.

These data provide a national overview of residential educational settings for young people with IDD. This enables a clearer picture of the location and type of provision offered and allows comparisons both within and between areas.

Notes increasing consolidation of the banking industry in the USA, Western Europe and Japan; and presents a study of 1980‐1994 acquisitions of US banks by large interstate banking firms. Considers possible motives for cross‐border expansion, reviews relevant research and compares the performance of target banks with their local competitors and their buyers; and buyers’ performance with their competitors. Finds that most buyers are located in rich, densely populated states and most targets in states which have traditionally restricted bank branching activity; that buyers and targets have very different performance profiles (although some differences gradually reduce after acquisition); and that local market influences have a greater effect than common ownership. Concludes that targets are selected for their location and expected future performance, with possible diversification benefits.

With growing concerns about an academic literacy crisis plaguing the education system in South Africa, tertiary institutions have to find ways to strengthen the academic literacy skills of underprepared students transitioning into higher education. This is more pressing for low socioeconomic status students who are linguistically marginalised and face historically poor graduation prospects. In response, this chapter offers a snapshot of two studies conducted in South Africa that sought to test the efficacy of a purposefully designed academic literacy intervention (Reading to Learn (RtL)). The intervention sought to address inequitable academic literacy skills development of linguistically marginalised students, who are also socioeconomically disadvantaged. Two small-scale, longitudinal studies were run in two separate educational contexts in South Africa – a senior secondary school context and a tertiary context with largely first-generation undergraduate students. Results of both studies showed the RtL intervention to be successful at raising the level of academic writing skills of the research participants. Furthermore, similar to other RtL studies conducted globally, the two studies found weaker-performing students made the greatest gains in their academic writing skills, showing evidence of a convergence effect – more equitable learning outcomes being exhibited in the English classroom.