Townies

His work has been featured in numerous publications.     

What could be achieved with greater public hospital autonomy? Comparison of public and PNFP hospitals in Uganda

The policy of hospital autonomy has been discussed for some time in Uganda. There is little evidence from Uganda or elsewhere that increased autonomy will improve hospital performance. This article compares the performance of three private not‐for‐profit (PNFP) and public hospital pairs to address this question. PNFP and public hospitals have similar management structures but PNFP hospitals had better trained managers and a church affiliated chair in the hospital management committee. Both types have problems with personnel management but these appear more pronounced in public hospitals. Drug supply management appears better in PNFP hospitals. Overall, workloads are similar, but analysis of patterns of utilisation and prices across services suggest that patient choice of facilities is influenced by relative price levels, and that willingness to pay is higher for PNFP services. PNFP hospitals are more successful at generating revenue. There are no clear differences in efficiency between PNFP and public hospitals but there is some evidence of higher quality levels in PNFP hospitals. PNFP hospitals' performance is plausibly related to three areas of managerial autonomy. First, better management of drug supply is facilitated by their freedom to purchase drugs from the open market. Second, greater success with personnel management is plausibly related to their greater autonomy over staffing. Third, higher levels of cost recovery are enabled by their freedom to set fees. However, differences in accountability and competence of hospital management, and population willingness to pay for services may also help to explain differences. Further, the use of PNFP financing strategy by public hospitals has implications for universal access to hospital services. Although there appear to be potential advantages from greater public hospital autonomy, the Ugandan government should ensure it has developed strategies to enhance public hospital management and to protect access to public hospitals before advancing further with hospital autonomy policy. Copyright © 2002 John Wiley & Sons, Ltd.     

Federalism with a Russian face: regional inequality, administrative capacity and regional budgets in Russia

The paper reviews fiscal federalism in Russian practice. Central control over sub-national budgets has tended to increase. In the classic literature on fiscal federalism such centralisation is potentially damaging to both static efficiency and growth. The paper reviews the propositions in that literature and the assumptions made in it, and notes that weak administrative capacity at sub-regional level, weak electoral competition and extreme unevenness of economic development across regions may provide grounds for greater central control than is treated as desirable in the established literature. The patterns of budgetary transfers from national to regional level are analysed and conclusions drawn about the effectiveness of the evolving fiscal-federal system in Russia.     

A Participant Evaluation of the U.S. Navy Parent Support Program

This study reports on the results of a program evaluation of the U.S. Navy New Parent Support Program (NPSP). NPSP is comprised of two components: center-based parenting classes and home-based visits. Data are presented on: (a) satisfaction with program quality, (b) how well the program met its primary objectives (e.g., helps reduce parenting stress), (c) how well the NPSP met its Reasons for Being (RFBs; e.g., Helps service members concentrate on their job), and (d) program impact on mission-related outcomes (i.e., quality of life (QOL), readiness, and program impact on their decision to remain in the military). Results indicate that parents who take part in both the parenting classes and home-based visits report that the program exceeded their expectations, the program improved their perceptions of their parenting and coping skills, they perceived that the program demonstrated the Navy’s concern for Sailors and their families, and the program enhanced the family’s quality of life. Implications of study findings are discussed.

Remembering and Voting: Theory and Evidence from Amnesic Patients

One of the most prominent claims to emerge from the field of public opinion is that citizens can vote for candidates whose issue positions best reflect their own beliefs even when they cannot remember previously learned stances associated with the candidates. The current experiment provides a unique and powerful examination of this claim by determining whether individuals with profound amnesia, whose severe memory impairments prevent them from remembering specific issue information associated with any particular candidate, can vote for candidates whose issue positions come closest to their own political views. We report here that amnesic patients, despite not being able to remember any issue information, consistently voted for candidates with favored political positions. Thus, sound voting decisions do not require recall or recognition of previously learned associations between candidates and their issue positions. This result supports a multiple memory systems model of political decision making.     

Firework displays as sources of particles similar to gunshot residue

In light of past research being targeted to find specific particles which may be similar to gunshot residue (GSR), this project was formulated to detect any possible particulate by random particle fallout onto substrates at firework displays and to assess the impact this may have on GSR evidence. Firework residue was collected at a display site, from amongst spectators as well as from the author's hair 90min after the display. SEM-EDX analysis has detected such particulate in all three scenarios, with the firework particle population at large providing a solid ground for discrimination from GSR. Wind dispersal was found to decrease the particle population and subsequently, the latter's discriminatory power. Some particles, if treated individually were found to be indistinguishable from GSR. Findings also include residues which may mimic strontium based GSR as well as GSR which may be mixed with that from previous firings. The continuous changes made to primer and propellant compositions by manufacturers also call for greater consideration when classifying particles as originating from pyrotechnic devices. Furthermore, authorities such as police forces should be made more aware about the incidence of such particle transfer in firework related periods.     

Housing instability is as strong a predictor of poor health outcomes as level of danger in an abusive relationship: findings from the SHARE Study

Advocates, clinicians, policy makers, and survivors frequently cite intimate partner violence (IPV) as an immediate cause of or precursor to housing problems. Research has indicated an association between homelessness and IPV, yet few studies examine IPV and housing instability. Housing instability differs from homelessness, in that someone experiencing housing instability may currently have a place to live but faces difficulties with maintaining the residence. We present baseline findings from a longitudinal cohort study of 278 female IPV survivors with housing as a primary concern. Our analysis indicates the greater the number of housing instability risk factors (e.g., eviction notice, problems with landlord, moving multiple times), the more likely the abused woman reported symptoms consistent with PTSD (p < .001), depression (p < .001), reduced quality of life (p < .001), increased work/school absence (OR = 1.28, p < .004), and increased hospital/emergency department use (OR = 1.22, p < .001). These outcomes persist even when controlling for the level of danger in the abusive relationship and for survivors' drug and alcohol use. Importantly, both housing instability and danger level had stronger associations with negative health outcomes than other factors such as age, alcohol, and drug use; both make unique contributions to negative health outcomes and could contribute in different ways. Housing instability is an important and understudied social determinant of health for IPV survivors. These findings begin to address the literature gap on the relationship between housing instability, IPV, and survivors' health, employment, and utilization of medical care services.