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A nurse home care scheduling system is described. The objective is to provide medical care at patients’ homes using the fewest number of nurses possible to deliver the required care. The heuristic scheduling system is easy to implement as a computerized adaptive system. As such, it is easy to use on a daily basis and easy to update as new data related to completed treatment and new requests are obtained. A case study illustrates the advantages of implementing such a system.

The belief that children have mental health needs different than those of adults is a relatively recent phenomenon. Systematic field studies of mental illness began in the early 19th century (Anthony, Eaton, & Henderson, 1995), although awareness of these illnesses and the recognition of the need for treatment were well established by the 1600s (Grob, 1994). Field studies and census data from mental hospitals in the 1800s reveal few cases of mental illness identified among children under the age of 16. In the late 19th and early 20th centuries, the recognition that children have specific mental health needs arose as the result of the confluence of several factors. The Progressive Movement promoted child labor and mandatory public education laws that created legal separations between the role of children and adults (Abbott, 1908; Sutton, 1983). Hall (1905) helped popularize the idea that childhood and adolescence constituted distinct periods of development. Perhaps most pressing, however, was a perceived rise in juvenile delinquency and sexual promiscuity. To address these problems, separate courts were established for juvenile offenders to keep children out of institutions and to provide treatment and rehabilitation (Alper, 1941). Based on the work of Healy and Bronner (1916), researchers and policy makers began to think of juvenile crime as arising from “mental conflicts” in children. Institutions such as the Chicago Juvenile Psychopathic Institute and the Boston Psychopathic Hospital were established to care for these children (Horn, 1989).

This chapter describes the efforts of a team of health care workers to make a sub-acute health care facility (SCF) serving profoundly damaged children into a high reliability organization (HRO). To obtain this goal, the health care team implemented change in four behavioral areas: (1) risk awareness and acknowledgment; (2) defining care; (3) how to think and make decisions; and (4) information flow. The team focused on five reliability enhancement issues that emerged from previous research on banking institutions: (1) process auditing; (2) the reward system; (3) quality degradation; (4) risk awareness and acknowledgment; and (5) command and control. These HRO processes emerged from the change effort. Three additional HRO processes also emerged: high trust, and building a high reliability culture based on values and on beliefs. This case demonstrates that HRO processes can reduce costs, improve safety, and aid in developing new markets. Other experiences in implementing high reliability processes show that each organization must tailor make processes to its own situation (e.g. BP, U.S. Chemical Safety and Hazards Board, Federal Aviation Administration, U.S. Navy Aviation Program, and Kaiser Permanente Health Care System). Just as in the flexibility called for in organizing for high reliability operations, flexibility is called for in deciding which HRO processes work in specific situations.

We study changes in age-specific diabetes-related mortality and annual health care utilization. We find that half of the estimated 16% increase of diabetic mortality falls within employable age groups. We estimate that disease combination-specific increase in case fatality has resulted in premature diabetic mortality costing $3.2 billion annually. The estimated annual direct cost of treating high-risk diabetics reaches $36 billion, of which Medicare and Other Federal Programs compensate 54%. Respiratory conditions among diabetics comprise the same proportion of high-risk diabetics as do the disease combinations including coronary heart diseases. Treating of general diabetic conditions has become more efficient as indicated by the estimated declines in per unit health care costs.

To examine the evolution of health care integration strategies and associated conceptualization and practice through a review and synthesis of over 25 years of international academic research and literature.

A search of the health sciences literature was conducted using PubMed and EMBASE. A total of 114 articles were identified for inclusion and thematically analyzed using a strategy content model for systems-level integration.

Six major, inter-related shifts in integration strategies were identified: (1) from a focus on horizontal integration to an emphasis on vertical integration; (2) from acute care and institution-centered models of integration to a broader focus on community-based health and social services; (3) from economic arguments for integration to an emphasis on improving quality of care and creating value; (4) from evaluations of integration using an organizational perspective to an emerging interest in patient-centered measures; (5) from a focus on modifying organizational and environmental structures to an emphasis on changing ways of working and influencing underlying cultural attitudes and norms; and (6) from integration for all patients within defined regions to a strategic focus on integrating care for specific populations. We propose that underlying many of these shifts is a growing recognition of the value of understanding health care delivery and integration as processes situated in Complex-Adaptive Systems (CAS).

This review builds a descriptive framework against which to assess, compare, and track integration strategies over time.

There is a need for rigorous research documenting the important role of school nurses in facilitating positive health outcomes among students. Poorly managed care can affect student absenteeism rates, which are associated with academic performance and school funding, and students in underresourced schools are at particularly higher risk of suffering chronic conditions (e.g., asthma, diabetes) that necessitate proper care and management. The San Jose Unified School District (SJUSD) Nurse Demonstration Project was developed as a five-year endeavor to expand school nursing and formally link school nurses to a school-based health clinic. The initiative provides for full-time school nurses at four elementary and middle schools in SJUSD, and a nurse practitioner at School Health Clinics of Santa Clara County. The objectives are to: (1) improve access to primary care and prevention services, specifically asthma and chronic condition management and (2) facilitate the establishment of a medical home for students. Evaluation of the project employs a mixed methods research design, including a logic model, an intervention and control study design (comparing outcome measures in the four demonstration schools with five “control” schools), parent, teacher, and school administrator feedback, systematic nurse reports, and quantitative analysis of school health and administrative data, including health conditions and absenteeism information. Key findings in Phase I of the project are discussed, including improvement in screening and referrals, follow-up care among students with asthma, and mean days absent due to illness. With increasing budget cuts to public schools, documenting the impact of full-time school nurses will remain crucial in leveraging support and resources for school health services. Findings of this project indicate that school nurses provide valuable services and could be a major player in providing and coordinating effective management and prevention of chronic disease among children.

The stable and predictable agricultural, infrastructure, manufacturing, and energy economies of hard products have been followed by economies that offer softer products such as services, information, knowledge, health care, digitization, networking, globalization, entertainment, sustainability, and currently, well-being and happiness. Such soft market products are loaded with buyer–seller information asymmetries (BSIA) that create market risk, market uncertainty, market chaos, and ambiguity – all of which are specific types of market turbulence. In this context, this chapter investigates the phenomena of turbulence, specifically environmental turbulence whose major subsets are technological turbulence and market turbulence. We cite several recent geopolitical variables and events that have aggravated market turbulence such as Chinese economic invasion of global markets, global climate change, Brexit, international asylum-seeking migrations, artificial intelligence, and demonetization. We also define market turbulence as varied forms of BSIA for which both marketers and consumers must have appropriate joint responsibility. In addition, we focus on ethical and moral marketing responsibilities for reducing BSIA under each type of turbulence.

Purpose – To study the allocation in equity markets of sovereign wealth funds’ (SWF) investments with respect to other institutional investors. To analyze the role of political regimes in the sending and recipient countries as a determinant of the allocation of SWF investments.

Methodology/approach – We use mutual funds’ investments as a benchmark for SWF investment allocations. We collect data of SWF and mutual fund equity investments at the firm level and analyse them on a geographical and sector basis. We compare target investments for these two groups by looking at the political regime in the sending and recipient country, using different political indicators (Polity IV, Bertelsmann). We provide a comparison of SWFs and pension funds based on governance features related to investment.

Findings – We find that the fear that sovereigns with political motivations use their financial power to secure large stakes in OECD countries is not confirmed by the data. SWF investment decisions do not differ greatly from those of other wealth managers. Although there can be differences in the allocation, political regimes in the recipient countries do not play a role in explaining the allocation of sovereign wealth funds.

Social implications – Investment from public institutions, such as sovereign wealth funds, can have significant implications at the economic and social level. Sovereign funds are potential sources of capital for emerging economies, and therefore can enchance economic growth. It is important to understand to what extent public institutional investors behave differently from private investors. The “political bias” is not a relevant factor for sovereign funds, or for other institutional investors, for allocating their capital. More often than not, their asset allocation strategies converge with other large investors, these being driven by financial and not political bias.

Originality/value of the chapter – The chapter is an original contribution providing a firm-level analysis of equity holdings for two groups of institutional investors. Moreover, it emphasizes the political dimension of institutional investments, highlighting the priorities and constraints of public investors participating in financial markets. The chapter suggests that SWFs do not discriminate by the political regime of the recipient country in their asset allocation.

This paper is the first to use the individual level, longitudinal catch-up growth of boys and girls in a historical population to measure their relative deprivation. The data is drawn from two government schools, the Marcella Street Home (MSH) in Boston, MA (1889–1898), and the Ashford School of the West London School District (1908–1917). The paper provides an extensive discussion of the two schools including the characteristics of the children, their representativeness, selection bias and the conditions in each school. It also provides a methodological introduction to measuring children’s longitudinal catch-up growth. After analysing the catch-up growth of boys and girls in the schools, it finds that there were no substantial differences between the catch-up growth by gender. Thus, these data suggest that there were not major health disparities between boys and girls in late-nineteenth-century America and early-twentieth-century Britain.