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A first, basic question regarding the complexity of systems of care addresses the degrees to which individuals who are served by one program or service sector are also served by another program or service sector during the same time period. Program managers need to know whether and to what degree the young people on their caseload are also on the caseload of another specified program. The need for service coordination between community mental health and juvenile justice programs in the same geographical region, for instance, is indicated by the number of young people on both programs. This information also provides higher level system managers with an indication of the degree to which the community mental health program is serving this group of young people who have an elevated need for mental health services. Where there are integrated information systems or where individual information systems share unique person identifiers, caseload integration can be directly measured. In the absence of the ability to share unique person identifiers, information about caseload overlap may be derived using the statistical technology of Probabilistic Population Estimation (PPE).

Nationally, the welfare caseload declined by more than 50% between 1994 and 2000. Considerable research has been devoted to understanding what caused this decline. Much of the literature examining these changes has modeled the total caseload (the stock) directly. Klerman and Haider (forthcoming) model the underlying flows and show analytically and empirically that previous methods are likely to be biased because they ignore important dynamics. However, due to their focus on the bias of the stock models, they present only limited results concerning the robustness of their findings and utilize only a single measure of economic conditions, the unemployment rate. This paper examines the robustness of the basic stock-flow model developed in Klerman and Haider (forthcoming), considering both richer dynamic specifications and richer measures of economic condition. We find that more complex dynamic specifications do not change the substantive conclusions, but richer measures of the economy do. While a model that only includes the unemployment rate attributes about half of the California caseload decline between 1995 and 1998 to the economy, models that incorporate richer measures of the economy attribute more than 90% of the decline to the economy.

Higher caseloads are associated with better outcomes for many conditions treated in secondary and tertiary care settings, including colorectal cancer (CRC). There is little known whether such volume-outcome relationship exist in primary care settings. The purpose of this paper is to examine general practitioner (GP) CRC-specific caseload for possible associations with referral pathways, disease stage and CRC patients’ overall survival.

The paper retrospectively analyses a prospectively maintained CRC database for 2009-2014 in a single district hospital providing bowel cancer screening and tertiary rectal cancer services.

Of 1,145 CRC patients, 937 (81.8 per cent) were diagnosed as symptomatic cancers. In total, 210 GPs from 44 practices were stratified according to their CRC caseload over the study period into low volume (LV, 1-4); medium volume (MV, 5-7); and high volume (HV, 8-21 cases). Emergency presentation (LV: 49/287 (17.1 per cent); MV: 75/264 (28.4 per cent); HV: 105/386 (27.2 per cent); p=0.007) and advanced disease at presentation (LV: 84/287 (29.3 per cent); MV: 94/264 (35.6 per cent); HV: 144/386 (37.3 per cent); p=0.034) was more common amongst HV GPs. Three-year mortality risk was significantly higher for HV GPs (MV: (hazard ratio) HR 1.185 (confidence interval=0.897-1.566), p=0.231, and HV: HR 1.366 (CI=1.061-1.759), p=0.016), but adjustment for emergency presentation and advanced disease largely accounted for this difference. There was some evidence that HV GPs used elective cancer pathways less frequently (LV: 166/287 (57.8 per cent); MV: 130/264 (49.2 per cent); HV: 182/386 (47.2 per cent); p=0.007) and more selectively (CRC/referrals: LV: 166/2,743 (6.1 per cent); MV: 130/2,321 (5.6 per cent); HV: 182/2,508 (7.3 per cent); p=0.048).

Higher GP CRC caseload in primary care may be associated with advanced disease and poorer survival; more work is required to determine the reasons and to develop targeted intervention at local level to improve elective referral rates.

Criminal law has dramatically expanded since the 1970s. Despite popular and academic attention to overcriminalization in the United States, empirical research on how court actors and, in particular, prosecutors, use the legal tools associated with overcriminalization is scarce. In this chapter, we describe three forms of overcriminalization that, in theory, have created new tools for prosecutors: the criminalization of new behaviors, mandatory minimum sentencing statutes, and the internal expansion of criminal laws. We then use a unique dataset of felony filings and dispositions in Florida from 1995 to 2015 to test a series of hypotheses examining how overcriminalization influences prosecutorial practices given three changes to the political economy during this time: the decline in violent and property crime, the Great Recession, and a growing call for criminal justice reform. We find that prosecutors have been unconstrained by declining crime rates. Yet, rather than rely on new criminal statutes or mandatory minimum sentence laws, they maintained their caseloads by increasing their filing rates for traditional violent, property and drug offenses. At the same time, the data demonstrate nonviolent other offenses are the top charge in almost 20% of the felony caseload between 2005 and 2015. Our findings also suggest that, despite reform rhetoric, filing and conviction rates decreased due to the Recession, not changes in the law. We discuss the implications of these findings for criminal justice reform.

Coaching in higher education has become increasingly common across the United States. Our qualitative study explores the perceptions of coaches and advisors, as they consider academic coaching as a role distinct from academic advising.

Our study adopts a qualitative research approach. Two focus groups were conducted with 14 coaching and academic advising professionals.

Our findings identify at least three major themes when considering academic coaching as a role distinct from academic advising: (1) Potential role overlap, (2) Caseload disparities and (3) Philosophical differences. The indiscriminate use of the title of “coach” contributed to confusion, ambiguity and tension.

Without a clear understanding of the coach role as a distinct type of support in higher education, confusion and ambiguity are likely to continue.

No studies have explored the perceptions of coaches and advisors, as they consider academic coaching as a role distinct in the United States.

This study profiled the work activities, including caseloads, of psychologists in clinical training (n=51; hereafter referred to as “trainees”) in the Republic of Ireland (RoI). The purpose of this paper is to highlight the value of trainees by focusing on the effect they had on the waiting times across the services where they were on placement.

This study employed a survey design using the online survey software, Limesurvey, in order to profile the work activities of 51 trainees (response rate=47 per cent) on various placements across the RoI.

Findings suggest that the trainees work contributed in a meaningful way to their host services through their engagement in both direct and indirect clinical work.

The study relied on self-report data, some of which were estimates (e.g. waitlist lengths at placement end). Future research could employ other methods (e.g. work activity diaries) to increase reliability.

By highlighting the valuable contribution made by trainees while on placement, this study supports the continued funding of clinical training programmes in the RoI.

This study investigates the effects of a broad-based policy change that altered maternal employment, family income, and other family characteristics on drug-related crime among youth. Specifically, we exploit differences in the implementation of welfare reform in the United States across states and over time in the attempt to identify causal effects of welfare reform on youth arrests for drug-related crimes between 1990 and 2005, the period during which welfare reform unfolded. We use monthly arrest data from the U.S. Federal Bureau of Investigation’s Uniform Crime Reports to estimate the effects of welfare reform implementation on drug-related arrests among 15- to 17-year-old teens exposed to welfare reform. The findings, based on numerous different model specifications, suggest that welfare reform had no statistically significant effect on teen drug arrests. Most estimates were positive and suggestive of a small (3%) increase in arrests.

The US 1996 Welfare Reform Act creating the Temporary Assistance for Needy Families (TANF) and replacing the Aid to Families with Dependent Children (AFDC) and the Job Opportunities and Basic Skills Training (JOBS) is discussed and reviewed. Based on the latest data for 35 states, the regression results estimated by the weighted least squares indicate that welfare caseload reductions are mainly attributable to lower unemployment rates, lower benefits, more education, and more sanctions. The administrative expense per welfare recipient ratio is insignificant, probably because some human efforts cannot be measured or because the positive and the negative effects of administrative expense on welfare rolls cancel each other.

This article describes a quality assurance effort aimed at defining the characteristics of the patient population of the Connecticut Mental Health Center, a state‐funded agency that provides comprehensive clinical and rehabilitative services to persons with mental illness. Also described is how this information guided management decisions in both caseload distribution and clinical service development. This “Patient Profile Project” was informed by research principles which view evaluation as continual, rather than terminal activity that involves key stakeholders from all levels within the mental health system of care and makes maximum use of data in ongoing performance improvement initiatives. The service‐need index that the project produced represents our first efforts to accurately capture service need and use it in clinical decision making. This review of the Connecticut Mental Health Center Patient Profile Project illustrates the utility of a continuous evaluation system in promoting improvements in a large mental health treatment system.