Scott Cummings

The evolution of hospice in America toward organizational homogeneity.

This article describes and explores the evolution of hospice in America. Using a theory of organizational isomorphism developed by DiMaggio and Powell (1983), the authors assess the development of hospice under conditions of uncertainty, co-optation by external forces, and professionalization by existing health care practitioners. The authors find that hospice programs have become isomorphic over time. That is, they have become more similar to each other as well as to other health care organizations.

Race Relations and Public Policy in Louisville: Historical Development of an Urban Underclass

Louisvilles racial legacy was shaped by Kentuckys strategic position as a border state during the Civil War and by the activities of Northern troops stationed there. Maintaining the allegiance of the border states was central to the success of Lincolns presidency during the early years of the war (Howard, 1983). According to Lincolns political calculations, the border states were dominoes, with Kentucky standing first in line. The state was deeply divided over the slavery question, and Lincoln reasoned that full emancipation might compel alignment with the Confederacy. Attempting to separate preservation of the Union from slavery, the president promoted gradual emancipation based on compensation and voluntary compliance (Howard, 1983). This policy temporarily appeased Kentucky slaveholders who. failed to recognize the ultimate need of the Lincoln administration to embrace an antislavery policy. The movement of large numbers of Northern troops into Kentucky, especially Louisville, during 1861 and 1862 was a watershed event signalling an abrupt end to slavery in the state.

Neighborhood Participation in Community Development: A Comparison of Strategic Approaches

This study compares the ability of community development corporations to mobilize residents of low income neighborhoods to participate in redevelopment efforts. The evidence and argument show that community development corporations have not been more successful than other types of community-based organizations in (1) the degree to which organizational leadership has been recruited from the neighborhood; (2) the type of control exercised by residents over redevelopment policy, and; (3) the degree of fiscal autonomy achieved by the organization. The policy ramifications of the findings are discussed and analyzed.

INJECTION DRUG USERS AND HIV RISK BEHAVIORS: CRIMINAL JUSTICE PROFESSIONALS’ ROLE IN IDENTIFYING AND RESPONDING TO RISK BEHAVIORS

ABSTRACT This research uses data from a community wide assessment of knowledge, attitudes and behaviors to determine risks for HIV infection among traditional high risk populations. This analysis is based upon a sample of self-identified injection drug users. It examines the multiple avenues to infection that threaten this population. The role of criminal justice practitioners in the control and reduction of the likelihood of HIV transmission by this population is also considered Policy makers should reevaluate traditional methods of compelling interactions between offenders and revise their means and systems for communicating information about HIV to injection drug using offenders.

Immigration restrictions and the American worker: An examination of competing interpretations

This paper examines three competing interpretations of support for tougher immigration restrictions. One interpretation posits that tighter restrictions are favored by those in direct competition with immigrants for jobs, namely low or unskilled workers who toil in labor markets that are low-paying and often unstable. A second line of thought is that greater restrictions are favored by workers who perceive immigrants as potential competitors in labor markets, even though there may be no real basis for such perceptions. The third interpretation explaining support for tougher restrictions is rooted in a broad based cultural nativism or nationalism, and relies heavily on traditional theories of prejudice and discrimination. Data for the study are derived from the 1992 National Election Survey, Inter-University Consortium for Political and Social Research. Contrary to theoretical expectations, neither actual nor perceived economic insecurity explain variations in current levels of support for tougher immigration restrictions among American workers. The theoretical significance of the findings are discussed and elaborated. Suggestions are made for future research in this important area of inquiry.

Community development in a Mexican squatter settlement: A program evaluation

This paper critically examines various approaches to community development in Mexican squatter settlements. Using a quasi-experimental design, the authors show systematic differences between government-sponsored and spontaneous squatter communities. Results suggest that residents in the non-government squatter settlement are not disadvantaged in their ability to construct adequate housing or to obtain resources similar to those living in government-sponsored communities. Government-sponsored settlements, however, showed significantly higher levels of collective action and community building than those that were spontaneously formed. The authors conclude with suggestions for improving the social and physical conditions of squatters.

Examining the caring function of hospices. Differences between community based and institutionally based hospice programs.

Thisarticleexaminesaquestionof growingconcern amonghospiceadvocatesacrossthecountry:Are hospicesableto implementtheircaringmissionin theface of increasedintegrationinto themedicalmainstream? This importantpolicy issue hasreceivedwidespread attentionamonglegislatorsandopinion leaders,and hascausedfragmentationandconsiderabledisagreementamonghospiceprogramdirectors. Programdirectors of community-basedhospices contend that larger, institutionally affiliated and governmentallyfundedprogramsare intent on gaining legitimacy within the traditional medical care system.Theymaintainthat this questfor legitimacy, for purposesof reimbursement,hascausednegative shifts in the philosophyandorganizational structure of hospiceprograms,andcompromisedsomeof the ideals upon which American hospice care is premised.’ According to critics,2 the recent trend toward hospital and home health agency mergers erodesthe quality of palliative andcaring therapies for hospicepatientsand families. Becauseservices, suchas bereavement andpastoralcounseling,arenot directly reimbursedby third-party payors,theyoften receivelittle attentionfrom institutionally affiliated program staff. Communityand all volunteer programs,on the other hand,allegedlyare not as concernedaboutthe fiscal andpolitical pressurescreated by third-partyreimbursement andcontinueto provide moreintimateandindividualizedservices. Disagreementover the desirability of third party reimbursement was articulatedat the 1984 National HospiceOrganization(NHO) meetingin Hartford,

One-Way Busing and Community Psychology; School Desegregation at Minimal Costs.

Busing in black pupils seemed to have little effect on white attitudes and communities toward the pupils.