Trends in Alcohol Services Utilization from 1991–1992 to 2001–2002: Ethnic Group Differences in the U.S. Population

Background:  During the early 1990s in the United States, changes to the provision and financing of alcohol treatment services included reductions in inpatient treatment services and in private sector spending for treatment. We investigated trends in alcohol services utilization over the 10‐year period from 1991–1992 to 2001–2002 among U.S. whites, blacks, and Hispanics. Methods:  Data come from 2 household surveys of the U.S. adult population. The 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey and the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions conducted face‐to‐face interviews with a multistage cluster sample of individuals 18 years of age and older in the continental United States. Treatment utilization represented both total utilization and the use of alcohol services. Data analyses were prevalence rates and multivariate logistic regressions for lifetime utilization with drinkers and individuals with alcohol use disorders (AUDs). Results:  From 1991–1992 to 2001–2002, drinking‐related emergency room and human services use increased for drinkers, while total utilization and the use of private health professional services and mutual aid decreased for individuals with AUDs. In drinkers and individuals with AUDs, blacks and Hispanics were less likely than whites to use private health professional care. Hispanics with AUDs were less likely than whites with AUDs to use alcohol or drug programs. Ethnicity interacted with alcohol severity to predict alcohol services utilization. At higher levels of alcohol severity, blacks and Hispanics were less likely than whites to ever use treatment and to use alcohol services (i.e., human services for Hispanic drinkers, mental health services for blacks with AUDs, and mutual aid for Hispanics with AUDs). Conclusions:  Our findings showed increases from 1991–1992 to 2001–2002 in alcohol services utilization for drinkers, but reductions in utilization for individuals with AUDs. Blacks and Hispanics, particularly those at higher levels of alcohol severity, underutilized treatment services compared to whites. These utilization trends for blacks and Hispanics may reflect underlying disparities in healthcare access for minority groups, and language and logistical barriers to utilizing services

Blockchain, Leadership And Management: Business AS Usual Or Radical Disruption?

The Internet provided the world with interconnection. However, it did not provide it with trust. Trust is lacking everywhere in our society and is the reason for the existence of powerful intermediaries aggregating power. Trust is what prevents the digital world to take over. This has consequences for organisations: they are inefficient because time, energy, money and passion are wasted on verifying everything happens as decided. Managers play the role of intermediaries in such case: they connect experts with each others and instruct them of what to do. As a result, in our expert society, people's engagement is low because no one is there to inspire and empower them. In other words, our society faces an unprecedented lack of leadership. Provided all those shortcomings, the study imagines the potential repercussions, especially in the context of management, of implementing a blockchain infrastructure in any type of organisation. Indeed, the blockchain technology seems to be able to remedy to those issues, for this distributed and immutable ledger provides security, decentralisation and transparency. In the context of a blockchain economy, the findings show that value creation will be rearranged, with experts directly collaborating with each others, and hierarchy being eliminated. This could, in turn, render managers obsolete, as a blockchain infrastructure will automate most of the tasks. As a result, only a strong, action-oriented, leadership would maintain the organisation together. This leadership-in-action would consist in igniting people to take action; coach members of the organisations so that their contribution makes sense in the greater context of life

Implications of Spatially Variable Costs and Habitat Conversion Risk in Landscape-Scale Conservation Planning

‘‘Strategic habitat conservation’’ refers to a process used by the U.S. Fish and Wildlife Service to develop cost-efficient strategies for conserving wildlife populations and their habitats. Strategic habitat conservation focuses on resolving uncertainties surrounding habitat conservation to meet specific wildlife population objectives (i.e., targets) and developing tools to guide where conservation actions should be focused on the landscape. Although there are examples of using optimization models to highlight where conservation should be delivered, such methods often do not explicitly account for spatial variation in the costs of conservation actions. Furthermore, many planning approaches assume that habitat protection is a preferred option, but they do not assess its value relative to other actions, such as restoration. We developed a case study to assess the implications of accounting for and ignoring spatial variation in conservation costs in optimizing conservation targets. We included assumptions about habitat loss to determine the extent to which protection or restoration would be necessary to meet an established population target. Our case study focused on optimal placement of grassland protection or restoration actions to influence bobolink Dolichonyx oryzivorus populations in the tallgrass prairie ecoregion of the north central United States. Our results show that not accounting for spatially variable costs doubled or tripled the cost of meeting the population target. Furthermore, our results suggest that one should not assume that protecting existing habitat is always a preferred option. Rather, our results show that the balance between protection and restoration can be influenced by a combination of desired targets, assumptions about habitat loss, and the relative cost of the two actions. Our analysis also points out how difficult it may be to reach targets, given the expense to meet them. We suggest that a full accounting of expected costs and benefits will help to guide development of viable management actions and meaningful conservation plans

A 10-year Study of Factors Associated with Alcohol Treatment Use and Non-use in a U.S. Population Sample

Background This study seeks to identify changes in perceived barriers to alcohol treatment and predictors of treatment use between 1991–92 and 2001–02, to potentially help understand reported reductions in treatment use at this time. Social, economic, and health trends during these 10 years provide a context for the study. Methods Subjects were Whites, Blacks, and Hispanics. The data were from the National Longitudinal Alcohol Epidemiologic Survey (NLAES) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We conducted two analyses that compared the surveys on: 1) perceived treatment barriers for subjects who thought they should get help for their drinking, and 2) variables predicting past-year treatment use in an alcohol use disorder subsample using a multi-group multivariate regression model. Results In the first analysis, those barriers that reflected negative beliefs and fears about seeking treatment as well as perceptions about the lack of need for treatment were more prevalent in 2001–02. The second analysis showed that survey year moderated the relationship between public insurance coverage and treatment use. This relationship was not statistically significant in 1991–92 but was significant and positive in 2001–02, although the effect of this change on treatment use was small. Conclusions Use of alcohol treatment in the U.S. may be affected by a number of factors, such as trends in public knowledge about treatment, social pressures to reduce drinking, and changes in the public financing of treatment

Le syndicalisme est-il la réponse au problème des « cadres »?

Après avoir souligné la modification relativement récente, en divers milieux québécois, des attitudes traditionnelles à l'endroit des«  cadres » d'entreprise, l'auteur déplore la faiblesse lexicologique du terme«  cadres » dans ce contexte, de même que l'ambiguïté de ce vocable globaliste, eu égard à la grande diversité des agents qu'il recouvre. A partir donc d'une esquisse de typologie des«  cadres », il s'interroge ensuite sur leursproblèmes présumés ou réels— qu'il s'agisse plus largement d'«  aliénation » ou plus spécifiquement de divers malaises concrètement identifiables à partir d'une échelle donnée de besoins. Pour chacun de ces problèmes, l'auteur examine enfin diversessolutions institutionnelles qui sont à la disposition des«  cadres » : action patronale, association de cadres, syndicalisme de cadres et législation élargieIn recent years, managerial and supervisory personnel have elicited quite a bit of interest, not only from top managementwithin the business organization — this is, of course, not a new development, since top management has always seen all their levels of management and supervision as one monolithic block—, but also from various quartersoutside the firm proper, namely :1)university pofessors (and especially sociologists and industrial relations specialists), who have always been sympathetic and sensitive to collective problems and solutions, to proletarian miseries (are we not now talking and writing more and more about the « new proletarians of knowledge » ?) and to democratic values everywhere, respect and freedom for man ; and who easily see in unions of all types and levels of employees an « irreversible » trend, and a good and necessary one at that, which should be fostered by intellectuals and legislation ;2)union leaders, who used to blast any and all executives or foremen as capitalistic exploiters or technocrats, and who now discover in them a great reservoir, both strategic and numerous, to be tapped in order to multiply union strength tenfold ;3)government people, who are quite ambivalent about management and. supervision, since they act as both employer and lawmaker ; in the first rote, they are stuck with very difficult problems of an administrative nature : assaults by politicians, a history of nepotism, and an increasingly large bureaucracy spread over a broad territory ; in the second, they are tempted to enact all-embracing legislation (for all employees of all sectors, whether public or private) to solve problems which initially and basically could and should be solved at home.This newly-oriented interest in management and supervision from outside groups coincides with some aspirations of some levels of management, mainly in the public and para-public sectors, toward some form of unionization, especially in the Province of Quebec.All this interest, however gratuitous or selfish, should blind no executive to the basic postulate that he, and he alone, should be the one to define his problems and to find appropriate solutions for them, according to the great variety which is evident among his ranks : does he act in a line or a staff capacity, and then, at what level of supervision or management ? Obviously, problems and solutions will differ in kind and intensity according to the nature of the function held by the executive.And then, if one turns to theproblems of managers or supervisors, one should not « overkill » with such broad diagnoses as « alienation », which today means just about everything and then nothing, not being specific enough and leading nowhere in terms of remedies. What needs are not met by managers and supervisors : are they, or do they feel, relatively powerless, meaningless, normless, isolated, and self-estranged ? Is it a problem of not having enough of the primary needs satisfied : physiological-hygienic or safety (not enough money, not enough security) ? Or does it go deeper and more diffuse in terms of lack of belonging, esteem, and self-achievement ?And finally, if we now turn to solutions.Which are the ones most closely adapted to the specific problems diagnosed ? Will it be a new realization by top management, aided by lower levels, of the need for more of the behavioral satisfactions : more communication, more information, more participation in decision-making, more warmth in the day-to-day relation-ships ? Should this fail, will it lead to in-firm managerial or supervisory associations ? Should these appear inadequate, will they be turned into regular unions, with the standard paraphernalia of collective bargaining ? And then, will these affiliate to an outside federation of managerial people exclusively, or rather will this affiliate with a central labour body ?Before deciding, managerial and supervisory personnel should first evaluate their problems realistically, and then reach first for the means closest to their reach. Unions carry their own brand of bureaucracy and « alienation » ; they are not a dogma or a postulate any more, even among their own membership ; they have not yet made much headway in North America, at the professional and managerial levels ; for the time being, at least, they may seem like a jack-hammer cracking a nut. So, legislation at this level of personnel seems at this time inopportune and would create much ambiguity