Persistence of low drug treatment coverage for injection drug users in large US metropolitan areas

<p>Abstract</p> <p>Objectives</p> <p>Injection drug users (IDUs) are at high risk for HIV, hepatitis, overdose and other harms. Greater drug treatment availability has been shown to reduce these harms among IDUs. Yet, little is known about changes in drug treatment availability for IDUs in the U.S. This paper investigates change in drug treatment coverage for IDUs in 90 metropolitan statistical areas (MSAs) during 1993-2002.</p> <p>Methods</p> <p>We define <it>treatment coverage </it>as the percent of IDUs who are in treatment. The number of IDUs in drug treatment is calculated from treatment entry data and treatment census data acquired from the Substance Abuse and Mental Health Service Administration, divided by our estimated number of IDUs in each MSA.</p> <p>Results</p> <p>Treatment coverage was low in 1993 (mean 6.7%; median 6.0%) and only increased to a mean of 8.3% and median of 8.0% coverage in 2002.</p> <p>Conclusions</p> <p>Although some MSAs experienced increases in treatment coverage over time, overall levels of coverage were low. The persistence of low drug treatment coverage for IDUs represents a failure by the U.S. health care system to prevent avoidable harms and unnecessary deaths in this population. Policy makers should expand drug treatment for IDUs to reduce blood-borne infections and community harms associated with untreated injection drug use.</p

Long Live Marketization for Local Public Spaces: A Study of Scandinavian Managers’ Satisfaction with Private Provider Performance

Continued critiques, evidence and newer reform trends have increasingly contested the use of market-centered models–the competition prescription–for urban public space maintenance as well as other local services. This article adopts a contextualized contingency perspective on the competition prescription and questions the contested status of market-centered models in a survey-based study of the current use of and satisfaction with private providers for maintenance of parks/greenspaces and road/streets in Scandinavian local governments. The study finds widespread use of and satisfaction with private providers. However, satisfaction depends on national context and multiple contingencies. The study challenges the contested status of market-centered models, highlights that different models serve different strategic objectives, and directs attention to discussions of context and key contingencies that define how well market-centered models perform

Long Live Marketization for Local Public Spaces: A Study of Scandinavian Managers’ Satisfaction with Private Provider Performance

Continued critiques, evidence and newer reform trends have increasingly contested the use of market-centered models–the competition prescription–for urban public space maintenance as well as other local services. This article adopts a contextualized contingency perspective on the competition prescription and questions the contested status of market-centered models in a survey-based study of the current use of and satisfaction with private providers for maintenance of parks/greenspaces and road/streets in Scandinavian local governments. The study finds widespread use of and satisfaction with private providers. However, satisfaction depends on national context and multiple contingencies. The study challenges the contested status of market-centered models, highlights that different models serve different strategic objectives, and directs attention to discussions of context and key contingencies that define how well market-centered models perform

Who's at the table? An analysis of ministers’ participation in EU Council of Ministers meetings

The Council of Ministers is an important part of EU decision-making. However, contrary to what is formally expected member, states are not always represented by ministers at Council meetings. Unfortunately, our knowledge of who is actually participating is limited. First, the article investigates the extent to which ministers actually participate in Council meetings. We conclude that a substantial number of the participants are not ministers. Second, based on an institutional approach, the article tests six hypotheses as to when ministers participate. Here, we find the salience of meetings, the importance of the policy area, the length of EU membership and a high share of EU-positive parties enhance the likelihood of ministerial participation. Finally, we test whether the existence of junior ministers affects the likelihood of politicians participating. Here, our findings are inconclusive. The article builds on a database including all participants in Council meetings between 2005 and 2009

sj-docx-1-uar-10.1177_10780874211042544 - Supplemental material for Long Live Marketization for Local Public Spaces: A Study of Scandinavian Managers’ Satisfaction with Private Provider Performance

Supplemental material, sj-docx-1-uar-10.1177_10780874211042544 for Long Live Marketization for Local Public Spaces: A Study of Scandinavian Managers’ Satisfaction with Private Provider Performance by Andrej Christian Lindholst in Urban Affairs Revie

sj-xls-1-sjp-10.1177_14034948221085398 – Supplemental material for Which factors are associated with COVID-19 infection incidence in care services for older people in Nordic countries? A cross-sectional survey

Supplemental material, sj-xls-1-sjp-10.1177_14034948221085398 for Which factors are associated with COVID-19 infection incidence in care services for older people in Nordic countries? A cross-sectional survey by Auvo S. Rauhala, Lisbeth M. Fagerström, Andrej C. Lindholst, Timo S. Sinervo, Tilde M. Bertelsen, Trond Bliksvær, Bente V. Lunde, Rolf Solli, Maria G. Wolmesjö and Morten B. Hansen in Scandinavian Journal of Public Healt

Which factors are associated with COVID-19 infection incidence in care services for older people in Nordic countries? A cross-sectional survey

Aims:To investigate the differences between Sweden, Denmark, Finland and Norway regarding residential/home care units’ and frontline managers’ background factors, the resources allocated and measures taken during the initial phases of the COVID-19 pandemic, and whether and how these differences were associated with COVID-19 among older people in residential/home units.Methods:Register- and survey-based data. Responses from managers in municipal and private residential/home units. Number of municipal COVID-19 cases from national registries. Multilevel logistic multivariate regression analysis with presence of COVID-19 among older people in residential/home units as the outcome variable.Results:The proportions of residential/home units with client COVID-19 cases, mid-March–April 2020 were Denmark 22.7%, Finland 9.0%, Norway 9.7% and Sweden 38.8%, most cases found in clusters. The proportions were similar among employees. Client likelihood of having COVID-19 was six-fold higher if the employees had COVID-19. Mean client cases per residential/home unit were Denmark 0.78, Finland 0.46, Norway 0.22 and Sweden 1.23. For the same municipal infection incidence class, Sweden’s mean client infection levels were three-fold those of other countries. The regression analysis variables country, municipal COVID-19 incidence proportion, and care type were associated with client cases at p ⩽ .001. Compared with Denmark, the odds ratios (ORs) for Sweden, Norway and Finland were 1.86, 0.41 and 0.35 respectively. The variable difficulties in preventive testing had an OR of 1.56, p ⩽ .05.Conclusions:Municipal COVID-19 incidence, employee cases, and the lack of testing resources somewhat explained the confirmed COVID-19 cases among older people in residential/home units. A two- to five-fold unexplained inter-country difference in ORs in the multivariate analyses was notable. The level of protection of vulnerable older clients in municipal and private residential/home units differed between the included countries

sj-xls-1-sjp-10.1177_14034948221085398 – Supplemental material for Which factors are associated with COVID-19 infection incidence in care services for older people in Nordic countries? A cross-sectional survey

Supplemental material, sj-xls-1-sjp-10.1177_14034948221085398 for Which factors are associated with COVID-19 infection incidence in care services for older people in Nordic countries? A cross-sectional survey by Auvo S. Rauhala, Lisbeth M. Fagerström, Andrej C. Lindholst, Timo S. Sinervo, Tilde M. Bertelsen, Trond Bliksvær, Bente V. Lunde, Rolf Solli, Maria G. Wolmesjö and Morten B. Hansen in Scandinavian Journal of Public Healt