Assessing the Enhanced Ranch Program of the Santa Clara County Probation Department

In 2006, the Santa Clara County Probation Department (SCCPD) changed its approach to serving youth in two of its juvenile justice programs--the William F. James Boys' Ranch and the Muriel Wright Center. The overarching objectives of the change were to provide specific therapeutic services to youth and families while maintaining a commitment to public safety. The new cognitive-behavioral model marks a vastly different structure and philosophy, patterned after the evidence-based program developed by the Missouri Division of Youth Services. The new model, entitled the Enhanced Ranch Program, targets youth heavily entrenched in the juvenile justice system and emphasizes positive, peer-based group interactions and a holistic approach to developing individual case plans. Specially trained teams of staff work with small groups of youth offenders.Teams function as therapeutic units that share the daily activities of life with youth and focus on their critical thinking, personal development, and group processes. The Enhanced Ranch Program serves high-risk, high- need youth with gang affiliations, substance abuse issues, and significant criminal histories. This model was designed to improve outcomes for youth with extensive criminal histories by ensuring that they receive the most appropriate and purposeful services. The primary focus is to help youth internalize healthy behavior that will help them succeed.In November, 2008, Santa Clara County Chief Probation Officer Sheila Mitchell, commissioned NCCD to evaluate the implementation of the Enhanced Ranch Program. In large part, this report presents the findings of a process evaluation--an analysis of the specific structure and practice instituted by the County. It also presents some preliminary outcomes for youth

Early Home Visits by a Registered Nurse Care Manager with Heart Failure Patients

Strategies focused on 30 days in the life of a patient with heart failure will have limited impact on the burden that heart failure will have nationally or individually. The broader landscape of readmission risk underscores the need for a more comprehensive approach to heart failure management. Care management with a registered nurse demonstrated efficiently coordinate care. Home visits address the peaks of risk in the post-discharge transition and palliative phase while providing longitudinal support. The purpose of this study is to substantiate that early home visits and telephone followup with a registered nurse after discharge from the hospital will decrease the readmission rates of heart failure patients. The interventions used were face-to-face encounters, follow up telephone phone calls, a quality of life self-report tool and a medication reconciliation tool. This study utilized a secondary analysis of data collected with a state-funded grant to decrease readmissions of heart failure patients at a local 700-bed, not-for-profit hospital. The participants were identified based on their lack of insurance or being underinsured with Medicaid. A newly dedicated heart failure unit with 10 dedicated beds was opened in 2011. A team of case managers, nurses, and physicians responsible for referring the patients who met certain guidelines were referred to the care manager. If the patient met the insurance criteria and was NYHF Class III or IV, the patient would then be eligible for a care manager and pharmacist to assist with the transition home. Study results concluded that there were definite advantages to both these services in decreasing readmissions

Reparable Harm: Assessing and Addressing Disparities Faced by Boys and Men of Color in California

The California Endowment commissioned this report to highlight the most glaring inequities in socioeconomics, health, safety, and education faced by African-American and Latino men and boys in the state. In addition to presenting the statistics on these indicators, the authors outline a framework for addressing the disparities at the individual, community, and macro levels

Pressures and Preferences Affecting Willingness to Apply Beef Manure on Crops in the Colorado High Plains

Little is known about producers' willingness to use manure. Past studies have focused on substitutability for fertilizers. We surveyed crop producers in a cattle-dense region of the Colorado Plains about whether and why they apply manure, focusing on how pressures (like owning cattle) or preferences (pro and con) affect their adoption. Using logistic regression, findings show that pressure and preference (PS/PF) significantly affect adoption. A producer with high PS/PF was 10 times more likely to use manure than one with low PS/PF. Policy and decision makers can use such findings to inform education and policy aimed at increasing the land application of manure.cattle, economic benefits, economic costs, management, manure application, Crop Production/Industries,

Impact of the DRA Citizenship and Identity Documentation Requirement on Medi-Cal: Findings From Site Visits to Six Counties

Evaluates how the 2006 requirement for Medicaid beneficiaries to present proof of citizenship affected the workloads of California counties and enrollees' and applicants' access to Medi-Cal. Examines stakeholders' views of the requirement

The Many Texts of the Law

This paper contends that even as jurists invoke the official canonic version of the legal text, it is in danger of being replaced for the jurist, as well as for the lay person, if it has not been substituted already, by some apocryphal, inauthentic or casual text. We argue that in addition to the approximate nature of legal knowledge, the overuse of overedited and perverted casebooks, as well as the distribution of legal information among imperfect sources – some official but partial, others inauthentic but highly accessible, and a few reliable but highly unaffordable commercial sources – are largely responsible for this situation

Legitimacy, globally: The incoherence of free trade practice, global economics and their governing principles of political economy

In this article, we observe the legalized character of the phenomenon popularly called "globalization." We first examine what it means to be a legalized phenomenon and observe that an important part of legalization is legitimation. In domestic legal regimes, legitimation is accomplished through the Rule of Law, which makes certain claims about the nature of the society of which the legal regime is a part. Simply stated, the Rule of Law claims that a legal system is legitimate if its rules are definite and predictable and are applied in a general, impartial, and non-retroactive manner. In the international trading system of which globalization is the legalized regime, the legitimizing role is played by the so-called law of comparative advantage, developed originally by David Ricardo. Simply stated, the law of comparative advantage claims that all nations, not just the richest or most powerful, can profit from unhindered international trade, since each country can exploit and thus profit from its own particular advantages, even while it pays others for goods produced elsewhere. This globalized legitimation, similar to domestic legitimation, makes certain claims about the nature of the system of which the globalized regime is a part. We then examine what particular features of globalization are supported by the law of comparative advantage, and we note how the legitimating role of that law conceals the true nature of those features. Finally, we observe that globalization and those features we have examined produce, contrary to their express claims, disastrous global disparities in income and welfare. We conclude that it is the legitimizing functions of the law of comparative advantage that allows globalization to proceed in the manner it does while claiming to do quite the opposite. The legitimizing function of the global regime thus prevents a true understanding of globalization's nature

Caring for parents with neurodegenerative disease: a qualitative description

PURPOSE/OBJECTIVE: The objective of this study was to explore the positive aspects experienced by adult children in providing care to their parent who has either Parkinson's or Alzheimer's disease. DESIGN:A qualitative descriptive approach was used to analyze audiotaped in-depth semistructured interviews that were conducted with 34 adult children who were primary caregivers as part of a larger randomized clinical trial. SETTING: Individual interviews were conducted by trained research assistants in the caregiver's home. SAMPLE: Thirty-four adult children caregivers who were primary caregivers for their respective 34 parents. Seventy-six percent (n = 26) of the caregivers were caring for a parent with Alzheimer's disease. Twenty-four percent (n = 8) were caring for a parent with Parkinson's disease. Eighty-two percent were adult daughters. Mean age of the caregiver was 52 years, and the mean age of the parent was 81 years. Fifty-three percent of caregivers were white, and 47% were black. DATA ANALYSIS: A conventional content analysis was performed to summarize themes. FINDINGS: Results indicated that most caregivers had positive experiences. Three relationship-centered themes were identified: spending and enjoying time together, appreciating each other and becoming closer, and giving back care. A small number of caregivers (n = 6) could not identify positive experiences. CONCLUSION/IMPLICATIONS: Caregivers who had positive experiences in caregiving expressed fewer feelings of being overwhelmed or distressed by their situations. Further study is needed on caregivers who do not experience positive aspects in caring for a parent, and these caregivers potentially may be a group that warrants further intervention by advanced practice nurses