According to W. Edwards Deming, American companies require nothing less than a transformation of management style and of governmental relations with industry. In Out of the Crisis, originally published in 1982, Deming offers a theory of management based on his famous 14 Points for Management. Management's failure to plan for the future, he claims, brings about loss of market, which brings about loss of jobs. Management must be judged not only by the quarterly dividend, but by innovative plans to stay in business, protect investment, ensure future dividends, and provide more jobs through improved product and service. In simple, direct language, he explains the principles of management transformation and how to apply them.

Out of the Crisis

Maternal Depression in Home Visitation: A Systematic Review

Recent research has suggested that mothers participating in home visitation programs have a high incidence of mental health problems, particularly depression. Posttraumatic stress disorder (PTSD) is a common comorbidity with depression, yet its prevalence among home visiting populations and implications for parenting and maternal functioning have not been examined. This study contrasted depressed mothers with (n = 35) and without PTSD (n = 55) who were enrolled in a home visitation program. Results indicated that depressed mothers with comorbid PTSD were more likely to have experienced childhood sexual abuse, had greater severity of depressive symptoms, increased social isolation, and lower overall functioning than their counterparts without PTSD. Among PTSD mothers, greater severity of PTSD symptoms, in particular avoidance and emotional numbness, were associated with increased maternal psychopathology and parenting deficits even after controlling for depression severity. These findings add to the literature documenting the negative impacts of PTSD on maternal functioning and parenting. Implications for screening and treatment in the context of home visitation are discussed.

PTSD in Depressed Mothers in Home Visitation.

The National Center for Children in Poverty (NCCP) is the nation's leading public policy center dedicated to promoting the economic security, health, and well-being of America's low-income families and children. Using research to inform policy and practice, NCCP seeks to advance family-oriented solutions and the strategic use of public resources at the state and national levels to ensure positive outcomes for the next generation. Founded in 1989 as a division of the Mailman School of Public Health at Columbia University, NCCP is a nonpartisan, public interest research organization. This report examines whether states are investing in home visiting in ways that promote better outcomes for young children and whether they meet the needs of children facing the greatest social and developmental risks. The purpose was to assess the direction of state policies and programs, not to evaluate program effectiveness. AUTHOR Kay Johnson, MPH, MEd, is a consultant to NCCP and former project director of its Project Thrive, which links policies for child health, early learning, and family support. She has broad expertise in many areas of maternal and child health and has led numerous studies of maternal and child health and early childhood fiscal and infrastructure issues. Thanks go first to the state program and policy officials who assisted us by completing the survey of state-based home visiting programs. we deeply appreciate their participation in this study and commitment to improving the lives of children and families. Thanks also to the participants in the policy roundta-ble, who represented perspectives from state policy, academic research, and program practice. The author is particularly grateful to Jane Knitzer, lisa Klein, and Helene Stebbins, who provided a thorough and thoughtful peer-review of earlier drafts, and to Judy Van ginkel, who provided useful insights about the structure of effective programs. Finally, we acknowledge the work of the NCCP publications staff who support the editorial and graphic quality of the document. Introduction Home visiting for families with young children is a longstanding strategy offering information, guidance, risk assessment, and parenting support interventions at home. The typical " home visiting program " is designed to improve some combination of pregnancy outcomes, parenting skills and early childhood health and development, particularly for families at higher social risk. This report is designed to help inform the field about two central questions related to home visiting: 1) Are states investing in home visiting in ways that promote improved outcomes for …

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State-based Home Visiting Strengthening Programs through State Leadership

Dosage, or the amount of intervention delivered, is an important factor in understanding implementation. This brief for researchers and practitioners aims to help establish a common language for communication of findings.

Intervention Dosage in Early Childhood Care and Education: It's Complicated

SUMMARY As home visitation programs go to scale, numerous challenges are faced in implementation and quality assurance. This article describes the origins and implementation of Every Child Succeeds, a multisite home visitation program in southwestern Ohio and Northern Kentucky. In order to optimize quality assurance and generate new learning for the field, a Web-based system (eECS) was designed to systematically collect and use data. Continuous quality assurance procedures derived from business and industry have been established. Findings from data collection have documented outcomes, and have identified clinical needs that potentially undermine the impact of home visitation. An augmented module approach has been used to address these needs, and a program to treat maternal depression is described as an example of this approach. Challenges encountered are also discussed.

Alan R. Spector

Papers

Development and implementation of a quality assurance infrastructure in a multisite home visitation program in Ohio and Kentucky.