Does Mental Illness Affect Consumer Direction of Community-Based Care? Lessons From the Arkansas Cash and Counseling Program

Purpose: Previous research from the Cash and Counseling Demonstration and Evaluation (CCDE) in Arkansas, New Jersey, and Florida suggests that giving consumers control over their personal care greatly increases their satisfaction and improves their outlook on life. Still, some argue that consumerdirected care may not be appropriate for consumers with intellectual disabilities or mental health diagnoses. This study examined how Cash and Counseling— a new option allowing consumers to manage an individualized budget equivalent to what agencies would have spent on their care—changes the way consumers with mental health diagnoses meet their personal care needs and how that affects their wellbeing. Design and Methods: Using the Arkansas CCDE baseline and the 9-month follow-up data for individuals in the treatment and control groups, we compared and contrasted the experience of elderly consumers with and without mental health diagnoses utilizing logit regression. Results: After examining several outcome measures, including satisfaction with care arrangements and the paid caregiver’s reliability and schedule, unmet needs, and satisfaction with the relationship with paid caregivers, this study found evidence that, from the perspective of consumers, the Cash and Counseling program works well for participants with mental health diagnoses. Implications: Considering the growing need for long-term-care services and the limited resources available, a consumer-directed option makes sense, and it can be a valuable alternative for persons with mental health needs.

The Investigation of Uniform, Monodisperse Crystalline Particles via the Evaporation of Small Droplets

Many industrial solids processes require the production of disperse particles. In industries such as food, personal care, and pharmaceuticals, particle formation is widely used to produce solid products or to separate substances in intermediate process steps. The most important characteristics known to impact the effectiveness of a solid product are purity, size, internal structure, and morphology. These characteristics are essential to maintain optimal operation of subsequent process steps and for obtaining the desired high quality product. This thesis aims to aid in the advancement of particle production technology by (1) investigating the use of a vibrating orifice aerosol generator (VOAG) for collecting data to predict particle attributes including morphology, size, and internal structure as a function of processing parameters such as solvent, solution concentration, air flow rate, and initial droplet size, as well as to (2) determine the extent to which uniform droplet evaporation can be a tool to achieve novel particle morphologies, controlled sizes, or internal structures (crystallinity and crystal form). Experimental results for succinic acid, L-serine, and L-glutamic acid suggest that particles of controlled characteristics can indeed be produced by this method. Analysis by scanning electron microscopy (SEM), nanoindentation, and X-ray diffraction (XRD) shows that various sizes, internal structures, and morphologies can be obtained using the VOAG. Furthermore, unique morphologies and unexpected internal structures were able to be achieved for succinic acid, providing an added benefit to particle formation by this method.