PurposeThe purpose of this paper is to examine the development of the Northlake Homeless Coalition, a collaborative network among homeless serving agencies in southeastern Louisiana. These collaboratives are required for obtaining government funds for housing programs in the USA.Design/methodology/approachThe study involved a literature review and the application of findings to analyse a case study of the Homeless Coalition.FindingsAmongst the reasons for the success of the programme seem to be the longevity of involvement of many participants, which encourages social bonds and commitment to grow; financial interests and individual attributes of agency representatives, including personalities, relationships, and belief systems. Many of the most active members are from agencies with legitimacy due to their governmental or larger organizational bases, but this is to the exclusion of small, faith‐based organizations and shelters that frequently provide services not able to be funded by the grant. The inflexible requirements that are established at the national level introduce a concern for meeting the needs of front‐line service providers. The infusion of funds has increased services to the homeless in this area. However, location in the most impoverished populations in the USA translates into very poorly funded agencies, with high demands.Originality/valueThe close analysis of the case has thrown light upon the key issues raised by the wider literature on collaborative networks.

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Our ability to improve prognostic modeling of the Greenland Ice Sheet relies on understanding the long-term relationships between climate and mass flux (via iceberg calving) from marine-terminating tidewater glaciers (TWGs). Observations of recent TWG behavior are widely available, but long-term records of TWG advance are currently lacking. We present glacial geomorphological, sedimentological, archaeological, and modeling data to reconstruct the ~20 km advance of Kangiata Nunaata Sermia (KNS; the largest tidewater glacier in southwest Greenland) during the first half of the past millennium. The data show that KNS advanced ~15 km during the 12th and 13th centuries CE at a rate of ~115 m a–1, contemporaneous with regional climate cooling toward the Little Ice Age and comparable to rates of TWG retreat witnessed over the past ~200 years. Presence of Norse farmsteads proximal to KNS demonstrates their resilience to climate change, manifest as a rapidly advancing TWG in a cooling climate. The results place limits on the magnitude of ice-margin advance and demonstrate TWG sensitivity to climate cooling as well as warming. These data combined with our grounding-line stability analysis provide a long-term record that validates approaches to numerical modeling aiming to link calving to climate.

The occurrence of multihospital systems, two or more hospitals owned, leased, or managed by a separate organization, represents a note-worthy change in the way health care is organized today. The impact of this for small rural hospitals, however, has only been studied indirectly or anecdotally. This investigation, using data from national surveys, systematically documents and analyzes this trend and discusses its potential impact. By 1983 almost one quarter of all small rural hospitals were affiliated with multihospital systems. This growth occurred primarily over the last few years, and was accompanied by a rapid surge in the involvement of for-profit systems. This contrasts sharply with traditional rural hospital care which had been provided primarily by nonprofit or religious institutions. There also were differences in the form of affiliation the hospitals had with their parent organizations, with the most recent movement toward management contracts. Differential changes also occurred in the patterns of affiliation by geographic region.

Prologue: The nation's community hospitals are undergoing a transformation in their corporate structure, their internal organization, and in the economic incentives under which they have traditionally operated. While these developments are underway, myths are rampant about the processes by which hospitals decide to recast their futures. Authors Jeffrey Alexander, Bonnie Lewis, and Michael Morrisey seek in this paper to report reality on the subject of how seven multiospital systems approach the strategic questions about their respective futures. The authors, all of whom hold doctorate degrees, were all employed by the AHA's Hospital Research and Educational Trust at the time this essay was written. The doctorates of Alexander (Stanford University) and Lewis (Purdue University), who resigned recently from the trust, are in sociology. Mowisey holds a Ph.D. in economics from the University of Washington. The research interests of all three authors have included multihospital systems.Alexander also has pursued research in hospital governance and Morrisey has targeted his interests on hospital-physician relationships and Medicare's prospective payment system. The findings of the authors were gleaned from interviews with multihospital system executives and data available to the AHA. One of the more interesting findings was that no system envisioned its future as solely or even mostly a provider of inpatient services. Rather, the corporate strategies culled for the marketing of health insurance us well us the provision of medical care. Insurance services were usually linked to participation in preferred provider or health maintenance organizations. Another interesting finding was the disinclination of all of the systems to pursue growth for growth's sake alone. Instead, all carefully analyzed market conditions facing the hospital and most acknowledged they often declined invitations to absorb hospitals because of unfavorable market conditions.