The process of exempt immediate relative immigration to the United States

"To examine the chain migration issue [in the United States], this article develops and analyzes a new data base that links information on a sample of exempt immediate relative immigrants in Fiscal Year 1985 with information on the characteristics of their petitioners or sponsors. The analysis generally does not indicate that an explosive increase in future chain migration of exempt immediate relative immigrants is likely in the next ten years." Exempt immediate relative immigrants are defined as those who are exempt from numerical limitations because of their relationship with a U.S. citizen. Data are from the U.S. General Accounting Office.     

Does disease management work?

Is disease management the "solution of the month" or a valid approach to organizing patient care? In the era of rapid change in health care, disease management is emerging as one technique suited to improving measurable health care outcomes at greater cost effectiveness. By taking a leading role in the process, those physician executives who commit to this approach can greatly enhance the potential of these programs to accomplish the desired results.     

Challenges of Dealing with Financial Concerns during Life-Threatening Illness: Perspectives of Health Care Practitioners

ABSTRACT

The costs of serious medical illness and end of life care are often a heavy burden for patients and families (Collins, Stepanczuk, Williams, & Rich, 2016 Collins, A., Stepanczuk, C., Williams, N., & Rich, E. (2016). Supporting better patient decisions at the point of care: What payers and delivery systems can do (Mathematica Policy Research Issue Brief). Retrieved from http://econpapers.repec.org/paper/mprmprres/6c6a86e28d7149c993713352eeceaa18.htm [Google Scholar]; Kim, 2007 Kim, P. (2007). Cost of cancer care: The patient perspective. Journal of Clinical Oncology, 25(2), 228–232. doi:10.1200/JCO.2006.07.9111[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; May et al., 2014 May, C. R., Eton, D. T., Boehmer, K., Gallacher, K., Hunt, K., MacDonald, S.,?… &?Rogers, A. E. (2014). Rethinking the patient: Using burden of treatment theory to understand the changing dynamics of illness. BMC health services research, 14(1), 1–11. doi:10.1186/1472-6963-14-281[Crossref], [PubMed] , [Google Scholar]; Zarit, 2004 Zarit, S. H. (2004). Family care and burden at the end of life. Canadian Medical Association Journal, 170(12), 1811–1812. doi:10.1503/cmaj.1040196[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Twenty-six practitioners, including social workers, managers/administrators, supervisors, and case managers from five health care settings, participated in qualitative semistructured interviews about financial challenges patients encountered. Seven practitioners took part in a focus group. Practitioners were recruited from hospice (n?=?5), long-term care (n?=?5), intensive care (n?=?5), dialysis (n?=?6), and oncology (n?=?5). Interview and focus group questions focused on financial challenges patients encountered when facing life-threatening illness. Interview data were transcribed and thematically coded and trustworthiness of data was established with peer debriefing, member checking, and agreement on themes among the authors. Practitioners described interacting micro, meso, and macroinfluences on the financial well-being and challenges patients encountered. Microlevel influences involved patient characteristics, such as their demographic profile and/or health status that set them up for financial aptitude or challenges. Macrolevel influences involved the larger health care/safety net system, which provided valuable resources for some patients but not others. Practitioners also discussed the mesolevel of influence, the local setting where they worked to match available resources with patients’ individual needs given the constraints emerging from the micro and macrolevels. Practitioners described how they navigated the interplay of these three areas to meet patients’ needs and cope with financial challenges. Implications for practice point to directly addressing the kind of financial concerns that patients and families facing financial burden from serious medical illness have, and identifying ways to bridge knowledge and resource access gaps at the individual, organizational, and societal levels.     

UK Privatization: Its Impact on Procurement

This study is concerned with changes in procurement and supply chain management in UK privatized companies. In most cases, privatization requires the organization to develop a completely new approach. This is because of the change in ownership and the new competitive environment into which the company moves. Part of this reassessment of the business by senior management can be expected to include procurement. The paper focuses on the nature and direction of the changes in procurement associated with privatization, based on research into the privatized sector in Britain. The method adopted involves an extensive questionnaire completed by 28 major companies privatized in the UK, followed up by interviews with twelve of these companies. Questions centre on the following key areas: changes in the structure of procurement, procurement strategy, the role and profile of procurement within the company, attitudes to outsourcing and supplier performance and changes in approach to assessing the performance of the procurement function. Our results indicate extensive change. Although cost reduction is often a driver of these changes, as the companies strive to reduce costs to meet City expectations and best practice in the private sector, another consideration is the contribution that procurement can make to the overall strategy of the company, so as to gain and maintain competitive advantage.     

From bodies as ‘meat’ to bodies as ‘flesh’: the expression of performance management as ‘sacrificial acts’ within professional rugby

ABSTRACT

In this article, we argue that to extend the research on performance management we need to examine further how organisational members interweave the technology of such management into their work. Using Maurice Merleau-Ponty’s philosophy, we question the notion that technology acts on bodies in a linear manner as ‘meat’ to be manipulated. His reversible ontology suggests that these materials can be woven into the flesh of organising in a multitude of ways. Specifically, we refer to professional rugby, and the manner in which its players utilise the technology of performance management, to forge a localised expression of sacrifice. We suggest that this expression provides a means for players to define and evaluate themselves against ‘good rugby’. As forms of evaluation may vary in organisations, we recommend that researchers do not solely associate performance management with metrics but also look to other, more localised, expressions to inform their work.     

The Integration of Immigrants in Northern Sweden: A Case Study of the Municipality of Strömsund

The aim of this study was to examine the integration process with regard to an integration and voluntary re‐settlement project in a rural area in northern Sweden. The project was an attempt to use existing resources in the municipality to attract people with an immigrant background to move from segregated urban environments to a rural municipality. Potential settlers were also recruited abroad. The empirical data were based on eight group interviews with recently arrived immigrant families, and eleven individual interviews with people who played an active role in the project organisation. The results showed that the new families had been integrated into the community to the extent promised by the local authority. The process was facilitated by the resources provided by both parties, but it did not involve significant costs. The immigrants were motivated to move because they wanted a new lifestyle, while the local community was motivated to provide a supportive structure for the new inhabitants because of an awareness of the imminent demographic crisis facing the community due to depopulation. The integration process was strongly influenced by the implicit criteria on which the newcomers were recruited.     

Predictors of High-Risk Sexual Behavior Among Individuals Living with HIV Disease and AIDS

An important focus of the 1996 World Aids Conference related to the extent of unprotected sex among gay men, particularly those in their twenties. This paper will use logistic analysis to explore the extent of unsafe sexual practices among individuals living in Bexar County, Texas, who are HIV+ assymptomatic, HIV+ symptomatic, or have AIDS. Using survey research data, we assess the significance and impact of various independent factors on whether respondents reported they did or did not engage in unprotected sex. The most striking finding is that unprotected sexual activity is prevalent regardless of demographic and/or status differences among respondents. Findings reinforce the use of community planning processes, which emphasize the importance of sound behavioral and social science combined with efforts to include the affected constituency to create effective HIV prevention programs.     

Gender Role Ideology and the Gender Based Differences in Earnings

Much of the research on gender differences in occupational earnings still focuses on human capital and the structure of the labor market. However, these variables rarely explain even half of the gender gap in earnings. Most research has examined the impact of gender role ideology as it impacts occupational choice, which indirectly can impact earnings. Using data from the National Opinion Research Center General Social Surveys, this research focuses on the relationship between attitudes about gender roles and two variables: (a) earnings, and (b) occupational positions held by women and men. Findings show that traditional gender-role ideology contributes to lower observed earnings for both males and females, independent of the influences of human capital characteristics, occupational context, and ascribed characteristics. Results support socialization as a partial explanation for the gender-based earnings differences and suggest that, to the extent that economic rewards are used to assess the value of gender role expectations, traditional gender role attitudes might continue to change and lead to relatively equal earnings among women and men.