The effect of war on marriage,divorce and birth rates

The impact of war on marriage, divorce, and birth rates in the United States from 1933 to 1986 is explored. The author concludes that "the involvement of the nation in military activities was accompanied by a decrease in marriage and birth rates but not by any change in divorce rates. Mobilization of the armed forces and demobilization had no discernible impact on divorce, marriage or birth rates."     

Pastoral care in Candyland. Maintaining power and life in a world of illness

Wrestling with ghosts and staging fatal accidents with Matchbox cars allow a critically ill six-year-old to come to terms with the fears prompted by his illness.     

The health care system should produce health

Reform of the U.S. health care system along the lines to be proposed by the Clinton Administration will not be an easy task, and it will not be accomplished quickly. A fundamental objective of the changes should be a health system whose purpose is improvement in the health of U.S. citizens, and not just the provision of services to all. This column is jointly edited by Kevin M. Fickenscher, MD, and David A. Kindig, MD, PhD, chair and member, respectively, of the College's Forum on National Health Policy. Dr. Fickenscher is participating in various advisory capacities on health care in the Clinton Administration, and Dr. Kindig is Senior Advisor to HHS Secretary Donna Shalala.     

Correlates of honor ratings in a clinical clerkship employing a faculty forum evaluation system

5he purpose of this study was to determine whether or not suspected variables affected a surgery clerk's chances of being awarded an honor rating. Findings indicated a significant relationship between a student receiving an honor rating and his or her preceptor's predetermined level of student advocacy, the number of completed patient interview and physical examination write-ups, and final examination scores. There was no significant relationship found between honor ratings and the preceptor's status, the sequence in which the student was discussed or the length of time spent discussing the student at the final evaluation meeting, or the number of clinical faculty present at the meeting. These results lend support to the faculty forum evaluation approach, but suggest a need for further scrutiny of some influencing variables to ensure all students are fairly considered and honor ratings judiciously awarded.     

Immigration reform,American style

This article reviews the background of the proposed Immigration and Reform Act (also known as the Simpson-Mazzoli bill), which seeks to overhaul US immigration law for the first time since 1952. This bill is consistent with President Reagan's hard line on border enforcement and mandates stiff penalties for those who transport illegal aliens for commercial advantage or private profit. It further offers Mexico preferential treatment in immigration (40,000 additional visas/year). It includes an amnesty program to offer legal status to qualified illegal residents. The bill directs the President to develop a secure national worker identification system and would create a large-scale temporary foreign agricultural program for perishable commodities. Agricultural workers' families would not be eligible to accompany them unless they also obtain temporary visas. Foreign temporary workers, employable only in cases where local domestic workers are not available, must be provided with wages and working conditions equal to those prevailing among domestic workers. Stiff penalties are stipulated for employers who fail to abide with the terms of the program. In the author's opinion, this bill fails to appreciate the global character of international migration and its complexity. It relects a fundamental ambivalence about a strictly controlled main gate versus a back door approach to immigration as well as the conflicting images of the US as a nation of immigrants versus the historical reality of American nativism and xenophobia. Needed are comprehensive initiatives whose mutually reinforcing components can address the multiple dimensions of the immigration problem within a framework that does not ignore workers who have contributed to the economic well-being of the US, regardless of their legal status.     

Proxies for birth control. Comment on Kelly and Cutright,Sociological Focus,April 1983

Kelly and Cutright (1983), using regression techniques, conclude that birth control is among the more important determinants of Swedish illegitimacy. To derive this conclusion, they use changes in the marital fertility of wives aged 35-39 as a proxy for birth control. They maintain that annual change in the marital fertility rate of wives aged 35-39 is not likely to be greatly influenced by annual change in factors other than birth control. The "argument" appears to derive from the "desired family size" model of childbearing--a basic assumption of social demography. In it simplest form it states that most couples do not practice birth control until they reach a preconceived goal, or desired family size. It thus implies that a change in family size preferences will most affect the birth control practices of the oldest reproductive age groups. The simple form of the model has been questioned by the failure of Western couples to reproductively compensate for a major proportion of their child deaths, by the proportions of Western couples who say they would have preferred larger families than they actually had, by the predictive inadequacy of family size preferences, and by suggestions that age may be the more important determinant of reproduction. As a result some demographers now concede its inadequacy. Others are trying to relax its assumptions, with as yet problematic success. Essentially every Western fertility decline to date has been characterized by an increasing concentration of childbearing in the youngest age groups. In discussing this pattern social demographers have maintained that it could only have come about by a decline in family size preferences. This then is the standard argument supporting Kelly and Cutright's proxy for birth control. The authorities who offer it generally ignore the difficulties with the desired family size model and simply assert without justification that couples do in fact conform to it. Data on the age patterns of chronic disease and on the reproductive effects of environmental stressors suggest that the modern age pattern of fertility could also be produced by a deteriorating environment. Kelly and Cutright are incorrect in asserting that factors other than voluntary birth control could not be responsible for changes in fertility at ages 35-39. At best they may argue that their proxy is uniquely definitive provided that the desired family size model can be saved and provided the health of Western populations has not been compromised by technological change. At issue is a debate between what Dunlap calls the human exemptionalist and the ecological world views.     

Eye-contact as a chance product of individual looking: Implications for the intimacy model of argyle and dean

From time to time during social encounters, people look at one another in the region of the eyes, and sometimes their eyes meet to make eye-contact. According to Argyle and Dean (1965), eye-contact in dyadic encounters signals the intimacy of the interaction and is controlled largely by the competing approach and avoidance forces that motivate the pair. In the present paper, new analyses are reported of three published experiments that were designed originally to test aspects of the intimacy model and it is shown that the duration of eye-contact is no more than a chance product of how long the two subjects look individually. Looking and not eye-contact, it is argued, should be the basis for models of visual interaction, and the intimacy model is ill-founded conceptually; the role of emotion in gaze has been overstressed at the expense of the concept of information; and the most important aspect of vision is in any case not looking and eye-contact but visual access to the whole person. The more cueless the encounter—that is, the fewer the social cues from vision and all the other senses combined—the greater the psychological distance; and the greater the psychological distance, the more task-oriented and depersonalized the content of what people say and, in turn, the less spontaneous their style of speech and the less likely a debate to end in compromise.Research for this article was sponsored by the Social Science Research Council of Great Britain.     

Mental health services for Chinese in a community health center

Serious mental health problems exist within the Chinese population of the United States. This article describes one center's attempt to meet the psychiatric needs of both nonpsychotic and psychotic Chinese patients through bilingual, culturally relevant treatments.