Family Change and Continuity in Iran: Birth Control Use Before First Pregnancy

Using data from the 2002 Iran Fertility Transition Survey, we examined birth control use between marriage and first pregnancy. We focused on the post‐1990 increase in birth control use and develop two explanations. The first posits that birth control use reflects a new marriage form, the conjugal marriage, which places a heightened value on the spousal relationship while deemphasizing the centrality of parenthood. A second explanation stresses the use of a new resource, effective birth control, within an Iranian‐Islamist view of marriage. Key to this explanation is the role of the state—Iranian political/religious actors encourage early marriage and the use of birth control. Although the explanations could be complementary, evidence provides more support for the latter.     

Care management challenge is the toughest yet.

The newest health care trend involves changing the core business--health care delivery and the resources involved--through better care management. This impacts every practitioner all day, every day. This issue truly belongs to the physicians, and thus to physician executives. Care management is the latest frontier, the place where the delivery of quality care, in the most efficient way, at the best possible cost, all come together. And physician executives are being challenged to make it happen, to change the way medicine is practiced and health care is delivered across the country, to move from treating episodes of care to a true preventive mindset and population-based methodologies. This column outlines the skills in care management that systems-based physician executives will need to develop or enhance to remain competitive--effective communication skills and team-building capabilities are critical attributes for those who hope for success.     

Veterans’ Use of Programs and Services as They Transition to Civilian Life: Baseline Assessment for the Veteran Metrics Initiative

Abstract

A substantial minority of veterans struggle as they reintegrate into civilian life, reporting problems with vocational attainment, legal/financial/housing challenges, physical and mental health conditions, and social/interpersonal issues. While there are thousands of programs and services offered to veterans, little is known about which ones they use. In the current exploratory study, veterans separated from active duty in the prior three-months (48,965) were invited to complete a survey. Two primary questions were addressed: What programs/services did veterans use to assist in their reintegration to civilian life? What specific components/attributes of those programs did veterans report using? A total of 9566 veterans completed the survey. Approximately, two-thirds of veterans used at least one program to enhance their well-being, while one-third reported using multiple programs across multiple domains. Veterans primarily sought assistance for employment and educational advancement. Fewer veterans sought assistance for legal/financial/housing, health, and social functioning challenges. Social service providers and policy makers should be aware of the resources veterans use as they reintegrate into civilian life. Future research should examine factors that predict the use and nonuse of veteran reintegration programs, how use changes over time, and what factors predict program/service use, particularly among veterans at risk for poor transition outcomes.     

Responding to Hard Times in the “Big Easy”: Meeting the Vocational Needs of Low‐Income African American New Orleans Residents

The already limited vocational prospects of low‐income African Americans in New Orleans were further devastated by Hurricane Katrina in 2005. The 2010 Deepwater Horizon oil spill added to the devastation, highlighting the continued vulnerability of New Orleanians seeking employment. As a result, opportunities persist for vocational practitioners to lend their expertise. In this article, the post‐Katrina vocational situation of low‐income African American residents is conceptualized using Bronfenbrenner's (1977) ecological model. Furthermore, needed interventions are described at each level of this ecological model.     

Distributional properties of simpson's index of diversity

Closed expressions for the first four moments of Simpson's index of diversity are derived using techniaues suggested by Haldane (1937). As the samole size increases the behavior of the skewness and kurtosis is studied for several Dopulations with varying degrees of diversity, If the populationproportions decrease accordinq to a geometric progression, graphs of β₁and β₂ indicate that convergence to normality in general is more rapid for populations which are less diverse.     

Decision Making in Voluntary Career Change: An Other‐Than‐Rational Perspective

The authors present a qualitative study of voluntary career change, which highlighted the importance of positive emotions, unplanned action, and building certainty and perceiving continuity in the realization of change. Interpretative phenomenological analysis was used to broaden theoretical understanding of real‐life career decision making. The accounts of 8 women who had changed careers were explored, and the analysis supported other‐than‐rational perspectives of career decision making. An action‐affect‐cognition framework of decision making is proposed. The framework adds the role of emotion and the importance of self‐regulation to existing theory of career decision making. Implications for career counseling are discussed.     

Be positive--it's a necessary strategy.

The hallmarks of successful health care organizations include: A positive physician culture; meaningful physician involvement in governance and top management; and stability and strong community roots. Success is most likely where physicians in the facilities are having professional fun, where freedom from negativity allows them to perform at their highest level of quality. When a positive physician culture takes hold, remarkable things can occur. In the best scenarios, physicians are deeply involved in strategic direction, as well as in practice. They are part of making the decisions, instead of merely grumbling about decisions made by others. The column provides suggestions for creating a positive physician culture.     

Improved estimation of the stable laws

Fitting general stable laws to data by maximum likelihood is important but difficult. This is why much research has considered alternative procedures based on empirical characteristic functions. Two problems then are how many values of the characteristic function to select, and how to position them. We provide recommendations for both of these topics. We propose an arithmetic spacing of transform variables, coupled with a recommendation for the location of the variables. It is shown that arithmetic spacing, which is far simpler to implement, closely approximates optimum spacing. The new methods that result are compared in simulation studies with existing methods, including maximum-likelihood. The main conclusion is that arithmetic spacing of the values of the characteristic function, coupled with appropriately limiting the range for these values, improves the overall performance of the regression-type method of Koutrouvelis, which is the standard procedure for estimating general stable law parameters.