Housestaff coverage in a nonteaching community hospital

In August 1992, a project team of senior medical and administrative personnel was formed (Housestaff Coverage Project Team) at the Park Ridge Health System, Rochester, N.Y.. The team was given a mandate to address housestaff coverage, primarily from an economic standpoint. Through total quality management (TQM), the project team sought to develop a house coverage plan that was sustainable, efficient, and effective. A plan was developed that includes three layers of service. A minimum "standard hospital coverage" would be available to all physicians and their patients and cover the basic needs of admission, crisis intervention, and issues of length of stay. A complete level of service would be available under the title of "case management" and would consist of total patient management, under the direction of the attending physician, from admission through discharge. The third level of service available to both "standard" and "case managed" patients would be a "consultative service." The latter would function as a traditional in-house medical service and would bill for its services. Park Ridge Hospital believes it has developed a system of housestaff coverage that is sustainable, efficient, and effective. An evaluation mechanism, primarily addressed at length of stay, will tell if we are correct in this assumption.     

The impact of migration on gender roles: findings of field research in Turkey

Findings are based on a sample of four types of Turkish women affected by migration: 1) pioneer women who emigrated on their own (33 persons); 2) followers with wage work experience, who joined or left with husbands (44 persons); 3) followers without wage work experience (39 persons); and 4) women left behind when husbands migrated (45 persons). These women are compared to a non-migrant control group (54 persons). Sample surveys were conducted in three sites, which varied in levels of industrial development, economic diversification, and urbanization (Ankara, Kisehir, and eight rural villages in the province of Kisehir). The sample includes returnees registered with the Social Insurance Institute and persons located by the chain inquiry method. Prior research supports the importance of including typologies based on family types, marriage types, levels of education, and experience with wage work. This study confirms that pioneer women were more likely to have romantic marriages, to have nuclear families, to have higher educational levels, and to have prior wage work. Analysis of the 116 women with migration experience shows that 75% migrated during 1968-74. 22% migrated after 1980. 51% were returnees during 1983-85, and many received retirement benefits. Almost 65% spent 10 or more years abroad. 56% were aged under 24 years. 85% were married at the time of emigration. 61% viewed their migration experiences as improving their maturity and ability to handle affairs compared to nonmigrant women. 88% became housewives after returning. 27% of return migrants and 82% of nonmigrants had never had their own bank accounts. 69% of return migrants and only 22% of nonmigrants reported movement outside the home without permission. 63% of migrants and 39% of nonmigrants would cast political votes independently of their husbands. Migrating women exercised more independent behavior but retained traditional responsibility for housework. The greatest differences were between women with wage work and women without or with migrating husbands. Followers without wage work were the most disadvantaged. Migration is viewed as a significant factor in determining gender roles among Turkish women.     

《新西兰文化与认同感·序言》

《新西兰文化与认同感·序言》大卫·诺维茨比尔·威尔莫特著涂开益徐永安译编选本书的初衷,源出编者在讨论新西兰民族认同感与文化的基本命题时,对于人们所持方式的关注。我们俩人一致认为,当时的争论有两点失之偏颇：一是如何准确理解被称之为文化的这种奇特现象,二...     

A problem in household composition

"Distinction made between household-persons and household-markers [the person who identifies the family or household as a unit] is formalized in the notion of nested populations. This leads to an extension of the Leslie model into a formulation of growth for both population and households. The extended model involves the matrix presentation of household composition where ratios of household-persons who are age 0, per household-marker, function as surrogate values for fertility rates. The extended model describes change over time in the distribution of population by age, and in the distribution of households by age of household-marker, or household-head. The model involves the inversion of a nonnegative matrix, and is feasible only if it yields, projected over time, nonnegative entries in vectors representing distribution of population by age, and distribution of household-heads by age. Conditions for the feasibility of the extended model are discussed, and a sufficient condition for feasibility over a single interval is identified." (SUMMARY IN FRE)     

Premarital relationships and livelihoods in Ghana

This study is based on interviews with a sample of 400 single women aged 18-25 years from the Fante ethnic group in Cape Coast, Ghana, in 1991, and on focus groups. This case study illustrates the importance of economic and living arrangement support expected from partners in premarital relationships. Support may be for living and maintenance ('chopmoney', provisions, household items, and rent); for financial security (provision of capital); and for clothing and hairdressing. Women did not always require economic support in premarital relationships. Women expect boyfriends to provide 'chopmoney' (money for food and general upkeep) and contribute some money for the rent. Only 36% of sexually active women expected their boyfriends to supply food provisions. Premarital sexual relationships are used to obtain start-up capital. The author refers to evidence that senior government officials engaged in sexual transactions with clients before loans and credit facilities were offered. 87% of sexually experienced women expected their partners to pay for at least part of clothing expenses. The study revealed that there was considerable disparity between women's expectations and actual receipt of economic support. 56% desired, but only 36% received, 'chopmoney' in full. 40% expected their partners to pay for household furnishings in full, while only 10% did so. 55% expected capital, but only 15% received it. The three most frequently received benefits in full were hair dressing, shoes, and dresses. Men provided most non-negotiable items as a means of "boosting their egos." Many young women rely on the support of men in order to improve their status. Ghanaian men control financial resources and economic power. Mothers of adolescent daughters encourage premarital sexual behavior. Prostitution is considered different from sexual exchange relationships. It is argued that gender inequalities and domestic abuse are perpetuated through sexual exchange relationships.     

Breaking the glass ceiling

The glass ceiling is a form of organizational bias and discrimination that prevents qualified professionals from achieving positions of top governance and leadership. This article examines glass ceiling barriers that keep physicians from the upper reaches of management. While these factors apply mainly to women and minority physicians in academia, and are attributable to sexual harassment and discrimination, physicians as a class are frequently denied executive management positions. Such denial results from inadequate preparation for a career in health care administration. Important issues in the professional development of physician executives include mentoring, training and education, administrative experience, and cultural and personality factors. All of those must be considered when making the transition from medicine to management.     

Temporary and illegal labour migration: the Israeli experience

In recent years, Israel has become a major recipient of documented and undocumented temporary labour migrants from many countries outside the Middle East region. The purposes of this article are to describe Israel's experience of temporary labour migration and its concomitant, illegal labour migration; and also to explore what her policies on temporary labour migration indicate about the nature of the policy-making process in this policy domain in Israel.
To these ends the article traces the evolution of temporary labour migration – legal and illegal – and recent policy initiatives of the Israeli government. It then considers some of the major conceptions of the policy-making process found in public policy literature. The article concludes by pointing to the uniqueness of Israel's experience of temporary labour migration and to the fact that her policies have been overwhelmingly reactive – inadequately considered, ill-conceived, ambivalent in relation to their ultimate purpose and, in the course of implementation, vulnerable to "privatization" (being taken over by vested interest groups).
Analysis of the most recent policy initiatives designed to reduce the number of legal labour migrants and address the problem of illegal labour migrants, reflect a policy-making process that is not followed by commensurate action.     

Family migration and the economic status of women in Malaysia

"The impact of family migration on women's economic position in a developing country setting is an area that has received relatively little research attention. Incorporating a lifetime perspective, this study makes use of the retrospective migration histories of husbands and wives from the second round of the Malaysian Family Life Survey to estimate how joint migration with the husband affects women's socioeconomic achievement. The findings show that family migration depresses the chances of working, but it does not significantly reduce socioeconomic attainment of those who do work. However, when a woman migrates with her husband she does forgo the substantial advantage she could have derived had she moved alone."