Migration from Latin American countries to the United States: the economic,social and reproductive lives of Hispanic female immigrants, 1980

The authors describe the socioeconomic characteristics and fertility patterns of female immigrants from Latin America to the United States, with a focus on reasons for fertility differentials. "Using the one per cent public use sample from the 1970 and 1980 United States census, we first compare changes in socio economic characteristics from 1970 to 1980, and then examine the determinants of fertility of female immigrants to the United States, aged 16-49, from four Latin American areas or countries of birth.... The findings...suggest that there are direct effects of demographic, assimilation, and socioeconomic variables beyond those mediated by the variables in each of these sets. Further, regardless of the model, the effect of the clusters of demographic characteristics is most apparent. Age categories and marital status are the strongest indexed determinants of immigrant fertility.... The effect of education and employment is strong. Among assimilation variables, duration of residence and language ability are significant determinants of Hispanic immigrant fertility." (SUMMARY IN FRE AND SPA)     

Reconceptualizing migration as a household phenomenon: outmigration from New York City by race and Hispanic origin

"This paper proposes a conceptual framework for analyzing migration as a household event and presents two public use microdata applications of this approach for out-migrants from New York City. The distribution of single- and multi-origin households by race and Hispanic origin permits a more rigorous analysis of household migration differentials....and the disaggregation of household members by migration status provides insight into the household outcomes of the migration process...." (SUMMARY IN FRE AND SPA)     

Temporal dimensions of the fertility transition: an age-period-cohort analysis of frontier fertility

"This paper evaluates age, period, and cohort effects on marital fertility during onset of the Utah fertility transition (1880-1900). Computerized genealogies are used to derive age-period-cohort fertility rates for 49,842 once-married couples. Age, period and cohort effects on marital fertility are then estimated using Johnson's (1985) relational model. Declining marital fertility in Utah is shown to be explained by both lower fertility levels across periods and increasing age-specific limitation across cohorts. Direct cohort effects on fertility are insignificant. These results are consistent with prior research, and the view that fertility levels were adaptive (in part through birth spacing across ages) to immediate contexts of childbearing while age-specific fertility truncation increased across cohorts (in part through the more general diffusion of contraceptive innovations)."     

Triangular empathy: “The other” in psychotherapy with individuals

This paper seeks to explore triangular dimensions in individual psychotherapy. In addition to serving as the dyadic object of transference projection and/or as selfobject for a person in psychotherapy, the therapist may be called upon to help the patient work on relationships with certain early, important people or their representations and on the interplay between such relationships and the therapeutic one, that is, in a triangular configuration. Because patients' attempts to introduce others into individual psychotherapy are sometimes experienced by therapists as resistant rather than as integral to the therapeutic process, I propose an empathic reconsideration of such patient efforts to get us to help with the complicated dimensions of human relatedness.     

How to fight the regulator glut: the role of the HCFA-type survey

More and more hospitals in this country are being threatened by the removal of their Health Care Financing Authority (HCFA) Medicare Certification. A perception of competitiveness among HCFA, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and other organizations has heightened this concern. This unpleasant situation has provoked many hospitals to prevent any type of regulator decertification. One of the practical methods of prevention is the use of a HCFA-type survey. These surveys prepare institutions for unexpected, unarmored review by regulators and should be part of the quality improvement (QI) process even in institutions with limited resources. This article discusses the means to accomplish the HCFA-type survey. The development of the survey process involves institutional commitment, hospital policy and procedures, a department review schedule, selection of review personnel, preparation of review personnel, record keeping, and department education.     

The ethics of health care system reform

The United States is now engaged in a momentous national debate about health care. How can we provide the best care possible while simultaneously containing cost (to promote the general economic integrity of society) and somehow maintain a semblance of a free health care marketplace. This is not just a political question; it is also a question of ethics. It is an ethical consideration because the current debate is not just about designing or promoting health care systems that can best address our concerns for costs, quality, and accessibility. It appears that at least some participants in the debate would not stop at arguing their beliefs as valid; they would make their beliefs law. Some urge the creation of the right to health care as a matter of law. There are significant differences between beliefs and rights, however, and they need to be considered carefully in the ongoing debate over the future of this country's health care delivery and financing system.