Lifestyle Options and Economic Strategies: Subsistence Activities in the Mississippi Delta1

Abstract "Subsistence" and "informal economy" are contrasted in their utility as sociological concepts and their ability to explain a variety of activities in two rural Mississippi Delta communities. Literature on subsistence stresses that the desired outcome of participation is not an increase in income but the social rewards of participation itself. Two underlying dimensions of participation in these activities are documented through the literature and through a confirmatory factor analysis of empirical data: life-style choice and economic strategy. These were constructed into indexes and examined individually and in combination as dependent variables using regressors at the community, household, and individual levels. Community ties were weakly associated with participation in such activities. Whites and those with higher incomes participated more in lifestyle choice oriented activities. Participation in general was statistically related to households needing less weekly income and being of larger size. Potential connections with persistent rural poverty are discussed.     

Patient assertiveness in ethnically diverse older women with breast cancer: Challenging stereotypes of the elderly

Patients' views of patient-physician interactions—particularly the perspectives of older, ethnically diverse women—are poorly understood. The older patient's attitude toward and understanding of the medical encounter, however, are essential to the design of strategies to improve patient-physician communication. To date, investigations have primarily emphasised the ways in which the therapeutic relationship is influenced by immutable patient characteristics. This qualitative study extends previous research findings by looking beyond the effect of ascribed categories (such as age, race, and gender) and focusing on aspects of patient behavior, specifically assertiveness. Focus groups were conducted with older African-, Chinese-, European-, and Hispanic American breast cancer patients from sites in the eastern and western United States. The study explores the potential of a form of patient activation for challenging stereotypes of the elderly and changing health care practitioners' behavior.     

Application of Markov chain Monte Carlo methods to modelling birth prevalence of Down syndrome

Data collected before the routine application of prenatal screening are of unique value in estimating the natural live-birth prevalence of Down syndrome. However, much of these data are from births from over 20 years ago and they are of uncertain quality. In particular, they are subject to varying degrees of underascertainment. Published approaches have used ad hoc corrections to deal with this problem or have been restricted to data sets in which ascertainment is assumed to be complete. In this paper we adopt a Bayesian approach to modelling ascertainment and live-birth prevalence. We consider three prior specifications concerning ascertainment and compare predicted maternal-age-specific prevalence under these three different prior specifications. The computations are carried out by using Markov chain Monte Carlo methods in which model parameters and missing data are sampled.     

Severely Traumatized Siblings: A Treatment Strategy

Siblings who have suffered severe trauma and disrupted attachment relate to one another in ways that interfere with individual development, the chance to benefit from connections with adults, the establishment of healthy sibling relationships, and the working through of traumatic experiences. The authors use case examples to illustrate four distinct sibling patterns: absent, adult lockout, half and half, and trauma shield. The authors highlight the importance of recognizing these types and then varying the therapist's treatment stance to pursue five goals. These include suspending problematic sibling relationships to create room for bonding with caring adults, transferring attachment behaviors and impulses to a receptive adult, resuming healthy individual development, forming more adaptive sibling connections, and expressing shared traumatic content.     

Lessons from the trenches in physician integration

Beyond the theoretical basis for integration, three core considerations stand out as the primary reasons for pursuing integration from a physician's perspective. In the authors' experience, the ability to make a case for physician integration stands or falls based on the ability of the integrated delivery system to address these considerations: Gain greater access to capital; develop human resources with talents in managed care and the full spectrum of care services; and sustain an information infrastructure. This article explores the lessons learned in pursuing physician integration.     

A case study of the labour market status of recent mainland Chinese immigrants,metropolitan Toronto

"This article focuses on an analysis of the labour market status of recent MCIs [mainland Chinese immigrants to Canada], taking into account such factors as gender, educational attainment, language proficiency and period of arrival (or length of residence in Canada), and uses Metropolitan Toronto as a case study. The effect of each factor on MCIs' labour market status will be analysed separately, followed by two logit models examining the simultaneous effects of the factors and their relative importance." (SUMMARY IN FRE AND SPA)