Regulation of board-and-care homes: research to guide policy

Information about board-and-care homes reported in the media and in federal committee hearings indicates that they are shoddy and exploitative environments that do not provide adequate care. Research done in board-and-care homes in recent years, however, demonstrates that they can provide adequate care and a satisfying environment for some of the people they serve. Policy at the federal, state, and local levels should be guided by both the need to assure the health and safety of board-and-care residents and the needs of residents and operators identified in scientific studies.     

The relative economic progress of male foreign workers in Kuwait

"A human capital framework is utilized to examine the economic progress of nine nationality groups of foreign workers [in Kuwait] using data from the 1983 national Labor Survey. The sources of earnings' variations of particular interest to us included different degrees of education and experience transferability, occupational affiliation and ethnic background. In general, the results derived from the analysis suggest that 1) foreign workers achieve a discernible economic progress as their residence lengthens; 2) the rate of economic progress varies depending on worker's education, home and Kuwait-specific experience, occupational status and ethnic background; and 3) about one third of the earnings inequality is due to unexplained factors including discrimination."     

Caribbean immigrants: a black success story?

"This article examines the 1980 earnings and earnings attainment process of Afro-Caribbean immigrants [to the United States] relative to Afro-Americans, native-born whites and foreign-born whites. Controlling for gender, the comparisons consider Caribbean Islanders as a whole and disaggregated by nation of origin. The results indicate that, in 1980 at least, fact did not justify the opinion that any West Indian subgroup had higher gross or net earnings than native-born blacks. Rather, a few non-English speaking subgroups fared worse. In addition, regardless of national background, Caribbean-born men experienced vast earnings disparities relative to white men. This was not the case for West Indian women, whose net earnings were, at minimum, equivalent to those of white women. Further analysis suggests that, for most Caribbean groups, West Indian background adds little to an understanding of the earnings attainment process that cannot be obtained from other measurable characteristics."     

Long term demographic effect of a constant stream of immigration when the population is not reproducing itself

The author describes the use of a model to investigate "the age composition of the stationary population resulting from a condition of below replacement fertility and a continuous stream of immigrants, the size of which for any age remain invariant over time.... We have shown that the number dying among [migrants] is the same as the number of them entering over any time interval, and that is precisely how their stationarity is maintained." The geographical focus is on developed countries that are experiencing below-replacement fertility levels. (SUMMARY IN FRE AND SPA)     

Refugee research in Africa: problems and possibilities

The author discusses the magnitude of the refugee problem in selected countries of Africa, with a focus on the "conceptual, methodological and practical problems faced by refugee researchers in Africa." (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)     

Old and thin

Viewing an elderly patient's refusal of food from the perspective of the jain tradition of sallekhana (voluntary starvation) permits the author to reconcile her need to "do something" with her belief in the principle of patient autonomy.     

Effects of fixed costs in two-person sequential bargaining

Rubinstein (1982) considered the problem of dividing a given surplus between two players sequentially, and then proposed a model in which the two players alternately make and respond to each other's offers through time. He further characterized the perfect equilibrium outcomes, which depend on the players time preferences and order of moves. Using both equal and unequal bargaining cost conditions and an unlimited number of rounds, two experiments were designed to compare the perfect equilibrium model to alternative models based on norms of fairness. We report analyses of final agreements, first offers, and number of bargaining rounds, which provide limited support to the perfect equilibrium model, and then conclude by recommending a shift in focus from model testing to specification of the conditions favoring one model over another.     

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.