Clinical supervision: Its role in “Containing” countertransference responses to a filicidal patient

This paper illustrates the role of supervision in processing countertransference responses with might have disrupted the therapist's empathy with a patient who had killed her child. The clinical material demonstrates how the therapist's responses of initial denial and subsequent disgust and fear were dealt with in supervision. As a result, the treatment process led to genuine, albeit limited, therapeutic change in a patient with severe character pathology.This paper is developed from a presentation of the case of Mrs. Jay at Department of Psychiatry Grand Rounds, University of Cincinnati College of Medicine, on May 2, 1989.     

The NTEE classification system: tests of reliability/validity in the field of higher education

An analysis of the field of higher education reveals a surprisingly large number of classification errors within the (US) National Taxonomy of Exempt Entities database. Of the nearly 4,000 non-profit entities coded within the universe of institutions of higher education, we estimate that approximately 60 per cent were incorrectly included (Type II errors). Institutions incorrectly excluded from the higher education universe (Type I errors) represent roughly 10 per cent of the institutions coded correctly. These errors result primarily from assigning codes on the basis of the names of organisations (for example, College Park Towers is classified as a college, when it is in fact a housing complex for senior citizens) and from trying too hard to assign codes in ambiguous situations. The consequences can be significant for the users of these data, and we recommend raising bright warning flags while simultaneously enlisting the help of the entire non-profit sector in improving the classification coding process.The authors are with The Andrew W. Mellon Foundation. In addition to our colleagues on the staff of the Foundation, we wish to thank Helmut Anheier, Ted Bozovich, Harvey Dale, Virginia Hodgkinson, Stephen Noga and Christopher Toppe for helpful suggestions.     

Financial manager's perception of rural household Economie Well-Being: Development and testing of a composite measure

An index of Perceived Economic Well-Being is constructed using factor analysis and tested for reliability and validity. The index is composed of (a) perceived income adequacy, and satisfaction with (b) current total household income, (c) amount of money your family is able to save, (d) amount of current debt, (e) level of consumption, (f) amount of household net worth, and (g) resources available to meet a financial emergency. The index is used in regression analysis. Results show that financial managers perceive economic well-being more favorably if they are more satisfied with resources and with the current level of living, view the present financial situation as better compared to 5 years ago, save on a regular basis for goal(s), and have a higher income. Financial managers who report more frequent financial problems, worry more about where money would come from to pay bills, and more frequently make only minimum payments on charge accounts perceive economic well-being less favorably.Preparation of this research was supported in part by the Illinois Agricultural Experiment Station. Data were collected in conjunction with the cooperative regional research project NC-182, Family Resource Utilization as a Factor in Determining Economic Well-Being of Rural Families. Cooperating states are Arizona, California, Illinois, Indiana, Iowa, Kansas, Michigan, and Minnesota.He received his Ph.D. from the University of Illinois in 1991 with Dr. Fitzsimmons as advisor. His current research interest is economic well-being.She received her Ph.D. from the University of Illinois; her current research interests include gender roles, family financial management, and economic well-being.     

A method of computing the marital composition of the population between population censuses

A method for calculating the marital status distribution of the population of the USSR between censuses is outlined. The method is based on the use of population census and vital statistics data.     

Declining world fertility: trends,causes, implications

This Bulletin examines the evidence that the world's fertility has declined in recent years, the factors that appear to have accounted for the decline, and the implications for fertility and population growth rates to the end of the century. On the basis of a compilation of estimates available for all nations of the world, the authors derive estimates which indicate that the world's total fertility rate dropped from 4.6 to 4.1 births per woman between 1968 and 1975, thanks largely to an earlier and more rapid and universal decline in the fertility of less developed countries (LDCs) than had been anticipated. Statistical analysis of available data suggests that the socioeconomic progress made by LDCs in this period was not great enough to account for more than a proportion of the fertility decline and that organized family planning programs were a major contributing factor. The authors' projections, which are compared to similar projections from the World Bank, the United Nations, and the U.S. Bureau of the Census, indicate that, by the year 2000, less than 1/5 of the world's population will be in the "red danger" circle of explosive population growth (2.1% or more annually); most LDCs will be in a phase of fertility decline; and many of them -- along with most now developed countries -- will be at or near replacement level of fertility. The authors warn that "our optimistic prediction is premised upon a big IF -- if (organized) family planning (in LDCs) continues. It remains imperative that all of the developed nations of the world continue their contribution to this program undiminished."     

Toward an assessment of the social role of rural midwives and its implication for the family planning program: an Iranian case study

An axiom of family planning programming is the importance of culturally-appropriate communicators and motivators. Traditional midwives seem ideal for this task but few studies have been done to verify this assumption by analyzing the midwife's social role as perceived by the community. 325 married women and 81 unmarried girls from a "model village" near Shiraz were interviewed by female undergraduates. 82.5% of the women are of childbearing age; 66% married before 14 years; 33% use contraception, mostly the pill, but most want large families because they expect high child mortality rates. Most of the older women are able to assist in childbirth but none, except the village's one recognized midwife, who is considered to have divine backing, will do so except in an emergency. The midwife's activities cause her to be held in low esteem by the community because 1) she has contact with a woman's sexual parts and this fact is public; 2) she has contact with vaginal excretia which are, in Islam, polluting; and 3) she is paid for her services, which labels her as a woman "without shame". The midwife is, however, widely used since women and their husbands fear the trip to the hospital and treatment by a male doctor much more than a midwife-supervised birth. The midwife in the study village had been there only 2 years and feels that she is not fully trusted. She is not consulted on birth control at all, because women expect the pill to be dispensed by doctors and consider other methods as a matter strictly between husband and wife. The midwife's role seems to complement that of the government health authorities rather than compete. The midwife's low status and circumscribed sphere of activity, the weak respect in which her advice is held and the pattern of having only 1 recognized midwife in a village at a time make the midwife a poor agent for family planning services. Her effectiveness as an agent of social change could be improved by training her in hygienic practices of childbirth and by redefining her role-relationship with the community. Studies should be done to identify the areas where traditional birth attendants are the best family planning communicators and those where that role is best left to others.     

The administrative costs of non-profit health insurers

Interest in the efficiency or inefficiency of non-profit firms has spawned research on the administrative costs of Blue Cross and Blue Shield plans. Relying on plausible implications of the property rights theory of the firm, both Blair, Ginsburg, and Vogel (1975) and Vogel (1977) noted some evidence of inefficiency in these firms. Our analysis, however, utilizing their models and more recent data, reveals little convincing evidence for the view that Blue Shield plans are inefficient.