《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...     

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.     

Matching anonymous pre-posttests using subject-generated information

Sensitive research issues call for anonymous questionnaires. This makes accurately matching pretests with posttests difficult or impossible. Various subject-generated coding schemes have been developed, but their accuracy has been unknown. This anonymous study, with 745 students, used subject-generated coding to match pretests with posttests. The matching was verified for accuracy with the use of a collateral, anonymous, sticker identification system. The coding system was able to accurately match 75.2% of all the pretest-posttest pairs. An additional 22.1% of the pairs were left unmatched and only 2.7% were matched incorrectly. Subject-generated coding systems can be very effective where confidentiality is important to protect.     

"Dislocation", shelter,and crisis: Afghanistan's refugees and notions of home

Millions of people have become refugees or been displaced within Afghanistan during 17 years of war within the country. Conversations with women in a camp for the displaced reveal what it means for women to lose their homes, especially in the context of ongoing instability and conflict. Sections discuss homelessness in Kabul, linking psycho-social and practical needs, coping with dislocation, stability and land ownership, mobility and security, family breakdown, temporary and permanent settlements, and meeting needs versus creating dependency. The author concludes that among people displaced from their homes for so many years, their physical and spiritual homes nonetheless remain inseparable from their lives. It is important to maintain the individual notion of home if life is to be worth living and hope retained. Relief agencies must help in an appropriate manner and to an appropriate extent. Oxfam has been working beyond the refugee camps, in a return to the city of Kabul, since July 1995. When this article was written, the NGO was involved in a joint venture to restore the piped water supply which, like the electricity supply, was looted and damaged. It also plans to distribute plastic sheeting for use as roofs and floor covering during the winter. Oxfam currently plans discreet activities rather than an integrated approach.     

Health care futures. Part 2: The future of physician executives? Panel discussion

What is the future of health care in America? This is Part 2 of The Physician Executive panel discussion that explores the future of health care in America. To narrow this ambitious focus somewhat, the future is defined as five to 10 years hence. In Part 1, which was published in the May/June issue, Russell C. Coile, Jr., Barbara LeTourneau, MD, MBA, FACPE, James Reinertsen, MD, Uwe Reinhardt, PhD, Marshall Ruffin, MD, MPH, MBA, FACPE, and David Vogel, MS, shared their opinions about what the future holds in managed care, information technology, and biotechnology. In Part 2, Susan Cejka, Barbara LeTourneau, MD, MBA, FACPE, John Henry Pfifferling, PhD, Uwe Reinhardt, PhD, and James Todd, MD, share their views on the future of medical education and physician executives.     

Ability, disability, and the oldest old

A measure of range of ability is used to profile the 85-years-old-and-older (oldest old) population, including the highly disabled institutional population. This new measure uses two new questions available in the 1990 Decennial Census concerning a self-care limitation and a mobility limitation as well as the usual question concerning a work limitation. In addition to examining the extent of disability among the oldest old, the article examines the extent of care potentially available in the household as well as the economic characteristics of this age group. It is also profiled in terms of relevant personal characteristics, including age, gender, marital status, race, ethnicity, rural residence, education, and employment. A key question addressed is the need for help or care among the oldest old and how various long-term care proposals would meet such needs. A careful analysis of this unique and growing population is necessary to both allay fears of the cost of care or help as well as to dispel stereotypes of this age group as frail and dependent, and in need of institutional care.     

Implementation and process evaluation of a student "school-as-community" group. A component of a school-based drug abuse prevention program

Little documentation exists regarding the functioning of formalized adolescent groups as drug abuse prevention agents. Two studies are described that were conducted at high schools whose students are at high risk for drug abuse. Twenty-one schools were randomly assigned to one of three conditions: (a) standard care, (b) classroom drug abuse education only, or (c) classroom plus school-as-community. Results of the first study indicated that the school-as-community component--which involved weekly meetings and periodic events at seven schools--was implemented as planned, drug abused focused, and perceived as productive in discouraging drug abuse. In the second study, staff in the classroom plus school-as-community condition self-reported involvement in the greatest number of community activities across the school year, compared with staff from the other two conditions. These two studies support the feasibility of formalized groups of high-risk youth to promote drug-free events.     

Comparing measures of poverty and relative deprivation: an example for Belgium

This paper presents three different poverty standards. A first approach takes the disposable income as an indicator of poverty. A second approach uses the Leyden approach. Finally an aggregate index of deprivation, based on the observation of consumption events, is constructed through a particular econometric procedure proposed by Desai and Shah (1988). These alternative measures are then compared on a sample composed of 6380 Belgian households. Such an analysis can be expected to provide some further insight into the problem of measuring poverty, which has been the subject of a recent controversial debate.We thank the participants of the Second Annual Meeting of the European Society for Population Economics, June 23–25, 1988, Mannheim (FRG), L. Gevers, J. Lindsey, P. Pestieau, B. Sak, K. Van den Bosch and two anonymous referees for their comments and suggestions.     

The social implications of population displacement and resettlement: an overview with a focus on the Arab Middle East

"Recent decades have witnessed a global increase in the collective displacement of populations as a result of natural disasters, wars and development projects. The social implications of displacement, and its corollary process of resettlement, are explored in this article, with a focus on the Arab world....[The author suggests that] an approach which emphasizes the relation between the causes and consequences of displacement, examines cases in their historical contexts, and selects the appropriate unit of analysis is essential in developing an adequate framework of analysis."     

Residential segregation in Australian cities: a literature review

"In this review of literature dealing with the postwar immigrant experience in urban Australia, some of the key interpretations of residential segregation are assessed. The article focuses on studies which have examined ethnic clusters formed by southern Europeans in Sydney and Melbourne and more recently by Indochinese refugees. Much of the analysis to date has been based on measuring static residential patterns rather than social interaction, and the need to question the significance of ethnic concentrations which sometimes characterize the early stages of immigrant adaptation is suggested."