The new health care civilization: integration of physician land and manageria

Changes occurring in health care demand that physicians expand their professional knowledge and skills beyond the medical and behavioral sciences. Subjects absent from traditional medical education curricula, such as the economics and politics of health care, practice management, and leadership of professional organizations, will become important competencies, particularly for physicians who serve in management roles. Because physicians occupy a central role in planning and allocating medical care services and other health care resources, they must be better prepared to work with other health care professionals to create a new civilization, even if this means leaving the cloistered domain of "physician land" to serve as interface professionals between the delivery of medical services and the management of health care. Our research findings and conclusions strongly suggest that economic, management, and leadership competencies need to be incorporated into the professional development of physicians, especially in postgraduate and continuing education curricula.     

The new illegal immigration in Japan, 1980-1992

"This article presents some of the latest available figures on illegal immigration in Japan, a process that did not assume significant proportions until the mid-1980s. It also discusses briefly the latest developments around 'immigration' policy--more precisely, the law on the entry and exit of aliens."     

Women's income generation activities in Merowe Province,Northern State,Sudan

Merowe province in rural northern Sudan has been divided into three local government council areas: Merowe, Karima, and Ed Debba. A government program was instituted to increase the welfare of residents and food production. A baseline survey of 490 respondents was conducted in order to ascertain how illiterate women viewed development in the area and to provide useful information for program design and implementation. Women from 24 villages were administered questionnaires, observed in their daily activities, and engaged in discussion in a local meeting place. Discussions were also held with members of the local Popular Committee. Demographic information was very sketchy about age, and 48% had no formal education in writing and reading. General reading and writing skills of the remainder were very poor. There were 500 female children and 502 male children, and the sex ratio varied among the 3 council areas. 52% were married and 14% were divorced or widowed and living with relatives. The average monthly income was from Ls. 700 to Ls. 3000 based on reports from only 59.3% of respondents. Most of the women had skills in food processing and 25.7% were skilled in handicrafts. Water was obtained primarily from local wells and not decontaminated before use. Pit latrines were the standard. One bathing facility was available in the compound for the entire council area. Health units were either in each village or within 20-30 minutes walk. Child mortality was 4.3% in Merowe province. 77 children 0-5 years old died out of a total of 1002 live births. Life expectancy was 41-50 years for women and 61-70 years for men. Cleanliness and healthful eating were observed. 58% owned no land; plots were under 5 feddans and usually half a feddan. 92.1% had no bank account and 90% had no experience with loans. 70.2% were indifferent about involvement in an income generation program. 26% were interested in part-time participation. Only 3.9% desired full-time participation. 8.6% said they wanted raw materials to produce handicrafts, and 21% said they wanted cash to raise livestock. 28.4% had radios. 80.4% lacked any farm equipment. 7.6% owned an electric pump and 7% had an ox plough. A program could be offered after lunch and coordinated with other activities after 4 P.M. at a local center. The population would have to be oriented to business and income generation would have to be planned very carefully.     

Ropes course training for youth in a rural setting: “At first I thought it was going to be boring ...”

Outdoor structured activities, such as Ropes Challenge Courses, are typically utilized as interventions for youth coming from urban settings. Evaluation of such programs is scanty at best. In this instance, the course experience is used as a prevention tool for high risk youth in a remote, rural setting of high unemployment, alcohol problems, and low income. The authors discuss the effectiveness of this approach, and the intended and unintended consequences for the rural community at large. The evaluation design relies on extensive qualitative methodology as well as quantitative methods to capture the unique nature of this rural project.     

DO SURVEYS OVERSTATE PUBLIC CONCERNS?

Because the item, "How concerned are you about...?" asks respondentsto indicate their level of concern about an issue, some respondentsmay sense it assumes they are concerned or should be concernedabout the issue. Using a filter question to first determineif people are concerned about the issue before asking for theirdegree of concern may help solve this problem. To test thishypothesis, a split-ballot experiment was embedded in a nationalrandom digit dialing telephone survey on food-related issues.For the four items included in the experiment, the group receivingthe filter versions of the questions gave roughly double thepercentages of "not concerned" responses as the group receivingstandard items, and the filter group also gave fewer responsesat the upper end of the response scale.     

DO RESPONDENTS REALLY "MARK ALL THAT APPLY" ON SELF-ADMINISTERED QUESTIONS?

An experiment was conducted to assess the effect of using "markall that apply" question instructions on survey reporting aspart of the field test for the Second Follow-up of the NationalEducation Longitudinal Study of 1988 Eighth Graders (NELS:88).Mark-all-that-apply instructions were compared with instructionsasking respondents to indicate "yes" or "no" to each responseoption on responses to three items dispersed throughout thequestionnaire and consisting of different topics and numbersof response options. For the three items, significantly fewerresponse options were selected with the mark-all-that-applyinstructions than with the yes/no instructions, but becauseexternal validity criteria were not available, overreportingto the yes/no instructions cannot be ruled out. Instructiondependentprimacy effects, predicted under the hypothesis that respondentswould engage in more superficial processing when given the mark-all-that-applyinstructions, were not found.     

Freud's “Anna O.”: Social work's Bertha Pappenheim

The story of Anna O. has loomed large in psychoanalytic history, but few social workers know that the young woman, who was so influential in the development of Freud's thinking, became a pioneer social worker in Germany. The story of the transformation of the troubled young woman, who was actually Joseph Breuer's patient, is the focus of this paper. In addition, some of the facts of the case are discussed as social constructions. Anna O./ Bertha Pappenheim participated in the creation of the talking cure and eventually went on to be a leading feminist, developer of social programs for women, and social reformer.     

Political theater and student organizations in the 1989 Chinese movement: A multivariate analysis of Tiananmen

Social movement research has often been divided between organizational and cultural analyses of collective action. Organizationally oriented theorists have viewed indigenous organizational structure as the critical variable in the emergence of collective action. Political culture and cultural frame theorists have focused instead on the cultural frames that resonate with audiences, mobilizing them to action. But social movements cannot be the result of one or the other of these factors. An analysis of the 1989 Chinese movement illuminates the multivariate aspects of this social movement. This movement was a two-tiered movement with an organized student leadership tier and a mass audience. Enmeshed in university organizations and student networks, the student leaders relied on an organizational structure that had been emerging since the mid-1980s. This organized leadership tier employed cultural symbols and acts to mobilize mass audiences that were beyond the scope of the students' organizational linkages. The political theater of the organized student leaders was complemented by institutional changes that had been occurring over the decade of reform in China and a political opportunity that allowed wide coverage of the students' activities.     

Gambling and the Law®: Endless fields of dreams

This article examines the current trends of proliferation of commercial gaming, especially in the United States, in the context of the third wave of legalization of gambling that has been experienced since the founding of the nation. The author looks at the historic foundations of the spread of casino-style gambling, and notes the types of casino gaming that have led the way in the current expansion. He also points out why it is reasonable to expect that this wave too may come crashing down, as general acceptance of wide-spread casino gaming in America may indeed be short-lived.Gambling and the Law^® is a registered trademark of I. Nelson Rose.     

Psycho-social impacts of terrorism and organized crime: The counterfinality of the practico-inert

The phrase, the counterfinality of the practico-inert is from Sartre with reference to implications of modern technology as a shorthand for that enormous properly human and anti-natural power of dead human labor stored up in our machinery — an alienated power, which turns back on and against us in unrecognizable forms and can symbolize the massive dystopian horizon of organized crime as well as individual terrorist praxis (Jean-Paul Sartre (1948).Situations II. Paris: Gallimard).