Communication apprehension and reactions to proxemic violations

An experiment was designed to examine the role of a person's predispositions toward communication in reactions to violations of proxemic expectations. Working with Burgoon's (1983) violations of nonverbal expectations model, Buller and Burgoon (1986) predicted that predispositions may bias evaluations of initiator reward and violation valence. Apprehensive individuals should unfavorably evaluate the initiator, negatively valence a violation and comply less, while nonapprehensive individuals should favorably evaluate the initiator, positively valence a violation, and comply more. Alternately, this paper proposes that predispositions may affect arousal-induction rather than initiator evaluation and violation valencing. Following Patterson (1983), apprehensives should experience more arousal and comply more to reduce the arousal, whereas nonapprehensives should experience less arousal and comply less. Four initiators engaged 90 subjects in experimental conversations which ended with a request for the subjects' signature on a petition. Initiators either remained at the normative distance, moved one seat closer, or moved one seat farther from the subject. Results showed that apprehensives and subjects experiencing close violations complied more, suggesting that communication apprehension influences arousal-induction. Communication apprehension had no main effect on perceptions of initiator attractiveness and similarity, implying that arousal not perceptions of the initiator is affected by predispositions toward communication. Initiator gender again emerged as an important characteristic which influences a subject's perceptions of initiator reward.     

Recent trends in the process of stratification

Using the 14 annual cross-sections from the General Social Survey, we specify a "basic model" of attainment and describe the year-by-year fluctuations in its parameters. The results are partially consistent with theories describing the gradual growth of universalistic patterns of stratification and mobility. Under a linear model of educational achievement, we find that the direct effects of race are weakening and the returns to class-based advantages are declining in tandem. The contours of the socioeconomic "gender gap" are also changing in important ways, with the male intercept declining at a rapid pace and the female term registering small and insignificant year-by-year gains. At the same time, the returns to experience and schooling are increasing for men, whereas the corresponding returns for women have remained stable over the 15-year period. This pattern of interaction effects implies that the size of the gender gap varies over time and across different population groups.     

Bringing baby home: a comprehensive case management program for obstetrical services

Originally presented to the Society of Home Health Care Management of the American College of Physician Executives at its November 16, 1993, meeting in Tucson, Ariz., the program described in this article was the winner of the College's 1994 Innovations Award in Medical Quality Management, sponsored by Merck Sharp & Dohme. The program shows the potential of case management for both improvement in the quality of care and containment of costs for a managed care population with a substantial Medicaid segment. This article is part of a continuing series on innovative programs in home health care.     

An evaluation of population projection errors for census tracts

"In this article we evaluate the accuracy and bias of projections of total population and population by age group for census tracts in three counties in Florida. We use [U.S. census] data from 1970 and 1980 and several simple extrapolation techniques to produce projections for 1990; we then compare these projections with 1990 census counts and evaluate the differences. For the total sample, we find mean absolute errors of 17%-20% for the three most accurate techniques for projecting total population and find no indication of overall bias. For individual age groups, mean absolute errors range from 20%-29%." This is a revised version of a paper presented at the 1993 Annual Meeting of the Population Association of America.     

Finite mixture models with concomitant information: assessing diagnostic criteria for diabetes

The World Health Organization (WHO) diagnostic criteria for diabetes mellitus were determined in part by evidence that in some populations the plasma glucose level 2 h after an oral glucose load is a mixture of two distinct distributions. We present a finite mixture model that allows the two component densities to be generalized linear models and the mixture probability to be a logistic regression model. The model allows us to estimate the prevalence of diabetes and sensitivity and specificity of the diagnostic criteria as a function of covariates and to estimate them in the absence of an external standard. Sensitivity is the probability that a test indicates disease conditionally on disease being present. Specificity is the probability that a test indicates no disease conditionally on no disease being present. We obtained maximum likelihood estimates via the EM algorithm and derived the standard errors from the information matrix and by the bootstrap. In the application to data from the diabetes in Egypt project a two-component mixture model fits well and the two components are interpreted as normal and diabetes. The means and variances are similar to results found in other populations. The minimum misclassification cutpoints decrease with age, are lower in urban areas and are higher in rural areas than the 200 mg dl^-1 cutpoint recommended by the WHO. These differences are modest and our results generally support the WHO criterion. Our methods allow the direct inclusion of concomitant data whereas past analyses were based on partitioning the data.     

The Limitations and Opportunities of Business Process Re-engineering in a Politicized Organizational Climate

This paper is concerned with the organizationalchange and project management issues raised by theimplementation of a business process re-engineering(BPR) approach in the politicized hospital context. This is a report of research in progress,focusing on the issues arising at the problem definitionand project planning stages of a BPR application in anoperating theaters department experiencing problems with scheduling and delays. The research designrelies on a case study approach, with the researcher asparticipant observer, as both an adviser to the projectteam and as field interviewer. The paper argues that an ambitious BPR agenda is compromised inat least two regards. First, the lack of precisionsurrounding the focus and methodology of BPR givespolitically motivated actors considerable influence with respect to defining terms of reference in wayswhich will shape potential outcomes in their favor.Second, the complexity and indeterminacy of the businessprocess or patient trail can also diluteredesign attempts. The principal limitations of theapproach thus concern the impracticality of embarking onrapid and radical change working from a blanksheet of paper with respect to organizational and job design. BPR, unlike other organizationdevelopment interventions, is not a contextsensitive approach. The role of project manageris critical in establishing a working balance betweenindividual, occupational, and organizational goals in a manner perceivedto be legitimate in the context. Effective BPR projectmanagement thus requires a combination of political andprocess analysis skills. The principal opportunities of BPR derive from its process orientation,which brings a fresh perspective to a traditionally andfunctionally fragmented organizational setting, andwhich presents a potentially valuable platform for anevolutionary approach to process improvement.     

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.