The five "S" levels of enterprise health.

Whether pride, necessity, or inattention is at the root, some "slowly boiling" physicians find themselves working harder for fewer compensations of all sorts, and may not be fully cognizant of their circumstances. This article helps to diagnose and manage the health of physicians' practices and/or related enterprises. There are five levels of enterprise health, ranging from success (S-1) to shutdown (S-5), that serve as weather vanes about how the enterprise is adapting to changes in its environment. How should physicians respond to chaos and the threats of deteriorating enterprise health? A five-step approach is offered: (1) Discern what is important; (2) place and keep your program in alignment with those patient interests that will enhance your enterprise viability; (3) keep score with an internal balanced scorecard; (4) manage and shepherd your resources in a manner that demonstrably adds value to patient care; and (5) know the score and use it.     

Accelerating acceptance

Innovations are either accepted or rejected in large part because of their implementation--sometimes without regard to improvements over existing techniques. By understanding the dynamics of how innovations are adopted and by whom, physician executives will have insight into influencing others. All adopters are not created equal. They fall into five categories, beginning with those who embrace innovation, even seek it out. In any given organization, or the population in general, there are: (1) innovators (2.5 percent); (2) early adopters (13.5 percent); (3) early majority (34 percent); (4) late majority (34 percent); and (5) laggards (16 percent). As these categories imply, each group has specific personalities related to adopting innovations that can be identified and used to implement new policies and procedures. By identifying and encouraging innovators and early adopters to think outside the box and then gaining critical mass through the early majority, who also act as opinion leaders, organizations can accelerate the pace of adopting innovations. New processes are adopted when opinion leaders initiate new practices, whose results can be tangibly discerned by the majority of adopters.     

When children work: implications for youth, society and organizations

We review the literature on youth employment. In particular, we highlight data suggesting youth is not a homogenous group, and that employment is not a homogenous experience for young workers. Demographic and motivational differences within the group categorized as 'youth', as well as differences in the context and quality of youth employment experiences, are shown to have substantial implications for research, policy and organizations.     

Changing food production and quality of diet in India, 1947-98

Systematic and critical evaluation, using food balance sheets, census population data, government surveys, food composition statistics, and estimates of the population's biological requirements, shows that the realized improvements in food supplies in India of the past five decades, while beneficial, have been insufficient to meet the nutritional needs of the average person in a population that grew from less than 350 million to nearly one billion during this period. The improvements also fall significantly short of meeting the needs of the clinically malnourished. Present per capita dietary energy intakes range from as high as 95 percent to as low as 50 percent of daily requirements. Additionally, comparison of past and present diets shows that as the composition of the diet has changed with time, its nutritional quality for many has deteriorated despite an apparent increase in overall food quantity. This has come about from changes in the production system that have emphasized wheat and rice crops at the expense of more nutritional pulses and coarse grains, and from widespread poverty that leaves high-quality animal foods beyond the means of most.     

Return migration: changing roles of men and women

The study concerns Greek returnees from the Federal Republic of Germany and explores changes in task sharing behaviour and gender role attitudes resulting from changes in cultural environments.
A group of return migrants was compared with a group of non-migrants, both living in villages in the District of Drama, Greece. Groups were interviewed to investigate the extent to which each spouse shared house tasks as well as their attitudes towards gender roles in the family.
The data were factor analysed and a t-test was used to determine any differences between the groups. In addition to demographic variables, those concerning the "time lived abroad" and the "number of years in Greece" after return were inserted into a series of regression analyses for the purpose of explaining task sharing and gender role attitudes.
The results showed that: (a) task sharing of return migrants differs from on-migrants with respect to tasks which are peripheral to house organization. It seems that migrants' task sharing behaviour changes to a certain degree as a result of their changing socio-cultural environments. Results also suggest that migrant husbands and wives either take on new patterns of behaviour or maintain traditional ones only when these are congruent with the financial aims of the family or can be integrated into living conditions in Greece upon return. (b) Lack of differences between groups in an Attitude Questionnaire suggest that gender role attitudes have changed for both migrants and non-migrants over the last 15 to 20 years, although for different reasons and the different conditions under which these groups had lived.     

Socio-economic re-structuring and employment: the case of minority ethnic groups

The consequences of major changes in employment, due to the decline of manufacturing and the growth of the service sector, have not been well-documented, nor theorized, in the sociology of ethnic relations, even in recent studies. For example, Blumer's classic argument that economic development adapts to 'race relations', rather than the reverse as predicted by the modernization school, has not been either empirically resolved or conceptually applied to the UK. By adapting data from the Labour Force Survey and the Census, the paper begins to fill this gap with a detailed account of three main minority ethnic groups, and a separate analysis of male and female employment. It is demonstrated that, contrary to assumptions that members of the minority ethnic groups suffered most from de-industrialization, they actually did rather well, and in some cases did better than the majority population. These findings are re-conceptualized as collective social mobility, as part of a review of a number of conceptual frameworks in the light of the data.     

Social mobility and personal satisfaction: evidence from ten countries

This paper examines survey data relating class mobility to satisfaction and dissatisfaction with seven different domains of everyday life among nationally representative samples of men and women living in ten industrialized nations. The evidence is set against competing pessimistic and optimistic accounts of the mobility experience found in earlier literature. Results show that individuals who move from working-class origins to middle-class destinations are no more likely to be systematically satisfied or dissatisfied with life than are the socially immobile or even those downwardly mobile from advantaged backgrounds into the working class. Indeed, in all nations, the overall association between class experience and satisfaction with life is both weak and uneven across the different life-domains. The study also serves to illustrate an important principle of research methodology more generally.     

The role of birth/previously adopted children in families choosing to adopt children with special needs.

Engaging birth/previously adopted children during the adoption process is crucial to laying the ground-work for successful placements. When families choose to adopt children with special needs, however, the role their other children will play in the adoption's success is often overlooked. This article presents a practical model that recognizes the dynamics of strength and vulnerability in adoptive families, then applies this model in preparing and supporting the family through the changes that are inevitable in special needs adoption. The model can also be used to assist adoptive parents in identifying and developing the skills they need to manage these shifts within the family.