The Negotiation of Child Care and Employment Demands Among Low-Income Parents

Low-income working mothers face significant child care challenges. These challenges are particularly salient in an era of welfare reform, when welfare recipients are under increased pressure to find a job. The current study examines how child care demands are negotiated for an urban sample of low-income mothers. The sample includes a racially and ethnically diverse group of 57 respondents with and without welfare experience who are mothering children under 13 years of age and working in entry-level jobs. Findings suggest that respondents seek arrangements that are affordable, convenient, and safe, and informal arrangements may be most compatible with convenience and cost considerations. Informal care is not universally available, however, andmay be less reliable. Implications for child care policy are discussed.     

Leadership and followership.

Along with the well-known leadership traits, there are some subtle characteristics of true leaders. Managing managers, making decisions, tolerating diversity, and showing a sense of humor are other marks of leadership that physician executives should possess.     

The MBA mystique

Is an MBA the solution for you? Do physician executives need to have a business degree to compete in today's competitive marketplace? What are clients looking for when they make hiring decisions? The answers may surprise you. This column is an attempt to dispel myths about physician executives and the MBA degree. Clients want to attract and hire physician executives who possess sometimes intangible skills--with or without the MBA credential. These intangible skills include the ability to educate other physicians to the new health care realities, a sales orientation emphasizing effective communication that focuses on patients and payers as customers, comfort with ambiguity, flexibility, and tact and sensitivity in negotiations.     

Eating disorders in graduate students: exploring the SCOFF questionnaire as a simple screening tool

The results of several studies have established the validity of the SCOFF questionnaire (a 5-question screening tool for eating disorders), but researchers need to explore further replicability using the US version in the graduate school population. In this study, the authors asked 335 graduate students attending the Northwestern student health clinic on the Chicago campus to complete a written survey anonymously. A total of 305 (91%) patients completed the survey. The sensitivity and specificity for the SCOFF was 53.3% and 93.2%, respectively. This produced a PPV (the proportion who tested positive on the screen and actually had an eating disorder) of 66.7% and an NPV (the proportion of those who tested negative on the screen and actually did not have an eating disorder) of 88.7%. More than 80% of respondents were dissatisfied with their shape and weight, with over one third having a moderate to severe body image disturbance. The SCOFF is an easy instrument to administer that health care providers can use to screen for eating disorders in the primary care setting.     

When it's time to say goodbye

You've landed the perfect job, but now you must face your current employer and deliver the news that you're leaving the organization. While an exciting time, this can also certainly be a stressful one. Here are some strategies and ideas for saying goodbye to an employer that may be useful in guiding your actions. From being ready for counter-offers to downright hostility, you need to be prepared to deal with various scenarios. No matter how you have steeled yourself to go into the boss's office to share your news, you cannot predict with total accuracy just what his or her response will be. There will always be surprises, although usually things are never as bad as your imagined worst-case scenario. However, when you are ready to make your plans known, one simple rule is always required: You must have total commitment to your new position.     

The physician executive "arrives"--a new generation prepares for the future

The recent rise in the number of physician executives in the health care industry vividly demonstrates that a genuinely new generation of physician executives is seeking to combine the sensitivity of their clinical skills with the business acumen that today's health care organizations need to prosper and grow. But physicians who are preparing themselves to be selected one day as chief executive officers by hospitals, integrated systems, and managed care organizations should understand that the CEO role is radically different from that of the CEO of a physician practice. The corporate CEO role requires the management of managers and responsiveness to the organization's board. Those who imagine that the corporate CEO role bears any resemblance to the autonomous, independent existence of the practitioner are certain to have a rough time.     

The purpose of a job interview is a job offer

Perhaps empathy has been overdone in recent years. Most of us would admit to some cynicism or disbelief when we hear the words, "I know how you feel." Having said that, however, I actually do know how you feel. If I can't identify exactly where you are coming from, I do know where you are likely to be going and how bumpy the ride is likely to be. I'm a physician and a physician executive. I am also an executive search consultant who is daily in the field interviewing physicians who may or may not be the right individuals for a client's situation. If I don't exactly feel your pain, at least I know its sources. I know how difficult it is to make the move from challenging clinical work to an administrative role in health care. While, as a group, physicians are multiskilled and multitalented, it's an unfortunate fact that some of the skills and talents that made you an excellent physician may be blocking you from succeeding in an executive capacity. My hope is that, through an occasional entry in this column, I can share my experiences and relate the remarkable wisdom of the impressive physician executives whom I meet every day. The first issue I'm opening up for discussion is employment interviewing: Why the interview is so important, what the interviewing process is, and how you can become more adept in this critical skill area.     

Childhood Sexual Abuse Profiles and Psychological Functioning in Adult Males

ABSTRACT

This study used a person-centered approach to generate profiles of males’ sexual abuse characteristics and then link profiles to other types of childhood maltreatment and adversity, and adult outcomes. Data were drawn from 215 North American males (86% Caucasian) aged 17–61 years recruited from websites offering support for sexual abuse. Latent profile analysis identified three profiles, ranging from 1–2 instances of fondling by an unfamiliar extrafamilial perpetrator to chronic, penetrative abuse by individuals within and outside the family. Profiles were labeled Severe (26%), More Severe (33%), and Most Severe (41%). Chi-squares and analysis of variance showed that men in the Most Severe profile were more likely to experience childhood emotional and physical abuse, and a greater number of non-victimization adversities, than men in the other two profiles. After controlling for multiple victimization and adversity, men in the More Severe and Most Severe profiles reported significantly greater internalizing problems than men in the Severe profile, and men in the Most Severe profile reported significantly more trauma symptoms than men in the Severe profile. While these results require replication, they suggest that treatment should be tailored to the individual needs of male survivors.     

Developing an understanding of lean thinking in process industries

The research described in this article has set out to determine the extent to which lean thinking is being adopted as a manufacturing philosophy by process industries. It concerns the application and examination of key lean manufacturing principles, namely, the alignment of production with demand, the elimination of waste, the integration of suppliers (IS) and the creative involvement of the workforce in improvement activities, to a range of process industry types based on Dennis and Meredith's taxonomy of process industry transformation systems [Dennis, D. and Meredith, J., 2000a. An empirical analysis of process industry transformation systems. Management Science, 46 (8), 1085–1099]. Seventy-nine process industry product streams across 62 sites were studied. In addition, a five-site investigative field study was also undertaken. The findings demonstrate that lean practices associated with the elimination of waste are consistently used for improving manufacturing performance throughout the taxonomy of process industries but practices associated with other lean principles are inconsistently applied. In addition, explanations are provided on the appropriateness of lean thinking as a manufacturing philosophy and a strategy for improving manufacturing performance in different process industry types, and on the extent to which lean principles and practices are dependent on the characteristics of process industry transformation systems.