The impact of an integrated family planning program in Russia

In 1995, the U.S. Agency for International Development implemented an integrated program of family planning education and services in six Russian cities to increase physicians' and women's contraceptive knowledge and change current contraceptive use. Large population-based surveys of women ages 15-44 were carried out at the beginning of project implementation (in 1996) and 3 years later in two project sites and a comparison site. Results from these surveys indicate that project activities affected women's knowledge of family planning methods, and caused women to have more favorable attitudes toward modern contraception. In addition, abortion rates decreased in project sites while remaining virtually unchanged in the comparison site. Because of uneven implementation of project interventions in the demonstration sites, however, the intervention's actual impact on abortion rates remains unclear.     

Child sexual abuse evaluations: adherence to recommendations

Sixty-eight parents of children with alleged child sexual abuse (CSA) were surveyed 4 months after visiting an interdisciplinary CSA evaluation clinic in order to examine the extent to which recommendations were recalled and implemented. Of those parents for whom specific recommendations were provided, 9% recalled recommendations for medical follow-up, 79% recalled recommendations for child therapy, and 43% recalled recommendations for parental therapy. Families were more likely to receive and adhere to recommendations when there were behavioral problems and a strong indication of CSA. To improve communication with families, the reasons for recommendations must be clearly conveyed, and possible barriers to implementation should be anticipated and addressed. In addition, recommendations need to be realistic, and professionals need to facilitate the implementation of their treatment plan.     

The common-sense model of illness representation: Theoretical and practical considerations

This article focuses on several areas. After reviewing the most commonly used approaches in the study of health behaviors, (e.g., the medical model, the health belief model, and the theory of reasoned action) the common-sense model is presented as an alternative. By presenting evidence across a wide range of illness domains, we demonstrate the usefulness of the common-sense, self-regulatory approach. We then discuss the importance of the common-sense model for health research among minorities. We conclude the article with examples of the operationalization of illness representations in past research and directions for future research.     

Winning the Export War: British, Japanese and West German Exporters' Strategy Compared

A comparison of pricing policies, price and volume volatility, and investment in distribution, sales and marketing systems across 462 product categories identifies important differences in the strategies of British, Japanese and West German exporters towards the US market. The impact of these strategic choices on the evolution of market share is tested. The results suggest that many British manufacturers' export strategy has been dominated by UK supply and demand considerations. A large proportion of British exports are therefore confined to niches where sensitivity to price fluctuations and ‘stop-start’ supply is low and local distribution support is less important. Products where ‘pull marketing’ dominates are the key exception. Japanese exporters have invested heavily in US distribution and channel support, combined with a policy of stable US prices, aiding long term penetration. West German exporters have built share on technological advantage and direct sales support supplied from Germany to a limited number of customers.     

The resolutions of separation: Are marital reconciliations attempted?

This study, using 1987–88 National Survey of Families and Households data, has examined the prevalence and characteristics of ever-separated white women who attempt a marital reconciliation. Marital reconciliations are quite common as 44% of the separated women attempt a reconciliation. There is some support for the thesis that those with the fewest resources and greatest reliance on the relationship are the most likely to attempt a reconciliation. In comparing these findings with previous research on the marital dissolution process, there is little consistency in the relationship that the sociodemographic variables have with attempting a reconciliation and with the success of an attempted reconciliation. The implications of these findings are discussed.     

Elite Revisionists and Popular Beliefs: Christopher Columbus, Hero or Villain?

According to revisionist historians and American Indian activists,Christopher Columbus deserves condemnation for having broughtslavery, disease, and death to America’s indigenous peoples.We ask whether the general public’s beliefs about Columbusshow signs of reflecting these critical accounts, which increasedmarkedly as the 1992 Quincentenary approached. Our nationalsurveys, using several different question wordings, indicatethat most Americans continue to admire Columbus because, astradition puts it, "he discovered America," though only a smallnumber of mainly older respondents speak of him in the heroicterms common in earlier years. At the same time, the percentageof Americans who reject traditional beliefs about Columbus isalso small and is divided between those who simply acknowledgethe priority of Indians as the "First Americans" and those whogo further to view Columbus as a villain. The latter group ofrespondents, we find, show a critical stance toward modal Americanbeliefs much more broadly. We also analyze American history school textbooks for evidenceof influence from revisionist writings, and we consider representationsof Columbus in the mass media as well. Revisionist history canbe seen as one consequence of the "minority rights revolution"that began after World War II and has achieved considerablesuccess, but the endurance of Columbus’s reputation—toa considerable extent even among the minorities who have theleast reason to respect him—raises important questionsabout the inertia of tradition, the politics of collective memory,and the difference between elite and popular beliefs.     

Strategic Management and Change in High Dependency Environments: The Case of a Philanthropic Organization

On the basis of a detailed, in-depth study of the operations and strategic decision-making of Centraide, a charitable organization in Greater Montreal, this paper suggests that dependency on the environment can be a stimulus to organizational adaptation. Two major changes over a 10-year period are studied to show that strategic management in high dependency situations requires a continual attention to the organization's relationships and interactions with the forces in its environment, and a continuous management of the process by which change takes place. The basic position advanced is that: strategy in philanthropic organizations is more effective in ensuring survival and growth when the search for autonomy is seen as irrelevant and when dependence is seen as an unavoidable fact that should shape behavior. A set of propositions helps conceptualize the findings and is offered as a guide for further research.     

The Iowa Gambling Treatment Program: Treatment Outcomes for a Follow-up Sample

The Iowa Gambling Treatment Program (IGTP) amassed participant data for gamblers and concerned others of gamblers over 4 years (1997–2001). Data collection opportunities included: (1) crisis contacts, (2) placement screening, (3) admission, (4) treatment services, (5) discharge, and (6) follow-up. Among followed gamblers, 74% of treatment completers, 49% of substantial treatment completers, and 36% of dropouts and referrals were abstaining from gambling at 6-month follow-up. The reduction in dollars lost to gambling was similar; 85% of treatment completers, 88% of substantial treatment completers, and 65% of others reduced their dollars lost per week. Although more extensive follow-up efforts are needed to properly evaluate the effectiveness of the IGTP, these results suggest that the IGTP shows promise.     

Is health care a right or a privilege?

In this overview of the American health system, the author make arguments for declaring health care a right in the U.S. Constitution. Learn why he believes this is necessary.     

Organizational Fields and Third Sector Housing in Ireland,North and South

This paper applies organizational field analysis to compare the structure of the third sector housing fields in Northern Ireland and the Republic of Ireland. Following preliminary accounts of history, structure, funding, and regulation, four key dimensions of field structure are compared: interaction, subgroups, structural equivalence, and patterns of domination. In both fields studied, early steering by the state into specialist roles has been overtaken by state funded expansion in general needs housing--increasing the dominance of larger organizations and tensions around voluntary sector identity. However, differences remain in the extent of domination and tightness of field structure, with greater emphasis on whole organization regulation, and adherence to professional and trade bodies in Northern Ireland. It is also shown how cross-border activity and the espousal of a European model will influence future trajectories.