Involving constituents in agency priority setting: a case study

Many government agencies have "constituents" who believe the agencies should hear and consider their needs and desires in establishing program priorities. This article describes how one involves interested constituents (consumers, industry, medical professionals, and state organizations) in the agency's annual priority-setting process. This participation has produced a number of beneficial results-some expected and some unexpected.     

Micromomentary movement and the deconding of face and body cues

A new version of the Profile of Nonverbal Sensitivity Test (PONS)—a standardized test of sensitivity to nonverbal cues—was developed to determine the effects of five levels or sequences of micromomentary movement on accuracy in decoding nonverbal face and body cues, presented for 125 microseconds (msecs). The five sequences were: backward movement, partially backward movement, no movement, partially forward movement, and fully forward movement. Two versions of this test—the Test of Micromomentary Movement Effects (TOMME)—were administered to two samples of female high school and college students. The results, averaged over face and body cues, showed that as the movement sequences more closely approximated the fully forward sequence, decoding accuracy increased. These results, showing the benefits of adding properly sequenced information at split second (42 msec) exposures, not only support the findings of previous researchers that micromomentary facial affect displays may be helpful in decoding nonverbal facial cues, but also suggest that micromomentary movements may be important for decoding body cues as well.     

The dynamics and differentials of fertility in the USSR (survey results)

The results of a fertility survey carried out in the USSR in 1978 are presented. The survey included 33,076 women aged 18 to 59. Data are included on fertility rates by region and Union Republic and by urban or rural area, and on expected fertility of women aged 18 to 44. Changes in actual and desired fertility over time are compared for five-year periods from 1945 to 1978. Differences in fertility are analyzed by type of settlement, educational status, and nationality.     

Assessment of patient satisfaction: development and refinement of a service evaluation questionnaire

A series of seven studies was conducted by the authors and their colleagues to produce an efficient measure of service satisfaction that can easily be related to symptom level, demographic characteristics, and type and extent of service utilization. The resulting measure, the Service Evaluation Questionnaire (SEQ) is a brief, global index that has excellent internal consistency and solid psychometric properties. Data from an extensive SEQ field study can be used as a comparison base for future applications of the two SEQ component scales, the CSQ-8 and the SCL-10. A new hypothesis has emerged from this series of studies that will guide future research: Service recipients may find if difficult to formally express dissatisfaction in the face of significant caring--however ineffectual--when the technical capacity to offer definitive treatment is not yet fully developed and when criteria for evaluating the efficacy of treatment are not yet crystal clear.     

The validity of indices for rural health manpower needs assessment

Population-to-practitioner ratios have long been the primary index in the designation of health manpower shortage areas. This paper documents that application of the widely used population-to-dentist index results in understatement of the need for dental health manpower in rural areas. Through the analysis of utilization data collected from a statewide health screening program in Colorado, the practice of sole reliance on the population-to-dentist indices as an indicator of need was tested. Another measure, the area-(square miles) to-dentist ratio was formulated, examined, and found to be a more useful referent of the need for additional health manpower in rural areas. Utilization of dental services in sparsely settled rural counties of Colorado was unrelated to population-to-dentist ratios. A strong, statistically significant association of utilization with land area-to-dentist ratios was found. The findings of this analysis suggest a need for reevaluation of needs assessment methodologies used in the designation of health manpower shortage areas. Indices more sensitive to consumer circumstance than to the number of health care providers available must be considered.     

Some specifics on the brain drain from the Andean region

An analysis of the brain drain from the Andean countries of Bolivia, Chile, Colombia, Ecuador, and Peru to the United States is presented. The data are from a survey of 62 persons from those countries who are currently residing in the United States and are listed in the current edition of "American Men and Women of Science". The reasons why they left their country of origin and are staying in the United States are considered. (summary in FRE, SPA)     

The meaning of patient satisfaction with prepaid primary health care in Israel

This paper reports the development of a self-administered Hebrew-language questionnaire for assessing patient satisfaction with primary care in Israel. Four scale measures of patient satisfaction were empirically constructed. These scales pertained to doctor conduct, doctor-patient communication, teamwork, and ease of access. In addition, a single direct question was used to measure overall satisfaction with the care. Ratings of all aspects of care were negatively skewed, with doctor-conduct and doctor-patient communication usually being the most satisfactory aspects and access the least satisfactory. It was shown that different practices, or the same practice at different points in time, can easily and meaningfully be compared, using mean satisfaction scores, measures of standard deviation, or percentages in each practice with ratings above (or below) the overall mean of all practices. The use of specific measures of patient satisfaction for comparison and intervention is discussed.     

Policy sources of worker dissatisfactions: the case of human services in aging

This article explores job dissatisfaction experienced by service providers in the field of aging and the policy sources of such dissatisfactions. Workers interviewed identified four major areas of complaint about their jobs: lack of resources, agency problems, mandates and regulations, and client characteristics. Such problems, it is argued, are associated with specific characteristics of policies under which the respondents work. These characteristics include the symbolic nature of legislation, policy ambiguity, universal entitlement, and calculated fragmentation. Whether or not policy changes should be made to alleviate worker dissatisfactions is discussed in the concluding section of the article.