The minds of a medical director

This article is offered in a nod to all those readers who have been exposed to "whole brain" theory, either through the American College of Physician Executives or elsewhere. As managers struggle with balancing the "left brain" and "right brain" aspects of their work, the author says, they might consider exploiting a third area of activity, or inactivity--the "no brain." This center position can be especially effective in dealing with the high-technology aspects of delivering health care.     

Human genetic technology: who shall control?

The biotechnical "revolution" has fast come upon us. It promises to produce both substantial benefits and difficult dilemmas for individuals and society. Despite the growing attention being paid to biotechnology, a major unanswered question is who shall control the development and use of the powerful array of human genetic and reproductive innovations. Should the decisions be left to individual consumers and private industry or should they be made by the government or other social institutions? After briefly reviewing development in human genetics and reproduction and describing trends toward commercialization of them, this article discusses the dilemmas these trends raise for a democratic society. It argues for the urgent need to delineate societal goals and priorities for the future and for technology assessment as early as possible in the developmental process. The article concludes by presenting some examples of the social policy problems now emerging.     

Family composition preferences in a developing culture: The case of Taiwan, 1973

Abstract As fertility comes increasingly under voluntary control in a developing society, it can be argued that individual desires or preferences about children will become more salient and more significant for eventual fertility. Hence, the study of preferences is increasingly important as contraceptive use is extended and results in decreasing the number of unwanted births.(1) Further changes in fertility then depend on changes in preferences. The assumption is that people will at least try to achieve the families they want, if the means to do so are available. The fact that contraception is used at all is some evidence of the soundness of this assumption, although it should be recognized that family size desires operate in a complex of preferences, under varying degrees of conflict and control. To expect a one-to-one relationship between attitudes or preferences and overt behaviour would be simplistic.     

Migration, remittances and rural development: findings of a case study in the Indian Punjab

Rural household survey data in the Ludhiana district of the Indian Punjab was used to study the nature and role of remittances in rural development. Of the 1646 outmigrants from the area since 1961, the 949 women who migrated for marriage and children under 12 years old were excluded from the study. Nearly all husbands who outmigrated had sent remittances. Parents and grandparents were 2nd and 3rd most likely to remit, but their numbers were small. Education did not correlate with remittance. Distance and time since emigration did not affect remittance. The frequency and the size of remittances are discussed. Remittances to outmigrants were insignificant. The remittances from outmigrants seem to raise the incomes and the levels of living of rural households. The remittances serve the purpose of redistributing income from urban to rural areas. Remittances also widened the gap between rich and poor in the rural areas because the better-off groups were more likely to receive remittances than the poorer groups. Most of the money sent from outmigrants was spent on consumable goods, food and clothing. Only a small proportion was spent on productive investment. This was usually done by farming families who invested in land or farm necessities. It is concluded that remittances from outmigrants can have a positive effect on the rural economies. Investment opportunities for nonagricultural families must be provided.     

Optimal Times to Contact Sample Households

Finding a suitable respondent at home is an essential and expensivecomponent of a household survey. This article reports on theresults of a study of the probabilities of finding someone aged14 or older at home and discusses the application of such datato survey design and budgeting.