Clinical program renovation management

The day-to-day management of medical practice is so heavily influenced by tactical imperatives that few physicians have the time to think strategically. Traditionally, the difference between tactics and strategy is not a major concern of most physician executives. The realm of tactics is the short run, when managers must make do with the fixed resources at hand. Strategy addresses the long run, when all resources and markets are variable. A tactical focus is understandable, maybe even acceptable, in industries where nothing challenges traditional approaches to production of an established product or service. However, medical care in the 1990s is changing so fast that a physician executive must devote an incredible amount of time and effort just to stay confused about what is going on.     

Bulgarian Turkish emigration and return

The main factors which determined the 1989 migration of Turks in Bulgaria back to Turkey are discussed. Background history is provided. After World War I, Turks in bulgaria comprised 10% of the total population. Bulgarian policy had been, up to the 1980s to send Rumelian Turks back, but the policy after 1980 was one of a national revival process to integrate Turks into the developed socialist society. Muslim traditions, customs, and Turkish language were interfered with. International disfavor resulted. In May 1989, the Communist Party declared, in an effort to show democratic ideals, open borders. Thus began the new emigration wave. 369,839 people fled to the Turkish border. 43% of the 9.47 ethnic Turks in bulgaria went to Turkey within 4 months. The numbers decreased in November, and soon after the communist regime ended. New laws were adopted allowing Turks to assume their original Turkish names. The huge migration was clearly political, and as such, the emigrant Turks should be determined as refugees and asylum seekers. The provocation of ethnic Turks was used by the communist regime to solve potential social conflicts. Not only did Turks flee to escape from violence or for religious, cultural, and moral reasons but also due to free market initiatives begun in Turkey in the early 1980s which improved Turkish quality of life. Food and consumer goods were cheaper and economic advantages were perceived. Emigrants were primarily peasants with lower levels of education, professional qualifications, and labor skills. 154,937 (42%) returned to bulgaria and 58% stayed in Turkey to comprise 25% of the former Turkish population. During this period, tensions between countries was high.l Bulgarians actively encouraged emigration and Turkey welcomed it. The emigrants to Turkey were seen as foreigners (muhacir or gocmen) but were received with good will and were readily accepted into menial positions. Emigrants were confronted with political, linguistic, and cultural differences. The unifying factor was the Islamic religion. For those returning to Bulgaria, the change in regime meant the government worked to solve the emigrants' housing problems and teaching Turkish in primary and secondary schools. The result of this massive migration has been a change in the demographics and social structure of Bulgaria, and the realization that forceful migration is inefficient in solving problems.     

Current status of and prospects for China Population Information Centre

The China Population information Centre (CPIC), set up in May 1980, is a national institution for population information research under the State Family Planning Commission. Its main functions are to 1) collect, process, and distribute and foreign materials on population and family planning; 2) collect, tabulate, and analyze population and family planning data; 3) keep abreast of new population and family planning developments within and outside the country; 4) edit and publish information materials; and 5) provide information users with diversified services. The CPIC has 8 operational units: 1) the Library, 2) the Statistics Division, 3) the 1st Information Research Division, 4) the 2nd Information Research Division, 5) the Editorial Division, 6) the Translation Division, 7) the Computer Division, and 8) the Technical Support Division.     

Measures to facilitate the return and reintegration of highly skilled migrants into African countries

A very large number of skilled Africans are found to be operating in the developed industrialized countries of the West at a time when their national economies are crying out for their services. Ways must be found to return as many of these skilled Africans as possible to the African economy. This out-migration or brain drain has a number of causes, including: 1) real incomes in Africa have been on the decline in the past several years while prices were constantly rising. Professional and salaried workers seek employment in other countries that pay much higher salaries. 2) Promotion on criteria other than merit is common in Africa and diligence and high productivity are not often rewarded. 3) Political interference frustrates public services professionals; they are rendered unable to use their professional judgement in making decisions that affect the economic and social fabric. 4) The inadequacy of higher education facilities and opportunities in African countries encourages the brightest and best qualified Africans to go to Western Europe and North America for school; they tend not to return after graduation. 5) Political upheavals and general instability contribute to feelings of individual insecurity, sending Africans to seek sanctuary in more politically stable and less repressive environments. Actions needed to control this out-migration include: 1) incentive systems should be reviewed with a view to providing realistic levels of renumeration and working conditions should be made to promote job satisfaction and self-actualization. 2) Capacities and capabilities should be strengthened so as to ensure that production of goods and services becomes indigenized and that the development and operation of institutions emanates from within the continent. 3) Educational services should be expanded and improved to obviate the need for large numbers of Africans to seek educational opportunities abroad.     

The use of metaphor in therapeutic communication with young adolescents

The ability to utilize metaphor is presented as the normal stage in the development of the capacity to symbolize that is characteristic of the young adolescent. Symbolization is considered to be the basic structure through which the individual constructs a knowledge of the reality and of the self. Therefore, staying within the framework of the metaphor in treatment with the young adolescent is beginning where the client is but equally as importantly it is assisting the youngster to further develop both his symbolic capacities and himself. A case illustration is utilized to demonstrate both healthy and pathological usage of metaphorical language.     

Secularization and the politics of traditionalism: The case of the right-to-life movement

Research on the traditionalist movement against abortion needs alignment with currents in historical sociology, the theory of social movements and the sociology of politics. The religious (specifically, Christian) basis of the right-to-life movement has attracted considerable attention in the literature. The movement is seen as a traditionalist bloc claiming to oppose secularization and return to customary restrictions. However the tradition in question appears to be a recent social construction. There is slim warrant in the actual traditions of Western religion for asserting a categorical right to life. As a result, the movement's ideology is best approached as the product of—rather than the antidote to—secularizing processes (including the demographic transition, discourse about rights, markets for symbolic entrepreneurs and the separation of church and state) and possibly as an unintended import from non-Western religion. Implications for traditionalism, the functions of religion, and the study of countermovements are explored. This case illustrates the value of attending to historical sequences and the external cultural environments of social movements.     

Stochastic modelling of regional annual rainfall anomalies in East Africa

ARIMA (p, d, q) models were fitted to areal annual rainfall of two homogeneous regions in East Africa with rainfall records extending between the period 1922–80. The areal estimates of the regional rainfall were derived from the time series of the first eigenvector, which was significantly dominant at each of the two regions. The first eigenvector accounted for about 80% of the total rainfall variance in each region.

The class of ARIMA (p, d, q) models which best fitted the areal indices of relative wetness/dryness were the A R M A (3, 1) models. Tests of forecasting skill however indicated low skill in the forecasts given by these models. In all cases the models accounted for less than 50% of the total variance.

Spectral analysis of the indices time series indicated dominant quasi-periodic fluctuations around 2.2–2.8 years, 3–3.7 years, 5–6 years and 10–13 years. These spectral bands however accounted for very low proportion of the total rainfall variance.     

Researching in the Victorian censuses: a note on a computerized,annotated bibliography of publications based substantially on the census enumerators' books

The authors describe a project, begun in 1981, to locate, list, and annotate all the published work based substantially on the census enumerators' books for nineteenth-century censuses for England and Wales. The results are currently available in a computerized file, enabling a variety of searches by topic, geographical area, and type of population. Information is provided on using the data and the computerized bibliography. The authors note that, subsequently, data for censuses of Scotland and Ireland have been added.     

The politics of health in the fourth world: a northern Canadian example

This paper describes the major structural and historical dimensions of health ideology and praxis in the Canadian Arctic. It examines the problems that occur when primary care services exclude their clients from meaningful involvement in planning and administration. It argues that the structure of health services in northern Canada reflects an internal colonial political economy which is characteristic of most Fourth World situations.