Is it our turn to be CEO yet?

Physician executives continue to have ambitions for the health care CEO role, despite the difficult economic times. And though few have yet been chosen for the position, the expectation is that this will change markedly in the next five to seven years. Today, physician executives have legitimate, relevant professional experiences that directly qualify them for CEO roles in health initiatives. And no executive is more qualified to deal with medical care management issues than the physician executive. Key elements of preparedness are: Executive thinking, bundling projects, and learning to manage managers. The opportunities will be open to those who are ready to take them on.     

Weighing the success of a national Alzheimer's disease service demonstration

As the need for long-term care services within the United States has grown dramatically, Congress has consistently deflected the primary responsibility for such care to state governments, local organizations, and, ultimately, the family. This paper examines the impact of the Alzheimer's Disease Demonstration Grants to States (ADDGS) program, a small federally funded initiative within the context of this trend. Although the demonstration can be deemed a huge success relative to the goals of creating new services for an underserved target population, questions are raised about the merits of the program relative to the exploding need for an effective network of long-term care services.     

The right paperwork for the right audiences

Physician executives need to exercise considerable discretion, care, and judgment when they write about their professional accomplishments in the form of a résumé or curriculum vitae (CV). This paperwork is intensely personal. It must be a true reflection of you, your achievements and goals. Others read it to learn more about you. Those you fail to convince, you're likely to lose--along with your chance to meet and charm them in a personal interview. A physician executive's thoughtfully prepared résumé and CV can result in him or her being offered terrific opportunities for career growth. The paperwork is a self-constructed gateway through which you can properly approach hiring organizations--and how it reads is totally under your control. Some suggestions to consider in developing your résumé or CV are: be succinct; don't overstate; use both documents; do your homework; and be ready for the next steps.     

A semi‐Markov model for binary longitudinal responses subject to misclassification

The authors propose a two‐state continuous‐time semi‐Markov model for an unobservable alternating binary process. Another process is observed at discrete time points that may misclassify the true state of the process of interest. To estimate the model's parameters, the authors propose a minimum Pearson chi‐square type estimating approach based on approximated joint probabilities when the true process is in equilibrium. Three consecutive observations are required to have sufficient degrees of freedom to perform estimation. The methodology is demonstrated on parasitic infection data with exponential and gamma sojourn time distributions.     

Too Cool for School? The Relationship between Coolness and Academic Reputation in Early Adolescence

The relationship between peer‐nominated coolness and academic reputation was examined at two time points spanning the first year of middle school (N = 807; 52 percent female; 52 percent African‐American; 48 percent European American). Students predominantly nominated peers who were from their same gender and ethnic group as being cool. Associations between coolness and academic reputation differed across subgroups, were contingent upon level of disruptive behavior, and changed over time from fall to spring of the academic year. In the fall, patterns differed by gender, not by ethnicity. For both white and African‐American boys, hierarchical regressions evidenced a null association between coolness and academic reputation; for both white and African‐American girls, this association was positive. In the spring, findings for white girls were similar to findings from the fall. For the three remaining groups—white boys and African‐American boys and girls—conditions worsened over time, albeit in slightly dissimilar ways. For white boys, fall coolness did not predict significant declines in academic reputation over time; nonetheless, as a group, the coolness–academic reputation was negative by the end of the year. For African‐American boys and girls, fall coolness significantly predicted declines in academic reputation from fall to spring, although the concurrent coolness–academic reputation association was not significantly negative for either group in the spring.     

A theoretical analysis of antecedents of young couples’ fertility decisions and outcomes

Longitudinal survey data from 509 couples who at Time 1 interview had recently married or had their first child did not support the hypothesis that demographic factors influence fertility intentions, decisions, and outcomes only indirectly through their effects on attitudes and motivations. Husbands’ and wives’ attitudes exerted reciprocal influence on one another. However, while husbands’ sex-role traditionalism and motivation for parenthood strongly influenced wives’ traditionalism and motivation in the case of recently married couples, this pattern was reversed for riew parents. Birth control use was directly affected by wives’ fertility intentions, but not by husbands’ intentions. Difficulties in examining couple interaction variables such as relative power and the possible limitations of fitting these data to a complex theoretical model using LISREL are discussed.     

School Based Vision Centers: striving to optimize learning

As the average age of the Canadian population continues to increase, and providing care at home to frail older adults becomes ever more prevalent, support for family and friend caregivers remains a key social policy issue. Economic support is an important consideration given the impact of caregiving on labour force participation. Yet the caregiving/paid work relationship is not always straightforward. While caregiving often restricts employment, limited attachment to employment may also influence the decision to provide care. Isabel's story, collected as part of a study of sibling views of fairness in sharing parent care as well as parent assets, provides a case study in how siblings give different priority to care work versus career work and what support needs arise including those related to sibling conflict over differing priorities. Isabel claims she sacrificed her career to care for her ailing mother while her siblings argue that through caregiving, Isabel was sheltered from the paid workforce.     

Land fragmentation under rapid urbanization: A cross-site analysis of Southwestern cities

Explosive population growth and increasing demand for rural homes and lifestyles fueled exurbanization and urbanization in the western USA over the past decades. Using National Land Cover Data we analyzed land fragmentation trends from 1992 to 2001 in five southwestern cities associated with Long Term Ecological Research (LTER) sites. We observed two general fragmentation trends: expansion of the urbanized area leading to fragmentation in the exurban and peri-urban regions and decreased fragmentation associated with infill in the previously developed urban areas. We identified three fragmentation patterns, riparian, polycentric, and monocentric, that reflect the recent western experience with growth and urbanization. From the literature and local expert opinion, we identified five relevant drivers ?C water provisioning, population dynamics, transportation, topography, and institutions ?C that shape land use decision-making and fragmentation in the southwest. In order to assess the relative importance of each driver on urbanization, we linked historical site-specific driver information obtained through literature reviews and archival analyses to the observed fragmentation patterns. Our work highlights the importance of understanding land use decision-making drivers in concert and throughout time, as historic decisions leave legacies on landscapes that continue to affect land form and function, a process often forgotten in a region and era of blinding change.     

Social capital as social relations: the contribution of normative structures

This paper presents a framework for social capital that highlights the normative structures through which it is manifested. The primary focus is on the ways that norms structure the relationships in which social capital is embedded. To this end, we introduce four types of normative structures which condition social capital: market, bureaucratic, associative, and communal. A field site in Japan is used to illustrate how different aspects of social capital interact. This case analysis also serves to make an important distinction between the availability and use of social capital. The central arguments are that 1) social capital is organized in different ways by the normative structures in which it is embedded; 2) there are important interactions between these different aspects of social capital that are often overlooked by simpler frameworks; 3) a useful distinction can be made between available social capital and used social capital; 4) access to social capital can be used to analyze power relations; and 5) distinguishing different aspects of social capital makes areas visible that are overlooked by other understandings of social capital. We conclude by identifying the utility of our perspective for informing public policy and guiding future research.