Analysing Structural Interests in Primary Care Groups

Alford's theory of structural interests in health care has been used as a heuristic device both in the USA and the UK. Despite concerns about its heuristic power it provides a lucid analytical framework and is helpful in exposing the structural interests that underpin political processes in health systems. To date its application in the UK has been primarily in relation to an NHS dominated by health authorities and hospital providers. Recent reforms in the UK have created a new context dominated by primary care organizations. In this paper we identify the key players in English primary care groups as they relate to Alford's structural interest groups: the professional monopolizers, corporate rationalizers and community. The paper outlines the context of the involvement of the key groups and then analyses the relationships between them. In doing so it raises concerns about the structure and purpose of primary care groups and the probability that key tensions between general practitioners who adopt a corporate rationalizer role and those who retain a professional monopolizer role will be damaging to the progress and development of PCGs. Our analysis also highlights the continuing weakness of the community as an interest group despite the emphasis on involving patients and the public. Importantly, we would suggest that the professional monopolizers among GPs will retain a powerful voice, countering the new corporate rationalizers and continuing to claim that they represent the community's interests.     

Storage and retrieval of life history data

Recently many social scientists have begun collection and analysis of life history data. The analysis of these data is made possible largely because of appropriate computer storage and retrieval techniques. These techniques differ in several aspects from the conventional procedures employed in most social science research. The paper discusses some alternate methods for storage of these data and suggests some general capabilities for a retrieval system for life-history data.     

Where you stand depends on where you sit: Participation and reactions to change

Although a considerable body of research on strategic planning, organizational decision making, and organizational change has emphasized the importance of participation by key stakeholders for the successful management of organizational change, few empirical studies have produced in‐depth understanding of the differing perspectives of stakeholder groups according to their level of involvement in decisions about major change. This case study examines the differing perspectives and perceptions of stakeholders leading into and during the merger of two nonprofit arts organizations. It refines and enriches existing empirical research on the effects of participation on the implementation of change.     

New Fathers' Labor Supply: Does Child Health Matter?*

Objective. We estimate the effect of poor child health on the labor supply of fathers post‐welfare reform, using a national sample of mostly unwed parents and their children—a group at high risk of living in poverty. Method. We control for a rich set of covariates, include state fixed effects, and test for the endogeneity of child health by estimating bivariate probit models. Results. We find that having a young child in poor health reduces the father's probability of being employed by four percentage points. The effect appears to be strongest among fathers who cohabit with, but are not married to, the child's mother. Conclusion. The results suggest a potential source by which young children with serious health problems may receive lower levels of health investment than their healthier peers—their fathers' reduced likelihood of being employed.     

Transgression narratives,dialogic voicing,and cultural change1

The narrative discursively analyzed in this paper is taken from a larger study involving life history interviews with Latina/o immigrants in California. It exemplifies a type of narrative among these interviews in which tellers recount how they or their family members have broken with cultural expectations. In this story, the teller, a Nicaraguan woman, recounts how her uncle violated traditional values in her family by enlisting in the Sandinista army during wartime. Despite discursively distancing herself from this transgression, she ends by evaluating the transgressor and his recent accomplishments positively. Through an analysis of the appraisal strategies and interdiscursivity within this narrative, the paper contends that the narrators of such stories can go beyond managing deviations to dialogically position themselves among competing ‘social and historical voices’( Bakhtin 1981 ). Thus, the paper contends that transgression narratives represent the tellers’ efforts to come to terms with cultural changes in their communities.     

Basic Confidence Predictors of Career Decision‐Making Self‐Efficacy

The extent to which Basic Confidence Scales predicted career decision‐making self‐efficacy was studied in a sample of 627 undergraduate students. Six confidence variables accounted for 49% of the variance in career decision‐making self‐efficacy. Leadership confidence was the most important, but confidence in science, mathematics, writing, using technology, and cultural sensitivity all contributed significant incremental variance. There were some differences as a function of race and gender, but leadership confidence was the most significant predictor in all subgroups. Implications for educational and career counseling are discussed.     

Social Support Networks and Loneliness Among Elderly Jews in Russia and Ukraine

The collapse of the Soviet Union had devastating consequences for the lives of its population, especially for older adults, many of whom became impoverished and were left with no social support. Using data from a survey of 2,579 elderly Jews in two of the largest countries of the former Soviet Union, Russia and Ukraine, we examine variables that affect their feeling of loneliness. Unmarried and childless elderly persons reported the highest feelings of loneliness. Married elderly persons who maintained frequent contact with their children felt least lonely. Moreover, married and unmarried elderly persons who did not maintain frequent contact with relatives or friends were lonelier than those who maintained such contact. The characteristics of social networks were significantly correlated with loneliness. The findings also showed that Jews in Ukraine had fewer social networks and felt lonelier compared to Jews in Russia.     

Laughter in Conversation: Features of Occurrence and Acoustic Structure

Although human laughter mainly occurs in social contexts, most studies have dealt with laughter evoked by media. In our study, we investigated conversational laughter. Our results show that laughter is much more frequent than has been described previously by self-report studies. Contrary to the common view that laughter is elicited by external stimuli, participants frequently laughed after their own verbal utterances. We thus suggest that laughter in conversation may primarily serve to regulate the flow of interaction and to mitigate the meaning of the preceding utterance. Conversational laughter bouts consisted of a smaller number of laughter elements and had longer interval durations than laughter bouts elicited by media. These parameters also varied with conversational context. The high intraindividual variability in the acoustic parameters of laughter, which greatly exceeded the parameter variability between subjects, may thus be a result of the laughter context.