Elective single mothers and their children: The missing fathers

Elective single mothers are adult, unmarried women who intentionally become mothers. This study utilized longitudinal data about 17 Caucasian, elective single mothers and their children to identify fathers' roles in these families, and to understand children's views of their fathers. These single mothers and their children resided for the first six years of the children's lives in father-absent households. By age six, most of the children had ghost fathers, whom they had never met or knew little about. The data suggest that the father often becomes a family secret, and that children may blame themselves for their fathers' absence.     

Helping oneself by helping others: evaluation of a service credit banking demonstration

Between 1987 and 1990, the Robert Wood Johnson Foundation funded six service credit banking demonstration programs among the elderly in which participants delivered services in return for credits, entitling them to later service. This evaluation of the demonstrations found that these six sites successfully attracted elders for the delivery of household support services to a relatively old, frail population with potentially limited social networks. Evidence on the significance of the "credit" in attracting volunteers was mixed, but the programs have attracted new volunteers, and have not substituted for other volunteer activities. Program development has entailed considerable staff investment in volunteer support; programs are better understood as community membership organizations than as mechanical exchanges.     

Federalism and aging policy in the 1980s: implications for changing interest group roles in the 1990s

Shifts in the American political landscape during the 1980s had impacts on aging policy and on the behavior of aging interest groups through that decade. But perhaps even more important are the likely effects of those changes on aging policy and on the roles of age-related groups in the 1990s--and probably beyond. First, some of the major policy trends of the 1980s are sketched out, especially the renewed emphasis on federalism. Then, an assessment of their effects on aging policy and aging interest groups is provided. Next, a rationale for focusing on state-level policy and a discussion of current aging interest-group mobilization at the state level are presented. Last, the prospects for aging interest-group influence in the 1990s--a period in which the prior decade's emphasis on dual federalism is likely to continue--is addressed.     

Breast implants, Hippocrates, and burden of proof

The author argues that the burden of proof for the safety and efficacy of some medical devices properly lies with the manufacturers of the devices and with the providers who use them. The controversy over breast implants is used as a case for this shift in the burden of proof of safety and effectiveness.     

Physician executives: where they are and what they do

As hospital operations become increasingly complex, so does the institution's management and organizational structure. Physician executives with titles of medical director, vice president for medical affairs, medical administrator, chief of staff, medical staff president, etc., are playing more important roles than ever before. This article will briefly review some recent literature describing physician executive profiles. The results from a survey of ten university teaching hospitals are also presented as supplementary information regarding current staffing models. Finally, several physician executive staffing-related issues will be discussed in light of the literature and the survey results.     

Eliminating smoking from the workplace

Employers are more readily realizing that a nonsmoking policy in the workplace is a more effective way to run their businesses. They are recognizing costs such as productivity losses, increased health and life insurance costs, employer liability for diseases jointly linked to smoking and occupational exposures, absenteeism, passive smoking-induced health care costs among nonsmokers, workers' compensation, and fire losses. Concomitantly, employees are supporting policies that limit smoking to achieve a clean air environment. Former Surgeon General Koop's goal of "a smokefree society by the year 2000" is being recognized by more and more segments of society.     

Biotechnology: will it break the health care bank?

Pharmaceuticals traditionally have been viewed as a cost-effective component in medicine's technological armamentarium. The use of pharmaceuticals has been estimated to account for 6-8 percent of the nation's total expenditures on health care. The first wave of pharmaceuticals/biologicals that has been produced by the biotechnology industry has offered therapies that can provide much benefit to patients, but it has also raised concern about the cost of these new recombinant drugs. In addition to pricing, methods of promotion and modifications in the FDA approval process have raised concerns.