"Conflict management" and "conflict resolution" are not synonymous terms

Robbins sees functional conflict as an absolute necessity within organizations and explicitly encourages it. He explains: "Survival can result only when an organization is able to adapt to constant changes in the environment. Adaption is possible only through change, and change is stimulated by conflict." Robbins cites evidence indicating that conflict can be related to increased productivity and that critical thinking encourages well-developed decisions. He admits, however, that not all conflicts are good for the organization. Their functional or dysfunctional nature is determined by the impact of the conflict on the objectives of the organization. The author identifies several factors underlying the need for conflict stimulation: (1) managers who are surrounded by "yes men"; (2) subordinates who are afraid to admit ignorance or uncertainty; (3) decision-makers' excessive concern about hurting the feelings of others; or (4) an environment where new ideas are slow in coming forth. He suggests techniques for stimulating conflict; manipulating the communication channels (i.e., repression of information); changing the organizational structure (i.e., changes in size or position); and altering personal behavior factors (i.e., role incongruence). Robbins stresses that the actual method to be used in either resolving or stimulating conflict must be appropriate to the situation.     

Final report of the Color Additive Scientific Review Panel

The Color Additives Scientific Review Panel considered whether there was information sufficient to perform a carcinogenic risk assessment on the colors D&C Red No. 19 (R-19), D&C Red No. 37 (R-37), D&C Orange No. 17 (O-17), D&C Red No. 9 (R-9), D&C Red No. 8 (R-8) and FD&C Red No. 3 (R-3) and to evaluate the assessments sent to FDA as part of the petitions for use of the colors for drug and external uses by the Cosmetic, Toiletry and Fragrance Association (CTFA). There is a lack of human data concerning the colors for making a human health assessment, so the assessments are based upon the extrapolation of animal data. The risk assessments are determined for exposure to single chemicals. Excluded from consideration are possible effects from exposure to multiple chemicals, such as co-carcinogenesis, promotion, synergism, antagonism, etc. In the light of recent efforts in establishing a consensus in risk assessment, the Panel has determined that the CTFA assessments for R-10, O-17, and R-9 are consistent with present acceptable usages, although it questions some of the assumptions used in the assessments. The Panel identified a number of general assumptions made, and discusses their validity, their impact on total uncertainty, and the potential options to address the gaps in understanding that necessitate the assumption. The Panel also derived revised risk estimates using more "reasonable" assumptions than "worst-case" situations, for 90th percentile and average exposure. For those assumptions that are easily quantifiable, the Panel's estimates are less than an order of magnitude lower than the CTFA risk estimates, indicating that the underestimates and overestimates of the CTFA risk estimates tend to balance each other. The impact of most of the assumptions is not quantifiable. The assessment for R-3 is complicated by the fact that there is no good skin penetrance study for this color. It was assumed that the penetrance is similar to that of another water-soluble xanthene color, R-19. It is expected that the absorption of the color is not likely to exceed that of the smaller molecule, R-19. Therefore, the risk estimates are similar to the CTFA estimates, but with different reasoning. The estimates for R-8 and R-37 are different from the others in that there is a lack of any exposure or toxicological information on these colors.(ABSTRACT TRUNCATED AT 400 WORDS)     

Gays and lesbians in local races: a study of electoral viability

Although lesbians and gays are more visible in the political arena than in the past, there is little published research on their electoral viability. This article helps to fill that void by presenting results of experimental research featuring respondents' reactions to a hypothetical candidate for a non-partisan city council seat. Sex and sexual orientation of the candidates were manipulated so that six categories were tested: a straight woman, a lesbian, a woman rumored to be lesbian, a straight man, a gay man, and a man rumored to be gay. The findings suggest that openly gay and lesbian candidates are seen as less viable than straight candidates or those rumored to be homosexual. Hence, the extent to which a candidate portrays his or her sexual orientation appears to make a difference in the chance to win elective office.     

True patient safety begins at the top. Leaders at one large health system rally around safety,avoid blame game

Making patient safety the No. 1 priority at a hospital or clinic sounds like a easy task. It isn't. At one Oklahoma health system, an improved patient safety program is a massive effort requiring input and participation from every member of the staff. Figuring out how to convince employees that patient safety is their first priority means developing an extensive communication and education program.     

A longitudinal analysis of the distinction between for-profit and not-for-profit hospitals in America

Have changes in the hospital industry forced not-for-profit hospitals to become more like for-profit hospitals in measures of efficiency and community service? As a result, are not-for-profit hospitals moving away from their community service missions? In recent years researchers have asserted that the once-salient distinctions between not-for-profit and for-profit hospitals are quickly eroding and that this convergence threatens the community service that not-for-profit hospitals have historically provided. Neo-institutionalists explain that regulatory changes often force differing organization types to pursue similar strategies (Fligstein 1991, 1985; DiMaggio and Powell 1983). Guided by this theory, the present research analyzes if regulatory changes and the implementation of similar strategies result in not-for-profit and for-profit hospitals having similar efficiency and community service outcomes.     

Neighborhood disadvantage, stress, and drug use among adults

This paper explores the relationships among neighborhood disadvantage, stress, and the likelihood of drug use in a sample of adults (N = 1,101). Using the 1995 Detroit Area Study in conjunction with tract-level data from the 1990 census, we find a positive relationship between neighborhood disadvantage and drug use, and this relationship remains statistically significant net of controls for individual-level socioeconomic status. Neighborhood disadvantage is moderately associated with drug related behaviors, indirectly through increased social stressors and higher levels of psychological distress among residents of disadvantaged neighborhoods. A residual effect of neighborhood disadvantage remains, net of a large number of socially relevant controls. Finally, results from interactive models suggest that the relationship between neighborhood disadvantage and drug use is most pronounced among individuals with lower incomes.     

The impact of childhood abuse and neglect on adult mental health: a prospective study

This paper examines the impact of three types of victimization in childhood--sexual abuse, physical abuse, and neglect--on lifetime measures of mental health among adults. In contrast to research that relies on retrospective recall of childhood victimization, this work uses a prospective sample gathered from records of documented court cases of childhood abuse and neglect in a midwestern city around 1970. These subjects were interviewed about twenty years later. In addition, this research compares outcomes of the 641 members of the abuse and neglect group with a matched control group of 510 persons who did not have documented cases of abuse or neglect. The results indicate that men who were abused and neglected as children have more dysthymia and antisocial personality disorder as adults than matched controls, but they did not have more alcohol problems. Abused and neglected women report more symptoms of dysthymia, antisocial personality disorder, and alcohol problems than controls. After controlling for stressful life events, however, childhood victimization had little direct impact on any lifetime mental health outcome. This research indicates the importance of adopting an approach that places childhood victimization in the context of other life stressors and of prospective changes over the life course.     

Evidence-based medicine, clinical uncertainty, and learning to doctor

For the past two decades, evidence-based medicine (EBM), or the reliance on current scientific evidence to reach medical decisions, has been embraced as a new paradigm to standardize clinical care. Drawing from in-depth interviews with seventeen pediatric residents in two residency programs, we evaluate the extent to which the medical sociology scholarship on uncertainty analytically elucidates the recent influx of EBM during residency training. Our findings suggest that residents interpret EBM in varying ways to match their work practices: "Librarians" consult the literature while "researchers" evaluate it critically. For both groups, EBM might generate new uncertainties due to the increased reliance on information technologies and epidemiology. Whether EBM reduces uncertainty depends upon the residents' understanding of standardized knowledge and consequent incorporation of EBM in their clinical practice. Contrary to the predictions of some sociologists, EBM does not lead to a diminishment of humanitarian values in medical care. Nor does EBM lead to a science-based meritocracy on the patient ward, as claimed by some EBM advocates. Our conceptual updating of uncertainty emphasizes the continuous management of uncertainty during the medical socialization process. We argue that managing uncertainty develops along with what we term evidence-based clinical judgment.     

Assessing progress against the size of the problem

To summarize articles with the depth and range of the nine in this collection is difficult. What the articles demonstrate as a whole is that a great deal of activity is under way in the arena of connecting child welfare and substance abuse services, with a growing body of documentation accompanying it. The articles bode good news in that they indicate a broadening awareness of the interconnectedness of these issues, and they highlight a number of creative and effective programs that have been established to mitigate the problems. Tremendous challenges-from funding to outcomes research-however, are also made evident in this body of work.