Administrative fellowships in emergency medicine

Physicians today need to be effective managers, as well as clinicians. In previous years, physicians gained managerial experience either through on-the-job training, degree programs, or continuing medical education courses. The specialty of emergency medicine began its first administrative fellowship in 1990 in California. Currently, three administrative fellowships exist nationally in emergency medicine. This article will describe the purpose of the fellowships and their curricula. Each fellowship has a different emphasis, with the goal to educate physicians who are interested in developing administrative skills to manage emergency departments or management groups or accept roles in hospital leadership. The existence of these fellowships will ideally influence the establishment of administrative fellowships in other specialties.     

‘I'm Mexican,remember?’ Constructing ethnic identities via authenticating discourse1

This paper examines how an ideology of cultural authenticity emerges in the casual but playful conversations of a bilingual Mexican American friendship group. Authenticating discourse, as illustrated here, is part of an ongoing, ordinary interactional routine through which speakers take overt (authentication) stances, which I call authenticating moves, to display, impugn, vie for, and enact forms of ethnic identity. In the data, issues of authenticity in relation to Mexicanness emerge as a result of the interactional exploitation of three ideological constructs: purity of bloodline, purity of nationality, and Spanish linguistic fluency.     

Estimating excess deaths in Iraq since the US—British-led invasion

No-one knows how many Iraqis have died as a result of the invasion of their country. Surveys published in The Lancet in 2004 and 2006 estimated the number at 10 times figures previously given. Predictably, they raised a storm of protest. Politicians attacked the surveys; public media gave their own spin. Here Scott Zeger and Elizabeth Johnson , statistical analysts of the surveys, discuss these and other attempts to count the dead, and how statistical messages should be best communicated.     

“I Try Not to Depend on Anyone but Me”: Welfare‐Reliant Women's Perspectives on Self‐Sufficiency,Work, and Marriage*

Welfare reformers sought to reduce “dependency,” or reliance on state‐supported cash benefits and deployed a discourse of “self‐sufficiency” to promote the legitimacy of efforts to remove welfare recipients from publicly funded cash assistance through either wage labor or marriage. We use longitudinal, qualitative interview data collected from 38 initially welfare‐reliant women to examine what self‐sufficiency means to them and their perspectives on how work and marriage affect their ability to be self‐sufficient. Grounded theory analysis revealed that for these women, self‐sufficiency means formal independence from both the state (i.e., Temporary Assistance to Needy Families [TANF]) and men (i.e., marriage). Although they value marriage as an institution and would ideally marry, they do not consider marriage to be a likely route to self‐sufficiency given the pool of men available to them. Rather, they embrace their own market‐based wage labor as the means by which they can attain some measure of independence. Taking our lead from the women in this study, we challenge the emphasis on marriage in current welfare policy. We argue that employment training that results in better jobs for women and men and work supports that make low‐wage work pay are clearly the appropriate direction for policy aimed at the welfare‐reliant and working poor.     

Transformative Processes in Marriage: An Analysis of Emerging Trends

The study of conflict has dominated psychological research on marriage. This article documents its move from center stage, outlining how a broader canvas accommodates a richer picture of marriage. A brief sampling of new constructs such as forgiveness and sacrifice points to an organizing theme of transformative processes in emerging marital research. The implications of marital transformations are explored including spontaneous remission of distress, nonlinear dynamic systems that may produce unexpected and discontinuous change, possible nonarbitrary definitions of marital discord, and the potential for developing other constructs related to self‐transformation in marital research.     

What Affects the Quality of Economic Analysis for Life‐Saving Investments?‡

Economic analysis of life-saving investments in both the public and private sectors has the potential to dramatically improve longevity and the quality of life, but only if the analyses on which decisions are based are done well. In this article, we analyze a data set that provides information on the content and quality of journal articles that measure the cost-effectiveness of life-saving investments. Our study is the first to provide a detailed multivariate analysis of factors affecting objective measures of quality. We also explore whether a series of recommendations by an expert panel convened by the U.S. Public Health Service affect the way analyses of specific life-saving investments are done. Our results suggest that four factors are positively correlated with an index we construct to measure analytical quality: (1) having at least one author affiliated with a university, (2) publication in a journal that has experience in publishing these analyses, (3) if the life-saving investment is located in the United States, and (4) if the analysis considers a measure of social costs or benefits. Somewhat surprisingly, a study's funding source and whether it is affiliated with industry are not significantly correlated with the quality index. Finally, neither time nor the panel guidelines had an impact on the index.