Some specifics on the brain drain from the Andean region

An analysis of the brain drain from the Andean countries of Bolivia, Chile, Colombia, Ecuador, and Peru to the United States is presented. The data are from a survey of 62 persons from those countries who are currently residing in the United States and are listed in the current edition of "American Men and Women of Science". The reasons why they left their country of origin and are staying in the United States are considered. (summary in FRE, SPA)     

The meaning of patient satisfaction with prepaid primary health care in Israel

This paper reports the development of a self-administered Hebrew-language questionnaire for assessing patient satisfaction with primary care in Israel. Four scale measures of patient satisfaction were empirically constructed. These scales pertained to doctor conduct, doctor-patient communication, teamwork, and ease of access. In addition, a single direct question was used to measure overall satisfaction with the care. Ratings of all aspects of care were negatively skewed, with doctor-conduct and doctor-patient communication usually being the most satisfactory aspects and access the least satisfactory. It was shown that different practices, or the same practice at different points in time, can easily and meaningfully be compared, using mean satisfaction scores, measures of standard deviation, or percentages in each practice with ratings above (or below) the overall mean of all practices. The use of specific measures of patient satisfaction for comparison and intervention is discussed.     

Policy sources of worker dissatisfactions: the case of human services in aging

This article explores job dissatisfaction experienced by service providers in the field of aging and the policy sources of such dissatisfactions. Workers interviewed identified four major areas of complaint about their jobs: lack of resources, agency problems, mandates and regulations, and client characteristics. Such problems, it is argued, are associated with specific characteristics of policies under which the respondents work. These characteristics include the symbolic nature of legislation, policy ambiguity, universal entitlement, and calculated fragmentation. Whether or not policy changes should be made to alleviate worker dissatisfactions is discussed in the concluding section of the article.     

Blacks, whites, and attitudes towards abortion

This article examines patterns of black and white support forabortion from 1972 to 1980. The findings reveal that black-whitedifferences are present on the abortion issue. Many of the differencesare due to the different demographic characteristics of blacksand whites and the greater degree of religiosity of blacks.     

The impact of revolution on social welfare in Latin America

Conclusion The foregoing analysis assessed ways that revolutions affected the social welfare of Latin Americans. It compared differences between societies of roughly similar levels of economic development that did and did not have revolutions, revolutions ushered in by different class alliances, revolutions instituting different modes of production, and revolutions occurring in countries differently situated within the world economy. The class transformations in Mexico, Bolivia, Cuba, and Peru gave rise to more egalitarian societies than they displaced, but low income groups in each country gained most during the new regimes' consolidation of power. Subsequently, the interests of the popular sectors were sacrificed to those of middle and upper income groups. The rural masses benefited from revolution mainly in conjunction with agrarian reforms.Agrarian reforms have been promulgated in all the countries under study, but a much larger proportion of the agrarian population and a much larger proportion of the farmland has been redistributed in the four countries that had political upheavals than in the paired countries that did not. Whereas all the land reforms perpetuate minifundismo, recipients of land titles enjoy a modicum of security and the opportunity to appropriate the full product of their labor, which rural wage workers and peasants dependent on usufruct arrangements do not.Examining the countries that have had revolutions shows that peasants and workers do not necessarily benefit most when they participate in the destruction of the old order. Peasants and rural farm laborers gained land where they were disruptive, but in Mexico only after a global Depression weakened the ability of large landowners to resist expropriation. The Peruvian experience demonstrates that rural laborers may benefit even if they are politically quiescent at the time of the extralegal takeover of power, and that they may, under certain conditions, gain benefits sooner after revolutions from above than after revolutions from below. The level of development of the economy and the way the societies have been integrated into the world economy historically limit what Third World revolutions can accomplish, quite independently of how the upheavals originated. The four revolutionary governments adapted land policies to property relations under the anciens régimes, and they reorganized agriculture to profit from trade. Global constraints have also been one factor restricting labor's ability to improve its earning power and influence over the organization of production. Labor did benefit from the upheavals, but as the postrevolutionary governments became concerned with attracting foreign investment and foreign financial assistance, and with improving profits from trade, labor was marginalized. The Mexican-Brazilian comparison, however, suggests that the middle class and the small proportion of workers employed in the oligopolistic sector benefit more and the richest 5% less in societies where civilian groups have been incorporated into the political apparatus as a result of revolution than in equally industrialized societies where they have been excluded, in the absence of revolution.Revolutionary-linked forces may modify the income generating effect of capitalist industrial dynamics, though not to the advantage of the lowest income earners.The dominant mode of production instituted under the new order is the aspect of revolution most affecting patterns of land and income distribution and health care. To the extent that ownership of the economy is socialized the state has direct access to the surplus generated. Although the Cuban state has not consistently allocated the resources it controls to low income groups, because the Castro regime need not provide a favorable investment climate, it can more readily redistribute wealth downward than can the capitalist regimes. It accordingly has also been freer to redesign the health care delivery system in accordance with societal needs rather than business interests and market power. But the Cuban experience suggests that the distributive effects even of socialist revolutions can be limited. Although socialism allows certain allocative options that capitalism does not, the capacity to improve the welfare of Third World people by any revolutionary means is constricted by the weak position of less developed nations within the global economy, by investment-consumption tradeoffs, and by internal political and economic pressures.     

Behaviorally caused loss of health and the use of medical care

This paper extends the analysis of the demand for medical care to an aspect which has previously been ignored: variations in expected, as opposed to experienced, cause of losses of health and the current use of medical care. Losses of health which cannot be prevented by the prior use of medical care are hypothesized to decrease the use of medical care by reducing the rate of return to investments in health, ceteris paribus. The reduction in the rate of return occurs both because these losses curtail the length of the stream of benefits to the use of medical care and because prior use of medical care is not effective in reducing the occurrence of these types of loss. Empirical findings support this hypothesis. Results suggest that differences in expected losses may account for some of the differences in utilization of medical care by sex.     

Are sex differences in nonverbal and verbal behavior generalizable to mentally retarded persons?

Sex differences in three communication behaviors consistently found to be more common among females than males — smiling, gazing at one's partner, and sentence complexity — were examined through analysis of interviews with 78 institutionalized mentally retarded adults. While females were significantly more likely than males to smile or laugh, and tended to use longer, more complex sentences, the commonly observed sex difference in gazing failed to generalize to a retarded sample. These findings clarify limits on the generalizability of sex differences beyond college students and other normal populations.This research was partially supported by a grant to the Texas Tech University Research and Training Center in Mental Retardation from the Rehabilitation Services Administration, Department of Health Education, and Welfare.