Gambling and the Law®: Endless fields of dreams

This article examines the current trends of proliferation of commercial gaming, especially in the United States, in the context of the third wave of legalization of gambling that has been experienced since the founding of the nation. The author looks at the historic foundations of the spread of casino-style gambling, and notes the types of casino gaming that have led the way in the current expansion. He also points out why it is reasonable to expect that this wave too may come crashing down, as general acceptance of wide-spread casino gaming in America may indeed be short-lived.Gambling and the Law^® is a registered trademark of I. Nelson Rose.     

Zeroing in on leadership effectiveness: The methodological challenges of benchmarking leadership practices

Business success in the 21st century will be based on the widespread mastery of leadership roles, rather than on the directives of a professional or leadership elite. The first step for systematically enacting a leadership development agenda for our nation is to identify the factors, values or qualities most important to leadership effectiveness. Next, we must improve our understanding of how these guiding ideas and insights translate into what successful leaders do. As we perfect this understanding, we will need to operationally define the best practices of successful leaders. These best practices must then become benchmarks for intensive leadership development efforts.This article considers nine methodological challenges of the first agenda item-identification of the factors, values or qualities most important to leadership effectiveness. To illustrate these challenges, the authors use their own business leadership research as a case study. This research surveys 127 chairmen, chief executive officers, and presidents-a cross section of successful U.S.A. business leaders, including men and women from all parts of the nation who have diverse industry, racial, ethnic and religious backgrounds. The authors identify where methodological improvements are needed to cope with the challenges of leadership research. They suggest important directions for methodological development and propose three minimum standards for future leadership research.     

Herding stats: the quality measurement dilemma

All over the country, millions of research dollars are being spent to devise an effective way of measuring quality that could be standardized in health care, and hospitals and managed care companies are experimenting with a variety of quality tools, trying to document what they now can only perceive as improvement. Experts are divided on what works best, but all applaud and embrace the efforts. In this special report, several of them discuss their views on what works, and what doesn't work, in the exploding field of health care quality measurement.     

Keeping the "care" in managed care: the importance of the therapeutic relationship and psychosocial factors in the managed care setting

There is much truth in the adage that "the more things change, the more they stay the same." Nowhere does this seem more apparent than in health care where, amidst monumental reconfiguration, basic foundations of physician-patient relationships and attention to the impact of psychosocial factors on health and health care delivery remain as critical influences. While the importance of the therapeutic relationship and the influence of psychosocial factors in medical care has been clear in traditional systems of delivery, these factors may be even more critical in managed care systems. These emphases must be incorporated by design, however, and not left to default.     

Ascendancy of primary care will create role intensification for physician executives

The need for physicians in management roles in the health care system has never been greater. And the years ahead will see that need broadened and intensified. To maintain their leadership role in medical affairs in hospitals and other types of health care delivery organizations, physician executives will have to envision provider organizations and systems that have not yet been conceived, let alone developed and implemented. They have to become totally open-minded and futuristic in their thinking. And they will have to help other physicians accommodate this new way of thinking if the medical profession is to continue in a leading role in health care matters. Although numerous factors will have to be anticipated and analyzed by these new physician leaders, the ascendancy of primary care in a managed health care world long dominated by the technical and technological superiority of hospital care will present a particular challenge to the physician executive.     

Drawing households and other living spaces in the process of assessment and psychotherapy

This paper introduces a drawing technique developed by the author for use in the assessment and treatment of individuals and families. The client is invited to draw a floor plan of his or her home or apartment, or an aerial view of un outdoor area. The drawing is then discussed and considered as a means of understanding critical elements of the experience of life space. The material derived is discussed from the eerspectives of family systems, psychodynamic, and abuse treatment theories, with special reference to notions of family structure, boundary, the self, and memory. Emphasis is placed on the actual physical layout of the home, as well as the subjective experience of it. Applications of the drawing technique for exploring memories are illustrated. Case examples are presented from clinical trials with children and adults in residential treatment, inpatient, and outpatient settings.The Heller Financial Corporation generously supports the development of household and spatial drawings for treatment and prevention. A version of this paper was presented at the 43rd Annual Meeting of the American Association of Psychiatric Services for Children, New Orleans, February 26, 1992. The author wishes to thank Robert B. Bloom, Ph.D., Excutive Director of JCB, for supporting the development of ideas and techniques discribed in this paper.     

International migration: demographic and socioeconomic consequences in the United Kingdom and Europe

"This article evaluates the consequences of international migration since World War II, with particular reference to Great Britain. It emphasizes the substantial differences between the origins and responses to immigration in the United Kingdom and that of the rest of Western Europe." It is found that "people of non-European origin from Commonwealth countries have predominated in postwar immigration to the United Kingdom. That migration neutralized the previously dominant pattern of emigration and increased U.K. population by about 3 million people through immigration and higher fertility, with only slight effects upon the age distribution."     

An evaluation of population projection errors for census tracts

"In this article we evaluate the accuracy and bias of projections of total population and population by age group for census tracts in three counties in Florida. We use [U.S. census] data from 1970 and 1980 and several simple extrapolation techniques to produce projections for 1990; we then compare these projections with 1990 census counts and evaluate the differences. For the total sample, we find mean absolute errors of 17%-20% for the three most accurate techniques for projecting total population and find no indication of overall bias. For individual age groups, mean absolute errors range from 20%-29%." This is a revised version of a paper presented at the 1993 Annual Meeting of the Population Association of America.     

Community,Family, and Race/Ethnic Differences in Health Status in Rural Areas1

Abstract Many race-specific differences in health outcomes that have been observed in previous research have been attributed to class and racebased group differences which either facilitate or constrain health opportunities and behaviors. These include such variables as different rates of poverty, health insurance coverage, and access to medical care. However, these relationships have been inadequately examined in rural communities where minority status may be even more detrimental to health than in urban areas, due to various constraints on access to health care. We present an analysis that assesses the effects of community, family structure, sociodemographic, and medical care variables on self-reported health status among Hispanics, Mrican Americans, and non-Hispanic whites in six rural communities in Florida. Community structural characteristics had a significant effect on self-reported health, as did some of the measures of how respondents “experience” community. These relationships held even when other sets of variables were added to the models. Family/household characteristics and sociodemographic and medical care variables were less important in explaining self-reported health status. These findings suggest that community continues to be important in explaining differences in health status in rural areas.