Practices and beliefs of the traditional Dinka healer in relation to provision of modern medical and veterinary services for the Southern Sudan

One class of traditional Dinka healers is a practical surgeon-bonesetter-obstetrician who practices (all but obstetrics) on both people and animals. His anatomical, physiological, and pathological knowledge and surmises, derived almost entirely from observations on cattle, are in some respects remarkable, especially those on the function of the kidney and nature of the circulatory system. He shares with ancient Egyptian healers the belief that sperm originate in the spinal cord and brain and performs a unique surgical operation on the horns of bulls that has been known in the Nile valley since the Egyptian 5th dynasty. With minimum training he might function effectively within the governmental health and veterinary services of the southern Sudan, an area populated mostly by transhumant cattle-culture peoples not easily reached through conventional health services.     

Negotiating for more than a slice of the pie

Negotiation is an important way for physician executives to manage conflict and to accomplish new projects. Because of the rapidly changing nature of the health care environment, as well as conflicts and politics within their organizations, managers need to effectively negotiate with a wide range of other parties. Managers should consider the relative importance of both the substantive and relationship outcomes of any potential negotiation. These two factors may guide the executive's selection of initial negotiation strategies.     

Consumer Evaluations of Food Risk Management Quality in Europe

In developing and implementing appropriate food risk management strategies, it is important to understand how consumers evaluate the quality of food risk management practices. The aim of this study is to model the underlying psychological factors influencing consumer evaluations of food risk management quality using structural equation modeling techniques (SEM), and to examine the extent to which the influence of these factors is country-specific (comparing respondents from Denmark, Germany, Greece, Slovenia, and the United Kingdom). A survey was developed to model the factors that drive consumer evaluations of food risk management practices and their relative importance (n= 2,533 total respondents). The measurement scales included in the structural model were configurally and metrically invariant across countries. Results show that some factors appear to drive perceptions of effective food risk management in all the countries studied, such as proactive consumer protection, which was positively related to consumers' evaluation of food risk management quality, while opaque and reactive risk management was negatively related to perceived food risk management quality. Other factors appeared to apply only in certain countries. For example, skepticism in risk assessment and communication practices was negatively related to food risk management quality, particularly so in the UK. Expertise of food risk managers appeared to be a key factor in consumers' evaluation of food risk management quality in some countries. However, trust in the honesty of food risk managers did not have a significant effect on food risk management quality. From the results, policy implications for food risk management are discussed and important directions for future research are identified.     

Integrating risk assessment and life cycle assessment: a case study of insulation.

Increasing residential insulation can decrease energy consumption and provide public health benefits, given changes in emissions from fuel combustion, but also has cost implications and ancillary risks and benefits. Risk assessment or life cycle assessment can be used to calculate the net impacts and determine whether more stringent energy codes or other conservation policies would be warranted, but few analyses have combined the critical elements of both methodologies In this article, we present the first portion of a combined analysis, with the goal of estimating the net public health impacts of increasing residential insulation for new housing from current practice to the latest International Energy Conservation Code (IECC 2000). We model state-by-state residential energy savings and evaluate particulate matter less than 2.5 microm in diameter (PM2.5), NOx, and SO2 emission reductions. We use past dispersion modeling results to estimate reductions in exposure, and we apply concentration-response functions for premature mortality and selected morbidity outcomes using current epidemiological knowledge of effects of PM2.5 (primary and secondary). We find that an insulation policy shift would save 3 x 10(14) British thermal units or BTU (3 x 10(17) J) over a 10-year period, resulting in reduced emissions of 1,000 tons of PM2.5, 30,000 tons of NOx, and 40,000 tons of SO2. These emission reductions yield an estimated 60 fewer fatalities during this period, with the geographic distribution of health benefits differing from the distribution of energy savings because of differences in energy sources, population patterns, and meteorology. We discuss the methodology to be used to integrate life cycle calculations, which can ultimately yield estimates that can be compared with costs to determine the influence of external costs on benefit-cost calculations.     

Work Alienation and Organizational Leadership

This study examines the extent to which a leader's behaviour (i.e. transactional and transformational styles) and aspects of an organization's structure (i.e. centralization, formalization dimensions) directly and/or indirectly relate to elements of work alienation (i.e. powerlessness, meaninglessness, self estrangement). The study utilized structural equation modeling techniques to estimate the goodness of fit of a leadership–organizational structure–work alienation model based on the responses of personnel in a major US eastern seaboard fire department (a bureaucratic, quasi–military type organization) ( n = 326). Goodness of fit statistics indicate good fit to the observed data. Results show that transformational leadership was associated with lower work alienation, whereas transactional leadership was associated with higher work alienation. Organizational structure was not significantly predictive of work alienation, but was negatively associated with transformational leadership and positively associated with transactional leadership. The significant indirect effects between organizational structure and work alienation, and between organizational structure and transformational leadership, provide further evidence that the leadership style of the organization has a more significant impact on feelings of work alienation than antecedent conditions such as organization rigidity. The study argues that managers as well as leaders need to question bureaucratic orientations to work and manager Ðemployee relations by rethinking their value orientations and adapting new models that encourage individual fulfilment, learning and personal development.     

Medicaid Expansions and Fertility in the United States

Beginning in the mid-1980s and extending through the early to mid-1990s, a substantial number of women and children in the United States gained eligibility for Medicaid through a series of income-based expansions. Using natality data from the National Center for Health Statistics, we estimate fertility responses to these eligibility expansions. We follow Currie and Gruber (2001) and measure changes in state Medicaid-eligibility policy by simulating the fraction of a standard population that would qualify for benefits in different states and different time periods. From 1985 to 1996, the fraction of women aged 15–44 who were eligible for Medicaid coverage for a pregnancy increased more than 20 percentage points. When we use a state and year fixed-effects model with a limited set of covariates, our estimates indicate that fertility increases in response to Medicaid expansions. However, after we include fixed effects for demographic characteristics, the estimated relationship diminishes substantially in size and is no longer statistically significant. We conclude that there is no robust relationship between Medicaid expansions and fertility.     

The optimum growth rate for population under critical-level utilitarianism

We characterize optimal consumption, capital, and population growth of a production economy under critical-level utilitarianism. First, we show that neither classical utilitarianism nor average utilitarianism can avoid a corner solution for the population growth rate, in that under the former, population grows at the maximum speed (the so-called repugnant conclusion) while under the latter, it grows at the minimum. Second, we show that critical level utilitarianism yields an interior solution for the population growth rate provided the critical level belongs to a positive, open interval. Finally, we characterize the transition to the steady state and perform comparative dynamics analysis.     

Why Youths Drop out of High School: The Impact of Preferences,Opportunities, and Abilities

In this paper, we develop and structurally estimate a sequential model of high school attendance and work decisions. The model's estimates imply that youths who drop out of high school have different traits than those who graduate—they have lower school ability and/or motivation, they have lower expectations about the rewards from graduation, they have a comparative advantage at jobs that are done by nongraduates, and they place a higher value on leisure and have a lower consumption value of school attendance. We also found that working while in school reduces school performance. However, policy experiments based on the model's estimates indicate that even the most restrictive prohibition on working while attending high school would have only a limited impact on the high school graduation rates of white males.