Physician executives' persuasive styles of communication in upward influence situations

This article examines the communicator style choices of physician executives when attempting to persuade a superior whose own style of communication is attractive and unattractive. In the November-December 1990 issue of Physician Executive, the author reported on persuasive strategies physician executives use to influence such targets of influence. Whereas the earlier study focused on what physician executives communicate to be persuasive, the present investigation treated the way physician executives communicate to persuade attractive and unattractive superiors. The results suggest that the way physician executives communicate in upward influence situations is affected by the way their superiors communicate with them.     

Study tour examines health care systems in Germany, Holland--Part II: The German system

In October 1992, the American College of Physician Executives sponsored a study tour to Berlin, Germany, and Amsterdam, Holland. Meetings were held with government officials, third-party payers, and providers, and on-site visits were made at hospitals, clinics, and academic centers. The purpose was to study the health care delivery system in those countries and to share some insights with the countries' hosts on the U.S. system. In a series of reports that began in the July issue of the journal, 5 of the 10 study tour participants describe their impressions of the tour and of the health care systems in the countries that were visited. In the first report, the health care delivery systems of the United States, Germany, and Holland were compared. In this report, the German system is analyzed in greater detail.     

Immigration reform,American style

This article reviews the background of the proposed Immigration and Reform Act (also known as the Simpson-Mazzoli bill), which seeks to overhaul US immigration law for the first time since 1952. This bill is consistent with President Reagan's hard line on border enforcement and mandates stiff penalties for those who transport illegal aliens for commercial advantage or private profit. It further offers Mexico preferential treatment in immigration (40,000 additional visas/year). It includes an amnesty program to offer legal status to qualified illegal residents. The bill directs the President to develop a secure national worker identification system and would create a large-scale temporary foreign agricultural program for perishable commodities. Agricultural workers' families would not be eligible to accompany them unless they also obtain temporary visas. Foreign temporary workers, employable only in cases where local domestic workers are not available, must be provided with wages and working conditions equal to those prevailing among domestic workers. Stiff penalties are stipulated for employers who fail to abide with the terms of the program. In the author's opinion, this bill fails to appreciate the global character of international migration and its complexity. It relects a fundamental ambivalence about a strictly controlled main gate versus a back door approach to immigration as well as the conflicting images of the US as a nation of immigrants versus the historical reality of American nativism and xenophobia. Needed are comprehensive initiatives whose mutually reinforcing components can address the multiple dimensions of the immigration problem within a framework that does not ignore workers who have contributed to the economic well-being of the US, regardless of their legal status.     

Proxies for birth control. Comment on Kelly and Cutright,Sociological Focus,April 1983

Kelly and Cutright (1983), using regression techniques, conclude that birth control is among the more important determinants of Swedish illegitimacy. To derive this conclusion, they use changes in the marital fertility of wives aged 35-39 as a proxy for birth control. They maintain that annual change in the marital fertility rate of wives aged 35-39 is not likely to be greatly influenced by annual change in factors other than birth control. The "argument" appears to derive from the "desired family size" model of childbearing--a basic assumption of social demography. In it simplest form it states that most couples do not practice birth control until they reach a preconceived goal, or desired family size. It thus implies that a change in family size preferences will most affect the birth control practices of the oldest reproductive age groups. The simple form of the model has been questioned by the failure of Western couples to reproductively compensate for a major proportion of their child deaths, by the proportions of Western couples who say they would have preferred larger families than they actually had, by the predictive inadequacy of family size preferences, and by suggestions that age may be the more important determinant of reproduction. As a result some demographers now concede its inadequacy. Others are trying to relax its assumptions, with as yet problematic success. Essentially every Western fertility decline to date has been characterized by an increasing concentration of childbearing in the youngest age groups. In discussing this pattern social demographers have maintained that it could only have come about by a decline in family size preferences. This then is the standard argument supporting Kelly and Cutright's proxy for birth control. The authorities who offer it generally ignore the difficulties with the desired family size model and simply assert without justification that couples do in fact conform to it. Data on the age patterns of chronic disease and on the reproductive effects of environmental stressors suggest that the modern age pattern of fertility could also be produced by a deteriorating environment. Kelly and Cutright are incorrect in asserting that factors other than voluntary birth control could not be responsible for changes in fertility at ages 35-39. At best they may argue that their proxy is uniquely definitive provided that the desired family size model can be saved and provided the health of Western populations has not been compromised by technological change. At issue is a debate between what Dunlap calls the human exemptionalist and the ecological world views.     

Touristic authenticity,touristic angst,and modern reality

The tourist has become the symbol of a peculiarly modern type of inauthenticity. This paper explores the criticisms that have been directed at the reality experiences of the tourist. In so doing, the following inexhaustive typology of touristic realities is developed: 1) the first-order or true tourist, 2) the second-order or Angst-ridden tourist, 3( the third-order or anthropological tourist, and 4) the fourth-order or spiritual tourist. Each of these types represents a progressively more intense search for reality through travel. Each is, however, criticized for participating in its own form of inauthenticity.After exploring the reality experiences and criticisms of each of these travellers, the paper turns the tables on the cultured despisers of tourism to argue that perhaps the lowly first-order tourist is not so inauthentic after all. True, this traveller may not be having a real heroic adventure, but such is not the goal. Rather, the reality experienced by the first-order tourist is a pleasurable liberation from the normal concerns of everyday life which simultaneously reaffirms commitment to that reality. Quite frequently the first-order tourist is less concerned about having a real experience in the visited place than in experiencing family and friendship relationships-relationships completely ignored by the anti-touristic tourists in their search for authenticity in someone else's reality.The author would like to thank Peter L. Berger, Harry C. Bredemeier, Warren I. Susman, and M. Kathy Kenyon for their comments and suggestions on earlier versions of this paper. This research was supported in part by NIMH grant no. 5 T32 NH14660.     

Illegal immigrants in Canada: recent developments

Immigration policies and their management in a country like Canada have long been an interesting and instructive study for other countries. 1) With borders naturally protected by great distance from almost all migrant routes; 2) with a long, undefended border with the US and a further 3000 kilometers to its border on the south; 3) with a parliamentary system capable of comparatively rapid legislative and administrative responses to problems; and 4) with a relatively small legal, and even smaller illegal, population Canada had historically "experimented" with novel, often quite creative, immigration policies and programs to both encourage and control the increases in its population. This paper summarizes what Canada did and is doing in response to am important item of public policy--the entry and presence of illegal migrants. Canada has experimented with 1) discretionary amnesty for long-term illegals with a capacity to be successfully integrated into Canadian life, 2) tighter border controls with the extended use of the visitor's visa, and 3) employer sanctions. To address the problem more substantively, however, requires detailed study and significant change, including legislative change.     

Non-collegial simple games and the nowhere denseness of the set of preference profiles having a core

In recent papers, somewhat conflicting results on the generic emptiness of the core have been proven. Rubinstein (1979) has shown that the core is generically empty in the Kannai topology even without a restriction on the dimensionality of the alternative space. Schofield (1980) finds the core generically empty in the Whitney-C topology, but requires a dimensionality condition. This note explores the apparent conflict by proving a generalization of Rubinstein's result for the Whitney-C ⁰ topology, and showing that the result does not extend to the Whitney-C ¹ topology without a dimensionality condition.I would like to thank Kim Border and Richard McKelvey for their helpful discussion and comments. This research was supported in part by the National Science Foundation under Grant no. SES 78-2478781     

An analysis of cyclically dense data using EBLOC

Everett (1982a) has proposed a graph theoretic technique for analysing social networks. It is not usually possible to apply this method to data which contain a large number of interlocking cycles. We demonstrate a technique which overcomes this problem by referring to the data analysed by MacRae (1960).