Socialization to dying: social determinants of death acknowledgement and treatment among terminally ill geriatric patients.

Although the vast majority of deaths occur among terminally ill geriatric patients, little is known about the etiology of these patients' death acknowledgement and ultimate type of treatment. Based on interviews with 76 triads composed of physicians, terminally ill patients, and primary caregivers, this study uses the socialization perspective to identify the actors and actions that most strongly affect the patient's death acknowledgment and receipt of exclusively palliative care (i.e., socialization to the dying role). Whereas patient preferences and sociodemographic characteristics do not influence significantly the patient's odds of death acknowledgment, these odds are increased if their primary caregivers accept death, their physicians are not affiliated with a teaching hospital, and the terminal prognosis is disclosed to them and disclosed "matter-of-factly." Patients who acknowledge death, whose agents value pain alleviation over life-prolongation, and whose physicians are not affiliated with a teaching hospital, are substantially more likely to receive exclusively palliative rather than curative terminal treatment.     

Migration research and immigration policy

The author briefly reviews the impact of migration research on U.S. immigration policy over the period 1964-1992. Consideration is given to legal and illegal migrants and refugees.     

Realities of life and future prospects within two cultures: unaccompanied minor refugees from South East Asia in the Federal Republic of Germany

From August 1979 on, more than 30,000 refugees from South East Asia were accepted in the Federal Republic of Germany as quota refugees in a special program; among them were 1600 unaccompanied minor refugees. About 1500 were accompanied Vietnamese children and youths who had fled their home country as 'boat people' across the South China Sea. Unaccompanied minor refugees have, like all other recognized refugees, a legal claim to family reunion in the Federal Republic. Today, only parents can join their children and vice versa, and spouses their spouses. The 1st phase of socialization in the lives of the unaccompanied minor refugees evolved in the cultural traditions of their South East Asian country of origin up to the age of 10 to 15 years. In the 2nd phase of socialization--the enculturation--the child establishes its culturally specific emotionality, language, mentality, and patterns of behavior through interaction and verbal communication with the people nearest him. The 3rd phase of socialization begins at school age and reaches full significance at the age of starting to work, with the accompanying expectations of society. Most of the minor unaccompanied refugees from South Asia had already completed their enculturation--the establishment of their cultural identity. The realities of life the young single refugees as foreigners in German society are determined by 4 special factors: 1) the great cultural differences between their country of originin South East Asia and the resettlement country, 2) the young people left their homes as refugees and their resettlement in the Federal Repulic was determined by chance events, 3) they have to live there alone and without the emotional support of their families in a situation of cultural change, and 4) because of their Asian physiognomy they will always appear as foreigners even if they have integrated well. The future prospects of the young South East Asian refugees in German society will be determined primarily by to what extent they will be able to find a satisfactory place within both cultures.     

Computer support of placement planning: the use of expert systems in child welfare

Computers have become commonplace in nearly every setting, from home to office. In addition to their usefulness for managerial tasks, they have the potential to aid the primary decision-making tasks of professional social service workers. The benefits and background of such "expert systems" are explored, and the structure of one experimental consulting program for child welfare workers, PLACECON, is presented.     

How bad can a voting location be

Two questions concerning the location of a single facility by a voting process are investigated for transportation networks:

- What is the maximum number of customers located on the network preferring some rival point over a voting solution?

- How does the average distance of the customers to the facility increase when a voting location instead of a Weber location is chosen for the facility?

Complete answers are given for general networks and for certain planar networks, viz., the so-called generalized cacti.     

Selectivity,adaptation, or disruption? A comparison of alternative hypotheses on the effects of migration on fertility: the case of Brazil

This study, based on Brazilian data from 1976, compared the fertility of migrants and stayers at both origin and destination areas. Observed patterns of fertility differentials were then analyzed in terms of 4 hypotheses of fertility behavior focused on processes of socialization, adaptation, selectivity, and disruption. In the study sample, 31% of migrants moved from rural to urban areas, 45% of moves were between urban areas, and 20% of moves were between rural areas. Among rural-to-urban migrants, only 1/3 moved from traditional to modern regions. To uncover the main patterns of migrant and stayer fertility differentials in the study population, the major flows of migrants by origin and destination were disaggregated by recency of migration, education, and age. The overall conclusions were as follows: 1) rural-urban migration flows need to be disaggregated into various modern/traditional cross-classifications (e.g., modern-rural, traditional-urban, frontier-urban) and greater emphasis needs to be placed on rural-urban, urban-urban, and rural-rural flows; 2) no robust quantitative measures of migrant-stayer fertility differentials held across migrant groups, implying that migrants differing in terms of age, education, origin, and destination are likely to behave in significantly variable fashion with regard to stayer standards of fertility behavior; 3) migrant groups with overall lower fertility levels, such as the young and better educated, are less likely to experience significant fertility reduction to bridge the origin/destination fertility gap; 4) rural-to-rural migrants do not appear to experience any lasting fertility reduction even when they move to areas with lower overall fertility rates; 5) urban-to-rural migrants tend to bridge a larger fraction of the uphill fertility gap than rural-to-urban migrants; and 6) there was evidence of partial adaptation for most migrant categories once disruption effects disappear and evidence consistent with the socialization hypothesis (no fertility reduction for at least 1 generation) was apparent for migrants originating in the least developed parts of Brazil, the frontier region, and the traditional-rural region.