RESPONSE-TIME MEASUREMENT IN SURVEY RESEARCH A METHOD FOR CATI AND A NEW LOOK AT NONATTITUDES

The paper introduces a methodology for measuring accuratelythe time it takes respondents to answer questions in computer-assistedtelephone surveys. The methodology, which is completely invisibleto respondents, comprises a computer "clock," capable of timingresponses with millisecond accuracy, and a "voice-key" thatconverts sounds emitted by respondents into signals capableof triggering the computer clock. Response times to questionson a range of attitude questions, including stable and unstableattitudes, were measured. The results revealed orderly normsin the latencies associated with various types of survey questions.The latencies associated with the expression of stable and unstableattitudes are discussed in the context of the notion of "nonattitudes"and shed new light on this controversial thesis. Overall, ourresults demonstrate that response latencies can be measuredprecisely and reliably in telephone surveys and that the datafrom such measurement open new windows on the cognitive dynamicsof survey responses.     

Family ties and economic stability concerns of migrant labour families in Jordan

74 labor migrant families from various socioeconomic classes in Amman, Jordan were interviewed to examine changes in relationships among family members, extended family, and neighbors and their concerns about economic stability in the host country, Jordan, and the world market. Another purpose was to determine how current migration policies of the Arab oil-producing countries which prohibit labor migrants from bringing their families to the host country affect labor migration among families. The families consisted of either those who did or did not accompany the labor migrant. Overall labor migration affected unaccompanied families more than accompanied families, e.g., only 19% of the unaccompanied families reported increased family unity compared with 56% of accompanied families. Problems within unaccompanied families increased in 43% of the cases but in only 6% of the accompanied families. Many of these problems resulted in children dropping out of school which reflected the control fathers had within the family, separation, or divorce. Yet labor migration reduced family ties with extended family members and neighbors almost equally for both groups. Accompanied families were not as concerned about economic stability in Jordan as unaccompanied families (38% vs. 50%). Perhaps these families tended not to invest remittances received from the labor migrants working in Arab oil-producing countries in Jordan. Both groups were quite concerned about the economic stability in the host countries (66% and 72%, respectively) and the world market (59% and 62%, respectively), however. Since family unity suffers when families do not accompany labor migrants, it is suggested that oil-producing nations that depend on foreign labor should guarantee family unity as a human right.     

Reconciling commodities and personal relations in industrial society

Conclusions I began this article with Colin Campbell's lament about the productionist bias in sociology and the related point that most sociologists concerned with consumption have ignored private meanings and small-scale structures in favor of public meanings and large-scale structures. This article calls attention to and builds on an emerging alternative approach to what happens after production, using an understanding of the social nature of objects that springs from Marcel Mauss's distinction between gifts and commodities.Mauss's model directs attention to the conflict in industrial societies between the two realms of commodity exchange and gift exchange, which I have cast as the conflict between the world of work and the world of family, and as the contrast between commodities and possessions. Thus, the model directs attention to the fact that objects are not simply transformed in production and displayed in consumption. However important these facts may be for understanding objects and society, they do not exhaust the important ways that people experience, use, and think about the objects that surround them. In particular, Mauss's model throws into relief the problematic nature of the objects that surround us and that we use in our social relations. And in doing so it directs attention to the ways that people try to reconstruct and redefine those objects by transforming them into personal possessions. This transformation makes objects acquired as commodities suitable for gift transactions, and hence suitable for the key task of recreating social relationships and social identities, the task of creating, not merely defining, who we are and how we are related to each other.Although the Maussian model addresses many of the links between people in the worlds of work and the home, and many of the ways that objects are part of these links, I am concerned here primarily with the ways that people can appropriate commodities in the process of purchase: shopping. This concern with shopping points out the social significance of retail trade, which I take to include advertising and shopping. This is not simply a passive conduit between production and consumption. Instead, it is an important point at which objects begin to leave the realm of work, commodities, and commodity relations and enter the realm of home, possessions, and gift relations. Shopping is an ubiquitous activity in industrial society and one that is highly significant culturally: we spend vast amounts of time, energy, money, and attention on it. Doubtless part of the reason for this is utilitarian, for we need to buy to live, but it would be foolish to reduce the significance of shopping to some combination of the need of individuals to acquire in order to survive and the need of companies to generate demand in order to profit. Thus, retail trade needs to be seen as well as a set of relations and transactions between seller and buyer that define and are defined by the objects and services involved, their history, and their future. My focus on purchasing food in supermarkets has the advantage of throwing into relief the problem of appropriation, because of the impersonality of object and social relations in large, self-service supermarkets. However, the very extremity of this example can create a false impression. As I noted, in other forms of shopping the social relations between buyer and seller, like the social identity of objects, can be more personal. This personality can be real, as when buyer and seller know each other or where the object is hand-made or even unique. Alternatively, it can be more purely symbolic, as when the selling company touts itself or its employees as friendly and caring or where the manufacturer advertises the personal nature of its commodities. In some cases, indeed, the manufacturing or trading company can present itself in such a way that the company itself becomes the person with whom the purchaser transacts. In addition, because of the focus on the appropriation of commodities in purchasing, I have touched only briefly on production and the world of work more generally. As does life at home, so life at work involves the transaction of objects and labor. Relations at work, then, will shape and be shaped by the nature of what is transacted. Co-workers who transact things that are more clearly stamped with their own identity, as among service workers and craft producers, will likely have more personal relations with fellow workers than will those who transact things that are themselves relatively impersonal, as in assembly-line production. This variability in the objects and relations at work suggests that people will have diverse understandings of work, and hence of manufactured objects more generally, which will affect the need they feel to appropriate commodities. In all, though, the point of this article is simple. People use objects to create and recreate personal social identities and relationships, and in industrial capitalist societies these objects are likely to be produced and purchased as commodities and understood as manufactures in Miller's sense. Our experience with and understanding of the production and sale of objects will affect the way we use them in transactions that create and recreate social identity and relationship, and will affect our understanding of the social identities and relationships that are created and recreated. Thus, the objects that people use in social relationships mediate between realms of economy and society, between the public realms where those objects are produced and distributed, and the private realms where those objects are transacted as part of social reproduction. The fact of this mediation and its effects on people's understanding of objects and social relations deserve careful attention.

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Problems in measuring role strains and social functioning in relation to psychological symptoms

The problems that people experience in social roles can be regarded as either causes or consequences of psychological symptoms. To reflect one of these possibilities, Pearlin et al. (1981) developed measures of "role strains" which are considered sources of psychopathology. To reflect the other position, Dohrenwend et al. (1981) constructed measures of "role functioning" which are seen as consequences of psychopathology. We show that the measures developed by these two teams of investigators are similar in content and show substantial empirical overlap despite the different meanings attributed to them. In an effort to understand whether these highly correlated measures assess, "role strain" or "role functioning," we conduct an exploratory analysis of marital and housework role problems, using a small panel sample of New York City residents. Specifically, we use instrumental variables to identify reciprocal effects between psychological distress and each role area. We find that the relationship between housework role problems and distress is more consistent with Pearlin et al.'s interpretation, whereas the relationship between marital problems and distress is more consistent with that of Dohrenwend et al. Investigators interested in measuring either role strain or role functioning must bear in mind the strong possibility of contamination from the other construct.     

Bringing baby home: a comprehensive case management program for obstetrical services

Originally presented to the Society of Home Health Care Management of the American College of Physician Executives at its November 16, 1993, meeting in Tucson, Ariz., the program described in this article was the winner of the College's 1994 Innovations Award in Medical Quality Management, sponsored by Merck Sharp & Dohme. The program shows the potential of case management for both improvement in the quality of care and containment of costs for a managed care population with a substantial Medicaid segment. This article is part of a continuing series on innovative programs in home health care.     

Delivery and funding are provincial matters in Canada

The following article is one of a series that deal with the provision of health care services around the world. Other countries in the series include Germany, Italy, Japan, Mexico, the Netherlands, and the United States. Countries scheduled for coverage in the series include Austria, France, Singapore, Spain, and the United Kingdom. The countries are described using a grid of characteristics so that comparisons may be made more easily. All of the analyses, along with further comparative data, will be gathered into a freestanding book to be published later in the year. Dr. Mendoza serves as editor for the project.     

IRS offers safe harbor in physician employment contracts

Last year, the Internal Revenue Service (IRS) issued Revenue Procedure 93-19 (Rev. Proc. 93-19), which provides guidelines regarding service and other contracts involving facilities financed with tax-exempt bonds. Rev. Proc. 93-19 creates four "safe harbors" for certain contracts signed by tax-exempt organizations that will not jeopardize the organizations' tax-exempt bond interest. Those guidelines and methods for complying with them are the subject of the following article. "Health Law" is a regular feature of Physician Executive contributed by Epstein Becker & Green. Mark Lutes of the law firm's Washington, D.C., offices serves as editor of the column.     

Education and the professionals. Some aspects of innovation in medical education adopted by Ahfad University for Women

This article describes the establishment in 1990 of a School of Medicine at Ahfad University for Women in Sudan. The school was premised on the view that women doctors would have a better opportunity to affect and improve women's health than men doctors. The curriculum is innovative and relies on a community orientation and a problem-solving approach. Medicine and health are taught in a holistic way. The new approach is rooted in the Alma Ata Declaration in 1978 of Health for All by the year 2000. The new method of delivery of medical care in the School of Medicine is based on the promotion of health through health education, prevention of disease, proper nutrition, provision of a safe water supply, attention to maternal/child health and family planning, and attention to the treatment of endemic diseases. In order to teach primary health care, medical schools must change their practices. Delivery of health care will have to be changed. New curriculum approaches emphasize learning objectives in each of the teaching modules and small group teaching. Integrated learning means the separate disciplines of medicine are taught as a whole multidisciplinary unit. Case management learning has the potential for increasing motivation and the ability to discover the knowledge needed to solve the problem. McMaster University relies on a problem-oriented approach to medical education that prepares the student for coping with changes in medical knowledge in the future. The challenge for educators is to create an efficient and comprehensive curriculum that will prepare a doctor for lifelong learning. Health settings have also changed to deemphasize sophisticated hospital settings in favor of community-based health centers. Ahfad University is the only one of its kind in Sudan. Medical education includes 6 years of schooling divided into 3 phases.