Clinical program renovation management

The day-to-day management of medical practice is so heavily influenced by tactical imperatives that few physicians have the time to think strategically. Traditionally, the difference between tactics and strategy is not a major concern of most physician executives. The realm of tactics is the short run, when managers must make do with the fixed resources at hand. Strategy addresses the long run, when all resources and markets are variable. A tactical focus is understandable, maybe even acceptable, in industries where nothing challenges traditional approaches to production of an established product or service. However, medical care in the 1990s is changing so fast that a physician executive must devote an incredible amount of time and effort just to stay confused about what is going on.     

Environmental issues: the challenge for the chief executive

Businesses are under pressure to adopt environmental policies and incorporate them into their strategic business planning as a matter of routine. These pressures are coming from at least five sources--stricter legislation, consumer demand, competitive advantage, staff concerns and community pressure. The challenge is enormous but there is growing evidence that sound environmental management provides pay-off in bottom line results. Business organizations have a vital role to play and its good for them. There are opportunities for new business as well as threats to those organizations which continue to ignore the trends.     

Youth's recreation and drug sensations: is there a relationship?

Adolescents' social behaviors remain a mystery to parks and recreation providers. Adolescence is a "high-risk" time for all youth in terms of experimenting with potentially health-compromising behavior, whether alcohol, drugs, or sex. Most of these antisocial behaviors occur during adolescents' leisure time. These inferences gave impetus to this research effort. The study was designed to ascertain information on adolescents' preferences for pleasure: drugs or recreation. Data were collected from a sample of 100 high school students from a medium-sized college town, and 100 students from a rural town in Florida. Findings revealed four statistically significant associations in the motives or pleasures sought in recreation and in drug behaviors: "enhancement of popularity," "provision of a means for self-discovery," "achievement of personal goal," and means to rebel against parents. In reference to the latter motive, findings revealed that neither drugs nor recreation were used to rebel against parents. Findings also provide documentation of the value of recreation in insulating adolescents against many of the stressors of contemporary life.     

Conference on international manpower flows and foreign investment in the Asian region

This is a report from a conference held in Tokyo, Japan, in 1991 on the economic aspects of labor mobility in Asia. The authors briefly describe selected papers given at the conference and outline conference topics. A list of participants is included. (SUMMARY IN FRE AND SPA)     

Reattraction of needed skills to developing countries of origin

This research note briefly outlines International Labour Organization concerns about return migration in developing countries, research being done in the field, and activities in related fields. Attention is being focused on the following topics and areas of study: 1) recommendations and conventions which cover workers generally and migrant workers particularly; 2) measures to avoid the departure of skilled workers from developing countries; 3) special problems encountered in improving migrant professionals' working conditions; 4) developing a central pool of information on labor markets and employment at the international level; 5) bilateral or multilateral migration agreements to optimize the flows of health personnel, scientific workers, engineers, and high level technicians, protecting their rights, and facilitating their reintegration into the country of origin; 6) creating a compensation scheme for skill outflows and training substitutes to fill the gaps left behind by migration; 7) classifying migratory policies adopted by developing countries; 8) reattraction of needed skills to developing countries of origin; 9) transfer of know-how through expatriate nationals; 10) labor reinsertion patterns of migrants returning to Greece, Italy, Portugal, and Spain; 11) Socioeconomic reintegration of migrants returning to Pakistan and Uruguay; and 12) Sri Lanka's experience with self-employment schemes for returned migrants.     

Post-war immigration in the United States and the state of Minnesota: the process of entering an all-American community

The author focuses on characteristics of Polish immigrants in Minnesota in the years since World War II. Particular attention is given to the immigrants' adaptation to the American way of life and to democratic institutions after being accustomed to centralized power in a socialist system. "This article is based on participant observation, publications concerning immigration to the United States, and unstructured interviews with newcomers from Poland and other Eastern European countries." Distinctions are made among the characteristics of Polish-Americans, pre-World War II immigrants, war immigrants, and those who have come during the last 20 years, including groups that the author identifies as the "calculated-decision" immigrants, the post-Solidarity immigrants, and the "adjusted visitor" immigrants. Consideration is given to the demographic characteristics, legal status, education and employment, and territorial mobility of 35 Poles living in Minnesota who were interviewed by the author. (SUMMARY IN FRE AND SPA)     

Utilizing a game for both needs assessment and learning in adolescent sexuality education

A fact-gathering, experimental game proved to be an effective instrument in the needs assessment phase of an adolescent sexuality educational program aimed at low-income females. The game ("Family Few"), which covered the topics of menstruation and reproduction, was played by 35 Black, Hispanic, and white females aged 13-16 years recruited from medical and psychiatric clinics in Miami, Florida. The goals of the game were to elicit terminology used by participants, identify and correct misconceptions and misinformation, and determine if learning could occur. Although 57% of participants reported prior exposure to formal sex education, misinformation about the need for activity curtailment during menstruation and the importance of early pregnancy detection was widespread. Group members believed they needed to restrict activities involving physical exercise, sexual relations, water, and cold during menses and were not likely to seek medical or family consultation regarding a missed period until the end of the 1st trimester of pregnancy. Also evident was a need for accurate information on the side effects, risk factors, benefits, and effectiveness of contraceptive methods. The group responses enabled the sex educators to prepare a culturally responsive, developmentally oriented curriculum for further work with disadvantaged female adolescents. The group process was ranked highly on the Likert Scale by these teenagers as an enjoyable, useful means of information dissemination and problem solving.     

Researching in the Victorian censuses: a note on a computerized,annotated bibliography of publications based substantially on the census enumerators' books

The authors describe a project, begun in 1981, to locate, list, and annotate all the published work based substantially on the census enumerators' books for nineteenth-century censuses for England and Wales. The results are currently available in a computerized file, enabling a variety of searches by topic, geographical area, and type of population. Information is provided on using the data and the computerized bibliography. The authors note that, subsequently, data for censuses of Scotland and Ireland have been added.     

Temporary workers in Canada: a multifaceted program

"This article highlights important developments in the character of temporary worker flows to Canada between 1973 and 1985 through the use of unpublished data and new measures for analyzing this data. The number of employment authorizations are converted to person years to indicate the overall labor market impact of temporary worker flows and this measure is employed in an analysis of unpublished data from Employment and Immigration Canada. The analysis reveals that a significant and growing proportion of employment authorizations are exempted from governmental procedures which link the admission of temporary workers to the Canadian labor market." Reasons for these exemptions and policy implications are discussed