Physician executives: where they are and what they do

As hospital operations become increasingly complex, so does the institution's management and organizational structure. Physician executives with titles of medical director, vice president for medical affairs, medical administrator, chief of staff, medical staff president, etc., are playing more important roles than ever before. This article will briefly review some recent literature describing physician executive profiles. The results from a survey of ten university teaching hospitals are also presented as supplementary information regarding current staffing models. Finally, several physician executive staffing-related issues will be discussed in light of the literature and the survey results.     

Eliminating smoking from the workplace

Employers are more readily realizing that a nonsmoking policy in the workplace is a more effective way to run their businesses. They are recognizing costs such as productivity losses, increased health and life insurance costs, employer liability for diseases jointly linked to smoking and occupational exposures, absenteeism, passive smoking-induced health care costs among nonsmokers, workers' compensation, and fire losses. Concomitantly, employees are supporting policies that limit smoking to achieve a clean air environment. Former Surgeon General Koop's goal of "a smokefree society by the year 2000" is being recognized by more and more segments of society.     

German-Polish migration: the elusive search for a German nation-state

"This article examines past and present migrations to Germany from the perspective of nation-state formation.... Focusing on the many experiences with the Polish minority (ranging from the eighteenth century to the present), this essay suggests that Germans have never discovered an acceptable and workable approach for dealing with large non-German minorities in the German nation-state. Rather, different regimes at different times have vacillated between an exclusive approach founded on nationalist principles and practices and an inclusive one founded on liberal principles and practices.... The confusion over the two approaches produces not only a confused immigration policy, but also reflects deep-seated confusion over the definition of the new German state and identity of the newly united German nation."     

Return migration from Australia: a case study

"The study investigates the departure from Australia of former settlers who arrived during the 1980 calendar year. The 1980 settler arrival cohort [consists] of 75,167 visaed migrants.... The study has three main aims: (i) to analyse departures from Australia of the 1980 settler arrival cohort with a view to gauging the success of Australia's immigration program in retaining settlers; (ii) to examine the retention rates of settlers with respect to characteristics...including age, sex, marital status, country of last residence, and settler eligibility category; and (iii) to consider implications of the findings." Australia's present immigration policy is discussed, previous research on return migration from Australia is summarized, and a detailed analysis of the departure data is presented. "This study found that by August 1984, 12.4 per cent of non-refugee settlers who arrived in Australia during 1980 had departed permanently but that only 0.6 per cent of the 1980 refugee cohort had done so." These figures represent a decline in immigrant departure rates since the 1960s and early 1970s. Small differences in departure rates by place of birth, age, and marital status, which may have demographic consequences if sustained over time, are noted. (SUMMARY IN FRE AND SPA)     

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     

Spontaneously settled refugees in Northwestern Province,Zambia

The UN High Commissioner for Refugees (UNHCR) commissioned researchers from the University of Zambia to conduct a socioeconomic survey and census of "spontaneously settled" Zairean and Angolan refugees in the Northwestern Province of Zambia in 1982. The sample consisted of 188 Angolans, 201 Zaireans, and 2 South Africans. The difficulties experienced by refugees in Northwestern Province in achieving integration were related to a combination of factors including the lack of a clear national policy on refugees and refugee status, a national concern for maintaining security, the popular belief that aliens are responsible for an increasing crime rate, the desire by immigration officials for stricter laws to control alien infiltration, conflict between traditional and modern leaders, and Zambia's deteriorating economic situation. In spite of the problems described, the integration of refugees into existing communities is a desirable goal and should be encouraged. One should not assume that self-settling refugees are able to live with ethnic kin, receive assistance and hospitality, and thus are better off than those in camps. The Zambian case provides ample evidence that integration is not easy even with kin support, shared ethnicity, language, and historical connections. Moreover, given the fact that Zambia will continue to receive refugees it is vital that there is a well defined refugee policy and an administrative mechanism for implementing that policy at all levels. This will be particularly important in Zambia as it will undoubtedly continue to receive large influxes of refugees, from countries such as Namibia, Uganda, Angola, Mozambique, and South Africa.     

Contributors to disruption and dissolution of older-child adoptions

According to recent evidence, adoptive placements that do not work out are increasingly common. This article reviews research on rates of, and contributors to, adoption and "foster-adoption" disruptions and dissolutions. Implications for practice are included.     

Relationship quality of gay men in closed or open relationships

This study compared gay men in monogamous ("closed") relationships (n = 98) and gay men in nonmonogamous ("open") relationships (n = 34). Partners in open relationships were living together significantly longer than partners in closed relationships. Partners in the two types of relationships did not differ in Psychological Adjustment. Controlling for length of time living together, partners in closed relationships reported higher Affiliation/Dependency, more Favorable Attitudes toward the Relationship, and lower Tension than partners in open relationships. Global relationship quality for both types of couples was related to many Attractions, many Barriers, and few Alternatives to the relationship; few beliefs regarding both Disagreement is Destructive and Partners Cannot Change; high Dyadic Attachment; high Shared Decision Making; and low Psychological Maladjustment. Partners in both types of relationships were more similar to each other than different from each other, especially on the variables of Relationship Quality, a belief in Partner Changeability, and Dyadic Attachment.     

The nature and scope of international migration data in Nigeria

Nigeria, the largest country in Western Africa, has been attracting migrants from neighboring countries for the past decade or so. Although most of the movement of African migrants has occurred outside the regulatory framework set up to control migration, it is important to know the main elements of the latter to understand the likely limitations of the data collection systems currently in operation. Sources of data on international migration include censuses, arrival and departure statistics, work and resident permits, and sample surveys. The author concludes that, with the exception of information on residence and work permits, the relationship between Nigeria's data sources and the laws regulating migration is weak. Arrival and departure statistics, in particular, are not designed to distinguish migrants from all other international travellers. Lacking the political will to modify the system in accordance with internationally accepted recommendations, the prospects for increasing the usefulness of available data are grim.     

Efforts to improve international migration statistics: a historical perspective

During the past decade, the international statistical community has made several efforts to develop standards for the definition, collection and publication of statistics on international migration. This article surveys the history of official initiatives to standardize international migration statistics by reviewing the recommendations of the International Statistical Institute, International Labor Organization, and the UN, and reports a recently proposed agenda for moving toward comparability among national statistical systems. Heightening awareness of the benefits of exchange and creating motivation to implement international standards requires a 3-pronged effort from the international statistical community. 1st, it is essential to continue discussion about the significance of improvement, specifically standardization, of international migration statistics. The move from theory to practice in this area requires ongoing focus by migration statisticians so that conformity to international standards itself becomes a criterion by which national statistical practices are examined and assessed. 2nd, the countries should be provided with technical documentation to support and facilitate the implementation of the recommended statistical systems. Documentation should be developed with an understanding that conformity to international standards for migration and travel statistics must be achieved within existing national statistical programs. 3rd, the call for statistical research in this area requires more efforts by the community of migration statisticians, beginning with the mobilization of bilateral and multilateral resources to undertake the preceding list of activities.