Shifts in household demographics herald economic changes for Thailand

In Thailand, dramatic changes in households and the health status of the population have led to important implications for the economic sector. These changes affect health, education, housing, employment and transportation. A new book on the economic impact of demographic change by Andrew Mason and Burnham O. Campbell is referred to as a full discussion of the issues. National planning and projections must include household characteristics as well as numerical projections. The analysis of Mason and Campbell is summarized in this article. Important changes are occurring in the size, rate of growth, and age structure of Thailand's population. Life expectancy has risen to 63 years for men and 68 years for women. Fertility has fallen to 2 children/woman. Population growth was 1.9% in 1990. In 1990, there were only 1 in 3 under the age of 15, and these numbers are expected to shrink to 1 in 4 by the year 2000. 60% of the population is of working age; this is expected to increase to 65% by the year 2000. The 60 years old population is expected to be 7.5% of the total in the year 2000. The average household has 1.6 children. 96% of households live with a relative. The expectation is that household size will continue to decrease and the number of households will continue to grow. The number of elderly heads of households is expected to rise to 11% by 2010. Households will become "adultified." The policy implications for education are that the school age population will gradually decreases but the number enrolled will increase. Primary school enrollment will stabilize and then decline after 1995. Secondary school enrollment will increase and level off in 2005. Total enrollment will increase from 10.5 million in 1990 to 11.4 million in 2000 and decline to 10.7 in 2015. These changes will allow for improvements in the quality of education and expand educational attainment. In health care, the demand for maternal and child health services will decline; changes will occur in the kinds of medical care needed.     

Comparing measures of poverty and relative deprivation: an example for Belgium

This paper presents three different poverty standards. A first approach takes the disposable income as an indicator of poverty. A second approach uses the Leyden approach. Finally an aggregate index of deprivation, based on the observation of consumption events, is constructed through a particular econometric procedure proposed by Desai and Shah (1988). These alternative measures are then compared on a sample composed of 6380 Belgian households. Such an analysis can be expected to provide some further insight into the problem of measuring poverty, which has been the subject of a recent controversial debate.We thank the participants of the Second Annual Meeting of the European Society for Population Economics, June 23–25, 1988, Mannheim (FRG), L. Gevers, J. Lindsey, P. Pestieau, B. Sak, K. Van den Bosch and two anonymous referees for their comments and suggestions.     

Clinical supervision: Its role in “Containing” countertransference responses to a filicidal patient

This paper illustrates the role of supervision in processing countertransference responses with might have disrupted the therapist's empathy with a patient who had killed her child. The clinical material demonstrates how the therapist's responses of initial denial and subsequent disgust and fear were dealt with in supervision. As a result, the treatment process led to genuine, albeit limited, therapeutic change in a patient with severe character pathology.This paper is developed from a presentation of the case of Mrs. Jay at Department of Psychiatry Grand Rounds, University of Cincinnati College of Medicine, on May 2, 1989.     

Under new management: the changing role of the state in the care of older people in the United Kingdom

This article examines recent changes and those currently being introduced in the formal care of older people in the United Kingdom. These are part of a general trend in all welfare states towards welfare pluralism but, in addition, the United Kingdom represents something of a special case because of the radical ideological engine that has driven the restructuring of the role of the state. The first part of the article outlines the main changes--the promotion of the private sector, the residualization of the public social services, and the new managerial role of the state in the care of older people. The second part considers the implications of these changes for older people and their informal helpers (or caregivers). The conclusion refers to both the particular changes taking place in the United Kingdom and, in general terms, to welfare pluralism as a policy goal.     

The private practitioner in hospital quality assurance

External forces continue to dictate the necessity of delivering high-quality health care along with methods of proving that the claimed quality is attained. Gone are the days when both the institution and its practitioners could answer quality questions simply by stating that they were delivering excellent health care to their patient population. The federal government, via the Health Care Financing Administration, and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) are mandating that institutions prove, without question, that they are delivering health care of the highest quality. The essential key to attaining these goals is cooperative private practitioners.     

Correlates of honor ratings in a clinical clerkship employing a faculty forum evaluation system

5he purpose of this study was to determine whether or not suspected variables affected a surgery clerk's chances of being awarded an honor rating. Findings indicated a significant relationship between a student receiving an honor rating and his or her preceptor's predetermined level of student advocacy, the number of completed patient interview and physical examination write-ups, and final examination scores. There was no significant relationship found between honor ratings and the preceptor's status, the sequence in which the student was discussed or the length of time spent discussing the student at the final evaluation meeting, or the number of clinical faculty present at the meeting. These results lend support to the faculty forum evaluation approach, but suggest a need for further scrutiny of some influencing variables to ensure all students are fairly considered and honor ratings judiciously awarded.     

Geographic distribution of undocumented immigrants: estimates of undocumented aliens counted in the 1980 census by state

"This article presents estimates of the number of undocumented aliens counted in the 1980 [U.S.] census for each state and the District of Columbia. The estimates, which indicate that 2.06 million undocumented aliens were counted in the 1980 census, are not based on individual records, but are aggregate estimates derived by a residual technique. The census count of aliens (modified somewhat to account for deficiencies in the data) is compared with estimates of the legally resident alien population based on data collected by the Immigration and Naturalization Service in January 1980." Estimates are provided "for each of the states for selected countries of birth and for age, sex, and period of entry categories.... The origins of the undocumented alien population [are described], as well as some of their demographic characteristics. Some of the implications of the numbers and distribution of undocumented aliens are also discussed." This paper was originally presented at the 1984 Annual Meeting of the Population Association of America (see Population Index, Vol. 50, No. 3, Fall 1984, p. 435).     

Mental health services for Chinese in a community health center

Serious mental health problems exist within the Chinese population of the United States. This article describes one center's attempt to meet the psychiatric needs of both nonpsychotic and psychotic Chinese patients through bilingual, culturally relevant treatments.