Die Akzeptanz der elektronischen Gesundheitskarte in Deutschland

Against the background of the increasing importance of eHealth, this contribution concentrates on the issue of acceptance regarding the introduction of the electronic health card (English for elektronische Gesundheitskarte, hereinafter referred to as eHC) on the part of the service providing health institutions. After presenting the general issue, the relevance of the subject is described and the eHC is defined. Then the eHC is classified in terms of terminology and afterwards the current state of research of investigations regarding acceptance in the field of eHC is presented and evaluated. Based on both the technology acceptance model and the relevant literature, the important factors influencing the attitude towards and the eventual use of the eHC are conceptualized and integrated in an investigation model. The empirical investigation took place throughout Germany within the scope of an online survey of the health care providers. All in all, 502 questionnaires were reflected in the evaluation of the willingness of acceptance. The empirical results show that regarding the perceived usefulness the performance of the system and a well balanced cost-/benefit-ratio lead to an increasing acceptance of the eHC. Being integrated in the decision process, however, is not relevant for the German physicians. Within the context of the perceived ease of use the compatibility of the system is much less relevant than the controllability or the general usability.     

Review essay: Slavery now: Unfree labour and modern capitalism

Capitalism and Unfree Labour: Anomaly or Necessity? Robert Miles. London and New York: Tavistock Publications. 1987. 250pp. £10.95 pbk.

The New Helots: Migrants in the International Division of Labour. Robin Cohen. Aldershot: Gower Publishing Co. 1987. 290pp. £8.95 pbk; £27.50 hbk.

Sugar and Modern Slavery: A Tale of Two Countries. Roger Plant. London: Zed Press, 1987. 177pp. £7.95 pbk; £24.95 hbk.

Slavery in the Twentieth Century. Roger Sawyer. London and New York: Routledge &; Kegan Paul. 1986. 274pp. £15.95 hbk.     

Food security, consumption diversification and foreign exchange balances in Indonesia: Results from a multi-commodity simulation

Many countries adopt economic development strategies, within which an important element is the maintenance of low and stable food prices. In Indonesia, this is achieved principally through government subsidies to consumers of imported rice, the total cost of which fluctuates considerably from year to year, depending on world price movements and domestic production performance. Higher and possibly less stable domestic food prices appear inevitable in Indonesia, however, as the spectre of reduced oil revenues increases the government's concern with the cost of its food policy. Results from a stochastic simulation model of the agricultural sector show that the food price risk to which consumers and producers would be exposed in the absence of the stabilizing component of Indonesia's food policy would be considerable, rendering this component an unlikely area for significant change. A viable policy option appears to be the continuance of rice and wheat price stabilization, but with a graduated increase in the relative price of rice, reaching a total of 10% by 1985. Such a policy could result in net self-sufficiency in foreign exchange from staple food trade by 1990 and an improvement in aggregate economic surplus, although the expected decade improvement in food-energy consumption per capita would fall from 10% to 8%.     

A Family Therapy Approach to Alcoholism*

Data accumulated from recent studies strongly suggest that family therapy is a promising method of treatment for alcoholism. In this paper a comprehensive treatment approach is proposed, based on known characteristics of alcoholic family systems and the author's clinical experiences in working with families of alcoholics. Specific strategies are described that can enhance treatment success by reducing resistances and maximizing changes in dysfunctional family interaction patterns. The relationship between the spouses is such as to perpetuate the need for alcohol. The major focus in therapy therefore is on understanding and changing the marital relationship.     

Micro Foundations of Religion: A Revised Theory

In a major revision of my earlier theoretical work on religion, I attempt to identify and connect the basic micro elements and processes underlying religious expression. I show that all primary aspects of religion—belief, emotion, ritual, prayer, sacrifice, mysticism, and miracle—can be understood on the basis of exchange relations between humans and supernatural beings. Although I utilize a cognitive definition of religion, this new version of the theory is especially concerned with the emotional and expressive aspects of religion. Along the way I also clarify the difference between religion and magic and this sets the stage for explaining the conditions under which religion (but not magic) can require extended and exclusive exchange relations between humans and the gods, thus enabling some religions to sustain stable organizations based on a lay membership.     

A likelihood ratio test for bimodality in two-component mixtures with application to regional income distribution in the EU

We propose a parametric test for bimodality based on the likelihood principle by using two-component mixtures. The test uses explicit characterizations of the modal structure of such mixtures in terms of their parameters. Examples include the univariate and multivariate normal distributions and the von Mises distribution. We present the asymptotic distribution of the proposed test and analyze its finite sample performance in a simulation study. To illustrate our method, we use mixtures to investigate the modal structure of the cross-sectional distribution of per capita log GDP across EU regions from 1977 to 1993. Although these mixtures clearly have two components over the whole time period, the resulting distributions evolve from bimodality toward unimodality at the end of the 1970s.     

Public accountability in non-profit industrial development organisations

Non-profit industrial development organisations (NIDOs) represent a common but little studied community response to widespread deindustrialisation in the United States. These non-profits are organised as chartered not-for-profit corporations, public authorities or agencies of local government. Most receive at least some public funding to promote local industrial development. Thus, a key issue is how accountable NIDOs are to the public they have been created to serve. Data from national surveys of NIDO executive directors in 1984 and 1994, as well as a survey of six case study boards of directors, suggest that public accountability is an increasingly important concern among NIDOs. Public hearings, efforts to diversify the boards in terms of gender and race, and connections to community development corporations and other local organisations are among the ways NIDOs attempt to be accountable to the general public. Although few women or racial minorities serve on NIDO boards, those boards with representation of these groups tend to be more concerned with public accountability. Boards containing public officials tend to be less concerned, presumably because their presence makes the NIDOs more directly accountable as a result of the participation of elected public representatives.     

A concept of an integrated transport model

This paper is one of a series being produced on the application of Operational Research techniques in the integrated planning of public service resource provision and consumption. It describes a conceptual basis for planning transportation services within the context of a public service, the others are related to Health Services, Educational Services and community development services.Two sub-models, a linear sub-model and a dynamic sub-model are linked to form the integrated approach to the planning problem. The overall concept is to evaluate in terms of penalties and benefits the alternative plans of resource provisions.It is of interest to know that the principles of the Linear model described here has been applied to long range planning in the Health Service in the U.S.A. and U.K., and has been reported at the NATO conference, Portugal (1974). The Dynamic model has been used, in a more unstructured fashion than described here, by the Greater London Councils. The model in this paper is to form the basis of a more detailed evaluation of alternative transportation plans.