The new health care civilization: integration of physician land and manageria

Changes occurring in health care demand that physicians expand their professional knowledge and skills beyond the medical and behavioral sciences. Subjects absent from traditional medical education curricula, such as the economics and politics of health care, practice management, and leadership of professional organizations, will become important competencies, particularly for physicians who serve in management roles. Because physicians occupy a central role in planning and allocating medical care services and other health care resources, they must be better prepared to work with other health care professionals to create a new civilization, even if this means leaving the cloistered domain of "physician land" to serve as interface professionals between the delivery of medical services and the management of health care. Our research findings and conclusions strongly suggest that economic, management, and leadership competencies need to be incorporated into the professional development of physicians, especially in postgraduate and continuing education curricula.     

Impact of an Overt Response System on Staff Performance and Maintenance of Computer-Based Instruction

Interactive Computer Based Instruction (CBI) systems involve teaching strategies to facilitate greater response opportunities during training in an effort to improve learner performance. The current study investigated the effect of online staff training videos with and without overt response requirements on posttest and maintenance test scores across six block-randomized instructional modules for four employees of a university located in the southeastern region of the United States. The overt response consisted of multiple-choice questions administered throughout select teaching modules using an alternating treatment design. Findings suggest that learning occurred as a result of the CBI training; however, the effectiveness of the overt response system varied across individuals, with no discernible differentiation between learning gains associated with response requirements. Other areas of research for expanding the efficacy of CBI and overt response systems are highlighted.     

The Eating Disorders NOS Diagnostic Profile Among College Women

Abstract

The authors examined a proposed profile of eating-related behaviors, associated features, developmental issues, and help-seeking behavior among college women, using an eating disorder response program. The most common symptom scenario was a pattern of regular binge eating, together with daily exercise and occasional purging. The most common associated features were distressing or dysfunctional overconcern about body image and self-esteem, usually with day-to-day stress and intermittent depression. The women who fit this pattern also presented developmental issues of perfectionism, conflictual relationships with parents, and struggles for independence; and they tended to be ambivalent about seeking services. Implications for practice, including the need to develop a framework for eating disorder responses on campus that includes preventive programs and developmental interventions to target emerging and moderate concerns are discussed; limitations and the preliminary nature of the findings are explicated.     

The Self-Employment of Men and Women: What are their Motivations?

Do men and women carry different motivations for entering self-employment? Earlier researchers have suggested that, as primary care givers for children and families, women face a more stringent time constraint relative to men. Thus, where men see self-employment as a chance for greater financial opportunity, women see a chance to take work that allows more time at home. This paper investigates this hypothesis using unique data that allow analysis of individual self-employment as a function of traditional economic and demographic variables as well as variables that partially capture individuals’ opinions and perceptions of pecuniary and nonpecuniary aspects of entrepreneurism. Results suggest that men who choose self-employment are influenced principally by pecuniary concerns, while women are influenced principally by family concerns and by the opinions of their family, friends, and peers.     

Inference problems in life testing under multivariate normality

Modified maximum likelihood estimators of the parameters of a multivariate normal distribution are developed when the smallest or largest observations on one of the components are censored. These estimators are used to construct tests for means and correlation coefficients. The robustness of these tests to deviations from normality is investigated.     

Roll-out neoliberalism and hybrid practices of regulation in Australian agri-environmental governance

In the last 15 years, agri-environmental programmes in Australia have been underpinned by a neoliberal regime of governing which seeks to foster participation and ‘bottom-up’ change at the regional level at the same time as encouraging farmers to become entrepreneurial and improve their productivity and environmental performance without government interference. However, while experiencing a degree of success in terms of farmer involvement, considerable tensions are evident in such programmes. Drawing on an ‘analytics of governmentality’, this paper argues that while current agri-environmental programmes enable authorities to combine often competing and contradictory imperatives under the rubric of single political problems—what has been termed hybrid forms of governing—it also contributes to the continuing failure of these programmes to achieve their desired effects. As a consequence, neoliberal forms of governing tend to be characterised by experimentation with a range of governmental technologies in order to make programmes workable in practice. We explore two different types of technologies—standards schemes and direct government regulation—that have emerged in recent years, and how these have sought to address the limitations evident in ‘participatory’ programmes. The paper concludes by arguing that while these initiatives seek to encourage farmer compliance in seemingly divergent ways, their capacity to be workable, and have broader effects, in practice will depend upon their capacity to manage the competing imperatives of environmental degradation, capital accumulation and private property rights.