Evaluating risk: global fees and episodic care

In 1999, two articles in The Physician Executive -- "Part I: Global Theory and the Nature of Risk (July-August)." and "Part II: Towards a Choice-Based Model of Managed Care (October-November)" -- outlined the flaws of orthodox managed care theory and highlighted the unique advantages of moving to a genuinely market-based model, which included the concept of direct contracting for integrated episodes of care. This follow-up focuses on comparing an episode contracting system to a traditional capitated program and outlines the features that make this approach much more attractive to physicians, payers, and most importantly patients.     

"Conflict management" and "conflict resolution" are not synonymous terms

Robbins sees functional conflict as an absolute necessity within organizations and explicitly encourages it. He explains: "Survival can result only when an organization is able to adapt to constant changes in the environment. Adaption is possible only through change, and change is stimulated by conflict." Robbins cites evidence indicating that conflict can be related to increased productivity and that critical thinking encourages well-developed decisions. He admits, however, that not all conflicts are good for the organization. Their functional or dysfunctional nature is determined by the impact of the conflict on the objectives of the organization. The author identifies several factors underlying the need for conflict stimulation: (1) managers who are surrounded by "yes men"; (2) subordinates who are afraid to admit ignorance or uncertainty; (3) decision-makers' excessive concern about hurting the feelings of others; or (4) an environment where new ideas are slow in coming forth. He suggests techniques for stimulating conflict; manipulating the communication channels (i.e., repression of information); changing the organizational structure (i.e., changes in size or position); and altering personal behavior factors (i.e., role incongruence). Robbins stresses that the actual method to be used in either resolving or stimulating conflict must be appropriate to the situation.     

The Cost of a Calling? Clergywomen and Work in the Church of England

This article explores the work of clergywomen in the Church of England within an analysis of the Church as a gendered organization. We highlight the sex discrimination they often face, at the same time as satisfaction with their work and the need to follow their calling regardless of the difficulties. This is explained through an analysis of the significance of religious calling and the requirement for ‘sacrifice’ on their ability to endure their work and to challenge discriminatory treatment.     

AN ETHNOGRAPHY OF COUPLE AND THERAPIST EXPERIENCES IN REFLECTING TEAM PRACTICE

Couple and therapist perspectives about the use and process of reflecting team practice were analyzed using ethnographic research. A domain analysis was performed on postession interviews from both couples and therapists, and on field notes from each therapist. Seven couples and five therapists were interviewed at least twice over a 4-month period concerning their reactions to and perceptions of reflecting team practice. Six domains concerning reflecting team practice emerged from the analysis: (a)benefits of its use, (b) effects of gender, (c)recommended use, (d) contraindicated use, (e) the importance of creating spatial separateness between couple and team members, and (f) sequences of communication between the couple and team members that elicit change. The latter two domains described the process of reflecting team practice (i.e., steps in how it is used and how it is implemented). The role of ethnog rahy in reflecting team practice and in family therapy research is discussed.     

Energy modelling: A new challenge for management science

The Arab oil embargo in 1973 and the subsequent price rises and production restrictions have given birth to a distinct branch within Management Science: energy modelling. This paper gives a critical and selective review on energy modelling, an industry which though thriving in an era of general economic anxiety, is showing signs of arrogant immaturity. After giving a historical background, the paper classifies energy models into three groups: open loop demand or supply models; energy closed loop models; energy-economy closed loop models. For each group the problem area is analysed and some illustrative examples are described. In the last sections, an attempt is made to sum up the experience that has been gained with energy modelling: the basic deficiencies, the impact of this activity on policy formulation and its position within Management Science. It is concluded that energy models, though very poor forecasting devices, can be very useful to policy makers as tools for analysis; energy model developers must convince potential model users and for that purpose they can benefit immensely from the 35-year-long experience accumulated by their colleagues in Management Science.     

Large scale communication networks—Design and analysis

The paper discusses the problem of design and analysis of large scale communication systems. An iterative process, composed of a minimum cost network design algorithm and a network performance algorithm, is presented for the solution of these problems. Computational considerations, using these algorithms, are discussed.     

Youth Culture Religious Movements: Evaluating the Integrative Hypothesis*

This paper assesses the “integrative hypothesis” as an aid to understanding the current emergence of new religious movements appealing mainly to young persons. Four ways in which these movements reintegrate young persons into the social system are identified: adjustive socialization, combination, compensation, and redirection. The limitations of each of these as an explanation for the integrative consequences of youth culture religious movements are discussed. A distinction is made between adaptive movements which actually appear to reassimilate social “dropouts” into conventional instrumental routines, and marginal movements which appear to take converts out of conventional roles and routines, but which also perform latent tension management functions for the social system. The correlated properties of adaptive and marginal movements and the tendency for marginal movements to evolve into adaptive movements are discussed. Finally, the problem of “reductionism” in analyzing religious movements in terms of their latent integrative “functions” is discussed.     

The origins, early development and status of Bourdieu's concept of 'cultural capital'

The paper examines the context of the first introduction of the concept of 'cultural capital' in the sociology of education analyses undertaken in the early 1960s and published by Bourdieu in collaboration with Jean-Claude Passeron in 'Les etudiants et leurs etudes' (1964a) and Les Heritiers (1964b). It first considers the cultural contexts within which Bourdieu's thinking about culture originated--both in relation to his social origins and in relation to his intellectual training. It then examines the extent to which Bourdieu's early anthropological research in Algeria was influenced by his knowledge of American acculturation theory. It concludes that Bourdieu sought to use acculturation theory in a distinctive way--one which he articulated more confidently as he explored the relationship between agency and structural explanation in the late 1960s and early 1970s. The specific educational researches which stimulated the articulation of the concept of 'linguistic' or 'cultural' capital belonged to the period in which Bourdieu was only just beginning to refine his post-structuralist philosophy of social scientific explanation. To use these concepts now involves deploying them reflexively in accordance with Bourdieu's later thinking rather than at face value as they were first developed during the period in which he and Passeron were 'apprentice' researchers.