How to fire a physician

How does one fire a physician? In a word, carefully! Most of the legal protections for other employees apply just as well to physicians. And physicians have access to an expanded realm of protections because of the nature of their profession and because of its role in the health care delivery system. The ordinary employee cannot raise antitrust; the fired physician may very well raise just that issue. And yet the need to terminate a physician will sometimes, even though rarely, occur. How can the organization be certain that it has treated the physician fairly, has documented any and all offenses in a defensible fashion, and has generally followed accepted practices in all aspects of dealing with the physician? The author provides some guidelines for dealing with the problem or the incompetent physician.     

Child custody issues and co‐occurrence of intimate partner violence and child maltreatment: controversies and points of agreement amongst practitioners

The situation of families undergoing separation in a context of co‐occurrence of intimate partner violence (IPV) and child maltreatment raises certain issues related to child custody. The results presented in this paper were collected and analysed within the framework of a qualitative study aiming to identify the principal points of agreement and the main controversies amongst practitioners in several different types of organizations. Focus groups were held with a total of 43 practitioners from six different settings concerned with child custody in cases of co‐occurrence of IPV and child maltreatment. Although they agreed on the importance of ensuring the safety of victims of violence, their views diverged on three points: (1) the importance of preserving the father–child relationship; (2) collaboration between voluntary organizations and semi‐voluntary or legal agencies; and (3) consideration of cultural differences.     

TEACHING SUPPLY CHAIN MANAGEMENT THROUGH GLOBAL PROJECTS WITH GLOBAL PROJECT TEAMS

In this article, we describe the Global Project Coordination Course, a course in which project teams composed of three students from each of two overseas universities execute company‐sponsored projects dealing with global supply chain management issues. The $75,000 to $100,00 contributed in total by the three to four sponsoring companies funds all course expenses. We assess the benefits and challenges of the use of cross‐cultural project teams with diverse educational backgrounds. We conclude that the course provides a unique and effective vehicle for furthering students' knowledge of Supply Chain Management and Information Systems, improving understanding of “soft” issues, and training students to work in diverse, global, cross‐cultural project teams.     

The Role of Social Work Education in Advancing Social Development in the English-speaking Caribbean

This article presents a discussion of the role of professional social work education in advancing social development in the countries of the English-speaking Caribbean. It addresses issues around the development of the profession in the region, student enrolment, curriculum expansion and programme delivery by the institutions which offer social work education. The events which contributed to the emergence of social work education in the region during the fourth decade of the twentieth century and social work education's continued contribution to regional development are discussed. The prospective use of the new Global Agenda for Social Work and Social Development to advance the profession in the region in the twenty-first century is noted. The article concludes by highlighting the many challenges that currently impact social work education in the Caribbean and the fact that the development of social work education in the region is inextricably linked to the region's social development needs. Social work education as delivered through the University of the West Indies is used as the case in point for discussion.     

Cue-Reactive Rationality,Visual Imagery and Volitional Control Predict Cue-Reactive Urge to Gamble in Poker-Machine Gamblers

Poker-machine gamblers have been demonstrated to report increases in the urge to gamble following exposure to salient gambling cues. However, the processes which contribute to this urge to gamble remain to be understood. The present study aimed to investigate whether changes in the conscious experience of visual imagery, rationality and volitional control (over one’s thoughts, images and attention) predicted changes in the urge to gamble following exposure to a gambling cue. Thirty-one regular poker-machine gamblers who reported at least low levels of problem gambling on the Problem Gambling Severity Index (PGSI), were recruited to complete an online cue-reactivity experiment. Participants completed the PGSI, the visual imagery, rationality and volitional control subscales of the Phenomenology of Consciousness Inventory (PCI), and a visual analogue scale (VAS) assessing urge to gamble. Participants completed the PCI subscales and VAS at baseline, following a neutral video cue and following a gambling video cue. Urge to gamble was found to significantly increase from neutral cue to gambling cue (while controlling for baseline urge) and this increase was predicted by PGSI score. After accounting for the effects of problem-gambling severity, cue-reactive visual imagery, rationality and volitional control significantly improved the prediction of cue-reactive urge to gamble. The small sample size and limited participant characteristic data restricts the generalizability of the findings. Nevertheless, this is the first study to demonstrate that changes in the subjective experience of visual imagery, volitional control and rationality predict changes in the urge to gamble from neutral to gambling cue. The results suggest that visual imagery, rationality and volitional control may play an important role in the experience of the urge to gamble in poker-machine gamblers.     

Trait Mindfulness,Problem-Gambling Severity,Altered State of Awareness and Urge to Gamble in Poker-Machine Gamblers

In Australia, poker-machine gamblers represent a disproportionate number of problem gamblers. To cultivate a greater understanding of the psychological mechanisms involved in poker-machine gambling, a repeated measures cue-reactivity protocol was administered. A community sample of 38 poker-machine gamblers was assessed for problem-gambling severity and trait mindfulness. Participants were also assessed regarding altered state of awareness (ASA) and urge to gamble at baseline, following a neutral cue, and following a gambling cue. Results indicated that: (a) urge to gamble significantly increased from neutral cue to gambling cue, while controlling for baseline urge; (b) cue-reactive ASA did not significantly mediate the relationship between problem-gambling severity and cue-reactive urge (from neutral cue to gambling cue); (c) trait mindfulness was significantly negatively associated with both problem-gambling severity and cue-reactive urge (i.e., from neutral cue to gambling cue, while controlling for baseline urge); and (d) trait mindfulness did not significantly moderate the effect of problem-gambling severity on cue-reactive urge (from neutral cue to gambling cue). This is the first study to demonstrate a negative association between trait mindfulness and cue-reactive urge to gamble in a population of poker-machine gamblers. Thus, this association merits further evaluation both in relation to poker-machine gambling and other gambling modalities.