The Division of Household Labor in Germany and Israel

We compare the patterns of household division of labor in Germany and Israel—two countries that share key elements of the corporatist welfare regime but differ in their gender regimes—and evaluate several hypotheses using data from the 2002 International Social Survey Program. Although time constraints and relative resources affect the division of household labor and women’s housework in both societies, we find that in Germany the gender order of household labor is more rigid, whereas in Israel the spouses’ linked labor market status exerts distinctive effects. We also find significant relationships between gender ideology and the division of household labor. We discuss the theoretical advantages of approaching the comparative study of gender inequality from the vantage point of family and gender regimes.     

Legal implications of managed care arrangements

Prior to the 1980s, managed care was virtually nonexistent as a force in health care. Presently, 64 percent of employees in America are covered by managed care plans, including health maintenance organizations (20 percent) and preferred provider organizations (44 percent). In contrast, only 29 percent of employees were enrolled in managed care plans in 1988 and only 47 percent in 1991. To date, the primary reason for this incredible growth in managed care has been economic-market pressure to reduce health care costs. For the foreseeable future, political pressures are likely to fuel this growth, as managed care is at the center of President Clinton's national health care plan. Although there are numerous legal issues surrounding managed care, this article focuses primarily on antitrust implications when forming managed care entities. In addition, the corporate practice of medicine doctrine, certain tax issues, and the fraud and abuse laws are discussed.     

The meaning of patient satisfaction with prepaid primary health care in Israel

This paper reports the development of a self-administered Hebrew-language questionnaire for assessing patient satisfaction with primary care in Israel. Four scale measures of patient satisfaction were empirically constructed. These scales pertained to doctor conduct, doctor-patient communication, teamwork, and ease of access. In addition, a single direct question was used to measure overall satisfaction with the care. Ratings of all aspects of care were negatively skewed, with doctor-conduct and doctor-patient communication usually being the most satisfactory aspects and access the least satisfactory. It was shown that different practices, or the same practice at different points in time, can easily and meaningfully be compared, using mean satisfaction scores, measures of standard deviation, or percentages in each practice with ratings above (or below) the overall mean of all practices. The use of specific measures of patient satisfaction for comparison and intervention is discussed.     

Beyond the urban stream syndrome: organic matter budget for diagnostics and restoration of an impaired urban river

In response to water quality standard violations linked to excessive organic matter (OM) and a lack of sampling data informing the Total Maximum Daily Load (TMDL), an organic matter budget was created to quantify and identify sources of OM in the lower Jordan River (Salt Lake City, UT). By sampling dissolved, fine and coarse particulate OM, as well as measuring ecosystem metabolism at seven different sites, the researchers aimed to identify the origin of excess OM, and understand pathways by which different size classes of the OM pool are generated. The dissolved fraction (DOM; 94 %) was found to be the dominant form of OM transported within the river with fine particulate organic matter (FPOM; 6 %) the second most abundant, and coarse particulate organic matter (CPOM; 1 %) transport relatively insignificant in the overall OM budget. Primary production exceeded respiratory losses in the upper river, and this, along with OM inputs from two tributaries (where water reclamation facilities discharge into the river) delivered excess OM to the impaired lower reaches. Increasing stream metabolism index (SMI) with distance downstream (>1 in the lower river) further demonstrated that transport of excessive organic matter into the lower river was from upstream sources and not due to lateral inputs. This simple approach to characterizing the organic matter budget as it relates to water quality in the Jordan River was effective and could serve as a model for future studies attempting to quantify and identify sources of OM in urban ecosystems.     

Completing the Circuit: Routine,Reflection, and Ethical Consumption

Efforts to explain why some people incorporate ethical concerns into everyday shopping for food and household goods, while many do not, have so far left significant variation in “ethical consumption” unexplained. Seeking to move beyond explanations that rely mainly on differences in consumers' social class, gender, and political engagement, I draw on concepts associated with “practice theory” to argue that ethical consumption is closely tied to people's willingness and ability to spend time, while shopping, on distinct activities associated with breaking old routines and establishing new ones. The central insight of practice theory is that most consumption is the product of unconscious routine. And it is precisely because consciously departing from routine is, according to my study, a fundamentally time‐consuming process, that lack of time emerges as a crucial obstacle to translating abstract ethical concerns into concrete action as a consumer.     

Improving performance in a contracted physician network

Health care organizations face significant performance challenges. Achieving desired results requires the highest level of partnership with independent physicians. Tufts Health Plan invited medical directors of its affiliated groups to participate in a leadership development process to improve clinical, service, and business performance. The design included performance review, gap analysis, priority setting, improvement work plans, and defining the optimum practice culture. Medical directors practiced core leadership capabilities, including building a shared context, getting physician buy-in, and managing outliers. The peer learning environment has been sustained in redesigned medical directors' meetings. There has been significant performance improvement in several practices and enhanced relations between the health plan and medical directors.     

Symbolic segregation: Similarities and differences in the language and non-verbal communication of women and men

Societies use symbolic means to segregate the sexes conceptually as well as physically. Social rules designate some forms of verbal and non-verbal communication according to sex, to maintain distinctions. This paper explores both the non-verbal means of communication and the content and form of verbal modes as they are related to (1) the creation and maintenance of gender distinctions, (2) the symbolic ways they reinforce social arrangements between the sexes, and (3) the problems of analysis researchers have found in attempting to describe and explain sex differences in communication. The paper points out that in the field of language and communication there has been a tendency to emphasize the findings of differences between the sexes rather than of similarities. It also illustrates that linguistic differences tend to be superficial, to be linked to power differentials, and to be context specific. The paper concludes that these differences are socially created and therefore may be socially altered.     

The McMaster Model of Family Functioning

The model of family functioning being presented is the product of over twenty years of research in clinical work with family units. A method of family therapy has been developed based upon this model and will be described in a future issue. The model utilizes a general systems theory approach in an attempt to describe the structure, organization, and transactional patterns of the family unit. It allows examination of families along the total spectrum ranging from healthy to severely pathological in their functioning. It is based upon a Judaeo-Christian value set, and allows attention to be paid to cultural differences and other issues of cultural relativity .     

Semi-online scheduling with “end of sequence” information

We study a variant of classical scheduling, which is called scheduling with “end of sequence” information. It is known in advance that the last job has the longest processing time. Moreover, the last job is marked, and thus it is known for every new job whether it is the final job of the sequence. We explore this model on two uniformly related machines, that is, two machines with possibly different speeds. Two objectives are considered, maximizing the minimum completion time and minimizing the maximum completion time (makespan). Let s be the speed ratio between the two machines, we consider the competitive ratios which are possible to achieve for the two problems as functions of s. We present algorithms for different values of s and lower bounds on the competitive ratio. The proposed algorithms are best possible for a wide range of values of s. For the overall competitive ratio, we show tight bounds of ϕ + 1 ≈ 2.618 for the first problem, and upper and lower bounds of 1.5 and 1.46557 for the second problem. The authors would like to dedicate this paper to the memory of our colleague and friend Yong He who passed away in August 2005 after struggling with illness. D. Ye: Research was supported in part by NSFC (10601048).