Perceptions of responsibility for clinical risk management: evidence from orthopaedics practitioners, practice managers and patients in an Australian capital city

The article describes a study of the perceptions of three groups--patients, orthopaedic surgeons and the surgeons' practice managers--concerning three types of legal risk associated with the duty of care: failure to follow up, failure to warn and failure to diagnose. The study found there is cause for concern about doctors' follow-up and documentation of patient care. Doctors may be unaware of the Australian courts' propensity to emphasise practitioner responsibility rather than patient autonomy. A further important result is the considerable disparity between the surgeons' views and the views of their practice managers about the duty of care. The article draws out implications for improved risk awareness and suggests further research.     

Contraceptive behavior in adolescence: A decision-making perspective

The contraceptive behavior of adolescent girls was viewed from a decision-making perspective. A semistructured interview protocol was used in interviewing 120 girls aged 12–19 in three clinics (Teen Family Planning, Prenatal, Pediatric Acute Care) at Michael Reese Hospital and Medical Center on (1) demographic in formation; (2) sexual and obstetric history; (3) contraceptive and sexual knowledge, attitudes, and practices; (4) environmental pressures; (5) personality factors; and (6) decision-making style. We found that the girls were generally poor contraceptors. They viewed the costs of contraception (in terms of safety) to be high; and they positively valued physical intimacy, opportunities for which come up unexpectedly and sporadically. These factors, along with their ambivalent views toward pregnancy and childbearing seemed to encourage their risk-taking behavior. Once pregnancy occurred, it was carried to term because of the strong internal and external pressures they felt to have and keep the baby. The peer-led intervention program that we are developing based on the survey findings will focus on (1) the teenagers' lack of accurate and complete knowledge about birth control and conception, (2) their limited sense of options concerning birth control and pregnancy outcomes, and (3) their poor understanding of and lack of insight into what motivates their behavior.This study is part of the investigation being conducted by the YADMAC (Young Adult and Adolescent Decision Making About Contraception) Project at Michael Reese Hospital and Medical Center, 2959 South Cottage Grove, Chicago, Illinois 60616. The authors are all members of the YADMAC research team.Received Ph.D. from the University of Chicago. Current interests are human sexuality and reproductive behavior. Currently at Department of Psychology, St. Xavier College.Received M.D. from the University of Michigan. Current interests are liaison child psychiatry and adolescent sexuality.Received Ph.D. from the University of Chicago. Current interests are early adolescent development issues.Current interests are puberty and sex differences.B. A. candidate in social work, Roosevelt University. Current interests are adolescent sexuality and contraceptive behavior.     

Aid: A mixed blessing

Despite a growing emphasis by aid agencies on local participation and consultation, the recipients of aid commonly have mixed, if not hostile, responses to relief assistance. Agencies need to acknowledge the inequalities that are inherent in an aid relationship, and be more judicious in determining their proper role. The author calls for aid providers and recipients to accept our innate human equality and our circumstantial inequality in order to establish relationships of mutual respect and contemporaneous enjoyment of each other.     

What Workers Want Depends: Legal Knowledge and the Desire for Workplace Change among Day Laborers

In this article, we identify legal knowledge as a key difference between workers who desire workplace change and those who do not. Based on surveys with 121 day laborers, we find that not all day laborers are equally dissatisfied with their jobs, despite uniformly difficult working conditions. Some day laborers do not want to make any real changes to the day labor industry, while others desire a range of industry changes, from higher wages to greater government regulation and unionization. A key difference between these workers is their knowledge of employment law: Those who know the law are more likely to desire workplace change.     

Signaling virtue: voluntary accountability programs among nonprofit organizations

This article examines the structure of nonprofit voluntary accountability and standard-setting programs, arguing that these programs can be understood as collective action institutions designed to address information asymmetries between nonprofits and their stakeholders. Club theory and the economics of certification suggest that such programs have the potential to provide a signal of quality by setting high standards and fees and rigorously verifying compliance. Such mechanisms can signal quality because higher participation costs may allow only high-quality organizations to join. The article examines the implications of signaling theory using an original dataset on the structure of 32 nonprofit accountability programs across the globe. While many programs set high standards for compliance, the key distinction between strong and weak programs is the use of disclosure or verification mechanisms to enforce compliance. Contrary to theoretical expectations, compliance standards and verification do not appear to be substitutes in creating stronger voluntary programs.

The Unexpected: Bionic Woman at the Millennium

Wilfred Bion's A Memoir of the Future provides a point of departure for feminist thinking about the millennium. Bion problematizes hopes for the future and associates thought with catastrophic change. Women play an unexpected role in Bion's experimental autobiography, posing provocative questions and unsettling the status quo . Since Bion has little to say about women in his clinical writings, A Memoir sheds light on his thinking and on the post-Kleinian culture of the 1970s. Book I of A Memoir depicts a class- and sex-nightmare played out between men and women, and women and women, in an age of anxiety whose setting appears to be the fascist 'pacification' of Middle England during an unspecified period. In this hallucinatory drama, all encounters are reduced to a brutal fiction of dominance and submission. The violence of the action suggests the primitive mental world of psychosis. Book II of A Memoir satirizes 'the brilliance of masculine thought' through the voices and criticisms of women. But this is the purgatorial movement of Bion's autobiography, inhabited by 'idées mères' (untransformed beta-elements) and haunted by the ghosts of Bion's traumatic war-time experience. A monstrous plot is hatched to kill primitive, fascistic Man, who retaliates and takes the female spoils. Is this the prelude to catastrophic change? Book III stages a country-house debate between different characters who represent aspects of Bion's personality, recapitulating the concerns of his later writing. The debate includes a meditation on childbirth as compared to war trauma, but Bion takes his distance from feminine intuition or common sense. Women fight on both sides of the barriers in the Bionic revolution - becoming, however, figures for the 'unexpected' and precursors of emotional upheaval. The gendering of millennial thought in Bion's Memoir provides an opportunity to scrutinize our own unthought fantasies of change.     

Graffiti vandalism: Frequency and context differences between the sexes

This paper explores a popular yet highly destructive form of property crime — graffiti vandalism. The localities of such destruction selected for study were male and female restrooms. Three hundred and ninety-two cases were collected and analyzed. Prior research theorized the existence of a significant difference in the amount of graffiti produced between the sexes. (It was believed that males produce more graffiti than females). Analysis, however, revealed equal production of graffiti by males and females.Content differences between the sexes were hypothesized. The content categories included homosexual, heterosexual, nonsexual (humorous and political statements) and racial graffiti. The findings as they relate to content differences between the sexes are presented and discussed relative to sex-role socialization theory.