Medical alert: sexual harassment in the health care industry

Sexual harassment is an illegal form of sexual discrimination prohibited by Title VII of the Civil Rights Act of 1964. Although the U. S. Supreme Court has recognized that sexual harassment is illegal conduct for which an employer is liable, this transgression continues to be a major workplace problem. Although some researchers have analyzed the incident level of sexual harassment in general, little work has been conducted on particular industries.

The research described in this article is the summary of the results of a study of sexual harassment in the health care industry. A written survey was sent to 950 randomly selected members of the Kentucky Board of Nursing. Thirty-five percent of the 441 respondents to the survey indicated they had been sexually harassed in their capacity as nurses. More than 77 percent of those occurrences involved physicians as the harassers. When harassed, 51 percent of the respondents were aged 25 to 35; 25 percent, 25 or younger; 20 percent, 36 to 45; and 4 percent were 46 to 55. Fifty-three percent said they were harassed by supervisors; 32 percent said they were harassed by patients.

The survey showed that 23 percent of those harassed felt threatened in their job status if they did not go along with harassing behavior, and 24 percent reported the incidents. Only 23 percent of the nurses indicated that their employers had policies and procedures in place to address sexual harassment. Further, of the respondents that reported being sexually harassed, only 23 percent of these victims reported the incidents.

Sexual harassment complaints in the health care industry must be taken seriously. Health care institutions must adopt appropriate policies and procedures to address sexual harassment. The written policy statement on sexual harassment should show strong support from top management, specify the types of behavior perceived as sexual harassment, and be widely disseminated. Training should be provided to all staff, and effective enforcement mechanisms should be implemented.     

Policy guidelines for collective bargaining and family planning

The benfits of establishing family planning through collective bargaining to both labor and management are discussed. Until workers can be convinced that their children will receive health care, education and employment, and that they will be economically secure in old age, it is difficult to convince them of the many benefits of child spacing and small family size. In 1953, it was calculated by management in a Japanese steel factory that about 70% of all acidents could be attributable to difficulties in the private lives of employees. In order to ease problems in the home, collective agreements were initiated by management in the Nippon Express Company to provide family planning services. Labor agreed as long as the workers were to share in the economic awards which came from participation. Costs of implementing the family planning programs were fully offset by the decrease in expenditure on family allowances, confinement, nursing, and so on. In India some ten estates began a program in which a certain amount of money is paid into an account for every month that a woman does not become pregnant. If the woman becomes pregnant, she forfeits a substantial amount of the fund. This money comes directly from the funds which would normally have to be set aside to provide for maternity and child support programs. Certain guidelines are presented in the paper to outline the areas of responsibility of labor and management in the provision of family planning services. Among the many possibilities mentioned is the idea that both labor and management could look into the conceivability of plowing back a portion of whatever savings are accrued by management into a pension scheme to compensate workers for the loss of labor caused by having fewer children than were previously anticipated.     

Health care benefits in the public sector: An examination of availability,size, and managerial effects among north carolina municipalities

This study focuses on the extent to which health care benefits are used in North Carolina municipal governments. As such, it not only maps out the existence of these practices, but also the conditions and circumstances in which they occur. Health care practices (Basic dental and medical coverage, employee assistance programs, and child care provisions) are examined.

Since group health coverage is nearly universal (albeit the type and extent of coverage varies), it was not examined in this survey. With the exception of pre-paid dental insurance (41 percent) and unpaid maternity leave (31 percent), limited use is made of the various health care programs surveyed.

Population and workforce size effects are marginal.The presence of a city manager or town administrator, on the other hand, results in two or three fold the use as occurs in mayor-council cities.     

Exploring Language Dominance,English Literacy and Life Satisfaction Among Dominican Children of Immigrant Parents

ABSTRACT

The purpose of this pilot study was to explore language dominance and English language literacy, and examine the effects of an intervention focused on facilitating English language acquisition among Dominican children. Eighteen first and second generation Dominican children, ages 7–11, participated in a school based after school literacy language immersion program. Following participation in the literacy language immersion intervention, participants demonstrated an increase in school satisfaction and improvements in English literacy levels. This article makes recommendations for the provision of school-based programs that focus on the specific needs of Latino students associated with Spanish language dominance.     

Macro versus micro remedies for alienation in the workplace

Manifestations of alienation are ubiquitous in modern society and are not limited to the workplace. The paradigm of alienation as delineated by Karl Marx is a valuable tool for understanding this phenomenon at societal and organizational levels. In addition, comprehension of this model can assist decision-makers in formulating better diagnoses and more effective solutions.

A review of the major points of Marx's three forms of alienation is described as a basis for examining the manifestations of alienation in society and the workplace. Subsequently, the author indicates societal solutions offered by selected scholars.

In examining the problem of estrangement in the workplace, it is clear that managers could identify the forces causing alienation more precisely through an understanding of Marx's paradigm. This knowledge would enable managers to select appropriate remedies to ameliorate the condition.

What the workers want most, as more than 100 studies in the past 20 years show, is to become masters of their immediate environments and to feel that their work and they themselves are important--the twin ingredients of self-esteem. Workers recognize that some of the dirty jobs can be transformed only into the merely tolerable, but the most oppressive features of work are felt to be avoidable: constant supervision and coercion, lack of variety, monotony, meaningless tasks, and isolation. An increasing number of workers want more autonomy in tackling their tasks, greater opportunity for increasing their skills, rewards that are directly connected to the intrinsic aspects of work, and greater participation in the design of work and the formulation of their tasks.

--Work in America     

Child Schooling,Child Health,and Rainfall Shocks: Evidence from Rural Vietnam

Abstract

We study the effect of rainfall shocks on child schooling outcomes and on standardised height for age (a measure of child health) in rural Vietnam. We find that adverse rainfall shocks during pregnancy adversely affect children’s school entry delay and progress through school. Adverse rainfall shocks in the third year of life adversely affect both schooling and child health. These effects differ by region, as a result of constraints that reflect regional economic heterogeneity. We predict that policies that help rural families smooth income shocks will result in increases in human capital and in substantial cumulative returns over a worker’s working life.     

Patterns and issues in health care collective bargaining

Unionization of health care facilities has grown significantly over the last twenty years. More than 20 percent of American hospitals have one or more union contracts and an equal percentage of the industry's labor force is represented for collective bargaining purposes. Union membership is concentrated in the Northeast, Upper Midwest and Pacific Coast and is to be found particularly among large metropolitan hospitals. Although many different unions are actively organizing in the health care industry four labor organizations predominate: American Federation of State, County, Municipal Workers; Service Employees International Union; National Union of Hospital and Health Care Workers - District 1199; and the American Nurses Association.

One of the obstacles to union growth for many years was the absence of Federal legal regulation of labor relations. In 1974 Congress amended the so-called Taft Hartley Act to cover private nonprofit hospitals, the largest component of the industry. Since 1974 the application of Federal labor law has resolved old problems that arose from the lack of a basis to handle recognition disputes but at the same time created new issues. Among these issues are such legal questions as the legitimacy of the ANA to act as a labor organization, the proper bargaining classification for registered nurses, and the proper role in labor relations for hired consultants.

The growth of unions in health care raised concern that collective bargaining would impose onerous new burdens on an industry already hard pressed financially. Research indicates, however, that the impact on hospital costs have not been great -- perhaps on the order of an increase of 10 percent over what would be the case in the absence of unions. The greatest effects seem to be in the area of fringe benefits, working conditions, and the provision for grievance machinery.

Special problems have arisen in conjunction with the unionization of registered nurses. This particular category of health care workers occupies a strategic position in the hospital's work force. After a slow start nurse bargaining activity has come rapidly particularly as nonnursing unions such as 1199, SEIU, and the American Federation of Teachers have forced the ANA to respond to their efforts to make inroads among nurses.

Union growth in the industry seems to have stabilized for the time being without the prospect for much change in the remaining years of the decade. Incidence of conflict has been relatively low compared to other industries and this also shows little likelihood of change. While some visible signs of conflict over representation rights still remain collective bargaining is moving rapidly into an era of mutual accommodation.     

Two-dimensional legislative conflict: unique implications for the effectiveness of local councils

ABSTRACT

Organisational scholars argue there are two distinct types of conflict found in the private-sector workplace. One is referred to as task conflict and the other relational conflict. We use their insights to devise our own measures of conflict on local elected councils. As opposed to ‘task conflict’ we use the term ‘policy conflict’ and keep the same nomenclature ‘relational conflict.’ We will contend it is important to not conflate the two. In this work, we test our unique operationalisations of conflict on an established measure of Governing Board Effectiveness. Because of concerns over using the same survey instrument to measure both explanatory variables and the dependent variable we also test our thesis regarding two-dimensional legislative conflict on entirely exogenous measures of ‘healthy cities.’ We find that higher levels of policy conflict comport with good governance outcomes, while relational conflict provides no measurable benefit.     

The American University in Bulgaria and U.S. Agency for International Development Relationship

Abstract

Upon recognizing a need for a center of western oriented university education, an initiative committee including representatives from the Republic of Bulgaria, the city of Blagoevgrad, and the University of Maine obtained support from philanthropist George Soros's Open Society Institute and the U.S. Agency for International Development (USAID) to start a university in Bulgaria in 1991. The hallmark of its existence was that its programs would be oriented toward teaching democratic values through the American liberal arts tradition. Instruction would be in English so it could draw on students throughout the region if they were proficient in English. The university has grown from a small enrollment of 208 students to over 700 students in several disciplines in the humanities and social sciences. As the American University in Bulgaria (AUBG) has become a regional institution, the AUBG–USAID relationship has been crucial. Now it is beginning to offer an EMBA program and has developed an excellent reputation through its graduated students.     

Paan and Gutka Use in the United States

Abstract

Smokeless tobacco and areca nut are popular with South Asians and South Asian immigrants, most commonly used as paan and gutka. Their regular use leads to oral cancer. The South Asian community in the U.S. is rapidly growing, where paan and gutka are readily available. The study was the first exploration of the migration of the paan and gutka habits, and their use in the U.S.

A 108-item questionnaire on paan and gutka usage and beliefs was administered to 138 first-generation Bangladeshi and Indian-Gujarati immigrant adults at community sites in the New York metropolitan area. Forty-five percent Indian-Gujaratis reported ever-regular paan use; of which 5% are current users. Thirty-one percent reported ever-regular gutka use; of which 77% are current users. Thirty-five percent Bangladeshis reported ever-regular paan use; of which 70% are current users. Nine percent reported ever-regular gutka use; of which 67% are current users. Bangladeshis are more likely to identify paan as causing oral cancer. Indian-Gujaratis are more likely to identify gutka as causing oral cancer.

Between the two communities, there were significant differences in paan and gutka usage, migration effects, and oral cancer risk perception. There is a need for comprehensive migration studies on the determinants of usage, and for community-specific interventions for these carcinogenic products.     

Routine Activity Theory,Target Congruence,and School Context: A Multilevel Analysis of Teacher Victimization

Teachers at school are typically considered as handlers or guardians of students and managers of classrooms—in roles that foster learning and protect students from harm. Thus, relatively little research attention is given to identifying the risk factors for teacher victimization in comparison with the great deal of work addressing the correlates of student victimization at school. The present study fills this gap in the literature on school violence by examining the individual- and school-level predictors of teacher victimization. The authors’ analysis is framed using a multilevel opportunity theoretical approach, incorporating measures of teacher activities, self-protection, teacher attributes that suggest target vulnerability and target antagonism, school-level norms supportive of delinquency, and school-level guardianship. These various risk and protective factors are examined using hierarchical negative binomial regression models with data from over 4,100 teachers in 98 schools in Kentucky.     

Public service as a calling: an exploration of a concept. part II

This paper chronicles the work of Josephine Goldmark, a social activist of the early 20th century. Special attention is given to her contributions in the areas of the reduction of work days, reform of laws for working women, reform of child labor laws, the alleviation of fatigue, and nursing school improvements. Her efforts had lasting effects in each of these areas. Throughout, Goldmark's dedication to thorough preparation is a consistent theme.     

Social Work with West Indian Families

SUMMARY

This conceptual analysis explores the psychosocial and cultural experiences of English-speaking West Indians in the United States. Relevant factors include family role changes; parent/child conflicts; prolonged separation from and reunification with parents; finding suitable employment and education-related issues. The challenge for social work is to develop programs for these families that contribute to their social and economic integration. Given the extent to which social, economic and related policies impact on the needs of this population, the author suggests that a multilevel approach which utilizes the micro skills associated with individual intervention and the macro strategies of intervening at the societal and institutional levels is needed. This approach necessarily includes activities such as advocacy and empowerment.     

Quiet Casualties: An Analysis of U Non-Immigrant Status of Undocumented Immigrant Victims of Intimate Partner Violence

Although immigration policy is a key component of public administration scholarship in the United States, research into Intimate Partner Violence (IPV) for both documented and particularly undocumented immigrants has been tangential in focus. This exploratory study questions 1. the effect of immigration reform on U.S. undocumented immigrant women of IPV and

2. how changes in the number of undocumented immigrants affect IPV victimization rates and the regulations concerning U non-immigrant status.

A least-square trend line suggests that the 10,000 U visa applications permitted annually will not cover the undocumented female population of IPV let alone the victims qualified under the U non-immigrant status. Based on a review of the laws and policies regarding the U-Visa we provide several recommendations to reform immigration laws directed toward immigrant victims of IPV. This study adds to the growing, but still weak body of knowledge on abused immigrant female populations in the United States and how federal legislation toward immigration reform and policy will help these women become valuable contributors to our society.     

Peer Relations,Violence and School Attendance: Analyses of Bullying in Senior High Schools in Ghana

Abstract

This article focuses on bullying among students and explores the ways it affects the attendance of senior high school students in Ghana. It explores whether having emotional problems, in addition to being bullied, incrementally affects the relationship between bullying and school attendance and the mitigating influence of peer friendships on these relationships. The results show gender differences in which absenteeism associated with bullying was mitigated by the support of friends for boys but not to the same degree for girls, especially those girls who had reported being psychologically bullied. Our findings suggest a school environment in which peer friendship and emotional wellbeing are intertwined in complex ways.     

Civil Society,the Economy,and Educational Assistance in Former Soviet Republics

Abstract

Liberal democracies throughout the world are committed to civil society in support of market economics and democratic politics. Through educational assistance programs, the U.S. government demonstrates this commitment by attempting to reinvigorate civil society in former Soviet republics and Eastern European countries in support of their economic and political reform efforts. Of particular interest are the Community Connections and Partners in Education programs conducted by the U.S. Department of State for interns from the former Soviet republics or now Eurasia, who participate in business and other professional internships in various locations in the U.S., including Northern Alabama.     

Disinvesting in America? the legacy of consumption policy in the 1980s

This article traces patterns of consumption, low productivity, debt accumulation and slow economic growth. Rather than calling for an increased emphasis on market and corporate incentives, the author calls for increased public investment. He favors particularly increases in scientific research and development and technology, in public works to rebuild the infrastructure, and calls for a public administration associated with increased investment in government.

The New Deal and the Great Society established the foundations of the public policy and administration of consumption—income transfer, entitlement, loan, loan guarantee, credit, subsidy, tax expenditure, and related programs designed to maintain or improve the income levels and social and economic well being of many elements of the United States population. Such programs now constitute approximately 50 percent of the federal budget. In the late 1980s, the United States entered into a new international economic, technological, and demographic order in which the public administration of investment will be increasingly important. The “public administration of investment” is defined as the administration of policies designed to produce future benefits for the nation through investment in people, knowledge and technology, the environment and public infrastructure, and public systems and public service.

Several trends in the 1980s contributed to the increasing importance of the public administration of investment. The first trend was the continuation of the low rate of productivity growth in the United States, a condition that has persisted since the early 1970s. ⁽¹⁾

Despite low productivity growth, the United States as a nation continues to spend as if productivity were increasing at pre-1973 rates and to borrow from other nations to make up the difference. The result has been large public and private debt. Increased productivity growth will require additional public as well as private investment if the United States is to maintain its standard of living and capacity to pursue social justice and other values into the next century.

The second trend has been the globalization of technology and the economy. The United States has been losing the comparative advantage it once enjoyed in many scientific and technological fields, as technological know-how has spread throughout the world. The United States fell further behind in the 1980s in the development of new production processes and in the commercialization of new processes and products in consumer electronics, semiconductors, and other fields.⁽²⁾ There is compelling evidence that both the private and public sectors underinvested in developing the scientific and technical workforce that will be essential in the global technological competition of the future.⁽³⁾ More generally, by many measures the education system of the United States has not been producing a well-educated workforce or well-educated citizens.⁽⁴⁾

The third trend of the ’80s was the maturation of the baby boom generation. This generation is now in the high consumption stage of its life cycle—homes, cars, and other consumer goods. The aging of the baby boom generation in the early decades of the twenty-first century will pose a complex challenge to public policy and administration. Early in the twenty-first century, the baby boomers will enter a stage of life usually marked by reduced consumption and higher saving.⁽⁵⁾ At the same time, increased longevity suggests growing demands on both public and private systems for income maintenance, health care, and social services. New technologies will compound health care costs. Unless saving and investment are increased now to partially support the baby boom generation in retirement, the “baby bust” generation that followed the baby boom will face a heavy burden of support.⁽⁶⁾ Currently, the Social Security Trust Fund does not have a single penny in it because the Treasury is borrowing the funds to reduce the federal deficit. Substantially increased productivity or substantially higher taxes will be necessary to replenish the fund in the early twenty-first century.

To compound the problem, by the year 2050, for the first time in American history (according to the middle series of Census projections), there will be more old than young Americans. The age cohort 60 and older will make up 28 percent of the population, while the age cohort 1-19 years will make up about 23 percent of the population.⁽⁷⁾ This is in stark contrast to the 16 percent of the population 60 and over, and the 32 percent of the population 1-19 years, in 1980. Greatly increased saving, increased productivity, substantially lower standards of living for working people, extended working years, or an influx of immigrant workers will be needed to produce the benefits that are promised in the entitlement programs of the federal government and expected by the American people.

Finally, many observers perceived an increase in private greed during the last decade in the United States and a growing indifference to common concerns—eroding public infrastructure, the highest infant mortality rate among industrialized nations, the highest rate of child poverty, and similar social conditions. They see a preoccupation with current pleasure at the expense of future benefits, and a decline in social discipline and civic virtue. To some observers, the United States has been in a temporary cycle of preoccupation with private needs.⁽⁸⁾ To others, civic virtue in the United States has been in decline.⁽⁹⁾

In any event, diminishing growth may intensify each individual's desire to protect his or her interests. In this context, redistribution in the pursuit of social equity will become increasingly difficult.     

Harming America: Corporate Crime in a Context of Deregulation

ABSTRACT

Like many Republican presidential candidates before him, Donald J. Trump campaigned on a pro-business, anti-regulation platform, and since his election in November 2016, he has directed his administration to move forward with deregulation in many arenas, including consumer financial protections, environmental controls, and workplace safety among others. Past efforts to roll back regulations governing certain industries, such as the savings and loan and the mortgage industries, have had harmful consequences for the general public or for specific interest groups. In this study, we review what the Trump administration has accomplished with regard to deregulation to date. Then, based on past deregulatory fiascos, we theorize the harmful collateral consequences that may result from this most recent swing of the regulatory-deregulatory pendulum.     

An Assessment of a Drastically Changed Federal Workplace in the United States

Abstract

Written by four experienced government employees, this article discusses many alarming changes that have been forced on the Federal government workplace over the past 20 years. The article identifies actions by elected and appointed officials that have greatly changed and weakened a workplace that was a model for America. Several attributes of the Federal workplace of the past and of the present are compared and contrasted.     

Developing Countries in Need: Which Characteristics Appeal Most to People when Donating Money?

Abstract

A discrete choice experiment was conducted to discover the relative importance of five characteristics of developing countries considered by people when choosing countries to donate money to. The experiment was administered via an online survey involving almost 700 university student participants (potential donors). The most important recipient country characteristic for participants on average is hunger and malnutrition, followed by child mortality, quality of infrastructure, income per capita, and, least importantly, ties to the donor’s home country. A cluster analysis of participants’ individual ‘part worth utilities’ representing the relative importance of the country characteristics reveals they are not strongly correlated with participants’ demographic characteristics.