Doctors under the knife

With Bill Clinton's new reforms only a month away, the health-care system is on the operating table--and the doctors are under the knife. Americans have a love-hate relationship with physicians: they like the care that doctors provide but hold them to blame for the nation's health-care mess. NEWSWEEK looks at how the culture of medicine may change, assesses doctors' fears--and examines the brave new world of HMOs.     

Measuring School-Related Stressors in Adolescents

Some 1620 high school students responded to 68 items that measure adolescent stressors. Thirty-five of the items were based on J. P. Kohn and G. H. Frazer's Academic Stress Scale [1(1986) An Academic Stress Scale: Identification and Rated Importance of Academic Stressors, Psychological Reports, Vol. 59, pp. 415–426] developed in the United States, while the remaining 33 items were developed from P. Strutynski's [(1985) A Survey of Queensland Year 10, 11 and 12 Student Attitudes to Schools and Schooling, State Planning Committee, International Youth Year, Brisbane] lists of the most frequently named problems of 2336 Australian high school students. Confirmatory Factor Analysis was used to test and develop a measurement model developed from an extensive review of previous scales. The High School Stressors Scale emerged from the analytic process and measures nine school-related stressors. For researchers focusing on school-related problems and stressors among adolescents, the HSSS promises to be a very useful instrument. It has sound construct and predictive validity and adequate reliability, as demonstrated by the goodness-of-fit indices the squared multiple correlations.     

Immigration as a source of political discontent and frustration in Western democracies

"This article describes the migration context of three sets of Western democracies and then explores plausible linkages between the scale, timing, and characteristics of migration, and the substance and process of migration policies, on the one hand, and support for government, on the other. Trying to move beyond plausibility, I discuss indirect indicators of the impact of immigration on Western publics: attitudes toward immigration policy and immigrants, support for extremist parties, and acts of violence and disorder linked to anti-immigrant or racist motives."     

Beyond the World Food Summit

While most speakers at the 1996 World Food Summit expressed concern about the injustice that forces more than 800 million people worldwide to live with hunger, some sought solutions through economic and social development while others called for a more liberal marketplace. Among world leaders, only Fidel Castro raised issues and challenges that addressed some of the underlying causes of malnutrition. The Plan of Action that grew out of the Summit has only one measurable commitment, which is to halve the number of undernourished people by 2015. The other six commitments, while diluted, contain important objectives even though they give little emphasis to the underlying causes of poverty or hunger. The Summit process, however, did contribute to the fact that food-related issues are now placed higher on the world agenda because many of these issue were raised by civil service organizations (CSOs) at the Summit's parallel NGO (nongovernmental organization) forum. In fact, one of the most positive outcomes of the Summit may prove to be the increased effectiveness of the CSOs as a result of the creation of improved networks in preparation for the Summit. The CSOs contributed examples of how food security could be improved, published an active site on the World Wide Web, and challenged the statements of governments. In addition to raising trade issues, CSOs also lobbied for sustainable agriculture and agricultural biodiversity. In fact, CSOs may have to set a new action agenda for the formal sector to encourage development of new institutions and new global forums that give NGOs a place at the table.     

EEOC guidance on psychiatric disabilities: many problems, few workable solutions

The EEOC recently issued "Enforcement Guidance" on psychiatric disabilities under the Americans with Disabilities Act. Although the Guidance provides clarification of a few issues involving mental disabilities under the ADA, in most respects the Guidance is problematic. For example, the Guidance suggests that the inability to get along with a supervisor or coworkers may constitute a disability under the ADA, that an employer may have to "accommodate" a disabled employee's misconduct, that an employer cannot require an employee to follow doctor's orders as a condition of employment, and that an employer may be obligated to modify work rules and procedures to accommodate a mentally disabled employee but is prohibited from explaining to coworkers why it is making such modifications. As the EEOC's Guidance exceeds or conflicts with the ADA in some respects and is largely unworkable in many respects, it remains to be seen how many courts will actually follow it.