The structural and economic implications of urbanization

"This study surveys the policy issues associated with urbanization following the abolition of the pass laws [in South Africa]. The demographic background is briefly sketched. Using neo-classical analysis as a starting point, particular attention is paid to the present inefficiencies of city form associated with segregation. It is argued that current planning procedures are in danger of perpetuating or even worsening the situation. Obstacles to employment generation are considered and transport, local government and housing issues are discussed. On every front, urbanization policy is unstable and, even in the short term, there will be pressures to change it."     

Projecting the future size and health status of the U.S. elderly population

"A projection model based on a multivariate continuous state, stochastic process is presented. The model allows multiple time-varying covariates to be used so parameters can be estimated from time series information on health changes and mortality, and their interaction. Health changes are simulated by altering parameters controlling the age trajectory and diffusion of risk factor means, variances, and covariances....By increasing the information used in projections it may be possible to better (a) anticipate the state of health at extreme ages, (b) forecast changes in health at specific ages over time, (c) stimulate the effects of specific interventions, and (d) determine the sensitivity of outcomes to a range of interventions."     

Purchasing practices in a hospital environment: an ethical analysis

The critical state of the hospital industry, as previously described, generates a difficult decision environment for the materiel manager and those in the purchasing function. The unique life- and death circumstances of hospitals impose a further onus on those who manage them. In the name of saving lives, they can find a convenient excuse to disregard all moral principles, forgetting the Socratic dictum "it is not enough that one lives, but that one lives well." Without the moral "right stuff," they can easily give in to the seductions of momentary gains and glory through ethical short-cuts. There is wisdom and consolation in the words that "nice guys may appear to finish last, but usually they're running in a different race." Studies have established a direct relationship between corporate excellence and ethical values. The reality of competition in the hospital industry dictates that the integration of ethics into the life of the organization should happen by design and not by accident. This is what is meant by strategy. If hospitals would strive for excellence to survive and grow, they should have a strategy with a mission statement that also embodies its moral values and moral agenda. Such an approach does not guarantee that an organization will become immune to moral contamination, but it does provide an antidote.     

Body support testing and rating

The REF, C, and score are a means to give quantitative values for product performance. Other product variables defined as humidity control factor, shear control factor, differential temperature control factor, product life factor, and cost factor were not addressed as part of this study. Additional variables include delivery, maintenance, and warranties. These components can be added to the score in some weighted manner as they become clinically founded. Interface pressures and shears were not measured for beds that are gatched. Each product tested will have characteristics pertinent to its own design that must be addressed to minimize sacral and coccyx skin breakdown when subjects are in this posture because some pneumatic pads bottom out to give excessive sacral and coccyx pressure while others wrinkle when used in this position. This is of major concern when one considers that the coccyx is more susceptible to pressure than any other bony prominence. There may be some aversion to labeling support product performance because it will allow the purchaser to know what is being bought. This initial study indicates the feasibility of quantitating what all patients require: a valid interface support surface for each specific need. The user can be adequately informed before the purchase as to a product's merits without being influenced by the results of inadequate testing, referrals, or sales media influences. Although cushions, shoes, or other prosthetic/orthotic devices were not part of this study, it is appropriate to rate all these devices in a similar manner by simply comparing pressure relief attained to that desired, expressing the result as a percentage of the worst case, and then labeling the product accordingly. Those subjects with sensation can rate comfort as part of the overall score. For cushions, ischial tuberosity pressure relief can be expressed as a percentage of the maximum attainable relief. Metatarsal head relief during gait as well as during static testing can be measured, and claims can be made for shoes and sneakers. Where impact loads and shear forces are paramount, the score must comprise appropriate parameters. Similarly, amputee distal stump relief as a percentage of worst case could be specified by the fitter. Iliac crest relief as a percentage of worst case can also be specified by the fitter. In all instances the score is not a subjective rating but one that can be measured correctly. All body support products can be given an REF, C value, and score as well as other qualifying values where appropriate instrumentation and sufficient subject sampling is used.     

The role and place of research and intellectual discourse in the reproduction of social relations of racial domination in South Africa

The South African research community which undertakes all research activity in the social and natural sciences, with and without state and corporate sponsorship, draws its membership mainly from the dominant social group. In this country, the dominant group is both economically and racially determined. Consequently, the white minority dominates the research community and intellectual discourse as it does other socio‐economic and political spheres of society. This situation guarantees the constant reproduction and perpetuation of the social relations of racial domination.

As an agent that generates knowledge and new ideas, research as an academic and intellectual tool of enquiry is an instrument of social control, producing new concepts, language and theoretical abstractions which are not accessible to those outside its multi‐farious disciplines. Insofar as the largest proportion of practitioners of these specialised disciplines is drawn from the dominant group, research has itself become a pivotal part of the dominant ideology. Its role is inevitably and inextricably bound up with the processes of systematic reproduction of the relations of domination.

The aim of this viewpoint is therefore to explore various ways in which research bodies and intellectual discourse in general in South Africa can be deracialised and be made more representative of the social make‐up of society.     

Yes, the market can curb health costs

Memo to Clinton's transition team: forget those tough expenditure ceilings you're considering. Look instead at what managed competition is already accomplishing.     

Struggling to save our kids

Many more than ever face the crises of childhood: violence, drugs, bad schools, poverty, divorce, or two parents at work. And no one seems to care.