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.     

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.     

Local and National Impacts from Landing North Sea Gas in Western Norway

A bstract . A simple framework is presented for the analysis of the local employment, income, sales , and local government impacts of landing North Sea gas at either of two Norwegian kommunes (municipalities). These impacts indicate the different forms of economic change arising from a major economic development event. The average annual net change in these economic measures is estimated for the operational phase of a gas terminal. The analysis indicated substantial differences in local and regional net gains. Both sites yielded positive neteconomic gains, which means noneconomic and national considerations become key decision determinates. These national issues provide the setting to judge the local/regional net gains. The unresolved questions include the national benefits and costs of the landing decision given the small scale of the Norwegian economy, potential future gas finds, and a fully employed economy.     

Timing and duration effects in residence histories and other longitudinal data: II. Studies of duration effects in Norway, 1965-1971

The main results of eleven studies of the nature and determinants of the timing of moves and duration of residence effects are presented. The studies (see table 1) illustrate the use of the methodological framework for studying individual histories of the previous article. There are substantial duration of residence effects in most population subgroups, implying that the migration process in non-Markovian at the mocro level and that the semi-Markov model is required. However, characterization of effects and their determinants are shown to depend so heavily on the type of interval and observation scheme used, that only within a comprehensive framework is proper interpretation of empirical results possible.     

The Self-concept of Black and White Women: The Influences Upon Its Formation of Welfare Dependency, Work Effort, Family Networks, and Illnesses

Abstract . The concept of “self-efficacy” is used to test the hypothesis that the negative self-concept of welfare recipients coniributes to long term psychological and material dependency on such assistance. Self-efficacy focuses on the extent to which people are able to produce and regulate events in their lives and is associated with self-imposed performance expectations. The extent to which the minority status which Blacks occupy in this society decreases self efficacy relative to Whites is examined, using information generated from structured interviews with 290 low income Black and White women. Operationalizing the concept of self-efficacy with appropriate controls for socioeconomic status, family composition and other factors results in finding no racial differences in sense of self-efficacy between Black and White women. Observed differences in patterns of receipt of public assistance are found to be more directly related to the persistence of structural barriers to upward mobility that have differential impacts on Blacks and Whites. Long term receipt of public assistance is found to adversely affect both self-worth and work orientation/perceived efficacy for all women.     

HUMAN RESOURCE MANAGEMENT AND INDUSTRIAL RELATIONS[1]

Human resource management (HRM) is a term which is now widely used but very loosely defined. In this paper it is argued that if the concept is to have any social scientific value, it should be defined in such a way as to differentiate it from traditional personnel management and to allow the development of testable hypotheses about its impact. Based on theoretical work in the field of organizational behaviour it is proposed that HRM comprises a set of policies designed to maximize organizational integration, employee commitment, flexibility and quality of work. Within this model, collective industrial relations have, at best, only a minor role. Despite the apparent attractions of HRM to managements, there is very little evidence of any quality about its impact. Furthermore very few UK organizations appear to practise a distinctive form of HRM, although many are moving slowly in that direction through, for example, policies of employee involvement.     

Cost and technical change: Effects from bank deregulation

Banks were substantially deregulated during the 1980s. This altered the cost-minimizing mix between deposit interest payments and operating expenses (capital and labor for branch convenience and free deposit services). Measured bank output was relatively unaffected by these changes. The proportion of deposits receiving higher interest rates increased more rapidly than factor quantities were reduced, so unit deposit costs rose. Consumers benefited, but the measured net effects for banks were negative, averaging –0.8% to –1.4% a year in net technical change from 1977 to 1988. These influences were measured three different ways and for both equilibrium and disequilibrium factor input specifications. All three approaches—a standard time trend, a time-specific index, and shifts in cross-sectional cost functions—gave consistent results. The results were robust whether measured at the banking firm or branch office level or on the cost frontier.     

Legalistic organizational responses to catastrophic illness: The effect of stigmatization on reactions to HIV/AIDS

The HIV/AIDS epidemic has focused increased attention on catastrophic illnesses in the workplace, and because of the stigmas associated with HIV/AIDS, it raises three primary concerns for organizations: (1) organizational avoidance of legal sanctions and litigation; (2) the maintenance of organizational legitimacy; and (3) organizational protection of employee rights. Although many organizations adopt legalistic responses to cope with these concerns, the analysis presented in this article suggests that while legalistic approaches function well to protect organizational interests in terms of both legal liability and legitimacy, the are only partially able to protect employee rights. Drawing upon the limited literature on HIV/AIDS in the workplace, this article presents an agenda for future research on organizational responses to HIV/AIDS.