The reporting of grief by one newspaper of record for the U.S.: the New York Times

One source people can rely on for clues on how to grieve a loss is through accounts of such experiences reported in the mass media. This research examines how grief has been reported at one newspaper of record for the U.S.: The New York Times. Using theories of social construction and the sick role, this exploratory study attempts to observe whether grieving is portrayed by media as a social problem, particularly as a health or medical issue which can be treated and cured, and also discusses those who are not identified in the mourner role in newspaper reports.     

The doctor/patient relationship for the 21st century. Clash of 'cultural creatives' and 'traditionals' helps focus the future of patient care

The doctor/patient relationship is at a crossroads. Some patients--traditionals--want the doctor calling all the shots, deciding the best treatment path to follow. But cultural creatives--heavily influenced by bioethics--desire more of a give and take when it comes to their health care. They see the physician as an advisor, and they want to decide the best treatment on their own terms. Take a close-up look at factors influencing the doctor/patient relationship in the 21st Century.     

The marriage of risk management and the processes of patient care

So, your organization is considering taking on a capitation contract. Or you have already done so. Sooner or later, most physician executives with whom I have worked have asked the question: "How the hell are we going to manage this thing so we don't go broke?" Good question. Here, in brief, is the answer: Accepting capitated contracts without having the resources to manage both insurance-like risk and the process of caring for capitated patients is roughly equivalent to flying through mountains shrouded by clouds: Sooner or later, a mountainside is likely to appear in your windshield, close up and closing rapidly, at a point where it is too late to do anything about it!     

We are all in this together. Terrorism and the physician executive.

The threat of bioterrorism striking America is no longer a threat. It's real. Take a look at how the anthrax-laced letters and future acts of terrorism impact physician executives. Also consider some ways to prepare your physicians for a bioterrorism emergency.     

The Design and Introduction of Product Lines When Consumer Valuations are Uncertain

This article presents a model of the design and introduction of a product line when the firm is uncertain about consumer valuations for the products. We find that product line introduction strategy depends on this uncertainty. Specifically, under low levels of uncertainty the firm introduces both models during the first period; under higher levels of uncertainty, the firm prefers sequential introduction and delays design of the second product until the second period. Under intermediate levels of uncertainty the firm's first product should be of lower quality than one produced by a myopic firm that does not take product line effects into consideration. We find that when the firm introduces a product sequentially, the strategy might depend on realized demand. For example, if realized demand is high, the firm's second product should be a higher‐end model; if demand turns out to be low, the firm's second product should be a lower‐end model or replace the first product with a lower‐end model.     

The Cost of Children When Children are a Choice

The standard methods of measuring the cost of children are flawed because of the endogeneity of fertility decisions and because — even if they were exogenous — children bring (or may bring) utility to the household. This paper presents a simple structural model of household allocation of time and income to ‘children’s (quantity and quality) production’. From the estimates one can compute the cost of children as the market value of resources devoted to children. Some policy simulations illustrate the relevance of accounting for the endogeneity of children.     

The old ways of doing medical business are passing

Doctors must realize that the ?us and them? labels have to be discarded. No longer do physicians wield the ultimate power. We've lost our patients to insurance companies and part of our medical knowledge rests with nonphysicians. Likewise, physicians must accept the reality that all doctors aren't going to be in the same practice setting: some will work for hospitals, some for insurance companies, some for HMOs, some for themselves. But we're all members of a great profession that has proven its ability to give high-quality care to our patients, and now more than ever with more attention paid to costs.     

Developing and validating historiometric measures of leader individual differences by computerized content analysis of documents

Individual differences have been a part of leadership research since the days of trait theory. There has been an upsurge in interest in the topic due to recent theoretical and methodological advances. Also, there is increasing interest in measuring individual leader differences using nontraditional methods such as the quantitative analysis of archival data. We describe a general methodology for developing and validating measures of leader individual differences based on computerized language analysis of archival data. Two empirical examples focusing on narcissism among Fortune 100 CEOs illustrate the methodology. We summarize prospects and problems of computerized content analysis of archival materials.     

Using computerized ambulatory diaries for the assessment of job characteristics and work-related stress in nurses

Much research into work-related stress is based on retrospective self-reports, whereas records made at the time could be more valuable. In this study the primary components of two models of work stress, Karasek's demand-control (DC) model and Siegrist's effort-reward imbalance (ERI), were assessed in trained nurses using ambulatory diaries and traditional questionnaire methods. The diaries were entered on small hand-held computers and the method used has been termed ecological momentary assessment (EMA), in which recordings are made in real time in the working environment. The participants were 36 nurses who completed standardized questionnaires evaluating ERI, strain (from DC model), and, over three shifts, computerized behavioural diaries that measured effort-demand, control, reward, and stress every 90 minutes on average, enabling determination of strain and ERI repeatedly in the work situation. A total of 674 observations were recorded. Using multilevel linear modelling, it was found that the questionnaire and computerized diary derived measures of strain (DC) and ERI were reliably correlated. In addition, the ambulatory measures of both strain (DC) and ERI correlated with ratings of stress taken at the same time. From this study it would appear that ambulatory diaries could be a powerful and flexible way of assessing work related stress and its putative determinants in a real life work setting.     

Using computerized ambulatory diaries for the assessment of job characteristics and work-related stress in nurses

Abstract

Much research into work-related stress is based on retrospective self-reports, whereas records made at the time could be more valuable. In this study the primary components of two models of work stress, Karasek's demand-control (DC) model and Siegrist's effort-reward imbalance (ERI), were assessed in trained nurses using ambulatory diaries and traditional questionnaire methods. The diaries were entered on small hand-held computers and the method used has been termed ecological momentary assessment (EMA), in which recordings are made in real time in the working environment. The participants were 36 nurses who completed standardized questionnaires evaluating ERI, strain (from DC model), and, over three shifts, computerized behavioural diaries that measured effort-demand, control, reward, and stress every 90 minutes on average, enabling determination of strain and ERI repeatedly in the work situation. A total of 674 observations were recorded. Using multilevel linear modelling, it was found that the questionnaire and computerized diary derived measures of strain (DC) and ERI were reliably correlated. In addition, the ambulatory measures of both strain (DC) and ERI correlated with ratings of stress taken at the same time. From this study it would appear that ambulatory diaries could be a powerful and flexible way of assessing work related stress and its putative determinants in a real life work setting.     

The virtual patient encounter--units of service in the electronic age

A patient, preoperative evaluation center can reduce delays and cancellations, but it's critical to measure staff workload and determine the best ways to coordinate care. See how one clinic in Ohio is succeeding with this effort.     

Physician-owned health care ventures: the question of patient referrals.

This article explores the various legal and ethical restrictions governing physician-owned health care ventures to which the physician-investors expect to refer patients. The article also suggests ways to structure such enterprises so as to minimize the risk of liability to the physician-investors as well as to the health care venture itself.     

美国对弱势群体的教育援助及其启示

党的十届六中全会提出构建社会主义和谐社会以来,如何改变弱势群体的生存环境和状态越来越受到全社会的关注。然而,如何帮助弱势群体走出困境?如何改善弱势群体的生存状况?     

Cooperation, cost control and consumer focus are critical challenges for health care.

As we move into the 21st Century, the U.S. health care system faces tremendous challenges such as care for an aging and increasingly diverse population, escalating costs and limited resources. Government, consumers, hospitals and the insurance industry are positioning themselves for the future. Physicians need to do the same. Physicians must come to the table and assert leadership by working collaboratively with major stakeholders. Examine some steps that need to be taken to help shape the future of medicine.