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Changes occurring in health care demand that physicians expand their professional knowledge and skills beyond the medical and behavioral sciences. Subjects absent from traditional medical education curricula, such as the economics and politics of health care, practice management, and leadership of professional organizations, will become important competencies, particularly for physicians who serve in management roles. Because physicians occupy a central role in planning and allocating medical care services and other health care resources, they must be better prepared to work with other health care professionals to create a new civilization, even if this means leaving the cloistered domain of "physician land" to serve as interface professionals between the delivery of medical services and the management of health care. Our research findings and conclusions strongly suggest that economic, management, and leadership competencies need to be incorporated into the professional development of physicians, especially in postgraduate and continuing education curricula. 相似文献
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Modified maximum likelihood estimators of the parameters of a multivariate normal distribution are developed when the smallest or largest observations on one of the components are censored. These estimators are used to construct tests for means and correlation coefficients. The robustness of these tests to deviations from normality is investigated. 相似文献
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In the last 15 years, agri-environmental programmes in Australia have been underpinned by a neoliberal regime of governing which seeks to foster participation and ‘bottom-up’ change at the regional level at the same time as encouraging farmers to become entrepreneurial and improve their productivity and environmental performance without government interference. However, while experiencing a degree of success in terms of farmer involvement, considerable tensions are evident in such programmes. Drawing on an ‘analytics of governmentality’, this paper argues that while current agri-environmental programmes enable authorities to combine often competing and contradictory imperatives under the rubric of single political problems—what has been termed hybrid forms of governing—it also contributes to the continuing failure of these programmes to achieve their desired effects. As a consequence, neoliberal forms of governing tend to be characterised by experimentation with a range of governmental technologies in order to make programmes workable in practice. We explore two different types of technologies—standards schemes and direct government regulation—that have emerged in recent years, and how these have sought to address the limitations evident in ‘participatory’ programmes. The paper concludes by arguing that while these initiatives seek to encourage farmer compliance in seemingly divergent ways, their capacity to be workable, and have broader effects, in practice will depend upon their capacity to manage the competing imperatives of environmental degradation, capital accumulation and private property rights. 相似文献
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The purpose of this article is to examine factors related to the professional involvement of highly educated women. Three indicators of involvement are considered: nonemployment, part-time work, employment not making use of highest degree. The sample consists of 663 women who received high-level degrees from a large midwestern university between 1964 and 1974. Results indicate that both family role position and role bargaining outcomes play a major role in determining the level of involvement. Indicators of the latter, including previously untested measures of the timing of family and career beginnings and husband's moves for his wife's career, were important determinants of all three measures of involvement. As a caveat, we question the culturally pervasive assumption that lower involvement is necessarily negative. Information from a small number of in-depth interviews suggests that these women value an overall balance between work and family rather than consistently high levels of professional involvement. Future research must explore this possibility. 相似文献
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