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151.
Abstract

Objective: To implement a pilot quality improvement project for depression identification and treatment in college health. Participants: Eight college health center teams composed primarily of primary care and counseling service directors and clinicians. Methods: Chronic (Collaborative) Care Model (CCM) used with standardized screening to identify, treat, and track depressed students for 12 weeks to monitor predetermined process and clinical outcomes. Results: Of all students receiving primary medical care services between January 2007 and May 2008, 69% (n = 71,908) were screened for depression. A total of 801 depressed students were treated and tracked; most predetermined treatment process and clinical outcome targets were achieved. Conclusion: The CCM for depression shows promise for improving depression identification and care for college students.  相似文献   
152.
It is commonly believed that labour‐market returns to education are highest for the primary level of education and lower for subsequent levels. Recent evidence reviewed in this article suggests that the pattern is changing. The causes of such changes, and their implications for both education and labour‐market policy, are explored.  相似文献   
153.
In this paper we seek to contribute to recent efforts to develop and implement multi-dimensional approaches to social exclusion by applying self-organising maps (SOMs) to a set of material deprivation indicators from the Irish component of EU-SILC. The first stage of our analysis involves the identification of sixteen clusters that confirm the multi-dimensional nature of deprivation in contemporary Ireland and the limitations of focusing solely on income. In going beyond this mapping stage, we consider both patterns of socio-economic differentiation in relation to cluster membership and the extent to which such membership contributes to our understanding of economic stress. Our analysis makes clear the continuing importance of traditional forms of stratification relating to factors such as income, social class and housing tenure in accounting for patterns of multiple deprivation. However, it also confirms the role of acute life events and life cycle and location influences. Most importantly, it demonstrates that conclusions relating to the relative impact of different kinds of socio-economic influences are highly dependent on the form of deprivation being considered. Our analysis suggests that debates relating to the extent to which poverty and social exclusion have become individualized should take particular care to distinguish between different kinds of outcomes. Further analysis demonstrates that the SOM approach is considerably more successful than a comparable latent class analysis in identifying those exposed to subjective economic stress.  相似文献   
154.
155.
对用于固液相变问题数值模拟的界面流动技术的精度进行了讨论,分析表明对移动界面项使用一阶有限差分不能精确地描述界面的运动,特别是在解决如爆融情况下的高热流问题,建议使用二阶方法,其在所有情况下均可保证足够的精度。  相似文献   
156.
Historically, U.S. regulators have derived cancer slope factors by using applied dose and tumor response data from a single key bioassay or by averaging the cancer slope factors of several key bioassays. Recent changes in U.S. Environmental Protection Agency (EPA) guidelines for cancer risk assessment have acknowledged the value of better use of mechanistic data and better dose–response characterization. However, agency guidelines may benefit from additional considerations presented in this paper. An exploratory study was conducted by using rat brain tumor data for acrylonitrile (AN) to investigate the use of physiologically based pharmacokinetic (PBPK) modeling along with pooling of dose–response data across routes of exposure as a means for improving carcinogen risk assessment methods. In this study, two contrasting assessments were conducted for AN-induced brain tumors in the rat on the basis of (1) the EPA's approach, the dose–response relationship was characterized by using administered dose/concentration for each of the key studies assessed individually; and (2) an analysis of the pooled data, the dose–response relationship was characterized by using PBPK-derived internal dose measures for a combined database of ten bioassays. The cancer potencies predicted for AN by the contrasting assessments are remarkably different (i.e., risk-specific doses differ by as much as two to four orders of magnitude), with the pooled data assessments yielding lower values. This result suggests that current carcinogen risk assessment practices overestimate AN cancer potency. This methodology should be equally applicable to other data-rich chemicals in identifying (1) a useful dose measure, (2) an appropriate dose–response model, (3) an acceptable point of departure, and (4) an appropriate method of extrapolation from the range of observation to the range of prediction when a chemical's mode of action remains uncertain.  相似文献   
157.
A substantial portion of Germany's workforce will soon retire, making it difficult for businesses to meet their human capital needs; training older workers may help to manage this demographic transition. The authors therefore examine the relationships between employer‐provided training programmes, wages and retirement among older workers. They find that when establishments offer special training programmes targeted at these workers, women – especially low‐paid women – are less likely to retire, possibly because of consequent wage growth. Their results suggest that such targeted training can indeed play an important role in retaining low‐wage older women and advancing their careers.  相似文献   
158.
Assigning grades is an integral and everyday part of social work education. However, social work educators, especially those teaching the academically-based as opposed to practice-based courses, must decide whether to use norm-referenced or criterion-referenced measurements to grade exams and other assignments. Norm-referenced measurement is commonly called grading on a curve in higher education. While grading on the curve is not obsolete in academia, I have eliminated it in my courses. New and perhaps experienced social work educators may benefit from a review of both grading methods. This article examines both sides of a grading issue relevant to the wider context of higher education and, therefore, relevant to social work education. Grading with norm-referenced or criterion-referenced measurements is reviewed along with issues related to both types of grading. I will describe why I grade with criterion-referenced measurement and why I believe it is a better choice for social work education.  相似文献   
159.
Pseudo maximum likelihood estimation (PML) for the Dirich-let-multinomial distribution is proposed and examined in this pa-per. The procedure is compared to that based on moments (MM) for its asymptotic relative efficiency (ARE) relative to the maximum likelihood estimate (ML). It is found that PML, requiring much less computational effort than ML and possessing considerably higher ARE than MM, constitutes a good compromise between ML and MM. PML is also found to have very high ARE when an estimate for the scale parameter in the Dirichlet-multinomial distribution is all that is needed.  相似文献   
160.
The public sector, in its policy statements and in the design of programmes of intervention, appears to be subscribing to a rhetoric of “grassroots participation”. At the same time, however, pressures are increasing for bureaucracies to adopt a managerialist modus operandi. This article considers the tensions that arise when participative service provision and programmes are subjected to evaluation scrutiny by managerialist bodies. The discussion takes place in the context of an EU-sponsored endogenous socio-economic development initiative. This prepares the ground for an exploration of participative evaluation.  相似文献   
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