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991.
In hospitals, the management of operating rooms faces a trade‐off between the need to be responsive to emergency surgeries and to conduct scheduled elective surgeries efficiently. Operating rooms can be configured as flexible and handle both electives and emergencies, or as dedicated to focus on either electives or emergencies. With flexible rooms, the prioritization of emergencies over scheduled electives can lead to schedule disruptions. Focused rooms can lead to imbalances between capacity and surgery workload. Whereas hospital administrators typically handle this trade‐off by employing either flexible rooms (complete flexibility) or dedicated rooms (complete focus), we investigate whether a combination of flexible and dedicated rooms (partial flexibility) could be a preferable alternative. The ensuing question is what is the right combination of flexible and dedicated rooms? A versatile simulation model is developed to evaluate different resource allocation policies under various environmental parameters and performance metrics, including patient wait time, staff overtime, and operating room utilization. The main result is that partial flexibility configurations outperform both complete flexibility and complete focus policies by providing solutions with improved values of expected wait time for both emergency and elective patients. 相似文献
992.
993.
Jandl M 《International migration (Geneva, Switzerland)》2011,49(5):53-77
This paper presents a comprehensive review of available methods for sizing irregular migrant populations as a particular group in the study of hidden populations. Based on the existing body of literature on the subject, a generic classification scheme is developed that divides existing estimation procedures into subcategories like “approaches”, “methods” and “estimation techniques”. For each of these categories, basic principles, methodical strengths and weaknesses, as well as practical problems, are identified and discussed with the use of existing examples. Special emphasis is placed on data requirements, data shortcomings and possible estimation biases. In addition, based on the empirical classification and quality assessment of country-specific estimates developed in the CLANDESTINO research project, the potential and requirements for replicating best practice models in other countries are explored. Finally, a number of conclusions on the appropriate design of estimation projects are offered. 相似文献
994.
Mann M 《The British journal of sociology》2011,62(1):42-8; discussion 62-8
995.
Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the United States. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. The article concludes that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, the article suggests that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors. 相似文献
996.
Byrnes HF Miller BA Chamratrithirong A Rhucharoenpornpanich O Cupp PK Atwood KA Fongkaew W Rosati MJ Chookhare W 《Journal of drug education》2011,41(2):161-181
Due to concerns over Thai adolescent risky behaviors, effective prevention strategies are needed. Determining the role neighborhood context plays in program engagement and outcomes may inform these strategies. This study includes 170 mother-adolescent pairs (M = 13.44, SD = .52) in Bangkok, Thailand in a prevention program for adolescent substance use and sexual risk. Neighborhoods were related to engagement, which was critical to outcomes. Neighborhood disorganization was related to confidence in program effects and program completion. Completion was related to increased ATOD communication. Neighborhood cohesion was related to less program enjoyment, while neighborhood social control was related to more enjoyment. Enjoyment was related to increased ATOD communication and formation and monitoring of alcohol rules. Prevention strategies should focus on neighborhood contexts and enhancing engagement. 相似文献
997.
In this paper, we examine the relative efficacy of two mechanisms--price consideration and the message of social responsibility--in accounting for Family Cap effects on fertility behavior. The Family Cap is a component of welfare reform policy that denies additional cash benefits to children born 10 or more months after a woman entered the welfare rolls. We use data from the New Jersey Family Development Program (FDP) evaluation that employed a classical experimental design. We find that fertility behaviors are influenced by both Family Cap price and message mechanisms but that these effects are conditioned by welfare recipients' time on welfare and race. Black women who have longer stays on welfare are more likely to be influenced by price while women with shorter stays are influenced by both price and the social message. We believe our results have implications not only for future public welfare policy initiatives but for any social policies that attempt to influence behavior directly, through individual rewards and punishments, and indirectly through the activation of social or community pressures. 相似文献
998.
Despite numerous studies on the myriad of psychosocial factors that affect youthful offenders, research on gender differences with respect to risky sexual behavior are limited. Using data on juvenile offenders in a residential facility, we analyzed impact of gender on sexual behavior (N = 227). Girls reported higher likelihood of diagnosis with sexually transmitted diseases, and injecting drug use including heroin and cocaine than boys. Multivariate analysis indicated that number of sexual partners, childhood trauma, and services received from emergency shelter and psychiatric settings were associated with risky sexual behavior. Discouraging, abusive and dysfunctional home environment with little support from parents/caregivers, or teachers, priests/religious leaders appear to dispose youth to a life of risky sex, drugs and delinquency. 相似文献
999.
Elizabeth K. Anthony Bryn King Michael J. Austin 《Children and youth services review》2011,33(10):1999-2009
Child poverty in the United States persists despite a range of social services designed to reduce poverty rates and improve the economic self-sufficiency of families. The economic downturns resulting in job losses and the housing crisis have converged to create a new group of families who were managing to remain out of poverty prior to the recession but are now slipping into poverty, putting additional strain on services. In light of these pressing issues, this article synthesizes the literature examining child poverty to take a long-range view of the relationship between economic strain, system involvement, and impacts on children and the systems attempting to serve these children. The effectiveness of various policy and program efforts aimed at reducing child poverty rates and/or ameliorating the negative effects of living in poverty is reviewed. The article concludes by suggesting a major shift in focus from reducing child poverty as a singular goal to a comprehensive approach to promoting child and family well-being. 相似文献
1000.
Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent-adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n = 108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed. 相似文献