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221.
222.
This integrative literature review examines the sources of the persistent debate over the influence of disasters on individual mental health that characterizes the disaster research literature. Using an interdisciplinary approach, this paper highlights how the connections between individuals and the systems in which they are embedded influence people's varied responses to disaster. Consistent with the emerging emphasis in the social sciences on contextualizing individual behavior, this paper examines how family, community, social structural, cultural, and environmental factors affect the development of stress in disaster populations. It concludes with recommendations for policy, practice, and research related to disaster recovery. 相似文献
223.
Andreu López-blasco 《European Journal of Social Work》1998,1(1):41-53
The Spanish Civil War (1936—1939) interrupted the evolution and development of social pedagogy, which in Spain had reached similar levels as in other European countries. This was followed by a period when Spain was isolated from developments in social welfare and the changes that go along with the economic and social transformations of cities and give rise to community action, self-help and popular education programmes. The reinstatement of democracy and of new City Councils that are genuinely devoted to solve the problems of the population are the starting point for new social services, that is for social work and social pedagogy. Initially it was practical work that gave an answer to emerging demand, followed by theoretical analysis and efforts of conceptualisation. The professionals and later the universities lead the debate on methodology. The interest and involvement of the universities increased as the Diploma in Social Education was introduced as a new university degree. 相似文献
224.
Institutional Ethnography and Experience as Data 总被引:1,自引:0,他引:1
Experience, as concept, is contested among feminists as to its epistemological status, thus its usefulness in knowledge claims. Institutional ethnography (Smith 1987) is a feminist methodology that nonetheless relies fundamentally on people's experience. Not as Truth, nor the object of inquiry, but as thepoint d'appui for sociological inquiry. This article offers a demonstration of institutional enthnography using observational and interview data that show experience as methodologically central to a trustworthy analysis. A moment in the work lives of nursing assistants in a long-term care setting is captured by a participant observer. The analysis produces two lines of argument. One is methodological; it is argued that nursing assistants' experiences are an entry into the social relations of the setting that, when mapped and disclosed, make those experiences understandable in terms of the ruling arrangements permeating both the organization and their own experiences. The other argument is substantive; the inquiry uncovers how a quality improvement' strategy in a long term care hospital in Canada is reorganizing caregivers' values and practices toward a market orientation in which care appears to be compromised. Use of experience as data in this approach holds the analysis accountable to everyday/everynight actualities in a lived world. 相似文献
225.
Relatively little is known about Asian American tobacco and alcohol use patterns. This is particularly true of Chinese living in the United States--either U.S.-born or non-U.S.-born Chinese. This article presents data from a research project studying tobacco and alcohol use patterns in San Francisco's Chinese community. Data were secured both from focus groups and a self-report telephone survey of a random sample of 1,808 Chinese residents in San Francisco. This results indicate that the prevalence of both tobacco and alcohol use is lower for San Francisco's Chinese population than for the general population. Moreover, those persons who report smoking tend to be different from those who report consuming alcohol. The study concludes that specific, culturally relevant tobacco and alcohol prevention programs should be designed to better reach this target population. 相似文献
226.
How accurately can you measure quality of care in health care? Recently, HMOs and other types of managed care organizations have been in the process of defining quality in quantitative terms. Physicians who utilize fewer resources and who care for more patients per-unit-of-time are valued as providing better care than colleagues who may work at a slower (more expensive?) pace. The pressure to evaluate or treat greater numbers of patients in shorter periods of time can produce adverse consequences. And numbers do not necessarily take into account the quality of the care delivered. There is clearly a middle road. Physicians must take care of a sufficient number of patients with a given problem to gain and maintain expertise and mastery. But they must also guard against the insidious pressure for the procedure to become the end in itself. 相似文献
227.
Virtually no managed care organization provides a comprehensive and integrated program for physician career development. That's the principal finding of a survey we carried out in Spring 1994 in which we interviewed several individuals who have proven instrumental in the creation of career development programs at their managed care organizations. We started our research with the hypothesis that career development programs for physicians--frequently the most highly paid category of employees and the ones often most directly involved in the delivery of health care--should parallel the mission of the organization. In many of the organizations we surveyed, the mission included clinical excellence, managerial competence, research, teaching, community service, and building shareholder equity. While each organization offered some component of career development--usually clinical improvement and management development--very few offered programs that fostered the continued professional development of physicians in other aspects of their missions. In most cases, even in organizations with stronger career development agendas, the programs were passive and were rarely linked to the overall "corporate" goal of the managed care institution. This critical disconnect makes it extremely difficult for health care organizations to develop a workable system of accountability for their career development programs. 相似文献
228.
Brown M 《Physician executive》1996,22(1):5-11
Projecting out to the year 2015 sounds presumptuous. Who can predict that far ahead? Perhaps no one can. Social and organizational arrangements come slowly. It takes five years or so to implement simple concepts, sometimes decades for more radical changes. Once you have the ideas in tangible form, it can take another five years to get it working right. Early adopters bring others into the movement and, over 15-25 years, new directions dominate. It takes at least a generation of new practitioners to take on the new values and methods so what is likely to dominate in 2015 is beginning to be taken somewhat seriously as the successor movement to our current fad with externally imposed managed care. Put another way, entire generations of people will resist new ideas, making implementation unlikely until their control fades and a new generation takes the helm. The exciting challenge for the observer is to address the issue of where health is and should be going. Both are difficult challenges. Agreeing on what is important and what is not represents a competitive challenge. How do we perceive the world? Surely our value sets will color what we see. Who is not predisposed to select a future where they fit and their pet theories are likely to become reality. For these and other reasons, it is probably easier to agree on what we would like to see happen in the future than on what is happening. Unfortunately, unless we see the world as it is, we are less likely to be able to shift it in a direction we would like to see. 相似文献
229.
This study examines the impact of mandatory seat belt laws on fatal and incapacitating injury rates in the states. Annual data for all 50 states for the period 1975-1991 are used. Pooled time series analysis is employed. The general conclusion that emerges from this analysis is that seat belt laws significantly impact state fatal injury rates. Primary enforcement and all-seat coverage provisions appear to be particularly effective in reducing fatality rates. 相似文献
230.
Stephen Rowe 《Statistics and Computing》1996,6(3):187-190
In Flury (1990) the k principal points of a random vector X are defned as the points p(1),..., p(k) minimizing EX–p(i)2; i=1,..., k. We extend this concept to that of k principal points with respect to a loss function L, and present an algorithm for their computation in the univariate case. 相似文献