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991.
992.
Potter SJ 《Journal of health and social behavior》2001,42(1):17-44
Have changes in the hospital industry forced not-for-profit hospitals to become more like for-profit hospitals in measures of efficiency and community service? As a result, are not-for-profit hospitals moving away from their community service missions? In recent years researchers have asserted that the once-salient distinctions between not-for-profit and for-profit hospitals are quickly eroding and that this convergence threatens the community service that not-for-profit hospitals have historically provided. Neo-institutionalists explain that regulatory changes often force differing organization types to pursue similar strategies (Fligstein 1991, 1985; DiMaggio and Powell 1983). Guided by this theory, the present research analyzes if regulatory changes and the implementation of similar strategies result in not-for-profit and for-profit hospitals having similar efficiency and community service outcomes. 相似文献
993.
Neighborhood disadvantage, stress, and drug use among adults 总被引:1,自引:0,他引:1
Boardman JD Finch BK Ellison CG Williams DR Jackson JS 《Journal of health and social behavior》2001,42(2):151-165
This paper explores the relationships among neighborhood disadvantage, stress, and the likelihood of drug use in a sample of adults (N = 1,101). Using the 1995 Detroit Area Study in conjunction with tract-level data from the 1990 census, we find a positive relationship between neighborhood disadvantage and drug use, and this relationship remains statistically significant net of controls for individual-level socioeconomic status. Neighborhood disadvantage is moderately associated with drug related behaviors, indirectly through increased social stressors and higher levels of psychological distress among residents of disadvantaged neighborhoods. A residual effect of neighborhood disadvantage remains, net of a large number of socially relevant controls. Finally, results from interactive models suggest that the relationship between neighborhood disadvantage and drug use is most pronounced among individuals with lower incomes. 相似文献
994.
The impact of childhood abuse and neglect on adult mental health: a prospective study 总被引:10,自引:0,他引:10
This paper examines the impact of three types of victimization in childhood--sexual abuse, physical abuse, and neglect--on lifetime measures of mental health among adults. In contrast to research that relies on retrospective recall of childhood victimization, this work uses a prospective sample gathered from records of documented court cases of childhood abuse and neglect in a midwestern city around 1970. These subjects were interviewed about twenty years later. In addition, this research compares outcomes of the 641 members of the abuse and neglect group with a matched control group of 510 persons who did not have documented cases of abuse or neglect. The results indicate that men who were abused and neglected as children have more dysthymia and antisocial personality disorder as adults than matched controls, but they did not have more alcohol problems. Abused and neglected women report more symptoms of dysthymia, antisocial personality disorder, and alcohol problems than controls. After controlling for stressful life events, however, childhood victimization had little direct impact on any lifetime mental health outcome. This research indicates the importance of adopting an approach that places childhood victimization in the context of other life stressors and of prospective changes over the life course. 相似文献
995.
For the past two decades, evidence-based medicine (EBM), or the reliance on current scientific evidence to reach medical decisions, has been embraced as a new paradigm to standardize clinical care. Drawing from in-depth interviews with seventeen pediatric residents in two residency programs, we evaluate the extent to which the medical sociology scholarship on uncertainty analytically elucidates the recent influx of EBM during residency training. Our findings suggest that residents interpret EBM in varying ways to match their work practices: "Librarians" consult the literature while "researchers" evaluate it critically. For both groups, EBM might generate new uncertainties due to the increased reliance on information technologies and epidemiology. Whether EBM reduces uncertainty depends upon the residents' understanding of standardized knowledge and consequent incorporation of EBM in their clinical practice. Contrary to the predictions of some sociologists, EBM does not lead to a diminishment of humanitarian values in medical care. Nor does EBM lead to a science-based meritocracy on the patient ward, as claimed by some EBM advocates. Our conceptual updating of uncertainty emphasizes the continuous management of uncertainty during the medical socialization process. We argue that managing uncertainty develops along with what we term evidence-based clinical judgment. 相似文献
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It is nothing new to suggest that money has meaning. Whether or not one accepts Freud's (1908)linkage of money and feces, within our culture money is frequently seen as a direct pathway to feelings of power, agency, self-directedness, and personal satisfaction. Trachtman (1999) states, Money, psychologically speaking, is our projection onto coins, bills, bank accounts, and other financial instruments of our beliefs, hopes, and fears about how those things will affect who we are, what will happen to us, and how we will be treated by others or by ourselves...(Trachtman, 1999, p. 283). Yet this material is often unavailable for therapeutic exploration or understanding until it explodes into the therapy, often in unmanageable and countertherapeutic ways. This article will look at some of the ways in which money can be utilized to negotiate the ever-changing tensions between self and other, object and subject, intrapyschic and interpersonal, connection and separation that appear in every relationship. In particular, it will explore some ways that money issues within the therapeutic relationship can be turned into significant tools for understanding and working with anxieties about connection and separateness, both within and outside the therapeutic dyad. 相似文献
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To summarize articles with the depth and range of the nine in this collection is difficult. What the articles demonstrate as a whole is that a great deal of activity is under way in the arena of connecting child welfare and substance abuse services, with a growing body of documentation accompanying it. The articles bode good news in that they indicate a broadening awareness of the interconnectedness of these issues, and they highlight a number of creative and effective programs that have been established to mitigate the problems. Tremendous challenges-from funding to outcomes research-however, are also made evident in this body of work. 相似文献