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With the increasing pressure on social and health care resources,professionals have to be more explicit in their decision makingregarding the long-term care of older people. This groundedtheory study used 19 focus groups and nine semi-structured interviews(99 staff in total) to explore professional perspectives onthis decision making. Focus group participants and intervieweescomprised care managers, social workers, consultant geriatricians,general medical practitioners, community nurses, home care managers,occupational therapists and hospital discharge support staff.The emerging themes spanned context, clients, families and services.Decisions were often prompted by a crisis, hindering professionalsseeking to make a measured assessment. Fear of burglary andassault, and the willingness and availability of family to helpwere major factors in decisions about living at home. Serviceavailability in terms of public funding for community care,the availability of home care workers and workload pressureson primary care services influenced decision ‘thresholds’regarding admission to institutional care. Assessment toolsdesigned to assist decision making about the long-term careof older people need to take into account the critical aspectsof individual fears and motivation, family support and the availabilityof publicly funded services as well as functional and medicalneeds.  相似文献   
114.
Summary.  The association of poor education and poor health has been consistently observed in many studies and in various countries. Thus far, studies examining the mechanisms underlying this association have looked at only a limited set of potential pathways. This study simultaneously examines six distinctive pathways, which have been hypothesized to link education and health and found support from previous studies. A causal analysis of education and health was performed using structural equation models. Data were used from six phases of the National Child Development Study, which is based on following up an initial sample of 17416 children who were born in 1958. The association between education and health appears to be explained by a combination of mechanisms: adolescent health and adult health behaviours for men and women, adult social class among men and parental social class among women. We conclude that improvements in population educational attainment may not automatically lead to improvements in population health, and that health policies for improving health and reducing health inequalities need to target specific causal pathways.  相似文献   
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Veenhoven (1994) contrasted hypotheses of whether happiness is a trait or state, concluding that it is a state variable. This article critiques the conceptual foundation of Veenhoven's paper, and examines technical deficiencies in his review of evidence. Based on previous findings and new analyses, we conclude that happiness has both traitlike and statelike properties, but that individual differences in happiness endure despite its situational reactivity, and explain greater variance than situational effects.  相似文献   
117.
Which countries tend to sign international environmental treaties and why? This study tests the ability of quantitative cross-national political and economic analysis to predict participation in international environmental agreements over the period 1963–1987. Cross-sectional ordinary least squares regressions suggest that poor, highly indebted countries that are dependent on very few trading partners and that have repres-sive regimes are far more likely to be nonsignatories. The results suggest strategies for increasing the likelihood that nations will ratify hture environmental treaties.  相似文献   
118.
The authors examined nineteen nonprofit performing arts organizations, investigating the distribution of influence among organizational members, the grouping of volunteers and staff in organizational structures, and the effectiveness of the organizations. The organizations' effectiveness was assessed using multiple performance indicators. The analysis revealed five groupings or configurations of influence, which correlated to the organizations exhibiting the highest and lowest levels of organizational effectiveness. The authors conclude that a variety of structures are associated with good performance but structural dysfunctions are associated with organizational failure, and that members' commitment to an organization's structure is an important element of success.  相似文献   
119.
Mortality data are often gathered using 5-year age groups rather than individual years of life. Furthermore, it is common practice to use a large open-ended interval (such as 85 and over) for mortality data at the older ages. These limitations of the data pose problems for the actuary or demographer who wishes to compile a full and accurate life table using individual years of life. The author devises formulae which handle these problems. He also devises methods for handling mortality during the 1st year of life and for dealing with other technical problems which arise in the compilation of the full life table from grouped data.  相似文献   
120.
"Using 1980 census and 1987 survey data on birth cohorts to examine recent primary and secondary school enrollment trends [in Thailand], this study reports that primary enrollment is nearly universal but secondary enrollment is much less prevalent. The study assesses several factors thought to influence enrollment and finds that urban residence, parents' completion of primary school, the mother's positive attitude toward education, and the family's being comfortable economically to be associated with children's enrollment in secondary school. It also indicates that, for moderately well-off families, proximity to schools has a major influence on secondary school attendance. For the wealthiest families, however, distance is not a hindrance to attendance, and for the poorest families, having a school nearby is not sufficient to ensure attendance."  相似文献   
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