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991.
Christopher Edward Falls MA MBA 《Journal of gerontological social work》2013,56(1-2):53-76
ABSTRACT American medical institutions throughout the 20th century prescribed high customer satisfaction, but when it came to death, largely ignored it. An accelerated accumulation of esoteric medical information and the application of this knowledge to affect new cures and longer lives instilled an unquestioning reverence for the medical community among the patient population. Diminishing marginal gains in life expectancy, escalating costs related to life sustaining technologies, and a psychographic shift in the dominant consumer base have challenged this traditional reverence. Armed with unprecedented access to medical information, a more knowledgeable and assertive patient population has emerged in the 21st century to institute its own standards of what constitutes quality health care. In terms of end of life care, this has meant recognition that the emotional needs of the dying have been largely underserved by the current American medical model. Patients and their families are no longer willing to accept the traditional medical perspective of death as failure and have numerous international palliative care models that serve as benchmarks of success when it comes to quality of dying. When cure is a possibility, Americans will pursue it at all costs, but when it is not a possibility, they want honest communication and the opportunity to say good-bye to their loved ones. In the context of these emergent needs, life review is offered as a solution. The value proposition targets not only dying patients and their families, but also society as a whole. 相似文献
992.
Walter W. Piegorsch Gregory J. Carr Christopher J. Portier David G. Hoel 《Risk analysis》1992,12(1):115-121
The use of average qualitative concordance between two bioassay endpoints is considered, with emphasis directed at agreement between rats and mice from results of long-term carcinogenicity studies. It is noted that concordance varies as a function of the underlying potency or toxicity of the chemicals over which the averaging is performed. Thus, the averaging process dilutes large observed concordances from potent chemicals, and possibly inflates lower observed concordances from weakly active chemicals. Stratification over some measure of potency is suggested as a method for taking these effects into account. Statistical simulations of concordance analyses limited to low-potency ranges are employed to examine the concordance measure in greater detail. It is seen that at low potencies, observed concordance is consistently underestimated, reaching maximum levels of only about 80%. 相似文献
993.
994.
We describe standard single-site Monte Carlo Markov chain methods, the Hastings and Metropolis algorithms, the Gibbs sampler and simulated annealing, for maximum a posteriori and marginal posterior modes image estimation. These methods can experience great difficulty in traversing the whole image space in a finite time when the target distribution is multi-modal. We present a survey of multiple-site update methods, including Swendsen and Wang's algorithm, coupled Markov chains and cascade algorithms designed to tackle the problem of moving between modes of the posterior image distribution. We compare the performance of some of these algorithms for sampling from degraded and non-degraded Ising models 相似文献
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996.
997.
An experimental investigation of the combined effects of noise and nightwork revealed the following sex differences. Female subjects showed a large night-time impairment on a test of manual dexterity, but performed working memory tasks better at night than in the day. In contrast to this, male subjects showed a small impairment at night on both types of task. Other tasks, such as the simple reaction time task, were impaired at night for both sexes, and some tasks, such as the high memory load search task, showed no night-time impairment in males or females. There was no evidence of noise producing different effects in the two sexes, and few instances of sex differences in the size of post-meal impairments. Overall, these results show mat the effect of working at night depends on the nature of the task and also the sex of the person performing it. 相似文献
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999.
Christopher Bagley Gloria Rodberg David Wellings Mehmoona Moosa-Mitha Loretta Young 《Child Abuse Review》1995,4(2):99-113
An attempt was made to construct a measure of dissociative personality traits from file review of 61 Canadian adolescents with a known history of sexual abuse before the age of six. The study was then extended to 55 British adolescents in residential care and therapy centres. Between 18 and 29% of adolescents displayed several features of dissociative personality, implying the possibility of multiple personality disorder. Those with two or more indicators of dissociative personality style tended to have more problematic behavioural histories, including a particularly high prevalence of deliberate self-harm. In the UK group the Dissociative Experiences Scale (Bernstein and Putnam, 1986) completed by 55 adolescents correlated 0.67 with the dissociative personality trait index constructed from case file review. Implications for treatment of abused children are discussed. 相似文献
1000.
Christopher Pierson 《Social Policy & Administration》1990,24(3):186-198
The author discusses the American welfare state in the context of Lash and Urry's thesis on ‘disorganized capitalism’. Attention is directed to the claim that the US welfare state has been the laggard of organized capitalism but is becoming the pathbreaker in defining patterns of public welfare provision under an increasingly disorganized capitalism. In this context the US may be “showing the way” to the welfare states of Western Europe. A number of claims about the “exceptional” nature of US development are reviewed and a number of reservations are entered against the “disorganization” thesis as applied to the welfare state. It is suggested that attention should be focussed upon contemporary patterns of welfare state re-organization rather than dis-organization. 相似文献