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111.
Golant SM 《Journal of aging & social policy》2003,15(4):21-48
A substantial share of the low-income older tenants who occupy U. S. government-subsidized rental housing has physical and cognitive limitations. These older tenants are often women living alone in their 70s and 80s, who need help obtaining community-based services, demand-responsive transportation, help with apartment housekeeping and maintenance, self-care assistance, and design modifications made to their dwellings. Other low-income and frail older persons who have large housing expense burdens or occupy physically deficient dwellings also need affordable rental housing with these supportive services. The unmet supportive service needs of these groups persist even as this country's major political and professional stakeholders are aware of their problems and have solutions. This paper examines five major political and organizational barriers that have restricted the availability of supportive services in affordable rental developments. It offers 12 policy recommendations. 相似文献
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The term ‘end-to-end’ process management is now commonplace in the language and practice of operations. Managers are encouraged to migrate from functional process management to end-to-end process management to realise a range of performance improvements. However, these improvements are often elusive; the specific challenges associated with such a migration are under-researched. This paper uses a cross-sector study to identify the challenges of end-to-end process management and to generate practical managerial guidance. Three areas are identified that demand particular managerial attention: the need to move beyond process mapping, the role of IT in process management and maintaining the process infrastructure as a strategic asset. More significantly, the findings highlight the need for greater conceptual clarity regarding the end-to-end concept itself. The existing literature suggests that scope is the primary differentiator of the end-to-end process – the requirement to manage an extended boundary from customer order through to customer fulfilment. However, this research suggests that the end-to-end concept is more complex, comprising of three core constructs with seven dimensions: scope (boundary conditions, sequence/flow and controls); scale (resources and input/output transformation) and complexity (interrelationships and orientation). End-to-end process management involves much more than an extended boundary. It requires a systemic perspective and clarity regarding controls and transforming resources. 相似文献
116.
Violence against psychiatric staff seems to be on the increase. Such abuse can lead to mental health consequences for the staff and a reluctance to be closely involved with patients. Few Swedish investigations have examined violence against mental nurses and psychiatrists, or undertaken comparative studies between them. In this study we examined the extent, nature and determinants (i.e. risk factors) of violence against psychiatric nurses (n = 731) and psychiatrists (n = 320) working in the eight health care districts of Stockholm. These caregivers were assessed cross-sectionally by means of a questionnaire covering various areas (e.g. violence and work environment). The majority of the participants (85%) reported having been exposed to violence during their careers, with 57% being victimized in the past 12 months. Physical violence was common, and factors such as negative attitudes to work and diminished sense of autonomy were associated with an increased vulnerability to violence. Nurses and psychiatrists did not differ in violence variables. In spite of the weaknesses of the design (cross-sectional self-selecting sample), this study corroborates previous findings and identifies personal factors associated with violence that have received little attention in the literature (e.g. lack of respect for the organization of care). 相似文献
117.
The U.S. Department of Energy has estimated that over 50 GW of offshore wind power will be required for the United States to generate 20% of its electricity from wind. Developers are actively planning offshore wind farms along the U.S. Atlantic and Gulf coasts and several leases have been signed for offshore sites. These planned projects are in areas that are sometimes struck by hurricanes. We present a method to estimate the catastrophe risk to offshore wind power using simulated hurricanes. Using this method, we estimate the fraction of offshore wind power simultaneously offline and the cumulative damage in a region. In Texas, the most vulnerable region we studied, 10% of offshore wind power could be offline simultaneously because of hurricane damage with a 100‐year return period and 6% could be destroyed in any 10‐year period. We also estimate the risks to single wind farms in four representative locations; we find the risks are significant but lower than those estimated in previously published results. Much of the hurricane risk to offshore wind turbines can be mitigated by designing turbines for higher maximum wind speeds, ensuring that turbine nacelles can turn quickly to track the wind direction even when grid power is lost, and building in areas with lower risk. 相似文献
118.
Randall Lutter Linda Abbott Rick Becker Chris Borgert Ann Bradley Gail Charnley Susan Dudley Alan Felsot Nancy Golden George Gray Daland Juberg Mary Mitchell Nancy Rachman Lorenz Rhomberg Keith Solomon Stephen Sundlof Kate Willett 《Risk analysis》2015,35(2):186-192
Federal and other regulatory agencies often use or claim to use a weight of evidence (WoE) approach in chemical evaluation. Their approaches to the use of WoE, however, differ significantly, rely heavily on subjective professional judgment, and merit improvement. We review uses of WoE approaches in key articles in the peer‐reviewed scientific literature, and find significant variations. We find that a hypothesis‐based WoE approach, developed by Lorenz Rhomberg et al., can provide a stronger scientific basis for chemical assessment while improving transparency and preserving the appropriate scope of professional judgment. Their approach, while still evolving, relies on the explicit specification of the hypothesized basis for using the information at hand to infer the ability of an agent to cause human health impacts or, more broadly, affect other endpoints of concern. We describe and endorse such a hypothesis‐based WoE approach to chemical evaluation. 相似文献
119.
Layered defenses are necessary for protecting the public from terrorist attacks. Designing a system of such defensive measures requires consideration of the interaction of these countermeasures. In this article, we present an analysis of a layered security system within the lower Manhattan area. It shows how portfolios of security measures can be evaluated through portfolio decision analysis. Consideration is given to the total benefits and costs of the system. Portfolio diagrams are created that help communicate alternatives among stakeholders who have differing views on the tradeoffs between security and economic activity. 相似文献
120.
We show that any point in the convex hull of each of (d+1) sets of (d+1) points in ℝ
d
is contained in at least ⌊(d+2)2/4⌋ simplices with one vertex from each set.
Both authors were supported by NSERC Discovery grants. Additionally, T. Stephen was supported by DFG FG-468 and the Dynamical
Systems research focus at the University of Magdeburg. 相似文献