Hospital-sponsored networks. The rush to consolidate and the future of medical practice

As the medical delivery system undergoes fundamental change, there is a growing pressure on hospitals to form networks with physicians. The prime motivation for these entities is to preserve market share and fill beds. There is likewise intense pressure on physicians to join them, even if these networks do not serve their best interests, or the goal of fostering physician-centered practice. A transformation is under way, however, that may well place doctors again in the central role of guiding the new modes of medical practice in the United States.     

Gaining Competitive Advantages in Higher Education: Analyzing the Gap between Expectations and Perceptions of Service Quality

The research findings have provided several implications for higher educational institutions, managers, and leaders of decision-making processes throughout the world. Service quality, customer satisfaction, and behavioral intentions are global issues that affect all organizations, large or small, profit or non-profit, global or local. We are all influenced or discouraged, satisfied or dissatisfied with positive loyalty behavioral intentions or negative complaining reactions, propelled by the level of service quality received. This revised version was published online in July 2006 with corrections to the Cover Date.     

Problem‐ and solution‐focused characteristics of parenting support, 3 years after implementation of the solution‐focused approach: A qualitative content analysis

In recent years, solution‐focused parenting support has been developed and implemented as a promising brief and strength‐based approach. Given the fundamental differences between solution‐focused and the historically more common problem‐focused parenting support and the complexity of transforming professional practice, an actual shift towards solution‐focused parenting support can be expected to be limited up to now. However, because research into the specific communication characteristics of professional parenting support is currently lacking, no conclusion can be drawn at present. Therefore, this study aims to explore the current problem‐ and solution‐focused characteristics of parenting support in the Dutch youth healthcare (YH). In total, 15 support sessions performed by 10 public health nurses were audio recorded and transcribed verbatim. A detailed qualitative content analysis of professional communication was conducted to identify problem‐ and solution‐focused factual, expressive, relational and appealing aspects of parenting support. Problem‐focused characteristics dominated all sessions of parenting support. This study is the first to thoroughly analyse the problem‐focused and solution‐focused communication characteristics of professional parenting support using a qualitative content analysis. Parenting support practice in the Dutch YH did not shift substantially to a solution‐focused approach. More effort is required to stimulate and facilitate this professional transformation.     

Explaining the Flight of Cupid’s Arrow: A Spatial Random Utility Model of Partner Choice

Spatial homogamy may be defined as follows: anyone may be attracted to anyone else, but near candidates are more attractive than distant candidates. In this article, we propose a model of partner choice, where homogamy is defined in terms of spatial, demographic, socioeconomic and cultural similarity. A spatial choice model using random utility theory is formulated, taking into account a relaxation of the independence from the irrelevant alternatives property, as spatial alternatives are not independent of one another. We model partner choice given the characteristics of the chosen partner and a choice set of alternatives, using unique micro data on all new cohabiters in the Netherlands, linked to other relevant data sets. The model takes the spatial locations of potential candidates within a choice set into account, including an indicator for the spatial similarity between alternatives. We find that spatial homogamy is a vital component of partner matching, aside from and adding to the spatial effects in demographic, socioeconomic and cultural homogamy. Given a choice set of partners, the highest likelihood of a match occurs with a person who is born and lives near by, who is close in age, is in the same life stage and has the same marital status, who has the same educational and income level and the same labour market status, who speaks the same dialect and lives in a culturally similar residential area. The distance effect is most pronounced for those individuals with lower levels of education and those living in rural areas.     

Attenuating Initial Beliefs: Increasing the Acceptance of Anthropogenic Climate Change Information by Reflecting on Values

Anthropogenic climate change information tends to be interpreted against the backdrop of initial environmental beliefs, which can lead to some people being resistant toward the information. In this article (N = 88), we examined whether self‐affirmation via reflection on personally important values could attenuate the impact of initial beliefs on the acceptance of anthropogenic climate change evidence. Our findings showed that initial beliefs about the human impact on ecological stability influenced the acceptance of information only among nonaffirmed participants. Self‐affirmed participants who were initially resistant toward the information showed stronger beliefs in the existence of climate change risks and greater acknowledgment that individual efficacy has a role to play in reducing climate change risks than did their nonaffirmed counterparts.     

How Moroccan‐Dutch parents learn in communities of practice: Evaluating a bottom‐up parenting programme

Research shows that top‐down‐designed parenting programmes do not always meet the needs of postmigration parents. Bottom‐up programmes by migrant organizations hold a promise to fill this gap; however, research about these programmes and appropriate evaluation methodologies is scarce. Drawing upon Wenger's ( 2010 ) “communities of practice,” this paper explores an alternative perspective on parenting programme evaluation. Findings are presented from a study looking into social learning processes of postmigration parents who participated in a bottom‐up programme about raising teenagers in urban areas. Using an ethnographically inspired method combined with a preprogramme and postprogramme design, 115 Moroccan‐Dutch mothers and fathers from 15 programme groups participated. Results show that the programme provided a social learning space in which parents used themselves as resources to learn collectively about parenting. Moreover, parents consciously engaged in learning interactions across learning spaces stretched into their social networks. These analyses showed how parents' development of “learning citizenship” (Wenger, 2009 ) provides us with insight in collective learning dimensions present in a bottom‐up parenting programme, which is often not included in evaluation studies. Implications for practitioners as facilitators of parents' collective learning are presented.     

Infill asymptotics for adaptive kernel estimators of spatial intensity

We apply the Abramson principle to define adaptive kernel estimators for the intensity function of a spatial point process. We derive asymptotic expansions for the bias and variance under the regime that n independent copies of a simple point process in Euclidean space are superposed. The method is illustrated by means of a simple example and applied to tornado data.     

Complex Latent Variable Modeling in Educational Assessment

Bayesian item response theory models have been widely used in different research fields. They support measuring constructs and modeling relationships between constructs, while accounting for complex test situations (e.g., complex sampling designs, missing data, heterogenous population). Advantages of this flexible modeling framework together with powerful simulation-based estimation techniques are discussed. Furthermore, it is shown how the Bayes factor can be used to test relevant hypotheses in assessment using the College Basic Academic Subjects Examination (CBASE) data.     

The German East-West Mortality Difference: Two Crossovers Driven by Smoking

Before the fall of the Berlin Wall, mortality was considerably higher in the former East Germany than in West Germany. The gap narrowed rapidly after German reunification. The convergence was particularly strong for women, to the point that Eastern women aged 50–69 now have lower mortality despite lower incomes and worse overall living conditions. Prior research has shown that lower smoking rates among East German female cohorts born in the 1940s and 1950s were a major contributor to this crossover. However, after 1990, smoking behavior changed dramatically, with higher smoking intensity observed among women in the eastern part of Germany. We forecast the impact of this changing smoking behavior on East-West mortality differences and find that the higher smoking rates among younger East German cohorts will reverse their contemporary mortality advantage. Mortality forecasting methods that do not account for smoking would, perhaps misleadingly, forecast a growing mortality advantage for East German women. Experience from other countries shows that smoking can be effectively reduced by strict anti-smoking policies. Instead, East Germany is becoming an example warning of the consequences of weakening anti-smoking policies and changing behavioral norms.