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71.
Over There     
  相似文献   
72.
Alcohol remains the drug of choice for many adolescents; however, the nature of the relationship between athletic involvement and alcohol misuse remains ambiguous. In this article, we used a longitudinal sample of over 600 Western New York adolescents and their families to explore the gender-specific and race-specific relationships between identification with the "jock" label and adolescent alcohol consumption, specifically problem drinking. Operationalization of problem drinking included frequency measures of heavy drinking, binge drinking, and social problems related to alcohol (e.g., trouble with family, friends, school officials over drinking). Self-identified adolescent "jocks" were more likely to engage in problem drinking than their non-jock counterparts, even after controlling for gender, age, race, socioeconomic status, physical maturity, social maturity, and frequency of athletic activity. Jock identity was strongly associated with higher binge drinking frequency in Black adolescent girls. This study underscores the need to distinguish between objective and subjective meanings of athletic involvement when assessing the relationship between sport and adolescent health-risk behavior.  相似文献   
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Progressive multi-state models provide a convenient framework for characterizing chronic disease processes where the states represent the degree of damage resulting from the disease. Incomplete data often arise in studies of such processes, and standard methods of analysis can lead to biased parameter estimates when observation of data is response-dependent. This paper describes a joint analysis useful for fitting progressive multi-state models to data arising in longitudinal studies in such settings. Likelihood based methods are described and parameters are shown to be identifiable. An EM algorithm is described for parameter estimation, and variance estimation is carried out using the Louis’ method. Simulation studies demonstrate that the proposed method works well in practice under a variety of settings. An application to data from a smoking prevention study illustrates the utility of the method.  相似文献   
75.

Background

Vaginal birth after caesarean can be a safe and satisfying option for many women who have had a previous caesarean, yet rates of vaginal birth after caesarean remain low in the majority of countries. Exploring women’s experiences of vaginal birth after caesarean can improve health practitioners’ understanding of the factors that facilitate or hinder women in the journey to have a vaginal birth after caesarean.

Methods

This paper reports on a meta-ethnographic review of 20 research papers exploring women’s experience of vaginal birth after caesarean in a variety of birth locations. Meta-ethnography utilises a seven-stage process to synthesise qualitative research.

Results

The overarching theme was ‘the journey from pain to power’. The theme ‘the hurt me’ describes the previous caesarean experience and resulting feelings. Women experience a journey of ‘peaks and troughs’ moving from their previous caesarean to their vaginal birth after caesarean. Achieving a vaginal birth after caesarean was seen in the theme ‘the powerful me,’ and the resultant benefits are described in the theme ‘the ongoing journey’.

Conclusion

Women undergo a journey from their previous caesarean with different positive and negative experiences as they move towards their goal of achieving a vaginal birth after caesarean. This ‘journey from pain to power’ is strongly influenced by both negative and positive support provided by health care practitioners. Positive support from a health care professional is more common in confident practitioners and continuity of care with a midwife.  相似文献   
76.
Nonmedical factors and diagnostic certainty contribute to variation in clinical decision making, but the process by which this occurs remains unclear. We examine how physicians' interpretations of patient sex-gender affect diagnostic certainty and, in turn, decision making for coronary heart disease. Data are from a factorial experiment of 256 physicians who viewed 1 of 16 video vignettes with different patient-actors presenting the same symptoms of coronary heart disease. Physician participants completed a structured interview and provided a narrative about their decision-making processes. Quantitative analysis showed that diagnostic uncertainty reduces the likelihood that physicians will order tests and medications appropriate for an urgent cardiac condition in particular. Qualitative analysis revealed that a subset of physicians applied knowledge that women have "atypical symptoms" as a generalization, which engendered uncertainty for some. Findings are discussed in relation to social-psychological processes that underlie clinical decision making and the social framing of medical knowledge.  相似文献   
77.
This paper reports a study designed to further validate a measure of quality of college life (QCL) of university students (Sirgy, Grzeskowiak, Rahtz, Soc Indic Res 80(2), 343–360, 2007). Two studies were conducted: a replication study and an extension study. The replication study involved surveys of 10 different college campuses in different countries. The results of the replication study provided additional nomological (predictive) validation support of the measure based on a theoretical model mapping out the antecedents and consequences of satisfaction with college life. With respect to the extension study, the focus was to further test the nomological validity of the QCL measure by arguing and empirically demonstrating that the consequence of QCL is life satisfaction. The extension study involved a survey of three college campuses in different countries. The results were also supportive of the nomological validity of the QCL measure.  相似文献   
78.
Longitudinal quality-of-life (QOL) research incorporating multiple perspectives can add to knowledge about how nursing home residents experience QOL, but these methods are seldom used. This study employed interviews and participant observation to conduct multiple-perspective, longitudinal case studies of six residents. Close, reciprocal relationships with staff members, staff knowledge of residents, and autonomy were fundamental to QOL. Autonomy was experienced through choice and self-advocacy. Changes in QOL over time related to changes in resident health status, acclimation to the setting and family member availability. Study results may have implications for staffing and staff training.  相似文献   
79.
Are the marriages of lower income couples less satisfying than the marriages of more affluent couples? To address this question, we compared trajectories of marital satisfaction among couples with a wide range of household incomes. The marital satisfaction of 862 Black, White, and Latino newlywed spouses (N = 431 couples) was assessed five times, each 9 months apart, during the first 4 years of marriage. Lower income couples did not have less satisfying marriages on average, nor did their satisfaction decline more steeply on average. They did, however, experience (a) significantly greater fluctuations in marital satisfaction across assessments and (b) significantly more variability between husbands and wives. If efforts to support the marriages of low‐income couples are to address the unique characteristics of their marital development, these findings suggest that efforts to stabilize their marriages may be more effective than efforts to improve their satisfaction alone.  相似文献   
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