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921.
922.
Numerous barriers to managing coronary artery disease (CAD) among older women are reported in the literature; however, few studies adjust for demographic and health status differences. A survey assessing barriers and other factors was distributed to a stratified random sampling of older women with CAD. Factor analysis and multiple logistic regression procedures were used to estimate the impact of these issues on receiving a CAD-related office visit. The most problematic barriers included denial and low health literacy. Efforts to promote patient awareness of heart health and better communication between patients and clinicians may alleviate these barriers.  相似文献   
923.
This exploratory qualitative study examined the roles of religiousness in the lives of 21 older women (mean age = 63) serving life sentences in one southern state. Based on survey and focus group methodology, several themes emerged as important focal points, including early religious experiences prior to incarceration, imprisonment and religious doubt, participation in formal and informal religious activities, and use of religion in coping with stressors such as interpersonal relationships, trauma, and health statuses. Irrespective of their religious upbringing, all participants agreed that religiosity/spirituality played a key role in their ability to cope with their prison experience as well as for maintaining hope and the opportunity for release.  相似文献   
924.
925.
This article offers a new definition of military cultural competence based on a review of the literature. As a starting point, the defining characteristics of military culture is discussed and includes the chain of command, military norms, and military identity. Having laid this groundwork, the multidimensionality of military cultural competence—attitudinal, cognitive, behavior—is discussed. Clinical applications of these various competencies are provided.  相似文献   
926.
We propose a methodology, called defender–attacker decision tree analysis, to evaluate defensive actions against terrorist attacks in a dynamic and hostile environment. Like most game‐theoretic formulations of this problem, we assume that the defenders act rationally by maximizing their expected utility or minimizing their expected costs. However, we do not assume that attackers maximize their expected utilities. Instead, we encode the defender's limited knowledge about the attacker's motivations and capabilities as a conditional probability distribution over the attacker's decisions. We apply this methodology to the problem of defending against possible terrorist attacks on commercial airplanes, using one of three weapons: infrared‐guided MANPADS (man‐portable air defense systems), laser‐guided MANPADS, or visually targeted RPGs (rocket propelled grenades). We also evaluate three countermeasures against these weapons: DIRCMs (directional infrared countermeasures), perimeter control around the airport, and hardening airplanes. The model includes deterrence effects, the effectiveness of the countermeasures, and the substitution of weapons and targets once a specific countermeasure is selected. It also includes a second stage of defensive decisions after an attack occurs. Key findings are: (1) due to the high cost of the countermeasures, not implementing countermeasures is the preferred defensive alternative for a large range of parameters; (2) if the probability of an attack and the associated consequences are large, a combination of DIRCMs and ground perimeter control are preferred over any single countermeasure.  相似文献   
927.
928.
Adult mental health clinicians face a range of challenges that hinder their use of family‐focused practices when working with consumers who are parents. The purpose of this study was (a) to examine clinicians' experiences when working with parents and (b) identify strategies they found to be effective when working with parents. Eleven Australian mental health clinicians were recruited who regularly worked with consumers who are parents. Semistructured interviews were conducted within a qualitative paradigm and analysed using interpretative phenomenological analysis. Themes were identified which related to (a) managing sensitive parenting conversations, (b) making decisions about child safety in unclear or unpredictable situations, and (c) working with child protection services. Participants had developed strategies for managing the challenges of the first two practice issues and suggested organizational changes that could facilitate collaboration with child protection services. The findings highlight that the challenges of working with parents with mental health issues cannot be addressed with a one‐size‐fits‐all approach. Initiatives to facilitate the effective support of parents and their children need to be informed by contextual factors, including clinical practice.  相似文献   
929.
The Great Recession, the most severe economic crisis since the Great Depression, officially began in December 2007 with an 8 trillion dollar housing bubble and lasted until June 2009, resulting in loss in consumer spending and collapse in the nation’s business investment. For American workers, the Great Recession had far-reaching implications: unemployment, underemployment, pay cuts, and cutbacks in household spending. Although social work has a historical commitment to address the vulnerabilities of people and communities, we argue that the profession neglected to understand fully the factors associated with the Great Recession and to mount an agenda for justice in response to its worker-related impact.  相似文献   
930.
This project applies and expands Gallagher’s (2005) theories concerning body image and body schema to the concept of gender in general and in particular how understanding gender through this lens can be used to aid transgender people in understanding their own gender. In addition, the paper discusses the effects of gender-incongruent mirroring for transgender and gender nonconforming persons’ ability to know their own feelings and its role in the development of shame. In furthering the understanding of gender and self-knowledge, the concepts of tacit knowledge and phantom limbs reveal how one comes to know gender as a fundamental aspect of the self.  相似文献   
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