Clinic Capacity Management: Planning Treatment Programs that Incorporate Adherence

For infectious diseases like tuberculosis and HIV, treatment adherence plays an important role in treatment effectiveness and epidemic control. Studies of some infectious diseases indicate that patients who live closer to their health facilities maintain higher adherence; however, most models ignore the heterogeneity of patients' adherence. Clinics must balance knowledge about adherence with epidemic growth when creating successful treatment programs. We develop an optimization model that integrates a clinic's capacity decisions with population health outcomes. We find that incorporating adherence into clinic planning models can lead to decisions that significantly improve outcomes. For example, in a realistic case study of the HIV epidemic in Zambia, we find that decision makers who ignore decreasing adherence make suboptimal decisions and overestimate the effectiveness of their treatment programs by as much as 94%. Our model is a first step toward understanding the relationship between adherence and health delivery.     

自上而下，打破部门藩篱

顾客满意度不断降低,重要客户扬言要退出,一度认为可轻易达到的收入预期迅速下滑流失。然而,你绝非轻言失败之辈,于是在CEO的支持下,你拟定一份可令业绩再次回升的远大计划——这需要企业的全体人员同心协力,劲往一处使。问题在于,公司员工似乎很难记得:他们必须齐心协力。IT人员优先钟情于IT,而把公司利益置于其次;销售及设计部门同样如此。部门主管似乎花费更多时间用来争夺资源与认可,而对未来的挑战不甚热心。看起来,很少有经理人或员工能够超越部门局限,行动顾全公司的大局利益。换句话说,你的公司处于严重的藩篱状态。所谓“藩篱”…     

A profile of the non-profit sector in Romania

With the revolution of December 1989, citizens of Romania gained the right to form non-profit organisations for the first time in 40 years. Since then, Romania has begun to explore the frontiers of private initiative through the introduction of non-profit, non-governmental organisations as well as profit-making businesses. In this article we review the historical development and legal framework of Romania's emerging non-profit sector. We also provide the first empirical snapshot of that sector by applying the International Classification of Nonprofit Organizations (ICNPO) developed by Salamon and Anheier to 499 organisations identified in theSoros Catalogue of Nongovernmental Organizations in Romania: 1991–92. Finally, we speculate on the future development of the Romanian non-profit sector by considering alternative scenarios involving the relationships between indigenous nonprofits, international NGOs and the Romanian government.     

For-Profit Welfare: Contracts, Conflicts, and the Performance Paradox

This article examines how financial inducements in performancecontracts shape the inner workings of a for-profit welfare-to-worktraining program serving long-term recipients. Our work paysparticular attention to how contract requirements shape relationshipsbetween manager and line staff and their treatment of clients.We argue that contract design, coupled with bottom-level managementefforts to meet contractual obligations, leads to a performanceparadox—the same actions taken to achieve contractualresults ironically produce negative program practice and poorclient outcomes. Thus, rigidly constructed legal agreementsbetween the government and private service providers can distortincentive structures, causing programmatic conflicts betweenmanagement and staff, and do little to reduce long-term welfareuse and diminish recipients' poverty.     

Do workers want OSHA’s ergonomics regulations?

conclusion OSHA’s proposed Ergonomics Rule will clearly impose serious costs on firms across many industries, but industries where MSD risk is highest will face much greater costs. OSHA recognizes this by excluding some high-risk industries. For the higher risk indus-tries that are covered by the proposal, OSHA suggests that benefits to firms and employ-ees will outweigh these costs. We argue that OSHA has ignored the importance of differences in individual preferences for accepting risk and that compensating wage differentials allow different individuals to maximize their utility by making trade-offs between safety and wages.     

Distribution and activity of bats at local and landscape scales within a rural–urban gradient

We examined the relationship between bat species activity and composition and the extent of forest cover and urbanization in and adjacent to 11 U.S. National Park Service, National Capital Region Parks in Maryland, Virginia, West Virginia, and Washington, D.C., from 2003–2004, using mist nets, harp traps, acoustical detectors, and visual observations in a variety of habitats. Our efforts included 363 trap nights across 74 sites along with acoustical sampling at 362 sites. We captured 383 bats and identified 6,380 echolocation passes of 6 species. Both overall and species-specific activities were affected more by forest fragmentation within parks than by urbanization adjacent to parks. With an ability to exploit anthropogenic structures for day-roosts, big brown bats (Eptesicus fuscus) were the most ubiquitous and probably the most abundant species in NCR Parks, particularly in forested, urban parks. Northern myotis (Myotis septentrionalis), and to a lesser extent, little brown myotis (Myotis lucifugus) were more prevalent in forested, rural parks of the Ridge and Valley and Blue Ridge than in eastern, less forested urban parks of the Piedmont and Coastal Plain physiographic provinces. Retention of larger, residual forest tracts and day-roosting habitat (i.e., trees and snags) would be beneficial to most species, as urban expansion continues throughout the region.     

Attitudes Toward Younger and Older Adults: An Updated Meta-Analytic Review

This meta-analytic review of 232 effect sizes showed that, across five categories, attitudes were more negative toward older than younger adults. Perceived age differences were largest for age stereotypes and smallest for evaluations. As predicted by social role theory ( Eagly, 1987 ), effect sizes were reduced when detailed information was provided about the person being rated. The double standard of aging emerged for evaluations and behavior/behavioral intentions, but was reversed for the competence category. Perceptions depended on respondent age also. Results demonstrated both the multi-dimensionality and the complexity of attitudes toward older adults ( Hummert, 1999 ; Kite & Wagner, 2002 ).     

Testosterone,marital quality,and role overload

In a sample of established working‐ and middle‐class families with school‐aged children (N= 307 wives and 307 husbands), neither husbands’ nor wives’ testosterone showed a direct connection with marital quality. In contrast, the association between husbands’ testosterone and positive and negative marital quality (as evaluated by both spouses) was conditional on husbands’ role overload. When perceptions of role overload were elevated, higher testosterone levels were associated with lower levels of marital quality. When perceptions of role overload were low, higher testosterone was linked to greater marital quality. The study supports the biosocial model such that, depending on perceptions of the social context, testosterone enables positive behavior in some instances and negative behavior in others.     

Social Psychologists' Expertise in the Public Interest: Civilian Morale Research During World War II

By reviewing the careers of three prominent social psychologists, Floyd Henry Allport, Daniel Katz, and Rensis Likert, this article describes the theoretical and practical psychological expertise that American psychologists developed before, during, and after World War II and describes how this expertise resulted in significant gains for the field of social psychology. Prior to World War II, Allport, Katz, and Likert made pioneering contributions to understanding issues relevant to society, to the science of social psychology, and to methods of attitude measurement and poll design. In response to World War II, each of the three pursued research topics more immediately connected to the war effort. Similar to other prominent social psychologists, Allport, Katz, and Likert were able to parlay their prewar reputations into significant, high-level roles in the service of the World War II effort. In turn, these successes helped to lay the foundation for a postwar boom in social psychology that had implications for training in and research on social psychology. Nonetheless, social psychology's and society's utilization of the knowledge gained during World War II appears to have been less than optimal.     

Investigating relationships between journalists and public relations practitioners: Working together to set,frame and build the public agenda, 1991–2004

A content analysis of 413 reports of interviews conducted with 418 journalists from 1991 to 2004 grounded in agenda-setting, framing and agenda-building theories found that journalists giving higher estimates of practitioners’ influence on the news reported having better relationships with practitioners. On average, journalists estimated that 44% of the content of news media in the United States is influenced by practitioners. Journalists who were interviewed in 2002–2004 valued public relations more, but expressed love–hate sentiments as much as those interviewed in 1991–1996. Journalists who had worked 18–45 years reported improving relationships with practitioners more often than journalists with 8 or fewer years of experience. Journalists believed good relationships with practitioners are important, but hold practitioners responsible for them.