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This paper deals with living systems at the level of the human organism, including all subsystems. It argues that, in medicine, conclusions about the adequacy of clinical heuristics, vis-à-vis normative models, may be suspect until the models are more adequately designed and the heuristics better defined. Through a theoretical analysis, it shows that dynamic information, ordinarily ignored in normative models yet often present in biological systems, can have a profound impact on the cost-effectiveness of test use. Empirically, it also shows that explicit clinical policies ignoring dynamic test patterns can lead to substantial loss in diagnostic information. These results motivate research on clinical strategies for using dynamic information. They also suggest unmet needs in evaluating tests, providing decision support, and educating physicians in cost-effective test use.  相似文献   
997.
We formulate a voting model for a legislature composed of two disjoint and cohesive subgroups. Each subgroup has a leader, and its cohesiveness is measured by the probability that a member votes the same way as the leader, which is presumed to be the same for all non-leader members within a subgroup. We examine the relative powers of the subgroups as a function of their sizes and cohesiveness.  相似文献   
998.
This paper reports a further empirical validation of the Demand-Control-Support Model (DCS model), which was developed by Johnson and colleagues (1988, 1989). Data were collected from a heterogeneous group of health-care professionals (nurses and nurses' aides; n = 249). Three major refinements were made to the validation of the DCS Model. First, all relationships in the model were estimated simultaneously by means of covariance structure modelling (LISREL 8). Second, the control dimension was refined substantially, using a psychometrically more sound assessment of the workers' autonomy. Third, the model was applied to the work of health-care professionals. The data did not confirm the assumption that both job strain and motivation are multiplicative functions of job demands, autonomy and social support. First, the results suggested that high levels of autonomy attenuate the increase of emotional exhaustion due to job demands. These results partially supported Karasek's Job Demand-Control Model (Karasek 1979). Second, high levels of social support proved to attenuate the increase of emotional exhaustion due to autonomy. Finally, the main effect of autonomy on job challenge implied that an increase in autonomy is accompanied by an increase in job challenge (and, consequently, job involvement). In addition, low job demands and a high amount of work-related support seem to reduce feelings of exhaustion and, consequently, health complaints.  相似文献   
999.
This study analyzed 161 cited and 177 uncited articles published in Public Relations Review (1975–1993) to determine if three independent variables—research methods, type of statistics, and topics—influenced whether or not articles were cited in other research articles. Significant differences were found between quantitative and qualitative research methods ( = 3.20, = .002) and topics (χ2(3,1)) = 10.47, = .01), but not by type of statistics. Topics also differed by years with professional topics the most published category and technical topics the least published. The authors provide tables listing the most cited authors, their university affiliations, and the journals citing their articles.  相似文献   
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