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1.
Medical practices historically have not been examined in terms of their organizational structures and of the appropriateness of their structures for survival as business entities. In this paper, we propose a model for the typical medical practice and discuss its fit with current organizational theory. It is apparent that the medical practice organization does not fit with the demands of a rapidly changing and complex environment. To survive and grow, the medical practice organization must align itself with others that have an interest and stake in the health care system, develop teamwork among physicians, bridge the gap between physicians and others in the organization, and recognize that the work done in the organization depends on other components of the organization.  相似文献   
2.
Engaging homeless youth in services is challenging. Novel methods are needed to better retain and empower this population. Photovoice, an innovative form of community-based participatory research, facilitates participants’ use of photography to document their everyday lives and struggles, while advocating for social change. This study examines, among 22 homeless youth, whether and why youth would be interested in participating in Photovoice activities, the types of social issues youth would be motivated to explore, and homeless youths’ opinions about committing to a longer-term, group-oriented project. Photovoice may represent promise in engaging marginalized and difficult-to-retain populations.  相似文献   
3.
印度东北与中国西南在地域上山水相连,相互之间的文化交流是非常密切的。这个区域里居住着众多的民族或族群,他们的文化相似性和可比性是很明显的。从跨国的视角来探寻文化互动或文化个性,这是一个理想的地域。这些不同民族或族群身份的诗人写作的民族志诗歌是探寻各自文化共性和个性的较好途径:虽然诗歌创作过程中采用不同的语言,印度东北的土著诗人通常用英语写作,中国西南少数民族诗人经常用汉语写作,但是这些诗人都受到了近代西方现代主义诗歌潮流的影响。同时,这些诗人的诗歌也受到了当下全球化的影响,比如本民族传统文化与文化教育现代化、全球生态环境日益恶化等等冲突的影响。因为受到了相似的影响,这个区域内的民族志诗歌的风格和肌理是可以比较的;诗歌的主题和内容也是可以展开对比研究的。  相似文献   
4.
Rubin (1976 Rubin, D.B. (1976). Inference and missing data. Biometrika 63(3):581592.[Crossref], [Web of Science ®] [Google Scholar]) derived general conditions under which inferences that ignore missing data are valid. These conditions are sufficient but not generally necessary, and therefore may be relaxed in some special cases. We consider here the case of frequentist estimation of a conditional cdf subject to missing outcomes. We partition a set of data into outcome, conditioning, and latent variables, all of which potentially affect the probability of a missing response. We describe sufficient conditions under which a complete-case estimate of the conditional cdf of the outcome given the conditioning variable is unbiased. We use simulations on a renal transplant data set (Dienemann et al.) to illustrate the implications of these results.  相似文献   
5.
There is increasing interest in the emergence of a ‘global middle class’ in which high achieving young graduates increasingly look to develop careers that transcend national boundaries. This paper explores this issue through comparing and contrasting the aspirations and orientations of two ‘elite’ cohorts of graduates. Interviews with students at the University of Oxford, England, and Sciences‐Po, France, reveal very different ambitions and allegiances. Our Oxford respondents portray their futures as projects of self‐fulfilment as they build portfolio careers by moving from job to job and from country to country with limited social allegiances – epitomizing the nomadic worker of the transnational elite. Our Parisian respondents, on the other hand, display strong allegiances to the nation, state and civic duty. Their projects of the self involve reconciling their personal aspirations with strong allegiances to France. The paper concludes by discussing the significance of these differences. It argues that the enduring role of education in the formation of national identities should not be overlooked and that more detailed research is needed on the contextual specifity of transnationalism and the (re)production of elites.  相似文献   
6.
Twenty-four-hour recall data from the Continuing Survey of Food Intake by Individuals (CSFII) are frequently used to estimate dietary exposure for risk assessment. Food frequency questionnaires are traditional instruments of epidemiological research; however, their application in dietary exposure and risk assessment has been limited. This article presents a probabilistic method of bridging the National Health and Nutrition Examination Survey (NHANES) food frequency and the CSFII data to estimate longitudinal (usual) intake, using a case study of seafood mercury exposures for two population subgroups (females 16 to 49 years and children 1 to 5 years). Two hundred forty-nine CSFII food codes were mapped into 28 NHANES fish/shellfish categories. FDA and state/local seafood mercury data were used. A uniform distribution with minimum and maximum blood-diet ratios of 0.66 to 1.07 was assumed. A probabilistic assessment was conducted to estimate distributions of individual 30-day average daily fish/shellfish intakes, methyl mercury exposure, and blood levels. The upper percentile estimates of fish and shellfish intakes based on the 30-day daily averages were lower than those based on two- and three-day daily averages. These results support previous findings that distributions of "usual" intakes based on a small number of consumption days provide overestimates in the upper percentiles. About 10% of the females (16 to 49 years) and children (1 to 5 years) may be exposed to mercury levels above the EPA's RfD. The predicted 75th and 90th percentile blood mercury levels for the females in the 16-to-49-year group were similar to those reported by NHANES. The predicted 90th percentile blood mercury levels for children in the 1-to-5-year subgroup was similar to NHANES and the 75th percentile estimates were slightly above the NHANES.  相似文献   
7.
Mediating effects of social support on the link between childhood maltreatment and adult intimate partner violence (IPV) were explored in a sample of 362 low-income, African American women. We examined relations between childhood maltreatment experiences (total maltreatment, sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect) and adult maltreatment (physical IPV and nonphysical IPV). Results of hierarchical multiple regression analyses revealed small, but significant, effects. Further, social support mediated revictimization. Social support fully mediated relations in which the form of childhood maltreatment was different than the form of adult IPV (e.g., the relation between childhood sexual abuse and adult nonphysical IPV), but only partially mediated the relations in which the form of childhood maltreatment was similar to adult IPV (e.g., the relation between childhood emotional abuse and adult nonphysical IPV). Implications for clinical interventions for women with intimate partner violence experiences are discussed.  相似文献   
8.
This study aimed to identify homeless youths’ lifestyle and trauma-related risk factors as well as protective factors associated with alcohol use disorder or no disorder and drug use disorder or no disorder. Youth receiving homeless services in Denver (n = 201), Austin (n = 200), and Los Angeles (n = 200; N = 601) completed quantitative interviews assessing demographic information, alcohol and drug use, homeless lifestyle risk factors, trauma-related risk factors, and protective factors. Findings showed differences in trauma-related risk factors between alcohol and drug use disorders, but not homeless lifestyle risks. Protective factors predicted substance use disorders beyond risk factors. Understanding trauma-related risk and protective factors associated with substance use disorders could improve interventions.  相似文献   
9.
Utilizing qualitative interviews with a large sample of 145 homeless youth seeking services at homeless youth service agencies from across three U.S. cities (Los Angeles, Denver, and Austin), this study sought to explore youths' perspectives on ways in which they detect risk and protect themselves on the streets. Results indicated that youth use a combination of internal cues (affective responses) and external cues (reading people) to detect danger, although many times danger was described as undetectable. Certain contexts, includes those that were unfamiliar, difficult to escape, or involved drugs were described as most dangerous. In response to these dangers, youth employed self‐protection strategies such as carrying weapons, banding together with trusted others, isolating, or seeking programing to leave the streets.  相似文献   
10.
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