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1.
This paper proposes new models for locating emergency medical services (EMS) by incorporating survival functions for capturing multiple-classes of heterogeneous patients. The Maximal Expected Survival Location Model for Heterogeneous Patients (MESLMHP) aims to maximize the overall expected survival probability of multiple-classes of patients, whereby different classes could be defined according to agreed patient categories based on response time targets, or by capturing differing medical conditions each with a corresponding survival function. Furthermore, we propose and demonstrate an approximation approach to solving the extended stochastic version of MESLMHP, which utilizes queuing theory to permit the modeling of congestion and utilization at each ambulance station, and does not require assumptions to be made on the utilization of ambulances. Both models are demonstrated using data from the ambulance service in Wales. We show that our multiple outcome measures and survival-maximizing approach, rather than one based on average response time targets alone or a single patient class provides more effective EMS ambulance allocations. 相似文献
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Linda S. Sprague Martinez Amanda J. Reich Cecilia A. Flores Uchenna J. Ndulue Doug Brugge David M. Gute 《Journal of Community Practice》2017,25(1):68-89
The Nuestro Futuro Saludable partnership designed a critical service-learning intervention focused on health equity and action. The 10-week afterschool intervention was implemented in a Boston middle school. Youths who took part in the intervention were knowledgeable about the social determinants of health in their communities, as well as to the barriers to health. Our findings indicate that engaging young people in a meaningful way will be critical if health improvement efforts are to be realized. We found that a critical service-learning framework that incorporates elements of applied inquiry and critical pedagogy was effective as a health intervention and provided opportunities for action. 相似文献
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Scott W. Semenyna Doug P. VanderLaan Lanna J. Petterson Paul L. Vasey 《Journal of sex research》2017,54(8):1077-1084
Previous research established that male androphilia (i.e., sexual arousal and attraction to adult males) clusters in families. Some studies find that male androphilia clusters in both the paternal and maternal lines, while others find that it clusters only in the latter. Most of the research investigating the familial nature of male androphilia has taken place in Western cultural contexts that are problematic for such research because they are characterized by low fertility. To address this, our previous work has examined familial patterning of male androphilia in Samoa, a high-fertility population in which androphilic males are readily identified due to their public status as fa’afafine (a third gender category). Building on this work, the present study replicated the familial nature of male androphilia in Samoa using a sample size that was ~122% larger than the one we previously employed (N = 382, M ±SD age: 29.72 years ±10.16). Samoan fa’afafine had significantly more fa’afafine relatives in their maternal and paternal lines compared to Samoan gynephilic males (p < .001). The prevalence of male androphilia was equivalent across both the paternal and maternal lines (all p > .15). The revised prevalence estimate of male androphilia in Samoa falls between 0.61% and 3.51%. 相似文献
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Catherine Harper 《Social Identities》2017,23(3):289-309
A weaver, seamstress, laundress and artist, in this essay I shall spin a yarn, tangle a web, and construct a text(ile) of the inter-weave of narrative and identity that I define as my intellectual, textual, somatic and material/visual practice obsessions. My work explores ‘the places in-between’ in the entanglements of Irish and Northern Irish gender and identity, and in the abject fabrics of death and of desire. As an Irish feminist, sense-making of the complexities, conundrums, challenges and contradictions of my land, my cloth, my body and my culture owes much to Irish women before me who fought for female suffrage, and Irish women now – north and south of the border that divides the island of Ireland – who still struggle for equality of citizenship, social justice, human rights, and full reproductive autonomy. My contention is that when we accept that Ireland herself is a many-layered cloth, a stained and bloodied cloth, a cloth marked irreversibly by history, conflict, denial and abuse, stained by its own repression, marked through denial of all its people’s rights and needs, and bloodied by its greatest export, the haemorrhage of its people, then – polemical, didactic or reflective, with more compassion, empathy, humility and heart – we just might make peace with our past. 相似文献
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This article is a call to the field of counseling to bridge the research on trans and gender nonconforming (TGNC) youth identity development, family acceptance, and ally development to promote TGNC-affirming family, school, and community environments for TGNC youth. Opportunities and challenges counselors face in supporting ally development of families of TGNC youth are described. Interventions and strategies are described and recommendations for counselors working with the family members of TGNC youth are provided. 相似文献
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Human labor is as much an export as any good. Remittances are a critical source of income for left‐behind families and communities. Transnational labor migrants often describe themselves as ‘invisible’: neither present in the lives of left‐behind families nor members of the receiving community. Building on social remittances literature, we argue that remittances serve as a remedy for this ‘invisibility.’ Through analysis of interviews with 26 temporary labor migrants from 11 countries resident in Israel, we find remittances can render migrants visible to transnational families and provide identity benefits to labor migrants. If visibility benefits decline because of familial role changes, reduced value as a remitter, cost exceeding benefits or because contracting partners change, remittance practices will change. Contrary to previous literature, our findings show that remittances decisions are dynamic, revealing why remittances practices change and even cease. Findings have implications for understanding the multibillion‐dollar remittances industry and immigrant incorporation. 相似文献
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Paul L. Vasey Doug P. VanderLaan Raymond Hames Amornthep Jaidee 《Journal of sex research》2016,53(2):149-152
Camperio Ciani et al. argued that the Urak-Lawoi people of Ko Lipe island live in a “traditional,” “subsistence primitive society” reminiscent of the “ancestral” human past and that their socio-cultural situation is “remarkably similar” to Samoa. On this basis, they asserted that the Ko Lipe Urak-Lawoi are an appropriate population for determining the role that kin selection played in the evolution of male androphilia. The purpose of this commentary is to outline some of our concerns with this characterization and with the statistical analyses conducted by Camperio Ciani et al. in their study of the Urak-Lawoi. 相似文献
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To serve Korean American families effectively, marriage and family therapists need to develop a level of cultural competence. This content analysis of the relevant treatment literature was conducted to discover the most common expert recommendations for family therapy with Asian Americans and to examine their application to Korean Americans. Eleven specific guidelines were generated: Assess support systems, assess immigration history establish professional credibility, provide role induction, facilitate "saving face," accept somatic complaints, be present/problem focused, be directive, respect family structure, be nonconfrontational, and provide positive reframes. Empirical support (clinical and nonclinical research) and conceptual support for each guideline are discussed, and conclusions are reached regarding culturally competent therapy with Korean American families. 相似文献