The health demographic profile system: current and longitudinal data base for social area analysis

The development of the Health Demographic Profile System, which is based on the 1980 census, is described. The system includes social and economic indicators designed to identify high risk target populations, in terms of mental health and general health service needs, as well as to describe the social and economic structure of both mental health service and other small geographic areas. The report describes: (1) the original system, that is, the Mental Health Demographic Profile System (MHDPS), which is based on the 1970 census, including details of the approach and content, (2) the 1980 provisional indicators and planned products, (3) plans for the development of a longitudinal system based on 1960, 1970, and 1980 data, and (4) current and future studies related to the 1980 Health Demographic Profile System.     

交际能力助你脱颖而出

如果每个应聘者都技能高超，受过良好教育且毕业于同一所学校，过往的成就也不相上下，委派受命的机率也均等，你将如何抉择？谁将成为幸运儿，谁又将出局？     

Family Caregiver Communication in the ICU: Toward a Relational View of Health Literacy

We interviewed 18 family caregivers about their communication experiences in the ICUs at an urban hospital. Analysis of their narratives suggests health literacy is important in family caregiver/healthcare provider communication, especially as complicated illnesses move the caregiver deeper into decision making. Using the domains of Yuen et al.’s conceptual model of caregiver health literacy (2015), we identified three themes within the context of ICU communication: agency, coordinated communication, and caregiver’s evolving role. We saw family caregivers negotiating domains of health literacy as they built upon knowledge of the patient’s needs, their rights as family caregivers, and the hierarchy of the professional staff. We found that these narratives represent co-created, or relational communication, rather than individual health literacy skills. Conceptualized in the transaction of relationship, health literacy is enacted; it is socially constructed and is the scaffolding upon which family caregivers make decisions, care for their loved one, and care for themselves.     

成功继任秘笈

为什么领导者继任规划总让人觉得是在浪费时间呢？我和我的朋友吉姆·摩尔在高层管理者的培训和继任方面进行了大量的研究。吉姆曾在大型企业担任首席学习官。以下是我们关于如何使领导者继任规划成为企业管理重要手段的一些观点。     

A new industrial order for physicians: a talk with Jeff C. Goldsmith, PhD. Interview by Richard L. Reece

Richard L. Reece, MD, interviewed Jeff C. Goldsmith, PhD, President of Health Futures, Inc. on October 12, 1999 to discuss how the Internet will affect health care delivery in the millennium. One of the most profound changes that he sees is how the relationship between physicians and patients will be altered. Empowered consumers are where the real revolution is happening--a trend sometimes overlooked by physicians. Goldsmith says, "The key thing physicians have missed is that the patient is in charge of the process.... The Internet has enabled patients to aggregate their collective experience across disease entities." But there is too much information. "It is almost universally acknowledged by patients and physicians that there is a terrible quality problem. Getting from information to knowledge is a huge commercial opportunity for somebody." He doesn't think that people have put enough emphasis on the collective learning part of this new technology.     

Self‐conscious Shyness: Growth during Toddlerhood,Strong Role of Genetics,and No Prediction from Fearful Shyness

Fearful and self‐conscious subtypes of shyness have received little attention in the empirical literature. Study aims included the following: (1) determining whether fearful shyness predicted self‐conscious shyness, (2) describing development of self‐conscious shyness, and (3) examining genetic and environmental contributions to fearful and self‐conscious shyness. Observed self‐conscious shyness was examined at 19, 22, 25, and 28 months in same‐sex twins (MZ = 102, DZ = 111, missing zygosity = 3 pairs). Self‐conscious shyness increased across toddlerhood, but onset was earlier than predicted by theory. Fearful shyness (observed [6 and 12 months] and parents’ reports [12 and 22 months]) was not predictive of self‐conscious shyness. Independent genetic factors made strong contributions to parent‐reported (but not observed) fearful shyness (additive genetic influence = .69 and .72 at 12 and 22 months, respectively) and self‐conscious shyness (additive genetic influence = .90 for the growth model intercept). Results encourage future investigation of patterns of change and inter‐relations in shyness subtypes.     

No Country Left Behind? Performance Standards and Accountability in US Foreign Assistance

The accountability movement in public policy hails a new programme for US foreign assistance – the Millennium Challenge Account established in 2004 with the aim of ‘picking winners’ for grants among developing countries based on their demonstrated quality of governance. This article uses the MCA's own rating system to dispute its claim to know in advance which countries are best positioned to meet major development goals. High governance scores alone bear little or no relationship to growth in national income or decline in poverty. Attempting to measure public‐policy performance limits the range of choice available to policy‐makers, and may inadvertently limit true performance.