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1.

Problem

Pacific Islanders are disproportionately burdened by poorer maternal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care.

Purpose

The purpose of this study was twofold: (1) to explore maternal health care providers’ perceptions and experiences of barriers in providing care to Marshallese women, and (2) providers perceived barriers of access to care among Marshallese women. This is the first paper to explore perceived barriers to maternal health care among a Marshallese community from maternal health care providers’ perspectives in the United States.

Methods

A phenomenological, qualitative design, using a focus group and in-depth interviews with 20 maternal health care providers residing in northwest Arkansas was chosen.

Findings

Several perceived barriers were noted, including transportation, lack of health insurance, communication and language, and socio-cultural barriers that described an incongruence between traditional and Western medical models of care. There was an overall discord between the collectivist cultural identity of Marshallese families and the individualistic maternal health care system that merits further research.

Discussion

Solutions to these barriers, such as increased cultural competency training for maternal health care providers and the incorporation of community health workers are discussed.  相似文献   
2.
论小说创作     
如果可能,请别写小说.小说创作是一种非社会行为,一旦动笔,小说家会时刻为小说中的人物所困扰;而且,真正写起来,小说指南一类书籍并不管用.假如非写不可,那么,小说家需考虑是以情节为主还是以人物为主.如果以情节为主,小说家即在虚构的事情中间而非在所谓的真实生活中寻找人物的时候,抓住情节不放;如果以人物为主,那么,小说家则需对适于情节的某些特征加以强调,使人物在新环境中显得真实可信,从而赋予他们生命.小说家无论重情节抑或是重人物,都还要考虑以何种形式、何种风格呈现情节和人物的问题;当然,在优秀的小说家笔下,故事和人物本身会以最适合的形式出现.小说家应对形式、人物和语言保持一种敏锐的感觉.此外,小说家可能会对道德教诲产生迷恋.尽管应当通过作品给读者以教益,但是,真诚的艺术家并不能专注于说教.  相似文献   
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Impulsivity has been implicated in the development of pathological gambling (PG); sensation seeking and urgency in particular have predicted gambling pathology in undergraduate and psychiatric samples. In light of the relevance of both depressed and elevated mood to impulsivity and gambling, the components of impulsivity associated with PG across mood disorders warrants investigation. The aim of the current investigation was to examine the association between impulsivity and gambling pathology severity across depressive versus bipolar disorders. A total of 275 participants with lifetime depressive or bipolar disorder completed measures of impulsivity and gambling. Urgency was consistently associated with gambling pathology indicators; lack of perseverance was specifically associated with gambling pathology within participants with depressive disorders. Reckless action during negative mood is associated with gambling pathology across mood disorders, whereas difficulty remaining focused is associated with PG solely within depressive disorders. Impulsivity and affective comorbidity may inform current understanding of PG.  相似文献   
5.
Abstract

The familiar language of codependency, while it represents an effort to name and articulate pain, has become a mythology in which the leading characters are defined as victims and as sick. This paper describes the historical evolution of the concept of codependency and discusses the dysfunctional dynamics in families that are seen as the origins of codependent behavior. An alternate language for describing such families is offered.  相似文献   
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This paper uses a variety of data sources to document the effect of long-term contracts (LTCs) on wage dispersion. The paper first shows that LTCs are responsible for the decrease in wage dispersion observed as labor markets tighten; absent LTCs (as in most other advanced nations outside North America), this effect does not exist. The paper next examines the relationship between cost-of-living escalators (COLAs) and wage dispersion. COLAs are typically found only in those countries that rely on LTCs, although the incidence of COLAs in these nations is affected by inflation variability. Thus, in the United States, COLAs became much more prevalent in long-term contracts during the 1970s, which caused an increase in wage dispersion, particularly between the union and nonunion sectors. The paper concludes that, despite some suggestions that we ban LTCs and COLAs because of their perverse effects on wage dispersion and other economic outcomes, such a ban would be unwise in light of historically high levels of industrial strife in those nations that rely on these contractual devices.  相似文献   
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In recent years, western governments influenced by neoliberalism have emphasized paid work as a key route to social inclusion and community participation for people with psychiatric disabilities. Although paid work can offer many rewards, access to mainstream employment for people with psychiatric disabilities is difficult as they continue to encounter discrimination and a lack of workplace accommodation. One response to these challenges has been the creation of social enterprises as ‘alternative spaces’ of employment for people with psychiatric disabilities. On the basis of interviews with key informants from 21 different social enterprises across Ontario, Canada, this paper critically analyzes the strategies used by organizations to create jobs that are both accommodating for people, but also conducive to the ongoing success of the business.  相似文献   
10.
This article tests competing mechanisms explaining linkages between parent–child educational similarity and parental advice and interest to adult children, asking whether mechanisms differ for mothers and fathers. Educational similarities might provide common ground whereas educational dissimilarity affects parents' authority to dispense advice. Using ordered logistic regression with data from the Netherlands Kinship Panel Study (N = 2,444) parental advice and interest are modeled separately for mothers and fathers. Seemingly unrelated estimation is used to test for gender differences across models, revealing that mechanisms driving parental support differ by parents' gender. Fathers show more interest in adult children when they are educationally similar (consistent with the homophily hypothesis), but only among the highly educated, whereas mothers show more interest to highly educated children, regardless of their own level of educational attainment. Fathers' advice is conditioned on their own educational attainment whereas mothers give advice unconditionally (consistent with the gender hypothesis).  相似文献   
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