Middle School Children's Perceptions on Welfare and Poverty: An Exploratory, Qualitative Study

This study was undertaken to determine how middle school children assess the effects of welfare reform on their daily lives. The study consisted of thirty interviews with children and their mothers recruited from a middle school in a large, metropolitan area. From the children's perspective, multiple jobs and evening/night hours interfered with the child-parent relationship. Other consequences included grades going down and not getting to school on time. All the children stated that mothers should work, but most children felt mothers should only work when their children are in school. Welfare and poverty were issues about which children were teased at school.     

Living Arrangements, Employment Status, and the Economic Well-Being of Mothers: Evidence from Brazil, Chile, and the U.S

Using data from Brazil, Chile, and the U.S., we estimate country specific models of household income that characterize mothers according to their marital status, living arrangement, and employment status. We assess the predicted economic well-being of each type of mother relative to a benchmark of married mothers in the same country, and at various points in the income distribution. We find dramatic cross-country differences in the distribution of mothers across categories, but few differences in each type's relative economic status. In all three countries and at all points in the income distribution, mothers who are the only adults in their households have the lowest levels of predicted income, while married mothers—followed closely by cohabitors—have the highest levels.     

African American Children's Adjustment: The Roles of Maternal and Teacher Depressive Symptoms

This study examined the unique and interactive roles of mother and teacher depressive symptoms in child adjustment in 277 African American single mother‐headed families, as well as whether the associations differed depending on the age and gender of the child. Findings revealed a significant association between maternal depressive symptoms and child depressive symptoms in girls, but not boys. Moreover, the combination of higher levels of both mother and teacher depressive symptoms was associated with the highest level of child depressive symptoms and, for younger children, externalizing symptoms. The importance of considering the multiple social contexts in which children interact is discussed.     

Who Gets What From Government? Distributional Consequences of Child‐Care Assistance Policies

Given the fragmented structure of child‐care assistance in the United States, it has been difficult to obtain accurate estimates of which families are assisted, through which mechanisms, and at what level. Making use of survey data from New York City, we analyze the distribution of several forms of public child‐care assistance. Results suggest that about 40% of all families with young children receive some form of child‐care assistance. Considering all forms of assistance, the distribution of child‐care help is targeted in both expected and some unexpected ways. Implications of these results are discussed in the context of U.S. child‐care policies governing access and benefit levels.     

江苏省基层医务人员工作压力研究

对905名基层医务人员进行问卷调查,了解基层医务人员工作压力情况及其影响因素,为建立适合基层卫生机构的良性人才发展机制提供依据。基层医务人员整体工作压力得分为56.54分;单因素方差分析显示,不同性别、年龄、婚姻状况、学历、职称、机构类型、工作量、工作年数、受患者尊重程度和社会地位的医务人员工作压力得分差异具有统计学意义;多元线性回归分析结果显示,社会地位、工作量、工作年数、受患者尊重程度、最高学历和性别对基层医务人员工作压力的影响具有统计学意义。需要着重关注乡镇卫生院医生的工作压力情况,重点应放在提升基层医务人员社会地位、及时关注中坚力量等方面,从而减轻其工作压力,提高工作积极性。     

Data envelopment analysis in the presence of measurement error: case study from the National Database of Nursing Quality Indicators® (NDNQI®)

Data envelopment analysis (DEA) is the most commonly used approach for evaluating healthcare efficiency [B. Hollingsworth, The measurement of efficiency and productivity of health care delivery. Health Economics 17(10) (2008), pp. 1107–1128], but a long-standing concern is that DEA assumes that data are measured without error. This is quite unlikely, and DEA and other efficiency analysis techniques may yield biased efficiency estimates if it is not realized [B.J. Gajewski, R. Lee, M. Bott, U. Piamjariyakul, and R.L. Taunton, On estimating the distribution of data envelopment analysis efficiency scores: an application to nursing homes’ care planning process. Journal of Applied Statistics 36(9) (2009), pp. 933–944; J. Ruggiero, Data envelopment analysis with stochastic data. Journal of the Operational Research Society 55 (2004), pp. 1008–1012]. We propose to address measurement error systematically using a Bayesian method (Bayesian DEA). We will apply Bayesian DEA to data from the National Database of Nursing Quality Indicators^® to estimate nursing units’ efficiency. Several external reliability studies inform the posterior distribution of the measurement error on the DEA variables. We will discuss the case of generalizing the approach to situations where an external reliability study is not feasible.     

Role of Temperament,Parenting Behaviors,and Stress on Turkish Preschoolers’ Internalizing Symptoms

Child‐ and family‐related factors that predict internalizing symptoms are understudied in preschool years and have a negative influence on children's functioning. We examined observational assessments of preschoolers' temperamental fearfulness and exuberance, mother reports of negative control, warmth, and parenting stress in a sample of 109 Turkish preschoolers. High temperamental fearfulness and low joyful/exuberant positive affectivity in addition to low warmth and high parenting stress had significant effects on internalizing symptoms. Parenting stress had both direct and indirect relations to internalizing symptoms via lower maternal warmth. When comorbid elevations in externalizing symptoms were controlled, the results were consistent with the interpretation that poor parenting practices and stress associated with the parenting role predict maladaptation in general but that the specific form of maladaptation may be best predicted by individual differences in children's temperamental characteristics. This study contributes to our understanding of risk and protective factors that predict preschoolers' internalizing symptoms with a sample from a non‐Western population. These findings can guide early prevention and intervention programs to address internalizing problems in a culturally‐sensitive way.     

弗洛伦斯·南丁格尔与克里米亚战争

弗洛伦斯·南丁格尔被誉为克里米亚战争（1854-1856）的女英雄和现代护理学的主要奠基人。战地记者无情揭露了克里米亚战争中英国军队存在的诸多弊端，促使英国政府派遣南丁格尔护士团前往克里米亚战争前线医院，而南丁格尔在护理教育、军队医疗和卫生改革等方面的贡献都要追溯到她在克里米亚战争中的经历。     

Every Minute Counts: Using Process Improvement and Performance Feedback to Improve Patient Flow in an Emergency Department

Prolonged emergency department (ED) visits are associated with a number of adverse outcomes for patients as well as lower patient satisfaction scores and increased costs. Several factors that influence the length of ED visits are out of the control of hospital employees, but some opportunities exist to improve performance. For this study, the ED department of a 150-bed hospital in the southeastern United States wanted to improve door-to-discharge time. To do so, a subprocess of door-to-discharge time was targeted, door-to-order. After analyzing the process, the team created standard orders for the 10 most common presenting conditions in the ER with preapproval, allowing nurses to submit the orders without the provider first visiting the patient. Following the process change, daily feedback was added to increase utilization of the preapproved orders. Reductions in door-to-order times and door-to-discharge were observed and patient satisfaction remained stable. Implications for future research in this area are discussed.     

Maternal Employment,Community Contexts,and the Child‐Care Arrangements of Diverse Groups

Integrating family and child data from the Early Childhood Longitudinal Study–Birth Cohort with contextual data from the census, this study examined associations among maternal employment, aspects of communities related to child‐care supply and demand, and the early care and education arrangements of 4 year olds in Mexican‐origin, Black, and White families. Children with employed mothers were more likely to be in informal care arrangements than in early childhood education, regardless of racial/ethnic background. For children in Mexican‐origin families, selection into informal care over early childhood education was more likely in zip codes with greater demand for care as measured by higher female employment. Utilization of parent care versus early childhood education was also more likely for children in Mexican‐origin and Black families in zip codes with higher female employment. Constraints associated with maternal employment thus hindered children from enrolling in early childhood education, and community contexts posed challenges for some groups.