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排序方式: 共有1371条查询结果,搜索用时 0 毫秒
71.
The perceptions of personal and professional identity development from four Black women counselor educators were examined through a collaborative autoethnography methodology. Themes identified include (a) intentionality of code-switching, (b) inextricable identities, (c) fight for and with authenticity, and (d) mutual development of personal and professional identities.  相似文献   
72.
Estimating treatment effects for subgroups defined by posttreatment behavior (i.e., estimating causal effects in a principal stratification framework) can be technically challenging and heavily reliant on strong assumptions. We investigate an alternative path: using bounds to identify ranges of possible effects that are consistent with the data. This simple approach relies on fewer assumptions and yet can result in policy-relevant findings. As we show, even moderately predictive covariates can be used to substantially tighten bounds in a straightforward manner. Via simulation, we demonstrate which types of covariates are maximally beneficial. We conclude with an analysis of a multisite experimental study of Early College High Schools. When examining the program's impact on students completing the ninth grade “on-track” for college, we find little impact for ECHS students who would otherwise attend a high-quality high school, but substantial effects for those who would not. This suggests a potential benefit in expanding these programs in areas primarily served by lower quality schools.  相似文献   
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It is increasingly important for government agencies to collaborate across jurisdictional and functional boundaries. Interorganizational systems supporting interagency collaboration must accommodate a wide range of factors from the external environment and participating organizations as part of their design and operation. This paper presents the findings from a case study of CapWIN, a collaborative network created to enable first responders to share information across jurisdictional and functional boundaries as they work together during emergencies and other critical events. The study examines how aspects of the external environment and the agency context impeded or facilitated the CapWIN collaborative network and the interorganizational system (IOS) that supports it. We identify factors affecting information sharing and collaborative processes, and describe how these factors interact to enable and constrain an IOS. The paper concludes with suggestions for further research on the interplay of environmental, organizational, and technical aspects of interagency collaboration networks as they evolve over time.  相似文献   
75.
OBJECTIVE: An updated systematic review was carried out of research studies looking at the value and impact of library services on health outcomes for patients and time saved by health professionals. METHODS: A comprehensive systematic search was undertaken of the published literature to September 2003 in ERIC, LISA, MEDLINE, PREMEDLINE, EMBASE, the Cochrane Controlled Trials Register and Google. Some handsearching was carried out, reference lists were scanned and experts in the field were contacted. Twenty-eight research studies of professionally led libraries for health-care staff, including clinical librarian projects, met the inclusion criterion of at least one health or 'time saved' outcome. Papers were critically appraised using internationally accepted criteria. Data were extracted and results were summarised using a narrative format as the studies were heterogeneous and precluded a statistical analysis. RESULTS: There is evidence of impact from both traditional and clinical librarian services. The higher quality studies of traditional services measured impacts of 37-97% on general patient care, 10-31% on diagnosis, 20-51% on choice of tests, 27-45% on choice of therapy and 10-19% on reduced length of stay. Four studies of clinical librarian projects suggested that professionals saved time as a result of clinical librarian input, and two of these studies showed evidence of cost-effectiveness. However, the clinical librarian studies were generally smaller, with poorer quality standards. CONCLUSIONS: Research studies suggest that professionally led library services have an impact on health outcomes for patients and may lead to time savings for health-care professionals. The available studies vary greatly in quality but the better quality studies also suggest positive impacts. Good practice can be gathered from these studies to guide the development of a pragmatic survey for library services that includes the direct effects for patients among the outcome measures.  相似文献   
76.
Abstract

Maternal dietary habits influence maternal and foetal health, representing a pathway for intervention to maximise pregnancy outcomes. Advice on energy intake is provided on a trimester basis, with no additional calories required in the first trimester and an additional 340?kcal?d?1 and 452?kcal?d?1 needed for the second and third trimesters. Energy intake depends on pre-gravid body mass index (BMI); underweight women are recommended an increase of 150, 200 and 300?kcal?d?1 during the first, second and third trimester, normal weight women an increase of 0, 350 and 500?kcal?d?1 and obese women an increase of 0, 450 and 350?kcal?day?1. The recommendations for carbohydrate and protein intake are 175?g?d?1 and 0.88–1.1?g?kgBM?d?1, with no change to fat intake. The number of pre-gravid obese women is rising; therefore, we need to regulate weight in women of childbearing age and limit gestational weight gain to within the recommended ranges [overweight women 6.8–11.3?kg and obese women 5.0–9.1?kg]. This can be achieved using nutritional interventions, as dietary changes have been shown to help with gestational weight management. As pregnancy has been identified as a risk factor for the development of obesity, normal weight women should gain 11.5–16.0?kg during pregnancy. While some research has shown that dietary interventions help to regulate gestational weight gain and promote postpartum weight loss to some extent, future research is needed to provide safe and effective guidelines to maximise these effects, while benefitting maternal and foetal health.  相似文献   
77.
Thepractice of evidence-based health care requires that information on methodology be identifiedfrom databases such as MEDLINE. Up until this year there have been no designated medicalsubject headings (MeSH) for evidence-based health care. ‘EVIDENCE-BASEDMEDICINE’ appears as a MeSH term from 1997. The absence of designated MeSH forthis concept prior to 1997 provides a challenge to the searcher. This paper describes the creationof a MEDLINE search strategy to retrieve articles on the methods of evidence-based health carepublished prior to the introduction of the new term, where an optimal combination of free-textand MeSH terms is required to identify relevant material. The study examines both free-text andsubject heading searching and attempts an optimal balance of sensitivity and specificity. It beginsby examining separate free-text and subject heading searches. Sensitivity of the subject headingsearch was 33% and specificity 80%, while the free-text search produced asensitivity of 50% and a specificity of 67%. The final strategy, combining bothapproaches, was more successful with sensitivity reaching between 82 and 90% andspecificity 83%. It is therefore possible to devise a search strategy to retrieve articles on themethods of evidence-based health care with relatively successful rates of sensitivity andspecificity. The limitations of MEDLINE, however, necessitate the use of additional approachesin identifying articles on the methods of evidence-based health care.  相似文献   
78.
This study examined the effects of social influences in the lives of an ethnically diverse sample of fifth through eighth grade students with and without learning disabilities (LD) using survey data and academic achievement scores collected in 19 Chicago public schools from 1993–1997. Similarities and differences in student perceptions of school, family, and peer group contexts were examined. In addition, longitudinal data were analyzed using hierarchical linear modeling (HLM) to identify contextual influences on changes in student reading achievement over time. Comparisons of student responses confirm and extend existing findings in the literature concerning the perceptions of students with LD of their social environments. In particular, having a learning disability was associated with consistent, mostly negative, effects on social relations across the contexts of students’ lives, regardless of gender, race, grade, and socioeconomic status. In addition, student perceptions of their friendship groups were found to have small, but significant, effects on their growth in reading achievement over the course of middle school. While students with and without LD had somewhat different views of their social contexts, the processes working within these environments appeared to affect their reading achievement in similar ways. The results suggest that careful attention should be paid to the social contexts of students’ lives when planning academic interventions.  相似文献   
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