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Managed care poses numerous opportunities and challenges for today's health care organizations and their employees. This article investigates the ways that hospital nurses develop and make sense of their professional roles and organizational environments in a changing and often uncertain managed care setting. The case study approach used in this research combined qualitative methodologies to gain a rich, detailed, and contextual understanding of nurses' work roles and organizational experiences. After an analysis of interviews with 24 nurses and observations of nurses' communicative activities on one inpatient unit, the complexity of sensemaking and role development in a managed care environment is considered. Conclusions are then drawn regarding the theoretical and pragmatic implications of nurses' communicative processes, as they attempted to develop and understand their roles in a changing organizational context.  相似文献   
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The poor reading achievement of African-American children in urban schools is well established. African-American children from low-income homes may be at particular risk for reading difficulties, although middle-income children often fare poorly as well. Intervention efforts have focused on children in kindergarten through fifth grade. This article suggests that prevention efforts must begin prior to kindergarten entry. Several key variables that may influence young children's performance, including poverty, general oral language skills, dialectal variations, home literacy practices, standardized testing bias, and teacher expectations, are explored. Future directions for research addressing emergent literacy in African-American children are discussed throughout.  相似文献   
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任何一门专业都有其用于行业自律的职业道德规范,博物馆也不例外。自1986年国际博协布宜诺斯艾利斯大会通过《博物馆职业道德准则》以来,已被世界上许多国家的博物馆及其专业人员所接受,成为国际博物馆界除《国际博协章程》之外一个最重要的文件。本文作者曾亲自参与该文件的讨论、起草和修订。在文章中,她对上个世纪70年代以来博物馆职业道德形成的社会背景、哲学体系、核心关注、道德与法律的关系以及近年来的最新修订作了较全面的回顾和分析。  相似文献   
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In 2001, the Regenstrief Institute for Health Care and the Indiana University School of Medicine (IUSM) began an IAIMS planning effort to create a vision and a tactical plan for the first Integrated Advanced Information Management Systems (IAIMS) implementation to cross a large area and include unaffiliated institutions. A number of elements made this planning effort unique. Among these elements were the existence of a network infrastructure that supported the Indianapolis Network for Patient Care, the existence of a mature medical informatics program at the Regenstrief Institute, and the existence of a wide-area knowledge network fostered by the IUSM libraries. However, the leadership for a strong information technology role in the IUSM that could promote collaboration in support of education and research across the diverse Indianapolis hospital systems had been lacking. By bringing together various groups, each with a commitment to improve health care quality and public health across the Indianapolis metropolitan area, regardless of individual institutional affiliation, the strategic directions for I3-Indianapolis IAIMS Initiative have been defined and the foundations for a third generation IAIMS construct have been laid in Indianapolis, Indiana.  相似文献   
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The Standards Committee of the Veterinary Medical Libraries Section was appointed in May 2000 and charged to create standards for the ideal academic veterinary medical library, written from the perspective of veterinary medical librarians. The resulting Standards for the Academic Veterinary Medical Library were approved by members of the Veterinary Medical Libraries Section during MLA '03 in San Diego, California. The standards were approved by Section Council in April 2005 and received final approval from the Board of Directors of the Medical Library Association during MLA '04 in Washington, DC.  相似文献   
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The study explored the role of second-screen use and binge-watching in moderating entertainment education (EE) effects. A pretest/posttest experiment of 273 viewers of East Los High measured the effects of exposure to three subplots, concerning alcohol abuse, abortion, and immigration. The effect of identification with characters on change in attitudes was significantly moderated by second-screen use and binge-watching. In particular, second-screening tended to enhance the positive impact of identification; whereas, among respondents who binge-watched the show, the effects of identification were weaker.  相似文献   
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The purpose of this study was to compare the validity and reliability of three short physical activity self-report instruments to determine their potential for use with university student populations. The participants (N = 155; 44.5% male; 22.9 ± 5.13 years) wore an accelerometer for 9 consecutive days and completed a single-item measure, the a brief two item measure and the International Physical Activity Questionnaire—Short Form questionnaires on day 1 and 9. Correlations between self-reported and accelerometer derived moderate-to-vigorous physical activity levels were moderate for the International Physical Activity Questionnaire—Short Form, while poor for the single-item measure and the a brief two item measure. The agreement level was high with the International Physical Activity Questionnaire—Short Form (77.4%) and moderate for both the single-item measure (45.2 %) and a brief two item measure (44.5 %). The intraclass correlations between the two administrations were moderate to strong across all measures (0.52–0.70) in 133 participants. The International Physical Activity Questionnaire—Short Form is the most suitable of these three self-report instruments for use with this population due to higher correlations and levels of agreement with accelerometry.  相似文献   
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