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Sarasota, FL, United States

Resilience and vulnerability refer to an individual's capacity to persevere in the face of adversity. Resiliency and vulnerability are distinctive personal characteristics influenced by environmental factors such as socio-cultural and institutional contexts. Resiliency and vulnerability are not absolute; they are psychosocial constructs of a phenomenological continuum. Hence, a resilient individual is not invincible to all life events but has the capacity to endure in most circumstances. Clients who sustain traumatic injuries or witness traumatic events have a greater vulnerability to stress disorders like posttraumatic stress disorder (PTSD). Occupational therapy practitioners should be cognizant of a client's resilient and adaptive capacities when providing services to a client who has endured a traumatic event. This paper explores resilience theory and its application to occupational therapy practice. © 2011 - IOS Press and the authors. All rights reserved. Source


Objectives: To explore the effectiveness of four different policy mechanisms in achieving a more equitable geographical distribution of general practitioners (GPs) in European countries. The following mechanisms were analysed: (1) interventions during medical training; (2) financial incentives; (3) quotas to allocate GPs to regions and (4) capitation-based remuneration. Methods: A macro-comparative method, namely, fuzzy set qualitative comparative analysis, was employed to explore the distributional effectiveness of the four mechanisms. A literature review yielded information on the use of these mechanisms in the 21 European countries included, while country-specific equity in the geographic GP distribution served as the outcome variable. Results: Quotas determining the number of GPs per region proved to be highly effective in producing an equitable GP distribution if calculated based on health care needs. Remunerating GPs largely through capitation payments also proved to be an effective policy mechanism. Financial bonuses to GPs practising in under-served areas and interventions during medical training had little or no impact. Conclusion: Several high income countries have a maldistribution of primary care physicians to the detriment of rural or socially deprived areas. Policy makers have instituted a variety of policies to counter this. This study helps to identify mechanisms which are likely to be more and less effective. © The Author(s) 2013. Source


Hale A.,Health Management Technology | Hale A.,Technical University of Delft | Borys D.,University of Ballarat
Safety Science | Year: 2013

The paper reviews the literature from 1986 on the management of those safety rules and procedures which relate to the workplace level in organisations. It contrasts two different paradigms of how rules and their development and use are perceived and managed. The first is a top-down classical, rational approach in which rules are seen as static, comprehensive limits of freedom of choice, imposed on operators at the sharp end and violations are seen as negative behaviour to be suppressed. The second is a bottom-up constructivist view of rules as dynamic, local, situated constructions of operators as experts, where competence is seen to a great extent as the ability to adapt rules to the diversity of reality. The paper explores the research underlying and illustrating these two paradigms, drawn from psychology, sociology and ethnography, organisational studies and behavioural economics. In a separate paper following on from this review (Hale and Borys, this issue) the authors propose a framework of rule management which attempts to draw the lessons from both paradigms. It places the monitoring and adaptation of rules central to its management process. © 2012 Elsevier Ltd. Source


Hale A.,Health Management Technology | Hale A.,Technical University of Delft | Borys D.,University of Ballarat
Safety Science | Year: 2013

Part 1, the companion paper to this paper (Hale and Borys, this issue) reviews the literature from 1986 on the management of those safety rules and procedures which relate to the workplace level in organisations. It contrasts two different paradigms of how work rules and their development and use are perceived and managed. The first is a top-down classical, rational approach in which rules are seen as static, comprehensive limits of freedom of choice, imposed on operators at the sharp end and violations are seen as negative behaviour to be suppressed. The second is a bottom-up constructivist view of rules as dynamic, local, situated constructions of operators as experts, where competence is seen to a great extent as the ability to adapt rules to the diversity of reality. That paper explores the research underlying and illustrating these two paradigms. In this second paper we draw on that literature study to propose a framework of rule management which attempts to draw the lessons from both paradigms. It places the monitoring and adaptation of rules central to its management process and emphasises the need for participation of the intended rule followers in the processes of rule-making, but more importantly in keeping those rules alive and up to date in a process of regular and explicit dialogue with first-line supervision, and through them with the technical, safety and legal experts on the system functioning. The framework is proposed for testing in the field as a benchmark for good practice. © 2012 Elsevier Ltd. Source


Ali M.M.,University of Toledo | Dwyer D.S.,Health Management Technology
Journal of Adolescence | Year: 2011

In this paper we seek to empirically quantify the role of peer social networks in influencing sexual behavior among adolescents. Using data of a nationally representative sample of adolescents we utilize a multivariate structural model with school-level fixed effects to account for the problems of contextual effects, correlated effects and peer selections to purge the potential biases from the estimates of peer influence. Our peer group measures are drawn not only from the nomination of close friends, but also from classmates. Controlling for parent level characteristics, and other demographic parameters, we find that a 10% increase in the proportion of close friends who initiates sex increases the probability that an individual chooses to initiate sex by 5% and a 10% increase in number of sexual partners among close friends increases an individual's sexual partner by 5%. The influence of classmates however, diminishes in magnitude after accounting for unobserved environmental confounders. © 2009 The Association for Professionals in Services for Adolescents. Source

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